Continuous Glucose Monitoring in Critically Ill Patients With COVID-19: Results of an Emergent Pilot Study

Archana R. Sadhu, Ivan Alexander Serrano, Jiaqiong Xu, Tariq Nisar, Jessica Lucier, Anjani R. Pandya, Bhargavi Patham

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Background: Amidst the coronavirus disease 2019 (COVID-19) pandemic, continuous glucose monitoring (CGM) has emerged as an alternative for inpatient point-of-care blood glucose (POC-BG) monitoring. We performed a feasibility pilot study using CGM in critically ill patients with COVID-19 in the intensive care unit (ICU). Methods: Single-center, retrospective study of glucose monitoring in critically ill patients with COVID-19 on insulin therapy using Medtronic Guardian Connect and Dexcom G6 CGM systems. Primary outcomes were feasibility and accuracy for trending POC-BG. Secondary outcomes included reliability and nurse acceptance. Sensor glucose (SG) was used for trends between POC-BG with nursing guidance to reduce POC-BG frequency from one to two hours to four hours when the SG was in the target range. Mean absolute relative difference (MARD), Clarke error grids analysis (EGA), and Bland-Altman (B&A) plots were calculated for accuracy of paired SG and POC-BG measurements. Results: CGM devices were placed on 11 patients: Medtronic (n = 6) and Dexcom G6 (n = 5). Both systems were feasible and reliable with good nurse acceptance. To determine accuracy, 437 paired SG and POC-BG readings were analyzed. For Medtronic, the MARD was 13.1% with 100% of readings in zones A and B on Clarke EGA. For Dexcom, MARD was 11.1% with 98% of readings in zones A and B. B&A plots had a mean bias of −17.76 mg/dL (Medtronic) and −1.94 mg/dL (Dexcom), with wide 95% limits of agreement. Conclusions: During the COVID-19 pandemic, CGM is feasible in critically ill patients and has acceptable accuracy to identify trends and guide intermittent blood glucose monitoring with insulin therapy.

Original languageEnglish (US)
Pages (from-to)1065-1073
Number of pages9
JournalJournal of Diabetes Science and Technology
Issue number6
StatePublished - Nov 2020


  • COVID-19
  • continuous glucose monitoring
  • critically ill
  • hospital
  • inpatient
  • intensive care unit
  • Pandemics
  • Prognosis
  • Blood Glucose Self-Monitoring/instrumentation
  • Humans
  • Middle Aged
  • Male
  • Feasibility Studies
  • Pneumonia, Viral/blood
  • Blood Glucose/analysis
  • Monitoring, Physiologic/instrumentation
  • Adult
  • Female
  • Insulin Infusion Systems
  • Retrospective Studies
  • Diabetes Mellitus/blood
  • Intensive Care Units
  • Reproducibility of Results
  • Betacoronavirus/physiology
  • Insulin/administration & dosage
  • Coronavirus Infections/blood
  • Pilot Projects
  • Point-of-Care Systems
  • Critical Illness/epidemiology
  • Aged
  • Hyperglycemia/blood

ASJC Scopus subject areas

  • Bioengineering
  • Internal Medicine
  • Biomedical Engineering
  • Endocrinology, Diabetes and Metabolism


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