Accuracy and Reliability of Intermittent Scanning and Real-Time Continuous Glucose Monitoring Systems in Diabetes Emergencies

Aims: Diabetes care is a major challenge of patients treated in hospitals. Continuous glucose monitoring (CGM) provides a more comprehensive assessment of glucose control compared to capillary blood glucose measurements. Especially in emergencies, data on CGM use in inpatients is limited. To evaluate real-world usability, accuracy of an intermittent scanning and a real-time CGM in patients admitted due to diabetes emergencies was assessed.

Methods: In 151 patients admitted due to diabetes emergencies this single-center prospective study investigated the mean absolute relative difference (MARD) in broad glycemic ranges. The CGM accuracy was evaluated by applying a modified version of the Food and Drug Administration (FDA) criteria for CGM use, Clark Error Grid (CEG) and Bland Altman analysis (BAA).

Results: Analysis of 1,498 CGM-/POC-glucose (CGM-/POC-G) pairs revealed a MARD of 10.8% with stepwise improvement from the hypoglycemic to the hyperglycemic range. The CEG analysis showed that 99.1% of all glucose values fell within the optimal or acceptable zones. BAA indicated that 96.0% of CGM-G values fell within the limits of the POC-G values. Day-by-day analysis of overall MARD revealed the highest MARD on the first day of CGM use, followed by consistent and stable MARD levels from day 2 onward until the end of wear time. Applying a modified version of the%20/20 agreement rate of the FDA criteria, 90.7% of CGM-G laid within+20 mg/dl/+20% agreement rule.

Conclusion: This study indicates the usability of CGM for inpatient diabetes care by demonstrating a high accuracy and reliability of CGM measurement.

 

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Interessenkonflikt

LVB, JR, JVC, FB, JK and DF declare no financial interests. LH is a consultant for Abbott, Embecta, Lifecare (also member of the Board of Directors), Medtronic EU Advisory Board, Dexcom Germany, Roche Diagnostics, Liom, and Perfood. He is part owner of the Profil Institut für Stoffwechselforschung in Neuss, Germany, Science Consulting in Diabetes GmbH, Düsseldorf, Germany, and diateam GmbH, Bad Mergentheim, Germany ST received honoria and/or expenses for invited speeches and/or consultancy from and participated in funded research of Abbott, Apo Science, Applied Therapeutics, AstraZeneca, Bayer, Berlin-Chemie, Boehringer-Ingelheim, Dexcom, Eli Lilly, Hoffmann-La Roche, NeoplasMed, Novo Nordisk, Novartis, Sanofi Aventis, SinoCare

Publication History

Article published online:
28 May 2025