Impact of shock requiring norepinephrine on the accuracy and reliability of subcutaneous continuous glucose monitoring

Holzinger, Ulrike; Warszawska, Joanna; Kitzberger, Reinhard; Herkner, Harald; Metnitz, Philipp; Madl, Christian

doi:10.1007/s00134-009-1471-y

Cited by 89 publications

(87 citation statements)

References 35 publications

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“…While few animal studies have been done, the reliability of CGMSs in critically ill patients is an area of active research. The results to date have revealed a strong correlation between arterial reference blood glucose and better performance, compared with point-of-care devices (Corstjens et al 2006;Hoedemaekers et al 2008;Holzinger et al 2009;Brunner et al 2011). These studies pointed out that the accuracy of CGMSs becomes diminished in the hypoglycaemic range.…”

Section: Discussionmentioning

confidence: 99%

Comparison of continuous and intermittent glucose monitoring systems in a dog with diabetic ketoacidosis: a case report

Kim¹,

Kim²,

Kang³

et al. 2017

Vet. Med. - Czech

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ABSTRACT:A Miniature schnauzer (12 years old, neutered male) was referred for lethargy, anorexia, and oral bleeding. On initial evaluation, severe hyperglycaemia (blood glucose concentration of 34.9 mmol/l), ketonuria, systemic inflammation (fever, panting, left-shift neutrophilia, and a high C-reactive protein level of 980.97 nmol/l, abnormal pancreatic lipase immunoreactivity, and periodontitis were found. With consideration of possible insulin resistance, blood glucose (BG) levels were monitored using a portable glucose meter (q 1-3 h) and a continuous glucose monitoring system (CGMS) for 72 h (three consecutive trials); intensive insulin therapy was initiated using regular insulin (2.2 IU/kg intravenously). The insulin doses needed, based on the nadir, peak, and duration of insulin action from a traditional intermittent glucose curve were higher than those based on the CGMS results. Meanwhile, transient hyperglycaemic and hypoglycaemic periods, occurring between the intermittent measurements, were easily identified with the CGMS. Therefore, insulin resistance and the Somogyi phenomenon are less likely to occur with use of the CGMS than with intermittent BG measurements. By comparing data from a CGMS to those from an intermittent portable BG measurement system, this case report emphasises the importance and usefulness of a CGMS.

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Section: Discussionmentioning

confidence: 99%

Comparison of continuous and intermittent glucose monitoring systems in a dog with diabetic ketoacidosis: a case report

Kim¹,

Kim²,

Kang³

et al. 2017

Vet. Med. - Czech

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“…The pinpoint of our study was not to ascertain the accuracy of current CGMS -we consider this question as being already solved by larger studies mentioned above [33][34][35][36][37][38][39][40][41] . We focused on glycaemia trends of operated patients, on identification of frequent patterns of glycaemic reaction to stress and on the determination of eventual CGM impact on glycaemic stability in individual cases.…”

Section: Hunger After the Surgerymentioning

confidence: 99%

“…Others found it useful for reducing hyperglycaemic episodes 35 . The analysis of two prospective randomized trials demonstrated clinically sufficient accuracy and safety 36,37 even in patients on vasopressors 38 . Some reject the use of subcutaneous sensors in the ICU setting 39,40 .…”

Section: Introductionmentioning

confidence: 95%

Glucose sensing module - is it time to integrate it into real-time perioperative monitoring? An observational pilot study with subcutaneous sensors

Poljakova¹,

Elsikova²,

Chlup³

et al. 2013

BIOMED PAP

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Aims.To explore the feasibility of subcutaneous continuous glucose monitoring (CGM) in perioperative settings and to evaluate the perioperative development of glycaemia in persons with diabetes mellitus or impaired glucose tolerance by means of CGM. Methods. Monitoring by means of Guardian® REAL-Time CGMS (Medtronic, Nortridge, USA) in 20 perioperative periods. Sensor was inserted on the day before surgery and continued for 3 days with some exceptions. Results. Full implementation of the method was successful in the intensive care unit setting only. No electromagnetic interference and no side effects were found. The Wilcoxon signed-rank test revealed no significant difference between sensor and laboratory analyser values. Pearson´s correlation coefficients of the values obtained by sensor and the Wellion Linus glucometer were 0.875 for the whole perioperative period, 0.866 for the intraoperative period and 0.903 for the first perioperative day. A decline in sensor accuracy on the 6 th day was registered in one case. 16 monitored cases (80%) did not meet the criteria for safe plasma glucose range. Hypoglycaemia was found in 4 (20%) cases. There was an association between grade of the perioperative dysglycaemia and need for reoperation within the next 3 months. The most frequent perioperative glycaemic patterns are demonstrated. Conclusion. Subcutaneous CGM is safe offering detailed insight into glucose homeostasis in the dynamic perioperative period. Laboratory confirmation of sensor plasma glucose concentration by approved laboratory analyser is still necessary. The potentional benefits of maintaining patients within a safe glucose range should be comfirmed by future studies.

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“…So far, both excellent and poor performance has been reported in ICU patients (Bridges et al,. 2010;Corstjens et al, 2006;Holzinger et al, 2009;Price et al, 2008). Until these matters are solved, continuous monitoring of interstitial glucose values should be used with caution in the ICU.…”

Section: Glucose Monitoring In the Icu Settingmentioning

confidence: 99%

Hypoglycemia in Critically Ill Patients

Hoedemaekers¹,

Hoeven²

2011

Diabetes - Damages and Treatments

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Impact of shock requiring norepinephrine on the accuracy and reliability of subcutaneous continuous glucose monitoring

Abstract: Circulatory shock requiring norepinephrine therapy, as well as other covariates, had no influence on the accuracy and reliability of the CGMS in critically ill patients.

Cited by 89 publications

References 35 publications

Comparison of continuous and intermittent glucose monitoring systems in a dog with diabetic ketoacidosis: a case report

Comparison of continuous and intermittent glucose monitoring systems in a dog with diabetic ketoacidosis: a case report

Glucose sensing module - is it time to integrate it into real-time perioperative monitoring? An observational pilot study with subcutaneous sensors

Hypoglycemia in Critically Ill Patients

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