Work

Feasibility and accuracy of continuous glucose monitoring in surgical intensive care unit patients: a single-center pilot study in South Korea

Year: 2026

Type: article

Abstract: Background: Continuous glucose monitoring (CGM) technology offers potential advantages over intermittent point-of-care testing in critically ill patients by providing real-time glucose trends and automated alerts. However, its accuracy and feasibility in intensive care settings require validation before widespread implementation. Methods: We conducted a single-center observational pilot study, evaluating CGM feasibility in 11 surgical intensive care unit (ICU) patients, including nine post-liver transplant recipients. The G6 CGM system was applied for continuous monitoring. CGM readings were paired with point-of-care glucose measurements for accuracy assessment. Performance metrics included the mean absolute relative difference (MARD), bias, standard deviation of relative differences (SDRD), Surveillance Error Grid (SEG) analysis, and International Organization for Standardization (ISO) 15197:2013 criteria compliance. Results: During a median monitoring period of 5 days (interquartile range [IQR], 3-9), we analyzed 326 paired glucose measurements. CGM demonstrated acceptable accuracy, with a MARD of 13.5% (95% CI, 11.43%-15.76%), bias of 2.79% (95% CI, -2.48 to 7.27%), and SDRD of 18.69% (95% CI, 13.75%-23.65%). SEG analysis confirmed 99.1% of readings were in clinically acceptable zones A and B. ISO 15197:2013 criteria showed 62.9% of measurements were within ±15 mg/dl or ±15%. The median patient-level mean glucose was 199.0 mg/dl (IQR, 162.0-248.0), reflecting substantial hyperglycemic exposure in patients receiving high-dose methylprednisolone despite protocolized insulin therapy targeting a range of 140-180 mg/dl. Conclusions: CGM was feasible and acceptably accurate in ICU patients. Persistent hyperglycemia despite protocolized care indicates that CGM-derived data may help to identify opportunities for future protocol improvement. Its potential impact on the time-in-target range, hypoglycemia, and clinical outcomes should be evaluated in future multicenter studies.

Source: Acute and Critical Care

DOI: 10.4266/acc.004975

Authors: Hyojun Park, Eunmi Gil, Joon Ho Lee, Chi-Min Park

Institutions: Samsung Medical Center, Sungkyunkwan University

Language: English

Topic: Hyperglycemia and glycemic control in critically ill and hospitalized patients

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7141258872