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Impact of Hybrid Continuous Glucose Monitoring on Glycemic Control in a Medical Intensive Care Unit

Year: 2026

Type: article

Abstract: OBJECTIVE: Continuous glucose monitoring (CGM) offers real-time glucose data that may improve dysglycemia detection in critically ill patients; however, evidence supporting its clinical effectiveness in the intensive care unit (ICU) remains limited. The objective of this study was to evaluate whether a nurse-driven hybrid continuous glucose monitoring plus point-of-care (POC) validation protocol improves glycemic outcomes compared with standard POC monitoring alone among medical ICU patients receiving continuous intravenous (IV) insulin. METHODS: In this single-center prospective intervention cohort study, 100 medical ICU (MICU) patients receiving continuous IV insulin were monitored using a hybrid CGM+POC protocol and compared with 100 matched historical controls. The primary outcome was % time in glucose range (70-180 mg/dL) during continuous IV insulin therapy, calculated using POC values (at least every 4 h) for between-group comparisons. Secondary outcomes included % time in additional glucose ranges, hyperglycemia (>250 and > 400 mg/dL), and hypoglycemia (<70 and < 54 mg/dL). RESULTS: Compared with controls, CGM-managed patients achieved an increased time in range (76% ± 18 vs 64% ± 21; P < .001) with persistent improvement after adjusting for confounders and marked reductions in severe hyperglycemia (>250 mg/dL: 6% ± 11 vs 17% ± 18; >300 mg/dL: 2.7 ± 0.6% vs 11.3 ± 1.4%; P < .001 for both). Hypoglycemic events were infrequent and similar between groups. A total of 3590 temporally matched CGM-POC pairs were available for analysis. CONCLUSION: In this prospective MICU cohort, real-time hybrid CGM use improved glycemic control and reduced severe hyperglycemia without increasing hypoglycemia, supporting further evaluation of structured CGM integration in critical care practice.

Source: Endocrine Practice

DOI: 10.1016/j.eprac.2026.08.021