Comparison of Dexcom G6 Continuous Glucose Monitoring and Point -of-Care Blood Glucose Testing in Hospitalized Patients with Diabetes

This prospective observational study compared the performance of the Dexcom G6 continuous glucose monitor (CGM) and point-of-care (POC) blood glucose (BG) testing in a non-ICU setting.Methods: We placed a blinded Dexcom G6 on 91 insulin-treated adult medicine and surgery patients (age 57±10 years, BMI 35±10 kg/m2, HbA1c 9.2±2.1%), with a median hospital length of stay of 8.0 days (min, max 2.0, 33.0), and total daily insulin dose of 45±29 U/day, to compare inpatient glycemic control metrics as measured by POC and CGM.Results: CGM mean absolute relative difference (MARD) was 12.5% with 98.9% of glucose values falling into Clark Error Grid zone A or B for matched POC and CGM glucose pairs. Compared to POC, a greater percentage of patients were identified by CGM to have hypoglycemia <70 mg/dl (47% vs. 27%), nocturnal hypoglycemia (22% vs. 1%), prolonged hypoglycemia > 2 hours (5.6% vs. 0%) and severe hyperglycemia >250 mg/dl (73% vs. 66%). Differences in glycemic metrics between POC and CGM are shown in the Table.Conclusion: Dexcom G6 detected more overall, nocturnal and prolonged hypoglycemia in hospitalized non-ICU patients with diabetes than POC testing. Future prospective studies are needed to determine the benefits of real-time CGM in improving inpatient diabetes care and in reducing hypoglycemia and hyperglycemia in hospitalized patients with diabetes.View largeDownload slideView largeDownload slide DisclosureG. M. Davis: None. P. Vellanki: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc. F. J. Pasquel: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Research Support; Self; Dexcom, Inc., Merck & Co., Inc. L. Peng: None. G. E. Umpierrez: Research Support; Self; AstraZeneca, Dexcom, Inc., Novo Nordisk. A. Migdal: None. M. A. Urrutia: None. K. Zamudio-coronado: None. M. C. Perez-guzman: None. B. S. Albury: None. S. Cardona: None. R. J. Galindo: Consultant; Self; Abbott Diabetes, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk, Sanofi US, Valeritas, Inc., Research Support; Self; Dexcom, Inc., Novo Nordisk. T. Idrees: None.FundingDexcom, Inc.