Real-World Concordance between Point-of-Care and Continuous Glucose Monitoring among Hospitalized Patients with Diabetes

Concordance between continuous glucose monitoring (CGM) and point-of-care testing (POCT) in research studies has been promising; however, the accuracy of using CGM for glucose management in real-world settings requires evaluation. Amid the COVID-19 pandemic, the CGM as “standard of care” (CGM as SOC) program was implemented at Scripps Mercy Hospital in San Diego, CA. In this real-world setting, concordance between the Dexcom G6 CGM system and POCT was evaluated among hospitalized adult patients with diabetes requiring insulin from May 2020-July 2022. For N=880 admissions, CGM readings over the first 24 hours of wear were analyzed relative to POCT conducted within 5 minutes. Patients had a median of 3 CGM-POCT data pairs, and the first CGM-POCT pair occurred a median of 2.75 hours after CGM device placement. Mean absolute relative difference (MARD) decreased over the first 24 hours of wear (B= -0.09%, p=0.0005; Figure 1A). Following the %20/20 rule, 62% of CGM readings were concordant upon the first measured POCT; 15.8% did not meet criteria at all during the first 24-hours. Using the Clarke Error Grid to describe concordance between CGM-POCT pairs (n=3015), only 0.7% (n=22) of CGM readings would have led to incorrect treatment decisions indicated by zones D/E (Figure 1B). These findings provide support for the accuracy of CGM for glucose management in the hospital. Disclosure S.R.Spierling bagsic: None. L.Talavera: None. A.Philis-tsimikas: Advisory Panel; Dexcom, Inc., Novo Nordisk A/S, Sanofi, Other Relationship; Medtronic, Research Support; Novo Nordisk A/S, Lilly, Viking Therapeutics, NIH - National Institutes of Health. A.L.Fortmann: Employee; Dexcom, Inc. R.Belasco: None. A.Ritko: None. S.Lohnes: Consultant; Dexcom, Inc. H.Sandoval: None. M.Chichmarenko: None. E.Soriano: None. A.Bastian: None.