Performance of a factory‐calibrated, real‐time continuous glucose monitoring system during elective abdominal surgery. Issue 9 (13th June 2020)

• Record Type: Journal Article
• Authors: Tripyla, Afroditi; Herzig, David; Joachim, Dehais; Nakas, Christos T.; Amiet, Franziska; Andreou, Andreas; Gloor, Beat; Vogt, Andreas; Bally, Lia
• Is Part Of: Diabetes, obesity & metabolism. Volume 22:Issue 9(2020)
• Page Start: 1678
• Page End: 1682
• Publication Date: 2020-06-13
• Subjects: continuous glucose monitoring (CGM) -- glycaemic control -- observational study -- type 1 diabetes -- type 2 diabetes; Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.14073
• Languages: English
• ISSNs: 1462-8902

Abstract

Abstract: We assessed the performance of the factory‐calibrated, sixth‐generation continuous glucose monitoring (CGM) system Dexcom G6® (DexCom Inc., San Diego, California) during elective abdominal surgery. Twenty adults with (pre)diabetes undergoing abdominal surgery (>2 hours; 15 men, age 69 ± 13 years, glycated haemoglobin 53 ± 14 mmol/mol) wore the sensor from 1 week prior to surgery until hospital discharge. From induction of anaesthesia until 2 hours post‐surgery, reference capillary glucose values were obtained every 20 minutes using the Accu‐Chek® Inform II meter (Roche Diabetes Care, Mannheim, Germany). The primary endpoint was the mean absolute relative difference (ARD) between sensor and reference method during this period. In total, 1207 CGM/reference pairs were obtained. In the peri‐operative period (523 pairs), mean ± SD and median (interquartile range [IQR]) ARD were 12.7% ± 8.7% and 9.9 (6.3;15.9)%, respectively, and 67.4% of sensor readings were within International Organization of Standardization 15197:2013 limits. CGM overestimated reference glucose by 1.1 ± 0.8 mmol/L (95% limits of agreement −0.5;2.7 mmol/L). Clarke error grid zones A or B contained 99.2% of pairs (A: 78.8%; B: 20.4%). The median (IQR) peri‐operative sensor availability was 98.6 (95.9;100.0)%. No clinically significant adverse events occurred. In conclusion, the Dexcom G6 device showed consistent and acceptable accuracy during elective abdominal surgery, opening new avenues for peri‐operative glucose management.