1118-P: Accuracy of Dexcom G6 Continuous Glucose Monitor in Pediatric Diabetic Ketoacidosis Admissions

Abstract

Continuous glucose monitors (CGMs) are an integral part of care for youth with type 1 diabetes (T1D) though lack FDA labeling for inpatient use. While some adult data on CGM use in inpatient settings is available, pediatric data are minimal. This retrospective chart review evaluated the accuracy of Dexcom G6 CGM versus point of care (POC, Nova Biomedical StatStrip [MARD 6%])) blood glucose values from pediatric inpatient encounters. Blood glucose data, diagnosis codes, and initial labs were collected from the medical record. CGM values were obtained from Dexcom Clarity CSV files. Paired glucose values (N=1191) from 83 patients with T1D (median age 12 yrs, 54% male, 69% non-Hispanic White) were used to calculate mean absolute relative difference (MARD) and Clarke Error Grid. Data from DKA admissions (N=665) had a MARD of 11.1% with 97.8% of values within A&B zones, compared to 11.4% and 98.5% for non-DKA admissions (N=526). Values from severe DKA admissions (N= 307) (pH <7.15 and/or bicarbonate <5 mmol/L) had a lower MARD compared to non-severe admissions (N=358) (8.4% vs 13.4%, p=0.01). In summary, CGM accuracy is comparable between DKA and non-DKA admissions. The accuracy of CGMs, even in severe DKA, suggests potential usability during pediatric hospital encounters. Further analysis will differentiate POC versus lab glucose and the effect of medications, including IV insulin infusions. Disclosure L.A.Waterman: None. L.Pyle: None. L.Towers: None. E.Jost: Other Relationship; Tandem Diabetes Care, Inc. A.J.Karami: None. C.Berget: Consultant; Insulet Corporation, Dexcom, Inc., Other Relationship; Tandem Diabetes Care, Inc. G.P.Forlenza: Advisory Panel; Medtronic, Consultant; Dexcom, Inc., Insulet Corporation, Tandem Diabetes Care, Inc., Lilly Diabetes, Research Support; Medtronic, Abbott, Dexcom, Inc., Insulet Corporation, Tandem Diabetes Care, Inc. R.Wadwa: Consultant; Eli Lilly and Company, Other Relationship; Dexcom, Inc., Eli Lilly and Company, Research Support; Dexcom, Inc., Eli Lilly and Company, Beta Bionics, Inc., Tandem Diabetes Care, Inc. E.C.Cobry: None. Funding National Institutes of Health (5T32DK063687)