948-P: Glycemic Monitoring Using the Dexcom G6 in Cardiac Surgery

Abstract

Hyperglycemia is associated with adverse post-surgical outcomes. We evaluated Dexcom G6 accuracy following cardiac surgery. A clinical glucose dataset included 1428 readings of 29 patients, Dexcom data included 45,645 measures. Clinical and Dexcom measures were restricted at least 1 hour after prior measure. Matching clinical and Dexcom measures were required within 5 min. Data were included at least 2 hr after Dexcom insertion and ICU admit. A dataset only measuring ≥24 hrs post ICU admit was created to explore device stability. Patients remained on Dexcom until discharge or 10 days postop. The population was 71% male 14% with known diabetes, 66% who went on intravenous insulin infusion. Figure 1a is Clarke error grid plot of all measures post-ICU admission: 53.5% were Zone A, 45.9% Zone B, and 0.6% (n=5) Zones D or E. Figure 1b uses restricted dataset beginning 24 hours post-ICU admission: 55.9% in Zone A, 43.9% in Zone B, and 0.2% in Zone D. MARD between clinical and Dexcom measures was 20.6% and 21.6% in post-ICU admission dataset and dataset excluding first 24 hours after ICU admission. Almost 100% of Dexcom G6 and clinical data matching points fell within areas considered as giving clinically correct decisions (Zone A) and clinically uncritical decisions (Zone B). If CGM readings are used for clinical decision-making, glucose targets or insulin dosing algorithms may need adjustment. As technology evolves, this device may limit glycemic fluctuations. Disclosure S.R.Insler: None. B.J.Wakefield: None. J.F.Bena: None. A.Debs: None. K.Brake: None. I.Nwosu: None. M.Lansang: Research Support; Dexcom, Inc., Abbott, Alertgy Inc.