Comparison of subcutaneous and intravenous continuous glucose monitoring accuracy in an operating room and an intensive care unit.

Abstract

Although we have used an intravenous continuous glucose monitor for blood glucose management, a previous study reported that a subcutaneous continuous glucose monitor was also reliable for use in critically ill patients. The aim of this study was to compare the subcutaneous and intravenous continuous glucose monitors. This was an observational trial (UMIN-CTR, ID:000013338). We included patients who were admitted to our intensive care units (ICU) after hepato-biliary pancreatic surgery. Continuous blood glucose measurement was performed from the beginning of the operation to ICU discharge using the intravenous continuous monitor STG-55 (Nikkiso, Tokyo, Japan) and the subcutaneous continuous monitor iPro2 (Medtronic Japan, Tokyo, Japan). The STG-55 measured the glucose level in real time, and the iPro2 measured this every 5min. We compared glucose levels obtained using the two devices every 5min using a Bland-Altman plot and a regression analyses. A total of 3592 comparative samples in 15 cases were analyzed. The mean glucose level measured using the STG-55 was 139±21mg/dl, and that measured using the iPro2 was 144±31mg/dl. A linear regression line had the equation of the form y=0.225x+106. The coefficient of determination was 0.11, and the F-test significance level was set as p<0.01. The mean of the differences was -5.2mg/dl, with a 95% agreement limit of -67 to+57mg/dL. The percent error was 44%. In conclusion, the current study suggests that subcutaneous and intravenous continuous glucose monitoring was not highly correlated during either surgery or ICU stay.