Clinical feasibility of remote intermittently scanned continuous glucose monitoring in coronavirus disease 2019 patients with and without diabetes during dexamethasone therapy

Endocr J. 2022 May 30;69(5):597-604. doi: 10.1507/endocrj.EJ21-0540. Epub 2021 Dec 22.

Abstract

The clinical utility of intermittently scanned continuous glucose monitoring (isCGM) in patients with coronavirus disease 2019 (COVID-19) is unclear. Hence, we investigated the accuracy of isCGM in COVID-19 patients during dexamethasone therapy. We evaluated the accuracy of the FreeStyle Libre via smartphone isCGM device compared to point-of-care (POC) fingerstick glucose level monitoring in 16 patients with COVID-19 (10 with and 6 without diabetes, 13 men; HbA1c 6.9 ± 1.0%). Overall, isCGM correlated well with POC measurements (46.2% and 53.8% within areas A and B of the Parkes error grid, respectively). The overall mean absolute relative difference (MARD) for isCGM compared to POC measurements was 19.4%. The MARDs were 19.8% and 19.7% for POC blood glucose measurements ranging from 70 to 180 mg/dL and >180 mg/dL, respectively. When divided according to the presence and absence of diabetes, both groups of paired glucose measurements showed a good correlation (56.3% and 43.7%, and 27.1% and 72.9% within the A and B areas in patients with and without diabetes, respectively), but the MARD was not significant but higher in patients without diabetes (16.5% and 24.2% in patients with and without diabetes). In conclusion, although isCGM may not be as accurate as traditional blood glucose monitoring, it has good reliability in COVID-19 patients with and without diabetes during dexamethasone therapy.

Keywords: Coronavirus disease 2019; Device accuracy; Dexamethasone; Intermittently scanned continuous glucose monitoring; Remote continuous glucose monitoring.

MeSH terms

  • Blood Glucose
  • Blood Glucose Self-Monitoring
  • COVID-19 Drug Treatment*
  • Dexamethasone / therapeutic use
  • Diabetes Mellitus, Type 1* / drug therapy
  • Feasibility Studies
  • Humans
  • Male
  • Reproducibility of Results

Substances

  • Blood Glucose
  • Dexamethasone