Impact of Hybrid Continuous Glucose Monitoring on Glycemic Control in a Medical Intensive Care Unit

OBJECTIVE: Continuous glucose monitoring (CGM) offers real-time glucose data that may improve dysglycemia detection in critically ill patients; however, evidence supporting its clinical effectiveness in the intensive care unit (ICU) remains limited. The objective of this study was to evaluate whether a nurse-driven hybrid continuous glucose monitoring (CGM) plus point-of-care (POC) validation protocol improves glycemic outcomes compared with standard POC monitoring alone among medical ICU patients receiving continuous intravenous (IV) insulin. METHODS: In this single-center prospective intervention cohort study, 100 MICU patients receiving continuous IV insulin were monitored using a hybrid CGM+POC protocol and compared with 100 matched historical controls. The primary outcome was % time in glucose range (70-180 mg/dL) during continuous IV insulin therapy, calculated using POC values (at least every 4 hours) for between-group comparisons. Secondary outcomes included % time in additional glucose ranges, hyperglycemia (>250 and >400 mg/dL), and hypoglycemia (