Peer-reviewed veterinary case report
Continuous vs intermittent glucose monitoring in ICU patients effects
By Gantzel CL et al.·2026·Department of Anesthesiology and Intensive Care·View original on Europe PMC →
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Original publication title: Effects of Continuous Versus Intermittent Glucose Monitoring in Intensive Care Unit Patients: A Systematic Review With Meta-Analysis.
Plain-English summary
This study looked at how continuous glucose monitoring (CGM) compares to traditional point-of-care (POC) blood glucose testing in patients in intensive care units (ICUs). The researchers reviewed 18 clinical trials involving over 2,000 patients and found that CGM might help reduce the risk of death and low blood sugar episodes, but the evidence is not very strong. They noted that while CGM could improve blood sugar management, the results were uncertain due to differences in how the studies were conducted. The authors suggest that more well-designed studies are needed to confirm these potential benefits. Overall, the findings indicate that CGM could be helpful, but we need more reliable evidence to be sure.
Abstract
<h4>Introduction</h4>Glucose management in intensive care unit (ICU) patients often relies on point of care (POC) blood glucose measurements. An increasing number of randomized clinical trials (RCTs) have investigated continuous glucose monitoring (CGM) compared to POC, but effects on patient-important outcomes are uncertain.<h4>Methods</h4>We systematically searched PubMed, Embase, CENTRAL, CINAHL and Web of Science. All reporting was done according to the PRISMA guideline. We included RCTs in ICU patients comparing the effects of CGM versus POC on glycemic and clinical outcomes. We performed meta-analyses, Trial Sequential Analysis, and assessed the certainty of the evidence using GRADE.<h4>Results</h4>We identified 1271 records and included 18 RCTs comparing CGM versus POC with a total of 2027 participants; 15 trials with 1600 participants reported on mortality (relative risk 0.61, 95% CI 0.35-1.04; very low certainty evidence) and 14 trials with 1515 participants on hypoglycemia (relative risk 0.44, 95% CI 0.23 to 0.82; very low certainty evidence). None of our remaining secondary outcomes were reported in the trials. We identified potential benefits of CGM versus POC on glycemic process outcomes; however, we did not evaluate certainty of evidence.<h4>Conclusions</h4>CGM used for glucose management in ICU patients may reduce mortality and hypoglycemia, but the evidence is very uncertain. Sufficiently powered trials at low risk of bias are needed to confirm potential beneficial effects.<h4>Editorial comment</h4>This meta-analysis reports the available literature on continuous versus intermittent monitoring of blood glucose in critically ill patients. The authors found that the available evidence was very uncertain, although continuous monitoring might improve outcomes. It is likely that this is partially due to lack of standardization of measurements and different management strategies. It is possible that the question is best answered with a larger trial with a well-defined treatment protocol.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41913067