OBJECTIVE The adoption of continuous glucose monitors (CGMs) in inpatient settings in the pediatric population has been slow because of a scarcity of data on their reliability in hospitalized children. RESEARCH DESIGN AND METHODS We retrospectively reviewed the accuracy of the Dexcom G6 CGM system in pediatric patients with diabetes admitted to our academic children’s hospital from March 2018 to September 2023. We cross-referenced the Dexcom Clarity database against an internal database of inpatient admissions to identify all children with CGM data admitted to the hospital. We recorded sensor glucose readings from Clarity and values for point-of-care (POC) glucose, blood urea nitrogen (BUN), and pH from the electronic medical record. CGM accuracy and clinical reliability were measured by mean absolute relative difference (MARD) and Clarke error grid (CEG) analyses. RESULTS There were 3,200 admissions of children with diabetes in this period, of which 277 (from 202 patients age 2–18 years) had associated CGM data. Paired CGM and POC measurements (n = 2,904) were compared, resulting in an MARD of 15.9%, with 96.6% of the values in zones A and B of the CEG analysis. Approximately 62% of paired values fell within a 15% or 15 mg/dL difference, whichever was larger (15%/15 mg/dL range), 74% within 20%/20, and 88% within 30%/30. Serum pH, sodium, and BUN had no impact on CGM values or absolute relative difference in linear regression analysis. CONCLUSIONS CGMs demonstrated acceptable accuracy in hospitalized children with diabetes. CGM data should be integrated into hospital electronic records to optimize management.

中文翻译：

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连续血糖监测仪在住院儿童糖尿病管理中的准确性


目的 由于缺乏关于连续血糖监测仪 （CGM） 在住院儿童中可靠性的数据，因此在儿科人群中采用连续血糖监测仪 （CGM） 的速度一直很慢。研究设计和方法 我们回顾性回顾了 2018 年 3 月至 2023 年 9 月我们学术儿童医院收治的儿科糖尿病患者中 Dexcom G6 CGM 系统的准确性。我们将 Dexcom Clarity 数据库与住院患者内部数据库进行交叉引用，以确定所有入院的具有 CGM 数据的儿童。我们记录了 Clarity 的传感器葡萄糖读数和电子病历中的床旁 （POC） 葡萄糖、血尿素氮 （BUN） 和 pH 值。通过平均绝对相对差 （MARD） 和克拉克误差网格 （CEG） 分析来衡量 CGM 准确性和临床可靠性。结果 在此期间有 3,200 名糖尿病儿童入院，其中 277 名 （来自 202 名 2-18 岁的患者） 有相关的 CGM 数据。比较配对的 CGM 和 POC 测量值 （n = 2,904），得出 MARD 为 15.9%，CEG 分析的 A 区和 B 区值为 96.6%。大约 62% 的配对值落在 15% 或 15 mg/dL 的差异范围内，以较大者为准（15%/15 mg/dL 范围），74% 在 20%/20 范围内，88% 在 30%/30 范围内。线性回归分析中血清 pH 值、钠和 BUN 对 CGM 值或绝对相对差异没有影响。结论 CGM 在住院糖尿病儿童中表现出可接受的准确性。应将 CGM 数据集成到医院电子记录中，以优化管理。