Variability - control requires visibility
Recent research has demonstrated an association between increased glycemic variability and mortality. The case below demonstrates the challenge of identifying and controlling variability with intermittent monitoring. Note the sharp peak in glucose between 11 and 13 hours that is missed by the intermittent testing.
Immediate feedback on therapeutic interventions
This is a patient with sepsis being managed in an
ICU. Not only does the sensor correlate well with the comparative
readings from the laboratory analyser (
), but when the patient receives dextrose infusions
right at the beginning of the monitoring period, and again at
approximately 7 hours, the sensor swiftly responds to show the
increase in blood glucose attributable to the infusion. In the
absence of a continuous trace, reliance on the intermittent points
at 6 and 10 hours might be interpreted as little change in the
overall downward trend.
ICU Patients are unpredictable
This is a CABG patient with well controlled
glucose on the first day post surgery. In this example the sensor
shows very close correlation with the intermittent laboratory
readings () and without
the benefit of the continuous trace (
) a caregiver might decide to reduce the
frequency of blood glucose assays around the 24 hour point. The
continuous signal clearly indicates a steep rise in blood glucose
at around this time which the next intermittent reading
confirms.
As with all these cases the sensor continues to track throughout the patients stay in the intensive care facility
