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