Networked continuous glucose monitoring within the Intensive Care Unit (ICU-TeleCGM)

Within critical care settings, hypoglycaemia is nearly threefold higher than in non-critical care. Although continuous glucose monitoring (CGM) is well established for people with diabetes in outpatient settings, its utility and safety in-hospital and critical care is unclear. The purpose of this study is to determine whether networked CGM (Dexcom G7) with telemetry (ViewsEMR/CampViews®) is safe and can be implemented in an NHS intensive care unit (ICU) in people with diabetes or stress hyperglycaemia requiring insulin therapy during critical illness. This is a two-step pilot feasibility study. The first step is a single arm, non-randomised study with 20 adults. Outcomes at this stage include recruitment feasibility and proportion completing study. The second step is a randomised parallel-group study, in which participants are randomised to the intervention, or usual care with masked CGM. Up to 50 adults admitted to ICU requiring insulin therapy will be randomised, aiming for 40 completed participants. The primary outcome is number of episodes of hypoglycaemia, with secondary outcomes including glycaemic and accuracy metrics. Perspectives from healthcare professionals on CGM use in ICU will also be obtained. Results from this pilot study will inform the design and conduct of a future multi-centred clinical trial in the UK.