Meta analysis of effect of subcutaneous continuous glucose monitoring on blood glucose control in adult ICU patients
Objective To evaluate the benefits of subcutaneous continuous glucose monitoring(SCGM)in blood glucose control of ICU patients,in order to open up the new ideas for blood glucose management in ICU patients.Methods The databases of PubMed,Cochrane Library,Embase,Web of Science,Wanfang,VIP,CNKI and China biomedical literature service system(SinoMed)were retrieved for the relevant randomized controlled trials(RCT)on SCGM in ICU patients from the establishment of the database to April 2024.The two researchers independently screened the literatures,extracted the data,and evaluated the risk of bias of the included studies by using Cochrane risk assessment tools.The Review manager5.4 was used for conducting the meta-analysis and the Stata16.0 was used for conducting the publication bias and sensitivity analysis.Re-sults Eighteen literatures were included,of which the quality evaluation of 17 literatures were the medium and included in the final study,1 literature was evaluated as low quality and was excluded from the analysis.A total of 1 799 research subjects,including the patients admitted to ICU after tumor and cardiac surgery,sepsis,oral space infection,acute pancreatitis,craniocerebral injury,etc,among them the diabetic patients accounted for 8.5％.The test group(SCGM)and control group(capillary glucose measurement by bedside glucometer or arterial glucose measurement by blood gas analyzer)showed a statistically significant in the incidence of hy-poglycemia(RR=0.35,95％CI:0.25-0.47,P＜0.001),mean blood glucose(SMD=-0.13,95％CI:-0.25 to-0.00,P=0.040),and the time proportion of glucose in the target range(SMD=0.29,95％CI:0.10-0.49,P=0.003);the insulin dosage subgroup analysis results showed that the insulin dosage between the two groups in the intensive insulin treatment group had no statistically significant difference(SMD=-0.44,95％CI:-1.05 to 0.17,P=0.160),but the insulin dosage between the two groups in the non-inten-sive insulin treatment group had statistically significant difference(SMD=-2.01,95％CI:-2.29 to-1.72,P＜0.001).Conclusion Compared with capillary glucose measurements by the bedside glucose me-ters or arterial glucose measurements by blood gas analyzers,using SCGM in ICU patients could reduce the in-cidence rate of hypoglycemia,insulin dosage and mean blood glucose,and improve the time proportion of glu-cose in the target range.
subcutaneous continuous glucose monitoringintensive care unitblood sugarmeta analysis
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