Feasibility of Blood Glucose Management Using Intra-Arterial Glucose Monitoring in Combination with an Automated Insulin Titration Algorithm in Critically Ill Patients

Diabetes Technol Ther. 2019 Oct;21(10):581-588. doi: 10.1089/dia.2019.0082.


Background: This two-center pilot study combined for the first time an intra-arterial glucose sensor with a decision support system for insulin dosing (SGCplus system) in critically ill patients with hyperglycemia. Methods: Twenty-two patients who were equipped with an arterial line and required iv insulin therapy were managed by the SGCplus system during their medical treatment at the intensive care unit. Results: Time to target was 111 ± 195 min (80-150 mg/dL) and 135 ± 267 min (100-160 mg/dL) in the lower and higher glucose target group. Mean blood glucose (BG) was 142 ± 32 mg/dL with seven BG values <70 mg/dL. Mean daily insulin dose was 62 ± 38 U and mean daily carbohydrate intake 148 ± 50 g/day (enteral nutrition) and 102 ± 58 g/day (parenteral nutrition). Acceptance of SGCplus suggestions was high (93%). Conclusions: The SGCplus system can be safely applied in critically ill patients with hyperglycemia and enables good glycemic control.

Keywords: Critically ill patients; Hyperglycemia; Insulin dosing algorithm; Intensive care unit; Intra-arterial glucose sensing; Sensors; Type 1 diabetes; Type 2 diabetes.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Algorithms
  • Blood Glucose / analysis*
  • Critical Care / methods*
  • Critical Illness*
  • Data Accuracy
  • Diabetes Mellitus / drug therapy
  • Feasibility Studies
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Insulin / administration & dosage*
  • Male
  • Middle Aged
  • Pilot Projects


  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin