Background and Aims

COVID-19 patients are often affected by Diabetes Mellitus (DM) and/or hyperglycemia, and the management of their glycemia is challenging.

Aim of this study is to assess clinical utility of intermittent scanning Continuous Glucose Monitoring (is-CGM).

Methods

We assessed many different clinical, bioumoral and Ambulatory Glucose Profile (AGP) derived parameters in 51 consecutive inpatients (male = 39 patients) (age, mean ± DS = 65.9 years ± 12.5) affected by COVID-19 pneumonia and with DM (n = 31) or prediabetes (n = 11) and/or fasting glycemia > 125 mg% (n = 9).

Main outcomes were: median glucose (compared to goal) (MG) across 5 different daily time intervals (hours 03-08; 08-12; 12-18; 18-22; 22-03); detection of episodes of hyperglycemia (> 180 mg% for > 15 minutes) or hypoglycemia (< 70 mg% for 15 minutes) by routinely performed blood glucose monitoring (BGM; pre-breakfast, pre-lunch, pre-dinner and 2 h post-meals) and by is-CGM.

Results

MG were significantly > than goal and > than 20% and 40 mg% greater than the whole day median in: 3/51 (hours 03-08), 4/51 (hours 08-12), 18/51 (hours 12-18), 13/51 (hours 18-22) and 2/51 (hours 22-03) patients (p < 0.0001).

We detected significantly more episodes of hyperglycemia and hypoglycemia with CGM than BGM (respectively: 11.3 ± 8.5 vs 7.7 ± 6.2, p < 0.0001; 3.4 ± 5.4 vs 1.7 ± 3.2; p < 0.0001).

Conclusions

In COVID-19 inpatients with diabetes, prediabetes or fasting hyperglycemia is-CGM showed peculiar data about glycemic variability across the day and about hyper- and hypoglycemic episodes, indispensable to optimize the glycemic management.