HyperglycemiaNCT05442853
Continuous Glucose Monitoring for Hyperglycemia in Critically Ill Patients
A study testing Continuous glucose monitoring and Point of care glucose monitoring in people with Hyperglycemia and Hypoglycemia, run by Malcom Randall VA Medical Center at 1 site in United States.
Trial summary
The investigators intend to conduct a single-center, prospective, randomized comparative trial of patients admitted to the intensive care unit (ICU) who received continuous glucose monitoring (CGM) vs point of care (POC) glucose monitoring. Read more about this study
- Who is it for?
- Ages 18 to 89 years
- Conditions the study is for
- Hyperglycemia, Hypoglycemia, Critical Illness
- What is being tested?
- Continuous glucose monitoring and Point of care glucose monitoring
- Type of treatment
- Injection or infusion, Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 85 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Apr 2023to 1 Aug 2024
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 89 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients age 18-89
- Past medical history of any diabetes mellitus OR patients with at least 1 measured BG of 180 being treated with insulin (subcutaneous or infusion)
- Enrollment will occur within 72 hours after being admitted to an ICU if history of diabetes
- Enrollment will occur within 72 hours after developing hyperglycemia in ICU if no diabetes
Who cannot join
- Pregnant patients
- Patients using CGMs in the outpatient setting
- Diagnosis of diabetic ketoacidosis (DKA)
- Diagnosis of hyperosmolar hyperglycemic state (HHS)
- Anticipated to require prone positioning while on insulin therapy
- Any contraindications to CGMs based on manufacturer labeling
Show all 10Show fewer
- BG above maximum reading for CGM (e.g. greater than 400 mg/dL)
- Receiving medication that could interfere with CGM readings (based on manufacturer specifications)
- Receiving any dose of hydroxyurea as this could falsely elevate the sensor readings (if applicable for specific CGM)
- Receiving greater than 1,000mg acetaminophen every 6 hours in any form as this could falsely elevate the sensor readings (if applicable for specific CGM)
Trial locations and contacts
1 site in 1 country.
United States1 site
North Florida/South Georgia Veterans Health System
Gainesville, Florida, 32608
About this study
The investigators intend to conduct a single-center, prospective, randomized comparative trial of patients admitted to the intensive care unit (ICU) who received continuous glucose monitoring (CGM) vs point of care (POC) glucose monitoring. The study will examine relevant outcomes for patients in the ICU with diabetes mellitus and/or hyperglycemia. The primary outcome of the study will be the proportion of time in target range (blood glucose 70-180 mg/dL).
Read the detailed description
Study Purpose:
The purpose of this study is to compare the use of continuous glucose monitoring (CGM) versus point of care (POC) glucose monitoring in the intensive care unit (ICU) setting for differences in glycemic control and other important outcomes.
Research Plan:
This will be a prospective, single-center, randomized comparative trial of adult patients at North Florida/South Georgia Veterans Health System anticipated to be admitted to an ICU for a minimum of 48 hours after enrollment. Study participants will be randomly assigned to one of the study groups (CGM or POC) after being found eligible for inclusion and giving consent to participate. The CGM group will receive glycemic management based on CGM readings. The POC group will receive glycemic management based on POC glucose readings.
Study Outcomes:
Groups will be compared for differences in clinical and safety outcomes. The primary outcome will be the proportion of time in target range (BG 70-180mg/dL). Secondary outcomes will include mean glucose, hypoglycemia, hyperglycemia, ICU length of stay, mortality, glucose variability, cost, and patient satisfaction. Safety outcomes will include new infection, acute kidney injury, delirium, agitation, and pain.
Analysis Methods:
Descriptive statistics and inferential statistical methods will be used as appropriate to report findings of this study.
- Conditions
- Hyperglycemia, Hypoglycemia, Critical Illness, Diabetes Mellitus
- Being tested
- Continuous glucose monitoring, Point of care glucose monitoring
- Medical subject headings
- Hyperglycemia, Hypoglycemia, Critical Illness, Diabetes Mellitus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Continuous glucose monitoringDevice
Continuous glucose monitoring involves a wearable device that measures glucose with a sensor that is inserted subcutaneously. The sensor transmits data to receiving device that displays the glucose values.
Point of care glucose monitoringDevice
Point of care glucose monitoring involves use of an external device that can provide glucose readings at a patient's bedside. These devices require a small blood sample from venous, arterial, or capillary fingerstick blood. The blood sample is analyzed by the device and reports a glucose value within 5 minutes. This method of glucose monitoring is a mainstay and standard of care for most hospitals in the United States.
| Study group | Role | What they receive |
|---|---|---|
| Continuous Glucose Monitoring | Active comparator | Study subjects in this arm will receive glycemic management based on continuous glucose monitoring with CGM device. CGM readings will be available to patients, nurses, and the treating team. All treatment decisions for this group will be based on CGM readings, confirmatory POC readings (as necessary), and venipuncture. Receives: Device: Continuous glucose monitoring |
| Point of Care Glucose Monitoring | Active comparator | Study subjects in this arm will receive glycemic management based on point of care blood glucose readings. CGM will be placed in blinded mode and used for study comparison only. Patients, nurses, and other treatment team will be blinded to the CGM readings. All treatment decisions for this group will be based on POC readings and venipuncture Receives: Device: Point of care glucose monitoring |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time in Target Blood Glucose Range (BG 70-180mg/dL)
Percentage of time within time glucose range based on CGM readings
Measured: For duration of study enrollment (up to 10 days)
Secondary outcomes (16)
Time in Clinically Significant Hypoglycemic Range (BG < 54 mg/dL)
Percentage of time with BG less than 54 mg/dl as measured by CGM
Measured: For duration of study enrollment (up to 10 days)
Time in Hypoglycemic Range (BG 54-69 mg/dL)
Percentage of time in this glucose range as measured by CGM
Measured: For duration of study enrollment (up to 10 days)
Time in Hyperglycemic Range (BG 181-250 mg/dL)
Percentage of time in this glucose range as measured by CGM
Measured: For duration of study enrollment (up to 10 days)
Time in Clinically Relevant Hyperglycemic Range (BG >250 mg/dL)
Percentage of time in this glucose range as measured by CGM
Measured: For duration of study enrollment (up to 10 days)
ICU Length of Stay
Total time (in days or hours) in the intensive care unit
Measured: At time of ICU discharge or death (assessed up to 1 month)
ICU Mortality
Death from any cause during ICU stay
Measured: At time of ICU discharge or death (assessed up to 1 month)
30 Day Mortality
Death from any cause at 30 days after admission to the ICU
Measured: At 30 days or time of death
Cost Associated With Monitoring
Monetary value assigned to blood glucose monitoring
Measured: For duration of study enrollment (up to 10 days)
Mean Blood Glucose
Average blood glucose (< 180 mg/dl) during the study timeframe
Measured: For duration of study enrollment (up to 10 days)
Glucose Variability
- % coefficient of variation = SD/mean BG*100%
Measured: For duration of study enrollment (up to 10 days)
Patient Satisfaction
Patient satisfaction with glucose monitoring as assessed by survey on Likert Scale (1-5). Score of 1 being 'very dissatisfied' to score of 5 being 'very satisfied.'
Measured: Once at completion of study enrollment (at day 10 or sooner)
New Infection
Any infection diagnosis that was not present upon admission to the ICU
Measured: Assessed daily, For duration of study enrollment (up to 10 days)
New Acute Kidney Injury
New acute kidney injury (based on Acute Kidney Injury Network guideline definitions) not present upon admission to the ICU
Measured: Assessed daily, For duration of study enrollment (up to 10 days)
ICU Delirium
Development of ICU delirium, based on Confusion Assessment Method for the ICU (CAM-ICU) score, with any positive score indicating presence of delirium.
Measured: Assessed daily, For duration of study enrollment (up to 10 days)
Agitation
Richmond agitation scores (-5 to +4), with scores of +2 or more indicated agitation.
Measured: Assessed daily, For duration of study enrollment (up to 10 days)
Pain Associated With Glucose Monitoring
Patient reported pain associated with glucose monitoring
Measured: Assessed daily, For duration of study enrollment (up to 10 days)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Jul 2022
- Study start1 Apr 2023
- Primary completion30 Jun 2024
- Study completion1 Aug 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for HyperglycemiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 85 participants (actual)
Sponsor and investigators
- Lead sponsor
- Malcom Randall VA Medical Center
- Sponsor type
- US federal agency
- Collaborators
- DexCom, Inc.
- Responsible party
- Principal investigator, Andrew Franck, Malcom Randall VA Medical Center
- Investigators
- Andrew J Franck, PharmD, Principal investigator, US Department of Veterans Affairs
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05442853
- Sponsor's protocol ID
- 202201063
- Status last verified
- Mar 2025
- First submitted
- 16 Jun 2022
- Last updated
- 8 Apr 2025
- Results posted
- Yes, on ClinicalTrials.gov
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- No
Publications
Franck AJ, Hendrickson AL, Telford ED, Davids BL, Murray Casanova I, Rosen AN, Hadigal S, Ross RC. Continuous Glucose Monitoring for Hyperglycemia in Critically Ill Patients: A Randomized Controlled Trial. Chest. 2025 Aug;168(2):326-335. doi: 10.1016/j.chest.2025.02.006. Epub 2025 Feb 15.
PubMed 39956190
Study at a glance
From the registry record, last updated by the sponsor on 8 Apr 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Continuous Glucose Monitoring for Hyperglycemia in Critically Ill Patients
- ClinicalTrials.gov ID
- NCT05442853
- Acronym / sponsor ID
- 202201063
- Conditions
- Hyperglycemia, Hypoglycemia, Critical Illness, Diabetes Mellitus
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 85 participants (actual)
- Lead sponsor
- Malcom Randall VA Medical CenterUS federal agency
- Collaborators
- DexCom, Inc.
- Study start
- 1 Apr 2023 (actual)
- Primary completion
- 30 Jun 2024 (actual)
- Study completion
- 1 Aug 2024 (actual)
- First posted
- 5 Jul 2022 (actual)
- Results
- Posted 8 Apr 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigators intend to conduct a single-center, prospective, randomized comparative trial of patients admitted to the intensive care unit (ICU) who received continuous glucose monitoring (CGM) vs point of care (POC) glucose monitoring. The study will examine relevant outcomes for patients in the ICU with diabetes mellitus and/or hyperglycemia. The primary outcome of the study will be the proportion of time in target range (blood glucose 70-180 mg/dL).
Detailed description
Study Purpose:
The purpose of this study is to compare the use of continuous glucose monitoring (CGM) versus point of care (POC) glucose monitoring in the intensive care unit (ICU) setting for differences in glycemic control and other important outcomes.
Research Plan:
This will be a prospective, single-center, randomized comparative trial of adult patients at North Florida/South Georgia Veterans Health System anticipated to be admitted to an ICU for a minimum of 48 hours after enrollment. Study participants will be randomly assigned to one of the study groups (CGM or POC) after being found eligible for inclusion and giving consent to participate. The CGM group will receive glycemic management based on CGM readings. The POC group will receive glycemic management based on POC glucose readings.
Study Outcomes:
Groups will be compared for differences in clinical and safety outcomes. The primary outcome will be the proportion of time in target range (BG 70-180mg/dL). Secondary outcomes will include mean glucose, hypoglycemia, hyperglycemia, ICU length of stay, mortality, glucose variability, cost, and patient satisfaction. Safety outcomes will include new infection, acute kidney injury, delirium, agitation, and pain.
Analysis Methods:
Descriptive statistics and inferential statistical methods will be used as appropriate to report findings of this study.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Continuous Glucose Monitoring | Active comparator | Device: Continuous glucose monitoringStudy subjects in this arm will receive glycemic management based on continuous glucose monitoring with CGM device. CGM readings will be available to patients, nurses, and the treating team. All treatment decisions for this group will be based on CGM readings, confirmatory POC readings (as necessary), and venipuncture. |
| Point of Care Glucose Monitoring | Active comparator | Device: Point of care glucose monitoringStudy subjects in this arm will receive glycemic management based on point of care blood glucose readings. CGM will be placed in blinded mode and used for study comparison only. Patients, nurses, and other treatment team will be blinded to the CGM readings. All treatment decisions for this group will be based on POC readings and venipuncture |
Who may qualify
- Ages
- 18 to 89 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Patients age 18-89
- Past medical history of any diabetes mellitus OR patients with at least 1 measured BG of 180 being treated with insulin (subcutaneous or infusion)
- Enrollment will occur within 72 hours after being admitted to an ICU if history of diabetes
- Enrollment will occur within 72 hours after developing hyperglycemia in ICU if no diabetes
Key exclusion criteria (10 listed)
- Pregnant patients
- Patients using CGMs in the outpatient setting
- Diagnosis of diabetic ketoacidosis (DKA)
- Diagnosis of hyperosmolar hyperglycemic state (HHS)
- Anticipated to require prone positioning while on insulin therapy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Continuous glucose monitoringContinuous glucose monitoring involves a wearable device that measures glucose with a sensor that is inserted subcutaneously. The sensor transmits data to receiving device that displays the glucose values. | Device | Continuous Glucose Monitoring |
| Point of care glucose monitoringPoint of care glucose monitoring involves use of an external device that can provide glucose readings at a patient's bedside. These devices require a small blood sample from venous, arterial, or capillary fingerstick blood. The blood sample is analyzed by the device and reports a glucose value within 5 minutes. This method of glucose monitoring is a mainstay and standard of care for most hospitals in the United States. | Device | Point of Care Glucose Monitoring |
Primary outcome
Time in Target Blood Glucose Range (BG 70-180mg/dL)
Time frame: For duration of study enrollment (up to 10 days)
Percentage of time within time glucose range based on CGM readings
16 secondary outcomes
Time in Clinically Significant Hypoglycemic Range (BG < 54 mg/dL)
Time frame: For duration of study enrollment (up to 10 days)
Time in Hypoglycemic Range (BG 54-69 mg/dL)
Time frame: For duration of study enrollment (up to 10 days)
Time in Hyperglycemic Range (BG 181-250 mg/dL)
Time frame: For duration of study enrollment (up to 10 days)
Time in Clinically Relevant Hyperglycemic Range (BG >250 mg/dL)
Time frame: For duration of study enrollment (up to 10 days)
ICU Length of Stay
Time frame: At time of ICU discharge or death (assessed up to 1 month)
ICU Mortality
Time frame: At time of ICU discharge or death (assessed up to 1 month)
30 Day Mortality
Time frame: At 30 days or time of death
Cost Associated With Monitoring
Time frame: For duration of study enrollment (up to 10 days)
Mean Blood Glucose
Time frame: For duration of study enrollment (up to 10 days)
Glucose Variability
Time frame: For duration of study enrollment (up to 10 days)
Patient Satisfaction
Time frame: Once at completion of study enrollment (at day 10 or sooner)
New Infection
Time frame: Assessed daily, For duration of study enrollment (up to 10 days)
New Acute Kidney Injury
Time frame: Assessed daily, For duration of study enrollment (up to 10 days)
ICU Delirium
Time frame: Assessed daily, For duration of study enrollment (up to 10 days)
Agitation
Time frame: Assessed daily, For duration of study enrollment (up to 10 days)
Pain Associated With Glucose Monitoring
Time frame: Assessed daily, For duration of study enrollment (up to 10 days)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Apr 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 39956190Franck AJ, Hendrickson AL, Telford ED, Davids BL, Murray Casanova I, Rosen AN, Hadigal S, Ross RC. Continuous Glucose Monitoring for Hyperglycemia in Critically Ill Patients: A Randomized Controlled Trial. Chest. 2025 Aug;168(2):326-335. doi: 10.1016/j.chest.2025.02.006. Epub 2025 Feb 15.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Andrew J Franck, PharmD principal investigator
US Department of Veterans Affairs
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Continuous glucose monitoring and Point of care glucose monitoring in people with Hyperglycemia and Hypoglycemia, run by Malcom Randall VA Medical Center at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 8 Apr 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Time in Target Blood Glucose Range (BG 70-180mg/dL) (time frame: For duration of study enrollment (up to 10 days)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05442853, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Apr 2025.