Abstract：
OBJECTIVE: The objectives of the current research were to evaluate the accuracy and reliability of continuous glucose monitoring (CGM) in patients undergoing cardiac surgery and assess the impact of preoperative liraglutide administration on perioperative glucose control as captured by CGM.
METHODS: This was a prospective, single-center, prespecified analysis of the GLOBE trial, a randomized controlled trial comparing preoperative liraglutide treatment to placebo in patients undergoing cardiac surgery.
METHODS: The work took place at a single-center academic hospital in the Netherlands.
METHODS: Twenty-five patients undergoing cardiac surgery were recruited from the hospital\'s cardiac surgery department.
METHODS: Participants received the Dexcom G5 CGM system from the day before surgery until discharge from the intensive care unit after surgery. Additionally, participants were randomized to receive either preoperative liraglutide or placebo.
RESULTS: Arterial blood gas (ABG) glucose measurements were collected as a reference and matched to CGM readings to assess accuracy and reliability. In 240 paired CGM-ABG glucose measurements, the mean absolute relative difference was 14.4 ± 12.5%. Temporary sensor interruption occurred mainly intraoperatively (92% of patients). The median duration of intraoperative sensor interruption was 65 (48-95) minutes. Liraglutide increased glycemic time in range 72% versus 47% in the control group (absolute difference 25%, 95% confidence interval -41.4 to -8.9, p = .004).
CONCLUSIONS: Despite intraoperative sensor interruption, CGM seems an accurate method for semi-invasive, real-time assessment of blood glucose levels. CGM can provide a detailed observation of the pre- and postoperative glycemic trajectory, demonstrating increased time in range following perioperative liraglutide treatment compared with placebo.
METHODS: This was a prospective, single-center, prespecified analysis of the GLOBE trial, a randomized controlled trial comparing preoperative liraglutide treatment to placebo in patients undergoing cardiac surgery.
METHODS: The work took place at a single-center academic hospital in the Netherlands.
METHODS: Twenty-five patients undergoing cardiac surgery were recruited from the hospital\'s cardiac surgery department.
METHODS: Participants received the Dexcom G5 CGM system from the day before surgery until discharge from the intensive care unit after surgery. Additionally, participants were randomized to receive either preoperative liraglutide or placebo.
RESULTS: Arterial blood gas (ABG) glucose measurements were collected as a reference and matched to CGM readings to assess accuracy and reliability. In 240 paired CGM-ABG glucose measurements, the mean absolute relative difference was 14.4 ± 12.5%. Temporary sensor interruption occurred mainly intraoperatively (92% of patients). The median duration of intraoperative sensor interruption was 65 (48-95) minutes. Liraglutide increased glycemic time in range 72% versus 47% in the control group (absolute difference 25%, 95% confidence interval -41.4 to -8.9, p = .004).
CONCLUSIONS: Despite intraoperative sensor interruption, CGM seems an accurate method for semi-invasive, real-time assessment of blood glucose levels. CGM can provide a detailed observation of the pre- and postoperative glycemic trajectory, demonstrating increased time in range following perioperative liraglutide treatment compared with placebo.
摘要：
目的：本研究的目的是评估心脏手术患者连续血糖监测（CGM）的准确性和可靠性，并评估术前利拉鲁肽给药对CGM显示的围手术期血糖控制的影响。
方法：这是一个前瞻性的，单中心,GLOBE试验的预设分析，一项随机对照试验,比较心脏手术患者术前利拉鲁肽治疗和安慰剂治疗.
方法：这项工作在荷兰的一家单中心学术医院进行。
方法：从医院心脏外科招募了25例接受心脏手术的患者。
方法：参与者从手术前一天开始接受DexcomG5CGM系统，直到手术后从重症监护病房出院。此外,参与者被随机分配接受术前利拉鲁肽或安慰剂.
结果：收集动脉血气（ABG）葡萄糖测量值作为参考，并与CGM读数进行匹配，以评估准确性和可靠性。在240个配对的CGM-ABG葡萄糖测量中，平均绝对相对差异为14.4±12.5%.暂时的传感器中断主要发生在术中（92％的患者）。术中传感器中断的中位持续时间为65（48-95）分钟。利拉鲁肽增加血糖时间范围为72%，对照组为47%（绝对差异为25%，95%置信区间-41.4至-8.9，p=.004)。
结论：尽管术中传感器中断，CGM似乎是半侵入性的准确方法，实时评估血糖水平。CGM可以提供术前和术后血糖轨迹的详细观察，与安慰剂相比，围手术期利拉鲁肽治疗时间增加。
方法：这是一个前瞻性的，单中心,GLOBE试验的预设分析，一项随机对照试验,比较心脏手术患者术前利拉鲁肽治疗和安慰剂治疗.
方法：这项工作在荷兰的一家单中心学术医院进行。
方法：从医院心脏外科招募了25例接受心脏手术的患者。
方法：参与者从手术前一天开始接受DexcomG5CGM系统，直到手术后从重症监护病房出院。此外,参与者被随机分配接受术前利拉鲁肽或安慰剂.
结果：收集动脉血气（ABG）葡萄糖测量值作为参考，并与CGM读数进行匹配，以评估准确性和可靠性。在240个配对的CGM-ABG葡萄糖测量中，平均绝对相对差异为14.4±12.5%.暂时的传感器中断主要发生在术中（92％的患者）。术中传感器中断的中位持续时间为65（48-95）分钟。利拉鲁肽增加血糖时间范围为72%，对照组为47%（绝对差异为25%，95%置信区间-41.4至-8.9，p=.004)。
结论：尽管术中传感器中断，CGM似乎是半侵入性的准确方法，实时评估血糖水平。CGM可以提供术前和术后血糖轨迹的详细观察，与安慰剂相比，围手术期利拉鲁肽治疗时间增加。
