Glucocorticoids represent frequently recommended and often indispensable immunosuppressant and anti-inflammatory agents prescribed in various medical conditions. Despite their proven efficacy, glucocorticoids bear a wide variety of side effects among which steroid induced hyperglycaemia (SIHG) is among the most important ones. SIHG, potentially causes new-onset hyperglycaemia or exacerbation of glucose control in patients with previously known diabetes. Retrospective data showed that similar to general hyperglycaemia in diabetes, SIHG in the hospital and in outpatient settings detrimentally impacts patient outcomes, including mortality. However, recommendations for treatment targets and guidelines for in-hospital as well as outpatient therapeutic management are lacking, partially due to missing evidence from clinical studies. Still, SIHG caused by various types of glucocorticoids is a common challenge in daily routine and clinical guidance is needed. In this review, we aimed to summarize clinical evidence of SIHG in inpatient care impacting clinical outcome, establishment of diagnosis, diagnostic procedures and therapeutic recommendations.

The aim of this study was to evaluate the accuracy and usability of a novel continuous glucose monitoring (CGM) system designed for needle-free insertion and reduced environmental impact. We assessed the sensor performance of two GlucoMen^® Day CGM systems worn simultaneously by eight participants with type 1 diabetes. Self-monitoring of blood glucose (SMBG) was performed regularly over 14 days at home. Participants underwent two standardized, 5-h meal challenges at the research center with frequent plasma glucose (PG) measurements using a laboratory reference (YSI) instrument. When comparing CGM to PG, the overall mean absolute relative difference (MARD) was 9.7 [2.6–14.6]%. The overall MARD for CGM vs. SMBG was 13.1 [3.5–18.6]%. The consensus error grid (CEG) analysis showed 98% of both CGM/PG and CGM/SMBG pairs in the clinically acceptable zones A and B. The analysis confirmed that GlucoMen^® Day CGM meets the clinical requirements for state-of-the-art CGM. In addition, the needle-free insertion technology is well tolerated by users and reduces medical waste compared to conventional CGM systems.

Aims: Continuous glucose monitoring (CGM) systems are increasingly used, but their accuracy under flight‐conditions remains insufficiently studied. We assessed sensor accuracy of four CGMs during in‐flight (mid‐haul) and ground conditions. Materials and Methods: Participants ( n = 20) wore four sensors (Abbott Libre 3, Dexcom G7, Medtronic Simplera, and Sinocare iCan i3) in parallel, inserted 1 day prior to experiment. Capillary reference measurements were performed every 30 min. Accuracy evaluation included: proportion of CGM values within 10% of comparator glucose levels >100 mg/dL or within 10 mg/days of comparator levels ≤100 mg/dL (%10/10), along with %20/20 agreement rates, mean absolute relative difference (MARD), Consensus error grid. Results: Twenty participants with type 1 diabetes (age: 37.9 ± 12.8 years, HbA1c: 52.3 ± 4.9 mmol/mol, diabetes duration 19.25 ± 10.6 years) were included in the analysis. Data from 297 sensors with 3473 matched pairs (G7/Libre3/Simplera/i3) were analysed. The overall MARDs were: 9.5% ± 3.3% (G7), 9.6% ± 3.8% (Libre3), 19.9% ± 6.2% (Simplera) and 15.7% ± 6.6% (i3). Overall %20/20 and %10/10 agreement rates were 90.6%/70.2% (G7), 90.8%/66.8% (Libre3), 63.6%/37.8% (Simplera) and 72.5%/42.2% (i3) respectively. The proportion of values in Zones A and B of the Consensus error grid was 98.9% (G7), 99.0% (Libre 3), 94.5% (Simplera) and 97.5% (i3). Prandial state and flight phase had limited influence on the relative performance ranking of the devices. Conclusions: G7 and Libre3 showed consistently higher accuracy and clinical reliability across various phases of flight and ground conditions. Simplera and i3 exhibited greater variability in accuracy. These findings suggest that while modern CGMs could support diabetes management in aviation, individual system performance may differ under specific operational conditions.

Background: In critically ill patients, deviations in glucose levels may lead to significant harm to individuals with and without diabetes. Although subcutaneous continuous glucose monitoring (scCGM) has proven beneficial for patients in standard wards, its implementation in critical care settings has been limited due to multiple factors, potentially resulting in inadequate glycemic control and consequent complications; here, intravascular systems (ivCGM) have the potential to overcome these limitations. Method: This single-center, open-label study, aimed to assess accuracy and safety of a novel intravenous glucose monitoring system in patients with and without diabetes, admitted to a cardiothoracic surgery intensive care unit. Glucose levels were continuously monitored for up to 72 hours in the predefined glucose range of 20 to 400 mg/dL and compared with arterial glucose measurements (blood gas analyses [BGAs]). Results: Twenty-eight participants successfully completed the study, allowing the collection of 1224 ivCGM/BGA data pairs. Due to the exploratory nature of the trial in this vulnerable patient population, no data pairs 250 mg/dL) were observed. A mean absolute relative difference (MARD) of 8.7 ± 7.8% was found, whereas the mean absolute difference (MAD) for values <100 mg/dL was 3.3 ± 2.7 mg/dL. In participants with diabetes (N = 8,332 ivCGM/BGA data pairs), MARD was 9.6 ± 8.1%. Diabetes Technology Society Error Grid (DTSEG) analysis revealed that all data pairs fell within clinically acceptable zones A and B. Notably, no serious adverse events associated with the device were observed during the study. Conclusion: The present findings indicate that the investigated intravenous glucose monitoring system provides accurate glucose monitoring and demonstrates its safety in critical care settings. This technology offers promise for improved glycemic management in critically ill patients, particularly those with diabetes, potentially mitigating the associated risks and complications.