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J Diabetes Sci Technol. 2014 Sep;8(5):945-50. doi: 10.1177/1932296814536138. Epub 2014 May 27.

Accuracy of a novel noninvasive transdermal continuous glucose monitor in critically ill patients.

Author information

  • 1Departments of Surgery/Anesthesiology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA.
  • 2Echo Therapeutics, Inc, Philadelphia, PA, USA.
  • 3The Epsilon Group, Charlottesville, VA, USA.
  • 4Departments of Surgery/Anesthesiology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA Snasraway@tuftsmedicalcenter.org.


Stress hyperglycemia and hypoglycemia are associated with increased morbidity and mortality in the critically ill. Intermittent, random blood glucose (BG) measurements can miss episodes of hyper- and hypoglycemia. The purpose of this study was to determine the accuracy of the Symphony® continuous glucose monitor (CGM) in critically ill cardiac surgery patients. Fifteen adult cardiac surgery patients were evaluated immediately postoperatively in the intensive care unit. Prelude® SkinPrep prepared the skin and a sensor was applied to 2 test sites on each subject to monitor interstitial fluid glucose. Reference BG was sampled at 30- to 60-minute intervals. The skin at the test sites was inspected for adverse effects. Accuracy of the retrospectively analyzed CGM data relative to reference BG values was determined using continuous glucose-error grid analysis (CG-EGA) and mean absolute relative difference (MARD). Using 570 Symphony CGM glucose readings paired with reference BG measurements, CG-EGA showed that 99.6% of the readings were within zones A and B. BG measurements ranged from 73 to 251 mg/dL. The MARD was 12.3%. No adverse device effects were reported. The Symphony CGM system is able to safely, continuously, and noninvasively monitor glucose in the transdermal interstitial fluid of cardiac surgery intensive care unit patients with accuracy similar to that reported with other CGM systems. Future versions of the system will need real-time data analysis, fast warm-up, and less frequent calibrations to be used in the clinical setting.

© 2014 Diabetes Technology Society.


biosensor; continuous glucose; diabetes; intensive care; tight glycemic; transdermal

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