Towards continuous glucose monitoring in the ICU ¿Hacia una monitorización continua de glucosa en la UCI?

After the two landmark Leuven studies, glucose monitoring and control in the ICU were highlighted and opened an innovative research field that is here to stay. After those studies the target glucose control, tight or less stringent, and their related outcomes were not only a matter of cutting-edge investigations but also forced a decisive move from glucose control from paper-based to computer-based algorithms and from intermittent to real-time continuous glucose monitoring (CGM) systems in order to better adjust insulin administration. Nearly at the same time research in the field moved towards additional improved clinical outcomes more specifically linked to the prevention of hyperglycemia, hypoglycemia and glycemic variability and complexity. In addition, requirements and recommendations to measure blood glucose and reporting glycemic control and describing performance characteristics and suggested criteria related to ideal CGM systems have recently been published. Tight glucose control (TGC) benefit in the ICU is still a matter of intense debate but it has been associated with an increase in the rate of hypoglycemia episodes compared to a conventional glucose control. The clinicians’ and nurses’ natural fear to iatrogenic hypoglycemia and the necessity to reduce glucose variability, independently of the chosen glucose target range, accelerated the development of computerized decision support systems and CGM devices to manage dysglycemia. CGM systems sample intermittently and the frequency of actual glucose measurements and the immediate of the