Patients on aggressive treatment for hematological malignancies generally experience hyperglycemia. While finger-stick glucose tests are standard, they may miss significant glucose level fluctuations. A new study, published in Diabetes Technology & Therapeutics, assessed the accuracy and clinical value of continuous glucose monitoring (CGM) in this high-risk population, even during complex therapies.

Researchers analyzed data from a prospective study comparing CGM to point-of-care (POC) capillary glucose measurements in adults hospitalized for chimeric antigen receptor T-cell therapy (CAR-T), allogeneic stem cell transplantation (allo-SCT), or autologous stem cell transplantation (auto-SCT). In total, 60 patients contributed 1,999 matched CGM and POC data points.

The overall mean absolute relative difference (MARD) between CGM and POC readings was 21.5%, with allo-SCT patients showing the highest CGM accuracy (mean ARD 18.3%) and auto-SCT patients the lowest (27.1%). Agreement rates within 15%, 20%, and 30% of reference values were 38.1%, 51.1%, and 75.1%, respectively. 99.6% of the data pairs fell within clinically acceptable zones (A + B) on the Diabetes Technology Society (DTS) Error Grid, suggesting minimal risk for harmful insulin dosing decisions.

Despite a relatively high MARD, CGM proved clinically reliable across all treatment types, offering a safer, less invasive, and more comprehensive approach to glucose monitoring during intensive hematological care.