Minimally invasive Arterial Glucose monitoring in Intensive Care

The challenge

Most patients who are critically ill or undergoing major surgery become insensitive to their own insulin because of stress hormones, cytokines and commonly used medications. The ensuing elevated glucose level increases risk of infection/sepsis (via immune system inhibition), arrhythmia and kidney injury, and these problems drive mortality, and costs.

Unlike diabetics, the insulin need is unstable in these patients because the factors that cause the insulin insensitivity changes. Today, half of ICU patients get intravenous insulin, and nurses do manual blood samples to measure glucose every 1-4 hours, depending on patient condition. In ICU patients, over 20% of nurse labour is spent on glucose measurements, according to a 2025 survey done by GlucoSet among US directors of surgical ICUs. Even then, as nurses care for multiple patients, delayed blood samples can have severe and even life-threatening consequences.

The solution

GlucoSet is developing a continuous glucose monitor (CGM) for the intensive care unit (ICU), so that dosing of insulin can be done safely, effortlessly and with maximal clinical benefit. The product shifts glycemic control from its current “point measurement” paradigm to that of vital signs that are monitored continuously because of patient risk from rapid changes and because the monitoring aids in life saving therapy decisions.

The GlucoSet ICU Monitoring System introduces a hair-thin fibre through a catheter the patient already has, measures glucose directly in the blood stream, and outputs the measurement on the patient monitor (or a small GlucoSet Monitor) in real-time with no delay. When glucose passes user-defined high or low limits, the system alerts the user. The intravascular access does not limit any other uses of the catheter. The system is compatible with most arterial catheters and can be set up by a nurse in a few minutes.

The single-use sensor has a lifetime of 72 hours so it can be replaced when tubings connected to the arterial lines are usually replaced. This design allows the sensor to be placed either on arrival to the OR or the ICU, even if an arterial catheter was chosen and placed before this.

Put very simply, the GlucoSet monitoring system removes the risk of unintended hypoglycemia while significantly reducing nurse workload, giving nurses full control and more flexibility.

Expected impact

The solution is expected to have a significant impact on abovementioned complications like mortality, complications like infection risk, atrial fibrillation and kidney injury, as well as length of stay, with relative risk reductions of around 25-59% according to a recent unpublished literature review by GlucoSet. The review found that with the expected benefits, the solution could lead to an average cost reduction in the average ICU patient of around €2,000 or more.

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