Adoption Barriers for Continuous Glucose Monitoring and Their Potential Reduction With a Fully Implanted System: Results From Patient Preference Surveys

Engler, Robert L.; Routh, Timothy L.; Lucisano, Joseph Y.

doi:10.2337/cd17-0053

Cited by 57 publications

(67 citation statements)

References 28 publications

(38 reference statements)

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“…10,11 Although increased adoption rates of CGM are at least partially attributable to improving accuracy, many patients still face barriers to adoption and continued use of CGM systems such as pain, complexity, the need for frequent sensor changes, toofrequent calibrations, or difficult application. 12,13 The G6 system's sensor was redesigned for increased stability during its working life and factory calibration.…”

Section: Cgm Performance With Reprocessed Factory Calibrationmentioning

confidence: 99%

Accuracy of a Factory-Calibrated, Real-Time Continuous Glucose Monitoring System During 10 Days of Use in Youth and Adults with Diabetes

Wadwa

Laffel

Shah

et al. 2018

Diabetes Technology & Therapeutics

149

116

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Section: Cgm Performance With Reprocessed Factory Calibrationmentioning

confidence: 99%

Accuracy of a Factory-Calibrated, Real-Time Continuous Glucose Monitoring System During 10 Days of Use in Youth and Adults with Diabetes

Wadwa

Laffel

Shah

et al. 2018

Diabetes Technology & Therapeutics

149

116

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show abstract

“…The sensor insertion and removal procedures were well tolerated with no SAEs. The most common AEs related to the insertion/removal process were presyncope (2), nausea (2) and vomiting (2). Sensor fracture occurred in the process of removal in two subjects without further impact.…”

Section: Safety Outcomesmentioning

confidence: 99%

“…The implanted sensor and wearable transmitter combination were also well tolerated with a median wear time of 23 ± 6.6 hours daily in the total cohort, and was not different in the paediatric cohort (23 ± 6.1 hours). Skin reactions to the sensor were mild when they occurred and included skin thinning (13), discoloration (2) and bruise (2). One subject experienced a skin reaction to the adhesive patch which was moderate and followed a prior history of chronic dermatitis and prior intolerance of other adhesives.…”

Section: Safety Outcomesmentioning

confidence: 99%

“…Their use is even lower among individuals with type 2 diabetes. One of the key barriers to long‐term adoption of CGM technology has been tiredness of use, with patients reporting discontinuation in the first year because of many reasons including perceived inaccuracy (53%), wear discomfort (47%), insertion pain (31%) and skin irritation (41%) …”

Section: Introductionmentioning

confidence: 99%

“…One of the key barriers to long-term adoption of CGM technology has been tiredness of use, with patients reporting discontinuation in the first year because of many reasons including perceived inaccuracy (53%), wear discomfort (47%), insertion pain (31%) and skin irritation (41%). 2 In contrast to the documented benefits of CGM use in adult patients with diabetes, 3,4 studies specifically involving paediatric patients have shown more inconsistent findings. 5 This disparity in benefits may be partly as a result of even more inconsistent use than that observed in adults.…”

mentioning

confidence: 99%

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First assessment of the performance of an implantable continuous glucose monitoring system through 180 days in a primarily adolescent population with type 1 diabetes

Aronson

Abitbol

Tweden

2019

Diabetes Obesity Metabolism

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Aim To investigate the performance of the Eversense XL implantable continuous glucose monitoring (CGM) system through 180 days in a primarily adolescent population with type 1 diabetes (T1D). Materials and methods This prospective, single‐centre, single‐arm, 180‐day study evaluated the effectiveness and safety of the implantable CGM system in Canadian adolescent and adult subjects with T1D. Accuracy measures included mean absolute relative difference (MARD), 15/15% agreement between CGM glucose and blood glucose measured by Yellow Springs Instruments and surveillance error grid analysis. Adolescent subjects received one sensor in the upper arm and adult subjects received one sensor in each upper arm. In‐clinic CGM system accuracy studies were performed every 30 days. The safety assessment included the incidence of adverse events related to either device or the insertion/removal procedure through 180 days. Results Thirty‐six subjects (30 adolescent/6 adult, 13 female/23 male, mean age 17 ± 9.2 years, mean body mass index 22 ± 4 kg/m 2 ) received the CGM system. Overall MARD was 9.4% (95% CI: 8.6%‐10.5%). CGM system agreement at 15/15% (N = 7163) through 60, 120 and 180 days was 82.9% (95% CI: 78.4%‐86.1%), 83.6% (95% CI: 80.4%‐85.7%) and 83.4% (95% CI: 79.7%‐85.5%), respectively. Surveillance error grid analysis showed 98.4% of paired values in clinically acceptable error zones A and B. No insertion/removal or device‐related serious adverse events were reported. Conclusion The Eversense XL CGM system is safe and accurate through 180 days in a primarily adolescent population of subjects with T1D.

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A Glucose Biosensor Based on Phosphorescence Lifetime Sensing and a Thermoresponsive Membrane

Dong

Lomeli

et al. 2022

Macromol. Rapid Commun.

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The adoption of existing continuous glucose monitors (CGMs) is limited by user burden. Herein, a design for a glucose biosensor with the potential for subcutaneous implantation, without the need for a transcutaneous probe or affixed transmitter, is presented. The design is based on the combination of an enzyme‐driven phosphorescence lifetime‐based glucose‐sensing assay and a thermoresponsive membrane anticipated to reduce biofouling. The metalloporphyrin, Pd meso‐tetra(sulfophenyl)‐tetrabenzoporphyrin ([PdPh4(SO3Na)4TBP]3, HULK) as well as glucose oxidase (GOx) are successfully incorporated into the UV‐cured double network (DN) membranes by leveraging electrostatic interactions and covalent conjugation, respectively. The oxygen‐sensitive metalloporphyrin is incorporated at different levels within the DN membranes. These HULK‐containing membranes retain the desired thermosensitivity, as well as glucose diffusivity and primary optical properties of the metalloporphyrin. After subsequently modifying the membranes with GOx, glucose‐sensing experiments reveal that membranes prepared with the lowest GOx level exhibit the expected increase in phosphorescent lifetime for glucose concentrations up to 200 mg dL−1. For membranes prepared with relatively higher GOx, oxygen‐limited behavior is considered the source of diminished sensitivity at higher glucose levels. This proof‐of‐concept study demonstrates the promising potential of a biosensor design integrating a specific optical biosensing chemistry into a thermoresponsive hydrogel membrane.

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Adoption Barriers for Continuous Glucose Monitoring and Their Potential Reduction With a Fully Implanted System: Results From Patient Preference Surveys

Cited by 57 publications

References 28 publications

Accuracy of a Factory-Calibrated, Real-Time Continuous Glucose Monitoring System During 10 Days of Use in Youth and Adults with Diabetes

Accuracy of a Factory-Calibrated, Real-Time Continuous Glucose Monitoring System During 10 Days of Use in Youth and Adults with Diabetes

First assessment of the performance of an implantable continuous glucose monitoring system through 180 days in a primarily adolescent population with type 1 diabetes

A Glucose Biosensor Based on Phosphorescence Lifetime Sensing and a Thermoresponsive Membrane

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