Performance of three different continuous glucose monitoring systems in children with type 1 diabetes during a diabetes summer camp

Abstract

The aim of this study was to assess accuracy of the three most commonly used continuous glucose monitoring (CGM) systems in almost real‐life situation during a diabetes camp in children with type 1 diabetes (T1D) aged 9–14 years. Data was gathered during a 2‐week summer camp under physicians' supervision. Out of 38 participating children with T1D (aged: 11.0 [9.9; 12.1] years; 57% girls, mean HbA1c 7.2 [6.9; 7.7] %,) 37 wore a CGM system (either Abbott FreeStyle Libre (FSL), Dexcom G6 (DEX) or Medtronic Enlite (ENL)) throughout the camp. All concomitantly available data pairs of capillary glucose measurements and sensor values were used for the analysis. Mean absolute relative difference (MARD) was calculated and Parkes Error Grid analyses were done for all three systems used. In total 2079 data pairs were available for analysis. The overall MARDs of CGM systems used at the camp was FSL: 13.3% (6.7;21.6). DEX: 10.3% (5.8; 16.7) and ENL 8.5% (3.6; 15.6). During eu‐, hypo‐ and hyperglycemia MARDs were lowest in ENL. Highest MARDs were seen in hypoglycemia, where all three systems exhibited MARDs above 15%. Overnight MARDs of all systems was higher than during daytime. All sensors performed worst in hypoglycemia. Performance of the adequately calibrated Medtronic system outperformed the factory‐calibrated sensors. For clinical practice, it is important to adequately train children with T1D and families in the correct procedures for sensors that require calibrations.

Evaluation of a continuous glucose monitoring system in neonatal foals

“…27 Thus, it is likely that the CGMS would perform within hypoglycemic ranges in foals (reportable glucose range of the device is 40-400 mg/dL), but this supposition will need to be confirmed in future studies of foals because another study in children observed better performance of the Dexcom G6 in the normoglycemic range compared to hypoglycemic measurements. 30 In summary, the CGMS provided accurate and immediate glucose concentration results within the glucose concentrations observed in our study. Further evaluation is necessary in hypoglycemic neonatal foals, but the CGMS might serve as a method of evaluating glucose concentration in hospitalized ill foals while eliminating the need for repeated blood collection from patients.…”

“… 27 Thus, it is likely that the CGMS would perform within hypoglycemic ranges in foals (reportable glucose range of the device is 40‐400 mg/dL), but this supposition will need to be confirmed in future studies of foals because another study in children observed better performance of the Dexcom G6 in the normoglycemic range compared to hypoglycemic measurements. 30 …”

“…However, in a large study involving 262 diabetic people (children to senior adults) evaluating 21 569 matched paired measurements, the Dexcom G6 provided accurate glucose measurements when blood glucose concentrations ranged from <54 mg/dL to >250 mg/dL 27 . Thus, it is likely that the CGMS would perform within hypoglycemic ranges in foals (reportable glucose range of the device is 40‐400 mg/dL), but this supposition will need to be confirmed in future studies of foals because another study in children observed better performance of the Dexcom G6 in the normoglycemic range compared to hypoglycemic measurements 30 …”

The beneficial effects of closed‐loop insulin delivery in patients with highly unstable type 1 diabetes eligible for islet transplantation are maintained over 6 months: An extension study of the DBLHU‐WP10 trial

“…Of note, using two different brands of sensor between the experimental and control phases, with different accuracy, could have introduced a bias to the outcomes. 15 Overall, our extension study provides a strong argument for proposing the use of DBLHU in all T1D patients with severe clinical and metabolic features indicating an islet or pancreas transplantation.…”

Association Between Time in Range and HbA1c in Japanese Patients With Type 2 Diabetes Mellitus

“…So the difference in the sensor used may have been related. Howard R et al reported that FLP-CGM tended to produce lower mean blood glucose levels than Dexcom G4 Platinum 18 , and Nagl K et al reported that FLP-CGM had a greater mean absolute relative difference (MARD) and lower mean glucose levels than Dexcom G6 and Medtronic Enlite19 . Third, the subjects of this study were Japanese patients with T2DM, and racial differences may also be relevant.…”