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Comparing the accuracy of transcutaneous sensor and 90-day implantable glucose sensor
Authors:Federico Boscari  Martina Vettoretti  Anna Maria Letizia Amato  Valeria Vallone  Ambra Uliana  Elisabetta Iori  Angelo Avogaro  Andrea Facchinetti  Daniela Bruttomesso
Institution:1. University of Padova, Department of Medicine (DIMED), Padova, Italy;2. University of Padova, Department of Information Engineering (DEI), Padova, Italy
Abstract:Background and aimsContinuous glucose monitoring improves glycemic control in diabetes. This study compared the accuracy of the Dexcom G5 Mobile (Dexcom, San Diego, CA) transcutaneous sensor (DG5) and the first version of Eversense (Senseonics,Inc., Germantown, MD) implantable sensor (EVS).Methods and resultsSubjects with type 1 diabetes (T1D) and using EVS wore simultaneously DG5 for seven days. At day 3, patients were admitted to a clinical research center (CRC) to receive breakfast with delayed and increased insulin bolus to induce glucose excursions. At CRC, venous glucose was monitored every 15 min (or 5 min during hypoglycemia) for 6 h by YSI 2300 STAT PLUS? glucose and lactate analyzer. At home patients were requested to perform 4 fingerstick glucose measurements per day.Eleven patients (9 males, age 47.4 ± 11.3 years, M±SD) were enrolled. During home-stay the median 25th-75th percentile] absolute relative difference (ARD) over all CGM-fingerstick matched-pairs was 11.64% 5.38–20.65]% for the DG5 and 10.75% 5.15–19.74]% for the EVS (p-value = 0.58). At CRC, considering all the CGM-YSI matched-pairs, the DG5 showed overall smaller median ARD than EVS, 7.91% 4.14–14.30]% vs 11.4% 5.04–18.54]% (p-value<0.001). Considering accuracy during blood glucose swings, DG5 performed better than EVS when glucose rate-of-change was ?0.5 to ?1.5 mg/dL/min, with median ARD of 7.34% 3.71–12.76]% vs 13.59% 4.53–20.78]% (p-value<0.001), and for rate-of-change < -1.5 mg/dl/min, with median ARD of 5.23% 2.09–15.29]% vs 12.73% 4.14–20.82]% (p-value = 0.02).ConclusionsDG5 was more accurate than EVS at CRC, especially when glucose decreased. No differences were found at home.
Keywords:Continuous glucose monitoring  Type 1 diabetes  Accuracy  Hypoglycemia
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