Within-Person and Between-Sensor Variability in Continuous Glucose Monitoring Metrics

Author:

Selvin Elizabeth12ORCID,Wang Dan12,Rooney Mary R12ORCID,Fang Michael12,Echouffo-Tcheugui Justin B23,Zeger Scott24,Sartini Joseph24,Tang Olive125,Coresh Josef12,Nisha Aurora R6,Punjabi Naresh M7

Affiliation:

1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD , USA

2. Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University , Baltimore, MD , USA

3. Division of Endocrinology, Diabetes Metabolism, Department of Medicine, Johns Hopkins School of Medicine , Baltimore, MD , USA

4. Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD , USA

5. Johns Hopkins School of Medicine , Baltimore, MD , USA

6. Department of Medicine, Rutgers Robert Wood Johnson Medical School , New Brunswick, NJ , USA

7. Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami, Miller School of Medicine , Miami, FL , USA

Abstract

Abstract Background The within-person and between-sensor variability of metrics from different interstitial continuous glucose monitoring (CGM) sensors in adults with type 2 diabetes not taking insulin is unclear. Methods Secondary analysis of data from 172 participants from the Hyperglycemic Profiles in Obstructive Sleep Apnea randomized clinical trial. Participants simultaneously wore Dexcom G4 and Abbott Libre Pro CGM sensors for up to 2 weeks at baseline and again at the 3-month follow-up visit. Results At baseline (up to 2 weeks of CGM), mean glucose for both the Abbott and Dexcom sensors was approximately 150 mg/dL (8.3 mmol/L) and time in range (70180 mg/dL [3.910.0 mmol/L]) was just below 80. When comparing the same sensor at 2 different time points (two 2-week periods, 3 months apart), the within-person coefficient of variation (CVw) in mean glucose was 17.4 (Abbott) and 14.2 (Dexcom). CVw for percent time in range: 20.1 (Abbott) and 18.6 (Dexcom). At baseline, the Pearson correlation of mean glucose from the 2 sensors worn simultaneously was r 0.86, root mean squared error (RMSE), 13 mg/dL (0.7 mmol/L); for time in range, r 0.88, RMSE, 8 percentage points. Conclusions Substantial variation was observed within sensors over time and across 2 different sensors worn simultaneously on the same individuals. Clinicians should be aware of this variability when using CGM technology to make clinical decisions. ClinicalTrials.gov Identifier: NCT02454153.

Funder

NIH

NHLBI

NIDDK

Publisher

Oxford University Press (OUP)

Subject

Biochemistry (medical),Clinical Biochemistry

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