Research Article
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Published Online: 9 July 2012

Influence of Time Point of Calibration on Accuracy of Continuous Glucose Monitoring in Individuals with Type 1 Diabetes

Publication: Diabetes Technology & Therapeutics
Volume 14, Issue Number 7

Abstract

Background and Aims: Data on the influence of calibration on accuracy of continuous glucose monitoring (CGM) are scarce. The aim of the present study was to investigate whether the time point of calibration has an influence on sensor accuracy and whether this effect differs according to glycemic level.
Subjects and Methods: Two CGM sensors were inserted simultaneously in the abdomen on either side of 20 individuals with type 1 diabetes. One sensor was calibrated predominantly using preprandial glucose (calibrationPRE). The other sensor was calibrated predominantly using postprandial glucose (calibrationPOST). At minimum three additional glucose values per day were obtained for analysis of accuracy. Sensor readings were divided into four categories according to the glycemic range of the reference values (low, ≤4 mmol/L; euglycemic, 4.1–7 mmol/L; hyperglycemic I, 7.1–14 mmol/L; and hyperglycemic II, >14 mmol/L).
Results: The overall mean±SEM absolute relative difference (MARD) between capillary reference values and sensor readings was 18.3±0.8% for calibrationPRE and 21.9±1.2% for calibrationPOST (P<0.001). MARD according to glycemic range was 47.4±6.5% (low), 17.4±1.3% (euglycemic), 15.0±0.8% (hyperglycemic I), and 17.7±1.9% (hyperglycemic II) for calibrationPRE and 67.5±9.5% (low), 24.2±1.8% (euglycemic), 15.5±0.9% (hyperglycemic I), and 15.3±1.9% (hyperglycemic II) for calibrationPOST. In the low and euglycemic ranges MARD was significantly lower in calibrationPRE compared with calibrationPOST (P=0.007 and P<0.001, respectively).
Conclusions: Sensor calibration predominantly based on preprandial glucose resulted in a significantly higher overall sensor accuracy compared with a predominantly postprandial calibration. The difference was most pronounced in the hypo- and euglycemic reference range, whereas both calibration patterns were comparable in the hyperglycemic range.

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cover image Diabetes Technology & Therapeutics
Diabetes Technology & Therapeutics
Volume 14Issue Number 7July 2012
Pages: 583 - 588
PubMed: 22512266

History

Published online: 9 July 2012
Published in print: July 2012
Published ahead of print: 18 April 2012

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Thomas Zueger
Division of Endocrinology, Diabetes and Clinical Nutrition, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Peter Diem
Division of Endocrinology, Diabetes and Clinical Nutrition, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Stavroula Mougiakakou
Artificial Organ Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Christoph Stettler
Division of Endocrinology, Diabetes and Clinical Nutrition, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.

Notes

Address correspondence to:Christoph Stettler, M.D.Division of Endocrinology, Diabetes and Clinical NutritionInselspitalCH-3010 Bern,Switzerland
E-mail: [email protected]
This work was presented in a poster session at the 47th annual meeting of the European Association for the Study of Diabetes in 2011 in Lisbon, Portugal.
This study is registered at www.trialregister.nl with Clinical Trial Registration Number NTR863.

Author Disclosure Statement

No competing financial interests exist.

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