Agreement between glucose trends derived from three simultaneously worn continuous glucose sensors

Area of Science:

• Biomedical Engineering
• Medical Device Technology
• Diabetes Technology

Background:

• Continuous glucose monitoring (CGM) sensors are crucial for tracking glucose trends.
• Sensor accuracy and reproducibility are vital for reliable diabetes management.
• Evaluating agreement between multiple CGM sensors is essential for clinical utility.

Purpose of the Study:

• To assess the agreement between simultaneously worn CGM sensors.
• To investigate the impact of different trend analysis methods on sensor agreement.
• To determine how glucose rate of change affects sensor data concordance.

Main Methods:

• Simultaneous wear of three CGMS Gold sensors in ten insulin pump-treated type 1 diabetic subjects.
• Sensors placed on the right abdomen (reference), left abdomen, and left upper arm.
• Data analysis included calibration, chronological alignment, and 24-hour simultaneous data acquisition.

Main Results:

• Improving trend analysis duration from 5 to 60 minutes enhanced sensor agreement.
• A 20-minute rolling average trend analysis achieved 94.3% agreement.
• The 'best of two' comparator sensor rolling average trend analysis improved agreement to 98.2%.
• Sensor agreement decreased significantly when the absolute rate of glucose change exceeded 1 mg/dl/min.

Conclusions:

• Trend agreement between multiple CGM sensors is inversely related to the rate of glucose change.
• Advanced trend analysis methods can improve sensor concordance, but limitations exist during rapid glucose fluctuations.
• Clinical interpretation of CGM data requires consideration of glucose variability and sensor performance limitations.