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Continuous glucose monitoring in subjects with type 1 diabetes: improvement in accuracy by correcting for background
Joseph El Youssef1, Jessica R Castle, Julia M Engle
1Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
Background:
A cause of suboptimal accuracy in amperometric glucose sensors is the presence of a background current (current produced in the absence of glucose) that is not accounted for. We hypothesized that a mathematical correction for the estimated background current of a commercially available sensor would lead to greater accuracy compared to a situation in which we assumed the background current to be zero. We also tested whether increasing the frequency of sensor calibration would improve sensor accuracy.
Methods:
This report includes analysis of 20 sensor datasets from seven human subjects with type 1 diabetes. Data were divided into a training set for algorithm development and a validation set on which the algorithm was tested. A range of potential background currents was tested.
Results:
Use of the background current correction of 4 nA led to a substantial improvement in accuracy (improvement of absolute relative difference or absolute difference of 3.5-5.5 units). An increase in calibration frequency led to a modest accuracy improvement, with an optimum at every 4 h.
Conclusions:
Compared to no correction, a correction for the estimated background current of a commercially available glucose sensor led to greater accuracy and better detection of hypoglycemia and hyperglycemia. The accuracy-optimizing scheme presented here can be implemented in real time.
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