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Updated: Jan 24, 2026

Simple Continuous Glucose Monitoring in Freely Moving Mice
Published on: February 24, 2023
Simple Post-Processing of Continuous Glucose Monitoring Measurements Improves Endpoints in Clinical Trials
Morten Hasselstrøm Jensen1,2, Claus Dethlefsen3, Ole Hejlesen2
1Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.
Background:
Continuous glucose monitoring (CGM) is a powerful tool to be considered both in clinical practice and clinical trials. However, CGM has been criticized for being inaccurate for many reasons including a physiological delay. This study sought to investigate the current delay issue and propose a simple post-processing procedure.
Method:
More than a million hours of the Dexcom G4 CGM from 472 subjects investigated in a state-of-the-art clinical trial were analyzed by time shifting the CGM measurements and comparing them to plasma glucose (PG) measurements. The resultant CGM measurements were then assessed in relation to real-world clinical research endpoints.
Results:
A CGM time shift of -9 minutes was optimal and reduced mean absolute relative difference (MARD) statistically significantly with 1.0% point. The MARD reduction resulted in better clinical research endpoints of hypoglycemia and postprandial glucose increments.
Conclusions:
The delay in CGM is still an issue. The delay in this study was identified to be 9 minutes compared to PG. With a simple post-processing approach of time shifting the CGM measurements with -9 minutes, it was possible to obtain a statistically significantly lower MARD and subsequently obtain clinical research endpoints of improved validity.
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