The Impact of Interfering Substances on Continuous Glucose Monitors: Part 4: Continuous Glucose Monitoring...

Presented is a series of narrative reviews that summarize published information regarding the effect or potential effect of interfering substances on the accuracy of continuous glucose monitoring (CGM) devices. Whilst drawing together what is currently known regarding this topic, the future direction in this field and clinical implications posed by polypharmacy on CGM performance are considered. This fourth and final in this series of articles reviews the following topics: the benefits and drawbacks of conducting interfering substance studies in vitro versus in vivo; the balance between the cost and complexity of undertaking in vitro or in vivo studies to screen for potential interferences versus the clinical relevance of the findings; clinical factors influencing interferent behavior on CGM performance (pharmacokinetics and polypharmacy considerations); the need for standardization, including consideration of the metrological traceability of CGM readings, establishment of CGM analytical performance metrics and standardized CGM assessment procedures for measuring interferents.