Abstract:
BACKGROUND:This study was designed to assess the accuracy, reliability, and contribution to clinical decision-making of two commercially available continuous glucose monitoring (CGM) devices using a novel analytical approach. STUDY DESIGN:Eleven individuals with type 1 diabetes and five with type 2 diabetes wore a Guardian RT (GRT) (Medtronic Minimed, Northridge, CA) or DexCom STS Continuous Monitoring System (DEX) (San Diego, CA) device for 200 h followed by an 8-h laboratory study. A subset of these subjects wore both devices simultaneously. RESULTS:Subjects produced 1,902 +/- 269 readings during the ambulatory phase. During the laboratory study we found: lag time of 21 +/- 5 min for GRT and 7 +/- 7 min for DEX (P < 0.005); mean absolute relative difference of 19.9% and 16.7%, respectively, for GRT and DEX; and glucose exposure (the ratio of study device/laboratory reference device [YSI Instruments, Inc., Yellow Springs, OH] area under the curve) of 95 +/- 6% for GRT and 101 +/- 13% for DEX. Reliability measured during laboratory study showed 82% for DEX and 99% for GRT. Clarke Error Grid analysis (YSI reference) showed for GRT 59% of values in zone A, 34% in zone B, and 7% in zone D and for DEX 70% in zone A, 28% in zone B, 1% in zone C, and 1% in zone D. Bland-Altman plots (YSI standard) yielded for DEX 3 mg/dL (95% confidence interval, -78 to 84 mg/dL) and for GRT -21 mg/dL (95% confidence interval, -124 to 82 mg/dL). Six of eight subjects completed both home and laboratory simultaneous use of DEX and GRT. Lag times were inconsistent between devices, ranging from 0 to 32 min; area under the curve revealed a tendency for DEX to report higher total glucose exposure than GRT for the same patient. CONCLUSIONS:CGM detects abnormalities in glycemic control in a manner heretofore impossible to obtain. However, our studies revealed sufficient incongruence between simultaneous laboratory blood glucose levels and interstitial fluid glucose (after calibrations) to question the fundamental assumption that interstitial fluid glucose and blood glucose could be made identical by resorting to algorithms based on concurrent blood glucose levels alone.
journal_name
Diabetes Technol Therjournal_title
Diabetes technology & therapeuticsauthors
Mazze RS,Strock E,Borgman S,Wesley D,Stout P,Racchini Jdoi
10.1089/dia.2008.0041subject
Has Abstractpub_date
2009-01-01 00:00:00pages
11-8issue
1eissn
1520-9156issn
1557-8593journal_volume
11pub_type
杂志文章abstract:AIMS:This study assessed patient-reported outcomes in a multicenter study of adults with type 2 diabetes taking mealtime Technosphere(®) inhaled insulin (MannKind Corp., Valencia, CA) and basal insulin (insulin glargine) or premixed aspart insulin 70/30. METHODS:Subjects were 618 non-smoking adults with starting hemog...
journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1089/dia.2011.0037
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:The hyperinsulinemic euglycemic clamp is the gold standard for assessment of insulin resistance and requires frequent, accurate measurements of blood glucose concentrations, typically utilizing the YSI 2300 STAT Plus™ glucose analyzer (YSI, Inc., Yellow Springs, OH). Despite its accuracy, the YSI has several...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2013.0288
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:We sought to cross validate several metrics for quality of glycemic control, hypoglycemia, and hyperglycemia. RESEARCH DESIGN AND METHODS:We analyzed the mathematical properties of several metrics for overall glycemic control, and for hypo- and hyperglycemia, to evaluate their similarities, differences, and ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2017.0416
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Patients undergoing intensive insulin therapy may have blood glucose (BG) samples drawn from arterial, capillary, or venous sources. This study compared capillary and venous BG across a range of glucose concentrations and under conditions of rapid change in BG. METHODS:Following a 10-h fast, 40 adult patien...
journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1089/dia.2009.0023
更新日期:2009-10-01 00:00:00
abstract::This study was designed to determine plasma glucose and insulin levels after administration of three escalating doses of the oral insulin product hexyl-insulin monoconjugate 2 (HIM2) in fasting, insulin-deprived adult patients with type 1 diabetes. The study was also designed to assess the safety of the product. Sixte...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/152091502760306544
更新日期:2002-01-01 00:00:00
abstract:: Background: International consensus on the use of continuous glucose monitoring (CGM) recommends coefficient of variation (CV) as the metric of choice to express glycemic variability (GV) with a cutoff of 36% to define unstable diabetes. Even though, CV is associated with ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2019.0075
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus is rare in young infants and neonates. Continuous subcutaneous insulin infusion (CSII) is used most frequently for insulin treatment in this age group. However, the individual doctor's experience is scarce because of the low prevalence of diabetes in this age. For this study patients treate...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1089/dia.2015.0030
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Continuous glucose monitoring (CGM) and sensor-augmented pump (SAP) therapy improve glucose control provided good adherence. In France, not only diabetologists, nurses, and dieticians but also nurses employed by homecare providers (HCPNs) are together involved in the initiation and/or follow-up of continuous...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1089/dia.2015.0240
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:This study assessed the association of serum adiponectin with carotid intimal medial thickness (IMT) in Asian Indians with different grades of glucose intolerance. METHODS:Subjects with normal glucose tolerance (NGT) (n = 520), impaired glucose tolerance (IGT) (n = 115), and type 2 diabetes mellitus (T2DM) (...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2009.0100
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:The objective of this investigation was to evaluate the test-retest repeatability of insulin sensitivity and secretion indices derived from liquid meal tolerance tests (MTTs) in subjects with normal fasting glucose (NFG) (n = 20), impaired fasting glucose (IFG) (n = 20), or type 2 diabetes mellitus (n = 38)....
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1089/dia.2010.0083
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:To protect against ischemia, pressure-induced vasodilation (PIV) causes an increase in skin blood flow. Endothelial dysfunction, which is commonly found in older patients and those with diabetes, and global temperatures can affect the resting blood flow in skin, which may reduce the blood flow during and aft...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2009.0097
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Faster aspart is insulin aspart (IAsp) in a new formulation, which in continuous subcutaneous insulin infusion (CSII) in subjects with type 1 diabetes has shown a faster onset and offset of glucose-lowering effect than IAsp. METHODS:This double-blind, randomized, crossover active-controlled trial compared 2...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1089/dia.2016.0350
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Glucose variability has been identified as a predictor of hypoglycemia and has been associated with mortality in critically ill patients without diabetes. A popular metric to quantify glucose variability is the mean amplitude of glycemic excursions (MAGE). The "ruler and pencil" approach to calculate MAGE is...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2013.0138
更新日期:2014-02-01 00:00:00
abstract:AIM:To describe the continuous glucose monitoring (CGM) profiles of type 1 diabetes (T1D) offspring in the early neonatal period and its association with maternal intrapartum glucose control. METHODS:A prospective observational study of T1D pregnant women and their neonatal offspring. Women had a CGM sensor inserted 2...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2018.0221
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Patients with diabetes do daily self-monitoring of blood glucose (SMBG). For such patients, we devised an engine that predicts not only the expected blood glucose level at the next meal but also the pending risks of hypoglycemia. The purpose of this study was to validate the predictions and provide evidence ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2005.7.487
更新日期:2005-06-01 00:00:00
abstract:: Background: Continuous glucose monitoring (CGM) is a method of estimating blood glucose values from those recorded in the interstitial fluid. Because increasingly longer CGM measurements are possible, errors and data loss become more and more likely and potentially more da...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2018.0247
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Obesity surgery elicits complex changes in glucose metabolism that are difficult to observe with discontinuous glucose measurements. We aimed to evaluate glucose variability after gastric bypass by continuous glucose monitoring (CGM) in a real-life setting. METHODS:CGM was performed for 4.2 ± 1.3 days in th...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2010.0203
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hyperglycemia occurs commonly in patients admitted to medical intensive care units (MICUs). Whether real-time (RT) continuous glucose monitoring (CGM) improves glycemic control and variability and reduces hypoglycemia in severely ill MICU patients with an Acute Physiology and Chronic Health Eva...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1089/dia.2015.0151
更新日期:2015-12-01 00:00:00
abstract::Rates of diabetes are increasing worldwide and there is not a sufficient clinical workforce to care for these patients. Diabetes-related apps are a feasible way to provide diabetes education to large numbers of people with diabetes but attrition rates are high. Apps enhanced by virtual coaching may be a way to circumn...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2019.0016
更新日期:2019-06-01 00:00:00
abstract::The Exubera system (Pfizer, New York, NY/Nektar Therapeutics, San Carlos, CA) is an integration of five major new technologies: protein formulation, powder processing, powder filling, drug packaging, and delivery device. The product provides a simple interface, where the patient interacts only with the delivery device...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2007.0222
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Diabetes in elderly adults is associated with an increased risk of fall. The aim of study was to determine whether a virtual reality exercise (VRE) program would improve balance, strength, gait, and falls efficacy in elderly adults with diabetes. SUBJECTS AND METHODS:Fifty-five subjects with diabetes mellit...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1089/dia.2013.0050
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Continuous glucose monitoring (CGM) has been shown to be a valuable tool to improve glycemic control in patients with diabetes. The objective of this pilot study was to develop and implement CGM in an existing diabetes clinic for low-income patients on multiple daily injections. SUBJECTS AND METHODS:This wa...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1089/dia.2013.0072
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Relatively little is known about parents' or children's attitudes toward recruitment for, and participation in, studies of new diabetes technologies immediately after diagnosis. This study investigated factors affecting recruitment of participants for studies in newly diagnosed youth with type 1 diabetes. M...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2016.0157
更新日期:2016-09-01 00:00:00
abstract:: Background: The Medtronic MiniMed™ 670G system adjusts basal insulin delivery in response to continuous glucose monitoring levels and is already in use in clinical practice. We tested the home-based feasibility of the new MiniMed advanced hybrid closed-loop (AHCL) system, ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2020.0448
更新日期:2020-12-08 00:00:00
abstract:: Background: We aimed to explore insulin pump settings in breastfeeding women with type 1 diabetes. Methods: Thirteen unselected breastfeeding women with type 1 diabetes on insulin pump therapy were included consecutively from A...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2019.0280
更新日期:2020-04-01 00:00:00
abstract::Hyperspectral imaging (HSI) has been useful in monitoring several medical conditions, which to date have generally involved local changes in skin oxygenation of isolated regions of interest such as skin flaps or small burns. Here, by contrast, we present a study in which HSI was used to assess the local cutaneous mani...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/152091503322527058
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVES:We evaluated patterns of meal intake, insulin bolus delivery, and fingerstick glucose measurements during hybrid closed-loop and sensor-augmented pump (SAP) therapy, including associations with glucose control. METHODS:Data were retrospectively analyzed from pump-treated adults with type 1 diabetes who unde...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1089/dia.2016.0307
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The masked continuous glucose monitoring system (Masked-CGMS) differs from standard CGMSs in three ways: (1) there is no feedback to the user so that no immediate regimen changes can be made; (2) it can only be worn for up to 5 days; and (3) there are no alarms to warn of hyperglycemia or hypoglycemia. Since...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2013.0297
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:Over the past 35 years considerable research has been performed toward the investigation of noninvasive and minimally invasive glucose monitoring techniques. Optical polarimetry is one noninvasive technique that has shown promise as a means to ascertain blood glucose levels through measuring the glucose conce...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2012.0070
更新日期:2012-09-01 00:00:00
abstract::This paper presents a critical review of continuous glucose monitoring studies that address accuracy, utility in assessing glucose variability, detection of hypoglycemia for improved metabolic control or reduced glucose variability, impact on quality of life, reduced fear of hypoglycemia, and applicability in helping ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2007.0261
更新日期:2008-04-01 00:00:00