Poor agreement of computerized calculators for mean amplitude of glycemic excursions.

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 operator-dependent and time-consuming for analysis of continuous glucose monitoring data. Therefore, several computer software programs have been developed for the automated calculation of MAGE. The aim of our study was to evaluate the agreement of currently available MAGE calculators when applied to the same set of continuous glucose monitoring (CGM) traces. MATERIALS AND METHODS:Four software programs for calculation of MAGE were identified and used to calculate MAGE of 21 CGM traces from seven patients with type 1 diabetes. Subsequently, the median MAGE per calculator was calculated. The correlation between the MAGE calculators was evaluated by Spearman's correlation analysis. Between-group comparison was performed using analysis of variance. RESULTS:The median MAGE (interquartile range) per calculator was 8.7 (7.1-10.7), 6.7 (5.5-8.6), 6.7 (5.2-8.6), and 5.8 (4.3-7.1), which was statistically different overall (P<0.001). The correlation coefficients between the calculators ranged from 0.787 to 0.999. CONCLUSIONS:Available computer programs developed to calculate MAGE show varying agreement. Although software programs for the calculation of MAGE would seem attractive to assess glucose variability, their use has limitations by different outcomes, in the absence of a gold standard.

journal_name

Diabetes Technol Ther

authors

Sechterberger MK,Luijf YM,Devries JH

doi

10.1089/dia.2013.0138

subject

Has Abstract

pub_date

2014-02-01 00:00:00

pages

72-5

issue

2

eissn

1520-9156

issn

1557-8593

journal_volume

16

pub_type

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