Reproducibility of glucose measurements using the glucose sensor.
OBJECTIVE
Recent studies have confirmed that improved glycemic control decreases the risk of diabetic complications in type 1 and type 2 diabetic patients. The Minimed glucose sensor allows continuous 72-h glucose monitoring and represents a potentially important tool to improve diabetes management. Its use is currently limited to the health care team. Our aim was to evaluate the reproducibility of data provided by the device by comparing data provided by two sensors worn simultaneously by the same subject.


METHODS
A total of 11 subjects (6 type 1 and 3 type 2 diabetic patients and 2 healthy subjects) agreed to wear two sensors and perform at least four daily finger-stick glucose determinations during 72 h. The simultaneous glucose values provided by the sensors were compared. To determine the clinical implications of the glucose data, each day was divided into eight periods, and for each period the glucose range was rated as satisfactory, too high, or too low by a blinded clinician experienced in interpreting glucose sensor data in the clinical setting. The evaluation of glycemic levels based on the recordings of the two sensors were compared for each paired time interval.


RESULTS
We discarded 18% of the sensor data for technical reasons. Examined as a group, the remaining 3,370 paired data points in all 11 patients were highly correlated (r = 0.84). However, when individual pairs were evaluated, large differences in the glucose values were apparent, with differences of >10% in 70% of the measurements and >50% in 7% of the measurements. Moreover, clinical evaluation of the glucose range provided simultaneously by two sensors was concordant for only 65% of the evaluation periods.


CONCLUSIONS
In a real-life setting, the accuracy of data provided by the Minimed glucose sensor may be less than expected. To avoid therapeutic errors, sensor findings should be confirmed by independent means before clinical decisions are made.
Metzger
Muriel
M
Diabetes Center, Endocrinology and Metabolism Service, Hadassah University Hospital, Jerusalem, Israel. muriel@hadassah.org.il
Leibowitz
Gil
G
Wainstein
Julio
J
Glaser
Benjamin
B
Raz
Itamar
I
D001786:Blood Glucose / Q000032:analysis* / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring / Q000592:standards*; D002138:Calibration; D002940:Circadian Rhythm; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D006801:Humans; D018670:Monitoring, Ambulatory / Q000379:methods; D015588:Observer Variation; D012016:Reference Values; D012044:Regression Analysis; D015203:Reproducibility of Results
D001786:Blood Glucose