title: Analysis of continuous glucose monitoring data from non-diabetic and diabetic children: a tale of two algorithms.
abstract: Use of the Medtronic MiniMed Continuous Glucose Monitoring System (CGMS) in non-diabetic children has revealed many low and high sensor glucose (SG) values, suggesting that the original analytical algorithm (Solutions 2.0) might be overreading glycemic excursions. A revised algorithm (Solutions 3.0) was introduced in 2001. Our aim was to compare analyses of the same sensor profiles using both programs. Twenty-five lean, non-diabetic subjects (mean age 14 +/- 4 years) underwent continuous glucose monitoring with CGMS for up to 72 h. Sensor tracings were analyzed with both algorithms and compared. Separate analyses were performed for nocturnal readings (12-6 a.m.). Mean SG values were similar (103 +/- 24 mg/dL for version 2.0 vs. 100 +/- 14 for version 3.0), but the distribution was significantly different: 13.8% of total SG were <70 mg/dL by version 2.0 versus 8.2% by version 3.0 (p < 0.001), and 7.7% of total SG were >150 mg/dL by version 2.0 versus 4.7% by version 3.0 (p = 0.02). Of nocturnal SG values, 25.8% were <70 mg/dL by version 2.0 compared with 17.9% by version 3.0, and 9.4% were >150 mg/dL by version 2.0 compared with 4.0% by version 3.0. In lean non-diabetic children, Solutions 2.0 identified significantly more hypoglycemia and hyperglycemia than Solutions 3.0. Similar analyses in 40 children with type 1 diabetes revealed no significant differences. Solutions 3.0 may be a more useful algorithm for preventing over-reading of low and high SG readings in non-diabetic children, whereas both algorithms give similar results in children with diabetes.
authors.affiliation: Department of Pediatrics and Children's Clinical Research Center, Yale University School of Medicine, New Haven, Connecticut 06520, USA. stuart.weinzimer@yale.edu
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Weinzimer
authors.forename: Maria C
authors.initials: MC
authors.lastname: DeLucia
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Boland
authors.forename: Amy
authors.initials: A
authors.lastname: Steffen
authors.forename: William V
authors.initials: WV
authors.lastname: Tamborlane
mesh_terms: D000293:Adolescent; D000465:Algorithms; D001786:Blood Glucose / Q000378:metabolism*; D002138:Calibration; D002648:Child; D003237:Connecticut; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory / Q000379:methods*; D044469:Racial Groups; D012016:Reference Values
chemical_list: D001786:Blood Glucose