title: Performance evaluation of a continuous glucose monitoring system under conditions similar to daily life.
abstract: BACKGROUND
  This study aimed at evaluating and comparing the performance of a new generation of continuous glucose monitoring (CGM) system versus other CGM systems, under daily lifelike conditions.
  
  
  METHODS
  A total of 10 subjects (7 female) were enrolled in this study. Each subject wore two Dexcom G4™ CGM systems in parallel for the sensor lifetime specified by the manufacturer (7 days) to allow assessment of sensor-to-sensor precision. Capillary blood glucose (BG) measurements were performed at least once per hour during daytime and once at night. Glucose excursions were induced on two occasions. Performance was assessed by calculating the mean absolute relative difference (MARD) between CGM readings and paired capillary BG readings and precision absolute relative difference (PARD), i.e., differences between paired CGM readings.
  
  
  RESULTS
  Overall aggregate MARD was 11.0% (n = 2392). Aggregate MARD for BG &lt;70 mg/dl was 13.7%; for BG between 70 and 180 mg/dl, MARD was 11.4%; and for BG &gt;180 mg/dl, MARD was 8.5%. Aggregate PARD was 7.3%, improving from 11.6% on day 1 to 5.2% on day 7.
  
  
  CONCLUSIONS
  The Dexcom G4 CGM system showed good overall MARD compared with results reported for other commercially available CGM systems. In the hypoglycemic range, where CGM performance is often reported to be low, the Dexcom G4 CGM system achieved better MARD than that reported for other CGM systems in the hypoglycemic range. In the hyperglycemic range, the MARD was comparable to that reported for other CGM systems, whereas during induced glucose excursions, the MARD was similar or slightly worse than that reported for other CGM systems. Overall PARD was 7.3%, improving markedly with sensor life time.
authors.affiliation: Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany. stefan.pleus@uni-ulm.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Pleus
authors.forename: Christina
authors.initials: C
authors.lastname: Schmid
authors.forename: Manuela
authors.initials: M
authors.lastname: Link
authors.forename: Eva
authors.initials: E
authors.lastname: Zschornack
authors.forename: Hans-Martin
authors.initials: HM
authors.lastname: Klötzer
authors.forename: Cornelia
authors.initials: C
authors.lastname: Haug
authors.forename: Guido
authors.initials: G
authors.lastname: Freckmann
mesh_terms: D000005:Abdomen; D000203:Activities of Daily Living; D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation / Q000379:methods; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006801:Humans; D020007:Implants, Experimental; D055104:Infusions, Subcutaneous; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D050151:Subcutaneous Fat
chemical_list: D001786:Blood Glucose; D007328:Insulin
references.citation: Diabetes Care. 1987 Sep-Oct;10(5):622-8
references.pmid: 3677983
references.citation: Diabetes Technol Ther. 2012 Jun;14(6):527-32
references.pmid: 22428621
references.citation: Diabet Med. 2011 Oct;28(10):1158-67
references.pmid: 21294770
references.citation: Diabetes Care. 2005 Oct;28(10):2412-7
references.pmid: 16186272
references.citation: Diabetes Technol Ther. 2011 Nov;13(11):1129-34
references.pmid: 21827318
references.citation: Diabetes Care. 2013 Apr;36(4):793-800
references.pmid: 23172973
references.citation: J Diabetes Sci Technol. 2013 Jul 01;7(4):842-53
references.pmid: 23911165
references.citation: Diabetes Technol Ther. 2009 Nov;11(11):689-95
references.pmid: 19905884
references.citation: Diabetes Care. 2006 Dec;29(12):2644-9
references.pmid: 17130198
references.citation: Diabetes Technol Ther. 2008 Aug;10(4):266-72
references.pmid: 18828242
references.citation: N Engl J Med. 2010 Jul 22;363(4):311-20
references.pmid: 20587585
references.citation: Diabetes Care. 2011 Nov;34(11):2403-5
references.pmid: 21933908
references.citation: Diabetes Obes Metab. 2013 Feb;15(2):130-5
references.pmid: 22974231
references.citation: Diabetes Care. 2013 Feb;36(2):251-9
references.pmid: 23275350
references.citation: Diabetes Care. 2006 Jan;29(1):44-50
references.pmid: 16373894
references.citation: J Diabetes Sci Technol. 2009 Sep 01;3(5):1146-54
references.pmid: 20144429
references.citation: J Diabetes Sci Technol. 2012 Sep 01;6(5):1103-6
references.pmid: 23063036
references.citation: Diabetes Technol Ther. 2009 Feb;11(2):65-72
references.pmid: 19243265
references.citation: J Diabetes Sci Technol. 2011 Jul 01;5(4):853-9
references.pmid: 21880226
references.citation: Diabetes Care. 2008 Jun;31(6):1160-4
references.pmid: 18339974
references.citation: Diabetes Technol Ther. 2009 Dec;11(12):749-55
references.pmid: 20001675
references.citation: Diabetes Care. 2007 May;30(5):1125-30
references.pmid: 17337488
references.citation: J Diabetes Sci Technol. 2008 May;2(3):484-9
references.pmid: 19885215
references.citation: Diabet Med. 2009 Jul;26(7):714-21
references.pmid: 19573121
references.citation: Diabetes Technol Ther. 2008 Oct;10(5):385-90
references.pmid: 18715215
references.citation: Diabetes Care. 2007 Jan;30(1):59-64
references.pmid: 17192334
references.citation: J Diabetes Sci Technol. 2010 Sep 01;4(5):1182-92
references.pmid: 20920438
references.citation: J Diabetes Sci Technol. 2013 Jul 01;7(4):824-32
references.pmid: 23911163