Redundancy in Glucose Sensing: Enhanced Accuracy and Reliability of an Electrochemical Redundant Sensor for Continuous Glucose Monitoring.
Current electrochemical glucose sensors use a single electrode. Multiple electrodes (redundancy) may enhance sensor performance. We evaluated an electrochemical redundant sensor (ERS) incorporating two working electrodes (WE1 and WE2) onto a single subcutaneous insertion platform with a processing algorithm providing a single real-time continuous glucose measure.



Twenty-three adults with type 1 diabetes each wore two ERSs concurrently for 168 hours. Post-insertion a frequent sampling test (FST) was performed with ERS benchmarked against a glucose meter (Bayer Contour Link). Day 4 and 7 FSTs were performed with a standard meal and venous blood collected for reference glucose measurements (YSI and meter). Between visits, ERS was worn with capillary blood glucose testing ≥8 times/day. Sensor glucose data were processed prospectively.



Mean absolute relative deviation (MARD) for ERS day 1-7 (3,297 paired points with glucose meter) was (mean [SD]) 10.1 [11.5]% versus 11.4 [11.9]% for WE1 and 12.0 [11.9]% for WE2; P < .0001. ERS Clarke A and A+B were 90.2% and 99.8%, respectively. ERS day 4 plus day 7 MARD (1,237 pairs with YSI) was 9.4 [9.5]% versus 9.6 [9.7]% for WE1 and 9.9 [9.7]% for WE2; P = ns. ERS day 1-7 precision absolute relative deviation (PARD) was 9.9 [3.6]% versus 11.5 [6.2]% for WE1 and 10.1 [4.4]% for WE2; P = ns. ERS sensor display time was 97.8 [6.0]% versus 91.0 [22.3]% for WE1 and 94.1 [14.3]% for WE2; P < .05.



Electrochemical redundancy enhances glucose sensor accuracy and display time compared with each individual sensing element alone. ERS performance compares favorably with 'best-in-class' of non-redundant sensors.
Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Australia Department of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, Australia.
Amin
A
Sharifi
Sensor R & D, Medtronic Diabetes, Northridge, CA, USA.
Andrea
A
Varsavsky
Sensor R & D, Medtronic Diabetes, Northridge, CA, USA.
Johanna
J
Ulloa
Department of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, Australia.
Jodie C
JC
Horsburgh
Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Australia Department of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, Australia.
Sybil A
SA
McAuley
Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Australia.
Balasubramanian
B
Krishnamurthy
Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Australia Department of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, Australia NHMRC Clinical Trials Centre, Sydney, Australia.
Alicia J
AJ
Jenkins
Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Australia.
Peter G
PG
Colman
Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Australia.
Glenn M
GM
Ward
Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Australia Department of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, Australia.
Richard J
RJ
MacIsaac
Sensor R & D, Medtronic Diabetes, Northridge, CA, USA.
Rajiv
R
Shah
Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Australia Department of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, Australia dno@unimelb.edu.au.
David N
DN
O'Neal
D000328:Adult; D000465:Algorithms; D015374:Biosensing Techniques / Q000295:instrumentation; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation*; D002138:Calibration; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D004567:Electrodes, Implanted; D004867:Equipment Design; D005260:Female; D006801:Humans; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose
accuracy; continuous glucose sensor; electrochemical redundant sensor; glucose oxidase; precision; reliability