Extensive Assessment of Blood Glucose Monitoring During Postprandial Period and Its Impact on Closed-Loop Performance. (November 2017)

• Record Type: Journal Article
• Authors: Biagi, Lyvia; Hirata Bertachi, Arthur; Conget, Ignacio; Quirós, Carmen; Giménez, Marga; Ampudia-Blasco, F. Javier; Rossetti, Paolo; Bondia, Jorge; Vehí, Josep
• Is Part Of: Journal of diabetes science and technology. Volume 11:Number 6(2017:Nov.)
• Page Start: 1089
• Page End: 1095
• Publication Date: 2017-11
• Subjects: accuracy -- closed-loop control -- continuous glucose monitoring -- postprandial period -- type 1 diabetes; Diabetes -- Periodicals; Medical technology -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1177/1932296817714272
• Languages: English
• ISSNs: 1932-2968

Abstract

Background: Closed-loop (CL) systems aims to outperform usual treatments in blood glucose control and continuous glucose monitors (CGM) are a key component in such systems. Meals represents one of the main disturbances in blood glucose control, and postprandial period (PP) is a challenging situation for both CL system and CGM accuracy. Methods: We performed an extensive analysis of sensor's performance by numerical accuracy and precision during PP, as well as its influence in blood glucose control under CL therapy. Results: During PP the mean absolute relative difference (MARD) for both sensors presented lower accuracy in the hypoglycemic range (19.4 ± 12.8%) than in other ranges (12.2 ± 8.6% in euglycemic range and 9.3 ± 9.3% in hyperglycemic range). The overall MARD was 12.1 ± 8.2%. We have also observed lower MARD for rates of change between 0 and 2 mg/dl. In CL therapy, the 10 trials with the best sensor spent less time in hypoglycemia (PG < 70 mg/dl) than the 10 trials with the worst sensors (2 ± 7 minutes vs 32 ± 38 minutes, respectively). Conclusions: In terms of accuracy, our results resemble to previously reported. Furthermore, our results showed that sensors with the lowest MARD spent less time in hypoglycemic range, indicating that the performance of CL algorithm to control PP was related to sensor accuracy.