Evaluation of factors affecting CGMS calibration.
Evaluation of factors affecting CGMS calibration.
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影响 CGMS 校准因素的评估。
DOI：
10.1089/dia.2006.8.318
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发表时间：
2006
影响因子：
5.4
通讯作者：
Tamborlane,
中科院分区：
文献类型：
--
作者：
DiabetesResearchInChildrenNetwork(Direcnet)StudyGroup;Buckingham,BruceA;Kollman,Craig;Beck,Roy;Kalajian,Andrea;Fiallo-Scharer,Rosanna;Tansey,MichaelJ;Fox,LarryA;Wilson,DarrellM;Weinzimer,StuartA;Ruedy,KatrinaJ;Tamborlane,
背景：进入CGMS®（美敦力MiniMed， Northridge， CA）连续血糖监测系统的校准的最佳次数/时间以前没有描述过。方法：50例1型糖尿病患者（10-18岁）在临床研究中心住院治疗~ 24小时（2天）。获得CGMS和OneTouch®Ultra®仪表（LifeScan, Milpitas， CA）数据。利用Ultra数据，改变校准的次数和时间，回顾性地重新校准CGMS。将所得的CGMS值与实验室参考值进行比较。结果：随着校准次数的增加，准确度有适度的提高。当使用3、4、5和7个校准值时，中位相对绝对偏差（RAD）分别为14%、15%、13%和13% （P< 0.001）。相应的cgms -参考对符合国际标准化组织标准的百分比分别为66%、67%、71%和72% （P< 0.001）。当白天的校准（午餐前和晚餐前）被删除后，夜间的精度得到了提高，只留下晚上9点和早上6点的两次校准。（中位差，- 2 vs - 9 mg/dL，P< 0.001；中位RAD， 12% vs. 15%，P= 0.001）。在校准时葡萄糖变化的平均绝对速率较低的访问中，准确性较好。在平均绝对比率<0.5、0.5至<1.0、1.0至<1.5和≥1.5 mg/dL/min时，中位RAD值分别为13%对14%、17%对19% （P= 0.05）。结论：虽然准确度随校准次数的增加而略有提高，但校准的时机显得更为重要。修改算法以减少对夜间值的白天校准的权重，并在葡萄糖相对稳定的时间进行校准，可能会对准确性产生更大的影响。
Background: The optimal number/timing of calibrations entered into the CGMS®(Medtronic MiniMed, Northridge, CA) continuous glucose monitoring system have not been previously described.Methods: Fifty subjects with Type 1 diabetes mellitus (10–18 years old) were hospitalized in a clinical research center for ∼ 24 h on two separate days. CGMS and OneTouch®Ultra®meter (LifeScan, Milpitas, CA) data were obtained. The CGMS was retrospectively recalibrated using the Ultra data varying the number and timing of calibrations. Resulting CGMS values were compared against laboratory reference values.Results: There was a modest improvement in accuracy with increasing number of calibrations. The median relative absolute deviation (RAD) was 14%, 15%, 13%, and 13% when using three, four, five, and seven calibration values, respectively (P< 0.001). Corresponding percentages of CGMS–reference pairs meeting the International Organisation for Standardisation criteria were 66%, 67%, 71%, and 72% (P< 0.001). Nighttime accuracy improved when daytime calibrations (pre-lunch and pre-dinner) were removed leaving only two calibrations at 9 p.m. and 6 a.m. (median difference, −2 vs. −9 mg/dL,P< 0.001; median RAD, 12% vs. 15%,P= 0.001). Accuracy was better on visits where the average absolute rate of glucose change at the times of calibration was lower. On visits with average absolute rates <0.5, 0.5 to <1.0, 1.0 to <1.5, and ≥1.5 mg/dL/min, median RAD values were 13% versus 14% versus 17% versus 19%, respectively (P= 0.05).Conclusions: Although accuracy is slightly improved with more calibrations, the timing of the calibrations appears more important. Modifying the algorithm to put less weight on daytime calibrations for nighttime values and calibrating during times of relative glucose stability may have greater impact on accuracy.