Hypoglycemic Accuracy and Improved Low Glucose Alerts of the Latest Dexcom G4 Platinum Continuous Glucose Monitoring System
Hypoglycemic Accuracy and Improved Low Glucose Alerts of the Latest Dexcom G4 Platinum Continuous Glucose Monitoring System
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DOI：
10.1089/dia.2014.0415
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发表时间：
2015-08-01
影响因子：
5.4
通讯作者：
Balo, Andrew
中科院分区：
文献类型：
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作者：
Peyser, Thomas A.;Nakamura, Katherine;Balo, Andrew
目的：连续血糖监测(CGM)设备对低血糖的准确性一直是该技术的一个被广泛报道的缺点。我们报告了一种新版本的Dexcom(加利福尼亚州圣地亚哥)G4白金CGM系统(软件505)在低血糖方面的准确性，并提供了关于CGM低血糖警报的最佳设置的结果。材料和方法：CGM值与YSI分析仪(YSI生命科学，黄泉，俄亥俄州)每15分钟测量一次。我们使用标准指标回顾了CGM系统在低血糖范围内的准确性。我们分析了CGM系统检测生化低血糖(70 mg/dL)所需的时间，并与警报设置为70 mg/dL和80 mg/dL的YSI进行了比较。我们还分析了从YSI值超过55 mg/dL(定义为低血糖导致认知损害的阈值)到CGM系统发出低血糖警报的时间。结果：血糖水平低于70 mg/dL的平均绝对差值为6 mg/dL。96%的CGM值在20 mg/dL以内，YSI值在40-80 mg/dL之间。当CGM降糖警报设置为80 mg/dL时，95%的患者在10分钟内发出生化低血糖警报，91%的患者在认知障碍阈值之前至少提前10分钟发出警报。结论：在G4白金(软件505)上使用80 mg/dL的低血糖警报阈值设置可以在认知障碍发生之前及时发出低血糖警报，使他们能够用快速作用碳水化合物治疗自己的低血糖，并预防与极低血糖水平相关的神经性低血糖。
Objective: Accuracy of continuous glucose monitoring (CGM) devices in hypoglycemia has been a widely reported shortcoming of this technology. We report the accuracy in hypoglycemia of a new version of the Dexcom (San Diego, CA) G4 Platinum CGM system (software 505) and present results regarding the optimum setting of CGM hypoglycemic alerts.Materials and Methods: CGM values were compared with YSI analyzer (YSI Life Sciences, Yellow Springs, OH) measurements every 15min. We reviewed the accuracy of the CGM system in the hypoglycemic range using standard metrics. We analyzed the time required for the CGM system to detect biochemical hypoglycemia (70mg/dL) compared with the YSI with alert settings at 70 mg/dL and 80 mg/dL. We also analyzed the time between the YSI value crossing 55 mg/dL, defined as the threshold for cognitive impairment due to hypoglycemia, and when the CGM system alerted for hypoglycemia.Results: The mean absolute difference for a glucose level of less than 70mg/dL was 6 mg/dL. Ninety-six percent of CGM values were within 20 mg/dL of the YSI values between 40 and 80 mg/dL. When the CGM hypoglycemic alert was set at 80 mg/dL, the device provided an alert for biochemical hypoglycemia within 10 min in 95% of instances and at least a 10-min advance warning before the cognitive impairment threshold in 91% of instances in the study.Conclusions: Use of an 80 mg/dL threshold setting for hypoglycemic alerts on the G4 Platinum (software 505) may provide patients with timely warning of hypoglycemia before the onset of cognitive impairment, enabling them to treat themselves for hypoglycemia with fast-acting carbohydrates and prevent neuroglycopenia associated with very low glucose levels.