Enhanced algorithm for glucose estimation using the continuous glucose monitoring system

Med Sci Monit. 2010 Jun;16(6):MT51-8.

Abstract

Background: The CGMS Gold continuous glucose monitor presents a problem of lack of accuracy, especially in the lower range, sometimes leading to missed or false alarms. The new algorithm aims to improve the measurement accuracy and hypoglycemia detection.

Material/methods: Twenty-one patients with type 1 diabetes were monitored for 3 days (1 day at the hospital and 2 at home) using the CGMS Gold. For these patients, blood glucose samples were taken every 15 minutes for 2 hours after meals and every half hour otherwise during the first day. A new calibration algorithm was developed and implemented using CGMS Gold intensity readings and capillary glucose.

Results: After 1 day, a comparison of results from either the CGMS Gold algorithm and the proposed algorithm, compared with results from blood (2450 points), showed an increase of data in zone A with the proposed algorithm (4.4% in the Clarke error grid analysis (EGA) and 5.0% in the Consensus EGA). After comparing for 3 days, a reduction of 24.7%, p<0.05, in the overall median relative absolute difference (RAD) was also obtained. In the hypoglycemic range, a significant decrease in median RAD was observed (64.4%, p<0.05). Furthermore, the undetected hypoglycemia events in capillary samples by the proposed algorithm were reduced by 59.8% compared to the CGMS Gold algorithm.

Conclusions: The performance as measured with clinical and numerical accuracy criteria illustrates the improved accuracy of the proposed algorithm in comparison with the CGMS Gold algorithm. A significant improvement in hypoglycemia detection was observed.

MeSH terms

  • Adolescent
  • Adult
  • Algorithms
  • Blood Glucose Self-Monitoring / instrumentation*
  • Blood Glucose Self-Monitoring / methods*
  • Calibration
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / diagnosis
  • Female
  • Gas Chromatography-Mass Spectrometry / methods
  • Glucose / metabolism*
  • Humans
  • Hypoglycemia / pathology
  • Male
  • Models, Biological
  • Models, Statistical
  • Reproducibility of Results

Substances

  • Glucose