Can continuous glucose monitoring systems predict glycemia?

Diabetes Technol Ther. 2012 Nov;14(11):1030-2. doi: 10.1089/dia.2012.0130. Epub 2012 Aug 30.

Abstract

Background: We investigated whether the arrow on a continuous glucose monitoring system (CGMS) screen predicts the course of the capillary glucose level 15 min later.

Subjects and methods: Twenty-three patients with type 1 diabetes (age, 40±13 years; diabetes duration, 19±12 years; hemoglobin A1c, 8.5±1.5%) admitted for education in the use of a CGMS performed 242 observations: the arrow was noted at time 0, and the interstitial and capillary glucose levels were noted at time 0 and 15 min later.

Results: The capillary glucose courses were -15±28 mg/dL after a descending arrow (n=55), +1±23 mg/dL after a stable arrow (n=147) (P<0.001 vs. descending), and +2±23 mg/dL after an ascending arrow (n=40) (P<0.01 vs. descending), with similar findings for the 67 observations after an interstitial glucose level <100 mg/dL. There were 4.5% grossly erroneous arrows: six descending with later increasing and five ascending with later decreasing capillary glucose.

Conclusions: Although there is a large room for improvement, the arrow on the CGMS screen does predict the decline in capillary glucose 15 min later.

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • Blood Glucose Self-Monitoring*
  • Diabetes Mellitus, Type 1 / blood*
  • Female
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Hypoglycemia / blood*
  • Male
  • Monitoring, Physiologic / methods*
  • Patient Education as Topic
  • Predictive Value of Tests
  • Reproducibility of Results

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human