Accuracy of continuous glucose monitoring during exercise-related hypoglycemia in individuals with type 1 diabetes
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Accuracy of continuous glucose monitoring during exercise-related hypoglycemia in individuals with type 1 diabetes. / Maytham, Kaisar; Hagelqvist, Per G; Engberg, Susanne; Forman, Julie L; Pedersen-Bjergaard, Ulrik; Knop, Filip K; Vilsbøll, Tina; Andersen, Andreas.
I: Frontiers in Endocrinology, Bind 15, 1352829, 2024.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Accuracy of continuous glucose monitoring during exercise-related hypoglycemia in individuals with type 1 diabetes
AU - Maytham, Kaisar
AU - Hagelqvist, Per G
AU - Engberg, Susanne
AU - Forman, Julie L
AU - Pedersen-Bjergaard, Ulrik
AU - Knop, Filip K
AU - Vilsbøll, Tina
AU - Andersen, Andreas
N1 - Copyright © 2024 Maytham, Hagelqvist, Engberg, Forman, Pedersen-Bjergaard, Knop, Vilsbøll and Andersen.
PY - 2024
Y1 - 2024
N2 - BACKGROUND: Hypoglycemia is common in individuals with type 1 diabetes, especially during exercise. We investigated the accuracy of two different continuous glucose monitoring systems during exercise-related hypoglycemia in an experimental setting.MATERIALS AND METHODS: Fifteen individuals with type 1 diabetes participated in two separate euglycemic-hypoglycemic clamp days (Clamp-exercise and Clamp-rest) including five phases: 1) baseline euglycemia, 2) plasma glucose (PG) decline ± exercise, 3) 15-minute hypoglycemia ± exercise, 4) 45-minute hypoglycemia, and 5) recovery euglycemia. Interstitial PG levels were measured every five minutes, using Dexcom G6 (DG6) and FreeStyle Libre 1 (FSL1). Yellow Springs Instruments 2900 was used as PG reference method, enabling mean absolute relative difference (MARD) assessment for each phase and Clarke error grid analysis for each day.RESULTS: Exercise had a negative effect on FSL1 accuracy in phase 2 and 3 compared to rest (ΔMARD = +5.3 percentage points [(95% CI): 1.6, 9.1] and +13.5 percentage points [6.4, 20.5], respectively). In contrast, exercise had a positive effect on DG6 accuracy during phase 2 and 4 compared to rest (ΔMARD = -6.2 percentage points [-11.2, -1.2] and -8.4 percentage points [-12.4, -4.3], respectively). Clarke error grid analysis showed a decrease in clinically acceptable treatment decisions during Clamp-exercise for FSL1 while a contrary increase was observed for DG6.CONCLUSION: Physical exercise had clinically relevant impact on the accuracy of the investigated continuous glucose monitoring systems and their ability to accurately detect hypoglycemia.
AB - BACKGROUND: Hypoglycemia is common in individuals with type 1 diabetes, especially during exercise. We investigated the accuracy of two different continuous glucose monitoring systems during exercise-related hypoglycemia in an experimental setting.MATERIALS AND METHODS: Fifteen individuals with type 1 diabetes participated in two separate euglycemic-hypoglycemic clamp days (Clamp-exercise and Clamp-rest) including five phases: 1) baseline euglycemia, 2) plasma glucose (PG) decline ± exercise, 3) 15-minute hypoglycemia ± exercise, 4) 45-minute hypoglycemia, and 5) recovery euglycemia. Interstitial PG levels were measured every five minutes, using Dexcom G6 (DG6) and FreeStyle Libre 1 (FSL1). Yellow Springs Instruments 2900 was used as PG reference method, enabling mean absolute relative difference (MARD) assessment for each phase and Clarke error grid analysis for each day.RESULTS: Exercise had a negative effect on FSL1 accuracy in phase 2 and 3 compared to rest (ΔMARD = +5.3 percentage points [(95% CI): 1.6, 9.1] and +13.5 percentage points [6.4, 20.5], respectively). In contrast, exercise had a positive effect on DG6 accuracy during phase 2 and 4 compared to rest (ΔMARD = -6.2 percentage points [-11.2, -1.2] and -8.4 percentage points [-12.4, -4.3], respectively). Clarke error grid analysis showed a decrease in clinically acceptable treatment decisions during Clamp-exercise for FSL1 while a contrary increase was observed for DG6.CONCLUSION: Physical exercise had clinically relevant impact on the accuracy of the investigated continuous glucose monitoring systems and their ability to accurately detect hypoglycemia.
KW - Humans
KW - Diabetes Mellitus, Type 1/blood
KW - Hypoglycemia/blood
KW - Male
KW - Exercise
KW - Female
KW - Adult
KW - Blood Glucose/analysis
KW - Blood Glucose Self-Monitoring/methods
KW - Glucose Clamp Technique
KW - Young Adult
KW - Middle Aged
KW - Continuous Glucose Monitoring
U2 - 10.3389/fendo.2024.1352829
DO - 10.3389/fendo.2024.1352829
M3 - Journal article
C2 - 38686202
VL - 15
JO - Frontiers in Endocrinology
JF - Frontiers in Endocrinology
SN - 1664-2392
M1 - 1352829
ER -
ID: 391045728