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TOPLINE:

Glucose values in patients with type 1 diabetes (T1D) may vary based on the continuous glucose monitoring (CGM) system used, resulting in differences that may affect the timing and choice of treatment decisions, such as insulin delivery or hypoglycemia interventions, as well as meeting clinical outcome targets for glycemic control.

METHODOLOGY:

• Clinicians and patients use data from CGM systems to assess glycemic control in diabetes management, but variations among different systems may result in discordant glucose profiles.
• Researchers conducted a prospective interventional study (April 2024 to July 2024) in Germany to examine the differences in glycemic metrics among CGM systems and their effect on therapeutic decision-making.
• They included 23 adults with T1D (17 men; mean age, 52.7 years; mean A1c, 6.6%) who, for 17 days, each wore sensors simultaneously on their upper arms from three CGM systems: FreeStyle Libre 3 (FL3; Abbott Diabetes Care), Dexcom G7 (DG7; Dexcom Inc), and Medtronic Simplera (MSP; Medtronic Minimed).
• Participants spent most of the study in free-living settings; three 7-hour in-clinic sessions were conducted to assess CGM accuracy, with deliberate manipulation of glucose levels and measurement of capillary glucose levels every 15 minutes using a blood glucose monitoring system.
• CGM metrics were assessed within individuals and on a population level, including time below range (< 70 mg/dL), time in range (70-180 mg/dL), time above range (> 180 mg/dL), and glucose management indicator.

TAKEAWAY:

• On average, FL3 and DG7 readings showed comparable metrics that were higher than those of MSP (14.2% and 11.2% higher, respectively).
• MSP showed on average a lower glucose management indicator, lower time above range, and a higher time in and below range than the other two CGM systems (P < .05 for all).
• In individuals, differences between FL3 and DG7 metrics were as high as 9.8% in time below range, 11.9% in time in range, and 13.4% in time above range. The highest individual difference in the time below range was 12.9% between FL3 and MSP readings.
• The CGM systems influenced whether specific therapy targets were met or not, such as < 4% of time below range, met by 70%, 48%, and 26% of participants according to FL3, DG7, and MSP data, respectively.

IN PRACTICE:

“[The study] results emphasize that glycemic metrics are influenced by the used CGM system and/or individual sensor, which should be considered by people with diabetes and health care professionals when comparing data from different systems or switching from one system to another,” the authors wrote. They advised caution on interpreting results of clinical trials comparing AID systems based on glycemic metrics measured with different CGM systems and urged better alignment of CGM systems.

SOURCE:

This study was led by Guido Freckmann, Institut für Diabetes-Technologie (IfDT), Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany. It was published online in Diabetes Care.

LIMITATIONS:

The observation period was short, and a small sample size led to a low overall number of sensors used. Additionally, the study population had above-average glycemic control, which may not represent a broad range of people with diabetes. 

DISCLOSURES:

This study received partial financial support from Bionime Corporation, Diabetes Center Berne, i-SENS, Inc., and Roche Diabetes Care GmbH. Blood glucose monitoring systems and related consumables were provided at no cost by Ascensia Diabetes Care, while the IfDT covered the remaining costs. No funding was provided by the manufacturers of the three systems/sensors studied. Several authors reported being employees of IfDT, and one author reported receiving research support, consulting fees, or speakers’ honoraria in the past 3 years from various pharmaceutical and medical device companies, including Abbott and Dexcom. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.