Evaluating Glucose Control With a Novel Composite Continuous Glucose Monitoring Index.

Leelarathna, Lalantha; Thabit, Hood; Wilinska, Malgorzata E; Bally, Lia; Mader, Julia K; Pieber, Thomas R; Benesch, Carsten; Arnolds, Sabine; Johnson, Terri; Heinemann, Lutz; Hermanns, Norbert; Evans, Mark L; Hovorka, Roman (2020). Evaluating Glucose Control With a Novel Composite Continuous Glucose Monitoring Index. Journal of diabetes science and technology, 14(2), pp. 277-283. Sage 10.1177/1932296819838525

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OBJECTIVE: The objective was to describe a novel composite continuous glucose monitoring index (COGI) and to evaluate its utility, in adults with type 1 diabetes, during hybrid closed-loop (HCL) therapy and multiple daily injections (MDI) therapy combined with real-time continuous glucose monitoring (CGM). METHODS: COGI consists of three key components of glucose control as assessed by CGM: Time in range (TIR), time below range (TBR), and glucose variability (GV) (weighted by 50%, 35% and 15%). COGI ranges from 0 to 100, where 1% increase of time <3.9 mmol/L (<70 mg/dl) is equivalent to 4.7% reduction of TIR between 3.9-10 mmol/L (70-180 mg/dl), and 0.5 mmol/L (9 mg/dl) increase in standard deviation is equivalent to 3% reduction in TIR. RESULTS: Continuous subcutaneous insulin infusion (CSII) users with HbA1c >7.5-10%, had significantly higher COGI during 12 weeks of HCL compared to sensor-augmented pump therapy, mean (SD), 60.3 (8.6) versus 69.5 (6.9), P < .001. Similarly, in CSII users with HbA1c <7.5%, HCL improved COGI from 59.9 (11.2) to 74.8 (6.6), P < .001. In MDI users with HbA1c >7.5% to 9.9%, use of real-time CGM led to improved COGI, 49.8 (14.2) versus 58.2 (9.1), P < .0001. In MDI users with impaired awareness of hypoglycemia, use of real-time CGM led to improved COGI, 53.4 (12.2) versus 66.7 (11.1), P < .001. CONCLUSIONS: COGI summarizes three key aspects of CGM data into a concise metric that could be utilized to evaluate the quality of glucose control and to demonstrate the incremental benefit of a wide range of treatment modalities.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Bally, Lia Claudia

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1932-2968

Publisher:

Sage

Language:

English

Submitter:

Regula Maria Schneider

Date Deposited:

23 Jan 2020 14:05

Last Modified:

04 Mar 2020 01:33

Publisher DOI:

10.1177/1932296819838525

PubMed ID:

30931606

Uncontrolled Keywords:

closed-loop insulin delivery continuous glucose monitoring type 1 diabetes

BORIS DOI:

10.7892/boris.138357

URI:

https://boris.unibe.ch/id/eprint/138357

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