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) |
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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: |
05 Dec 2022 15:35 |
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 |