Department of Endocrinology and Metabolism and Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, China.
Diabetes Technol Ther. 2012 Aug;14(8):710-8. doi: 10.1089/dia.2012.0014.
The purpose of this multicenter study was to investigate the accuracy of a real-time continuous glucose monitoring sensor in Chinese diabetes patients.
In total, 48 patients with type 1 or 2 diabetes from three centers in China were included in the study. The MiniMed Paradigm(®) 722 insulin pump (Medtronic, Northridge, CA) was used to monitor the real-time continuous changes of blood glucose levels for three successive days. Venous blood of the subjects was randomly collected every 15 min for seven consecutive hours on the day when the subjects were wearing the sensor. Reference values were provided by the YSI(®) 2300 STAT PLUS™ glucose and lactate analyzer (YSI Life Sciences, Yellow Springs, OH).
In total, 1,317 paired YSI-sensor values were collected from the 48 patients. Of the sensor readings, 88.3% (95% confidence interval, 0.84-0.92) were within±20% of the YSI values, and 95.7% were within±30% of the YSI values. Clarke and consensus error grid analyses showed that the ratios of the YSI-sensor values in Zone A to the values in Zone B were 99.1% and 99.9%, respectively. Continuous error grid analysis showed that the ratios of the YSI-sensor values in the region of accurate reading, benign errors, and erroneous reading were 96.4%, 1.8%, and 1.8%, respectively. The mean absolute relative difference (ARD) for all subjects was 10.4%, and the median ARD was 7.8%. Bland-Altman analysis detected a mean blood glucose level of 3.84 mg/dL. Trend analysis revealed that 86.1% of the difference of the rates of change between the YSI values and the sensor readings occurred within the range of 1 mg/dL/min.
The Paradigm insulin pump has high accuracy in both monitoring the real-time continuous changes and predicting the trend of changes in blood glucose level. However, actual clinical manifestations should be taken into account for diagnosis of hypoglycemia.
本多中心研究旨在探讨实时连续血糖监测传感器在中国糖尿病患者中的准确性。
本研究共纳入中国三个中心的 48 例 1 型或 2 型糖尿病患者。使用 MiniMed Paradigm(®)722 胰岛素泵(美敦力,加利福尼亚州北岭)连续监测 3 天血糖的实时连续变化。在佩戴传感器的当天,受试者的静脉血每隔 15 分钟随机采集 7 小时,共采集 7 次。参考值由 YSI(®)2300 STAT PLUS™血糖和乳酸分析仪(YSI 生命科学公司,俄亥俄州扬斯敦)提供。
共从 48 例患者中收集了 1317 对 YSI-传感器值。在传感器读数中,88.3%(95%置信区间,0.84-0.92)在 YSI 值的±20%以内,95.7%在 YSI 值的±30%以内。Clarke 和共识误差网格分析显示,YSI-传感器值在 A 区与 B 区的比值分别为 99.1%和 99.9%。连续误差网格分析显示,准确读数区、良性误差区和错误读数区的 YSI-传感器比值分别为 96.4%、1.8%和 1.8%。所有受试者的平均绝对相对差异(ARD)为 10.4%,中位数 ARD 为 7.8%。Bland-Altman 分析检测到平均血糖水平为 3.84mg/dL。趋势分析显示,YSI 值与传感器读数之间的变化率差值的 86.1%在 1mg/dL/min 的范围内。
Paradigm 胰岛素泵在监测血糖实时连续变化和预测血糖变化趋势方面具有较高的准确性。然而,在诊断低血糖时,应考虑实际临床表现。