Sinha Manasi, McKeon Katherine M, Parker Savan, Goergen Laura G, Zheng Hui, El-Khatib Firas H, Russell Steven J
1 Diabetes Unit and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
2 Texas A&M University Health Science Center, Houston, TX, USA.
J Diabetes Sci Technol. 2017 Nov;11(6):1132-1137. doi: 10.1177/1932296817704443. Epub 2017 May 1.
The physiologic delay in glucose diffusion from the blood to the interstitial fluid and instrumental factors contribute to the delay between changes in plasma glucose (PG) and measurements made by continuous glucose monitors (CGMs). This study compared the duration of this delay for three CGMs.
A total of 24 healthy adolescent and adult subjects with type 1 diabetes wore three CGM devices simultaneously for 48 hours: Dexcom G4 Platinum, Abbott Navigator, and Medtronic Enlite. The time delay between PG and CGM-estimated plasma glucose (CGMG) was estimated by comparing time-shifted CGMG with reference PG taken every 15 minutes.
The delay estimated by our approach was larger for the Navigator than for the G4 Platinum in adolescents (7.7 ± 1.1 versus 5.6 ± 0.9 min, P = .0396) and adults (10.9 ± 1.1 versus 8.1 ± 0.7 min, P = .0107). The delay was nominally longer for the Navigator than for the Enlite in both the adolescent (7.7 ± 1.1 versus 4.3 ± 1.0 min, P = .0728) and adult (10.9 ± 1.1 versus 8.3 ± 0.9 min, P = .111) populations, but these differences were not statistically significant. There was no difference in the delay between G4 Platinum and Enlite. Adolescents had shorter delays than adults for all three devices. There was a significant correlation between longer delay and increasing age for the G4 Platinum and Navigator.
There are differences in the estimated PG to CGMG time delays between CGM devices in the same subjects. The delay between PG and CGMG is smaller for adolescents than for adults. The PG-to-CGMG time delay is influenced by both instrument and host factors.
葡萄糖从血液扩散到组织间液的生理延迟以及仪器因素导致了血浆葡萄糖（PG）变化与连续血糖监测仪（CGM）测量值之间的延迟。本研究比较了三种CGM的这种延迟持续时间。
共有24名1型糖尿病健康青少年和成人受试者同时佩戴三种CGM设备48小时：德康G4铂金版、雅培导航者和美敦力恩适。通过比较每隔15分钟采集的参考PG与时间偏移后的CGM估算血浆葡萄糖（CGMG）来估计PG与CGMG之间的时间延迟。
在青少年中，我们的方法估计的导航者延迟比G4铂金版更大（7.7±1.1分钟对5.6±0.9分钟，P = 0.0396），在成人中也是如此（10.9±1.1分钟对8.1±0.7分钟，P = 0.0107）。在青少年（7.7±1.1分钟对4.3±1.0分钟，P = 0.0728）和成人（10.9±1.1分钟对8.3±0.9分钟，P = 0.111）人群中，导航者的延迟名义上比恩适更长，但这些差异无统计学意义。G4铂金版和恩适之间的延迟没有差异。对于所有三种设备，青少年的延迟都比成人短。G4铂金版和导航者的延迟延长与年龄增长之间存在显著相关性。
同一受试者使用的CGM设备在估计的PG到CGMG时间延迟方面存在差异。青少年中PG与CGMG之间的延迟比成人小。PG到CGMG的时间延迟受仪器和宿主因素的影响。
