Division of Pediatric Endocrinology, Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY, USA.
Wendy Novak Diabetes Center and University of Louisville School of Medicine, Louisville, KY, USA.
J Diabetes Sci Technol. 2024 May;18(3):584-591. doi: 10.1177/19322968221120433. Epub 2022 Sep 1.
Continuous glucose monitors (CGMs) are widely used for individuals with diabetes mellitus, particularly those with type 1 diabetes (T1D). Advancements in CGM technology allow for glycemic assessment without capillary glucose measurements as many come factory calibrated. However, exercise, an essential component of diabetes care, has been reported to alter accuracy of earlier generation CGM. Considering the importance of physical activity for individuals with T1D and the progression of CGM technology, we aimed to investigate the accuracy of the Dexcom G6 during physical activity.
Adolescents (ages 13-20 years) exercised on a treadmill for 40 minutes, with a 10-minute break at minute 20. We obtained paired CGM and glucometer measurements before and every 10 minutes during and after exercise. Accuracy analysis was determined by mean absolute relative difference (MARD), mean absolute difference (MAD), and Clarke Error Grid Analyses.
Mean absolute relative difference and MAD increased during exercise (14%-33% and 24.3-34 mg/dL) but improved after exercise. We noted certain CGM locations produced greater changes in accuracy as MARD and MAD increased markedly when the CGM was on the buttocks (18%-46% and 30-41 mg/dL). We also noted decreased odds of Zone A in the Clarke error grid when the CGM was on the buttocks compared to the abdomen (odds ratio [OR]: 0.146; = 0.0003; 95% CI = 0.052-0.415).
This CGM system showed alterations in accuracy during exercise. Our findings additionally suggest interstitial fluid changes in muscles during exercise alter accuracy of CGM; however, additional research is required.
连续血糖监测仪（CGM）广泛应用于糖尿病患者，尤其是 1 型糖尿病（T1D）患者。CGM 技术的进步使得无需毛细血管血糖测量即可进行血糖评估，因为许多 CGM 在出厂时已经校准。然而，运动作为糖尿病管理的重要组成部分，据报道会改变早期 CGM 的准确性。考虑到运动对 T1D 患者的重要性以及 CGM 技术的进步，我们旨在研究 Dexcom G6 在运动期间的准确性。
青少年（13-20 岁）在跑步机上运动 40 分钟，在第 20 分钟休息 10 分钟。我们在运动前、运动中和运动后每 10 分钟获得 CGM 和血糖仪的配对测量值。准确性分析通过平均绝对相对差异（MARD）、平均绝对差异（MAD）和 Clarke 误差网格分析确定。
运动期间 MARD 和 MAD 增加（14%-33%和 24.3-34mg/dL），但运动后改善。我们注意到某些 CGM 位置的准确性变化更大，因为当 CGM 位于臀部时，MARD 和 MAD 明显增加（18%-46%和 30-41mg/dL）。我们还注意到当 CGM 位于臀部时，Clarke 误差网格中 Zone A 的可能性降低，与腹部相比（比值比[OR]：0.146；P=0.0003；95%CI=0.052-0.415）。
该 CGM 系统在运动过程中准确性发生变化。我们的研究结果还表明，肌肉间液在运动过程中的变化会改变 CGM 的准确性；然而，还需要进一步的研究。
