Evaluating Glucose Control With a Novel Composite Continuous Glucose Monitoring Index.
Mader, Julia K
Pieber, Thomas R
J Diabetes Sci Technol
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Leelarathna, L., Thabit, H., Wilinska, G., Bally, L., Mader, J. K., Pieber, T. R., Benesch, C., et al. (2020). Evaluating Glucose Control With a Novel Composite Continuous Glucose Monitoring Index.. J Diabetes Sci Technol, 14 (2), 277-283. https://doi.org/10.1177/1932296819838525
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.
Humans, Diabetes Mellitus, Type 1, Insulin, Blood Glucose, Blood Glucose Self-Monitoring, Monitoring, Physiologic, Prognosis, Treatment Outcome, Insulin Infusion Systems, Injections, Subcutaneous, Drug Administration Schedule, Health Status Indicators, Retrospective Studies, Time Factors, Adult, Female, Male, Glycated Hemoglobin A, Glycemic Control
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
External DOI: https://doi.org/10.1177/1932296819838525
This record's URL: https://www.repository.cam.ac.uk/handle/1810/289667