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Evaluating Glucose Control With a Novel Composite Continuous Glucose Monitoring Index.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Leelarathna, Lalantha  ORCID logo  https://orcid.org/0000-0001-9602-1962
Thabit, Hood 
Wilinska, Malgorzata E 
Bally, Lia 
Mader, Julia K 

Abstract

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.

Description

Keywords

closed-loop insulin delivery, continuous glucose monitoring, type 1 diabetes, Adult, Blood Glucose, Blood Glucose Self-Monitoring, Diabetes Mellitus, Type 1, Drug Administration Schedule, Female, Glycated Hemoglobin, Glycemic Control, Health Status Indicators, Humans, Injections, Subcutaneous, Insulin, Insulin Infusion Systems, Male, Monitoring, Physiologic, Prognosis, Retrospective Studies, Time Factors, Treatment Outcome

Journal Title

J Diabetes Sci Technol

Conference Name

Journal ISSN

1932-2968
1932-2968

Volume Title

14

Publisher

SAGE Publications
Sponsorship
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)