Retrofitting Real-Life Dexcom G5 Data

Abstract

We proposed in 2014 a retrofitting algorithm to retrospectively increase the accuracy of continuous glucose monitoring (CGM) data by using some blood glucose (BG) measurements. The method proved effective on Dexcom SEVEN Plus when about 10 highly accurate YSI measurements/session were available. In this study, we test the method on Dexcom G5 sensor in a more realistic setup, where only five capillary BG measurements (self-monitoring blood glucose [SMBG]) per 12 h-session are available. Furthermore, we investigate how accuracy is affected by the number of BG measurements. The algorithm was tested in 51 adults and 46 adolescents studied for 7 days with Dexcom G5. Each patient also underwent an ∼12-h hospital admission where frequent SMBG and YSI measurements were collected. First, five SMBGs per 12-h session were used to retrofit the CGM. Then, we varied the number of SMBGs provided to the method from 2 to 10 per 12-h session. Retrofitted CGM traces with five SMBGs per 12-h session have lower mean absolute difference than original CGM, reduced from 16.2 to 10.7 mg/dL (P < 0.001) in adults and from 17.6 to 11.5 mg/dL (P < 0.001) in adolescents, and mean absolute relative difference is reduced from 9.0% to 6.4% (P < 0.001) in adults and from 10.3% to 6.8% (P < 0.001) in adolescents. Reducing the number of BG measurements reduces improvement in the accuracy from >30% with 10 SMBGs per 12-h session to <16% with 2 SMBGs/day. The retrofitting method retrospectively improves the accuracy of CGM data, even if applied to one of the most accurate CGM sensors currently available on the market.