Document Detail


The effect of rising vs. falling glucose level on amperometric glucose sensor lag and accuracy in Type 1 diabetes.
MedLine Citation:
PMID:  22150642     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:  Because declining glucose levels should be detected quickly in persons with Type 1 diabetes, a lag between blood glucose and subcutaneous sensor glucose can be problematic. It is unclear whether the magnitude of sensor lag is lower during falling glucose than during rising glucose. Methods:  Initially, we analysed 95 data segments during which glucose changed and during which very frequent reference blood glucose monitoring was performed. However, to minimize confounding effects of noise and calibration error, we excluded data segments in which there was substantial sensor error. After these exclusions, and combination of data from duplicate sensors, there were 72 analysable data segments (36 for rising glucose, 36 for falling). We measured lag in two ways: (1) the time delay at the vertical mid-point of the glucose change (regression delay); and (2) determination of the optimal time shift required to minimize the difference between glucose sensor signals and blood glucose values drawn concurrently. Results:  Using the regression delay method, the mean sensor lag for rising vs. falling glucose segments was 8.9 min (95% CI 6.1-11.6) vs. 1.5 min (95% CI -2.6 to 5.5, P < 0.005). Using the time shift optimization method, results were similar, with a lag that was higher for rising than for falling segments [8.3 (95% CI 5.8-10.7) vs. 1.5 min (95% CI -2.2 to 5.2), P < 0.001]. Commensurate with the lag results, sensor accuracy was greater during falling than during rising glucose segments. Conclusions:  In Type 1 diabetes, when noise and calibration error are minimized to reduce effects that confound delay measurement, subcutaneous glucose sensors demonstrate a shorter lag duration and greater accuracy when glucose is falling than when rising. © 2011 The Authors. Diabetic Medicine© 2011 Diabetes UK.
Authors:
W K Ward; J M Engle; D Branigan; J El Youssef; R G Massoud; J R Castle
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-12
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  -     ISSN:  1464-5491     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
Affiliation:
Legacy Health System, Legacy Research Institute Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR, USA.
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