Abstract
Background and Aims
Continuous glucose monitoring improves glycemic control in diabetes. This study compared the accuracy of the Dexcom G5 Mobile (Dexcom, San Diego, CA) transcutaneous sensor (DG5) and the Eversense (Senseonics, Inc., Germantown, MD) implantable sensor (EVS).
Methods
Subjects with type 1 diabetes using EVS simultaneously wore the DG5 for seven days. During day 3, patients were admitted to a clinical research center (CRC) to receive breakfast with delayed and increased insulin bolus to induce glucose excursions. At CRC, venous glucose was monitored every 15 min (or 5 min during hypoglycemia) for 6 hours by YSI 2300 STAT PLUSTM glucose and lactate analyzer. At home patients were requested to perform 4 fingerstick glucose measurements per day (Accu-Chek Aviva; Roche Diagnostics, Mannheim, Germany).
Results
11 patients (9 M, age 47.4±11.3 years, M±SD) were enrolled. During home-stay the median [25^th-75^th percentile] absolute relative difference (ARD) over all CGM-fingerstick matched-pairs was 11.64% [5.38-20.65]% for the DG5 and 10.75% [5.15-19.74]% for the EVS (p-value=0.58). At CRC, considering all the CGM-YSI matched-pairs, the DG5 showed overall smaller median ARD than EVS, 7.91% [4.14-14.30]% vs 11.4% [5.04-18.54]% (p-value<0.001). Considering accuracy during blood glucose swings, DG5 performed better than EVS when glucose rate-of-change was -0.5 to -1.5 mg/dL/min, with median ARD of 7.34% [3.71-12.76]% vs 13.59% [4.53-20.78]% (p-value<0.001), and for rate-of-change <-1.5 mg/dl/min, with median ARD of 5.23% [2.09-15.29]% vs 12.73% [4.14-20.82]% (p-value=0.02).
Conclusions
Dexcom G5 Mobile was more accurate than EVS in CRC, especially when glucose decreased. No statistically significant difference was found in accuracy at home.
