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Leelarathna, L; Thabit, H; Wilinska, ME; Bally, L; Mader, JK; Pieber, TR; Benesch, C; Arnolds, S; Johnson, T; Heinemann, L; Hermanns, N; Evans, ML; Hovorka, R.
Evaluating Glucose Control With a Novel Composite Continuous Glucose Monitoring Index.
J Diabetes Sci Technol. 2019; 144(1):1932296819838525-1932296819838525
Doi: 10.1177/1932296819838525
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- Co-authors Med Uni Graz
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Mader Julia
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Pieber Thomas
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- Abstract:
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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).
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.
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.
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.
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continuous glucose monitoring
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type 1 diabetes
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closed-loop insulin delivery