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Impact of physical exercise on sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system in people with Type 1 diabetes: a randomized crossover trial

O. Moser, M. L. Eckstein, A. Mueller, P. Birnbaumer, F. Aberer, G. Koehler, C. Sourij, H. Kojzar, P. Holler, H. Simi, P. Pferschy, P. Dietz, R. M. Bracken, P. Hofmann, H. Sourij, Richard Bracken Orcid Logo

Diabetic Medicine, Volume: 36, Issue: 5, Pages: 606 - 611

Swansea University Author: Richard Bracken Orcid Logo

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DOI (Published version): 10.1111/dme.13909

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AimsTo evaluate the sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system using reference blood glucose levels during moderate‐intensity exercise while on either full or reduced basal insulin dose in people with Type 1 diabetes.MethodsTen participants w...

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Published in: Diabetic Medicine
ISSN: 0742-3071 1464-5491
Published: Wiley 2019
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URI: https://cronfa.swan.ac.uk/Record/cronfa49756
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2020-08-21T16:27:45.7799751</datestamp><bib-version>v2</bib-version><id>49756</id><entry>2019-03-26</entry><title>Impact of physical exercise on sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system in people with Type 1 diabetes: a randomized crossover trial</title><swanseaauthors><author><sid>f5da81cd18adfdedb2ccb845bddc12f7</sid><ORCID>0000-0002-6986-6449</ORCID><firstname>Richard</firstname><surname>Bracken</surname><name>Richard Bracken</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2019-03-26</date><deptcode>STSC</deptcode><abstract>AimsTo evaluate the sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system using reference blood glucose levels during moderate&#x2010;intensity exercise while on either full or reduced basal insulin dose in people with Type 1 diabetes.MethodsTen participants with Type 1 diabetes [four women, mean &#xB1; sd age 31.4 &#xB1; 9.0 years, BMI 25.5&#xB1;3.8 kg/m2, HbA1c 55&#xB1;7 mmol/mol (7.2&#xB1;0.6%)] exercised on a cycle ergometer for 55 min at a moderate intensity for 5 consecutive days at the clinical research facility, while receiving either their usual or a 75% basal insulin dose. After a 4&#x2010;week washout period, participants performed the second exercise period having switched to the alternative basal insulin dose. During exercise, reference capillary blood glucose values were analysed using the fully enzymatic&#x2010;amperometric method and compared with the interstitial glucose values obtained. Intermittently viewed continuous glucose monitoring accuracy was analysed according to median (interquartile range) absolute relative difference, and Clarke error grid and Bland&#x2013;Altman analysis for overall glucose levels during exercise, stratified by glycaemic range and basal insulin dosing scheme (P&lt;0.05).ResultsA total of 845 glucose values were available during exercise to evaluate intermittently viewed continuous glucose monitoring sensor performance. The median (interquartile range) absolute relative difference between the reference values and those obtained by the sensor across the glycaemic range overall was 22 (13.9&#x2013;29.7)%, and was 36.3 (24.2&#x2013;45.2)% during hypoglycaemia, 22.8 (14.6&#x2013;30.6)% during euglycaemia and 15.4 (9&#x2013;21)% during hyperglycaemia. Usual basal insulin dose was associated with a worse sensor performance during exercise compared with the reduced (75%) basal insulin dose [median (interquartile range) absolute relative difference: 23.7 (17.2&#x2013;30.7)% vs 20.5 (12&#x2013;28.1)%; P&lt;0.001).ConclusionsThe intermittently viewed continuous glucose monitoring sensor showed diminished accuracy during exercise. Absolute glucose readings derived from the sensor should be used cautiously and need confirmation by additional finger&#x2010;prick blood glucose measurements.</abstract><type>Journal Article</type><journal>Diabetic Medicine</journal><volume>36</volume><journalNumber>5</journalNumber><paginationStart>606</paginationStart><paginationEnd>611</paginationEnd><publisher>Wiley</publisher><issnPrint>0742-3071</issnPrint><issnElectronic>1464-5491</issnElectronic><keywords/><publishedDay>13</publishedDay><publishedMonth>4</publishedMonth><publishedYear>2019</publishedYear><publishedDate>2019-04-13</publishedDate><doi>10.1111/dme.13909</doi><url/><notes/><college>COLLEGE NANME</college><department>Sport and Exercise Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>STSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2020-08-21T16:27:45.7799751</lastEdited><Created>2019-03-26T16:31:32.7689828</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences</level></path><authors><author><firstname>O.</firstname><surname>Moser</surname><order>1</order></author><author><firstname>M. L.</firstname><surname>Eckstein</surname><order>2</order></author><author><firstname>A.</firstname><surname>Mueller</surname><order>3</order></author><author><firstname>P.</firstname><surname>Birnbaumer</surname><order>4</order></author><author><firstname>F.</firstname><surname>Aberer</surname><order>5</order></author><author><firstname>G.</firstname><surname>Koehler</surname><order>6</order></author><author><firstname>C.</firstname><surname>Sourij</surname><order>7</order></author><author><firstname>H.</firstname><surname>Kojzar</surname><order>8</order></author><author><firstname>P.</firstname><surname>Holler</surname><order>9</order></author><author><firstname>H.</firstname><surname>Simi</surname><order>10</order></author><author><firstname>P.</firstname><surname>Pferschy</surname><order>11</order></author><author><firstname>P.</firstname><surname>Dietz</surname><order>12</order></author><author><firstname>R. M.</firstname><surname>Bracken</surname><order>13</order></author><author><firstname>P.</firstname><surname>Hofmann</surname><order>14</order></author><author><firstname>H.</firstname><surname>Sourij</surname><order>15</order></author><author><firstname>Richard</firstname><surname>Bracken</surname><orcid>0000-0002-6986-6449</orcid><order>16</order></author></authors><documents><document><filename>49756__13646__019e775a63a94d30b63407998392da94.pdf</filename><originalFilename>moser2019(2).pdf</originalFilename><uploaded>2019-05-01T11:20:23.6830000</uploaded><type>Output</type><contentLength>648867</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2020-01-24T00:00:00.0000000</embargoDate><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling 2020-08-21T16:27:45.7799751 v2 49756 2019-03-26 Impact of physical exercise on sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system in people with Type 1 diabetes: a randomized crossover trial f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2019-03-26 STSC AimsTo evaluate the sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system using reference blood glucose levels during moderate‐intensity exercise while on either full or reduced basal insulin dose in people with Type 1 diabetes.MethodsTen participants with Type 1 diabetes [four women, mean ± sd age 31.4 ± 9.0 years, BMI 25.5±3.8 kg/m2, HbA1c 55±7 mmol/mol (7.2±0.6%)] exercised on a cycle ergometer for 55 min at a moderate intensity for 5 consecutive days at the clinical research facility, while receiving either their usual or a 75% basal insulin dose. After a 4‐week washout period, participants performed the second exercise period having switched to the alternative basal insulin dose. During exercise, reference capillary blood glucose values were analysed using the fully enzymatic‐amperometric method and compared with the interstitial glucose values obtained. Intermittently viewed continuous glucose monitoring accuracy was analysed according to median (interquartile range) absolute relative difference, and Clarke error grid and Bland–Altman analysis for overall glucose levels during exercise, stratified by glycaemic range and basal insulin dosing scheme (P<0.05).ResultsA total of 845 glucose values were available during exercise to evaluate intermittently viewed continuous glucose monitoring sensor performance. The median (interquartile range) absolute relative difference between the reference values and those obtained by the sensor across the glycaemic range overall was 22 (13.9–29.7)%, and was 36.3 (24.2–45.2)% during hypoglycaemia, 22.8 (14.6–30.6)% during euglycaemia and 15.4 (9–21)% during hyperglycaemia. Usual basal insulin dose was associated with a worse sensor performance during exercise compared with the reduced (75%) basal insulin dose [median (interquartile range) absolute relative difference: 23.7 (17.2–30.7)% vs 20.5 (12–28.1)%; P<0.001).ConclusionsThe intermittently viewed continuous glucose monitoring sensor showed diminished accuracy during exercise. Absolute glucose readings derived from the sensor should be used cautiously and need confirmation by additional finger‐prick blood glucose measurements. Journal Article Diabetic Medicine 36 5 606 611 Wiley 0742-3071 1464-5491 13 4 2019 2019-04-13 10.1111/dme.13909 COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University 2020-08-21T16:27:45.7799751 2019-03-26T16:31:32.7689828 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences O. Moser 1 M. L. Eckstein 2 A. Mueller 3 P. Birnbaumer 4 F. Aberer 5 G. Koehler 6 C. Sourij 7 H. Kojzar 8 P. Holler 9 H. Simi 10 P. Pferschy 11 P. Dietz 12 R. M. Bracken 13 P. Hofmann 14 H. Sourij 15 Richard Bracken 0000-0002-6986-6449 16 49756__13646__019e775a63a94d30b63407998392da94.pdf moser2019(2).pdf 2019-05-01T11:20:23.6830000 Output 648867 application/pdf Accepted Manuscript true 2020-01-24T00:00:00.0000000 true eng
title Impact of physical exercise on sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system in people with Type 1 diabetes: a randomized crossover trial
spellingShingle Impact of physical exercise on sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system in people with Type 1 diabetes: a randomized crossover trial
Richard Bracken
title_short Impact of physical exercise on sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system in people with Type 1 diabetes: a randomized crossover trial
title_full Impact of physical exercise on sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system in people with Type 1 diabetes: a randomized crossover trial
title_fullStr Impact of physical exercise on sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system in people with Type 1 diabetes: a randomized crossover trial
title_full_unstemmed Impact of physical exercise on sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system in people with Type 1 diabetes: a randomized crossover trial
title_sort Impact of physical exercise on sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system in people with Type 1 diabetes: a randomized crossover trial
author_id_str_mv f5da81cd18adfdedb2ccb845bddc12f7
author_id_fullname_str_mv f5da81cd18adfdedb2ccb845bddc12f7_***_Richard Bracken
author Richard Bracken
author2 O. Moser
M. L. Eckstein
A. Mueller
P. Birnbaumer
F. Aberer
G. Koehler
C. Sourij
H. Kojzar
P. Holler
H. Simi
P. Pferschy
P. Dietz
R. M. Bracken
P. Hofmann
H. Sourij
Richard Bracken
format Journal article
container_title Diabetic Medicine
container_volume 36
container_issue 5
container_start_page 606
publishDate 2019
institution Swansea University
issn 0742-3071
1464-5491
doi_str_mv 10.1111/dme.13909
publisher Wiley
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences
document_store_str 1
active_str 0
description AimsTo evaluate the sensor performance of the FreeStyle Libre intermittently viewed continuous glucose monitoring system using reference blood glucose levels during moderate‐intensity exercise while on either full or reduced basal insulin dose in people with Type 1 diabetes.MethodsTen participants with Type 1 diabetes [four women, mean ± sd age 31.4 ± 9.0 years, BMI 25.5±3.8 kg/m2, HbA1c 55±7 mmol/mol (7.2±0.6%)] exercised on a cycle ergometer for 55 min at a moderate intensity for 5 consecutive days at the clinical research facility, while receiving either their usual or a 75% basal insulin dose. After a 4‐week washout period, participants performed the second exercise period having switched to the alternative basal insulin dose. During exercise, reference capillary blood glucose values were analysed using the fully enzymatic‐amperometric method and compared with the interstitial glucose values obtained. Intermittently viewed continuous glucose monitoring accuracy was analysed according to median (interquartile range) absolute relative difference, and Clarke error grid and Bland–Altman analysis for overall glucose levels during exercise, stratified by glycaemic range and basal insulin dosing scheme (P<0.05).ResultsA total of 845 glucose values were available during exercise to evaluate intermittently viewed continuous glucose monitoring sensor performance. The median (interquartile range) absolute relative difference between the reference values and those obtained by the sensor across the glycaemic range overall was 22 (13.9–29.7)%, and was 36.3 (24.2–45.2)% during hypoglycaemia, 22.8 (14.6–30.6)% during euglycaemia and 15.4 (9–21)% during hyperglycaemia. Usual basal insulin dose was associated with a worse sensor performance during exercise compared with the reduced (75%) basal insulin dose [median (interquartile range) absolute relative difference: 23.7 (17.2–30.7)% vs 20.5 (12–28.1)%; P<0.001).ConclusionsThe intermittently viewed continuous glucose monitoring sensor showed diminished accuracy during exercise. Absolute glucose readings derived from the sensor should be used cautiously and need confirmation by additional finger‐prick blood glucose measurements.
published_date 2019-04-13T04:00:57Z
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score 11.037603

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