Publications

Journal Article Epublish

PubMed: 40807953 DOI: 10.3390/s25154788

Evaluating Insulin Delivery Systems Using Dynamic Glucose Region Plots and Risk Space Analysis.

Sensors (Basel) 25(15)

Authors: Klavs W Hansen, Mia Christensen, Sanne Fisker, Ermina Bach, Bo M Bibby

Affiliations

  • Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus, Denmark.
  • Medical Diagnostic Center, Silkeborg Regional Hospital, Falkevej 1, 8600 Silkeborg, Denmark.
  • Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200 Aarhus, Denmark.
  • Medical Diagnostic Center, Viborg Regional Hospital, Heibergs Alle 5, 8800 Viborg, Denmark.
  • Section for Biostatistics, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark.

Abstract

Simultaneous values of glucose rate of change (RoC) and glucose can be presented in a dynamic glucose region plot, and risk spaces can be specified for (RoC, glucose) values expected to remain in the target range (glucose 3.9-10.0 mmol/L) or leave or return to the target range within the next 30 min. We downloaded continuous glucose monitoring (CGM) data for 60 days from persons with type 1 diabetes using two different systems for automated insulin delivery (AID), A (n = 65) or B (n = 85). The relative distribution of (RoC, glucose) values in risk spaces was compared. The fraction of all (RoC, glucose) values anticipated to remain in the target range in the next 30 min was higher with system A (62.5%) than with system B (56.8%) (difference 5.7, 95% CI (2.2-9.2%), p = 0.002). The fraction of (RoC, glucose) values in the target range with a risk of progressing to the above range (glucose > 10.0 mmol/L) was slightly lower in system A than in B (difference -1.1 (95% CI: -1.8--0.5%, p < 0.001). Dynamic glucose region plots and the concept of risk spaces are novel strategies to obtain insight into glucose homeostasis and to demonstrate clinically relevant differences comparing two AID systems.

MeSH

Insulin, Diabetes Mellitus, Type 1, Continuous Glucose Monitoring