Abstract
BACKGROUND: The physiologic delay in glucose diffusion from the blood to the interstitial fluid and instrumental factors contribute to the delay between changes in plasma glucose (PG) and measurements made by continuous glucose monitors (CGMs). This study compared the duration of this delay for three CGMs. METHODS: A total of 24 healthy adolescent and adult subjects with type 1 diabetes wore three CGM devices simultaneously for 48 hours: Dexcom G4 Platinum, Abbott Navigator, and Medtronic Enlite. The time delay between PG and CGM-estimated plasma glucose (CGMG) was estimated by comparing time-shifted CGMG with reference PG taken every 15 minutes. RESULTS: The delay estimated by our approach was larger for the Navigator than for the G4 Platinum in adolescents (7.7 ± 1.1 versus 5.6 ± 0.9 min, P = .0396) and adults (10.9 ± 1.1 versus 8.1 ± 0.7 min, P = .0107). The delay was nominally longer for the Navigator than for the Enlite in both the adolescent (7.7 ± 1.1 versus 4.3 ± 1.0 min, P = .0728) and adult (10.9 ± 1.1 versus 8.3 ± 0.9 min, P = .111) populations, but these differences were not statistically significant. There was no difference in the delay between G4 Platinum and Enlite. Adolescents had shorter delays than adults for all three devices. There was a significant correlation between longer delay and increasing age for the G4 Platinum and Navigator. CONCLUSIONS: There are differences in the estimated PG to CGMG time delays between CGM devices in the same subjects. The delay between PG and CGMG is smaller for adolescents than for adults. The PG-to-CGMG time delay is influenced by both instrument and host factors.