Head - to - comparison of the accuracy of Abbott FreeStyle Libre and Dexcom G5 mobile.
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• Both sensors were used according to their manufacturer specified lifetimes, patientsreceived one breakfast test and used a glucometer independently of the devices.
• Patients wore the two sensors simultaneously for 14 days (changing the G5 sensor after 7days), both at home and during a single 6-hour hospital admission on day 3, in which theyreceived a regular breakfast with 30-minute-delayed and doubled insulin bolus to producean early post-meal hyperglycaemia followed by a quick decrease in blood glucose.
•Sensor readings were matched at home with capillary glucose values (≥4/day) and inhospital with venous glucose values measured every 5-15 minutes.
•Accuracy was evaluated using the absolute relative difference (ARD), percentage of datamatching the ISO 15197:2013 standard, and percentage of datapoints in zones A and B ofthe Clarke Error Grid (CEG).
• Twenty patients (10 females; 39.0±13.8 years; diabetes duration 23.3±11.7 years; HbA1c7.4 ±0.7% [57.6±7.9 mmol/mol]) completed the study.
• At home, the overall ARD was 12.3% (5.6–21.4%) for FSL and 9.8% (4.7–18.0%) for DG5M(p<0.001). ARD increased during hypoglycaemia with both FSL and G5 sensors (13.7%[7.4–23.9%] and 14.0% [7.7–23.2%]; p=0.8468) and decreased during hyperglycaemia(10.2% [4.5–16.8%] and 8.5% [4.3–13.9%]; p=0.0073).
• Apart from lower accuracy during the first day after insertion, observed with bothsensors, G5M performed stably during its 7-day lifetime, whereas FSL became lessaccurate during the last four days of its 14-day lifetime; the ARD changed from 11.7%[5.0–21.2%] in days 2–10 to 13.2% [7.2–21.4%] in days 11–14 (p=0.0124).
• The increased ARD of DG5M on day 8 was instead due to the new sensor insertion andrecalibration, which is intrinsic to the Dexcom algorithm.
• The authors conclude that both systems perform safely and efficiently but the DG5Msensor has greater accuracy across all glucose values except in hypoglycaemia.
• The accuracy of the FSL system shows a decrease between days 11 and 14, an importantfinding according to the authors, especially for patients using the sensor as a non-adjunctive device continuously for 14 days.