Continuous glucose monitor clinically effective tool for individuals with diabetes on peritoneal dialysis: A Report

The study by Jack KC Ng and team, a single-centre, prospective, open-label study of Guardian Connect with Guardian Sensor 3, included 30 participants with diabetes undergoing continuous ambulatory PD (CAPD) enrolled between 8 March 2021 and 15 August 2022. The researchers compared Medtronic Guardian Sensor 3 with the gold standard reference Yellow Spring Instrument [YSI] glucose analyzer to assess CGM accuracy to capture a wide range of glucose levels with diet/insulin manipulation.

• Out of 30 participants,29 completed the in-clinic session, and One participant was withdrawn before the YSI session due to repeated sensor failure.
• The average age was 64.7 ± 5.6 years, 77% were men, diabetes duration was 17.6 ± 8.0 years, HbA1c was 7.1 ± 0.9%, and CAPD duration was 16.2 ± 19.5 months.
• Nine hundred sixty-one pairs of CGM-plasma YSI and 259 pairs of CGM-SMBG values were collected.
• Overall, the mean absolute relative difference (MARD) of CGM-plasma YSI pairs was 10.4% (95% CI 9.6, 11.2), and the MARD for CGM-SMBG pairs was 9.3% (95% CI 8.3, 10.3); 81.3% of readings were within %15/15 of YSI values in the full glycaemic range.
• The sensor's accuracy was not influenced by acidosis, urea concentration, and volume overload.
  

In addition to these findings, the researchers noted that the sample size was relatively small and did not perform head-to-head comparisons versus other sensors or against an age- or sex-matched non-ESKD control group.

“Medtronic Guardian Sensor 3 has shown more accurate and reliable across a wide range of glucose levels in PD patients with diabetes; further research will investigate whether optimization of CGM-based metrics will improve clinical outcomes in PD”, Jack KC added.

Reference:

Jack KC, Ling J et al. Evaluation of a Fourth-Generation Subcutaneous Real-Time Continuous Glucose Monitor (CGM) in Individuals with Diabetes on Peritoneal Dialysis. Diabetes Care 2023;46(6):1191–1195.