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

A recent report study published in Diabetes Care showed satisfactory performance of a real-time CGM sensor in peritoneal dialysis (PD) patients with diabetes in detecting asymptomatic glucose excursions.

The study by Jack KC Ng and team, a single-center, 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Out of 30 participants,29 completed the in-clinic session, and One participant was withdrawn before the YSI session due to repeated sensor failure.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.

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” the researchers concluded.

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.