Glucose Concentrations from Continuous Glucose Monitoring Devices Compared to Those from Blood Plasma during an Oral Glucose Tolerance Test in Healthy Young Adults

Continuous glucose monitoring devices measure glucose in interstitial fluid. The devices are effective when used by patients with type 1 and 2 diabetes but are increasingly being used by researchers who are interested in the effects of various behaviours of glucose concentrations in healthy participants. Despite their more frequent application in this setting, the devices have not yet been validated for use under such conditions. A total of 124 healthy participants were recruited to a ten-day laboratory study. Each participant underwent four oral glucose tolerance tests, and a total of 3315 out of a possible 4960 paired samples were included in the final analysis. Bland-Altman plots and mean absolute relative differences were used to determine the agreement between the two methods. Bland-Altman analyses revealed that the continuous glucose monitoring devices had proportional bias (R = 0.028, p < 0.001) and a mean bias of -0.048 mmol/L, and device measurements were more variable as glucose concentrations increased. Ninety-nine per cent of paired values were in Zones A and B of the Parkes Error Grid plot, and there was an overall mean absolute relative difference of 16.2% (+/- 15.8%). There was variability in the continuous glucose monitoring devices, and this variability was higher when glucose concentrations were higher. If researchers were to use continuous glucose monitoring devices to measure glucose concentrations during an oral glucose tolerance test in healthy participants, this variability would need to be considered.

Automated summary

Continuous glucose monitoring devices have not been validated for use in healthy participants and exhibit variability in measurements; findings show that the devices have proportional bias and mean bias, with measurements becoming more unstable as glucose concentrations increase.