freestyle libre flash glucose monitoring system invasive

#Freestyle libre flash glucose monitoring system invasive how to

We did not apply any language restriction. These were reviewed with a healthcare librarian (NR) specialised in planning systematic reviews. Search phrases used for the search are given in supplement 1. Data sources and searchesĪ literature search was conducted in June 2018 using the following databases: Clinical, Cochrane Library, Embase, PubMed, ProQuest, Scopus and Web of Science. The study protocol for this review was registered on PROSPERO on ( CRD42018104812). Therefore, in this systematic review, we aim to assess the diagnostic accuracy of hypoglycaemia detection of MID and NID. While many manufacturers of MID and NID advertise the safety and convenience with which those devices warn of hypoglycaemic episodes, there is no clear evidence how accurately they can actually detect hypoglycaemia. sensitivity/specificity, MARD (mean absolute relative difference)), which are often not directly comparable to each other and/or of uncertain clinical relevance. Consequently, studies report diagnostic accuracy in many different ways (e.g.

#Freestyle libre flash glucose monitoring system invasive how to

Comparison of different devices and between different studies is challenging as there is no consensus on how to optimally assess the general accuracy over the whole glycaemic range and the binary accuracy of hypoglycaemia detection of MID and NID. With hypoglycaemia being one of the most threatening complications of diabetes mellitus, it is critical that these devices are capable of accurately detecting hypoglycaemic episodes, especially in those patients who are unaware of their hypoglycaemic episodes. Minimally (MID) and non-invasive devices (NID) aim to facilitate diabetes control and improve patients’ adherence. However, the adherence to SMBG via glucometer was reported to be as low as 44% for adults with type 1 diabetes and 24% for adults with type 2 diabetes. Therefore, current guidelines recommend that patients with type 1 diabetes self-monitor their blood glucose (SMBG) 4–10 times a day. The consequences of hypoglycaemia do not just include the immediate symptoms and mortality, hypoglycaemic events also have an enormous impact on the long-term outcome (increased cardiovascular risk, impaired cognitive function). On average, a patient with type 1 diabetes has two episodes of symptomatic hypoglycaemia per week and experiences 1.0 to 1.7 episodes of severe hypoglycaemia per year. Hypoglycaemia is a common side effect of diabetes treatment.

Overall, the present data suggest that minimally and non-invasive monitoring systems are not sufficiently accurate for detecting hypoglycaemia in routine use. An additional analysis shows the absence of evidence for a better performance of the most recent generation of devices.

Meta-regression analyses showed a better hypoglycaemia detection in studies indicating a higher overall accuracy, whereas year of publication did not significantly influence diagnostic accuracy.

Pooled analysis revealed a mean sensitivity of 69.3% and a mean specificity of 93.3%. Different thresholds for hypoglycaemia detection ranging from 40 to 100 mg/dl were used. Finally, 15 studies with a total of 733 patients were included. We identified 3416 nonduplicate articles. The diagnostic accuracy of hypoglycaemia detection was analysed via meta-analysis using a bivariate random effects model and meta-regression with regard to pre-specified covariates. Two authors independently screened the articles, extracted data using a standardised extraction form and assessed methodological quality using a review-tailored quality assessment tool for diagnostic accuracy studies (QUADAS-2). MethodsĬlinical, Cochrane Library, Embase, PubMed, ProQuest, Scopus and Web of Science were systematically searched. In this systematic review and meta-analysis, we assessed the diagnostic accuracy of minimally and non-invasive hypoglycaemia detection in comparison to capillary or venous blood glucose in patients with type 1 or type 2 diabetes. Up to now, it remains unclear how accurate devices can detect hypoglycaemic episodes. The use of minimally and non-invasive monitoring systems (including continuous glucose monitoring) has increased rapidly over recent years.