Accuracy and Longevity of an Implantable Continuous Glucose Sensor in the PRECISE Study: A 180-Day, Prospective, Multicenter, Pivotal Trial

OBJECTIVE It is known that continuous glucose monitoring (CGM) systems can lower mean glucose compared with episodic self-monitoring of blood glucose. Implantable CGM systems may provide additional benefits. RESEARCH DESIGN AND METHODS We studied the Eversense (Senseonics Inc.) implantable CGM sensor in 71 participants aged 18 years and older with type 1 and type 2 diabetes in a 180-day multinational, multicenter pivotal trial. Participants used the CGM system at home and in the clinic. CGM accuracy was assessed during eight in-clinic visits with the mean absolute relative difference (MARD) for venous reference glucose values >4.2 mmol/L as the primary end point. Secondary end points included Clarke Error Grid Analysis and alarm performance. The primary safety outcome was device-related serious adverse events. This trial is registered with ClinicalTrials.gov, number NCT02154126. RESULTS The MARD value against reference glucose values >4.2 mmol/L was 11.1% (95% CI 10.5, 11.7). Clarke Error Grid Analysis showed 99.2% of samples in the clinically acceptable error zones A and B. Eighty-one percent of hypoglycemic events were detected by the CGM system within 30 min. No device-related serious adverse events occurred during the study. CONCLUSIONS Our results indicate the safety and accuracy of this new type of implantable CGM system and support it as an alternative for transcutaneous CGM.

[1]  Timothy L. Routh,et al.  Function of an Implanted Tissue Glucose Sensor for More than 1 Year in Animals , 2010, Science Translational Medicine.

[2]  David Rodbard,et al.  Continuous Glucose Monitoring: A Review of Successes, Challenges, and Opportunities. , 2016, Diabetes technology & therapeutics.

[3]  T. Bailey,et al.  Clinical Accuracy of a Continuous Glucose Monitoring System With an Advanced Algorithm , 2014, Journal of diabetes science and technology.

[4]  S. Garg,et al.  Improved glucose excursions using an implantable real-time continuous glucose sensor in adults with type 1 diabetes. , 2004, Diabetes care.

[5]  J. Hans DeVries,et al.  Accuracy and reliability of continuous glucose monitoring systems: a head-to-head comparison. , 2013, Diabetes technology & therapeutics.

[6]  Stephen D Patek,et al.  Assessing sensor accuracy for non-adjunct use of continuous glucose monitoring. , 2015, Diabetes technology & therapeutics.

[7]  Alex J Sutton,et al.  Glycaemic control in type 1 diabetes during real time continuous glucose monitoring compared with self monitoring of blood glucose: meta-analysis of randomised controlled trials using individual patient data , 2011, BMJ : British Medical Journal.

[8]  J. McGill,et al.  Evidence of a Strong Association Between Frequency of Self-Monitoring of Blood Glucose and Hemoglobin A1c Levels in T1D Exchange Clinic Registry Participants , 2013, Diabetes Care.

[9]  J K Mader,et al.  Accuracy of two continuous glucose monitoring systems: a head-to-head comparison under clinical research centre and daily life conditions , 2014, Diabetes, obesity & metabolism.

[10]  Ravinder J. Singh,et al.  Quantitative, highly sensitive liquid chromatography-tandem mass spectrometry method for detection of synthetic corticosteroids. , 2004, Clinical chemistry.

[11]  Steven J. Russell,et al.  A Comparative Effectiveness Analysis of Three Continuous Glucose Monitors , 2014, Journal of diabetes science and technology.

[12]  Malgorzata E. Wilinska,et al.  Accuracy of Continuous Glucose Monitoring During Three Closed-Loop Home Studies Under Free-Living Conditions , 2015, Diabetes technology & therapeutics.

[13]  K. Ruedy,et al.  Skin and Adhesive Issues With Continuous Glucose Monitors , 2014, Journal of diabetes science and technology.