Accuracy and reliability of a continuous glucose monitoring system with a focus on hypoglycaemia
Authors' conclusion
CGM accuracy can vary in different clinical hypoglycaemia scenarios. While it remains acceptable in people with diabetes receiving subcutaneous insulin therapy and people with insulinoma, it appears to be inaccurate for glucose monitoring during ITT.
Study context
- Population
- People with various causes of hypoglycaemia464 continuous glucose monitoring (CGM)/POC glucose pairs
- Participants
- 92 people
- Comparison
- CGM accuracy across three clinical hypoglycaemia settings: ITT, insulinoma, diabetes on subcutaneous insulin
- ITTn = 63
- Insulinoman = 16
- Diabetesn = 13reference
- Outcome
- CGM accuracy within the hypoglycaemic range (mean absolute relative difference (MARD), %20/20, diabetes technology society error grid, Bland-Altman analysis)
Performance
As reported in the abstract
CGM accuracy
| Outcome | ITT | Diabetes |
|---|---|---|
| MARD | 50.8% | 13.9% |
| %20/20 | 67.5% | 81.5% |
- ITT vs Diabetes: P < 0.01 — accuracy lower with ITT
- ITT vs Diabetes: p .02 — accuracy lower with ITT
Further findings
CGM values with moderate risk of failing to detect potentially dangerous hypoglycaemia (error grid) — ITT vs Diabetes · higher with ITT vs diabetes and insulinoma
P < 0.01
| Outcome | ITT | Insulinoma | Diabetes | P value |
|---|---|---|---|---|
| Bland-Altman biasITT vs Diabetes · significantly increasing bias with ITT | −15.2 ± 13.6 mg/dL | — not stated in the abstract | −3.3 (10.7) mg/dL | P < 0.01 |
— not stated in the abstract
Original publication
Accuracy and reliability of a continuous glucose monitoring system with a focus on hypoglycaemia. Diabetes Obes Metab. Published 25 December 2025. doi:10.
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