| Title: |
Biases in Glucose Metrics are Directly Related to Low Coverage of Continuous Glucose Monitoring:Insights from diverse populations |
| Authors: |
Cichosz, Simon Lebech; Hartvig, Niels Væver; Kronborg, Thomas; Hangaard, Stine; Vestergaard, Peter; Jensen, Morten Hasselstrøm |
| Source: |
Cichosz, S L, Hartvig, N V, Kronborg, T, Hangaard, S, Vestergaard, P & Jensen, M H 2026, 'Biases in Glucose Metrics are Directly Related to Low Coverage of Continuous Glucose Monitoring : Insights from diverse populations', Diabetes Technology & Therapeutics, vol. 28, no. 2, pp. 180-184. https://doi.org/10.1177/15209156251376007 |
| Publication Year: |
2026 |
| Collection: |
Aalborg University (AAU): Publications / Aalborg Universitet: Publikationer |
| Subject Terms: |
bias; continuous glucose monitoring; flash glucose monitoring; gaps; glycemic control; missing data; missing not-at-random (MNAR); time in range |
| Description: |
The aim was to investigate the association between continuous glucose monitoring (CGM) data coverage and glycemic metrics. This study included over 97,000 clinical study participants and real-world data from type 1 or type 2 diabetes treated with multiple daily insulin injections, closed-loop systems, or basal-only insulin regimens. Over 35 million days of CGM data were analyzed with multilevel modeling. Low coverage was observed in 6.4%-10.1% of days and was significantly associated with lower time in range (TIR) across sources (P < 0.001). Each 1% increase in coverage was associated with a within-person increase of 0.07%-0.13% in mean daily TIR (P < 0.001). Our analysis shows that higher daily sensor coverage is significantly associated with higher daily TIR, suggesting that missing CGM data may be missing not-at-random. Although low-coverage days are included in TIR calculations, they contribute fewer measurements and may underrepresent periods of poor glycemic control, potentially leading to a systematic overestimation and bias of overall TIR. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
1520-9156; 1557-8593 |
| Relation: |
info:eu-repo/semantics/altIdentifier/pissn/1520-9156; info:eu-repo/semantics/altIdentifier/eissn/1557-8593 |
| DOI: |
10.1177/15209156251376007 |
| Availability: |
https://vbn.aau.dk/da/publications/1399bbe3-c4ee-45c5-a098-31729b5b2fa2; https://doi.org/10.1177/15209156251376007; https://vbn.aau.dk/ws/files/815367848/Cichosz_vR2.pdf; https://www.scopus.com/pages/publications/105014989252 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.E554C6BB |
| Database: |
BASE |