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. 2025 Aug 4;25(15):4788.
doi: 10.3390/s25154788.

Evaluating Insulin Delivery Systems Using Dynamic Glucose Region Plots and Risk Space Analysis

Klavs W Hansen  1   2 , Mia Christensen  2 , Sanne Fisker  3 , Ermina Bach  3   4 , Bo M Bibby  5
Affiliations

Evaluating Insulin Delivery Systems Using Dynamic Glucose Region Plots and Risk Space Analysis

Klavs W Hansen et al. Sensors (Basel). .

Abstract

Simultaneous values of glucose rate of change (RoC) and glucose can be presented in a dynamic glucose region plot, and risk spaces can be specified for (RoC, glucose) values expected to remain in the target range (glucose 3.9-10.0 mmol/L) or leave or return to the target range within the next 30 min. We downloaded continuous glucose monitoring (CGM) data for 60 days from persons with type 1 diabetes using two different systems for automated insulin delivery (AID), A (n = 65) or B (n = 85). The relative distribution of (RoC, glucose) values in risk spaces was compared. The fraction of all (RoC, glucose) values anticipated to remain in the target range in the next 30 min was higher with system A (62.5%) than with system B (56.8%) (difference 5.7, 95% CI (2.2-9.2%), p = 0.002). The fraction of (RoC, glucose) values in the target range with a risk of progressing to the above range (glucose > 10.0 mmol/L) was slightly lower in system A than in B (difference -1.1 (95% CI: -1.8--0.5%, p < 0.001). Dynamic glucose region plots and the concept of risk spaces are novel strategies to obtain insight into glucose homeostasis and to demonstrate clinically relevant differences comparing two AID systems.

Keywords: automated insulin delivery; continuous glucose monitoring; dynamic glucose region plots; glucose rate of change; risk space analysis; type 1 diabetes.

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Conflict of interest statement

KWH has received research grants for an investigator-initiated study from Abbott Diabetes Care and Novo Nordisk.

Figures

Figure 1
Figure 1
Template to describe the relation of glucose dynamic risk spaces A, B, C, D, E, and O to the spaces for glucose above the target range, in the target range, and below the target range.
Figure 2
Figure 2
A two-dimensional heatmap of the distribution of (RoC, glucose) pairs in glucose dynamic risk spaces for (left) users of the MM780G (351,591 pairs) and (right) users of CoIQ system (461,943 pairs).
Figure 3
Figure 3
A three-dimensional heatmap of the distribution of (RoC, glucose) pairs in the MM780G system users.
Figure 4
Figure 4
A three-dimensional heatmap of the distribution of (RoC, glucose) pairs in users of the CoIQ system.
Figure 5
Figure 5
A two-dimensional heatmap of the distribution of (RoC, glucose) pairs in glucose dynamic risk spaces for users of (left) the AID pumps (853,534 values) and (right) users of isCGM (1,181,627 values).
Figure 6
Figure 6
A three-dimensional heatmap of the distribution of (Roc, glucose) values in users of isCGM.
See this image and copyright information in PMC

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