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Biosensors 2018, 8(4), 93;

Differences Between Flash Glucose Monitor and Fingerprick Measurements

Department of Engineering Cybernetics, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
Prediktor Medical, 1630 Gamle Fredrikstad, Norway
Department of Clinical and Molecular Medicine, NTNU, 7491 Trondheim, Norway
Department of Endocrinology, St. Olavs University Hospital, 7491 Trondheim, Norway
Author to whom correspondence should be addressed.
Received: 27 August 2018 / Revised: 1 October 2018 / Accepted: 15 October 2018 / Published: 17 October 2018
(This article belongs to the Special Issue Continuous Glucose Monitoring)
PDF [903 KB, uploaded 19 October 2018]


Freestyle Libre (FL) is a factory calibrated Flash Glucose Monitor (FGM). We investigated Mean Absolute Relative Difference (MARD) between Self Monitoring of Blood Glucose (SMBG) and FL measurements in the first day of sensor wear in 39 subjects with Type 1 diabetes. The overall MARD was 12.3%, while the individual MARDs ranged from 4% to 25%. Five participants had a MARD ≥ 20%. We estimated bias and lag between the FL and SMBG measurements. The estimated biases range from −1.8 mmol / L to 1.4 mmol / L , and lags range from 2 min to 24 min . Bias is identified as a main cause of poor individual MARDs. The biases seem to persist in days 2–7 of sensor usage. All cases of MARD ≥ 20% in the first day are eliminated by bias correction, and overall MARD is reduced from 12.3% to 9.2%, indicating that adding support for voluntary user-supplied bias correction in the FL could improve its performance. View Full-Text
Keywords: blood glucose; measurement; error analysis; continuous glucose monitor; flash glucose monitor; self monitoring of blood glucose blood glucose; measurement; error analysis; continuous glucose monitor; flash glucose monitor; self monitoring of blood glucose

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Staal, O.M.; Hansen, H.M.U.; Christiansen, S.C.; Fougner, A.L.; Carlsen, S.M.; Stavdahl, Ø. Differences Between Flash Glucose Monitor and Fingerprick Measurements. Biosensors 2018, 8, 93.

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