By Nina Hermansen, AAU Communication and Public Affairs
Photo: Colourbox

Today, small sensors that measure blood sugar every five minutes have become standard equipment for many people with diabetes. They continuously send data to the phone, so both patient and healthcare provider can monitor whether blood sugar levels are within the recommended range.

But the data overview is not always entirely accurate. During periods when the sensor is not in use, the picture is often markedly different. This is shown by a new study from Aalborg University.

"We see a correlation between low sensor coverage and poorer blood sugar control. There can be many reasons why data is missing during certain periods. If it happens randomly, it’s not a problem. But our study shows that it is likely not random," says Associate Professor Simon Lebech Cichosz from the Department of Medicine and Health Technology at Aalborg University.

He and his colleagues analyzed more than 35 million days of sensor data from nearly 100,000 people with type 1 and type 2 diabetes. The trend is clear across countries, age groups, and treatment types.

The study does not explain why the gaps occur.  Simon Lebech Cichosz explains that the sensor may have fallen off or there may be technical issues. But it may also be related to less engagement in diabetes management.

"Living with diabetes requires attention around the clock. It is therefore completely natural that sometimes you need a break, even if it’s not optimal. But as mentioned, this is only an assumption,"  says Simon Lebech Cichosz.

Overestimated treatment success

The findings challenge a widespread assumption among both clinicians and researchers: that days with missing data resemble the others. But if missing measurements are not considered, healthcare providers risk overestimating how well the patient is regulated.

This is explained by Professor Morten Hasselstrøm Jensen from the Department of Medicine and Health Technology at Aalborg University, one of the other researchers behind the study:

"The insights from the days with many gaps are extremely important, and precisely during these periods the sensor can be a crucial support, because it both protects the patient and gives healthcare professionals the opportunity to help in the best possible way."

The researchers therefore urge healthcare providers to combine data with conversations about the patient’s use of the sensor. It is essential to determine whether gaps in data are due to technical issues or behavior.

"It’s not necessarily a problem for all patients, but on average we see a clear and robust correlation," says Morten Hasselstrøm Jensen.

A step toward better individualized treatment

Going forward, the researchers hope to gain even more insight into how data can help identify patients whose blood sugar regulation appears better than it actually is. This could become an important decision-making tool in clinical practice and a step toward even more tailored treatment:

"We see these results as the first step toward giving people with diabetes the best conditions to understand their blood sugar regulation and achieve the most effective individualized treatment," says Simon Lebech Cichosz.

The study was conducted in collaboration with Steno Diabetes Center North Jutland and Novo Nordisk.