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Aims  To assess the accuracy and reliability of the two most widely used continuous glucose monitoring ( CGM ) systems.    Methods  We studied the Dexcom® G4  Platinum ( DG4P ; Dexcom, San Diego,  CA ,  USA ) and Medtronic Paradigm Veo Enlite system ( ENL ; Medtronic, Northridge,  CA ,  USA )  CGM  systems, in 24 patients with type 1 diabetes. The  CGM  systems were tested during 6‐day home use and a nested 6‐h clinical research centre ( CRC ) visit. During the  CRC  visit, frequent venous blood glucose samples were used as reference while patients received a meal with an increased insulin bolus to induce an aggravated postprandial glucose nadir. At home, patients performed at least six reference capillary blood measurements per day. A Wilcoxon signed‐rank test was performed using all data points ≥15 min apart.    Results  The overall mean absolute relative difference ( MARD ) value [standard deviation (s.d.)] measured at the  CRC  was 13.6 (11.0)% for the  DG4P  and 16.6 (13.5)% for the  ENL  [p < 0.0002, confidence interval of difference ( CI  Δ) 1.7–4.3%, n = 530]. The overall  MARD  assessed at home was 12.2 (12.0)% for the  DG4P  and 19.9 (20.5)% for the  ENL  (p < 0.0001,  CI  Δ = 5.8–8.7%, n = 839). During the  CRC  visit, the  MARD  in the hypoglycaemic range [≤3.9 mmol/l (70 mg/dl)], was 17.6 (12.2)% for the  DG4P  and 24.6 (18.8)% for the  ENL  (p = 0.005,  CI  Δ 3.1–10.7%, n = 117). Both sensors showed higher  MARD  values during hypoglycaemia than during euglycaemia [3.9–10 mmol/l (70–180 mg/dl)]: for the  DG4P  17.6 versus 13.0% and for the  ENL  24.6 versus 14.2%.    Conclusions  During circumstances of intended use, including both a  CRC  and home phase, the  ENL  was noticeably less accurate than the  DG4P  sensor. Both sensors showed lower accuracy in the hypoglycaemic range. The  DG4P  was less affected by this negative effect of hypoglycaemia on sensor accuracy than was the  ENL .

Accuracy of two continuous glucose monitoring systems: a head‐to‐head comparison under clinical research centre and daily life conditions