Detecting eating events in real-time using continuous glucose monitoring: A scoping review

Objective: Continuous glucose monitoring (CGM) shows promise in optimizing the assessment and monitoring of ingestive activity (IA; i.e., consumption of calorie-containing foods and beverages). We conducted a scoping review of publications examining the performance of CGM-based approach- es to automatically detect IA. We aimed to answer three questions: 1) Which CGM approaches for automatic detection of IA have been investigated? 2) How accurate are these approaches? 3) Can they be used in the context of Just-in-Time Adaptive Interventions (JITAIs)? Methods: We systematically searched four cross-disciplinary databases. In essence, we included publications that compared a CGM-based approach for automatically detecting IA to an established ground-truth method in humans. The evidence was synthesized qualitatively, and the methodological quality of included publications was critically appraised. Results: Of 1,561 publications identified, 19 (17 studies, total N = 311) were included in the review. Most publications included individuals with diabetes, often using meal announcements and/or insulin boluses with meals. Inpatient and free-liv- ing settings were used, and a wide range of CGM-only and CGM-based algorithms with additional inputs were tested. Performance assessment and measures varied among the publications. Some approaches achieved excellent performance metrics such as sensitivity and specificity (e.g., a feedback scheme-based algorithm). Detection times ranged from 9.0 to 45.0 minutes. Conclusion: There are several promising CGM-based approaches for automatically detecting IA. These might complement clinical/research practice, e.g., in combination with prompts for self-reporting IA. However, current detection times appear too long for the administration of JITAIs aimed at acutely influencing IA. Methodological issues and overall heterogeneity among articles make it difficult to provide clear recommendations on the best approach.     «

Objective: Continuous glucose monitoring (CGM) shows promise in optimizing the assessment and monitoring of ingestive activity (IA; i.e., consumption of calorie-containing foods and beverages). We conducted a scoping review of publications examining the performance of CGM-based approach- es to automatically detect IA. We aimed to answer three questions: 1) Which CGM approaches for automatic detection of IA have been investigated? 2) How accurate are these approaches? 3) Can they be used in the...     »