{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:49:49Z","timestamp":1790412589628,"version":"4.1.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Scuba diving was previously excluded because of hypoglycemic risks for patients with type 1 diabetes mellitus(T1DM). Specific eligibility criteria and a safety protocol have been defined, whereas continuous glucose monitoring (CGM) systems have enhanced diabetes management. This study aims to assess the feasibility and accuracy of CGM Dexcom G7 and Free Style Libre 3 in a setting of repetitive scuba diving in T1DM, exploring the possibility of nonadjunctive use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>\n                      The study was conducted during an event of\n                      <jats:italic toggle=\"yes\">\n                        Diabete Sommerso\n                        <jats:sup>\u00ae<\/jats:sup>\n                      <\/jats:italic>\n                      association in 2023. Participants followed a safety protocol, with capillary glucose as reference standard (Beurer GL50Evo). Sensors\u2019 accuracy was evaluated through median and mean absolute relative difference (MeARD, MARD) and surveillance error grid (SEG). Data distribution and correlation were estimated by Spearman test and Bland\u2013Altman plots. The ability of sensors to identify hypoglycemia was assessed by contingency tables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Data from 202 dives of 13 patients were collected. The overall MARD was 31% (Dexcom G7) and 14.2% (Free Style Libre 3) and MeARD was 19.7% and 11.6%, respectively. Free Style Libre 3 exhibited better accuracy in normoglycemic and hyperglycemic ranges. SEG analysis showed 82.1% (Dexcom G7) and 97.4% (Free Style Libre 3) data on no-risk zone. Free Style Libre 3 better performed on hypoglycemia identification (diagnostic odds ratio of 254.10 vs. 58.95). Neither of the sensors reached the MARD for nonadjunctive use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The study reveals Free Style Libre 3 superior accuracy compared with Dexcom G7 in a setting of repetitive scuba diving in T1DM, except for hypoglycemic range. Both sensors fail to achieve accuracy for nonadjunctive use. Capillary tests remain crucial for safe dive planning, and sensor data should be interpreted cautiously. We suggest exploring additional factors potentially influencing sensor performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/dia.2024.0126","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T16:04:40Z","timestamp":1716221080000},"page":"829-841","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Continuous Glucose Monitoring and Recreational Scuba Diving in Type 1 Diabetes: Head-to-Head Comparison Between Free Style Libre 3 and Dexcom G7 Performance"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0483-7126","authenticated-orcid":false,"given":"Elena","family":"Gamarra","sequence":"first","affiliation":[{"name":"Servizio di Endocrinologia e Diabetologia, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Careddu","sequence":"additional","affiliation":[{"name":"Endocrinologia Diabetologia e Malattie del Ricambio, ASL 3 Genovese, Genova, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Fazi","sequence":"additional","affiliation":[{"name":"Agenzia Regionale Sanitaria\u2014Regione Marche, Ancona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Turra","sequence":"additional","affiliation":[{"name":"ASST Spedali Civili di Brescia, Unit\u00e0 Operativa di Diabetologia, Brescia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambra","family":"Morelli","sequence":"additional","affiliation":[{"name":"Servizio di Dietologia e Nutrizione Clinica, Clinica San Carlo, Paderno Dugnano, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Camponovo","sequence":"additional","affiliation":[{"name":"Servizio di Endocrinologia e Diabetologia, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierpaolo","family":"Trimboli","sequence":"additional","affiliation":[{"name":"Servizio di Endocrinologia e Diabetologia, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland."},{"name":"Facolt\u00e0 di Scienze Biomediche, Universit\u00e0 della Svizzera Italiana (USI), Lugano, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,11,8]]},"reference":[{"key":"e_1_3_4_2_2","first-page":"231","volume-title":"Proceedings of the 1992 International Conference on underwater education","author":"Winsett RP","year":"1992","unstructured":"Winsett RP, , Kendrick WW, , Prosterman S, et al. Diving safely with diabetes. In Proceedings of the 1992 International Conference on underwater education. (Perry M. ed.) National Association of Underwater Instructors: Montclair, CA; 1992; pp. 231\u2013234."},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.3068\/2\/ildia1901c"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/17461391.2019.1606286"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.2892\/0\/dhm47.3.180-190"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.2892\/0\/dhm50.2.135-143"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.18.7.1074a"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.13105"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296819826584"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0011"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-023-01385-6"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296819855670"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2014.0272"},{"key":"e_1_3_4_14_2","unstructured":"Available from: https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfcfr\/cfrsearch.cfm?fr=862.1355"},{"issue":"1","key":"e_1_3_4_15_2","first-page":"A-128","article-title":"Accuracy of a real-time continuous glucose monitoring system (rtCGM) during consecutives scuba diving in type 1 diabetes (T1D): The \u201cDiabete Sommerso 2019\u201d experience","volume":"22","author":"Gamarra E","year":"2020","unstructured":"Gamarra E, , Cimino E, , Fazi A, et al. Accuracy of a real-time continuous glucose monitoring system (rtCGM) during consecutives scuba diving in type 1 diabetes (T1D): The \u201cDiabete Sommerso 2019\u201d experience. Diabetes Technology & Therapeutics, 2020; 22(1):A-128.","journal-title":"Diabetes Technology & Therapeutics"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.2892\/0\/dhm51.3.240-247"},{"issue":"3","key":"e_1_3_4_17_2","first-page":"265","article-title":"Continuous real-time monitoring and recording of glycemia during scuba diving: Pilot study","volume":"43","author":"Pieri M","year":"2016","unstructured":"Pieri M, , Cialoni D, , Marroni A. Continuous real-time monitoring and recording of glycemia during scuba diving: Pilot study. 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