Continuous glucose monitoring in interstitial fluid using glucose oxidase-based sensor compared to established blood glucose measurement in rats

2007 ◽  
Vol 581 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Stefanie Woderer ◽  
Nadja Henninger ◽  
Claus-Dieter Garthe ◽  
Hans Martin Kloetzer ◽  
Martin Hajnsek ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucose Oxidase ◽  
Continuous Glucose Monitoring ◽  
Interstitial Fluid ◽  
Glucose Monitoring ◽  
Blood Glucose Measurement ◽  
Glucose Measurement

scholarly journals Glucose Management during Insulinoma Resection Using Real-Time Subcutaneous Continuous Glucose Monitoring

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Yuki Sugiyama ◽  
Chiaki Kiuchi ◽  
Maiko Suzuki ◽  
Yuki Maruyama ◽  
Ryo Wakabayashi ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Real Time ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Blood Glucose Measurement ◽  
Glucose Measurement ◽  
Glucose Loading ◽  
Before And After ◽  
Interstitial Glucose ◽  
Glucose Management

Insulinoma is a rare neuroendocrine tumor that causes hypoglycemia due to unregulated insulin secretion. Blood glucose management during insulinoma resection is therefore challenging. We present a case in which real-time subcutaneous continuous glucose monitoring (SCGM) in combination with intermittent blood glucose measurement was used for glycemic control during surgery for insulinoma resection. The SCGM system showed the trends and peak of interstitial glucose in response to glucose loading and the change of interstitial glucose before and after insulinoma resection. These data were helpful for adjusting the glucose infusion; therefore, we think that an SCGM system as a supportive device for glucose monitoring may be useful for glucose management during surgery.

scholarly journals Discrepancies Between Blood Glucose and Interstitial Glucose—Technological Artifacts or Physiology: Implications for Selection of the Appropriate Therapeutic Target

2017 ◽  
Vol 11 (4) ◽  
pp. 766-772 ◽  
Author(s):  
Thorsten Siegmund ◽  
Lutz Heinemann ◽  
Ralf Kolassa ◽  
Andreas Thomas
Keyword(s):  
Blood Glucose ◽  
Therapeutic Target ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Blood Glucose Measurement ◽  
Glucose Measurement ◽  
Glucose Levels ◽  
Therapeutic Decisions ◽  
The Impact ◽  
Selection Of

Background: For decades, the major source of information used to make therapeutic decisions by patients with diabetes has been glucose measurements using capillary blood samples. Knowledge gained from clinical studies, for example, on the impact of metabolic control on diabetes-related complications, is based on such measurements. Different to traditional blood glucose measurement systems, systems for continuous glucose monitoring (CGM) measure glucose in interstitial fluid (ISF). The assumption is that glucose levels in blood and ISF are practically the same and that the information provided can be used interchangeably. Thus, therapeutic decisions, that is, the selection of insulin doses, are based on CGM system results interpreted as though they were blood glucose values. Methods: We performed a more detailed analysis and interpretation of glucose profiles obtained with CGM in situations with high glucose dynamics to evaluate this potentially misleading assumption. Results: Considering physical activity, hypoglycemic episodes, and meal-related differences between glucose levels in blood and ISF uncover clinically relevant differences that can make it risky from a therapeutic point of view to use blood glucose for therapeutic decisions. Conclusions: Further systematic and structured evaluation as to whether the use of ISF glucose is more safe and efficient when it comes to acute therapeutic decisions is necessary. These data might also have a higher prognostic relevance when it comes to long-term metabolic consequences of diabetes. In the long run, it may be reasonable to abandon blood glucose measurements as the basis for diabetes management and switch to using ISF glucose as the appropriate therapeutic target.

scholarly journals Measures of Accuracy for Continuous Glucose Monitoring and Blood Glucose Monitoring Devices

2018 ◽  
Vol 13 (3) ◽  
pp. 575-583 ◽  
Author(s):  
Guido Freckmann ◽  
Stefan Pleus ◽  
Mike Grady ◽  
Steven Setford ◽  
Brian Levy
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Measurement Accuracy ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Glucose Measurement ◽  
Bias Analysis ◽  
Patients With Diabetes ◽  
Monitoring Devices ◽  
Error Grid

Currently, patients with diabetes may choose between two major types of system for glucose measurement: blood glucose monitoring (BGM) systems measuring glucose within capillary blood and continuous glucose monitoring (CGM) systems measuring glucose within interstitial fluid. Although BGM and CGM systems offer different functionality, both types of system are intended to help users achieve improved glucose control. Another area in which BGM and CGM systems differ is measurement accuracy. In the literature, BGM system accuracy is assessed mainly according to ISO 15197:2013 accuracy requirements, whereas CGM accuracy has hitherto mainly been assessed by MARD, although often results from additional analyses such as bias analysis or error grid analysis are provided. The intention of this review is to provide a comparison of different approaches used to determine the accuracy of BGM and CGM systems and factors that should be considered when using these different measures of accuracy to make comparisons between the analytical performance (ie, accuracy) of BGM and CGM systems. In addition, real-world implications of accuracy and its relevance are discussed.

scholarly journals Performance of the Eversense versus the Free Style Libre Flash glucose monitor during exercise and normal daily activities in subjects with type 1 diabetes mellitus

2020 ◽  
Vol 8 (1) ◽  
pp. e001193 ◽  
Author(s):  
Marion Fokkert ◽  
Peter R van Dijk ◽  
Mireille A Edens ◽  
Alberto Díez Hernández ◽  
Robbert Slingerland ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Oxidase ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Daily Activities ◽  
Glucose Measurement ◽  
Beneficial Effects ◽  
Intensive Exercise ◽  
Interstitial Glucose

IntroductionAccurate blood glucose measurements are important in persons with diabetes during normal daily activities (NDA), even more so during exercise. We aimed to investigate the performance of fluorescence sensor-based and glucose oxidase-based interstitial glucose measurement during (intensive) exercise and NDA.Research design and methodsProspective, observational study in 23 persons with type 1 diabetes when mountain biking for 6 days, followed by 6 days of NDA. Readings of the Eversense (fluorescence-based continuous glucose monitoring (CGM); subcutaneously implanted) and of the Free Style Libre (FSL; glucose oxidase-based flash glucose monitoring (FGM); transcutaneously placed) were compared with capillary glucose levels (Free Style Libre Precision NeoPro strip (FSLCstrip)).ResultsMean average differences (MAD) and mean average relative differences (MARD) were significantly different when comparing exercise with NDA (reference FSLCstrip); Eversense MAD 25±19 vs 17±6 mg/dL (p<0.001); MARD 17±6 vs 13%±6% (p<0.01) and FSL MAD 32±17 vs 18±8 mg/dL (p<0.01); MARD 20±7 vs 12%±5% (p<0.001).When analyzing the data according to the Integrated Continuous Glucose Monitoring Approvals (class II–510(K) guidelines), the overall performance of interstitial glucose readings within 20% of the FSLCstrip during exercise compared with NDA was 69% vs 81% for the Eversense and 59% vs 83% for the FSL, respectively. Within 15% of the FSLCstrip was 59% vs 70% for the Eversense and 46% vs 71% for the FSL.ConclusionsDuring exercise, both fluorescence and glucose oxidase-based interstitial glucose measurements (using Eversense and FSL sensors) were less accurate compared with measurements during NDA. Even when acknowledging the beneficial effects of CGM or FGM, users should be aware of the risk of diminished accuracy of interstitial glucose readings during (intensive) exercise.

scholarly journals Effect of Poly-l-Lysine Polycation on the Glucose Oxidase/Ferricyanide Composite-Based Second-Generation Blood Glucose Sensors

Sensors ◽  
2019 ◽  
Vol 19 (6) ◽  
pp. 1448 ◽  
Author(s):  
Ming-Jie Lin ◽  
Ching-Chou Wu ◽  
Ko-Shing Chang
Keyword(s):  
Blood Glucose ◽  
Glucose Oxidase ◽  
Second Generation ◽  
Glucose Biosensor ◽  
Blood Glucose Measurement ◽  
Glucose Measurement ◽  
Diabetic Patients ◽  
Appreciable Effect ◽  
Serum Samples ◽  
Glucose Testing

Second-generation glucose biosensors are presently the mainstream commercial solution for blood glucose measurement of diabetic patients. Screen-printed carbon electrodes (SPCEs) are the most-used substrate for glucose testing strips. This study adopted hydrophilic and positively charged α-poly-l-lysine (αPLL) as the entrapment matrix for the immobilization of negatively charged glucose oxidase (GOx) and ferricyanide (FIC) on SPCEs to construct a disposable second-generation glucose biosensor. The αPLL modification is shown to facilitate the redox kinetics of FIC and ferrocyanide on the SPCEs. The SPCEs coated with 0.5 mM GOx, 99.5 mM FIC, and 5 mM αPLL had better sensitivity for glucose detection due to the appreciable effect of protonated αPLL on the promotion of electron transfer between GOx and FIC. Moreover, the SPCEs coated with 0.5 mM GOx, 99.5 mM FIC, and 5 mM αPLL were packaged as blood glucose testing strips for the measurement of glucose-containing human serum samples. The glucose testing strips had good linearity from 2.8 mM to 27.5 mM and a detection limit of 2.3 mM. Moreover, the 5 mM αPLL-based glucose testing strips had good long-term stability to maintain GOx activity in aging tests at 50 °C.

scholarly journals Interstitium versus Blood Equilibrium in Glucose Concentration and its Impact on Subcutaneous Continuous Glucose Monitoring Systems

2010 ◽  
Vol 10 (1) ◽  
pp. 36 ◽  
Author(s):  
Cosimo Scuffi ◽  
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Glucose Concentration ◽  
Interstitial Fluid ◽  
Glucose Monitoring ◽  
Foreign Body Response ◽  
Monitoring Systems ◽  
Glucose Levels ◽  
Consequent Reduction ◽  
The Impact

The relationship between both interstitial and blood glucose remains a debated topic, on which there is still no consensus. The experimental evidence suggests that blood and interstitial fluid glucose levels are correlated by a kinetic equilibrium, which as a consequence has a time and magnitude gradient in glucose concentration between blood and interstitium. Furthermore, this equilibrium can be perturbed by several physiological effects (such as foreign body response, wound-healing effect, etc.), with a consequent reduction of interstitial fluid glucose versus blood glucose correlation. In the present study, the impact of operating in the interstitium on continuous glucose monitoring systems (CGMs) will be discussed in depth, both for the application of CGMs in the management of diabetes and in other critical areas, such as tight glycaemic control in critically ill patients.

IoT Based Non Invasive Glucometer Using Optical Method

2017 ◽  
Vol 7 (9) ◽  
pp. 42
Author(s):  
Saina Sunny ◽  
S. Swapna Kumar
Keyword(s):  
Blood Glucose ◽  
Real Time ◽  
Glucose Monitoring ◽  
Blood Glucose Measurement ◽  
Blood Glucose Monitoring ◽  
World Health ◽  
Glucose Measurement ◽  
Body Parts ◽  
Non Invasive ◽  
The World

Analysis and measurement of Diabetes Mellitus (DM) became one of the critical challenges of the coming future. Since by 2030, diabetes effected are increased to 360 million all over the world by the World Health Organization (WHO) analytical study survey results. The main aim of this paper is non invasive and continuous glucose monitoring with the IoT technology involvement. Traditional finger pricking methods pros and cons are notified and tried to rectify its demerits. The designed device consist of an infrared led having a wavelength of 900 to 1100nm for the optical blood glucose measurement. NIR photodiodes used to collect light collected from body parts and regressive analysis is carried out. The signal processing, data algorithm is based on Beer-Lambert’s law. In assistance with internet of things (IoT) in WiFi range push alerts are reached to the patients and their concerns on real time. Therefore, it helps in emergency, continuous real time blood glucose monitoring. An IOT based noninvasive glucose monitoring will be a milestone for emerging and smart generation.

scholarly journals How Much Accuracy of Interstitial Glucose Measurement Is Enough? Is There a Need for New Evidence?

2016 ◽  
Vol 11 (2) ◽  
pp. 296-298 ◽  
Author(s):  
Norbert Hermanns ◽  
Dominic Ehrmann ◽  
Bernhard Kulzer
Keyword(s):  
Blood Glucose ◽  
Point Of Care ◽  
Glucose Monitoring ◽  
Blood Glucose Measurement ◽  
Capillary Blood ◽  
Glucose Measurement ◽  
Capillary Blood Glucose ◽  
Measurement Systems ◽  
Interstitial Glucose ◽  
New Evidence

This analytical comment discusses what standards are needed for the evaluation of the accuracy of glucose measurement systems continuously measuring glucose in the interstitial fluid. Since accuracy standards for continuous glucose monitoring (CGM)/flash glucose monitoring (FGM) systems are currently based on modeling studies or consensus of experts, we raised the question whether non-inferiority trials evaluating the safety and efficacy of CGM/FGM measurements compared to capillary blood glucose measurement with point-of-care devices could help to establish clarity about the needed accuracy standards of CGM/FGM. Such trials could also support the replacement of capillary blood glucose measurements by modern CGM/FGM systems.

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