scholarly journals The Impact of Continuous Glucose Monitoring on Low Interstitial Glucose Values and Low Blood Glucose Values Assessed by Point-of-care Blood Glucose Meters

2014 ◽  
Vol 8 (3) ◽  
pp. 516-522 ◽  
Author(s):  
Norbert Hermanns ◽  
Beatrix Schumann ◽  
Bernhard Kulzer ◽  
Thomas Haak
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Point Of Care ◽  
Glucose Monitoring ◽  
Interstitial Glucose ◽  
The Impact

scholarly journals Blood glucose and subcutaneous continuous glucose monitoring in critically ill horses: A pilot study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247561
Author(s):  
Valentina Vitale ◽  
Lise C. Berg ◽  
Bettina Birch Larsen ◽  
Andrea Hannesdottir ◽  
Preben Dybdahl Thomsen ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Critically Ill ◽  
Continuous Glucose Monitoring ◽  
Interstitial Fluid ◽  
Point Of Care ◽  
Glucose Monitoring ◽  
Relevant Information ◽  
Glucose Levels ◽  
Interstitial Glucose ◽  
Blood Gas Analyzer

This pilot prospective study reports the feasibility, management and cost of the use of a continuous glucose monitoring (CGM) system in critically ill adult horses and foals. We compared the glucose measurements obtained by the CGM device with blood glucose (BG) concentrations. Neonatal foals (0–2 weeks of age) and adult horses (> 1 year old) admitted in the period of March-May 2016 with clinical and laboratory parameters compatible with systemic inflammatory response syndrome (SIRS) were included. Glucose concentration was monitored every 4 hours on blood samples with a point-of-care (POC) glucometer and with a blood gas analyzer. A CGM system was also placed on six adults and four foals but recordings were successfully obtained only in four adults and one foal. Glucose concentrations corresponded fairly well between BG and CGM, however, there appeared to be a lag time for interstitial glucose levels. Fluctuations of glucose in the interstitial fluid did not always follow the same trend as BG. CGM identified peaks and drops that would have been missed with conventional glucose monitoring. The use of CGM system is feasible in ill horses and may provide clinically relevant information on glucose levels, but there are several challenges that need to be resolved for the system to gain more widespread usability.

Comparison of two glucose-monitoring systems for use in horses

2022 ◽  
pp. 1-7
Author(s):  
Caitlin E. Malik ◽  
David M. Wong ◽  
Katarzyna A. Dembek ◽  
Katherine E. Wilson
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Concentration ◽  
Point Of Care ◽  
Glucose Monitoring ◽  
Glucose Absorption ◽  
Monitoring Systems ◽  
Oral Glucose ◽  
Clinically Normal ◽  
Freestyle Libre ◽  
Interstitial Glucose

Abstract OBJECTIVE To determine the accuracy of 2 interstitial glucose-monitoring systems (GMSs) for use in horses compared with a point-of-care (POC) glucometer and standard laboratory enzymatic chemistry method (CHEM). ANIMALS 8 clinically normal adult horses. PROCEDURES One of each GMS device (Dexcom G6 and Freestyle Libre 14-day) was placed on each horse, and blood glucose concentration was measured via POC and CHEM at 33 time points and compared with simultaneous GMS readings. An oral glucose absorption test (OGAT) was performed on day 2, and glucose concentrations were measured and compared. RESULTS Glucose concentrations were significantly correlated with one another between all devices on days 1 to 5. Acceptable agreement was observed between Dexcom G6 and Freestyle Libre 14-day when compared with CHEM on days 1, 3, 4, and 5 with a combined mean bias of 10.45 mg/dL and 1.53 mg/dL, respectively. During dextrose-induced hyperglycemia on day 2, mean bias values for Dexcom G6 (10.49 mg/dL) and FreeStyle Libre 14-day (0.34 mg/dL) showed good agreement with CHEM. CLINICAL RELEVANCE Serial blood glucose measurements are used to diagnose or monitor a variety of conditions in equine medicine; advances in near-continuous interstitial glucose monitoring allow for minimally invasive glucose assessment, thereby reducing stress and discomfort to patients. Data from this study support the use of the Dexcom G6 and Freestyle Libre 14-day interstitial glucose-monitoring systems to estimate blood glucose concentrations in horses.

scholarly journals Continuous Glucose Monitoring in Critically Ill Patients With COVID-19: Results of an Emergent Pilot Study

2020 ◽  
Vol 14 (6) ◽  
pp. 1065-1073
Author(s):  
Archana R. Sadhu ◽  
Ivan Alexander Serrano ◽  
Jiaqiong Xu ◽  
Tariq Nisar ◽  
Jessica Lucier ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Pilot Study ◽  
Insulin Therapy ◽  
Critically Ill ◽  
Continuous Glucose Monitoring ◽  
Critically Ill Patients ◽  
Point Of Care ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Target Range

Background: Amidst the coronavirus disease 2019 (COVID-19) pandemic, continuous glucose monitoring (CGM) has emerged as an alternative for inpatient point-of-care blood glucose (POC-BG) monitoring. We performed a feasibility pilot study using CGM in critically ill patients with COVID-19 in the intensive care unit (ICU). Methods: Single-center, retrospective study of glucose monitoring in critically ill patients with COVID-19 on insulin therapy using Medtronic Guardian Connect and Dexcom G6 CGM systems. Primary outcomes were feasibility and accuracy for trending POC-BG. Secondary outcomes included reliability and nurse acceptance. Sensor glucose (SG) was used for trends between POC-BG with nursing guidance to reduce POC-BG frequency from one to two hours to four hours when the SG was in the target range. Mean absolute relative difference (MARD), Clarke error grids analysis (EGA), and Bland-Altman (B&A) plots were calculated for accuracy of paired SG and POC-BG measurements. Results: CGM devices were placed on 11 patients: Medtronic ( n = 6) and Dexcom G6 ( n = 5). Both systems were feasible and reliable with good nurse acceptance. To determine accuracy, 437 paired SG and POC-BG readings were analyzed. For Medtronic, the MARD was 13.1% with 100% of readings in zones A and B on Clarke EGA. For Dexcom, MARD was 11.1% with 98% of readings in zones A and B. B&A plots had a mean bias of −17.76 mg/dL (Medtronic) and −1.94 mg/dL (Dexcom), with wide 95% limits of agreement. Conclusions: During the COVID-19 pandemic, CGM is feasible in critically ill patients and has acceptable accuracy to identify trends and guide intermittent blood glucose monitoring with insulin therapy.

scholarly journals Continuous Glucose Monitoring (CGM) or Blood Glucose Monitoring (BGM): Interactions and Implications

2018 ◽  
Vol 12 (4) ◽  
pp. 873-879 ◽  
Author(s):  
Lutz Heinemann
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Patient Management ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Advanced Technologies ◽  
Patients With Diabetes ◽  
The Impact ◽  
Annual International Conference

At the 2017 10th annual International Conference on Advanced Technologies and Treatments for Diabetes (ATTD) in Paris, France, four speakers presented their perspectives on the roles of continuous glucose monitoring (CGM) and of blood glucose monitoring (BGM) in patient management within one symposium. These presentations included discussions of the differences in the accuracy of CGM and BGM, a clinical perspective on the physiological reasons behind differences in CGM and BGM values, and an overview of the impact of variations in device accuracy on patients with diabetes. Subsequently a short summary of these presentations is given, highlighting the value of good accuracy of BGM or CGM systems and the ongoing need for standardization. The important role of both BGM and CGM in patient management was a theme across all presentations.

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 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.

scholarly journals Assessment of a Noninvasive Chronic Glucose Monitoring System in Euglycemic and Diabetic Swine (Sus scrofa)

2020 ◽  
Author(s):  
Rebecca A Ober ◽  
Gail E Geist
Keyword(s):  
Blood Glucose ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Point Of Care ◽  
Glucose Monitoring ◽  
Continuous Glucose Monitoring System ◽  
Serum Chemistry ◽  
Continuous Glucose Monitor ◽  
Glucose Levels ◽  
Skin Patch

Models of type-I diabetes are well-characterized and commonly used in the preclinical evaluation of drugs and medical devices. The diabetic minipig is an excellent example of a translational model. However, chronic glucose monitoring in this species can be challenging; frequent blood sampling can be technically difficult and poorly tolerated in conscious swine. Skin-patch continuous blood glucose monitors are FDA-approved for human use and offer a potential refinement to cageside blood collection. However, this modality has not been evaluated in pigs. In this study, young adult male STZ-induced diabetic Yucatan minipigs (n = 4) and healthy York pigs (n = 4) were implanted with a 14-d skin-patch continuous glucose monitor. Readings from continuous glucose monitors were time-matched to whole blood samples, with glucose measurements performed using point-of-care blood glucose monitors, serum chemistry or both. The aims of the study were to assess if a continuous glucose monitoring system could accurately detect glucose levels in swine, and to compare the readings toboth point-of-care glucometers and serum chemistry results. We hypothesized that a continuous glucose monitoring system would accurately detect glucose levels in swine in comparison with a validated analyzer and could serve as an animal welfarerefinement for studies of diabetes. We found that the continuous glucose monitor used in this study provided an adequateadjunct for clinical management in the stable diabetic pig and a minimally invasive and inexpensive option for colony maintenanceof chronically diabetic swine.

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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