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

Author(s):  
Rebecca A Ober ◽  
Gail E Geist

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.

2020 ◽  
pp. 193229682096700
Author(s):  
Tejaswi Kompala ◽  
Aaron B. Neinstein

In this study by Alva et al, accuracy of a second-generation factory calibrated continuous glucose monitoring system is evaluated. Compared to the first-generation FreeStyle Libre 14-day system (FSL), accuracy was improved throughout the 14-day wear period, including improved accuracy in hypoglycemia for adults and youth. The addition of optional real-time alerts for hypoglycemia and hyperglycemia as well as an integrated continuous glucose monitor (iCGM) designation by the FDA may further enable users to benefit from using CGM in real time, including in future automated insulin delivery systems. As CGM accuracy, affordability, and accessibility improve, we anticipate increased uptake of CGM by people on intensive insulin therapy, and also potential benefits and expansion into a broader patient population. There are growing opportunities to leverage cloud-connected CGM devices in the increasingly virtual, continuous telehealth-driven diabetes care model, which will require more focus on development and use of data interoperability standards.


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