Assessment of subcutaneous glucose concentration: validation of the wick technique as a reference for implanted electrochemical sensors in normal and diabetic dogs

Fischer, Uwe; Ertle, R.; Abel, Peter; Rebrin, Kerstin; Brunstein, Elena; Dorsche, Herwig Hahn von; Freyse, Ernst‐Joachim

doi:10.1007/bf00295878

Cited by 114 publications

(77 citation statements)

References 23 publications

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“…Regittnig et al (5) found muscle and fat interstitial glucose values of 60 and 65% of blood glucose values during fasting conditions using the open-flow microperfusion technique. Interstitial values have been found to be identical to plasma values by some (8) and lower by 10 -55% by others (9,10), and microdialysis studies have shown glucose values that were lower by 15-30% (11)(12)(13). This is the first study with simultaneous continuous measurement of glucose in the interstitial fluid of adipose tissue, muscle tissue, and brain.…”

Section: Discussionmentioning

confidence: 62%

Continuous Glucose Monitoring in Interstitial Subcutaneous Adipose Tissue and Skeletal Muscle Reflects Excursions in Cerebral Cortex

et al. 2005

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Continuous glucose monitoring (CGM) is being explored using several types of glucose sensors. Some are designed for subcutaneous adipose tissue. It is important to determine to which extent these glucose fluctuations in different tissues reflect changes taking place in the central nervous system, where glucose sensing is thought to occur. We studied the ability of subcutaneous adipose interstitial fluid measurements to parallel glucose propagations in blood, muscle, and central nervous system (CNS) during hyper-and hypoglycemia. A subcutaneous CGM system was applied in the CNS, subcutaneous adipose tissue, and skeletal muscle of nine Vietnamese potbellied pigs, and data were compared with frequent sampling in blood. Alterations in glucose levels were induced with intravenous glucose and insulin. During hyperglycemia, no difference was detected in delay between blood and interstitial glucose levels in subcutaneous adipose tissue (18.0 ؎ 0.8 min), muscle (18.0 ؎ 0.9 min), and CNS (20.3 ؎ 1.2 min), respectively. During hypoglycemia, we found no time difference between interstitial parameters in the three tissues. However, the amplitude of glucose changes varied considerably, with a smaller magnitude of glucose change taking place in the brain. The timing of glucose excursions in subcutaneous adipose tissue and muscle reflect excursions in CNS. The reduced magnitude of glucose excursions in the brain suggests that different mechanisms of glucose transport are operative in CNS compared with subcutaneous adipose tissue and muscle.

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Section: Discussionmentioning

confidence: 62%

Continuous Glucose Monitoring in Interstitial Subcutaneous Adipose Tissue and Skeletal Muscle Reflects Excursions in Cerebral Cortex

et al. 2005

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“…Blood glucose concentrations are well correlated with subcutaneous glucose concentrations at steady-state (1)(2)(3)(4)(5). When the blood glucose concentration increases rapidly (3,4,(6)(7)(8)(9) or decreases (7,9,10) there is, however, a time lag, resulting in a transient difference between the blood and subcutaneous glucose concentrations.…”

mentioning

confidence: 99%

Measurement and modeling of the transient difference between blood and subcutaneous glucose concentrations in the rat after injection of insulin

Schmidtke

Freeland

Heller

et al. 1998

Proc. Natl. Acad. Sci. U.S.A.

113

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The kinetics of the fall in subcutaneous f luid glucose concentration in anesthetized rats (n ‫؍‬ 7) after intravenous injection of insulin (0.5 units͞kg) was studied by using 5 ؋ 10 ؊4 cm 2 active area, <150-sec 10-90% response time, amperometric glucose sensors. The onset of the decline in the subcutaneous glucose concentration was delayed and statistically different (P < 0.001) from that in blood (8.9 ؎ 2.1 min vs. 3.3 ؎ 0.5 min). Similarly, the rate of drop in glucose concentration between 6 and 20 min after the insulin injection was different for subcutaneous tissue (3.9 ؎ 1.3 mg⅐dl ؊1 ⅐ min ؊1 ) and blood (6.8 ؎ 2.0 mg⅐dl ؊1 ⅐min ؊1 ) (P ‫؍‬ 0.003). The hypoglycemic nadir in subcutaneous f luid occurred 24.5 ؎ 6.8 min after that in the blood (P < 0.001). A ''forward'' masstransfer model, predicting the subcutaneous glucose concentration from the blood glucose concentrations and an ''inverse'' model, predicting the blood glucose concentration from the subcutaneous glucose concentration were derived. By using an algorithm based on the latter, the average discrepancy between the measured blood glucose concentration and that estimated from the subcutaneous measurement through the entire 4-hr experiment was reduced from 22.9% to 11.1% (P ‫؍‬ 0.025). The maximum discrepancy during the 40-min period after the injection of insulin was reduced from 84.1% to 29.3% (P ‫؍‬ 0.006).We address the avoidance of clinical error in the treatment of diabetes when the glucose concentration is monitored not in the blood but in the subcutaneous interstitial fluid, where amperometric sensors, operating continuously, can be placed. Blood glucose concentrations are well correlated with subcutaneous glucose concentrations at steady-state (1-5). When the blood glucose concentration increases rapidly (3, 4, 6-9) or decreases (7, 9, 10) there is, however, a time lag, resulting in a transient difference between the blood and subcutaneous glucose concentrations. With recently developed 5 ϫ 10 Ϫ4 cm 2 active area, Ͻ150-sec response time flexible glucose electrodes, small enough to be implanted not only subcutaneously but also in the jugular vein of rats, it became possible to continuously and simultaneously track the two concentrations and to better time resolve them (11, 12). Here we report substantial transient differences between the two, large enough to lead to clinical error, after injection of regular insulin. We also show that this transient difference can be modeled and derive an algorithm that corrects for most of the transient difference. MATERIALS AND METHODSGlucose Electrodes. The electrodes were structurally similar to the earlier reported ones (12). Their 5 ϫ 10 Ϫ4 cm 2 active area had three layers. Of these layers, the ''wired'' glucose oxidase transduction layer and the biocompatible layer were identical with those described in ref. 12. The glucose flux restricting layer however was modified by sequentially filling the 90-m deep, 250-m diameter recess and curing (at room temperature for 20 min) twice with a 1% solu...

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“…In the enzymatic glucose sensors, packaging technology, which was used to coat the sensors with biologically inert materials, is being widely used to prevent fouling and increase their biocompatibility. For example, cellulose acetate, 65 polyethylene glycol, 66 polyvinyl chloride, 67 polyurethane, 68 and Nafion 69 are being widely employed as biocompatible packaging materials.…”

Section: Non-enzymatic Microneedle Glucose Sensingmentioning

confidence: 99%

Editors' Choice—Review—In Vivo and In Vitro Microneedle Based Enzymatic and Non-Enzymatic Continuous Glucose Monitoring Biosensors

Chinnadayyala

Park

Cho

2018

ECS J. Solid State Sci. Technol.

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Microneedles have emerged for transdermal monitoring of biomarkers, which are a miniaturized replica of hypodermic needles with length-scales of hundreds of micrometers, with a goal to achieve time-sensitive clinical information for routine point-of-care health monitoring. Transdermal biosensing via microneedles offers remarkable opportunities for moving biosensing technologies from research laboratories to real-field applications and enables development of easy-to-use point-of-care microdevices, minimally invasive, and with minimal-training features that are very attractive for both developed and emerging countries. This would eliminate the need for blood extraction using hypodermic needles and in turn, reduce the related problems such as infections in the patients, sample contaminations, and analysis artifacts. In this review, we provide a general overview of recent progress in microneedlebased sensing research, including: (a) in-vivo microneedle diagnostic systems for glucose monitoring with an emphasis on sensor construction and general health monitoring (b) in-vitro use of microneedle sensors. The main objective of the review is to provide a thorough and critical analysis of recent advances and developments in microneedle research field and to bridge the gap between microneedles and biosensors.

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Assessment of subcutaneous glucose concentration: validation of the wick technique as a reference for implanted electrochemical sensors in normal and diabetic dogs

Cited by 114 publications

References 23 publications

Continuous Glucose Monitoring in Interstitial Subcutaneous Adipose Tissue and Skeletal Muscle Reflects Excursions in Cerebral Cortex

Continuous Glucose Monitoring in Interstitial Subcutaneous Adipose Tissue and Skeletal Muscle Reflects Excursions in Cerebral Cortex

Measurement and modeling of the transient difference between blood and subcutaneous glucose concentrations in the rat after injection of insulin

Editors' Choice—Review—In Vivo and In Vitro Microneedle Based Enzymatic and Non-Enzymatic Continuous Glucose Monitoring Biosensors

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