Continuous Measurement of Glucose

Rice, Mark J.; Coursin, Douglas B.

doi:10.1097/aln.0b013e318236abf6

Cited by 32 publications

(26 citation statements)

References 38 publications

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“…Glucose 10% 500 mL with Humulin R 16 IU was distributed from 7:00 to 10:00 am before the surgery. Due to the interstitium -plasma time lag phenomenon, subcutaneous CGM could never be 100% in accordance with the laboratory analyser -but provided this delay is similar to the delay between plasma and central nervous system glucose concentration, the IF glucose concentration more realistically reflects the central nervous glucose concentration than directly measured PG 49 . If this hypothesis is confirmed, it would be beneficial to display the original IF glucose concentration in addition to the calculated PG value.…”

Section: Hunger After the Surgerymentioning

confidence: 99%

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Glucose sensing module - is it time to integrate it into real-time perioperative monitoring? An observational pilot study with subcutaneous sensors

Poljakova¹,

Elsikova²,

Chlup³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims.To explore the feasibility of subcutaneous continuous glucose monitoring (CGM) in perioperative settings and to evaluate the perioperative development of glycaemia in persons with diabetes mellitus or impaired glucose tolerance by means of CGM. Methods. Monitoring by means of Guardian® REAL-Time CGMS (Medtronic, Nortridge, USA) in 20 perioperative periods. Sensor was inserted on the day before surgery and continued for 3 days with some exceptions. Results. Full implementation of the method was successful in the intensive care unit setting only. No electromagnetic interference and no side effects were found. The Wilcoxon signed-rank test revealed no significant difference between sensor and laboratory analyser values. Pearson´s correlation coefficients of the values obtained by sensor and the Wellion Linus glucometer were 0.875 for the whole perioperative period, 0.866 for the intraoperative period and 0.903 for the first perioperative day. A decline in sensor accuracy on the 6 th day was registered in one case. 16 monitored cases (80%) did not meet the criteria for safe plasma glucose range. Hypoglycaemia was found in 4 (20%) cases. There was an association between grade of the perioperative dysglycaemia and need for reoperation within the next 3 months. The most frequent perioperative glycaemic patterns are demonstrated. Conclusion. Subcutaneous CGM is safe offering detailed insight into glucose homeostasis in the dynamic perioperative period. Laboratory confirmation of sensor plasma glucose concentration by approved laboratory analyser is still necessary. The potentional benefits of maintaining patients within a safe glucose range should be comfirmed by future studies.

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Section: Hunger After the Surgerymentioning

confidence: 99%

“…Until we have a new generation of "robust, high-performance sensors", the Rice´s comparison is valid: PG values estimated by a laboratory analyser are like an accurate snapshot, CGM data are like a bit blurry movie but providing us with a real-time picture 49 .…”

Section: Hunger After the Surgerymentioning

confidence: 99%

Glucose sensing module - is it time to integrate it into real-time perioperative monitoring? An observational pilot study with subcutaneous sensors

Poljakova¹,

Elsikova²,

Chlup³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…14 Critically ill patients stand to benefit from implementing continuous glucose monitoring (CGM) to improve intensive insulin therapy. [15][16] CGM systems range from invasive (intravascular) to noninvasive (transdermal). 16 Minimally invasive and noninvasive technologies exist on a spectrum and rely on measuring BG from interstitial fluid, across the skin, or via saliva and tears.…”

Section: Original Articlementioning

confidence: 99%

“…[15][16] CGM systems range from invasive (intravascular) to noninvasive (transdermal). 16 Minimally invasive and noninvasive technologies exist on a spectrum and rely on measuring BG from interstitial fluid, across the skin, or via saliva and tears. Methods to capture and analyze interstitial fluid include iontophoresis, electrical current applied across the skin; sonophoresis, low-frequency ultrasound applied across the skin; skin blister technique; micropore technique; and microneedle technique.…”

Section: Original Articlementioning

confidence: 99%

Accuracy of a Novel Noninvasive Transdermal Continuous Glucose Monitor in Critically Ill Patients

Saur

England

Menzie

et al. 2014

J Diabetes Sci Technol

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Stress hyperglycemia and hypoglycemia are associated with increased morbidity and mortality in the critically ill. Intermittent, random blood glucose (BG) measurements can miss episodes of hyper-and hypoglycemia. The purpose of this study was to determine the accuracy of the Symphony® continuous glucose monitor (CGM) in critically ill cardiac surgery patients. Fifteen adult cardiac surgery patients were evaluated immediately postoperatively in the intensive care unit. Prelude® SkinPrep prepared the skin and a sensor was applied to 2 test sites on each subject to monitor interstitial fluid glucose. Reference BG was sampled at 30-to 60-minute intervals. The skin at the test sites was inspected for adverse effects. Accuracy of the retrospectively analyzed CGM data relative to reference BG values was determined using continuous glucose-error grid analysis (CG-EGA) and mean absolute relative difference (MARD). Using 570 Symphony CGM glucose readings paired with reference BG measurements, CG-EGA showed that 99.6% of the readings were within zones A and B. BG measurements ranged from 73 to 251 mg/dL. The MARD was 12.3%. No adverse device effects were reported. The Symphony CGM system is able to safely, continuously, and noninvasively monitor glucose in the transdermal interstitial fluid of cardiac surgery intensive care unit patients with accuracy similar to that reported with other CGM systems. Future versions of the system will need real-time data analysis, fast warm-up, and less frequent calibrations to be used in the clinical setting.

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“…Continuous glucose monitoring (CGM) could be of value to facilitate or improve glycemic control. Previous studies have indicated an acceptable accuracy and reliability for subcutaneous CGM devices in critically ill patients [11][12][13][14][15]. The only prospective randomized controlled trial so far that assessed the role for CGM in glycemic control in critically ill patients showed that real-time CGM increased the safety of tight glycemic control in critically ill patients by significantly reducing severe hypoglycemic events [16].…”

Section: Introductionmentioning

confidence: 99%

Insulin treatment guided by subcutaneous continuous glucose monitoring compared to frequent point-of-care measurement in critically ill patients: a randomized controlled trial

et al. 2014

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Continuous Measurement of Glucose

Cited by 32 publications

References 38 publications

Glucose sensing module - is it time to integrate it into real-time perioperative monitoring? An observational pilot study with subcutaneous sensors

Glucose sensing module - is it time to integrate it into real-time perioperative monitoring? An observational pilot study with subcutaneous sensors

Accuracy of a Novel Noninvasive Transdermal Continuous Glucose Monitor in Critically Ill Patients

Insulin treatment guided by subcutaneous continuous glucose monitoring compared to frequent point-of-care measurement in critically ill patients: a randomized controlled trial

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