Skin mini-erosion technique for monitoring metabolites in interstitial fluid: its feasibility demonstrated by OGTT results in diabetic and non-diabetic subjects

Abstract

The aim of this study was to evaluate a new interstitial fluid (IF) sampling technique and its application in diabetology. IF and venous whole blood were sampled serially during an oral glucose tolerance test (OGTT) on days 1 and 3 after formation of a mini-erosion in eight non-diabetic controls and eight Type 2 diabetic subjects. Glucose, lactate, glycerol, 3-hydroxybutyrate and insulin were assayed in IF and plasma. With solitary exceptions, the IF sample volumes were in excess of those required for measurement of all five substances. However, mean IF sampling rates differed significantly both between the non-diabetic and diabetic groups and between days 1 and 3 (p < 0.001 in all cases). In both groups, the OGTT curves of glucose, glycerol and 3-hydroxybutyrate were similar to the respective curves for plasma, whereas for lactate concentrations they were markedly greater in IF than in plasma (40% and 93% in the control group and 57% and 100% greater in the diabetic group on days 1 and 3, respectively). The reverse was true of insulin concentrations in the non-diabetic group, which were 57% and 74% lower in IF than in plasma on days 1 and 3, respectively. In the non-diabetic group, the baseline (pre-OGTT) insulin level in IF increased from 49 +/- 22% (SD) of that in plasma on day 1 to 74 +/- 19% of that in plasma on day 3 (p=0.005). Sampling site re-epithelialization was rapid. In conclusion, the feasibility of transdermal sampling of IF via a skin mini-erosion has been demonstrated in both diabetic and non-diabetic subjects.

Plasma proteins in a standardised skin mini-erosion (I): permeability changes as a function of time

“…The pH in the erosion may be low, as indicated by lactate levels approximately 50 to 100% higher than those in plasma [3]. These factors may also affect the passage of plasma proteins, depending on their chemical and electrical characteristics.…”

Transdermal Suctioning Technique for Serial Sampling of Interstitial Fluid in Newborn Infants

“…IF sample volumes in this study were well in excess of the volume required of measuring glucose during the 3-day sampling period with a mean sampling rate of 1.9 l/min. This corresponded to the rate observed in adults during 6 days, and each sample is thus large enough to allow determination of a number of substances of interest in diabetic research [7,8] .…”

“…Groups of patients with dermatological, microvascular and metabolic diseases, or with impaired healing or defi cient immunological defences have been subjected to this procedure [7,17,18] . The epidermis has been found to regenerate rapidly after such sampling, local effects are subclinical, and no invasive complications have been reported [6,19] .…”

“…A silicone gel membrane may be used for this purpose [6,7] . IF sample volumes in this study were well in excess of the volume required of measuring glucose during the 3-day sampling period with a mean sampling rate of 1.9 l/min.…”

“…Hansen-Pupp /Håkansson /Polberger / Svedman Biol Neonate 2005;87:197-202 198 sampling of dermal IF, has been developed for adults [6][7][8] but has not yet been applied to infants. This technique allows determinations of glucose as well as of other substances over a period of several days, without the invasiveness and complexity of some existing procedures for assaying IF.…”