Accuracy of continuous subcutaneous glucose monitoring with the GlucoDay® in type 1 diabetic patients treated by subcutaneous insulin infusion during exercise of low versus high intensity

Fayolle, C.; Brun, J.F.; Bringer, J.; Mercier, Jacques; Renard, Éric

doi:10.1016/s1262-3636(07)70285-9

Cited by 37 publications

(31 citation statements)

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“…8 Another potential source of inaccuracy is sensor dislodgement due to sweating or by direct mechanical forces on sensors sited in exercising limbs. [11][12][13] The noninvasive GlucoWatch Ò Biographer (Cygnus, Redwood City, CA), no longer available for clinical use, measures interstitial glucose using reverse iontophoresis. It was the first CGM device to be tested during exercise, demonstrating a progressive decline in accuracy with more intense activity and a high skip rate due to perspiration.…”

Section: Discussionmentioning

confidence: 99%

“…13 The GlucoDay Ò (Menarini Diagnostics, Florence, Italy) was worn during exercise of varying intensity on a cycle ergometer, showing 99.3% of values in the safe zones (A + B) of the Clarke error grid analysis. 11 However, 39% of the inserted microfiber sensor probes broke because of the mechanical stress exerted by exercising muscles. In a study of 58 adolescents during three sports camps, one-third of sensors (CGMS System Gold) required replacing within 48 h because of disconnection from sweating or loss of signal.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12][13][14][15] The study was carried out in a carefully controlled clinical research facility setting, over a 22.5-h duration, thus providing numerous paired glucose values for analysis. We used plasma glucose measured by the YSI 2300 STAT Plus analyzer as the reference standard, unlike other studies that used capillary glucose.…”

Section: Discussionmentioning

confidence: 99%

“…Accuracy, as measured by the median relative absolute difference (RAD) between paired sensor and reference glucose values in time, ranges from 11% to 14% under resting conditions. 8,9 There is limited objective evidence on performance of CGMs during physical activity, [10][11][12][13][14][15] in particular none using current-generation sensors. There are no studies evaluating CGM use in pregnant women during exercise.…”

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confidence: 99%

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Accuracy of Continuous Glucose Monitoring During Exercise in Type 1 Diabetes Pregnancy

Kumareswaran

Elleri²,

Allen³

et al. 2013

Diabetes Technology & Therapeutics

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Background: Performance of continuous glucose monitors (CGMs) may be lower when glucose levels are changing rapidly, such as occurs during physical activity. Our aim was to evaluate accuracy of a current-generation CGM during moderateintensity exercise in type 1 diabetes (T1D) pregnancy. Subjects and Methods: As part of a study of 24-h closed-loop insulin delivery in 12 women with T1D (disease duration, 17.6 years; glycosylated hemoglobin, 6.4%) during pregnancy (gestation, 21 weeks), we evaluated the Freestyle Navigator Ò sensor (Abbott Diabetes Care, Alameda, CA) during afternoon (15:00-18:00 h) and morning (09:30-12:30 h) exercise (55 min of brisk walking on a treadmill followed by a 2-h recovery), compared with sedentary conditions (18:00-09:00 h). Plasma (reference) glucose, measured at regular 15-30-min intervals with the YSI Ltd. (Fleet, United Kingdom) model YSI 2300 analyzer, was used to assess CGM performance. Results: Sensor accuracy, as indicated by the larger relative absolute difference (RAD) between paired sensor and reference glucose values, was lower during exercise compared with rest (median RAD, 11.8% vs. 18.4%; P < 0.001). These differences remained significant when correcting for plasma glucose relative rate of change (P < 0.001). Analysis by glucose range showed lower accuracy during hypoglycemia for both sedentary (median RAD, 24.4%) and exercise (median RAD, 32.1%) conditions. Using Clarke error grid analysis, 96% of CGM values were clinically safe under resting conditions compared with only 87% during exercise. Conclusions: Compared with sedentary conditions, accuracy of the Freestyle Navigator CGM was lower during moderateintensity exercise in pregnant women with T1D. This difference was particularly marked in hypoglycemia and could not be solely explained by the glucose rate of change associated with physical activity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Accuracy of Continuous Glucose Monitoring During Exercise in Type 1 Diabetes Pregnancy

Kumareswaran

Elleri²,

Allen³

et al. 2013

Diabetes Technology & Therapeutics

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“…67,325, The SCGM1 system of Roche Diagnostics, Mannheim, Germany, 354 and the GlucoDay system of A. Menarini IFR S.r.l, Florence, Italy, 331,345,346,[349][350][351][352]355 are microdialysisbased. Their microdialysis fibers are implanted in the abdominal adipose-tissue, their fluid flowing to an external amperometric H 2 O 2 -electrooxidizing GOx-utilizing sensor.…”

Section: Systems With Subcutaneous Ultrafiltration and Microdialysis mentioning

confidence: 99%

Electrochemical Glucose Sensors and Their Applications in Diabetes Management

2008

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About 6,000 peer reviewed articles have been published on electrochemical glucose assays and sensors, of which 700 were published in the 2005-2006 two-year period. Their number makes a full review of the literature, or even of the most recent advances, impossible. Nevertheless, this review should acquaint the reader with the fundamentals of the electrochemistry of glucose and provide a perspective of the evolution of the electrochemical glucose assays and monitors helping diabetic people, who constitute about 5% of the world's population. Because of the large number of diabetic people, no assay is performed more frequently than that of glucose. Most of these assays are electrochemical. The reader interested also in nonelectrochemical assays used in, or proposed for, the management of diabetes is referred to a 2007 review of Kondepati and Heise. 1 Adam Heller was born in 1933. Surviving the Holocaust, he arrived in Israel in 1945. He received his M.Sc. in Chemistry and Physics in 1957, then his PhD in Organic Chemistry in 1961 from Ernst David Bergman at the Hebrew University in Jerusalem. He postdoced at UC Berkeley (1962-3) and at Bell Laboratories . At GTE Labs (1964-1975 he built the first Nd 3+ liquid laser and, with J. J. Auborn, the still worldwide used Li/SOCl 2 battery. At Bell Labs (1975)(1976)(1977)(1978)(1979)(1980)(1981)(1982)(1983)(1984)(1985)(1986)(1987)(1988) he designed the first >10% efficient electrochemical solar cells and the first >10% efficient hydrogengenerating solar-powered photoelectrode. He also headed Bell Labs' Electronic Materials Research Department (1977)(1978)(1979)(1980)(1981)(1982)(1983)(1984)(1985)(1986)(1987)(1988), which developed part of the high density chip interconnection technology underlying the miniaturization of portable electronic devices. He was appointed to the Ernest Cockrell Sr. Chair in Engineering of the University of Texas at Austin in 1988, and in 2001 became one of UT's first Research Professors. At UT he pioneered the electrical wiring of enzymes. In 1996 he cofounded with his son Ephraim Heller TheraSense Inc., now part of Abbott Diabetes Care, to improve the lives of diabetic people. The company introduced in 2000 the blood sugar monitor FreeStyle, a thin-layer microcoulometer utilizing only 300 nL of blood, so little that it was, for the first time, painlessly obtained. In 2007 it provided for more than 1 billion painless glucose assays. After alleviating the pain of diabetes monitoring, FreeStyle Navigator, based on the electrical wiring of glucose oxidase, introduced in 2007 in Europe and Israel and in 2008 in the U.S., removed the worry of diabetic people by continuously monitoring their glucose levels. Heller aims his work at alleviating suffering through bioelectrochemistry.

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