In-Vitro Performance of the Enlite Sensor in Various Glucose Concentrations during Hypobaric and Hyperbaric Conditions

Management of Diabetes During Air Travel: A Systematic Literature Review of Current Recommendations and their Supporting Evidence

“…The majority of publications provided recommendations on general travel advice or adjustment of insulin during air travel; 2 offered specific travel recommendations for children with diabetes (15,16). There were 10 experimental device studies that evaluated the function of hand-held glucometers, implantable subcutaneous glucose sensors (such as those used in continuous glucose monitors) or insulin pumps in hypobaric environments (17)(18)(19)(20)(21)(22)(23)(24)(25)(26). There were 2 case reports, 1 describing insulin-pump dysfunction during air travel (27) and the other detailing a case of air travel-related macular edema (28).…”

“…Although the literature is limited, 3 studies suggested that GDH-based glucometers may be more accurate at altitude given their lack of reliance on oxygen (21,22,24) and that altituderelated inaccuracies were in the "safe-zones" of EGA clinical decision-making (21,22,24). The sole subcutaneous glucose sensor tested at altitude relied on the GOX enzymatic system and was less accurate when measuring low and high glucose solutions (25). However, in a separate in vivo study of the same system, EGA revealed that the inaccuracies would not have led to inappropriate treatment (64).…”

“…Glucometers using hexokinase, glucose dehydrogenase (GDH), or glucose oxidase based (GOX) enzymatic systems were tested. One subcutaneous glucose sensor studied utilized a GOX enzymatic system (25). Glucometer accuracy is reportedly affected by eleva- (12,13,33,35,38,40,45,46,53,58).…”

Monitoring of Pediatric Type 1 Diabetes

“…As discussed previously, the accuracy of BGM, which often uses glucose oxidase for measurement, is impacted by altitude. Altitude's influence on CGM accuracy has been less well-studied; however, limited studies have suggested that extreme environments with both hypo-and hyperbaric conditions do not significantly alter the accuracy of CGM systems (33,65,66).…”

Reliability of the Dexcom G6 Continuous Glucose Monitor During Hyperbaric Oxygen Exposure

“…To date, there have been only two publicationsone in vitro and one in vivo -reporting the effects of hypobaric and hyperbaric chamber exposures on a CGM, however, those studies were done with air and not oxygen. 19,20 A patient receiving HBO 2 may have alveolar pO 2 over 1800 mmHg with tissue pO 2 over 1000 mmHg. POC glucometers utilizing GO test strips have been shown to underestimate glucose levels when exposed to high pO 2 levels, [21][22][23][24] while those using glucose dehydrogenase (GD) test strips are not affected by high pO 2 levels.…”