Pilot Studies of Transdermal Continuous Glucose Measurement in Outpatient Diabetic Patients and in Patients during and after Cardiac Surgery

Chuang, Han; Trieu, My-Quyen; Hurley, James C.; Taylor, Elizabeth Johnston; England, Michael R.; Nasraway, Stanley A.

doi:10.1177/193229680800200410

Cited by 31 publications

(23 citation statements)

References 18 publications

(17 reference statements)

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“…Furthermore, tightly controlling glucose levels in critically ill patients with diabetes and even without diabetes has shown to reduce numerous medical complications and premature death. 2,3 A highly sensitive glucose biosensor could improve the sensitivity and accuracy of current blood glucose monitoring technologies since reports by the Food and Drug Administration suggest raising standards in home glucose monitors, including glucose testing strips and meters, to improve their glucose detection accuracy. 4 Therefore, a glucose monitoring technology with increased glucose sensitivity and accuracy could substantially improve the prognosis of diabetes and critically ill patients and subsequently reduce their associated health care expenses.…”

Section: Introductionmentioning

confidence: 99%

Electrochemical Glucose Biosensor of Platinum Nanospheres Connected by Carbon Nanotubes

Claussen

Kim

Haque

et al. 2010

Journal of Diabetes Science and Technology

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Section: Introductionmentioning

confidence: 99%

Electrochemical Glucose Biosensor of Platinum Nanospheres Connected by Carbon Nanotubes

Claussen

Kim

Haque

et al. 2010

Journal of Diabetes Science and Technology

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“…14 Continuous transdermal glucose monitoring has been shown to be accurate (values falling in zones A and B for CEG analysis) for healthy controls, cardiac surgery patients, and patients with diabetes. 24 Ellmerer et al established that subcutaneous adipose tissue monitoring is effective in postoperative cardiac surgery patients and can be used to guide intensive insulin dosing. 29 Holzinger et al showed the incidence of hypoglycemia was lower in their study population when CGM was available to the clinical staff.…”

Section: Discussionmentioning

confidence: 99%

“…23 Our group reported a MARD of 12.4% with an earlier version of a transdermal system. 24 Subcutaneous and transdermal systems utilize interstitial fluid for glucose measurement. Glucose diffuses from the capillary endothelium to the interstitial fluid without a transporter.…”

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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“…For example, GlucoWatch used a transdermal method called reverse iontophoresis that had limited accuracy and could cause skin irritation [39]. More recently, Echo Therapeutics (Philadelphia, Pa., USA) has conducted multiple clinical trials of a system whereby a small area of skin is permeated with a microdermabrasion device, allowing interstitial glucose concentration to be measured with a glucose-oxidase-based sensor on the skin's surface [41].…”

Section: Noninvasive Glucose Sensorsmentioning

confidence: 99%

Continuous Glucose Monitoring: Professional and Real Time

Zisser¹,

Lane²,

Shivers³

2014

Frontiers in Diabetes

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Continuous glucose monitors are a valuable tool to obtain tight glycemic control in people with diabetes. Since 1999 when the first continuous glucose monitor became commercially available, continuous glucose monitors have continued to evolve, becoming more accurate and user-friendly. Novel uses have also been discovered, including tracking glucose during sleep and finding trends in glucose levels that may lead to diet or exercise changes. While continuous glucose monitors are continually advancing in accuracy and reliability, their 'hassle factor' and invasiveness have investigators seeking alternative routes of glucose measurement. New models of continuous glucose monitors are being pursued including implantable, intraperitoneal, and fluorescence-based glucose sensors, as well as noninvasive models that are used on the surface of the skin. Regardless of system type, the ultimate goal is to find the continuous glucose monitor that is best-suited for use in systems that automate insulin delivery partially (e.g. low glucose suspend) or entirely (e.g. 'fully closed-loop' artificial pancreas).A continuous glucose monitor is a device that measures the concentration of glucose in the subcutaneous (interstitial) fluid, automatically and periodically. Compared to self-monitoring with a glucose meter, continuous glucose monitoring (CGM) measurements can give patients and healthcare providers a better understanding of glycemic trends and patterns. This is because CGM provides much more data than selfmonitoring and can be quite accurate in portraying the direction and speed of glucose changes. However, individual glucose measurements tend to be less accurate with

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Pilot Studies of Transdermal Continuous Glucose Measurement in Outpatient Diabetic Patients and in Patients during and after Cardiac Surgery

Abstract: Continuous transdermal glucose monitoring was demonstrated successfully in diverse clinical settings. The performance of abrasion was equivalent to ultrasound skin permeation methodology for transdermal glucose monitoring.

Cited by 31 publications

References 18 publications

Electrochemical Glucose Biosensor of Platinum Nanospheres Connected by Carbon Nanotubes

Electrochemical Glucose Biosensor of Platinum Nanospheres Connected by Carbon Nanotubes

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

Continuous Glucose Monitoring: Professional and Real Time

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