The Development of a Continuous Intravascular Glucose Monitoring Sensor

Crane, B; Barwell, Nicholas P.; Gopal, Palepu; Gopichand, Mannam; Higgs, Timothy C.; James, Tony D.; Jones, Christopher M.; MacKenzie, Alasdair; Mulavisala, Krishna; Paterson, William G.

doi:10.1177/1932296815587937

Cited by 54 publications

(72 citation statements)

References 37 publications

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“…The CGM device assessed in this study compares well with intravascular sensors that use other techniques, including enzymatic reactions [27], fluorescence [28, 29] and microdialysis [30]. One advantage of the OptiScanner® is that it does not require placement of an additional central catheter, in contrast to other systems that require peripheral venous access [27] or dedicated arterial access [29].…”

Section: Discussionmentioning

confidence: 99%

Manual versus Automated moNitoring Accuracy of GlucosE II (MANAGE II)

et al. 2016

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BackgroundIntravascular continuous glucose monitoring (CGM) may facilitate glycemic control in the intensive care unit (ICU). We compared the accuracy of a CGM device (OptiScanner®) with a standard reference method.MethodsAdult patients who had blood glucose (BG) levels >150 mg/dl and required insertion of an arterial and central venous catheter were included. The OptiScanner® was inserted into a multiple-lumen central venous catheter. Patients were treated using a dynamic-scale insulin algorithm to achieve BG values between 80 and 150 mg/dl. The BG values measured by the OptiScanner® were plotted against BG values measured using a reference analyzer. The correlation between the BG values measured using the two methods and the clinical relevance of any differences were assessed using the coefficient of determination (r 2) and the Clarke error grid, respectively; bias was assessed by the mean absolute relative difference (MARD). Three different standards of glucose monitoring were used to assess accuracy. Glycemic control was assessed using the time in range (TIR). Six indices of glycemic variability were calculated.ResultsThe analysis included 929 paired samples from 88 patients, monitored for a total of 2584 hours. Reference BG values ranged between 60 and 484 mg/dl. The r 2 value was 0.89. The percentage of BG values within zones A and B of the Clarke error grid was 99.9%; the MARD was 7.7%. Using the ISO 15197 standard and Food and Drug Administration and consensus standards, respectively, 80.4% of measurements were within 15 mg/dl and 88.2% within 15% of reference values, 40% of measurements were within 7 mg/dl and 72.5% within 10% of reference values, and 65.2% of measurements were within 10 mg/dl and 82.7% within 12.5% of reference values. The TIR was slightly lower with the OptiScanner® than with the reference method. The J-index, standard deviation and maximal glucose change were the indices of glycemic variability least affected by the measurement device.ConclusionsBased on the MARD, the performance of the OptiScanner® is adequate for use in ICU patients. Because recent standards for accuracy were not met, the OptiScanner® should not be used as a sole monitor. The assessment of glycemic variability is influenced by the time interval between BG determinations.Trial registrationClinicaltrials.gov NCT01720381. Registered 31 October 2012.

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Section: Discussionmentioning

confidence: 99%

Manual versus Automated moNitoring Accuracy of GlucosE II (MANAGE II)

et al. 2016

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“…[14] Recently, solid-state optical fiber glucose sensors comprising of fluorescent diboronic acid receptors have been clinically tested for continuous intravascular glucose monitoring. [15] However, optical sensors utilizing solid-state ( e.g. silica) materials are not fully compatible with biological systems for implanting in vivo .…”

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Glucose‐Sensitive Hydrogel Optical Fibers Functionalized with Phenylboronic Acid

et al. 2017

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Optical fibers are widely used in biomedical applications for sensing, imaging, and therapies. Unlike existing solid-state optical fibers, soft polymer and hydrogel fibers offer physical and chemical properties well suited for functionalization with biomolecules and long-term implantation in the body. Here, hydrogel optical fibers are fabricated with glucose-sensitive moieties and the swelling-induced sensing is demonstrated. The core of the fiber is made of poly(acrylamide-co-poly(ethylene glycol) diacrylate) (p(AM-co-PEGDA)) hydrogel functionalized with phenylboronic acid. The complexation of the phenylboronic acid and cis diols of glucose molecules lowers the apparent pKa of the hydrogel network and increases the concentration of the boronate anions that enhances the Donnan osmotic pressure to swell and change the physical size of the hydrogel optical fiber. This mechanism is reversible through ester group dynamic covalent binding of the phenylboronic acid with glucose molecules. Dynamic changes in the effective RI of the hydrogel optical fiber are measured through light propagation loss. The sensor sensitivity to glucose concentration is 1.2 mmol L−1 over a physiological range of 1–12 mmol L−1. The biocompatible hydrogel optical fibers may be subcutaneously implanted for continuous monitoring of interstitial glucose concentrations.

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“…This enabled the detection of diol‐containing saccharides over a large pH range in aqueous media . In particular, fluorescence‐based boronate systems have been used in monitoring blood glucose levels . Interestingly, although the original system was published over 25 years ago, the binding mechanism has only recently been fully explained …”

Section: Figurementioning

confidence: 99%

Virtual Issue: Chemosensors

Sedgwick

James

2018

ChemistryOpen

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Chemosensors are compounds that incorporate a receptor unit and a reporter unit in a single molecule. A chemosensor transforms the action of binding to a specific analyte into a readable signal. Chemosensors have enabled the study of molecular interactions in a range of different media and interfaces. This offers a non‐invasive approach to observe living biological samples in real time without the sample being destroyed. For example, fluorescence‐based chemosensors are designed to have a high sensitivity and specificity, allowing them to interact selectively with a single target within a complex biological environment. As a result, such chemosensors can be used for fluorescence imaging, allowing for high spatial and temporal resolution of biological samples. Consequently, chemosensors have been used for a broad range of applications including clinical diagnostics and for the detection of environmental, agriculture, and industrial pollutants, making them critically important for public health and safety.

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The Development of a Continuous Intravascular Glucose Monitoring Sensor

Cited by 54 publications

References 37 publications

Manual versus Automated moNitoring Accuracy of GlucosE II (MANAGE II)

Manual versus Automated moNitoring Accuracy of GlucosE II (MANAGE II)

Glucose‐Sensitive Hydrogel Optical Fibers Functionalized with Phenylboronic Acid

Virtual Issue: Chemosensors

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