Subject    :    [2017 Aug;41(4)] Comparison of Glucose Area Under the Curve Measured Using Minimally Invasive Interstitial Fluid Extraction Technology with Continuous Glucose Monitoring System in Diabetic Patients
Writer KDA
Date 2018-12-03 18:18:29 Hit 2,035
Diabetes Metab J. 2017 Aug;41(4):265-274. English.
Published online Jul 31, 2017.  https://doi.org/10.4093/dmj.2017.41.4.265 
Copyright © 2017 Korean Diabetes Association
   
Comparison of Glucose Area Under the Curve Measured Using Minimally Invasive Interstitial Fluid Extraction Technology with Continuous Glucose Monitoring System in Diabetic Patients
Mei Uemura,1 Yutaka Yano,1 Toshinari Suzuki,2 Taro Yasuma,3 Toshiyuki Sato,4 Aya Morimoto,4Samiko Hosoya,4 Chihiro Suminaka,4 Hiromu Nakajima,5 Esteban C. Gabazza,3 and Yoshiyuki Takei6
1Department of Diabetes, Metabolism and Endocrinology, Mie University Graduate School of Medicine, Tsu, Japan.
2Department of Diabetes and Endocrinology, Mie University Hospital, Tsu, Japan.
3Department of Immunology, Mie University Graduate School of Medicine, Tsu, Japan.
4Central Research Laboratories, Sysmex Corporation, Kobe, Japan.
5Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
6Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan.

Corresponding author: Yutaka Yano. Department of Diabetes, Metabolism and Endocrinology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan. Email: yanoyuta@clin.medic.mie-u.ac.jp 
 
Received December 21, 2016; Accepted April 19, 2017.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
Abstract

Background

Continuous glucose monitoring (CGM) is reported to be a useful technique, but difficult or inconvenient for some patients and institutions. We are developing a glucose area under the curve (AUC) monitoring system without blood sampling using a minimally invasive interstitial fluid extraction technology (MIET). Here we evaluated the accuracy of interstitial fluid glucose (IG) AUC measured by MIET in patients with diabetes for an extended time interval and the potency of detecting hyperglycemia using CGM data as a reference.

Methods

Thirty-eight inpatients with diabetes undergoing CGM were enrolled. MIET comprised a pretreatment step using a plastic microneedle array and glucose accumulation step with a hydrogel patch, which was placed on two sites from 9:00 AM to 5:00 PM or from 10:00 PM to 6:00 AM. IG AUC was calculated by accumulated glucose extracted by hydrogel patches using sodium ion as standard.

Results

A significant correlation was observed between the predicted AUC by MIET and CGM in daytime (r=0.76) and nighttime (r=0.82). The optimal cutoff for the IG AUC value of MIET to predict hyperglycemia over 200 mg/dL measured by CGM for 8 hours was 1,067.3 mg·hr/dL with 88.2% sensitivity and 81.5% specificity.

Conclusion

We showed that 8-hour IG AUC levels using MIET were valuable in estimating the blood glucose AUC without blood sampling. The results also supported the concept of using this technique for evaluating glucose excursion and for screening hyperglycemia during 8 hours in patients with diabetes at any time of day.

   
Keywords:
Continuous glucose monitoringDiabetes mellitusGlucose area under the curveHyperglycemiaNocturnal blood glucosePost-prandial blood glucose

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