Diabetes & Metabolism Journal

Original Articles

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Evaluation of a Novel Glucose Area Under the Curve (AUC) Monitoring System: Comparison with the AUC by Continuous Glucose Monitoring: Satoshi Ugi, Hiroshi Maegawa, Katsutaro Morino, Yoshihiko Nishio, Toshiyuki Sato, Seiki Okada, Yasuo Kikkawa, Toshihiro Watanabe, Hiromu Nakajima, Atsunori Kashiwagi; Diabetes Metab J. 2016;40(4):326-333. Published online July 26, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.4.326

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Background

Management of postprandial hyperglycemia is a key aspect in diabetes treatment. We developed a novel system to measure glucose area under the curve (AUC) using minimally invasive interstitial fluid extraction technology (MIET) for simple monitoring of postprandial glucose excursions. In this study, we evaluated the relationship between our system and continuous glucose monitoring (CGM) by comparing glucose AUC obtained using MIET with that obtained using CGM for a long duration.

Methods

Twenty diabetic inpatients wearing a CGM system were enrolled. For MIET measurement, a plastic microneedle array was applied to the skin as pretreatment, and hydrogels were placed on the pretreated area to collect interstitial fluid. Hydrogels were replaced every 2 or 4 hours and AUC was predicted on the basis of glucose and sodium ion levels.

Results

AUC predicted by MIET correlated well with that measured by CGM (r=0.93). Good performances of both consecutive 2- and 4-hour measurements were observed (measurement error: 11.7%±10.2% for 2 hours and 11.1%±7.9% for 4 hours), indicating the possibility of repetitive measurements up to 8 hours. The influence of neither glucose fluctuation nor average glucose level over the measurement accuracy was observed through 8 hours.

Conclusion

Our system showed good relationship with AUC values from CGM up to 8 hours, indicating that single pretreatment can cover a large portion of glucose excursion in a day. These results indicated possibility of our system to contribute to convenient monitoring of glucose excursions for a long duration.

Citations

Citations to this article as recorded by

Effects of insulin glargine U300 versus insulin degludec U100 on glycemic variability, hypoglycemia, and diet evaluated by continuous glucose monitoring in type 1 diabetes: a retrospective cross‐sectional study
Pin‐Lun Tsai, Chia‐Hung Lin, Yu‐Yao Huang, Hsin‐Yun Chen, Yi‐Hsuan Lin
The Kaohsiung Journal of Medical Sciences.2024; 40(12): 1086. CrossRef
Continuous glucose monitoring metrics and pregnancy outcomes in insulin‐treated diabetes: A post‐hoc analysis of the GlucoMOMS trial
Doortje Rademaker, Anne W. T. van der Wel, Rik van Eekelen, Daphne N. Voormolen, Harold W. de Valk, Inge M. Evers, Ben Willem Mol, Arie Franx, Sarah E. Siegelaar, Bas B. van Rijn, J. Hans DeVries, Rebecca C. Painter
Diabetes, Obesity and Metabolism.2023; 25(12): 3798. CrossRef
Regimen comprising GLP-1 receptor agonist and basal insulin can decrease the effect of food on glycemic variability compared to a pre-mixed insulin regimen
Yi-Hsuan Lin, Chia-Hung Lin, Yu-Yao Huang, Hsin-Yun Chen, An-Shun Tai, Shih-Chen Fu, Sheng-Hwu Hsieh, Jui-Hung Sun, Szu-Tah Chen, Sheng-Hsuan Lin
European Journal of Medical Research.2022;[Epub] CrossRef
Advantages of Applying Artificial Intelligent System to Medical Neurology (Preprint)
Zhenqiang Fu, Jingtao Wang, Jingtao Wang
JMIR Medical Informatics.2020;[Epub] CrossRef
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, Yutaka Yano, Toshinari Suzuki, Taro Yasuma, Toshiyuki Sato, Aya Morimoto, Samiko Hosoya, Chihiro Suminaka, Hiromu Nakajima, Esteban C. Gabazza, Yoshiyuki Takei
Diabetes & Metabolism Journal.2017; 41(4): 265. CrossRef

The Correlation and Accuracy of Glucose Levels between Interstitial Fluid and Venous Plasma by Continuous Glucose Monitoring System: Young Ha Baek, Heung Yong Jin, Kyung Ae Lee, Seon Mee Kang, Woong Ji Kim, Min Gul Kim, Ji Hyun Park, Soo Wan Chae, Hong Sun Baek, Tae Sun Park; Korean Diabetes J. 2010;34(6):350-358. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.350

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Background

Clinical experience with the continuous glucose monitoring systems (CGMS) is limited in Korea. The objective of this study is to evaluate the accuracy of the CGMS and the correlation between interstitial fluid and venous plasma glucose level in Korean healthy male subjects.

Methods

Thirty-two subjects were served with glucose solution contained same amount of test food's carbohydrate and test foods after separate overnight fasts. CGMS was performed over 3 days during hopitalization for each subjects. Venous plasma glucose measurements were carried out during 4 hours (0, 0.25, 0.5, 0.75, 1, 2, 4 hours) just before and after glucose solution and test food load. The performance of the CGMS was evaluated by comparing its readings to those obtained at the same time by the hexokinase method using the auto biochemistry machine (Hitachi 7600-110). Also, correlations between glucose recorded with CGMS and venous plasma glucose value were examined.

Results

CGMS slightly underestimated the glucose value as compared with the venous plasma glucose level (16.3 ± 22.2 mg/dL). Correlation between CGMS and venous plasma glucose values throughout sensor lifetime is 0.73 (regression analysis: slope = 1.08, intercept = 8.38 mg/dL). Sensor sensitivity can deteriorate over time, with correlations between venous blood glucose and CGMS values dropping from 0.77 during 1st day to 0.65 during 2nd and 3rd day.

Conclusion

The accuracy of data provided by CGMS may be less than expected. CGMS sensor sensitivity is decreased with the passage of time. But, from this study, CGMS can be used for glucose variability tendency monitoring conveniently to the Korean.

Citations

Citations to this article as recorded by

Evaluation of the performance and usability of a novel continuous glucose monitoring system
Li Yan, Qiang Li, Qingbo Guan, Mingsong Han, Yu Zhao, Junfei Fang, Jiajun Zhao
International Journal of Diabetes in Developing Countries.2023; 43(4): 551. CrossRef
Correlation between short- and mid-term hemoglobin A1c and glycemic control determined by continuous glucose monitoring
Jen-Hung Huang, Yung-Kuo Lin, Ting-Wei Lee, Han-Wen Liu, Yu-Mei Chien, Yu-Chun Hsueh, Ting-I Lee, Yi-Jen Chen
Diabetology & Metabolic Syndrome.2021;[Epub] CrossRef
Accuracy of Flash Glucose Monitoring During Postprandial Rest and Different Walking Conditions in Overweight or Obese Young Adults
Xiaoyuan Zhang, Fenghua Sun, Waris Wongpipit, Wendy Y. J. Huang, Stephen H. S. Wong
Frontiers in Physiology.2021;[Epub] CrossRef
The MEDGICarb-Study: Design of a multi-center randomized controlled trial to determine the differential health-promoting effects of low- and high-glycemic index Mediterranean-style eating patterns
Robert E. Bergia, Izabela Biskup, Rosalba Giacco, Giuseppina Costabile, Savanna Gray, Amy Wright, Marilena Vitale, Wayne W. Campbell, Rikard Landberg, Gabriele Riccardi
Contemporary Clinical Trials Communications.2020; 19: 100640. CrossRef
A genetic programming-based regression for extrapolating a blood glucose-dynamics model from interstitial glucose measurements and their first derivatives
I. De Falco, A. Della Cioppa, A. Giugliano, A. Marcelli, T. Koutny, M. Krcma, U. Scafuri, E. Tarantino
Applied Soft Computing.2019; 77: 316. CrossRef
Genetic Programming-based induction of a glucose-dynamics model for telemedicine
Ivanoe De Falco, Antonio Della Cioppa, Tomas Koutny, Michal Krcma, Umberto Scafuri, Ernesto Tarantino
Journal of Network and Computer Applications.2018; 119: 1. CrossRef
A high-accuracy measurement method of glucose concentration in interstitial fluid based on microdialysis
Dachao Li, Qingmei Xu, Yu Liu, Ridong Wang, Kexin Xu, Haixia Yu
Measurement Science and Technology.2017; 28(11): 115701. CrossRef
Effects of Higher Dietary Protein and Fiber Intakes at Breakfast on Postprandial Glucose, Insulin, and 24-h Interstitial Glucose in Overweight Adults
Akua Amankwaah, R. Sayer, Amy Wright, Ningning Chen, Megan McCrory, Wayne Campbell
Nutrients.2017; 9(4): 352. CrossRef
High Surface Area Electrodes Generated via Electrochemical Roughening Improve the Signaling of Electrochemical Aptamer-Based Biosensors
Netzahualcóyotl Arroyo-Currás, Karen Scida, Kyle L. Ploense, Tod E. Kippin, Kevin W. Plaxco
Analytical Chemistry.2017; 89(22): 12185. CrossRef
Hyperglycemia-Induced Changes in Hyaluronan Contribute to Impaired Skin Wound Healing in Diabetes: Review and Perspective
Sajina Shakya, Yan Wang, Judith A. Mack, Edward V. Maytin
International Journal of Cell Biology.2015; 2015: 1. CrossRef
Hypoglycemia in everyday life after gastric bypass and duodenal switch
Niclas Abrahamsson, Britt Edén Engström, Magnus Sundbom, F Anders Karlsson
European Journal of Endocrinology.2015; 173(1): 91. CrossRef
The use of reinforcement learning algorithms to meet the challenges of an artificial pancreas
Melanie K Bothe, Luke Dickens, Katrin Reichel, Arn Tellmann, Björn Ellger, Martin Westphal, Ahmed A Faisal
Expert Review of Medical Devices.2013; 10(5): 661. CrossRef
Continuous glucose monitoring: current clinical use
Hun‐Sung Kim, Jeong‐Ah Shin, Jin‐Sun Chang, Jae‐Hyoung Cho, Ho‐Young Son, Kun‐Ho Yoon
Diabetes/Metabolism Research and Reviews.2012; 28(s2): 73. CrossRef
Correlations of Glucose Levels in Interstitial Fluid Estimated by Continuous Glucose Monitoring Systems and Venous Plasma
Byung-Joon Kim
Korean Diabetes Journal.2010; 34(6): 338. CrossRef

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