Skin Mini-Erosion Sampling Technique: Feasibility Study with Regard to Serial Glucose Measurement
Cite this article as: Svedman, P. & Svedman, C. Pharm Res (1998) 15: 883. doi:10.1023/A:1011924631680 Abstract . To describe a dermally non-invasive serial sampling technique and to test its clinical feasibility with regard to glucose measurement. Purpose . A standardized skin mini-erosion devoid of the epidermal barrier, and covered by an artificial one, was formed by a suctioning technique. Interstitial fluid (IF) was extracted serially by brief application of negative pressure, and its glucose content compared with that in capillary or venous blood samples. Methods . The procedure caused no discomfort. The epidermis regenerated rapidly after experimentation. There were no complications. In non-diabetic subjects (n = 13) the mean of all IF values measured daily for 6 days was 6.2 ± 0.1 mmol/1 (±SE). The corresponding capillary blood glucose value was 5.6 ± 0.1 mmol/1, and the venous glucose value was 5.4 ± 0.1 mmol/1. The differences between IF glucose values and invasive control values remained within narrow limits throughout. The 2SD limits of agreement for the differences were 1.44 mmol/1 (IF vs. capillary blood samples) and 1.76 mmol/1 (IF vs venous samples) respectively. The OGTT curves suggested glucose kinetics to be similar in IF and in capillary blood. In diabetic subjects, the mean of IF values determined serially during one day was 15.3 ± 1.0 mmol/1 (range, 6.7−21.8 mmol/1), and the corresponding mean capillary value was 12.0 ± 0.9 mmol/1 (range, 3.3−17.2 mmol/1). The ICC for all paired photometric observations was 0.948. Results . The results suggest the new sampling technique to be a feasible approach for clinical and experimental purposes. A functionally integrated sampling patch is entering the clinical testing stage. Conclusions transdermal access skin erosion transdermal dermal interstitial fluid sampling glucose monitoring diabetes mellitus pharmacokinetics REFERENCES
B. H. Ginsberg. An overview of minimally invasive technologies.
P. Glikfeld, R. S. Hinz, and R. H. Guy. Noninvasive sampling of biological fluids by iontophoresis.
F. J. Service, P. C. O'Brien, S. D. Wise, S. Ness, and S. M. LeBlanc. Dermal interstitial glucose as an indicator of ambient glycemia.
P. Svedman, S. Lundin, and Ch. Svedman. Administration of antidiuretic peptide (DDAVP) by way of suction deepithelialised skin.
P. Svedman, M. Lundquist, and Ch. Svedman. Oxygen tension on the surface of suction blister wounds measured with a polarographic technique in healthy volunteers.
D. Westerling, P. Höglund, S. Lundin, and P. Svedman. Transdermal administration of morphine to healthy subjects.
Br. J. clin. Pharmac.
P. Svedman, S. Lundin, P. Höglund, C. Hammarlund, C. Malmros, and N. Pantzar. Passive drug diffusion via standardized skin minierosion; methodological aspects and clinical findings with new device.
Ch. Svedman, J. S. Samra, M. L. Clarke, J. C. Levy, and K. N. Frayn. Skin mini-erosion technique for determining metabolic response in terms of interstitial fluid variables, tested in diabetic and non-diabetic subjects undergoing OGTT.
Scand. J. Clin. Lab. Invest. Submitted.
I. Hansen, K. Håkansson, S. Polberger, N. Svenningsen, and P. Svedman. Dermally non-invasive suctioning technique for painless serial sampling of interstitial fluid (ISF) in newborn infants.
Abstract, The American Pediatric Society Meeting, New Orleans, May 1998. Submitted.
P. A. M. Weiss, F. Kainer, M. C. H. Hauesler, P. Pürstner, and R. Urash. Schnellmetode zum Diabetesscreening in der Schwangershaft.
Geburtsh. u. Frauenheilk.
The suction blister method for the in vivo separation of epidermis from dermis in human skin. Dissertation thesis, Helsinki, 1976.
K. B. Hellum, A. Schreiner, A. Digranes, and I. Bergman. Skin blisters produced by suction: a new model for studies of penetration of antibiotics in humans. In W. Siegenthaler and R. Lüthy (eds.),
Current chemotherapy: proceedings of the 10th International Congress of Chemotherapy
, Zürich, 1977. Washington, American Society of Microbiology, 1978, pp 620-6.
J. E. Bernstein, L. E. Levine, M. M. Medecina, C. M. Yung, and K. Soltani. Reduced threshold to suction-induced blister formation in insulin-dependent diabetics.
J. Am. Acad. Dermatol.
R. Haaverstad, I. Romslo, S. Larsen, and H.O. Myhre. Protein concentration of subcutaneous interstitial fluid in the human leg. A comparison between the wick technique and the blister suction technique.
N. Kutlu and P. Svedman. Suction blister wounding, morphological and functional aspects.
N. Kutlu and P. Svedman. The superficial dermal microcirculation in suction blister wounds in healthy volunteers.
N. Kutlu and P. Svedman. The microcirculation i suction blister wounds on the upper and lower limb in healthy volunteers.
P. Svedman, C. Svedman, and T. Njalsson. Epithelialization and blood flow in suction blister wounds on healthy volunteers.
J. Invest. Surg.
C. Svedman, C. Hammarlund, N. Kutlu, and P. Svedman. A suction blister wound model exposed to u.v. irradiation: a burn wound model for use in humans.
D. J. Weisdorf, P. R. Craddock, and H. S. Jacob. Glycogenolysis versus glucose transport in human granulocytes: differential activation in phagocytosis and chemotaxis.
L. Beaman and B. L. Beaman. The role of oxygen and its derivates in microbial pathogenesis and host defense.
D. C. Hohn. Oxygen and leucocyte microbial killing. In J. C. Davis and T. K. Hunt (eds.),
Hyperbaric oxygen therapy
. Bethesda: Undersea Medical Society, 1977, pp. 101-10.
C. D. Hinman and H. Maibach. Effect of air exposure and occlusion on experimental human skin wounds.
P. Svedman. Irrigation treatment of leg ulcers.
B. Arnljots and P. Svedman. Irrigation treatment in the split thickness skin grafting of difficult ulcers.
Scand. J. Plast. Reconstr. Surg.
B. Alberts, D. Bray, J. Lewis, M. Raff, K. Roberts, and J. D. Watson.
Molecular biology of the cell
. Garland Publishing, Inc. New York & London, 1989.
B. M. Jensen, P. Bjerring, J. S. Christiansen, and H. Ørskov. Glucose content in human skin: relationship with blood glucose levels.
Scand. J. Clin. Lab. Invest.
B. J. Vermeer, F. C. Reman, and C. M. van Gent. The determination of lipids and proteins in suction blister fluid.
J. Invest. Dermatol.
S. Groth and B. Staberg. Suction blisters of the skin: a compartment with physiological, interstitium-like properties.
Scand. J. Clin. Lab. Invest.
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