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Diabetologia

, Volume 35, Issue 11, pp 1087–1092 | Cite as

On line continuous monitoring of subcutaneous tissue glucose in men by combining portable glucosensor with microdialysis

  • C. Meyerhoff
  • F. Bischof
  • F. Sternberg
  • H. Zier
  • E. F. Pfeiffer
Originals

Summary

For the normalisation of blood glucose levels in diabetic patients by feedback controlled insulin delivery, a self-manageable and reliable method for continuous glucose estimation is still not available. By combining a commercially available needle type dialysis probe (molecular cutoff 20,000 Da) with a sensitive glucose sensor, we obtained a device for continuous glucose measurement in dialysate. This device was tested in healthy volunteers during a 75-g oral glucose tolerance test and in Type 2 (non-insulin-dependent) diabetic patients. Venous glucose and subcutaneous sensor signal were followed for 300 min (ten healthy subjects), 21 h (three healthy subjects) or 9 h (seven Type 2 diabetic patients). The recovery of the microdialysis was interindividually different, but after calibration, glucose levels in the dialysate and subcutaneous glucose sensor signal correlated well (r = 0.84–0.95). Under the assumption of a physiologic and technical delay between intravenous and subcutaneous glucose, correlation coefficient between intravenous glucose and subcutaneous sensor signal ranged from 0.60 to 0.93. We conclude that changes in blood glucose could be monitored in the subcutaneous tissue by the microdialysis technique in a continuous on line manner.

Key words

Continuous glucose sensing enzyme electrode glucose oxidase subcutaneous glucose concentration microdialysis oral glucose load 

References

  1. 1.
    Albisser AM, Leibel BS, Ewart TG, Davidovac Z, Botz CK, Zingg W (1974) An artificial endocrine pancreas. Diabetes 23: 389–396PubMedGoogle Scholar
  2. 2.
    Pfeiffer EF, Thum C, Clemens AH (1974) The artificial beta-cell. A continuous control of blood sugar by external regulation of insulin infusion (glucose-controlled-insulin-infusion-system). Horm Metab Res 6: 339–342PubMedGoogle Scholar
  3. 3.
    Brückel J, Kerner W, Zier H, Steinbach G, Pfeiffer EF (1989) In vivo measurement of sc glucose concentrations with an enzymatic glucose sensor and a wick method. Klin Wochenschr 67: 491–495PubMedGoogle Scholar
  4. 4.
    Kerner W, Pfeiffer EF (1991) The artificial pancreas. In: Samols E (ed) The endocrine pancreas. Raven Press Ltd, New York, pp 441–456Google Scholar
  5. 5.
    Bito L, Davson H, Levin E, Murray M, Snider N (1966) The concentrations of free amino acids and other electrolytes in cerebrospinal fluid, in vivo dialysate of brain and blood plasma in the dog. J Neurochem 13: 1057–1067PubMedGoogle Scholar
  6. 6.
    Delgado JMR, DeFeudis FV, Roth RH, Ryugo DK, Mitruka BK (1972) Dialytrode for long term intracerebral perfusion in awake monkeys. Arch Int Pharmacoldyn 198: 9–21Google Scholar
  7. 7.
    Ungerstedt U, Herrera-Marchintz M, Jungnelius U, Ståle L, Tossman U, Zetterstrom T (1982) Dopamine synaptic mechanisms reflected in studies combining behavioural recordings and brain dialysis. In: Kotsiaka M (ed) Advances in dopamine research. Pergamon Press, New York, pp 219–131Google Scholar
  8. 8.
    Benveniste H (1989) Brain microdialysis. J Neurochem 52: 1667–1679PubMedGoogle Scholar
  9. 9.
    Lönnroth P, Smith U (1990) Microdialysis-a novel technique for clinical investigations. J Int Med 227: 295–300Google Scholar
  10. 10.
    Keck FS, Kerner W, Meyerhoff C, Zier H, Pfeiffer EF (1991) Combination of microdialysis and glucosensor permits continuous (on line) s. c. glucose monitoring in a patient operated device: I-in vitro evaluation. Horm Metab Res 23: 617–618PubMedGoogle Scholar
  11. 11.
    Brückel J, Zier H, Kerner W, Pfeiffer EF (1990) Progress in practical endocrinology. The glucosensor unites Ulm — a portable monitor for continuous blood glucose measurement. Horm Metab Res 22: 382–384PubMedGoogle Scholar
  12. 12.
    Raabo E, Terkildsen TC (1960) On the enzymatic determination of blood glucose. Scand J Clin Lab Invest 12: 402–407PubMedGoogle Scholar
  13. 13.
    Pickup JC, Shaw GW, Claremont DJ (1989) In vivo molecular sensing in diabetes mellitus: an implantable glucose sensor with direct electron transfer. Diabetologia 32: 213–217PubMedGoogle Scholar
  14. 14.
    Kerner W, Keck FS, Zier H, Pfeiffer EF (1991) The function of a hydrogen peroxide detecting enzyme electrode is markedly impaired on implantation into human subcutaneous tissue. Diabetes 40 [Suppl 1]: 400A (Abstract)Google Scholar
  15. 15.
    Aalders AL, Schmidt FJ, Schoonen AJM, Brock IR, Maessen AGFM, Doorenbos H (1991) Development of a wearable glucose sensor; studies in healthy volunteers and in diabetic patients. Int J Artif Organs 14: 102–108PubMedGoogle Scholar
  16. 16.
    Jansson PA, Fowelin J, Smith U, Lönnroth P (1988) Characterization by microdialysis of intercellular glucose level in subcutaneous tissue in humans. Am J Physiol 255: E218–220PubMedGoogle Scholar
  17. 17.
    Kerner W, Zier H, Steinbach G et al. (1988) A potentially implantable enzyme electrode for amperometric measurement of glucose. Horm Metab Res 20: [Suppl] 8–13Google Scholar
  18. 18.
    Benveniste H, Diemer NH (1987) Cellular reactions to implantation of a microdialysis tube in the rat hippocampus. Acta Neuropathol (Berl) 74: 234–238Google Scholar
  19. 19.
    Bungay PM, Morrison PF, Dedrick RL (1990) Steady-state theory for quantitative microdialysis of solutes and water in vivo and in vitro. Life Sci 46: 105–119PubMedGoogle Scholar
  20. 20.
    Moatti-Sirat D, Capron F, Reach G et al. (1992) Towards continuous glucose monitoring: in vivo evaluation of a miniaturized glucose sensor implanted for several days in rat subcutaneous tissue. Diabetologia 35: 224–230PubMedGoogle Scholar
  21. 21.
    Bolinder J, Hagström E, Ungerstedt U, Amer P (1989) Microdialysis of subcutaneous adipose tissue in vivo for continuous glucose monitoring in man. Scand J Clin Lab Invest 49: 465–474PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • C. Meyerhoff
    • 1
  • F. Bischof
    • 1
  • F. Sternberg
    • 1
  • H. Zier
    • 1
  • E. F. Pfeiffer
    • 1
  1. 1.Institut für Diabetes Technologie an der UniversitätUlmGermany

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