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Am J Physiol Endocrinol Metab 277: E561-E571, 1999;
0193-1849/99 $5.00
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Vol. 277, Issue 3, E561-E571, September 1999

EPILOGUE
Subcutaneous glucose predicts plasma glucose independent of insulin: implications for continuous monitoring

Kerstin Rebrin1, Garry M. Steil2, William P. van Antwerp1, and John J. Mastrototaro1

1 MiniMed Incorporated, Sylmar, California 91342; and the 2 Massachusetts General Hospital, Boston, Massachusetts 02114

The present study investigated the relationship between blood and subcutaneous interstitial fluid (ISF) glucose by employing an amperometric glucose sensor specifically developed for 3-day continuous glucose monitoring. The apparent sensor sensitivity and ISF glucose equilibration delay were estimated on separate days during hyperglycemic clamps in four dogs in which insulin was either suppressed with somatostatin, allowed to change, or increased with an exogenous infusion. A 2-h sensor "settling-in" period was allowed before the clamps. During insulin deficiency, the sensor sensitivity and ISF glucose delay were 0.23 ± 0.03 nA per mg/dl and 4.4 ± 0.8 min. Sensitivity was not affected by increases in endogenous (0.30 ± 0.04 vs. 0.28 ± 0.04 nA per mg/dl) or exogenous insulin (0.18 ± 0.01 vs. 0.16 ± 0.01 nA per mg/dl) nor was the delay (3.3 ± 1.2 vs. 5.7 ± 1.1 and 9.2 ± 2.6 vs. 12.3 ± 1.7 min; P > 0.05 for all). Sensor glucose accurately predicted plasma glucose without correcting for delays <10 min (r > 0.9 for all), whereas for longer delays a digital corrective filter was used (r = 0.91 with filter). We conclude that the relationship between blood and ISF glucose is not affected by insulin and that delays in ISF glucose equilibration can be corrected with digital filters.

continuous glucose sensor; subcutaneous tissue; interstitial fluid


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