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Related Experiment Videos

Interstitial fluid glucose dynamics during insulin-induced hypoglycaemia.

G M Steil1, K Rebrin, F Hariri

  • 1Division of Research and Development, Medtronic MiniMed, 18000 Devonshire Street, Northridge, CA 91325, USA. garry.steil@medtronic.com

Diabetologia
|July 8, 2005
PubMed
Summary

Subcutaneous glucose sensors accurately reflect plasma glucose levels during hypoglycemia recovery. This study found no significant delay or increased gradient, suggesting reliable glucose monitoring.

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Area of Science:

  • Endocrinology
  • Metabolic Research
  • Biomedical Engineering

Background:

  • Continuous glucose monitoring (CGM) often measures interstitial fluid (ISF) glucose, not plasma glucose.
  • Differences between plasma and ISF glucose, like delayed recovery from hypoglycemia, are poorly understood.
  • Existing sensor systems may introduce delays, complicating accurate ISF glucose measurement.

Purpose of the Study:

  • To define the relationship between plasma and subcutaneous ISF glucose during hypoglycemia.
  • To investigate potential delays and gradients in ISF glucose readings.
  • To assess these relationships in a well-equilibrated system without signal smoothing.

Main Methods:

  • Induced hypoglycemia via intravenous insulin infusion in non-diabetic subjects.

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  • Sequentially clamped plasma glucose levels to specific hypoglycemic points and allowed recovery.
  • Utilized two subcutaneous glucose sensors inserted for over 12 hours.
  • Employed a two-compartment model to quantify glucose delay and gradient.

    • Main Results:

    • No significant difference in glucose delay between falling plasma glucose and recovery phases.
    • No significant change in the sensor current to plasma glucose ratio during basal or hyperinsulinemic clamp phases.
    • A significant elevation in the sensor current to plasma glucose ratio was observed following recovery to normoglycemia.

    Conclusions:

    • The plasma to ISF glucose gradient decreases after hypoglycemia, potentially due to increased skin blood flow.
    • Recovery from hypoglycemia is not characterized by a prolonged delay in ISF glucose readings.
    • Insulin does not appear to increase the plasma to subcutaneous ISF glucose gradient.