Continuous tissue glucose measurement (CGM) to drive the therapy of diabetes mellitus

Germain

Ordination in Vienna 

In insulin-based diabetes therapy, it is now standard practice to determine the insulin dose with a CGM system; blood glucose measurement by means of a finger prick is usually only used to control the systems.

At the moment continues glucose measuring systems of the tissue (CGM) are very accurate and the sensor placed under the skin are robust and working a longer time period than before. The sensors are very fine wires, much leaner than a needle of an insulin pen.

The tissue glucose is a vague parameter in comparison to the blood glucose. But with available values every 5 minutes and an additional information of a trend this inaccuracy could be covered easily.

With the continuous glucose course over 24 hours a day, you can simply change the insulin therapy better than with the normally disposal finger stick blood glucose measurements.

CGM systems with a total error rate (MARD) of about 10% could be taken by patients in everyday life. The patient should be take care to place the sensor in a skin areal without lipodystrophia. The upper arm is the best for sensor accuracy.

The system should be calibrated if it is necessary in a time period without extreme blood glucose values. Calibrations in an extreme range direct to unacceptable inaccuracy and time lag of the sensor.

Then the values of the CGM systems can be used instead of blood glucose measurements to direct the insulin therapy.

The values of the subcutane sensors from the CGM systems were delivered to a receiver via Bluetooth.

The tissue glucose values shows physiological an time delay of about 6 minutes for falling values and about 12 minutes for rising values. So the tissue glucose lies always behind the blood glucose if the glucose levels are changing.