Katherine Iscoe

Thesis

Continuous Glucose Monitoring Systems: a useful tool for glycaemic management

Summary

Maintaining physiological blood glucose levels using exogenous insulin is the most challenging component of the treatment of insulin-dependent diabetes, with hypoglycaemia being the most common and most severe side-effect. Although a brief episode of hypoglycaemia may cause slight weakness and disorientation, repeated or severe episodes may result in cardiac problems, irreversible brain damage, coma and even death. Frequent testing of capillary glucose is one approach to prevent these complications; however, this is generally performed insufficiently because conventional glucose testing is often cumbersome. For this reason, continuous glucose monitoring systems (CGMS) provide a useful method to help stabilize blood glucose levels independently of the time of day, activity level or behaviour. These systems use a small sensor implanted subcutaneously which samples interstitial glucose and displays glucose values every five minutes on the monitor’s screen. CGMS store the data for later graphical viewing, can provide the direction and rate of glucose change, and most importantly incorporate an alarm to notify the individual of impending dysglycaemia.

CGMS, however, are limited in that they only provide a measurement of interstitial and not actual blood glucose concentrations. As a result, there is often a discrepancy in glucose levels between these two compartments which often leads to a high rate of false alarms and thus to user’s dissatisfaction. In addition, the usefulness of CGMS alarms in preventing hypoglycaemia is often limited, since actual blood glucose levels are often lower than CGMS readings. For these reasons, the primary purpose of this research proposal is to explore further the factors that influence the mismatch between interstitial and blood glucose readings and to develop strategies for CGMS alarm to be used more effectively for the prevention of hypoglycaemia.

Why my research is important

Funding

• NILL