Time lag of glucose from intravascular to interstitial compartment in type 1 diabetes.
Time lag of glucose from intravascular to interstitial compartment in type 1 diabetes.
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DOI：
10.1177/1932296814554797
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发表时间：
2015-01-01
影响因子：
5
通讯作者：
Basu, Rita
中科院分区：
文献类型：
--
作者：
Basu, Ananda;Dube, Simmi;Basu, Rita
1型糖尿病（T1 D）的有效闭环胰岛素治疗的前提依赖于连续间质液葡萄糖传感的准确性，这代表了这种系统的关键传入臂。传感器准确性的一个重要决定因素是葡萄糖从血管转运到间质空间的生理时间滞后。当前研究的目的是确定T1 D患者葡萄糖从血管转运至腹部皮下组织间隙的生理时滞。在禁食过夜条件下，将4根微透析导管插入6名T1 D受试者的腹部皮下空间。通过持续静脉输注胰岛素将血糖维持在113.7 ± 6.3 mg/dl。在葡萄糖同位素的顺序静脉推注给药后，按时间顺序收集定时血浆和间质液样本，并分析示踪剂富集。我们观察到静脉推注后示踪剂出现（检测时间）进入间质空间的中位（范围）时间滞后为6.8（4.8-9.8）分钟，所有参与者在9.8分钟前具有可检测值。我们的结论是，在T1 D成人过夜禁食状态下，葡萄糖从血管到组织间隙的延迟时间小于10分钟，从而意味着这种最小的生理时间滞后不应该是T1 D有效闭环控制系统发展的主要障碍。
The premise of effective closed-loop insulin therapy for type 1 diabetes (T1D) relies on the accuracy of continuous interstitial fluid glucose sensing that represents the crucial afferent arm of such a system. An important determinant of sensor accuracy is the physiological time lag of glucose transport from the vascular to the interstitial space. The purpose of current studies was to determine the physiological time lag of glucose transport from the vascular to the abdominal subcutaneous interstitial space in T1D. Four microdialysis catheters were inserted into the abdominal subcutaneous space in 6 T1D subjects under overnight fasted conditions. Plasma glucose was maintained at 113.7 ± 6.3 mg/dl using a continuous intravenous insulin infusion. After sequential intravenous bolus administrations of glucose isotopes, timed plasma and interstitial fluid samples were collected chronologically and analyzed for tracer enrichments. We observed a median (range) time lag of tracer appearance (time to detection) into the interstitial space after intravenous bolus of 6.8 (4.8-9.8) minutes, with all participants having detectable values by 9.8 minutes. We conclude that in the overnight fasted state in T1D adults, the delay of glucose appearance from the vascular to the interstitial space is less than 10 minutes, thereby implying that this minimal physiological time lag should not be a major impediment to the development of an effective closed-loop control system for T1D.