Interstitial Fluid Glucose Is Not Just a Shifted-in-Time but a Distorted Mirror of Blood Glucose: Insight from an In Silico Study.
Interstitial Fluid Glucose Is Not Just a Shifted-in-Time but a Distorted Mirror of Blood Glucose: Insight from an In Silico Study.
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DOI：
10.1089/dia.2016.0112
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发表时间：
2016-08
影响因子：
5.4
通讯作者：
Basu R
中科院分区：
文献类型：
--
作者：
Cobelli C;Schiavon M;Dalla Man C;Basu A;Basu R
背景：葡萄糖传感器测量远离血液的间质液 (ISF) 中的葡萄糖浓度。众所周知，ISF 葡萄糖相对于血糖 (BG) 具有“延迟”性。然而，ISF 葡萄糖不仅仅是 BG 的时间平移版本，而且表现出更复杂的模式。方法：为了深入了解这一问题，可以使用线性系统理论。然而，这可能会失去更多临床读者，因此我们使用模拟和两个案例研究来以更简单的方式传达我们的想法。特别是，我们考虑了 12 名健康志愿者餐后和运动后测量的 BG 浓度，而 ISF 葡萄糖是使用公认的血液-ISF 葡萄糖动力学模型进行模拟的，该模型允许计算平衡时间（表征系统的参数）。定义了两个指标：每个时间点的血液和 ISF 葡萄糖差以及血液和 ISF 中达到相同葡萄糖值的时间。结果：进行的模拟和两个指标表明，血液-ISF 葡萄糖谱之间的关系比纯粹的时间变化更复杂，并且该模式取决于平衡时间和 BG。结论：在这项计算机研究中，我们通过简单的案例研究说明了 ISF 葡萄糖相对于 BG 的含义。了解 ISF 葡萄糖不仅是时间平移的版本，而且是 BG 的扭曲镜像，对于正确使用连续血糖监测进行糖尿病管理非常重要。
Background: Glucose sensors measure glucose concentration in the interstitial fluid (ISF), remote from blood. ISF glucose is well known to be “delayed” with respect to blood glucose (BG). However, ISF glucose is not simply a shifted-in-time version of BG but exhibits a more complex pattern. Methods: To gain insight into this problem, one can use linear systems theory. However, this may lose a more clinical readership, thus we use simulation and two case studies to convey our thinking in an easier way. In particular, we consider BG concentration measured after meal and exercise in 12 healthy volunteers, whereas ISF glucose is simulated using a well-accepted model of blood–ISF glucose kinetics, which permits calculation of the equilibration time, a parameter characterizing the system. Two metrics are defined: blood and ISF glucose difference at each time point and time to reach the same glucose value in blood and ISF. Results: The simulation performed and the two metrics show that the relationship between blood–ISF glucose profiles is more complex than a pure shift in time and that the pattern depends on both equilibration time and BG. Conclusions: In this in silico study, we have illustrated, with simple case studies, the meaning of the of ISF glucose with respect to BG. Understanding that ISF glucose is not just a shifted-in-time version but a distorted mirror of BG is important for a correct use of continuous glucose monitoring for diabetes management.