Continuous Glucose Sensing: Future Technology Developments
Continuous Glucose Sensing: Future Technology Developments
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DOI：
10.1089/dia.2008.0137
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发表时间：
2009-04-01
影响因子：
5.4
通讯作者：
Brauker, Jim
中科院分区：
文献类型：
--
作者：
Brauker, Jim
来自血糖仪的数据是不连续的，仅提供对葡萄糖的“绝对值”的估计。连续传感器提供时间序列数据，包括“量”，但增加了方向，变化率和加速度。目前，连续传感器标记需要手指针刺确认，以用于治疗决策和定期校准。由于增加了信息，传感器在用于治疗决策时可能与血糖仪一样有效和安全，但尚未在独立模式下进行测试。葡萄糖传感器目前处于技术开发的早期采用阶段。为了扩展到更广泛的糖尿病患者群体，需要在可靠性、舒适性、易用性以及与其他技术的集成方面进行改进。为了实现闭环（人工胰腺），糖尿病设备行业的“圣杯”，还需要提高连续传感器的精度。传感器误差的主要来源是校准过程。由于插入后和整个佩戴期间传感器周围局部代谢（异物反应形成期间）的总体变化，需要在传感器佩戴期间进行校准更新。便携式传感器目前已获得批准，仅用于治疗使用胰岛素的糖尿病患者。在未来，该技术可能有利于肥胖症、代谢综合征和前驱糖尿病的诊断和行为改变，以及精英运动员、士兵、飞行员等的代谢监测。医院目前使用单点信息来跟踪患者的血糖。基于血液的连续感测可以提供预防院内低血糖所需的数据，并且可以导致医院中的闭环技术。
The data from blood glucose meters are discontinuous, providing only an estimate of the "amount'' of glucose. Continuous sensors provide time series data, including "amount,'' but adding direction, rate of change, and rate of acceleration. Currently, continuous sensor labeling requires a fingerstick confirmation for treatment decisions and for periodic calibration. Because of the added information, sensors may be as efficacious and safe as meters when used for treatment decisions but have not yet been tested in stand-alone mode. Glucose sensors are currently in the early adopter's phase of technology development. To extend to the broader diabetes patient population, improvements are needed in reliability, comfort, ease of use, and integration with other technologies. In order to achieve a closed loop (artificial pancreas), the "Holy Grail'' of the diabetes device industry, improvements in the accuracy of continuous sensors are also required. The main source of sensor inaccuracy is the calibration process. Calibration updates during the sensor wear period are required because of the gross changes in local metabolism (during the formation of the foreign body response) around the sensors after insertion and during the entire period of wear. Ambulatory sensors are currently approved and used only to treat insulin-using diabetes patients. In the future, the technology may have benefit for diagnostic use and behavior modification in obesity, metabolic syndrome, and prediabetes, as well as metabolic monitoring in elite athletes, soldiers, pilots, and the like. Hospitals currently use single-point information for tracking glucose in patients. Blood-based continuous sensing may provide the data needed to prevent in-hospital hypoglycemia and may lead to closed loop technology in the hospital.