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Usefulness of a novel system for measuring glucose area under the curve while screening for glucose intolerance in outpatients.

Sakamoto K, Kubo F, Yoshiuchi K, Ono A, Sato T, Tomita K, Sakaguchi K, Matsuhisa M, Kaneto H, Maegawa H, Nakajima H, Kashiwagi A, Kosugi K - J Diabetes Investig (2013)

Bottom Line: Plasma glucose (PG) levels were measured every 30 min for 2 h to calculate reference (actual) AUC.Good correlation between MIET-predicted and reference AUCs obtained using PG levels was confirmed for a wide AUC range.The results of a questionnaire-based survey administered to the subjects suggested that this system was readily accepted by the majority as a painless monitoring method.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine Osaka Police Hospital Osaka Japan.

ABSTRACT

Aims/introduction: To realize the effectiveness of a novel system for measuring glucose area under the curve (AUC) using minimally invasive interstitial fluid extraction technology (MIET), outpatients undergoing oral glucose tolerance tests (OGTT) were investigated for the efficacy of screening for glucose intolerance using this system.

Materials and methods: Fifty outpatients scheduled to undergo a 75-g OGTT for medical reasons were recruited to the study. An area of skin on the forearm was pretreated with microneedle arrays before the application of hydrogels for interstitial fluid extraction. Plasma glucose (PG) levels were measured every 30 min for 2 h to calculate reference (actual) AUC. The AUC was predicted by MIET on the basis of glucose extracted by the hydrogel using sodium ion levels as the internal standard.

Results: Good correlation between MIET-predicted and reference AUCs obtained using PG levels was confirmed for a wide AUC range. By introducing a threshold level for AUC to separate glucose intolerance with peak glucose ≥180 mg/dL from normal glucose tolerance, the system was demonstrated to provide better screening accuracy compared with conventional methods that use HbA1c and fasting PG levels. The results of a questionnaire-based survey administered to the subjects suggested that this system was readily accepted by the majority as a painless monitoring method.

Conclusions: The findings suggest that our glucose AUC measurement system using MIET would be useful for screening of glucose intolerance. In the future, this system may prove to be a useful aid as a screen for glucose intolerance before performing an OGTT for diagnosis.

No MeSH data available.


Related in: MedlinePlus

Screening performance of conventional indices: (a) fasting plasma glucose (FPG); (b) HbA1c; (d) plasma glucose (PG) 2 h after glucose loading; and (d) PG area under the curve (AUC). The dashed line shows the threshold level (upper limit) of normal glucose tolerance for each index. (◇), peak PG <180 mg/dL; (◆), peak PG ≥180 mg/dL. NGT, normal glucose tolerance; IFG, impaired fasting glucose; IGT, impaired glucose tolerance; DM, diabetes mellitus.
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jdi12096-fig-0003: Screening performance of conventional indices: (a) fasting plasma glucose (FPG); (b) HbA1c; (d) plasma glucose (PG) 2 h after glucose loading; and (d) PG area under the curve (AUC). The dashed line shows the threshold level (upper limit) of normal glucose tolerance for each index. (◇), peak PG <180 mg/dL; (◆), peak PG ≥180 mg/dL. NGT, normal glucose tolerance; IFG, impaired fasting glucose; IGT, impaired glucose tolerance; DM, diabetes mellitus.

Mentions: Figure 3 shows FPG (Figure 3a), HbA1c (Figure 3b), 2‐h PG (Figure 3c), and PG AUC (Figure 3d) levels categorized by glucose tolerance. Most IGT and some diabetes cases were judged as NGT according to FPG and HbA1c levels. A degree of overlap between NGT and IGT/diabetes makes it difficult to define a suitable threshold level while screening for glucose intolerance. Although classification by 2‐h PG levels improved separation, no high peak PG levels were found with NGT or IFG in addition to the false‐positive results associated with IGT with low peak PG levels. There was good correlation between PG AUC and IG AUC (Figure 2a); therefore, classification by PG AUC was similar to that by IG AUC (Figure 3d).


Usefulness of a novel system for measuring glucose area under the curve while screening for glucose intolerance in outpatients.

Sakamoto K, Kubo F, Yoshiuchi K, Ono A, Sato T, Tomita K, Sakaguchi K, Matsuhisa M, Kaneto H, Maegawa H, Nakajima H, Kashiwagi A, Kosugi K - J Diabetes Investig (2013)

Screening performance of conventional indices: (a) fasting plasma glucose (FPG); (b) HbA1c; (d) plasma glucose (PG) 2 h after glucose loading; and (d) PG area under the curve (AUC). The dashed line shows the threshold level (upper limit) of normal glucose tolerance for each index. (◇), peak PG <180 mg/dL; (◆), peak PG ≥180 mg/dL. NGT, normal glucose tolerance; IFG, impaired fasting glucose; IGT, impaired glucose tolerance; DM, diabetes mellitus.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4020250&req=5

jdi12096-fig-0003: Screening performance of conventional indices: (a) fasting plasma glucose (FPG); (b) HbA1c; (d) plasma glucose (PG) 2 h after glucose loading; and (d) PG area under the curve (AUC). The dashed line shows the threshold level (upper limit) of normal glucose tolerance for each index. (◇), peak PG <180 mg/dL; (◆), peak PG ≥180 mg/dL. NGT, normal glucose tolerance; IFG, impaired fasting glucose; IGT, impaired glucose tolerance; DM, diabetes mellitus.
Mentions: Figure 3 shows FPG (Figure 3a), HbA1c (Figure 3b), 2‐h PG (Figure 3c), and PG AUC (Figure 3d) levels categorized by glucose tolerance. Most IGT and some diabetes cases were judged as NGT according to FPG and HbA1c levels. A degree of overlap between NGT and IGT/diabetes makes it difficult to define a suitable threshold level while screening for glucose intolerance. Although classification by 2‐h PG levels improved separation, no high peak PG levels were found with NGT or IFG in addition to the false‐positive results associated with IGT with low peak PG levels. There was good correlation between PG AUC and IG AUC (Figure 2a); therefore, classification by PG AUC was similar to that by IG AUC (Figure 3d).

Bottom Line: Plasma glucose (PG) levels were measured every 30 min for 2 h to calculate reference (actual) AUC.Good correlation between MIET-predicted and reference AUCs obtained using PG levels was confirmed for a wide AUC range.The results of a questionnaire-based survey administered to the subjects suggested that this system was readily accepted by the majority as a painless monitoring method.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine Osaka Police Hospital Osaka Japan.

ABSTRACT

Aims/introduction: To realize the effectiveness of a novel system for measuring glucose area under the curve (AUC) using minimally invasive interstitial fluid extraction technology (MIET), outpatients undergoing oral glucose tolerance tests (OGTT) were investigated for the efficacy of screening for glucose intolerance using this system.

Materials and methods: Fifty outpatients scheduled to undergo a 75-g OGTT for medical reasons were recruited to the study. An area of skin on the forearm was pretreated with microneedle arrays before the application of hydrogels for interstitial fluid extraction. Plasma glucose (PG) levels were measured every 30 min for 2 h to calculate reference (actual) AUC. The AUC was predicted by MIET on the basis of glucose extracted by the hydrogel using sodium ion levels as the internal standard.

Results: Good correlation between MIET-predicted and reference AUCs obtained using PG levels was confirmed for a wide AUC range. By introducing a threshold level for AUC to separate glucose intolerance with peak glucose ≥180 mg/dL from normal glucose tolerance, the system was demonstrated to provide better screening accuracy compared with conventional methods that use HbA1c and fasting PG levels. The results of a questionnaire-based survey administered to the subjects suggested that this system was readily accepted by the majority as a painless monitoring method.

Conclusions: The findings suggest that our glucose AUC measurement system using MIET would be useful for screening of glucose intolerance. In the future, this system may prove to be a useful aid as a screen for glucose intolerance before performing an OGTT for diagnosis.

No MeSH data available.


Related in: MedlinePlus