New Application for Continuous Glucose Monitor Systems

Adipose Tissue Suitable for Glucose Monitoring in Critically Ill Patients Subcutaneous adipose tissue appears to be an appropriate site for monitoring glucose concentrations in patients after major cardiac surgery, and could be used for maintaining tight glycemic control in this situation, Austrian researchers report.

Lead investigator Dr. Martin Ellmerer found that there is substantial evidence that hypoglycemia, "as frequently seen in diabetic, but also non-diabetic critically ill patients is associated with a substantial risk for mortality and morbidity."

Moreover, "for the treatment of high glucose concentrations in critically ill patients … measurements of glucose are required on at least a 1 to 4 hourly basis." For diabetes care, he added, there is ongoing research into the development of continuous glucose monitoring systems using subcutaneous adipose tissue as a sampling site.

However, Dr. Ellmerer of Medical University Graz and colleagues note in the June issue of Diabetes Care that such an approach has not been tested in critically ill patients. In order to do so, the researchers studied 40 such patients in the ICU after undergoing cardiac surgery.

For sampling interstitial fluid, a microdialysis catheter was inserted into subcutaneous adipose tissue in the umbilical region, and dialysate was collected in hourly batches for analysis for up to 48 hours. For blood monitoring, samples from an arterial line were collected at hourly intervals over the same period.

After appropriate calibration, there was a good correlation between blood glucose and adipose tissue-derived glucose levels. In clinical evaluation, the researchers established that 96.1% of the adipose tissue readings would allow acceptable treatment and glycemic control.

"In principle," Dr. Ellmerer concluded, "our finding opens a new application field for the use and development of continuous glucose monitoring systems in critically ill patients."

Diabetes Care 2006;29:1275-1281.

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