Abstract
This work introduces the concept of multi-analyte biomarkers for continuous metabolic monitoring. The importance of using more than one marker lies in the ability to obtain a holistic understanding of the metabolism. This is showcased for the detection and prediction of exhaustion during intense physical exercise. The findings presented here indicate that when glucose and lactate changes over time are combined into multi-analyte biomarkers, their monitoring trends are more sensitive in the subcutaneous tissue, an implantation-friendly peripheral tissue, compared to the blood. This unexpected observation was confirmed in normal as well as type 1 diabetic rats. This study was designed to be of direct value to continuous monitoring biosensor research, where single analytes are typically monitored. These findings can be implemented in new multi-analyte continuous monitoring technologies for more accurate insulin dosing, as well as for exhaustion prediction studies based on objective data rather than the subject’s perception.
Highlights
Metabolic monitoring is the periodic recording of metabolic markers that give information on specific metabolic pathways
Exhaustion has been linked to several metabolic pathways and a close examination of the metabolic processes involved in physical activity could facilitate a more accurate prediction of exhaustion
Glucose and lactate changes in the blood and subcutaneous tissue are shown in four zones
Summary
Metabolic monitoring is the periodic recording of metabolic markers that give information on specific metabolic pathways. When a device that is implanted in a peripheral tissue such as subcutaneous tissue is used to monitor analyte changes in the blood, loss of sensitivity and lag times are observed[11]. Depletion of fuel stored in the muscle (i.e. creatine and glycogen, that are readily accessible as an energy source), as well as accumulation of metabolic byproducts (e.g. chloride and potassium ions and lactic acid) are considered the causes of exhaustion[15,16] These metabolic events take place in the exercising muscle, a body compartment that is not available for real-time, continuous monitoring via implantable devices mainly due to the trauma associated with intramuscular implantations. External observations (commencement of exercise, running speed, and onset of exhaustion) were correlated with internal shifts in metabolism (glucose and lactate as single readings or combined into multi-analyte biomarkers) recorded in the subcutaneous tissue and the blood. Microdialysis is a reliable technique that has been used extensively in laboratory settings to monitor analyte changes in various tissues
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