Abstract
BackgroundIn diabetes research, the development of the artificial pancreas has been a major topic since continuous glucose monitoring became available in the early 2000’s. A prerequisite for an artificial pancreas is fast and reliable glucose sensing. However, subcutaneous continuous glucose monitoring carries the disadvantage of slow dynamics. As an alternative, we explored continuous glucose sensing in the peritoneal space, and investigated potential spatial differences in glucose dynamics within the peritoneal cavity. As a secondary outcome, we compared the glucose dynamics in the peritoneal space to the subcutaneous tissue.Material and methodsEight-hour experiments were conducted on 12 anesthetised non-diabetic pigs. Four commercially available amperometric glucose sensors (FreeStyle Libre, Abbott Diabetes Care Ltd., Witney, UK) were inserted in four different locations of the peritoneal cavity and two sensors were inserted in the subcutaneous tissue. Meals were simulated by intravenous infusions of glucose, and frequent arterial blood and intraperitoneal fluid samples were collected for glucose reference.ResultsNo significant differences were discovered in glucose dynamics between the four quadrants of the peritoneal cavity. The intraperitoneal sensors responded faster to the glucose excursions than the subcutaneous sensors, and the time delay was significantly smaller for the intraperitoneal sensors, but we did not find significant results when comparing the other dynamic parameters.
Highlights
Achieving tight glucose control in diabetes mellitus type 1 (DM1) treatment is a challenge, but crucial in preventing hyperglycaemia-related late complications
The intraperitoneal sensors responded faster to the glucose excursions than the subcutaneous sensors, and the time delay was significantly smaller for the intraperitoneal sensors, but we did not find significant results when comparing the other dynamic parameters
Intraperitoneal glucose sensing in an animal model advantage of IP continuous glucose monitoring (CGM) must be considered against the obvious disadvantages; entering the IP space through a port imposes a risk for a more serious infection than in the SC space
Summary
Achieving tight glucose control in diabetes mellitus type 1 (DM1) treatment is a challenge, but crucial in preventing hyperglycaemia-related late complications. Patients face the burdens of constant self-surveillance of blood glucose levels, careful planning of exercise and carbohydrate consumption and deciding on dose and delivery of insulin. Automatic closed-loop delivery of insulin, i.e. a so-called artificial pancreas (AP), has the potential to revolutionise the way we treat diabetes, removing some of these burdens [3,4,5]. The development of the artificial pancreas has been a major topic since continuous glucose monitoring became available in the early 2000’s. A prerequisite for an artificial pancreas is fast and reliable glucose sensing. Subcutaneous continuous glucose monitoring carries the disadvantage of slow dynamics. We explored continuous glucose sensing in the peritoneal space, and investigated potential spatial differences in glucose dynamics within the peritoneal cavity. We compared the glucose dynamics in the peritoneal space to the subcutaneous tissue.
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