Subcutaneous Tissue Glucose Research Articles

Effects of dapagliflozin monotherapy and combined aerobic exercise on skeletal muscle mitochondrial quality control and insulin resistance in type 2 diabetes mellitus rats

Type 2 diabetes mellitus (T2DM) is a prevalent, chronic metabolic disease. Sodium-glucose cotransporter-2 (SGLT2) inhibitors and aerobic exercise (AE) have shown promise in mitigating insulin resistance (IR) and T2DM. This study investigated the effects of dapagliflozin (Dapa) monotherapy and combined AE on mitochondrial quality control (MQC) in skeletal muscle and IR in T2DM rats. T2DM rats, induced by a high-fat diet/streptozotocin model, were randomly assigned to the following groups: T2DM+vehicle group (DMV), T2DM rats treated with Dapa (DMDa, 10 mg/kg/d), T2DM rats subjected to combined Dapa treatment and AE (DMDa+AE), and the standard control group (CON). Blood and skeletal muscle samples were collected after 6 weeks of intragastric administration and treadmill exercise. The results showed that DMDa monotherapy could reduce the accumulation of white adipose tissue and skeletal muscle lipid droplets and improve HOMA-IR. While the combined AE led to further reductions in subcutaneous white adipose tissue and fasting glucose levels, it did not confer additional benefits in terms of HOMA-IR. Furthermore, Dapa monotherapy enhanced skeletal muscle mitochondrial biogenesis (PGC-1α, NRF1, TFAM, and COX IV), mitochondrial dynamics (OPA1, DRP1, and MFN2), and mitophagy (PGAM5 and PINK1) related protein levels. Nevertheless, the combination of Dapa with AE treatment did not yield an additive effect. In conclusion, this study highlights the potential of SGLT2 inhibitors, specifically Dapa, in ameliorating IR and maintaining MQC in skeletal muscle in rats with T2DM. However, combined AE did not produce an additive effect, indicating the need for further research.

Calving prediction with continuous measurement of subcutaneous tissue glucose concentration in pregnant cows.

To reduce losses of dams and calves due to unfortunate events, such as dystocia and freezing to death, identifying the onset of calving and providing necessary assistance are crucial. Prepartum increase in blood glucose concentration is a known indicator to detect labor in pregnant cows. However, some issues, including the need for frequent blood sampling and stress on cows, must be resolved before establishing a method for anticipating calving using changes in blood glucose concentrations. Herein, instead of measuring the blood glucose concentrations, subcutaneous tissue glucose concentration (tGLU) was measured in peripartum primiparous (n=6) and multiparous (n=8) cows at 15min intervals using a wearable sensor. A transient increase in tGLU was observed in the peripartum period, with peak individual concentrations occurring between 2.8h before and 3.5h after calving. tGLU in primiparous cows was significantly higher than that in multiparous cows. To account for individual variations in basal tGLU, the maximum relative increase in the 3-h moving average of tGLU (Max MA) was used to predict calving. Cutoff points for Max MA were established by parity, with receiver operating characteristic analysis predicting calving within 24, 18, 12, and 6h. Except for one multiparous cow that showed an increase in tGLU just before calving, all cows reached at least two cutoff points and calving was predicted successfully. The time interval between reaching the tGLU cutoff points that predicted calving within 12h and actual calving was 12.3±5.6h. In conclusion, this study demonstrated the potential role of tGLU as a predictive indicator of calving in cows. Advancements in machine learning-based prediction algorithms and bovine-optimized sensors will help in increasing the accuracy of calving prediction using tGLU.

First-trimester diet quality in association with maternal subcutaneous and visceral adipose tissue thicknesses and glucose homeostasis during pregnancy

We aimed to characterise the associations between first-trimester diet quality, adiposity, and glucose homeostasis measurements throughout pregnancy in a sample of 104 healthy pregnant women. Three Web-based 24-h recalls were completed, from which the Alternate Healthy Eating Index (AHEI) was calculated. At each trimester (12.5 ± 0.7, 22.8 ± 1.0, and 33.6 ± 1.3 weeks of gestation), fasting glucose and insulin were measured to compute an insulin resistance index (HOMA-IR). Subcutaneous and visceral adipose tissue thicknesses were estimated by ultrasound at the end of the first trimester. Inverse associations were observed between the first-trimester AHEI and first-trimester fasting insulin (r = 0.24; p < 0.05), and HOMA-IR (r = −0.22; p < 0.05), as well as third-trimester fasting insulin (r = −0.20; p < 0.05). A trend was also observed between first-trimester AHEI and first-trimester SAT thickness (r = −0.17; p < 0.1). Pre- and early-pregnancy adiposity measurements were identified as high predictors fasting insulin concentrations throughout pregnancy. Higher early-pregnancy diet quality is associated with more favourable metabolic measurements during pregnancy.

Visceral adipose tissue glucose uptake is linked to prognosis in multiple myeloma patients: An exploratory study

The use of computerized tomography to opportunistically assess body composition has highlighted abnormalities such as low muscle mass and high adiposity may be hidden conditions in cancer patients. However, the role of skeletal muscle (SM), subcutaneous (SAT) and visceral (VAT) adipose tissue glucose uptake measured by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)-CT on patient prognostication is unclear. Patients with multiple myeloma (MM) with satisfactory image frame for assessing body composition and for semi-quantification of SM, SAT and VAT glucose uptakes were included. Plasmatic pro-inflammatory cytokine and adipokine levels were measured. High VAT mean standardized uptake value (SUV) at baseline was associated with shorter event-free survival (EFS) (hazard ratio [HR]: 7.89; 95% confidence interval [CI], 1.58-39.30; P=0.012) and overall survival (OS) (HR, 15.24; 95% CI, 2.69-86.30; P=0.002) among patients with newly diagnosed MM, even after adjustment for covariates. The highest tertile of VAT SUV was significantly correlated with worse MM-EFS (HR for the highest vs the lowest tertile 3.71; 95% CI, 1.22-10.56; Ptrend=0.035) and mortality (HR, 4.41; 95% CI, 1.28-12.77; Ptrend=0.019). Notably, patients with higher VAT SUV presented with lower VAT area, VAT index, higher SAT SUV, and higher number of individuals with visceral obesity (all P<0.01). Additionally, we found a negative correlation between VAT mean SUV with leptin (R2=0.20, P=0.003); no correlations were detected between VAT mean SUV and resistin, tumor necrosis factor (TNF) or interleukin (IL)-6. Functional VAT activity estimated by 18F-FDG PET-CT is a relevant prognostic factor in MM patients, specifically, a higher VAT SUV might be an early biomarker of cancer cachexia in these patients.

Sensitivity Improvement of a Low-Invasive Type Amperometric Glucose Sensor

Implantable glucose biosensors for continuous glucose monitoring (CGM), are getting more attractive, since they can provide greater insight into the direction, magnitude, duration, frequency and possible causes of glucose fluctuations in response to meals, insulin injections, hypoglycemic episodes and exercise throughout the day. The current commercialized or presented conventional CGM sensor devise are required to have about 1.0 cm in length to be inserted inside the skin. Therefore, it is expected to develop lower invasive type glucose sensor in order to improve the life-quality of diabetic patients. We have previously reported that the sensor response of a fine tapered needle type glucose sensor, which has a sensing region at the tip, showed good correlation with blood glucose value, even it was implanted in the skin of a rabbit for a length of 1.0 mm [1]. This indicate that the glucose measurement in dermis may provide valuable information comparable to subcutaneous tissue glucose measurement. As part of our low-invasive improvement of the sensor, miniaturization of sensing region is essential, but it may lead to a decrease of response current to glucose. Therefore, at the same time, the improvement of sensor sensitivity is also indispensable. The sensitivity of an enzyme based glucose sensor can be improved by introduction of carbon nanomaterial or mediator, which can increase electrode surface area and the efficiency of electron or mass transport to the transducer. Due to their high chemical stability, high surface area, and unique electronic properties, carbon nanotubes (CNT) and graphene has greatly increased biosensor sensitivity and response speed. On the other hand, electroetching of the electrode surface is an effective method to obtain a higher surface area, which may be responsible for enhanced sensitivity. In this study, introduction of carbon nanomaterial and electroetching technique were introduced to improve the sensitivity of the proposed glucose sensor. [1] J. Li, P. Koinkar, Y. Fuchiwaki, M. Yasuzawa, Biosens. Bioelectron., 86 (2016) 90.

A prolonged run-in period of standard subcutaneous microdialysis ameliorates quality of interstitial glucose signal in patients after major cardiac surgery

We evaluated a standard subcutaneous microdialysis technique for glucose monitoring in two critically ill patient populations and tested whether a prolonged run-in period improves the quality of the interstitial glucose signal. 20 surgical patients after major cardiac surgery (APACHE II score: 10.1 ± 3.2) and 10 medical patients with severe sepsis (APACHE II score: 31.1 ± 4.3) were included in this investigation. A microdialysis catheter was inserted in the subcutaneous adipose tissue of the abdominal region. Interstitial fluid and arterial blood were sampled in hourly intervals to analyse glucose concentrations. Subcutaneous adipose tissue glucose was prospectively calibrated to reference arterial blood either at hour 1 or at hour 6. Median absolute relative difference of glucose (MARD), calibrated at hour 6 (6.2 (2.6; 12.4) %) versus hour 1 (9.9 (4.2; 17.9) %) after catheter insertion indicated a significant improvement in signal quality in patients after major cardiac surgery (p < 0.001). Prolonged run-in period revealed no significant improvement in patients with severe sepsis, but the number of extreme deviations from the blood plasma values could be reduced. Improved concurrence of glucose readings via a 6-hour run-in period could only be achieved in patients after major cardiac surgery.

A dielectric affinity glucose microsensor using hydrogel-functionalized coplanar electrodes.

This paper presents a dielectric affinity microsensor that consists of an in situ prepared hydrogel attached to a pair of coplanar electrodes for dielectrically based affinity detection of glucose in subcutaneous tissue in continuous glucose monitoring applications. The hydrogel, incorporating N-3-acrylamidophenylboronic acid that recognizes glucose via affinity binding, is synthetically prepared on the electrodes via in situ gelation. When implanted in subcutaneous tissue, glucose molecules in interstitial fluid diffuse rapidly through the hydrogel and bind to the phenylboronic acid moieties. This induces a change in the hydrogel's permittivity and hence in the impedance between the electrodes, which can be measured to determine the glucose concentration. The in situ hydrogel preparation allows for a reduced hydrogel thickness (~10 μm) to enable the device to respond rapidly to glucose concentration changes in tissue, as well as covalent electrode attachment of the hydrogel to eliminate the need for semipermeable membranes that would otherwise be required to restrain the sensing material within the device. Meanwhile, the use of coplanar electrodes is amenable to the in situ preparation and facilitates glucose accessibility of the hydrogel, and combined with dielectrically based transduction, also eliminates mechanical moving parts often found in existing affinity glucose microsensors that can be fragile and complicated to fabricate. Testing of the device in phosphate-buffered saline at pH 7.4 and 37 °C has shown that at glucose concentrations ranging from 0 to 500 mg/dL, the hydrogel-based microsensor exhibits a rapid, repeatable, and reversible response. In particular, in the glucose concentration range of 40-100 mg/dL, which is of great clinical interest to monitoring normal and low blood sugar levels, the device response is approximately linear with a resolution of 0.32 mg/dL based on effective capacitance and 0.27 mg/dL based on effective resistance, respectively. Thus, the device holds the potential to enable reliable and accurate continuous monitoring of glucose in subcutaneous tissue.

Testosterone differentially regulates targets of lipid and glucose metabolism in liver, muscle and adipose tissues of the testicular feminised mouse.

Testosterone deficiency is commonly associated with obesity, metabolic syndrome, type 2 diabetes and their clinical consequences—hepatic steatosis and atherosclerosis. The testicular feminised mouse (non-functional androgen receptor and low testosterone) develops fatty liver and aortic lipid streaks on a high-fat diet, whereas androgen-replete XY littermate controls do not. Testosterone treatment ameliorates these effects, although the underlying mechanisms remain unknown. We compared the influence of testosterone on the expression of regulatory targets of glucose, cholesterol and lipid metabolism in muscle, liver, abdominal subcutaneous and visceral adipose tissue. Testicular feminised mice displayed significantly reduced GLUT4 in muscle and glycolytic enzymes in muscle, liver and abdominal subcutaneous but not visceral adipose tissue. Lipoprotein lipase required for fatty acid uptake was only reduced in subcutaneous adipose tissue; enzymes of fatty acid synthesis were increased in liver and subcutaneous tissue. Stearoyl-CoA desaturase-1 that catalyses oleic acid synthesis and is associated with insulin resistance was increased in visceral adipose tissue and cholesterol efflux components (ABCA1, apoE) were decreased in subcutaneous and liver tissue. Master regulator nuclear receptors involved in metabolism—Liver X receptor expression was suppressed in all tissues except visceral adipose tissue, whereas PPARγ was lower in abdominal subcutaneous and visceral adipose tissue and PPARα only in abdominal subcutaneous. Testosterone treatment improved the expression (androgen receptor independent) of some targets but not all. These exploratory data suggest that androgen deficiency may reduce the buffering capability for glucose uptake and utilisation in abdominal subcutaneous and muscle and fatty acids in abdominal subcutaneous. This would lead to an overspill and uptake of excess glucose and triglycerides into visceral adipose tissue, liver and arterial walls.

On-line Blood Glucose Level Calculation

Diabetes is a silent disease. It is the 8th most common cause of death that does not hurt until it is too late and the disease has developed. Technology plays a vital role in managing diabetes and educating patients about importance of the treatment. The patient must be able to manage his blood glucose level. However, blood glucose level is measured sporadically as it causes important discomfort to the patient. Measuring glucose level in subcutaneous tissue is minimally invasive technique and thus considerably comfortable, but this level may be different from blood glucose level. We implemented a recently proposed method of blood glucose level calculation from the continuously measured subcutaneous tissue glucose level. Then, we developed a web portal that makes this method accessible to any doctor's office and any diabetic patient. To the best of our knowledge, we are the very first web portal that does this. In this paper, we describe the portal.

P66Shc deletion or deficiency protects from obesity but not metabolic dysfunction in mice and humans.

Oxygen radicals generated by p66Shc drive adipogenesis, but contradictory data exist on the role of p66Shc in the development of obesity and the metabolic syndrome. We herein explored the relationships among p66Shc, adipose tissue remodelling and glucose metabolism using mouse models and human adipose tissue samples. In wild-type (WT), leptin-deficient (ob/ob), p66Shc(-/-) and p66Shc(-/-) ob/ob mice up to 30 weeks of age, we analysed body weight, subcutaneous and visceral adipose tissue histopathology, glucose tolerance and insulin sensitivity, and liver and muscle fat accumulation. A group of mice on a high fat diet (HFD) was also analysed. A parallel study was conducted on adipose tissue collected from patients undergoing elective surgery. We found that p66Shc(-/-) mice were slightly leaner than WT mice, and p66Shc(-/-) ob/ob mice became less obese than ob/ob mice. Despite their lower body weight, p66Shc(-/-) mice accumulated ectopic fat in the liver and muscles, and were glucose intolerant and insulin resistant. Features of adverse adipose tissue remodelling induced by obesity, including adipocyte enlargement, apoptosis, inflammation and perfusion were modestly and transiently improved by p66Shc (also known as Shc1) deletion. After 12 weeks of the HFD, p66Shc(-/-) mice were leaner than but equally glucose intolerant and insulin resistant compared with WT mice. In 77 patients, we found a direct correlation between BMI and p66Shc protein levels. Patients with low p66Shc levels were less obese, but were not protected from other metabolic syndrome features (diabetes, dyslipidaemia and hypertension). In mice and humans, reduced p66Shc levels protect from obesity, but not from ectopic fat accumulation, glucose intolerance and insulin resistance.

Akkermansia Muciniphila and Gut Microbiota Richness are Associated with Improved Metabolic Status after Calorie Restriction

Populations with obesity and Type 2 Diabetes differ from healthy populations in the abundance of certain gut microbial species and microbial gene richness (MGR). Abundance of Akkermansia muciniphila (Akk) has been inversely associated to fat mass and glucose intolerance in mice. More evidence is needed in humans as well as on the impact of diet and weight loss on Akk abundance. Our aim was to evaluate the association between fecal Akk abundance and MGR, host characteristics, and their changes as a result of calorie restriction (CR) for 6 weeks followed by weight stabilization (WS) for 6 weeks in 49 overweight/obese adults. Fecal Akk, MGR, diet and bioclinical parameters were measured at baseline (BS) and after CR and WS. At BS Akk was inversely related to fasting glucose, waist‐to‐hip ratio, and adipocyte diameter in subcutaneous white adipose tissue. Subjects with higher MGR and Akk had the healthiest metabolic status, particularly in fasting glucose, triglycerides and body composition. Higher BS Akk was associated with greater improvement in insulin sensitivity and other clinical parameters after CR. Akk is associated with a healthier metabolic status and outcomes after CR in this population. Further studies are required to establish underlying mechanisms in humans. Support: ANR MICRO‐Obes, KOT‐Ceprodi, Fondation Coeur et Arteres, Metacardis HEALTH‐F4‐2012‐305312, FRS‐FNRS, ERC Starting grant 336452‐ENIGMO).

Compartmental neck fat accumulation and its relation to cardiovascular risk and metabolic syndrome

Neck circumference is a predictor of cardiovascular disease (CVD) risk. However, detailed assessment of neck fat has not been explored, and the contribution from individual neck fat compartments to CVD risk is unknown. The objective was to measure neck adipose tissue (NAT) compartments and examine relations with CVD risk markers, with the hypothesis that neck adipose tissue (NAT) accumulation preferentially involves specific compartments that contribute differently to metabolic risk. We retrospectively studied 303 subjects with successfully treated malignancies or benign etiologies [151 women, 152 men; mean (± SD) age: 55 ± 17 y; mean body mass index (BMI; in kg/m(2)): 28 ± 6] who underwent whole-body positron emission tomography/computed tomography. NAT was measured at the level of the C5 vertebral body, subdivided into posterior (NATpost), subcutaneous (NATsc), and perivertebral (NATperivert) compartments. Data on CVD risk factors (BMI, abdominal circumference, visceral and abdominal subcutaneous adipose tissue, blood pressure, serum lipids, and fasting plasma glucose) were collected. We compared NAT compartments across lean, overweight, and obese groups and performed multivariate regression models correlating NAT with CVD risk factors. Receiver operating characteristic curve and prevalence ratio analyses were performed to examine the association of NAT compartments with metabolic syndrome. NATpost and NATsc were more consistently associated with cardiometabolic risk, especially in women, correlating with visceral adipose tissue (P < 0.0001) and triglycerides (P < 0.001) and a nearly 1.5-fold increase in the prevalence ratio for metabolic syndrome after adjustment for age and BMI (P < 0.05). NATsc was most abundant in women, whereas intermuscular compartments (NATpost and NATperivert) were higher in men. In both sexes, NATpost and NATperivert showed the largest increment between lean and obese subjects. Neck fat compartments expand differently with increasing adiposity, correlate with CVD risk factors, and are associated with metabolic syndrome, most notably NATpost and NATsc in women. Although neck circumference remains an important method to assess metabolic risk, cross-sectional NAT assessment provides further insight into fat accumulation in the neck. This trial was registered at clinicaltrials.gov as NCT02205021.

Continuous monitoring of glucose in subcutaneous tissue using microfabricated differential affinity sensors.

We describe miniaturized differential glucose sensors based on affinity binding between glucose and a synthetic polymer. The sensors possess excellent resistance to environmental disturbances and can potentially allow wireless measurements of glucose concentrations within interstitial fluid in subcutaneous tissue for long-term, stable continuous glucose monitoring (CGM). The sensors are constructed using microelectromechanical systems (MEMS) technology and exploit poly(N-hydroxy-ethyl acrylamide-ran-3-acrylamidophenylboronic acid) (PHEAA-ran-PAAPBA), a glucose-binding polymer with excellent specificity, reversibility, and stability. Two sensing approaches have been investigated, which respectively, use a pair of magnetically actuated diaphragms and perforated electrodes to differentially measure the glucose-binding-induced changes in the viscosity and permittivity of the PHEAA-ran-PAAPBA solution with respect to a reference, glucose-unresponsive polymer solution. In vivo characterization of the MEMS affinity sensors were performed by controlling blood glucose concentrations of laboratory mice by exogenous glucose and insulin administration. The sensors experienced an 8-30 min initialization period after implantation and then closely tracked commercial capillary glucose meter readings with time lags ranging from 0-15 min during rapid glucose concentration changes. Clarke error grid plots obtained from sensor calibration suggest that, for the viscometric and dielectric sensors, respectively, approximately 95% (in the hyperglycemic range) and 84% (ranging from hypoglycemic to hyperglycemic glucose concentrations) of measurement points were clinically accurate, while 5% and 16% of the points were clinically acceptable. The miniaturized MEMS sensors explore differential measurements of affinity glucose recognition. In vivo testing demonstrated excellent accuracy and stability, suggesting that the devices hold the potential to enable long-term and reliable CGM in clinical applications.

Mechanical-tactile stimulation (MTS) during neonatal stress prevents hyperinsulinemia despite stress-induced adiposity in weanling rat pups

Stress in early life negatively influences growth quality through perturbations in body composition including increased fat mass. At term (40 weeks) preterm infants have greater fat mass and abdominal visceral adipose tissue than term-born infants. Mechanical-tactile stimulation (MTS) attenuates the stress response in preterm infants and rodents. We tested the hypothesis that MTS, administered during an established model of neonatal stress, would decrease stress-driven adiposity and prevent associated metabolic imbalances in rat pups. Pups received one of three treatments from postnatal days 5 to P9: Neonatal Stress (Stress; n = 20) = painful stimulus and hypoxic/hyperoxic challenge during 60 min of maternal separation; MTS (n = 20) = neonatal stress + 10 min of MTS; or Control (n = 20). Body weight, DXA whole body fat mass (g), MRI subcutaneous and visceral adipose tissue, and fasting adiponectin, leptin, glucose, insulin, and corticosterone were measured at weaning (P21). Stress and MTS weight gain (g/d) were accelerated following neonatal stress with greater fat mass, abdominal subcutaneous adipose tissue, serum adiponectin, leptin, and fasting glucose at weaning (P21). Male Stress and MTS pups had greater visceral adipose tissue depot. Male and female Stress pups were hyperinsulinemic. In summary, neonatal stress compromised body composition by increasing fat mass and abdominal subcutaneous adipose tissue depot, and in males, visceral adipose tissue depot. Importantly, MTS prevented hyperinsulinemia despite of stress-induced adiposity. We conclude that MTS during neonatal stress has the potential to minimize metabolic consequences associated with stress-driven perturbations in fat mass and abdominal adipose depots.

A MEMS affinity glucose sensor using a biocompatible glucose-responsive polymer

We present a MEMS affinity sensor that can potentially allow long-term continuous monitoring of glucose in subcutaneous tissue for diabetes management. The sensing principle is based on detection of viscosity changes due to affinity binding between glucose and poly(acrylamide- ran-3-acrylamidophenylboronic acid) (PAA- ran-PAAPBA), a biocompatible, glucose-specific polymer. The device uses a magnetically driven vibrating microcantilever as a sensing element, which is fabricated from Parylene and situated in a microchamber. A solution of PAA- ran-PAAPBA fills the microchamber, which is separated from the surroundings by a semi-permeable membrane. Glucose permeates through the membrane and binds reversibly to the phenylboronic acid moiety of the polymer. This results in a viscosity change of the sensing solution, which is obtained by measuring the damped cantilever vibration using an optical lever setup, allowing determination of the glucose concentration. Experimental results demonstrate that the device is capable of detecting glucose at physiologically relevant concentrations from 27 mg/dL to 324 mg/dL. The glucose response time constant of the sensor is approximately 3 min, which can be further improved with device design optimization. Excellent reversibility and stability are observed in sensor responses, as highly desired for long-term, stable continuous glucose monitoring.

The Pro12Ala polymorphism of the PPAR γ2 gene is associated with hepatic glucose uptake during hyperinsulinemia in subjects with type 2 diabetes mellitus

The Ala12 allele of the peroxisome proliferator–activated receptor γ gene ( PPARG2) has been associated with reduced risk of type 2 diabetes mellitus (T2DM) and increased whole-body and skeletal muscle insulin sensitivity in nondiabetic subjects. The effect of the Pro12Ala polymorphism on tissue specific insulin sensitivity in subjects with T2DM has not been previously investigated. We studied the effect of the Pro12Ala polymorphism on the rates of whole-body, skeletal muscle, and subcutaneous adipose tissue glucose uptake (GU) in T2DM subjects, and the rates of hepatic GU in nondiabetic and T2DM subjects during hyperinsulinemia. Our study included 105 T2DM subjects whose whole-body, skeletal muscle, subcutaneous adipose tissue, and hepatic GUs were measured using 18F-fluorodeoxyglucose and positron emission tomography during the hyperinsulinemic euglycemic clamp. Hepatic GU was also measured in 68 nondiabetic subjects. In obese (body mass index ≥27 kg/m 2) subjects with T2DM, the rate of hepatic GU was 28% lower in subjects with the Pro12Pro genotype than in carriers of the Ala12 allele ( P = .001); and a similar trend was observed in nondiabetic obese subjects ( P = .137). No effect of the Pro12Ala polymorphism on the rates of whole-body, skeletal muscle, or subcutaneous adipose tissue GU was observed in T2DM subjects. We conclude that the Ala12 allele of PPARG2 is associated with higher hepatic GU in obese subjects with T2DM.

Development of boronic acid grafted random copolymer sensing fluid for continuous glucose monitoring.

We have previously presented a microelectromechanical system (MEMS) based viscometric sensor for continuous glucose monitoring using protein Concanavalin A (Con A). To address its drawbacks, including immunotoxicity and instability issues, we have synthesized stable, biocompatible copolymers poly(acrylamide-ran-3-acrylamidophenylboronic acid) (PAA-ran-PAAPBA) for viscosity based glucose sensing. We found that PAA-ran-PAAPBA showed very high binding specificity to glucose. Several key factors such as polymer compositions, polymer molecular weights and polymer concentrations have been investigated to optimize viscometric responses. This polymer is able to detect glucose under physiological pH conditions in a reversible manner. Therefore, it has the potential to enable a highly reliable, continuous monitoring of glucose in subcutaneous tissue using the MEMS device.

Continuous In Vivo Monitoring of a Flexible Subcutaneous Sensor in Freely Moving Diabetic Rats

Subcutaneous tissue is frequently the target site for placement of continuous, real-time metabolic sensors. Since the 1960s, numerous research groups have developed needle-like sensor designs, patterned after the Clarke Electrode, to monitor glucose in subcutaneous tissue. These designs perform well in vitro but often fail in vivo due to sensor instability and tissue response. None of these studies focused on the mechanical properties of implanted sensors and how these properties may affect in vivo performance. To investigate the role of sensor stiffness on short term functionality we developed a low stiffness subcutaneous sensor patterned after the Clarke Electrode and tested it in rodents. The purpose of this study was two-fold. The first goal was to demonstrate the in vivo functionality of the flexible sensor. The second goal was to evaluate the effect of stiffness on functionality by co-implanting stiff and flexible sensors. In the first series of studies the low stiffness sensors provided glucose level measurements that fell within the A and B regions of the Clarke Error Grid 93.0% of the time. The results of the second study yielded similar accuracy; however, no performance difference was seen between the stiff and flexible sensors. We concluded that the flexible sensor works for at least 3days after implantation in the subcutaneous tissue of freely moving rats and that the key property of low stiffness has no differential effect on the accuracy of the sensor in the freely moving rodent model of these studies.

Development of a highly responsive needle-type glucose sensor using polyimide for a wearable artificial endocrine pancreas

To produce a long-life, stable, miniature glucose sensor for a wearable artificial endocrine pancreas (WAEP), we developed a novel microneedle-type glucose sensor using polyimide, designated the PI sensor (outer diameter, 0.3 mm; length, 16 mm), and investigated its characteristics in vitro and in vivo. In the in vitro study, we tested the sensor in 0.9% NaCl solution with varying glucose concentrations and observed an excellent linear relationship between the sensor output and glucose concentration (range: 0-500 mg/100 ml). In in vivo experiments, the PI sensor was inserted into the abdominal subcutaneous tissue of beagle dogs (n = 5), and interstitial fluid glucose concentrations were monitored after sensor calibration. Simultaneously, blood glucose concentrations were also monitored continuously with another PI sensor placed intravenously. The correlation and time delay between subcutaneous tissue glucose (Y) and blood glucose concentrations (X: 30-350 mg/100 ml) were Y = 1.03X + 7.98 (r = 0.969) and 6.6 +/- 1.2 min, respectively. We applied the new WAEP system/PI sensor and an intravenous insulin infusion algorithm developed previously for glycemic control in diabetic dogs. The use of the WAEP system resulted in excellent glycemic control after an oral glucose challenge of 1.5 g/kg (post-challenge blood glucose levels: 176 +/- 18 mg/100 ml at 65 min and 93 +/- 23 mg/100 ml at 240 min), without any hypoglycemia. Thus, we confirmed that our new PI sensor has excellent sensor characteristics in vitro and in vivo. The new WAEP using this sensor is potentially suitable for clinical application.

Miniaturized fiber-optic hybrid sensor for continuous glucose monitoring in subcutaneous tissue

A new optical fiber microsensor for continuous measurement of glucose in subcutaneous tissue is described. The hybrid sensor consists of two oxygen optodes wherein one optode contains immobilized glucose oxidase. The glucose signal which is a difference between pO 2 of both optodes allows the compensation of oxygen fluctuations in intercellular fluid. Based on the results of investigations of the oxygen dependence on sensor response, the optimization by thickening the diffusion barrier of glucose sensitive optode is done. The loss of the sensing resolution for glucose is compensated by the increased sensitivity of the oxygen transducer at the low oxygen concentrations. The optimized sensor is free of oxygen fluctuations in the expected pO 2 range between 53 and 95 hPa and the sensor output is linear in the physiological relevant glucose range up to 20 mM. The use of the reference oxygen sensor allows also the compensation of the slight temperature fluctuations.