Stout P J, Peled N, Erickson B J, Hilgers M E, Racchini J R, Hoegh T B
Integ, Inc, St Paul, Minnesota 55113, USA.
Diabetes Technol Ther. 2001 Spring;3(1):81-90. doi: 10.1089/152091501750220046.
Alternative methods for self-monitoring of blood glucose have been pursued by many researchers, largely in response to evidence gathered in several long-term studies of patients with diabetes mellitus. These studies suggest that long-term complications of the disease may be mitigated if the disease is intensively managed, a component of which is increased monitoring. Many of the alternative methods utilize interstitial fluid (ISF) as the diagnostic fluid, rather than finger blood. A time lag in the distribution of glucose from blood to the interstitium has been observed by many, with estimates of lag time varying from none to 45 min. Dermal ISF was sampled from diabetic subjects in two tests and compared to finger blood glucose. In the first test, data were collected over time in a manner that allowed a cross-correlation analysis to predict an average lag time. Information from this test was then used as input to a data collection format for a method comparison test of 691 patients with diabetes in which ISF data were collected immediately after the finger blood reference and 15 min after the reference. An average lag time of about 25 min was determined from the cross-correlation analysis, with the correlation error reduced by three-fourths within a 15-min lag time. In the method comparison test, the correlation coefficient between finger blood glucose and ISF glucose improved from 0.923 to 0.951, and the percentage of data in the A zone of the Clarke Error Grid rose from 80.2% to 90.6% for the ISF glucose data collected at no lag and 15-min lag, respectively. Dermal ISF glucose measurement might be a reasonable alternative to blood glucose measurement for patients routinely monitoring ambient glycemia, although more testing in the sensitive hypoglycemic range is needed to clarify what might happen in cases of rapidly changing glucose.
许多研究人员一直在探索血糖自我监测的替代方法，这主要是对多项糖尿病患者长期研究中收集到的证据所做出的回应。这些研究表明，如果对该疾病进行强化管理，疾病的长期并发症可能会得到缓解，其中一个组成部分就是加强监测。许多替代方法利用组织间液（ISF）作为诊断液，而不是指血。许多人观察到葡萄糖从血液到组织间隙的分布存在时间滞后，滞后时间的估计从无到45分钟不等。在两项测试中从糖尿病受试者身上采集了真皮组织间液，并与指血葡萄糖进行了比较。在第一次测试中，随着时间的推移收集数据，以便进行互相关分析来预测平均滞后时间。然后将该测试的信息用作691例糖尿病患者方法比较测试的数据收集格式的输入，在该测试中，在采集指血参考值后立即以及参考值后15分钟采集组织间液数据。通过互相关分析确定平均滞后时间约为25分钟，在15分钟的滞后时间内相关误差减少了四分之三。在方法比较测试中，指血葡萄糖与组织间液葡萄糖之间的相关系数从0.923提高到0.951，对于在无滞后和15分钟滞后时采集的组织间液葡萄糖数据，克拉克误差网格A区的数据百分比分别从80.2%上升到90.6%。对于常规监测血糖水平的患者，真皮组织间液葡萄糖测量可能是血糖测量的一种合理替代方法，尽管需要在敏感的低血糖范围内进行更多测试，以阐明在血糖快速变化的情况下可能会发生什么。
