Lee Inyoung, Probst David, Klonoff David, Sode Koji
Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, 27599, USA.
Diabetes Research Institute, Mills-Peninsula Medical Center, 100 South San Mateo Drive, Room 5147, San Mateo, CA, 94401, USA.
Biosens Bioelectron. 2021 Jun 1;181:113054. doi: 10.1016/j.bios.2021.113054. Epub 2021 Feb 2.
Diabetes mellitus is a chronic illness in the United States affecting nearly 120 million adults, as well as increasing in children under the age of 18. Diabetes was also the 7th leading cause of death in the United States with 270 K deaths in 2017. Diabetes is best managed by tight glycemic control, as achieving near-normal glucose levels is key to reduce the risk of microvascular complications. Currently, continuous glucose monitoring (CGM) systems have been recognized as the ideal monitoring systems for glycemic control of diabetic patients. Briefly, a CGM system measures blood glucose levels in subcutaneous tissue by attaching a CGM sensor to the skin, allowing the users to make appropriate modifications to their medical interventions according to experience or empirically derived algorithms. The principles of the glucose sensing employed in the current commercially available CGM systems are mainly electrochemical, and employ the gold standard enzyme, glucose oxidase, as the glucose sensing molecule with the combination of hydrogen peroxide monitoring or with the combination of redox mediator harboring hydrogel. Recently, by employing an abiotic synthetic receptor harboring a fluorescent probe combined with a fluorescent detection system, a chronic CGM was commercialized. In addition, the development of less or non-invasive monitoring sensors targeting glucose in tears, sweat, saliva and urine have become of great interest although their clinical relevancy is still controversial. This review article introduces current and future technological aspects of CGM systems, the flagship technology in biosensor research, which was initiated, matured and is still growing in North America.
糖尿病在美国是一种慢性病，影响着近1.2亿成年人，且18岁以下儿童的患病人数也在增加。糖尿病还是美国第七大死因，2017年有27万人死亡。糖尿病的最佳管理方法是严格控制血糖，因为实现接近正常的血糖水平是降低微血管并发症风险的关键。目前，连续血糖监测（CGM）系统已被公认为糖尿病患者血糖控制的理想监测系统。简而言之，CGM系统通过将CGM传感器贴在皮肤上测量皮下组织中的血糖水平，使用户能够根据经验或根据经验推导的算法对其医疗干预措施进行适当调整。当前市售CGM系统中使用的葡萄糖传感原理主要是电化学原理，采用金标准酶葡萄糖氧化酶作为葡萄糖传感分子，结合过氧化氢监测或与含有水凝胶的氧化还原介质结合。最近，通过采用带有荧光探针的非生物合成受体与荧光检测系统相结合，一种慢性CGM实现了商业化。此外，针对眼泪、汗液、唾液和尿液中葡萄糖的少侵入性或非侵入性监测传感器的开发也引起了人们的极大兴趣，尽管它们的临床相关性仍存在争议。这篇综述文章介绍了CGM系统的当前和未来技术方面，CGM系统是生物传感器研究中的旗舰技术，该技术在北美发起、成熟并仍在发展。
