Time lag of glucose from intravascular to interstitial compartment in type 1 Diabetes

Ananda Basu, Simmi Dube, Sona Veettil, Michael Slama, Yogish C Kudva, Thomas Peyser, Rickey E. Carter, Claudio Cobelli, Rita Basu

Research output: Contribution to journalArticle

71 Scopus citations

Abstract

Background and Objective: The premise of effective closed-loop insulin therapy for type 1 diabetes (T1D) relies on the accuracy of continuous interstitial fluid glucose sensing that represents the crucial afferent arm of such a system. An important determinant of sensor accuracy is the physiological time lag of glucose transport from the vascular to the interstitial space. The purpose of current studies was to determine the physiological time lag of glucose transport from the vascular to the abdominal subcutaneous interstitial space in T1D. Method: Four microdialysis catheters were inserted into the abdominal subcutaneous space in 6 T1D subjects under overnight fasted conditions. Plasma glucose was maintained at 113.7 ± 6.3 mg/dl using a continuous intravenous insulin infusion. After sequential intravenous bolus administrations of glucose isotopes, timed plasma and interstitial fluid samples were collected chronologically and analyzed for tracer enrichments. Results: We observed a median (range) time lag of tracer appearance (time to detection) into the interstitial space after intravenous bolus of 6.8 (4.8-9.8) minutes, with all participants having detectable values by 9.8 minutes. Conclusions: We conclude that in the overnight fasted state in T1D adults, the delay of glucose appearance from the vascular to the interstitial space is less than 10 minutes, thereby implying that this minimal physiological time lag should not be a major impediment to the development of an effective closed-loop control system for T1D.

Original languageEnglish (US)
Pages (from-to)63-68
Number of pages6
JournalJournal of diabetes science and technology
Volume9
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • continuous glucose monitors
  • interstitial glucose concentration
  • microdialysis
  • subcutaneous glucose transport
  • type 1 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine
  • Bioengineering
  • Biomedical Engineering

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