Introduction and Objective: Interstitial glucose concentrations are gaining clinical relevance with advances in CGM, as they more closely reflect glucopenia in cerebral and cardiac tissues. We therefore studied interstitial vs. arterialized-venous (AV) glucose differences during hypoglycemia.Methods: Participants with T2D underwent hyperinsulinemic-hypoglycemic clamps (YSI glucose 2.5 mmol/L [45 mg/dL] for 60 minutes). Interstitial glucose (Dexcom G6, Dexcom, CA) [CGM] was compared to time-matched AV whole blood glucose measured using a YSI 2500 analyzer (YSI Inc., Yellow Springs, OH) [YSI] and CareSens glucometer (Spirit Healthcare, UK) [GM], pre, during and post-hypo. Capillary blood glucose (CBG) measured with CareSens glucometer, was also compared post-hypo with CGM.Results: Data from 22 adults (14 males; mean [SD] HbA1c 64.1[12] mmol/mol) were analyzed. Mean differences (95% CI) (CGM vs YSI) were 1.1 (0.5, 1.8; p<0.001), 0.9 (0.5, 1.3; p<0.001), and -0.2 mmol/L (-0.8, 0.5; p=0.636) during pre-, hypo-, and post-hypo periods (figure 1). For GM vs YSI, differences were 0.7 (0.3, 1.0; p=0.001), 0.4 (0.2, 0.5; p<0.001), and 0.7 mmol/L (0.3, 1.1; p<0.001). Post-hypo, mean difference for CGM vs. CBG was 0.2 mmol/L (-0.4, 0.8; p=0.5).Conclusion: CGM and GM readings exceeded YSI during hypoglycemia, while CGM matched CBG post-hypo. We need further research to establish clinical implications.
M. Arshad: Stock/Shareholder; Eli Lilly and Company, Novo Nordisk. S.A. Berry: Research Support; Tandem Diabetes Care, Inc. S. Haughton: None. E. McNally: None. H.L. Casbolt: None. W. Parker: Research Support; AstraZeneca. I. Rombach: None. I. Goodman: None. S.R. Heller: Research Support; Dexcom, Inc. Advisory Panel; Vertex Pharmaceuticals Incorporated. Speaker’s Bureau; Medtronic. Other Relationship; Eli Lilly and Company, Novo Nordisk. Advisory Panel; Zucara Therapeutics. R. Storey: Consultant; AstraZeneca. Research Support; AstraZeneca. Consultant; CytoSorbents. Research Support; CytoSorbents. Speaker’s Bureau; Abbott. Board Member; Thrombolytic Science. Consultant; AlfaSigma, Boehringer-Ingelheim, Lilly Diabetes, Bristol-Myers Squibb Company, Johnson & Johnson Medical Devices Companies, Chiesi, Idorsia, Daiichi Sankyo, Novartis Pharmaceuticals Corporation, Novo Nordisk, Pfizer Inc, PhaseBio Pharmaceuticals, Inc. Speaker’s Bureau; Tabuk. A. Iqbal: Speaker’s Bureau; Lilly Diabetes. Research Support; Abbott, Dexcom, Inc. Speaker’s Bureau; AstraZeneca, Boehringer-Ingelheim. Research Support; Tandem Diabetes Care, Inc.
Medical Research Council (MRC) UK; Dexcom, CA
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