Avances en Diabetología - Sociedad Española de Diabetes

Revisión Av Diabetol 2005; 21: 15-20L. Heinemann Glucose monitoring inclinical diabetes: realityand promisesProfil Institute for Metabolic Research GmbH.Neuss, AlemaniaCorrespondencia:Prof. Dr. Lutz Heinemann. Profil Institute for MetabolicResearch GmbH. Hellersbergstr. 9, 41460 Neusse-mail: lutz.heinemann@profil-research.deABSTRACTThe first glucose monitoring systems (GMS) that allow monitoringof glucose changes continuously for up to 72 h are available.The two GMS, which are on the market, require insertion ofa needle or a microdialysis catheter through the skin into the subcutaneousadipose tissue. It is still the dream of patients (and oftheir treating diabetologists) to monitor glucose changes in theirbody without hurting the skin at all; that means they would preferto have a true non-invasive GMS. Patients would also prefer tobe able to use the GMS for prolonged periods of time, ideally everyday. The GMS should also reliably warn the user before hypoglycaemicevents take place. In addition, using the GMS should causeno side-effects. A considerable number of novel GMS are underdevelopment, that all have their individual pros and cons.It is important that physicians (and the patients) understandthe special clinical and technical aspects that are key to successfulimplementation of GMS into the daily practice of patients withdiabetes. For example, the sensor readings of interstitial fluid glucoselevels are transformed by means of a calibration process, sothat the readings show actual blood glucose levels and not theinterstitial glucose levels. However, if the calibration factor is inaccuratelyestimated, this error would be perpetuated with potentialclinical implications. Patients have to be informed about theproblems and limitations of each GMS in order to position thedifferent sensors adequately. In summary, continuous glucosemonitoring is possible nowadays, however, the use of GMS requireto differentiate between what is possible in reality and what arepromises that probably novel GMS in the future will be able tofulfill.Key Words: Blood glucose; SMBG; Continuous glucose monitoring;Hypoglycemia; Metabolic control.Recibido: 24 de Enero 2005 / Aceptado: 4 de Febrero 2005Acrónimos: AST, alternate site test; CGMS, continuous glucose monitoringsystem; GMS, glucose monitoring systems; SMBG–self-monitoring ofblood glucose.