Usefulness of a novel system for measuring glucose area under the curve while screening for glucose intolerance in outpatients.
OBJECTIVE
To realize the effectiveness of a novel system for measuring glucose area under the curve (AUC) using minimally invasive interstitial fluid extraction technology (MIET), outpatients undergoing oral glucose tolerance tests (OGTT) were investigated for the efficacy of screening for glucose intolerance using this system.


METHODS
Fifty outpatients scheduled to undergo a 75-g OGTT for medical reasons were recruited to the study. An area of skin on the forearm was pretreated with microneedle arrays before the application of hydrogels for interstitial fluid extraction. Plasma glucose (PG) levels were measured every 30 min for 2 h to calculate reference (actual) AUC. The AUC was predicted by MIET on the basis of glucose extracted by the hydrogel using sodium ion levels as the internal standard.


RESULTS
Good correlation between MIET-predicted and reference AUCs obtained using PG levels was confirmed for a wide AUC range. By introducing a threshold level for AUC to separate glucose intolerance with peak glucose ≥180 mg/dL from normal glucose tolerance, the system was demonstrated to provide better screening accuracy compared with conventional methods that use HbA1c and fasting PG levels. The results of a questionnaire-based survey administered to the subjects suggested that this system was readily accepted by the majority as a painless monitoring method.


CONCLUSIONS
The findings suggest that our glucose AUC measurement system using MIET would be useful for screening of glucose intolerance. In the future, this system may prove to be a useful aid as a screen for glucose intolerance before performing an OGTT for diagnosis.
Department of Internal Medicine Osaka Police Hospital Osaka Japan.
Kenya
K
Sakamoto
Department of Metabolic Medicine Osaka University Graduate School of Medicine Osaka Japan.
Fumiyo
F
Kubo
Department of Internal Medicine Osaka Police Hospital Osaka Japan.
Kazutomi
K
Yoshiuchi
Department of Internal Medicine Osaka Police Hospital Osaka Japan.
Akemi
A
Ono
Central Research Laboratories Sysmex Corporation Kobe Japan.
Toshiyuki
T
Sato
Department of Clinical Laboratory Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka Japan.
Koji
K
Tomita
Division of Diabetes, Metabolism and Endocrinology Kobe University Kobe Japan.
Kazuhiko
K
Sakaguchi
Diabetes Therapeutics and Research Center Tokushima University Tokushima Japan.
Munehide
M
Matsuhisa
Department of Metabolic Medicine Osaka University Graduate School of Medicine Osaka Japan.
Hideaki
H
Kaneto
Department of Medicine Shiga University of Medical Science Shiga Japan.
Hiroshi
H
Maegawa
Department of Clinical Laboratory Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka Japan.
Hiromu
H
Nakajima
Department of Medicine Shiga University of Medical Science Shiga Japan.
Atsunori
A
Kashiwagi
Department of Internal Medicine Osaka Police Hospital Osaka Japan.
Keisuke
K
Kosugi
Glucose area under the curve; Glucose monitoring; Screening