title: Evaluation of a Novel Glucose Area Under the Curve (AUC) Monitoring System: Comparison with the AUC by Continuous Glucose Monitoring.
abstract: BACKGROUND
  Management of postprandial hyperglycemia is a key aspect in diabetes treatment. We developed a novel system to measure glucose area under the curve (AUC) using minimally invasive interstitial fluid extraction technology (MIET) for simple monitoring of postprandial glucose excursions. In this study, we evaluated the relationship between our system and continuous glucose monitoring (CGM) by comparing glucose AUC obtained using MIET with that obtained using CGM for a long duration.
  
  
  METHODS
  Twenty diabetic inpatients wearing a CGM system were enrolled. For MIET measurement, a plastic microneedle array was applied to the skin as pretreatment, and hydrogels were placed on the pretreated area to collect interstitial fluid. Hydrogels were replaced every 2 or 4 hours and AUC was predicted on the basis of glucose and sodium ion levels.
  
  
  RESULTS
  AUC predicted by MIET correlated well with that measured by CGM (r=0.93). Good performances of both consecutive 2- and 4-hour measurements were observed (measurement error: 11.7%±10.2% for 2 hours and 11.1%±7.9% for 4 hours), indicating the possibility of repetitive measurements up to 8 hours. The influence of neither glucose fluctuation nor average glucose level over the measurement accuracy was observed through 8 hours.
  
  
  CONCLUSIONS
  Our system showed good relationship with AUC values from CGM up to 8 hours, indicating that single pretreatment can cover a large portion of glucose excursion in a day. These results indicated possibility of our system to contribute to convenient monitoring of glucose excursions for a long duration.
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Otsu, Japan. sugi@belle.shiga-med.ac.jp.
authors.forename: Satoshi
authors.identifier: http://orcid.org/0000-0001-5848-0666
authors.initials: S
authors.lastname: Ugi
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maegawa
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Katsutaro
authors.initials: K
authors.lastname: Morino
authors.affiliation: Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Nishio
authors.affiliation: Central Research Laboratories, Sysmex Corporation, Kobe, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sato
authors.affiliation: Central Research Laboratories, Sysmex Corporation, Kobe, Japan.
authors.forename: Seiki
authors.initials: S
authors.lastname: Okada
authors.affiliation: Central Research Laboratories, Sysmex Corporation, Kobe, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kikkawa
authors.affiliation: Central Research Laboratories, Sysmex Corporation, Kobe, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Clinical Laboratory, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Hiromu
authors.initials: H
authors.lastname: Nakajima
authors.affiliation: Department of Medicine, Kusatsu General Hospital, Kusatsu, Japan.
authors.forename: Atsunori
authors.initials: A
authors.lastname: Kashiwagi
keywords: Continuous glucose monitoring; Extracellular fluid; Glucose area under the curve; Glucose monitoring; Postprandial glycemic excursion