Cited by 198Diabetes Management and ResearchElectrochemical sensors and biosensorsPancreatic function and diabetes

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Delays in Minimally Invasive Continuous Glucose Monitoring Devices: A Review of Current Technology

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Keenan, D. Barry, Mastrototaro, John J., Voskanyan, Gayane, Steil, Garry M.·2009·Journal of Diabetes Science and Technology

DOI 10.1177/193229680900300528PMC PMC2769894

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Abstract

Through the use of enzymatic sensors—inserted subcutaneously in the abdomen or ex vivo by means of microdialysis fluid extraction—real-time minimally invasive continuous glucose monitoring (CGM) devices estimate blood glucose by measuring a patient's interstitial fluid (ISF) glucose concentration. Signals acquired from the interstitial space are subsequently calibrated with capillary blood glucose samples, a method that has raised certain questions regarding the effects of physiological time lags and of the duration of processing delays built into these devices. The time delay between a blood glucose reading and the value displayed by a continuous glucose monitor consists of the sum of the time lag between ISF and plasma glucose, in addition to the inherent electrochemical sensor delay due to the reaction process and any front-end signal-processing delays required to produce smooth traces. Presented is a review of commercially available, minimally invasive continuous glucose monitors with manufacturer-reported device delays. The data acquisition process for the Medtronic MiniMed (Northridge, CA) continuous glucose monitoring system—CGMS® Gold—and the Guardian® RT monitor is described with associated delays incurred for each processing step. Filter responses for each algorithm are examined using in vitro hypoglycemic and hyperglycemic clamps, as well as with an analysis of fast glucose excursions from a typical meal response. Results demonstrate that the digital filters used by each algorithm do not cause adverse effects to fast physiologic glucose excursions, although nonphysiologic signal characteristics can produce greater delays.

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Authors: Keenan, D. B., Mastrototaro, J. J., Voskanyan, G., & Steil, G. M.
Affiliations: Medtronic (United States) (US)
Boston Children's Hospital (US)
Corresponding author: Keenan, D. Barry
ORCID: Mastrototaro, John J.
Steil, Garry M.
Venue: Journal of Diabetes Science and Technology
Publisher: SAGE Publications
Published: 2009-09
Volume: 3
Issue: 5
Pages: 1207-1214
ISSN: 1932-2968 (ISSN-L)
DOI: 10.1177/193229680900300528
PMC: PMC2769894
OpenAlex: W2127835324
Cited by: 198
References: 27
Citations by year: 2026: 9 · 2025: 12 · 2024: 2 · 2023: 8 · 2022: 11 · 2021: 13 · 2020: 15 · 2019: 11 · 2018: 17 · 2017: 18 · 2016: 10 · 2015: 9 · 2014: 13 · 2013: 22 · 2012: 12
FWCI: 6.80
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Journal of Diabetes Science and Technology (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Physical Sciences › Chemistry › Analytical Chemistry › Electrochemical sensors and biosensors
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
Keywords: continuous glucose monitoring, interstitial glucose, sensor calibration, digital filters, hypoglycemic clamp, hyperglycemic clamp, meal response, diabetes management
MeSH terms: Algorithms, Blood Glucose, Diagnosis, Computer-Assisted, Dietary Carbohydrates, Equipment Design, Humans, Predictive Value of Tests, Signal Processing, Computer-Assisted, Time Factors, Blood Glucose Self-Monitoring, Reproducibility of Results, Artifacts, Diagnostic Equipment, Extracellular Fluid, Electrochemical Techniques

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Delays in Minimally Invasive Continuous Glucose Monitoring Devices: A Review of Current Technology

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