Susceptibility of Interstitial Continuous Glucose Monitor Performance to Sleeping Position
Open accessAbstract
Background Developing a round-the-clock artificial pancreas requires accurate and stable continuous glucose monitoring. The most widely used continuous glucose monitors (CGMs) are percutaneous, with the sensor residing in the interstitial space. Inaccuracies in percutaneous CGM readings during periods of lying on the devices (e.g., in various sleeping positions) have been anecdotally reported but not systematically studied. Methods In order to assess the impact of sleep and sleep position on CGM performance, we conducted a study in human subjects in which we measured the variability of interstitial CGM data at night as a function of sleeping position. Commercially available sensors were placed for 4 days in the abdominal subcutaneous tissue in healthy, nondiabetic volunteers (four sensors per person, two per side). Nocturnal sleeping position was determined from video recordings and correlated to sensor data. Results We observed that, although the median of the four sensor readings was typically 70-110 mg/dl during sleep, individual sensors intermittently exhibited aberrant glucose readings (>25 mg/dl away from median) and that these aberrant readings were strongly correlated with subjects lying on the sensors. We expected and observed that most of these aberrant sleep-position-related CGM readings were sudden decreases in reported glucose values, presumably due to local blood-flow decreases caused by tissue compression. Curiously, in rare cases, the aberrant CGM readings wer…
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CGMs measure interstitial fluid glucose that has diffused from capillaries into subcutaneous tissue and may indicate a falsely low blood glucose due to device compression, device calibration errors, and skin/soft tissue infections.
“These devices measure interstitial fluid glucose that has diffused from the capillaries and into the subcutaneous tissue and may indicate a falsely low BG due to device compression, device calibration errors, and skin/soft tissue infections [4,6,7].”
From Non-Diabetic Hypoglycemia: Evaluation and Management in Adults (2025) · cites this paper as [6]
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“These devices measure interstitial fluid glucose that has diffused from the capillaries and into the subcutaneous tissue and may indicate a falsely low BG due to device compression, device calibration errors, and skin/soft tissue infections [4,6,7].”
- Authors
- Mensh, B. D., Wisniewski, N. A., Neil, B. M., & Burnett, D. R.
- Affiliations
- Theranova (United States) (US)
- Profusa (United States) (US)
- Corresponding author
- Mensh, Brett D.
- Venue
- Journal of Diabetes Science and Technology
- Publisher
- SAGE Publications
- Published
- 2013-07
- Volume
- 7
- Issue
- 4
- Pages
- 863-870
- ISSN
- 1932-2968 (ISSN-L)
- PMC
- PMC3879750
- OpenAlex
- W20091527
- Cited by
- 97
- References
- 5
- Citations by year
- 2026: 11 · 2025: 13 · 2024: 13 · 2023: 20 · 2022: 6 · 2021: 5 · 2020: 8 · 2018: 3 · 2017: 6 · 2016: 5 · 2015: 1 · 2014: 6
- FWCI
- 3.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- 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 › Engineering › Electrical and Electronic Engineering › Electrochemical sensors and biosensors
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- continuous glucose monitoring, interstitial fluid, sleep position, sensor accuracy, artificial pancreas, nocturnal glucose, tissue compression, subcutaneous blood flow, sensor artifacts
- MeSH terms
- Abdomen, Adult, Diabetes Mellitus, Type 1, Glucose, Humans, Male, Posture, Sleep, Video Recording, Blood Glucose Self-Monitoring, Biosensing Techniques, Implants, Experimental, Extracellular Fluid, Subcutaneous Fat
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