Validation of glucose sensor measurement in the elderly

Diabetes mellitus elderly patients continue glucose monitoring

dr. P.R. van Dijk
dr. M.A.E. van Eersel

Nature of the research:
Clinical study

Fields of study:
endocrinology geriatrics diabetes

Background / introduction
Accurate glucose measurements are of utmost importance for persons with diabetes mellitus (DM), in particular persons treated with insulin. Continuous glucose measurements (CGM) in the interstitial fluid using glucose sensors is currently used in the majority of persons with DM. For this purpose both real-time CGM (rt-CGM) and intermittend/flash glucose monitoring (FGM) are available as methods for CGM. The accuracy of CGM devices has been established in previous studies by our research group and others (ref). It should be noted however, that in virtually none of these studies persons above > 70 years of age were included. Given the fact that DM is highly prevalent among the elderly, there is an urgent need for validation of CGM in the elderly. In this project we aim to validate the most commonly used FGM in The Netherlands among elderly persons with DM.
Research question / problem definition
Aim of this project is to establish the performance (accuracy) of the FGM in among persons > 70 years of age.
This project will start with a literature study by the student. In parralell, preparations for the measurements (e.g. learning to insert a glucose sensor and perform vena punctures) are made. Approximately 20 subjects with DM, aged 70 years and above will be recruited and included by the student. After obtaining informed consent a FGM sensor will be inserted by the student. During a 14-day out-of-hospital period FGM measurements (inserted in the upper arm) are compared with capillary blood glucose. In additon, the glucose response after a standardized oral glucose load will be measured by FGM, capillary samples and venous samples using an established central laboratory methods. In the last part of the internship, the results of these experiments will be analyzed according to current guidelines for glucose sensor performance.

We are looking for a student with enthusiasm, interest in diabetes and/or geriatrics, ambition and excellent communication skills. Previous experience with scientific research is not mandatory. If the collaboration is fruitful, this work will well result in co-authorship in a scientific publication and may even lead to a MD/PhD application.

Of notice, as this study is subject to Medical Research Involving Human Subjects an application procedure for the METC is necessary. This procedure will be performed by the supervisors of the project, but will take at least 3 months. Therefore, students interested in this project should get in touch early.
Performance of the FreeStyle Libre Flash glucose monitoring system in patients with type 1 and 2 diabetes mellitus.
Fokkert MJ, van Dijk PR, Edens MA, Abbes S, de Jong D, Slingerland RJ, Bilo HJ. BMJ Open Diabetes Res Care. 2017
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