Implantation of a refillable glucose monitoring-telemetry device.

This study describes the components and short-term in vivo evaluation of an integrated implantable system consisting of an amperometric glucose biosensor, a miniature potentiostat, a FM signal transmitter, and a power supply. The device (dimensions: 5.0 x 7.0 x 1.5 cm) was implanted subcutaneously in healthy mongrel dogs. The biosensor performance was evaluated in vitro prior to implantation using standard solutions simulating the physiological environment. A linear response to glucose concentration was observed throughout the physiological and pathophysiological range (with an upper limit of 25 mM glucose, and a sensitivity of 0.5 microA/mM). The results of short-term subcutaneous implantation of the integrated system demonstrated good agreement between the glucose concentration measured by the biosensor and that obtained using standard glucose determination methods. The delay-time between the tissue glucose level (measured by the biosensor) and the blood glucose level (obtained by standard methodology) was 3-7 min. These results demonstrated the feasibility of data transmission by a telemetry system through the skin of a dog and allowed the commencement of chronic in vivo testing. During the chronic implantation the biosensor was refilled in vivo. A rejuvenation of the sensor's response after refilling was observed suggesting the potential of such sensors for long-term implantation.

[1]  T. Seiyama,et al.  Chemical sensor technology , 1988 .

[2]  P. Atanasov,et al.  Towards an implantable and refillable glucose sensor based on oxygen electrode principles , 1994 .

[3]  J. Pickup Biotechnology of insulin therapy , 1991 .

[4]  P Atanasov,et al.  Effect of interference on the performance of glucose enzyme electrodes using Nafion coatings. , 1995, Medical engineering & physics.

[5]  E Wilkins,et al.  Performances of potentially implantable rechargeable glucose sensors in vitro at body temperature. , 1991, Biomedical instrumentation & technology.

[6]  W. Kerner,et al.  Combination of microdialysis and Glucosensor permits continuous (on line) s.c. glucose monitoring in a patient operated device: I. In vitro evaluation. , 1991, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[7]  G G Guilbault,et al.  An enzyme electrode for the amperometric determination of glucose. , 1973, Analytica chimica acta.

[8]  M. Charles,et al.  Implantable programmable insulin pumps for the treatment of diabetes. , 1992, Archives of surgery.

[9]  J. A. Hubbell,et al.  Design, characterization, and one-point in vivo calibration of a subcutaneously implanted glucose electrode. , 1994, Analytical chemistry.

[10]  G. S. Wilson,et al.  Design and in vitro studies of a needle-type glucose sensor for subcutaneous monitoring. , 1991, Analytical chemistry.

[11]  P Atanasov,et al.  Integrated implantable device for long-term glucose monitoring. , 1995, Biosensors & bioelectronics.

[12]  Anthony Turner,et al.  Assessment of devices for in vivo monitoring of chemical species , 1995 .

[13]  D. J. Harrison,et al.  A Miniaturized Nafion-Based Glucose Sensor: in vitro and in vivo evaluation in dogs , 1994, The International journal of artificial organs.

[14]  P Atanasov,et al.  Biosensor for continuos glucose monitoring. , 1994, Biotechnology and bioengineering.

[15]  Plamen Atanasov,et al.  Integrated sensor-telemetry system for in vivo glucose monitoring , 1996 .

[16]  C Meyerhoff,et al.  Subcutaneous Glucose Concentration in Humans: Real estimation and continuous monitoring , 1995, Diabetes Care.

[17]  E. Guilbeau,et al.  In vivo and in vitro deactivation rates of PTFE-coupled glucose oxidase. , 1996, Biosensors & bioelectronics.

[18]  M. Shults,et al.  Enzymatic Glucose Sensors: Improved Long-Term Performance In Vitro and In Vivo , 1994, ASAIO journal.

[19]  B.D. McKean,et al.  A telemetry-instrumentation system for chronically implanted glucose and oxygen sensors , 1988, IEEE Transactions on Biomedical Engineering.

[20]  D. Schmidtke,et al.  Statistics for critical clinical decision making based on readings of pairs of implanted sensors. , 1996, Analytical chemistry.

[21]  J. Schultz,et al.  Sterilization of biosensors. , 1987, ASAIO transactions.

[22]  U. Fischer,et al.  Fundamentals of Glucose Sensors , 1991, Diabetic medicine : a journal of the British Diabetic Association.

[23]  Y. Yamasaki,et al.  Telemetry Glucose Monitoring Device With Needle-Type Glucose Sensor: A Useful Tool for Blood Glucose Monitoring in Diabetic Individuals , 1986, Diabetes Care.

[24]  G. Hicks,et al.  The Enzyme Electrode , 1967, Nature.

[25]  J. Pickup In Vivo Glucose Monitoring: Sense and Sensorbility , 1993, Diabetes Care.

[26]  E. Wilkins,et al.  Biomaterials for implanted closed loop insulin delivery system: a review. , 1990, Biosensors & bioelectronics.

[27]  C. Lerk,et al.  Development of a potentially wearable glucose sensor for patients with diabetes mellitus: design and in-vitro evaluation. , 1990, Biosensors & bioelectronics.

[28]  M. Shults,et al.  Evaluation of a Subcutaneous Glucose Sensor out to 3 Months in a Dog Model , 1994, Diabetes Care.

[29]  D. Gough,et al.  Application of Chronic Intravascular Blood Glucose Sensor in Dogs , 1990, Diabetes.

[30]  A Heller,et al.  Design and optimization of a selective subcutaneously implantable glucose electrode based on "wired" glucose oxidase. , 1995, Analytical chemistry.

[31]  D. Gough,et al.  Time‐dependent inactivation of immobilized glucose oxidase and catalase , 1987, Biotechnology and bioengineering.

[32]  D. Gough,et al.  Development of the Implantable Glucose Sensor: What Are the Prospects and Why Is It Taking So Long? , 1995, Diabetes.

[33]  M. Shults,et al.  A telemetry-instrumentation system for monitoring multiple subcutaneously implanted glucose sensors , 1994, IEEE Transactions on Biomedical Engineering.

[34]  D. Moscone,et al.  Subcutaneous microdialysis probe coupled with glucose biosensor for in vivo continuous monitoring. , 1992, Talanta.

[35]  B H Ginsberg,et al.  An overview of minimally invasive technologies. , 1992, Clinical chemistry.

[36]  E Wilkins,et al.  Rechargeable glucose electrodes for long-term implantation. , 1991, Journal of biomedical engineering.

[37]  E. Wilkins,et al.  Towards implantable glucose sensors: a review. , 1989, Journal of biomedical engineering.

[38]  P. Zambonin,et al.  An interference-free biosensor based on glucose oxidase electrochemically immobilized in a non-conducting poly(pyrrole) film for continuous subcutaneous monitoring of glucose through microdialysis sampling , 1993 .

[39]  G. S. Wilson,et al.  Progress toward the development of an implantable sensor for glucose. , 1992, Clinical chemistry.

[40]  L. C. Clark,et al.  ELECTRODE SYSTEMS FOR CONTINUOUS MONITORING IN CARDIOVASCULAR SURGERY , 1962 .

[41]  D. J. Harrison,et al.  Performance of subcutaneously implanted needle-type glucose sensors employing a novel trilayer coating. , 1993, Analytical chemistry.

[42]  P. Vadgama,et al.  Stabilized needle electrode system for in vivo glucose monitoring based on open flow microperfusion. , 1996, The Analyst.

[43]  G Reach,et al.  Strategies for calibrating a subcutaneous glucose sensor. , 1989, Biomedica biochimica acta.

[44]  H. Buchwald,et al.  Implantable pumps. Recent progress and anticipated future advances. , 1992, ASAIO journal.

[45]  F J Schmidt,et al.  Glucose Concentration in Subcutaneous Extracellular Space , 1993, Diabetes Care.