Safety and Functional Integrity of Continuous Glucose Monitoring Components After Simulated Radiologic Procedures

BACKGROUND We investigated wearable components of the Dexcom G6 continuous glucose monitoring (CGM) System in simulated therapeutic and diagnostic radiologic procedures. METHODS G6 transmitters were loaded with simulated glucose data and attached to sensors. Sets of sensor/transmitter pairs were exposed to x-rays to simulate a radiotherapeutic procedure and to radiofrequency (RF) and magnetic fields to simulate diagnostic magnetic resonance imaging (MRI). The x-ray simulation provided a cumulative dose of 80 Gy. The MRI simulation used RF fields oscillating at 64 or 128 MHz and magnetic fields of 1.5 or 3 T. During the MRI simulation, displacement force, induced heating, and induced currents were measured. After the simulations, bench tests were used to assess data integrity on the transmitters and responsiveness of sensors to various concentrations of aqueous glucose. RESULTS Glucose concentrations reported by sensor/transmitter pairs after undergoing x-irradiation or a simulated MRI exam were similar to those from control (unexposed) devices. During the 3 T MRI simulation, the devices experienced a displacement force of 306 g, which was insufficient to dislodge the sensor/transmitter from the substrate, RF-induced heating of <2°C, and an induced current of <16 pA. Data stored on the transmitters prior to the MRI simulation remained intact. CONCLUSION Wearable components of the G6 CGM System retain basic functionality and data integrity after exposure to simulated therapeutic and diagnostic radiologic procedures. The devices are unlikely to be affected by x-irradiation used in typical imaging studies. Simulated MRI procedures create displacement force, minimal heating, and current in sensor/transmitter pairs.

[1]  F. Shellock,et al.  Cardiac pacemakers and implantable cardioverter defibrillators: in vitro magnetic resonance imaging evaluation at 1.5-tesla. , 2007, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[2]  David M Maahs,et al.  State of Type 1 Diabetes Management and Outcomes from the T1D Exchange in 2016-2018. , 2019, Diabetes technology & therapeutics.

[3]  Eyal Dassau,et al.  Six-Month Randomized, Multicenter Trial of Closed-Loop Control in Type 1 Diabetes. , 2019, The New England journal of medicine.

[4]  M. Dewhirst,et al.  Summary, conclusions and recommendations: adverse temperature levels in the human body , 2003, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[5]  Jean A. Tkach,et al.  Neurostimulation systems: Assessment of magnetic field interactions associated with 1.5‐ and 3‐Tesla MR systems , 2005, Journal of magnetic resonance imaging : JMRI.

[6]  Mark S Humayun,et al.  Assessment of MRI issues for the Argus II retinal prosthesis. , 2012, Magnetic resonance imaging.

[7]  Steven V. Edelman,et al.  Recommendations for Using Real-Time Continuous Glucose Monitoring (rtCGM) Data for Insulin Adjustments in Type 1 Diabetes , 2016, Journal of diabetes science and technology.