A pilot study in humans of microneedle sensor arrays for continuous glucose monitoring

Although subcutaneously implanted continuous glucose monitoring (CGM) devices have been shown to support diabetes self-management, their uptake remains low due to a combination of high manufacturing cost and limited accuracy and precision arising from their invasiveness. To address these points, minimally invasive, a solid microneedle array-based sensor for continuous glucose monitoring is reported here. These intradermal solid microneedle CGM sensors are designed for low cost manufacturing. The tolerability and performance of these devices is demonstrated through clinical studies, both in healthy volunteers and participants with type 1 diabetes (T1D). The geometry of these solid microneedles allows them to penetrate dermal tissue without the need for an applicator. The outer surface of these solid microneedles are modified as glucose biosensors. The microneedles sit in the interstitial fluid of the skin compartment and monitor real-time changes in glucose concentration. Optical coherence tomography measurements revealed no major axial movement of the microneedles in the tissue. No significant adverse events were observed and low pain scores were reported when compared to catheter insertion, deeming it safe for clinical studies in T1D. These amperometric sensors also yielded currents that tracked venous blood glucose concentrations, showing a clinically acceptable correlation. Studies in people with T1D gave a mean absolute relative difference (MARD) of 9% (with respect to venous blood glucose) with over 94% of the data points in the A and B zones of the Clarke error grid. These findings provide baseline data for further device development and a larger clinical efficacy and acceptability study of this microneedle intradermal glucose sensor in T1D.

[1]  Sanjiv Sharma,et al.  Rapid, low cost prototyping of transdermal devices for personal healthcare monitoring , 2017, Sensing and Bio-Sensing Research.

[2]  D. Cox,et al.  Evaluating Clinical Accuracy of Systems for Self-Monitoring of Blood Glucose , 1987, Diabetes Care.

[3]  R. Beck,et al.  Challenges and Future Directions of the T1D Exchange Clinic Network and Registry , 2013, Journal of diabetes science and technology.

[4]  Jung-Hwan Park,et al.  Microneedles for drug and vaccine delivery. , 2012, Advanced drug delivery reviews.

[5]  C Meyerhoff,et al.  Combination of Microdialysis and Glucose Sensor for Continuous On Line Measurement of the Subcutaneous Glucose Concentration: Theory and Practical Application , 1994, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[6]  Christofer Toumazou,et al.  Feasibility study of a bio-inspired artificial pancreas in adults with type 1 diabetes. , 2014, Diabetes technology & therapeutics.

[7]  Christofer Toumazou,et al.  Live demonstration: A handheld Bio-inspired Artificial pancreas for treatment of diabetes , 2014, 2014 IEEE Biomedical Circuits and Systems Conference (BioCAS) Proceedings.

[8]  Maelíosa T. C. McCrudden,et al.  The role of microneedles for drug and vaccine delivery , 2014, Expert opinion on drug delivery.

[9]  Howard Zisser,et al.  New features and performance of a next-generation SEVEN-day continuous glucose monitoring system with short lag time. , 2009, Diabetes technology & therapeutics.

[10]  R O Potts,et al.  The GlucoWatch® biographer: a frequent, automatic and noninvasive glucose monitor , 2000, Annals of medicine.

[11]  L. Thienpont,et al.  Evaluating clinical accuracy of systems for self-monitoring of blood glucose by error grid analysis: comment on constructing the "upper A-line". , 2000, Diabetes care.

[12]  Kostis Michelakis,et al.  Microfluidic device to investigate factors affecting performance in biosensors designed for transdermal applications. , 2012, Lab on a chip.

[13]  Pantelis Georgiou,et al.  Towards a minimally invasive device for beta-lactam monitoring in humans. , 2017, Electrochemistry communications.

[14]  C. Toumazou,et al.  Glucose sensors: a review of current and emerging technology , 2009, Diabetic medicine : a journal of the British Diabetic Association.

[15]  Michelle L Rogers,et al.  Evaluation of a minimally invasive glucose biosensor for continuous tissue monitoring , 2016, Analytical and Bioanalytical Chemistry.

[16]  D. Douroumis,et al.  Microneedles for drug and vaccine delivery and patient monitoring , 2015, Drug Delivery and Translational Research.

[17]  N. Oliver,et al.  Use of microneedle array devices for continuous glucose monitoring: a review. , 2013, Diabetes technology & therapeutics.

[18]  A. Cass,et al.  Microneedle Enzyme Sensor Arrays for Continuous In Vivo Monitoring. , 2017, Methods in enzymology.

[19]  Elizabeth Taylor,et al.  Clinical evaluation of a continuous minimally invasive glucose flux sensor placed over ultrasonically permeated skin. , 2004, Diabetes technology & therapeutics.

[20]  Ryan F Donnelly,et al.  Hydrogel-forming microneedle arrays: Potential for use in minimally-invasive lithium monitoring. , 2016, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[21]  Andrea Facchinetti,et al.  Continuous Glucose Monitoring Sensors: Past, Present and Future Algorithmic Challenges , 2016, Sensors.

[22]  Josep Vehí,et al.  Using Support Vector Machines to Detect Therapeutically Incorrect Measurements by the MiniMed CGMS® , 2008, Journal of diabetes science and technology.

[23]  Kostis Michelakis,et al.  Minimally Invasive Enzyme Microprobes: An Alternative Approach for Continuous Glucose Monitoring , 2012, Journal of diabetes science and technology.

[24]  Michael O'Grady,et al.  Continuous glucose monitoring and intensive treatment of type 1 diabetes. , 2008, The New England journal of medicine.

[25]  Roy Beck,et al.  Prolonged use of continuous glucose monitors in children with type 1 diabetes on continuous subcutaneous insulin infusion or intensive multiple‐daily injection therapy , 2009, Pediatric diabetes.

[26]  D. Klonoff Continuous glucose monitoring: roadmap for 21st century diabetes therapy. , 2005, Diabetes care.

[27]  Howard C. Zisser,et al.  Accuracy of the SEVEN® Continuous Glucose Monitoring System: Comparison with Frequently Sampled Venous Glucose Measurements , 2009, Journal of diabetes science and technology.

[28]  Ryan F. Donnelly,et al.  Microneedle-based drug delivery systems: Microfabrication, drug delivery, and safety , 2010, Drug delivery.

[29]  W. Kenneth Ward,et al.  The Accuracy Benefit of Multiple Amperometric Glucose Sensors in People With Type 1 Diabetes , 2012, Diabetes Care.

[30]  Beelee Chua,et al.  Design, Development, and Evaluation of a Novel Microneedle Array-based Continuous Glucose Monitor , 2014, Journal of diabetes science and technology.

[31]  Michelle L Rogers,et al.  Continuous Online Microdialysis Using Microfluidic Sensors: Dynamic Neurometabolic Changes during Spreading Depolarization , 2013, ACS chemical neuroscience.

[32]  M. Boschmann,et al.  Microdialysis Can Detect Age-Related Differences in Glucose Distribution within the Dermis and Subcutaneous Adipose Tissue , 2001, Dermatology.

[33]  Philip R. Miller,et al.  Microneedle-based sensors for medical diagnosis. , 2016, Journal of materials chemistry. B.