![]() In the long run, it may be reasonable to abandon blood glucose measurements as the basis for diabetes management and switch to using ISF glucose as the appropriate therapeutic target.īlood glucose continuous glucose monitoring glucose variability interstitial glucose physiology of glucose regulation. These data might also have a higher prognostic relevance when it comes to long-term metabolic consequences of diabetes. The extracellular fluidthe fluid outside the cellsis divided into that found within the blood and that found outside the blood the latter fluid is known as the interstitial fluid. We performed a more detailed analysis and interpretation of glucose profiles obtained with CGM in situations with high glucose dynamics to evaluate this potentially misleading assumption.Ĭonsidering physical activity, hypoglycemic episodes, and meal-related differences between glucose levels in blood and ISF uncover clinically relevant differences that can make it risky from a therapeutic point of view to use blood glucose for therapeutic decisions.įurther systematic and structured evaluation as to whether the use of ISF glucose is more safe and efficient when it comes to acute therapeutic decisions is necessary. Thus, therapeutic decisions, that is, the selection of insulin doses, are based on CGM system results interpreted as though they were blood glucose values. The assumption is that glucose levels in blood and ISF are practically the same and that the information provided can be used interchangeably. Relation of plasma to interstitial fluid volume in essential hypertension. doi: 10.1172/jci101435 Crossref Medline Google Scholar 20 Tarazi RC, Dustan HP, Frohlich ED. Different to traditional blood glucose measurement systems, systems for continuous glucose monitoring (CGM) measure glucose in interstitial fluid (ISF). The role of the extracellular fluid in the maintenance of a normal plasma volume. Knowledge gained from clinical studies, for example, on the impact of metabolic control on diabetes-related complications, is based on such measurements. The blood plasma, though, is confined within the blood vessels.For decades, the major source of information used to make therapeutic decisions by patients with diabetes has been glucose measurements using capillary blood samples. In terms of composition, the interstitial fluid is similar to the blood plasma since the two continuously exchange substances across capillary walls. It provides a means of delivering materials to the cells, intercellular communication, and removal of metabolic waste. Its main function is to bathe and surround the cells of the body. The presence of negatively charged, impermeant proteins in the plasma space alters the distribution of diffusible ions in the plasma and interstitial fluid. It is composed of water, amino acids, sugars, fatty acids, coenzymes, hormones, neurotransmitters, salts, and cellular products. The interstitial fluid is the fluid that fills the spaces between cells. The resulting increase in interstitial hydrostatic pressure, together with a dilution of the interstitially stored proteins, has been interpreted as an important edema-limiting mechanism.144An accompanying increase in lymph flow in addition limits interstitial fluid volume expansion despite extracellular overload. The interstitial fluid and the blood plasma are the major components of the extracellular fluid. ![]() cerebrospinal fluid, synovial fluid, aqueous humour, serous fluid, gut fluid, etc.). Functionally, the total body water can be subdivided into two major fluid compartments called the extracellular and the intracellular fluid compartments.Extracellular fluid (ECF) consists mainly of the plasma found in the blood vessels and the interstitial fluid that surrounds the cells (). It is composed of blood plasm a, interstitial fluid, lymph and transcellular fluid (e.g. Figure 8-6 In an overhydrated patient, Figure 8-7 Each bag of IV solution must be sterile and safe. ![]() It makes up about 26% of the total body water composition in humans. The extracellular fluid pertains to all body fluid outside the cell(s). It bathes and surrounds the cells of the body, and provides a means of delivering materials to the cells, intercellular communication, and removal of metabolic waste. ![]() The fluid found in the intercellular spaces composed of water, amino acids, sugars, fatty acids, coenzymes, hormones, neurotransmitters, salts, and cellular products. ![]()
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