Article preview from Start-Up - June 1, 2011
Despite mounting evidence that controlling blood sugar levels in critical care patients reduces complications and shortens the length of ICU stay, clinicians have found total glucose control hard to achieve because of the frequent testing required to achieve tight management. GlySure Ltd. is developing a continuous intravascular glucose monitoring system based on optical fluorescence.
Article preview from Start-Up - June 1, 2011
On rare occasions, outcomes data already exist for treatment of a medical condition before a product is launched to apply that therapy and replicate those results. Such is the case for a study by Greet Van den Berghe, MD, PhD, and colleagues from the University of Leuven, Belgium published in the New England Journal of Medicine in 2001 on the need to tightly control glucose levels in the intensive care unit (ICU). That study showed that tight glycemic control (TGC) caused a 34% reduction in mortality, a 46% decrease in sepsis, and dramatic decreases in transfusions and length of ICU stay.
Despite these impressive results and more recent similar findings, "clinicians have found it very difficult to implement TGC because of the workload involved in the frequent blood glucose testing required to achieve tight control," says Chris Jones, CEO of GlySure Ltd., a start-up with a continuous intravascular glucose monitoring system based on optical fluorescence. "Glucose has a U-shaped mortality curve, with an extremely narrow target range and a very severe penalty for dropping into the hypoglycemic range. Moreover, many patients in the ICU often have an elevated glucose level whether they are diabetic or not, in particular patients coming out of cardiac surgery."
Jones also notes that glucose has been found to be a multi-dimensional story throughout one's stay in the ICU, across a broad range of indications: cardiology to neurology to trauma. "It is not only your average glucose level that is important, but also the degree of variability and the extent of hypoglycemic episodes," he points out. "All three of these factors are independently and cumulatively associated with mortality."
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