Prestatie van de Free Style Libre Flash Monitor ten opzichte van de laboratoriumbepalinge en de Accuchek

In subjects with diabetes mellitus, adequate to good metabolic control is
necessary for a variety of reasons. In subjects under general anesthesia,
adequate glucose control, including prevention of hypo- and hyperglycemias,
improves surgical outcomes.
One variation on earlier continue glucose monitoring (CGM) is FreeStyle Libre
Flash Monitor (FLFM) an improved easiness of use and practical applicability.
Relying on a CGM device implicates the assumption, that the device will be
accurate and reliable.
For assessment of the accuracy and reliability the FLFM, under conditions of
general anesthesia, it is proposed to perform a comparison of this device with
a standard laboratory measurement during surgery under general anesthesia in
patients.
In an earlier study (unpublished data) Bilo et al. had to conclude that during
extreme exercise FLFM does show higher than actually present glucose levels (as
assessed by capillary measurements). Bilo et al. hypothesized that increases in
interstitial fluid flow contribute to reporting higher glucose concentrations
compared to result with lower interstitial fluid flow in resting circumstances.
Our hypothesis is that an operation under general anesthesia is a stressful
event and can be compared with exercise; however, due to supine position of the
patient and no muscle activity, blood flow and thus fluid refreshment of the
interstitium will be decreased. Therefore, we hypothesize that FLFM will
probably measure lower glucose concentration than peripheral measured blood
glucose concentrations.

Primaire doel van het onderzoek: Beoordeling van de betrouwbaarheid van de Free
Style Libre Monitor ten opzichte van de bloedglucosebepaling door het
laboratorium en de Accchek.
Secundaire doel: Het bestuderen van de glucoseverschuiving tussen interstitieel
en de bloedbaan tijdens een operatie onder algehele anesthesie.

15 patienten onder algehele anesthesie die voor de ingreep danwel vanwege hun
algemene toestand een arteriele lijn krijgen.
Elk half uur vergelijken van de glucosemeting door het laboratorium versus de
Accuchek en de Free Style Libre monitor.
Patienten die toestemming geven dienen 36 uur voor de ingreep de Free Style
Libre monitor in de bovenarm links dan wel rechts te krijgen. Dit vanwege het
stabiliseren van de glucosemeting.

Een klein naaldje wordt ingebracht door de huid en dient tot na de operatie te
blijven zitten.
Verder geen extra risico's voor de proefpersoon.