Continuous Glucose Monitor Interference with Commonly Prescribed Medications: A Pilot Study

Abstract

Background: Reliability of continuous glucose monitors (CGM) is a prerequisite for therapeutic dosing of insulin without the need for confirmatory blood glucose meter measurements. Interference of CGMs with commonly prescribed substances has not been extensively evaluated. Methods: We sought to undertake a novel pilot study to determine the susceptibility of FDA-approved CGM systems (Medtronic Guardian Sof-Sensor, Dexcom G4 Platinum) to erroneous readings in the presence of common medications. CGMs were placed on the abdomen of healthy subjects 48 hours prior to study. Subjects were admitted to the Clinical Research Trials Unit (CRTU) on the evening before study and fed a standard supper. The following morning, an oral medication was administered in the fasted state and blood was sampled for 9 hours. CGM values were compared to ambient glucose (measured with YSI) to observe variations in CGM readings. Microdialysis catheters were also placed in the abdomen to sample interstitial fluid (ISF) for drug concentrations. Results: Nineteen healthy drug-naïve subjects without diabetes participated in the study. A drug/substance was tested up to a maximum of nine times on separate occasions. Comparison of CGM glucose patterns to actual plasma glucose concentrations show several drugs, including lisinopril, albuterol, and acetaminophen, appear to interfere with commonly used CGM devices. Wine also interfered with CGM readings. Conclusions: We conclude there is some evidence of CGM interference with lisinopril, albuterol, acetaminophen, atenolol, and red wine. Future studies are required to address interference with newer sensors being approved or in the process of approval.