MR Safety: Insulin Pumps and Glucose MonitorsHow about insulin pumps and continuous glucose monitors (CGMs)?
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Insulin Pumps
No fully implantable insulin pumps are commercially available. All current insulin pumps are battery-powered, peristaltic-driven external devices worn by the patient that attach to a plastic cannula system for subcutaneous administration. Many of these pumps contain ferromagnetic materials and could even become projectiles in the MR environment. All insulin pumps are therefore considered MR Unsafe and must be removed prior to entry into the MR scanner room.
No fully implantable insulin pumps are commercially available. All current insulin pumps are battery-powered, peristaltic-driven external devices worn by the patient that attach to a plastic cannula system for subcutaneous administration. Many of these pumps contain ferromagnetic materials and could even become projectiles in the MR environment. All insulin pumps are therefore considered MR Unsafe and must be removed prior to entry into the MR scanner room.
"MR Unsafe" FreeStyle Libre CGM
Continuous Glucose Monitors
Continuous Glucose Monitors (CGMs) are "stick-on" diagnostic systems that utilize a tiny needle-like sensor and transmitter to measure glucose levels in the subcutaneous interstitial space (a surrogate for blood glucose concentration). Produced by multiple companies, the most commonly used models are the FreeStyle Libre (Abbott), Dexcom G6 (Dexcom), Eversense (Senseonics), and Guardian Connect (Medtronic). In addition to stand-alone devices, there are combination CGM-insulin pumps that work together to automatically titrate insulin dose to glucose levels. Examples include the MiniMed and Paradigm Revel (Medtronic) and the t:slim X2 (Tandem).
Continuous Glucose Monitors (CGMs) are "stick-on" diagnostic systems that utilize a tiny needle-like sensor and transmitter to measure glucose levels in the subcutaneous interstitial space (a surrogate for blood glucose concentration). Produced by multiple companies, the most commonly used models are the FreeStyle Libre (Abbott), Dexcom G6 (Dexcom), Eversense (Senseonics), and Guardian Connect (Medtronic). In addition to stand-alone devices, there are combination CGM-insulin pumps that work together to automatically titrate insulin dose to glucose levels. Examples include the MiniMed and Paradigm Revel (Medtronic) and the t:slim X2 (Tandem).
The battery and electronics in the "stick-on" recorder/transmitter portion of each device may be damaged by strong magnetic fields and must be removed prior to MR imaging. An additional reason to consider these devices MR Unsafe is that a skin burn might occur at the placement site (similar to that reported for retained EKG and other electrodes).
References
Funtanilla VD, Caliendo T, Hilas O. Continuous glucose monitoring: a review of available systems. Pharmacy & Therapeutics 2019; 44:550-553.
Sora ND, Shashpal F, Bond EA, Jenkins AJ. Insulin pumps: review of technological advancement in diabetes management. Am J Med Sci 2019; 358:326-331.
Funtanilla VD, Caliendo T, Hilas O. Continuous glucose monitoring: a review of available systems. Pharmacy & Therapeutics 2019; 44:550-553.
Sora ND, Shashpal F, Bond EA, Jenkins AJ. Insulin pumps: review of technological advancement in diabetes management. Am J Med Sci 2019; 358:326-331.
Related Questions
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