Assessment Of Blood Glucose Levels Research Articles

Hyperglycemia induces microglial pyroptosis by increasing oxygen extraction rate: Implication in neurological impairment during ischemic stroke.

Elevated levels of blood glucose in patients with ischemic stroke are associated with a worse prognosis. The present study aimed to explore whether hyperglycemia promotes microglial pyroptosis by increasing the oxygen extraction rate in an acute ischemic stroke model. C57BL/6 mice that underwent middle cerebral artery occlusion were used for assessment of blood glucose level and neurological function. The cerebral oxygen extraction ratio (CERO2), oxygen consumption rate (OCR) and partial pressure of brain tissue oxygen (PbtO2) were measured. To investigate the significance of the NOD‑like receptor protein 3 (NLRP3) inflammasome, NLRP3‑/‑ mice were used, and the expression levels of NLRP3, caspase‑1, full‑length gasdermin D (GSDMD‑FL), GSDMD‑N domain (GSDMD‑N), IL‑1β and IL‑18 were evaluated. In addition, Z‑YVAD‑FMK, a caspase‑1 inhibitor, was used to treat microglia to determine whether activation of the NLRP3 inflammasome was required for the enhancing effect of hyperglycemia on pyroptosis. It was revealed that hyperglycemia accelerated cerebral injury in the acute ischemic stroke model, as evidenced by decreased latency to fall and the percentage of foot fault. Hyperglycemia aggravated hypoxia by increasing the oxygen extraction rate, as evidenced by increased CERO2 and OCR, and decreased PbtO2 in response to high glucose treatment. Furthermore, hyperglycemia‑induced microglial pyroptosis was confirmed by detection of increased levels of caspase‑1, GSDMD‑N, IL‑1β and IL‑18 and a decreased level of GSDMD‑FL. However, the knockout of NLRP3 attenuated these effects. Pharmacological inhibition of caspase‑1 also reduced the expression levels of GSDMD‑N, IL‑1β and IL‑18 in microglial cells. These results suggested that hyperglycemia stimulated NLRP3 inflammasome activation by increasing the oxygen extraction rate, thus leading to the aggravation of pyroptosis following ischemic stroke.

Continuous Glucose Monitoring and the Effect of Liraglutide in Cardiac Surgery Patients: A Substudy of the Randomized Controlled GLOBE Trial

ObjectivesFirstly, to evaluate the accuracy and reliability of continuous glucose monitoring (CGM) in patients undergoing cardiac surgery and, secondly, to assess the impact of preoperative liraglutide administration on perioperative glucose control as captured by CGM. DesignProspective, single-center, pre-specified analyses of the GLOBE trial, a randomized controlled trial comparing preoperative liraglutide treatment to placebo in patients undergoing cardiac surgery. SettingA single center academic hospital in the Netherlands. ParticipantsTwenty-five patients undergoing cardiac surgery, recruited from the hospital's cardiac surgery department. InterventionsParticipants received the Dexcom G5 CGM system from the day before surgery until discharge from the Intensive Care Unit after surgery. Additionally, participants were randomized to receive either preoperative liraglutide or placebo. Measurements and Main ResultsArterial blood gas (ABG) glucose measurements were collected as reference and matched to CGM readings to assess accuracy and reliability. In 240 paired CGM–ABG glucose measurements, the mean absolute relative difference (MARD) was 14.4±12.5%. Temporary sensor interruption occurred mainly intraoperatively (92% of patients). The median duration of intraoperative sensor interruption was 65 (48-95) minutes. Liraglutide increased glycemic time in range, 72% vs 47% in the control group (absolute difference 25%, 95% CI -41.4 to -8.9, p = .004). ConclusionsDespite intraoperative sensor interruption, CGM seems an accurate method to use as a semi-invasive, real-time assessment of blood glucose levels. CGM can provide a detailed observation of the pre- and postoperative glycemic trajectory, demonstrating increased time in range following perioperative liraglutide treatment compared to placebo.

Device integration of electrochemical biosensors.

Electrochemical biosensors incorporate a recognition element and an electronic transducer for the highly sensitive detection of analytes in body fluids. Importantly, they can provide rapid readouts and they can be integrated into portable, wearable and implantable devices for point-of-care diagnostics; for example, the personal glucose meter enables at-home assessment of blood glucose levels, greatly improving the management of diabetes. In this Review, we discuss the principles of electrochemical biosensing and the design of electrochemical biosensor devices for health monitoring and disease diagnostics, with a particular focus on device integration into wearable, portable and implantable systems. Finally, we outline the key engineering challenges that need to be addressed to improve sensing accuracy, enable multiplexing and one-step processes, and integrate electrochemical biosensing devices in digital health-care pathways.

The acute-to-chronic glycemic ratio correlates with the severity of illness at admission in patients with diabetes experiencing acute ischemic stroke.

Acute hyperglycemia is a powerful indicator of the severity of acute ischemic stroke (AIS); however, the relationship between these two factors is not very clear in patients with diabetes. We aimed to retrospectively evaluate data from 335 consecutive patients who experienced AIS from November 2015 to November 2016 to investigate whether a comprehensive assessment of blood glucose levels is a more valuable indicator of the severity of AIS or the presence of acute hyperglycemia in patients with diabetes. We collected demographic data, clinical manifestation information, clinical scores, and laboratory data [including fasting blood glucose and glycated hemoglobin (HbA1c) levels]. We estimated prehospital mean blood glucose concentrations using the following formula [1.59 * HbA1c (%) - 2.59] to calculate the "Acute-to-Chronic Glycemic Ratio" (AC ratio). The AC ratio differed significantly among patients grouped according to the National Institutes of Health Stroke Scale/Score (NIHSS) at admission (admission NIHSS) (p = 0.006). Univariate regression analysis revealed a correlation between the AC ratio and admission NIHSS [standardized β-coefficient (Std. B) = 0.164, p = 0.004]. The adjusted linear regression analysis revealed a correlation between both HbA1c (Std. B = 0.368, p = 0.038) and the AC ratio (Std. B = 0.262, p = 0.022) and admission NIHSS. The AC ratio (Std. B = 0.161, p = 0.012) was related to admission NIHSS in the stepwise variable selection. For an admission NIHHS > 4, the AC ratio (Std. B = 0.186, p = 0.047) was related to admission NIHSS in the stepwise variable selection. The AC ratio (Std. B = 1.163, p = 0.006 and Std. B = 0.565, p = 0.021, respectively) were related to admission NIHSS in both large-artery atherosclerosis (LAA) and small-vessel occlusion (SVO) subgroups. Thus, the AC ratio is related to admission NIHSS in patients with diabetes who experienced AIS and may be a better indicator of severity than acute blood glucose levels.

Association between fasting blood glucose and thyroid stimulating hormones and suicidal tendency and disease severity in patients with major depressive disorder

Thyroid dysfunction and diabetes are reported to be associated with depression. However, their role in the suicide risk in patients with major depressive disorder (MDD) is unclear. The purpose of this study was to investigate and compare thyroid dysfunction and diabetes between suicide attempters and non-suicide attempters in a large sample of first-episode drug-naïve MDD patients. A descriptive study was conducted on 1279 Chinese outpatients with a diagnosis of first-episode MDD. Their socio-demographic information, blood levels of thyroid hormones, glucose, lipids and body mass index (BMI) parameters were collected. The positive subscales of the positive and negative syndrome scale (PANSS), Hamilton anxiety rating scale (HAMA), Hamilton depression rating scale (HAMD) were measured for psychotic, anxiety and depressive symptoms. Our results showed that compared with non-suicide attempters (p < 0.01), suicide attempters had statistically higher scores on HAMD, HAMA and PANSS psychotic symptoms, as well as higher thyroid stimulating hormone (TSH) serum levels, glucose, anti-thyroglobulin (A-TG), anti-thyroid peroxidase (A-TPO), total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), systolic blood pressure, and diastolic blood pressure (all with p < 0.001). These results revealed that TSH, A-TG, A-TPO, TC, TG, and LDL-C may be promising biomarkers of suicide risk in MDD, implying the importance of regular assessment of blood glucose level and thyroid function parameters for suicide prevention, along with possible treatment for impaired thyroid function and diabetes for the suicide intervention in MDD patients. Such patients with abnormal blood sugar and TSH must undergo thorough screening for suicidal ideation.

Incidence of Microalbuminuria and its Correlation with Ankle Brachial Index, Sugar Levels and Duration of type 2 Diabetes Mellitus with Special Emphasis to Predict Vascular Complications

Introduction: Diabetes Mellitus (DM) is a metabolic disorder characterized by persistence hyperglycemia resulting from the defects in insulin secretion, action or both. Diabetes prevalence is rapidly increasing, especially in urban India. The changing lifestyle has majorly contributed to the increasing prevalence of diabetes. Aim: To determine the incidence of microalbuminuria and its correlation with age, sex, duration, Fasting Blood Sugar (FBS), Postprandial Blood Sugar (PPBS) and Body Mass Index (BMI). Also to detect the presence of vascular complications using Ankle Brachial Index (ABI), Pulse Wave Velocity (PWV), Augmentaion Index (AI) and microalbuminuria. Materials and Methods: The present cross-sectional study was conducted in Shri B.M. Patil Medical College, Hospital and Research Centre, Vijayapura, Karnataka, India from March 2018 to June 2018. The study included assessment of blood glucose level both fasting blood sugar and postprandial blood sugar, microalbumin levels in 100 known diabetic patients and also ABI, PWV and AI were measured using periscope instrument. Analytical test to measure the differences between two means of the two groups independent t-test was applied and multiple regressoon analysis was done. Results: Out of total 100 subjects 59% were males and 41% were females. The correlation of microalbuminuria with factors like, duration of diabetes, FBS, PPBS, PWV and AI was statistically significant with a p-value of &lt;0.05 in this study. The correlation of duration of diabetes with factors like age, BMI, microalbuminuria was statistically significant with a p-value of &lt;0.05. Conclusion: This study confirmed that incidence of microalbuminuria increases with duration of diabetes, poorly controlled blood sugar levels. Microalbuminuria, ABI, PWV and AI are the reliable, non invasive and simple methods used for the screening of vascular complications.

Superior Non-Invasive Glucose Sensor Using Bimetallic CuNi Nanospecies Coated Mesoporous Carbon.

The assessment of blood glucose levels is necessary for the diagnosis and management of diabetes. The accurate quantification of serum or plasma glucose relies on enzymatic and nonenzymatic methods utilizing electrochemical biosensors. Current research efforts are focused on enhancing the non-invasive detection of glucose in sweat with accuracy, high sensitivity, and stability. In this work, nanostructured mesoporous carbon coupled with glucose oxidase (GOx) increased the direct electron transfer to the electrode surface. A mixed alloy of CuNi nanoparticle-coated mesoporous carbon (CuNi-MC) was synthesized using a hydrothermal process followed by annealing at 700 °C under the flow of argon gas. The prepared catalyst’s crystal structure and morphology were explored using X-ray diffraction and high-resolution transmission electron microscopy. The electrocatalytic activity of the as-prepared catalyst was investigated using cyclic voltammetry (CV) and amperometry. The findings show an excellent response time of 4 s and linear range detection from 0.005 to 0.45 mM with a high electrode sensitivity of 11.7 ± 0.061 mA mM cm−2 in a selective medium.

Comparison of venous, capillary and interstitial blood glucose data measured during hyperbaric oxygen treatment from patients with diabetes mellitus.

Patients undergoing hyperbaric oxygen treatments (HBOT) have been shown to experience a reduction in blood glucose (BG) levels during a treatment. This necessitates frequent assessment of BG levels. Continuous glucose monitoring (CGM) may represent an alternative to the current finger prick monitoring method in-chamber, however, continuous sensor glucose (SG) data has not been validated in situ. The aim was to determine the validity of continuous SG and intermittent BG monitoring with serum BG levels in diabetic patients during HBOT. Measurements were obtained (finger prick [capillary sample], CGM [interstitial fluid], and serum [venous sample]) at baseline, and at 30, 60, 90 and 120 minutes during the hyperbaric treatment. Data were analysed by calculating intraclass correlation coefficients (ICC) and using mixed effects linear regression. The ICC results (n = 10 patients) between the three methods indicated very high and statistically significant absolute agreement at baseline (pre-dive) (ICC = 0.90, 95% CI 0.74-0.97), at 30 minutes (ICC = 0.85, 95% CI 0.61-0.96), 60 minutes (ICC = 0.86, 95% CI 0.58-0.96), 90 minutes (ICC = 0.87, 96% CI 0.63-0.96) and 120 minutes (ICC = 0.90, 95% CI 0.70-0.97). Capillary glucose and CGM SG readings were each within 1 mmol·L-1 on average of the serum glucose reading, with multi-level linear regression finding the average difference between the CGM SG and capillary glucose methods of BG sampling was not statistically significant (P = 0.81). The CGM SG data were comparable with glucose readings from capillary monitoring. Both CGM and capillary data were consistent with serum values.

The Effects of Soyferment-Tempeh on Lipid Profile, Retinol-Binding Protein 4 (RBP4), and Phosphoenolpyruvate Carboxykinase (PEPCK) Gene Expression in Type 2 Diabetic Mice

Diabetes Type 2 can cause oxidative stress leading to the accumulation of reactive oxygen species. Soyferment-Tempeh, a fermented soybean product with aerobic and anaerobic R. oligosporus incubation has a high antioxidant content of isoflavones that can regulate oxidative stress in diabetes. In this study, we evaluate the effects of Soyferment-Tempeh on lipid profile, Retinol-Binding Protein 4 (RBP4), and Phosphoenolpyruvate Carboxykinase (PEPCK) gene expression in type 2 diabetic mice. A total of 30 mice with the age of eight weeks were divided into six groups as follows: A) nondiabetic, B) diabetic mice, C) diabetic mice with metformin, D), E), and F) diabetic mice with Soyferment-Tempeh doses of 10, 20, or 40mg/100g body weight (BW), respectively, were administered treatments orally by gavages. Blood was collected for assessment of blood glucose level, and lipid profile before and after 3 weeks of the administration. After sacrificing the mice, livers were used for RBP4 and PEPCK gene expression assessment. Supplementation with three different doses of Soyferment-Tempeh in streptozotocin-induced diabetic mice for 21 days significantly (p&lt;0.001) reduced blood glucose level, total cholesterol, triglycerides, low-density lipoprotein level, atherogenic index, and increased high-density lipoprotein level. There was a significant decrease in RBP4 gene expression in the Soyferment-Tempeh of dose 10mg/100g BW treatment groups (p&lt;0.05), while the PEPCK gene expression did not significantly differ (p&gt;0.05). These results demonstrate that supplementation with Soyferment-Tempeh decreases blood glucose level, atherogenic index, improves lipid profile, and decreases RBP4.

Assessing diagnostic variations and correlates of fasting blood glucose

Objective: To assess the diagnostic variables of blood glucose level among students of basic medical Sciences of Delta State University, Abraka Nigeria.Methods: A descriptive cross sectional survey on a total of one hundred and ten (110) students of the Faculty of Basic Medical Science, Delta State University, Abraka was conducted. Descriptive statistics was used to analyze the differences in the data collected.Results: The fasting blood glucose levels of 87.5% and 85% of the students had a normoglycemic level as indicated by the left and right thumb respectively. Also, a greater percentage (69.1%) of the students were between the age range 21 – 25. Furthermore, 72.7%, 76.4% and 64.5% of the students had normal weight, normal WHR and normal BP respectively.Conclusion: There is no significant difference in the diagnostic assessment of blood glucose level using either right or left thumb.&#x0D; Keywords: Fasting blood glucose, diabetes, diagnostic, Delta State, hypertension.

Assessing the Effect of Dietary Nursing Intervention on Nutritional Status of Diabetes and Kidney Disease Patients Who Are Treated by Hemodialysis

Objective: To assess the Effect of dietary nursing intervention on nutritional status of diabetes and kidney disease patients who are treated by hemodialysis. Methods: 80 patients who are diagnosed as diabetes or kidney disease and are treated by hemodialysis are invited to join our study. all participants were randomly assigned to two groups. In control group, the participants receive the common nursing intervention service. In intervention group, expect of common nursing intervention service, we provide additional dietary nursing intervention service. We record some index of participants that include water electrolyte index, nutritional status indicator, blood glucose levels and renal function index. Additionally, we use World Health Organization Quality of Life Brief Version (WHOQOL-BREF) to collect quality of life assessment. Result: In water electrolyte index research, the intervention group has lower index that that of control group in blood calcium, blood phosphorus and blood potassium. In assessment of nutritional status, intervention group participants have better performance than that of control group. In the assessment of blood glucose levels and renal function, intervention group participants have better blood glucose levels and renal function than that of control group. In quality of life assessment, the quality of life of the intervention group was significantly higher than that of the control group (p ≤ 0.05). Conclusion: the dietary nursing intervention can effectively improve some physiological aspects during the maintenance hemodialysis treatment of patients with diabetic nephropathy, that include: correct the disorder of water and electrolyte, reduce the risk of malnutrition, control blood sugar, improve renal function and improve the quality of life.

Efficacy of UB0316, a multi-strain probiotic formulation in patients with type 2 diabetes mellitus: A double blind, randomized, placebo controlled study.

BackgroundRole of multi-strain probiotic formulations in the management of type 2 diabetes mellitus (T2DM) has rarely been reported. In the present study, the effects of the probiotic formulation, UB0316 (L. salivarius UBLS22, L. casei UBLC42, L. plantarum UBLP40, L. acidophilus UBLA34, B. breve UBBr01, B. coagulans Unique IS2, 5 billion CFU each and fructo-oligosaccharides, 100 mg) in patients with T2DM were assessed.MethodsA total of 79 eligible subjects (18–65 years, on stable metformin therapy) were randomly assigned to receive UB0316 or placebo, twice-a-day for 12 weeks. The primary endpoint was change in glycated hemoglobin (HbA1c), secondary were assessment of blood glucose levels, HOMA-IR (homeostatic model assessment of insulin resistance), insulin, body weight, and blood lipids. Quality of life, vital signs, physical investigations, safety and Physician/Subject’s Global assessment were also evaluated.ResultsTwelve week multi-strain probiotic (UB0316) supplementation significantly reduced HbA1c (7.70 ± 0.79%; p = 0.0023) and weight (67.00 ± 8.82 kg; p < 0.001) as compared to placebo (HbA1c: 8.30 ± 1.35%; weight: 67.60 ± 9.46 kg). The changes recorded in fasting blood glucose (FBG), HOMA-IR, insulin, TC, TG, HDL, and LDL levels were however not significantly altered as compared to placebo. No severe adverse events, abnormal vital and physical signs were reported. The quality of life of T2DM was significantly improved.ConclusionsUB0316 significantly improved glycemic control as indicated by the decrease in HbA1c levels. There was also a significant decrease in weight in the probiotic treated subjects as compared to placebo.

Continuous Glucose Monitoring: A Brief Review for Primary Care Practitioners.

Glycated hemoglobin A1c (HbA1c) is routinely used as a marker of average glycemic control, but it fails to provide data on hypoglycemia and glycemic variability, both of which are associated with adverse clinical outcomes. Self-monitoring of blood glucose (SMBG), particularly in insulin-treated patients, is a cornerstone in the management of patients with diabetes. SMBG helps with treatment decisions that aim to reduce high glucose levels while avoiding hypoglycemia and limiting glucose variability. However, repeated SMBG can be inconvenient to patients and difficult to maintain in the long term. By contrast, continuous glucose monitoring (CGM) provides a convenient, comprehensive assessment of blood glucose levels, allowing the identification of high and low glucose levels, in addition to evaluating glycemic variability. CGM using newer detection and visualization systems can overcome many of the limitations of an HbA1c-based approach while addressing the inconvenience and fragmented glucose data associated with SMBG. When used together with HbA1c monitoring, CGM provides complementary information on glucose levels, thus facilitating the optimization of diabetes therapy while reducing the fear and risk of hypoglycemia. Here we review the capabilities and benefits of CGM, including cost-effectiveness data, and discuss the potential limitations of this glucose-monitoring strategy for the management of patients with diabetes.FundingSanofi US, Inc.

MicroRNA, Proteins, and Metabolites as Novel Biomarkers for Prediabetes, Diabetes, and Related Complications.

Type 2 diabetes mellitus (T2DM) is no more a lifestyle disease of developed countries. It has emerged as a major health problem worldwide including developing countries. However, how diabetes could be detected at an early stage (prediabetes) to prevent the progression of disease is still unclear. Currently used biomarkers like glycated hemoglobin and assessment of blood glucose level have their own limitations. These classical markers can be detected when the disease is already established. Prognosis of disease at early stages and prediction of population at a higher risk require identification of specific markers that are sensitive enough to be detected at early stages of disease. Biomarkers which could predict the risk of disease in people will be useful for developing preventive/proactive therapies to those individuals who are at a higher risk of developing the disease. Recent studies suggested that the expression of biomolecules including microRNAs, proteins, and metabolites specifically change during the progression of T2DM and related complications, suggestive of disease pathology. Owing to their omnipresence in body fluids and their association with onset, progression, and pathogenesis of T2DM, these biomolecules can be potential biomarker for prognosis, diagnosis, and management of disease. In this article, we summarize biomolecules that could be potential biomarkers and their signature changes associated with T2DM and related complications during disease pathogenesis.

Assessment of blood glucose levels in diabetic patients with periodontitis: A three-way method using gingival crevicular, capillary, and venous blood

Assessment of blood glucose levels in diabetic patients with periodontitis: A three-way method using gingival crevicular, capillary, and venous blood

Utility Of Gingival Crevicular Blood For Assessment Of Blood Glucose In Individuals With Diabetes Mellitus And Evidence Of Periodontitis

Background: Diabetes mellitus is a common finding in the medical history of patients receiving treatment for periodontal disease. Bleeding from the gingival tissues is considered to be more in poorly controlled diabetics than in good or moderately controlled diabetics. Periodontal inflammation with or without the complicating factor of diabetes mellitus is known to produce ample extravasated blood during the diagnostic procedures. Routine probing during a periodontal examination is more familiar to the practitioner and less traumatic than a finger puncture with a sharp lancet. Gingival crevicular blood from probing may be an excellent source of blood for glucometric analysis using glucometers. Aim: To determine the efficiency of gingival crevicular blood obtained on routine probing for assessment of blood glucose levels using glucometer. To compare the glucose levels in the gingival crevicular blood and sample obtained from finger puncture method using glucometer. Material and Methods: 50 patients with history of diabetes mellitus were examined for the study. The labial aspect of upper anterior teeth, irrespective of their probing depths were chosen for glucose measurement. Bleeding sites were isolated, blood sample was taken in a micropipette and transferred on to the blood glucose test strip using a filler. Following crevicular blood sampling, blood sample was taken from one of the patients’ finger for glucometric analysis. Result: A strong correlation (r = 0.946, p,0.001) between gingival crevicular and blood sample obtained using finger puncture method. There were no significant differences between capillary and crevicular blood glucose even with increasing blood glucose levels. Conclusion: The results suggests that gingival crevicular blood can provide an acceptable source for measuring blood glucose using glucometer. The use of micropipette was a reliable method for collecting gingival crevicular blood sample.

Developing a chair side, safe and non-invasive procedure for assessment of blood glucose level using gingival crevicular bleeding in dental clinics.

Aim:To study the accessibility of chair side blood glucose non-invasive screening method for diabetes mellitus during routine periodontal examination.Materials and Methods:Fifteen non-diabetics and 15 newly onset type 2 diabetics patients with moderate to severe periodontitis were selected after meeting inclusion and exclusion criteria. Periodontal pocket probing was performed using a Williams Graduated periodontal probe. Blood oozing from gingival sulcus of anterior teeth following periodontal pocket probing was collected with stick of a glucose self-monitoring device. As control, finger stick capillary blood was taken.Results:A statistically significant correlation was observed between the blood glucose level of gingival crevicular blood (GCB) and peripheral fasting blood (PFB) of diabetic subjects. The mean GCB glucose level of the subjects in diabetic group was 172.27 ± 5.02 mg/dl while mean PFB glucose was 167.80 ± 8.87 mg/dl. The correlation coefficient of diabetic and non-diabetic subjects were r = +0.715 and r = +0.619, respectively.Conclusion:The results suggested that blood oozing during routine periodontal examination may be used for diabetic mellitus screening in a dental office setting without the need for any extra procedure.

Diagnostic Efficacy of Gingival Crevicular Blood for Assessment of Blood Glucose Levels in Dental Office: A cross Sectional Study

Objectives: The gingival crevicular blood (GCB) obtained during routine periodontal probing may be a source for blood glucose measurements. The aim of this study was to compare gingival crevicular blood and fingerstick blood glucose measurements using a glucometer against the conventional laboratory methods. Materials and Methods: The study group comprised of three groups. In the first group 30 patients with periodontitis and positive bleeding on probing were chosen. Blood samples of two sites intraorally were analyzed using a glucose self-monitoring device. The second and third group comprised of 50 diabetic and 50 non-diabetic patients. After testing fasting plasma glucose (FPG), fasting glucose levels in gingival crevicular blood (GCBG), and fasting capillary fingerstick blood (CFBG) samples were analyzed using same device. Results: Significant correlation (r= 0.93, p<0.001) was found between gingival crevicular blood glucose levels and capillary finger stick blood glucose levels. Considerable correlation (r=0.75, p<0.001) was found between levels of fasting gingival crevicular blood glucose and fasting blood glucose both in diabetic patients and the normal population. Conclusion: It is evident that the blood obtained during routine periodontal probing can be used for estimation of blood glucose levels. GCB can be used as a marker for blood glucose estimation using glucometer. The technique described is safe, easy to perform and helps to increase the frequency of diabetes screening in dental office.

Self‐titration of insulin in the management of people with type 2 diabetes: a practical solution to improve management in primary care

Good glycaemic control in type 2 diabetes (T2DM) is associated with a reduced risk of diabetes complications; however, achieving and maintaining glycaemic control represents a major challenge to physicians, and despite the availability of a range of antidiabetic therapies, many patients with T2DM will eventually require insulin supplementation to reach target glycaemic levels. Insulin initiation, adjustment of the insulin dose and the need for frequent assessment of blood glucose levels are often complicated by patient and physician misconceptions and concerns regarding its use. For most patients requiring insulin therapy, dose titration is carried out by physicians; however, evidence suggests that this process may not provide optimal glycaemic management for patients. Self-monitoring of blood glucose and self-adjustment of insulin dose (insulin self-titration) is well established in type 1 diabetes, suggesting that similar therapeutic self-management may be beneficial when applied to patients with T2DM. This article reviews the rationale and clinical evidence for insulin self-titration in patients with T2DM with the aim of highlighting the importance of educating patients about insulin therapy and empowering them to manage their diabetes through self-titration of insulin.

Design of a prospective clinical study on the agreement between the Continuous GlucoseMonitor, a novel device for CONTinuous ASSessment of blood GLUcose levels, and the RAPIDLab® 1265 blood gas analyser: The CONTASSGLU study

BackgroundAlthough a device is needed to continuously measure blood glucose levels within an intensive care setting, and several large-scale prospective studies have shown that patients might benefit from intensive insulin, potassium, or glucose therapy during intensive care, no devices are currently available to continuously assess blood glucose levels in critically ill patients. We conceived the study described here to evaluate the clinical use of the Continuous Glucose Monitor (CGM) performed via a central vein, and to determine the impact of phenomena, such as drift and shift, on the agreement between the CGM and a RAPIDLab® 1265 blood gas analyser (BGA).Methods/designIn the CONTinuous ASSessment of blood GLUcose (CONTASSGLU) study, up to 130 patients under intensive care will be fitted with the CGM, an ex vivo device that continuously measures blood glucose and lactate levels. Readings from the device taken 8 h after initial placement and calibration will be compared with values measured by a BGA. For this study, we chose the BGA as it is an established standard point-of-care device, instead of the devices used in certified central laboratories. Nevertheless, we will also independently compare the results from the point-of-care BGA with those determined by a central laboratory-based device. Blood samples will be collected from each patient from the same site in which the CGM will measure blood glucose. Consequently, each participant will serve as their own control, and no randomisation is necessary. The 95% limits of agreement and the corresponding confidence intervals will be calculated and compared with a prespecified clinically acceptable relative difference of 20%.DiscussionSeveral attempts have been made to develop a device to continuously measure blood glucose levels within an intensive care setting or to use the devices that were originally designed for diabetes management, as several of these devices are already available. However, none of these devices were successful in intensive care settings. CONTASSGLU may well bridge this gap by confirming the ability of the CGM to continuously measure blood glucose levels in intensive care settings.Trial registrationClinicalTrials.gov NCT01580176