Measuring Blood Glucose Levels Research Articles

Application of Diabetes Self Management Education (DSME) in Patients with Type 2 Diabetes Mellitus based on Blood Glucose Levels

Diabetes Self Management Education (DSME) uses guidelines, counseling, and behavioral intervention methods to increase knowledge about diabetes and improve individual and family skills in managing diabetes mellitus (DM). This research is a quantitative study using a pre-experimental design that provides treatment or intervention to the research subjects then the effect of the treatment is measured and analyzed. This design is used to compare the results of the intervention of the application of Diabetes Self Management Education (DSME) on controlling blood glucose levels in patients with type 2 diabetes mellitus. The analysis used the dependent t-test / paired t-test. The results showed that there were significant differences in blood glucose levels in the measurement after giving DSME to the respondents, indicating that the measurement of blood glucose levels after treatment was smaller than the measurement before treatment. It is necessary to develop a program to increase the competence of nurses in nursing care for diabetic clients and education related to diabetic self-care to increase the knowledge and skills of nurses in managing diabetes.

The application of continuous glucose monitoring technology to eating disorders research: An idea worth researching.

Continuous glucose monitoring (CGM) devices have revolutionized our capacity to measure blood glucose levels in real time using minimally invasive technology, yet to date there are no studies using CGM in individuals with eating disorders (EDs). Preliminary evidence suggests that eating disorder behaviors (EDBs) have substantial and characteristic impacts on blood glucose levels and glucose-related variables (e.g., binge-eating episodes cause rapid spikes in blood glucose levels, purging causes rapid drops in blood glucose to below normal levels). The aims of this article are to describe the benefits of CGM technology over older methods of measuring blood glucose levels and to discuss several specific ways in which CGM technology can be applied to EDs research to (a) improve our ability to identify and predict engagement in EDBs in real time, (b) identify relationships between blood glucose levels and maintenance factors for EDs, and (c) increase our understanding of the physiological and psychological impacts of disordered eating. We also present preliminary acceptability and feasibility data on the use of CGM devices in individuals with EDs. Overall, the article will describe several applications of CGM technology in EDs research with compelling potential to improve research methodologies.

Glucose-water interactions at increasing concentrations and temperatures as revealed by Near-Infrared Spectroscopy

Water is an essential molecule and one of the most intensive research subjects, yet it is a peculiar molecule. The non-invasive measurement of blood glucose levels by near-infrared spectroscopy requires detailed information about the glucose-water interactions. The glucose in water induces strong hydrogen bonds and may influence the tetrahedral structure of water molecules. This knowledge is essential in constructing a non-invasive calibration of the blood glucose prediction model. How they are related to the absorption spectra of water and glucose is particularly valuable to comprehend. The evaluations were carried out using near-infrared spectroscopy, tracing changes in absorption intensity and shifts in corresponding peaks with glucose varying at an increasing concentration from a 0-0.9 molar fraction. The near-infrared spectra analysed were around 6900 cm-1 and 4716 cm-1 corresponding to the overtone and the combination band of water and glucose absorptions, respectively. The analysis suggests that glucose prefers to enter a water cluster, rather than bind to free molecules, and induce bond breaking at low glucose concentrations at which the molecular fraction is less than 0.05.

Diabetes Mellitus and Tuberculosis Comorbidity and Associated Factors Among Bale Zone Health Institutions, Southeast Ethiopia.

BackgroundGlobally, tuberculosis and diabetes mellitus co-morbidity is higher than tuberculosis and human immunodeficiency virus comorbidity. Considering this, the World Health Organization and the International Union against tuberculosis and lung disease recommend bi-directional screening of the two diseases. However, in Ethiopia, bi-directional screening has not been started yet.ObjectiveThe objective of this study was to assess the prevalence of diabetes mellitus and tuberculosis comorbidity and its predictors among adult tuberculosis patients in Bale Zone Health Institutions, Southeastern Ethiopia.Materials and MethodsInstitutional-based cross-sectional study carried out using interviewer administered questionnaire, registration review, anthropometric and blood glucose level measurement from March, 30, 2019 to April, 30, 2019. Three hundred twenty-one tuberculosis patients were selected from tuberculosis registration log book using lottery methods. The collected data were checked for completeness, coded and entered in to EpiData3.0.2 and exported to SPSS version 20. Independent variables that had p value less 0.25 were used as candidates for multiple logistic regressions to control confounders. Variables that had significant association were identified by calculating odds ratio, with 95% confidence interval, and p value less than 0.05 used to declare statistical significance.ResultsDiabetes mellitus and tuberculosis comorbidity among adult tuberculosis patients was 5.1% (95% CI: 2.7%, 7.5%). Age with ≥50 years (AOR=3.98, 95% CI: 1.13, 14.36), having extra pulmonary tuberculosis (AOR=3.31, 95% CI: 1.16, 9.44) and being females (AOR=3.8, 95% CI: 1.17, 12.33) were significantly associated with the comorbidity of the two diseases.Conclusion and RecommendationThe prevalence of diabetes mellitus and tuberculosis comorbidity was high. Female tuberculosis patients, tuberculosis patients with age ≥50 years and those having extra pulmonary tuberculosis patients should be screened for diabetes mellitus.

Effect of triamcinolone acetonide-loaded nanoparticles on diabetic retinopathy in rats

Triamcinolone acetonide acetate (TAA)-loaded nanostructured lipid carriers (NLC) were prepared to investigate their transdermal absorption in vitro and establish a diabetic retinopathy (DR) rat model. To evaluate the effect of triamcinolone acetonide-loaded nanoparticle capsules on improving the structure of the retina and pancreas, we measured blood glucose levels and investigated the pathological changes in the retina and pancreas. The effect of triamcinolone acetonide-loaded nanoparticle capsules on the morphology of the retina and pancreas of the rats with DR was determined and compared among the normal group, model control group, positive control group, and triamcinolone acetonide-loaded nanoparticle group. After treatment with triamcinolone acetonideloaded nanoparticle capsules for 2 months, the blood glucose and glycosylated hemoglobin levels were significantly lower (P < 0.01) and the pathological changes were less severe in the triamcinolone acetonide-loaded nanoparticle group than in the model control group. In addition, the arrangement of the photoreceptor cell layers in the retina was organized, intracellular and extracellular edema in each layer was reduced compared with that in the model control group, the capillary lumen was not occluded, and the peripheral cells were slightly edematous in the triamcinolone acetonide-loaded nanoparticle group. Triamcinolone acetonide-loaded nanoparticle capsules could effectively reduce the blood glucose and glycosylated hemoglobin levels and improve the structure of the retina and pancreas in the rats with DR.

Mean amplitude of glycemic excursions in septic patients and its association with outcomes: A prospective observational study using continuous glucose monitoring.

To apply continuous glucose monitoring (CGM) and determine the mean amplitude of glycemic excursions (MAGE) in septic patients and to assess the associations of MAGE with outcomes and oxidative stress. This study was conducted in adult septic patients expected to require intensive care for >48h. We continuously measured blood glucose level for the first 48h in the ICU using FreeStyle Libre®. MAGE was calculated using glycemic information obtained by CGM during the study period of 48h. The primary outcome was 90-day all-cause mortality. The secondary outcomes were 90-day ICU-free days and the concentration of urinary 8-isoprostaglandinF2α measured 48h after commencement of the study as a surrogate of oxidative stress. Forty patients were included in this study. Median of MAGE was higher in non-survivors than in survivors: 68.8 (IQR;39.7-97.2) vs. 39.3 (IQR;19.9-53.3), p=0.02. In multivariate analysis, MAGE was independently associated with 90-day all-cause mortality rate (p=0.02), urinary 8-isoprostaglandinF2α level (p=0.03) and 90-day ICU-free survival days (p=0.03). In the current study, MAGE for the first 48h of treatment that was obtained by using CGM was associated with 90-day all-cause mortality, 90-day ICU-free days and urinary 8-isoprostaglandinF2α level in septic patients.

Effect of water temperature on the physiological responses in Betta rubra, Perugia 1893 (Pisces: Osphronemidae)

Water temperature is a limiting factor in fish health and plays a crucial role, especially in endemic species that are more sensitive to ambient temperature changes. The objective of the present study was to examine the effects of temperature on growth patterns, survival, blood glucose, gill histology, and erythrocyte cell abnormality of Betta rubra, an endemic species in Aceh and Northern Sumatra, Indonesia. The fish sample was collected from Nagan Raya, Aceh Province, Indonesia. The fish were acclimatized for three days prior to experimental trials at five temperature levels; 24 °C, 26 °C, 28 °C, 30 °C and 32 °C for 14 days. Fish were taken randomly from every treatment to measure blood glucose levels and gill samples were taken at the start and end of the experiment. The results showed the highest survival at a temperature of 28 °C (83.33%). The lowest blood glucose level was also found at a temperature of 28 °C. In addition, an increase and decrease in temperature exceeding 28 °C caused gill damage. Higher temperatures caused an increase in the abnormality of erythrocyte cells, with the highest percentage of abnormality found at 32 °C. Overall, this study confirmed that exposure to lower and higher temperature than the optimal is stressful to B. rubra.

Health Literacy and Blood Glucose Level in Transitional Albania.

Aim: Our aim was to assess the independent association between blood glucose level and health literacy (HL) adjusting for many socio-demographic characteristics and body mass index (BMI) in an adult population in Albania, a transitional country in the South Eastern Europe.Methods: A cross-sectional study was carried out in Tirana in 2012–2014 including a population-based sample of 1,154 individuals aged ≥18 years (57% women; mean age: 45.5 ± 16.4 years; response rate: 88.6%). HL was assessed by use of HLS-EU-Q instrument. Blood glucose level was measured in a fasting state by use of rapid finger stick method. Information on socio-demographic characteristics was collected, and BMI was calculated based on measurement of height and weight in all participants. General Linear Model (GLM) and binary logistic regression were used to assess the independent association of blood glucose level and HL adjusting for all socio-demographic factors and BMI.Results: One-third of participants had pre-diabetes (100–125.9 mg/dl) and further 11% had diabetes (≥126 mg/dl) based on the measured blood glucose level. In fully-adjusted GLM, mean blood glucose level was significantly lower among individuals with excellent HL compared with their counterparts with inadequate HL (99.3 vs. 106.0, respectively). Furthermore, the odds for the presence of diabetes in the group of study participants whose HL was “inadequate” were 2.6 times higher (95% CI = 1.3–5.4) compared to those whose HL was “excellent.”Conclusion: We obtained evidence of a strong and significant inverse relationship between measured blood glucose level and HL, independent of many socio-demographic characteristics and measured BMI in a population-based study in a country of the Western Balkans.

PENGARUH SENAM ZUMBA TERHADAP PERUBAHAN KADAR GLUKOSA DARAH

Abstract: Hyperglycemia is one of the causes of chronic DM disease that is most experienced by the world's population and ranks fourth cause of death. The purpose of this study was to determine the effect of zumba gymnastics on changes in blood glucose levels in middle adulthood in the Bengkulu City East Rim Health Center Work Area in 2018. The study design was quasi experimental with pre-test and post-test with control group design. A total sample of 34 people consisted of 17 control groups and 17 intervention groups. The sampling technique is consequtive sampling. Measuring blood glucose levels using Glucose test GlucoDr brand, analysis using t-test at α ≤ 0.05%. The results showed that there was influence of zumba gymnastics on changes in blood glucose levels. Zumba exercises can be useful for controlling and reducing blood glucose levels.Keywords: Zumba, Glucose, Adult.

Evaluation of Outcomes Using a Tablet-Based System to Support Glycemic Management Workflow Operations: A Retrospective Observational Study.

The treatment of hospitalized patients with type 2 diabetes requires glycemic management to maintain the patients' blood glucose levels within a normal range. We developed a blood glucose management system (BGM) system in 2015, which is a tablet-based workflow support system. This system enables medical staff to continually confirm the physicians' instructions by measuring the blood glucose levels while using a tablet terminal.In this study, we examined electronic medical records (EMRs) to evaluate the usage frequency of the BGM system and the time required for the glycemic management workflow in comparison to conventional PC terminals in a large hospital setting. The data includes 197,927 blood glucose level measurements that were taken in the general wards of Tottori University Hospital between January 2016 and June 2017. The usage frequency of the glycemic management workflow while using the BGM system was 145,864 times (approximately 74% of the total blood glucose measurements). The mean time until the completion of the glycemic management workflow in the case of hyperglycemia was 16min 33s, which is 26% shorter than using a PC terminal for treatment that involves injection or infusion (1454 times). The BGM system is proactively utilized by medical staff, thereby improving the operating efficiency. The results of this study indicate that the BGM system installed on tablet terminals can improve the efficiency in large-scale medical institutions that treat patients with diabetes.

Human umbilical cord-derived mesenchymal stem cells prevent the progression of early diabetic nephropathy through inhibiting inflammation and fibrosis

BackgroundDiabetic nephropathy (DN) is one of the most serious complications of diabetes and the leading cause of end-stage chronic kidney disease. Currently, there are no effective drugs for treating DN. Therefore, novel and effective strategies to ameliorate DN at the early stage should be identified. This study aimed to explore the effectiveness and underlying mechanisms of human umbilical cord mesenchymal stem cells (UC-MSCs) in DN.MethodsWe identified the basic biological properties and examined the multilineage differentiation potential of UC-MSCs. Streptozotocin (STZ)-induced DN rats were infused with 2 × 106 UC-MSCs via the tail vein at week 6. After 2 weeks, we measured blood glucose level, levels of renal function parameters in the blood and urine, and cytokine levels in the kidney and blood, and analyzed renal pathological changes after UC-MSC treatment. We also determined the colonization of UC-MSCs in the kidney with or without STZ injection. Moreover, in vitro experiments were performed to analyze cytokine levels of renal tubular epithelial cell lines (NRK-52E, HK2) and human renal glomerular endothelial cell line (hrGECs).ResultsUC-MSCs significantly ameliorated functional parameters, such as 24-h urinary protein, creatinine clearance rate, serum creatinine, urea nitrogen, and renal hypertrophy index. Pathological changes in the kidney were manifested by significant reductions in renal vacuole degeneration, inflammatory cell infiltration, and renal interstitial fibrosis after UC-MSC treatment. We observed that the number of UC-MSCs recruited to the injured kidneys was increased compared with the controls. UC-MSCs apparently reduced the levels of pro-inflammatory cytokines (IL-6, IL-1β, and TNF-α) and pro-fibrotic factor (TGF-β) in the kidney and blood of DN rats. In vitro experiments showed that UC-MSC conditioned medium and UC-MSC-derived exosomes decreased the production of these cytokines in high glucose-injured renal tubular epithelial cells, and renal glomerular endothelial cells. Moreover, UC-MSCs secreted large amounts of growth factors including epidermal growth factor, fibroblast growth factor, hepatocyte growth factor, and vascular endothelial growth factor.ConclusionUC-MSCs can effectively improve the renal function, inhibit inflammation and fibrosis, and prevent its progression in a model of diabetes-induced chronic renal injury, indicating that UC-MSCs could be a promising treatment strategy for DN.

KOMPOSISI PROKSIMAT DAN INDEKS GLIKEMIK NIRA AREN

Penelitian ini bertujuan untuk mengevaluasi komposisi proksimat dan nilai indeks glikemik nira aren. Analisis kadar air menggunakan metode oven, protein menggunakan metode semimikro kjeldhal, kadar abu menggunakan metode thermografimetri, dan lemak menggunakan metode ekstruksi langsung dengan alat soxhlet, karbohidrat menggunakan metode by difference, dan gula mengunakan metode Luff schoorl . Analisis indeks glikemik menggunakan perhitungan luas area dibawah kurva menggunakan metode finger-prick capillary blood. Pengukuran kadar glukosa darah pada 10 orang responden yang diberi glukosa murni dan nira aren. Hasil penelitian menunjukkan nira aren mengandung 91,1% air, 0,28% kadar abu, 0,41% protein, 0% lemak, 8,21% karbohidrat dan 0,67% jumlah gula. Rata-rata glukosa darah responden setelah mengkonsumsi glukosa murni dan nira aren pada menit ke-0, 30, 60, 90, 120 yaitu sebagai berikut 93,2 mg/dL, 155,4 mg/dL, 124,2 mg/dL, 93,8 mg/dL, 79,1 mg/dL, dan 81,8 mg/dL, 118,6 mg/dL, 92,6 mg/dL, 74,1 mg/dL, dan 63,7 mg/dL. Nilai indeks glikemik nira aren adalah 35,56 berada pada kategori rendah, sehingga nira aren merupakan minuman alternatif untuk menjaga kadar gula darah.

Indeks glikemik cookies growol: studi pengembangan produk makanan selingan bagi penyandang diabetes mellitus

Glycemic index of growol cookies: snack development study for people with diabetes mellitusBackground: Low-glycemic foods with high fiber content have been shown to control blood glucose in diabetics. Growol, cassava fermented food, can be potentially developed as a functional food for diabetics. Growol has higher dietary fiber and lower total sugar, reducing sugar, and sucrose compared to cassava. Carbohydrates in growol combined with roasting processing techniques into cookies products may potentially change the glycemic index of the product.Objective: To examine the potency of growol cookies as a snack for diabetics in terms of the glycemic index of cookies.Methods: This observational laboratory study analyzed the glycemic index of growol cookies compared to glucose and control cookies. The study was conducted from April to October 2019. Ten subjects were involved in the glycemic index measurement. The glycemic index was analyzed through the area under the curve (AUC) ratio of glucose response of food by measuring blood glucose levels during fasting; 30; 60; 90; and 120 minutes after consuming test foods (growol cookies and control cookies).Results: AUC for glucose, control cookies, and growol cookies were 13,669.5; 11,886; and 11,941.5. The glucose glycemic index was 100, while the glycemic index of control cookies and growol cookies was 87. Both control cookies and growol cookies are high glycemic index food. There was an AUC difference between glucose and control cookies (p=0.001) and between glucose and growol cookies (p=0.001). The difference in AUC between control cookies and growol cookies (p=0.991) was not seen.Conclusions: Growol cookies have a lower glycemic index than glucose, but it still cannot be consumed as an alternative snack for diabetics.

Incidence and Prediction of Unstable Blood Glucose Level among Critically Ill Patients: A Cohort Study.

To evaluate the incidence and the prediction of unstable blood glucose level among critically ill patients hospitalized in an intensive care unit. A cohort study was conducted with 62 adult patients hospitalized at an intensive care unit of a hospital located in Minas Gerais, Brazil, between March and July of 2017. Patient's demographic information, along with scores for Simplified Acute Physiology Score III, primary medical diagnosis, discharge status, diagnosis of diabetes and/or sepsis, length of stay, glycemic variability, type of nutrition, types of medications and treatments, and oxygen therapy were collected daily. A daily venous blood sample was collected to measure blood glucose levels during the patient's hospitalization period. Bivariate analysis was used to explore the association among the potential diagnostic indicators and the outcome of unstable blood glucose levels. Multivariate Cox regression was used to identify the potential predictors for the outcome. Of the total of 62 participants, 45.1% (n=28) had unstable blood glucose level. Among the 28 patients with unstable blood glucose levels, half of them (n=14, 50%) had hypoglycemia and the other half had hyperglycemia (n=14, 50%). Decreased number of days hospitalized and the use of intensive glucose control with regular insulin were associated with decreased odds of developing hyperglycemia. The presence of mechanical ventilation was associated with a higher risk for the development of hypoglycemia. This study provides knowledge and evidence of diagnostic indicators for unstable blood glucose levels that are not currently included in the NANDA-International terminology for the nursing diagnosis Risk for unstable blood glucose level (00179). This study identified important diagnostic indicators that nurses can observe during the assessment to identify patients that are at risk for developing unstable blood glucose level and provide the appropriate care.

Effects of Insulin on Fibronectin Alterations in Sciatic Nerve of Diabetic Rats-A Brief Report

Objective: Alteration in the basement membrane proteins maybe associated with diabetic neuropathy. Fibronectin is one of the most important components of peripheral nerves basement membrane. In this study we investigated the effects of insulin administration on prevention of alteration in fibronectin contents of sciatic nerve in diabetic rats. Materials and Methods: Twenty-four wistar rats were divided into control, diabetic and diabetic with insulin treatment groups. Three months after diabetes induction, we measured blood glucose level, body weight and then expression of fibronectin in sciatic nerves of rats were evaluated by real time polymerase chain reaction (PCR) and immunohistochemical study. Results: Intensity of fibronectin immunoreactivity in the perineurium and endoneurium of sciatic nerves significantly increased in diabetic without treatment group compared to control group (P-value< 0.001). Conclusion: This finding suggested that diabetic neuropathy resulted in increased of fibronectin contents in sciatic nerves of rats.

Camellia Sinensis Leaves Hydroalcoholic Extract Improves the Alzheimer’s Disease-Like Alterations Induced by Type 2 Diabetes in Rats

Objective: Novel investigations have confirmed that hyperglycemia is strictly associated with the development of cognitive impairment and dementia. Sodium-dependent glucose transporter (SGLT) inhibitors, which are oral antidiabetic drugs, are currently being investigated as the medication in Alzheimer's disease (AD). In our study, Camellia sinensis (green tea), which inhibits sodium-dependent glucose transporter-1 (SGLT-1), was used in the treatment of type 2 diabetes mellitus (T2DM)-induced AD-like alterations via its antidiabetic effects.Methods: High-fat diet/streptozotocin-treated rat model was chosen to provide T2DM-induced AD-like alterations. Antidiabetic effects were evaluated with the measurement of blood glucose level (BGL), oral glucose tolerance test (OGTT), and insulin tolerance test (ITT). On the other hand, novel object recognition test (NORT), open field test (OFT), passive avoidance test (PAT), and Morris’s water maze (MWM) test were performed to investigate the anti-Alzheimer's effects of C. Sinensis.Results: C. sinensis tolerated BGL for a short time but metformin, the first medication prescribed for T2DM, tolerated BGL during the test for 120 min. C. sinensis increased the number of square crosses and the frequency of grooming activity in a similar manner to metformin in OFT. C. sinensis treatment improved exploratory behavior and memory retention components in NORT. The step-through latency decreased in HFD/STZ-treated rat model but it improved with metformin and C. sinensis treatment in PAT. According to the results obtained by the MWM test, C. sinensis treatment slightly improved learning.Conclusion: C. sinensis improved short-term memory and increased the locomotor activity in rats according to the results obtained by NORT, OFT, and PA.

Cryptotanshinone ameliorates placental oxidative stress and inflammation in mice with gestational diabetes mellitus.

Gestational diabetes mellitus (GDM) is a conditional diabetes which is defined as any degree of glucose intolerance or high blood glucose levels during any phase of pregnancy. It causes chronic severe damage to health of the pregnant women and their offspring. In this study, we aimed to study the protective effects of Cryptotanshinone on GDM-related impairments. We measured blood glucose levels, serum insulin levels, biochemical indexes, oxidative stress, inflammation and the activation of NF-κB signaling pathway in the blood and placenta of GDM mice. It is found that Cryptotanshinone significantly decreased blood glucose levels, oxidative stress, inflammation and NF-κB signaling with an increase of serum insulin levels in the placenta and blood of GDM mice. Taken together, Cryptotanshinone effectively ameliorated GDM, which suggested that Cryptotanshinone could be served as a promising therapeutic drug for GDM patients.

Effects of noises on near infrared sensor for blood glucose level measurement

This paper proposed the method of measuring glucose level in solution using near infrared light (NIR) and photodiode sensor. We studied noises that occurred on the output signal of NIR sensor in three different room conditions in order to know the effects on this sensor output voltage stability. The sensor’s circuit consisted of a 1450 nm NIR light emitting diode, a photodiode as the receiver, transimpedance amplifier, a notch filter, and a 4th order low pass filter. The results indicated that sunlight passing through windows was the most influencing factor caused the unstable sensor output voltage. Filters removed the effective voltages and the average sensor output voltages from the three rooms were 4.6825 V for air media, 2.2809 V for water media and 2.3368 V for glucose solution media. The output voltages tended to increase for one-hour measurement about 10 to 40 mV for air media, 40 to 90 mV for water media and 30 to 80 mV for glucose solution media. This sensor could only be used in a short time and suitable in a room without sunlight. Based on the voltage difference of the average sensor output voltage with water and glucose solution media, the sensor had the potential to be a blood glucose level meter.

Acclimation Prior to an Intraperitoneal Insulin Tolerance Test to Mitigate Stress-Induced Hyperglycemia in Conscious Mice.

The insulin tolerance test is commonly used in metabolic studies to assess whole body insulin sensitivity in rodents. It is a relatively simple test that involves measurement of blood glucose levels over time following a single intraperitoneal injection of insulin. Given that it is performed in the conscious state and blood is often collected via a tail snip, it has the potential to elicit a stress response from animals due to anxiety associated with handling and blood collection. As such, a stress-induced rise in blood glucose can occur, making it difficult to detect and interpret the primary endpoint measure, namely an insulin-mediated reduction in blood glucose. This has been seen in many mouse strains, and is quite common in diabetic db/db mice, where glucose levels can increase, rather than decrease, after insulin administration. Here, we describe a method of acclimating mice to handling, injections and blood sampling prior to performing the insulin tolerance test. We find that this lowers stress-induced hyperglycemia and results in data that more accurately reflects whole body insulin sensitivity.

On-skin glucose-biosensing and on-demand insulin-zinc hexamers delivery using microneedles for syringe-free diabetes management

Patients who have diabetes must receive insulin administration two to three times every day via subcutaneous (SC) injection after measurement of blood glucose levels (BGLs) using lancet/blood-glucose meter with the side effects of pain and lipodystrophy. Achieving instrument-free glucose-biosensing and persistent glycaemic control in a painless and safe way is the ultimate goal of diabetes management. Here, we report the design of a microneedles (MNs) set comprising a glucose-biosensing microneedle patch (GBMP) and an insulin-delivery MP (IDMP). Once in the skin, the skin interstitial fluid (ISF) would diffuse into GBMP from epidermis to develop colour in abnormal glucose concentration which then quantified by smartphone. Subsequently, the IDMP composing of free insulin and biodegradable insulin-loaded glucose-responsive nanovesicles (IG-NVs) as an artificial on-skin pancreas, could be applied for hyperglycaemia-triggered insulin release to self-regulate BGLs and improve the health and quality of life for patients with type 1 and advanced type 2 diabetes. In chemically induced type 1 diabetic rats, the BGLs can be rapidly measured by GBMP and the BGLs can also be immediately reduced to and kept at normoglycaemic levels for up to 13 h by IDMP. The whole system permits the syringe-free diabetes management, avoiding both hyperglycaemia and hypoglycaemia.