Blood Glucose Monitoring Devices Research Articles

Python scikit-fuzzy: developing a fuzzy expert system for diabetes diagnosis

Nowadays, improvements in diabetes detection that provide patients with vital information are needed. This is due to the fact that Diabetes mellitus has generated a worldwide epidemic that costs society and people. Also, patients tend to misread symptoms, and clinicians who collect insufficient data may produce erroneous outcomes. Therefore, this study aims to demonstrate that a programme that integrates expert advice such as decisions, recommendations, or solutions is an excellent method for reducing the incidence of diabetes. Specifically, this study intends to implement a fuzzy expert system that can detect and report the early stages of diabetes as a viable approach. Furthermore, since this programme is available to everyone, people may easily self-diagnose themselves if they have a blood glucose monitoring device. However, developing the fuzzy expert system for real-world situations, such as diabetes patients, using any programming tools is not straightforward. Therefore, this study will provide a comprehensive approach to constructing a fuzzy expert system using the popular programming language Python.

Blood glucose monitoring devices for type 1 diabetes: a journey from the food and drug administration approval to market availability.

Blood glucose monitoring constitutes a pivotal element in the clinical management of Type 1 diabetes (T1D), a globally escalating metabolic disorder. Continuous glucose monitoring (CGM) devices have demonstrated efficacy in optimizing glycemic control, mitigating adverse health outcomes, and augmenting the overall quality of life for individuals afflicted with T1D. Recent progress in the field encompasses the refinement of electrochemical sensors, which enhances the effectiveness of blood glucose monitoring. This progress empowers patients to assume greater control over their health, alleviating the burdens associated with their condition, and contributing to the overall alleviation of the healthcare system. The introduction of novel medical devices, whether derived from existing prototypes or originating as innovative creations, necessitates adherence to a rigorous approval process regulated by the Food and Drug Administration (FDA). Diverse device classifications, stratified by their associated risks, dictate distinct approval pathways, each characterized by varying timelines. This review underscores recent advancements in blood glucose monitoring devices primarily based on electrochemical sensors and elucidates their regulatory journey towards FDA approval. The advent of innovative, non-invasive blood glucose monitoring devices holds promise for maintaining stringent glycemic control, thereby preventing T1D-associated comorbidities, and extending the life expectancy of affected individuals.

Global Warming and Endocrinology: The Hyderabad Declaration of the South Asian Federation of Endocrine Societies.

Global warming and endocrine disorders are intertwined issues posing significant challenges. Greenhouse gases emanating from human activities drive global warming, leading to temperature rise and altered weather patterns. South Asia has experienced a noticeable temperature surge over the past century. The sizable population residing in the region heightens the susceptibility to the impact of global warming. In addition to affecting agriculture, water resources, and livelihood, environmental changes interfere with endocrine functioning. Resulting lifestyle changes increase the risk of metabolic and endocrine disorders. Individuals with diabetes face heightened vulnerability to extreme weather due to impaired thermoregulation. A high ambient temperature predisposes to heat-related illnesses, infertility, and nephropathy. Additionally, essential endocrine drugs and medical devices are susceptible to temperature fluctuations. The South Asian Federation of Endocrine Societies (SAFES) calls for collaboration among stakeholders to combat climate change and promote healthy living. Comprehensive approaches, including the establishment of sustainable food systems, promotion of physical activity, and raising awareness about environmental impacts, are imperative. SAFES recommends strategies such as prioritizing plant-based diets, reducing meat consumption, optimizing medical device usage, and enhancing accessibility to endocrine care. Raising awareness and educating caregivers and people living with diabetes on necessary precautions during extreme weather conditions are paramount. The heat sensitivity of insulin, blood glucose monitoring devices, and insulin pumps necessitates proper storage and consideration of environmental conditions for optimal efficacy. The inter-connectedness of global warming and endocrine disorders underscores the necessity of international collaboration guided by national endocrine societies. SAFES urges all stakeholders to actively implement sustainable practices to improve endocrine health in the face of climate change.

Technology and health inequities in diabetes care: How do we widen access to underserved populations and utilize technology to improve outcomes for all?

Digital health technologies are being utilized increasingly in the modern management of diabetes. These include tools such as continuous glucose monitoring systems, connected blood glucose monitoring devices, hybrid closed-loop systems, smart insulin pens, telehealth, and smartphone applications (apps). Although many of these technologies have a solid evidence base, from the perspective of a person living with diabetes, there remain multiple barriers preventing their optimal use, creating a digital divide. In this article, we describe many of the origins of these barriers and offer recommendations on widening access to digital health technologies for underserved populations living with diabetes to improve their health outcomes.

Analysis of Non-Invasive Devices and Techniques Involved in Continuous Monitoring of Interstitial Glucose of Patients with Type 1 Diabetes

Abstract: There are 422 million diabetes patients worldwide according to 2023 census of WHO, and around 100 million cases in India. 8.4 million type 1 diabetes cases were recorded as of 2021. By 2040, it is projected that the number of people living with Type 1 Diabetes will reach 13.5–17.4 million. The surge in diabetes cases has created the critical need for regular glucose monitoring to effectively manage this prevalent health issue. Currently, glucose levels are predominantly measured invasively by pricking the finger for a blood sample and involves invasive methods, such as fingertip pricks, which can be uncomfortable and inconvenient, particularly for paediatric patients. This method utilizes blood glucose monitoring devices, which measure sugar levels in a small blood sample placed on a disposable test strip and have a certain degree of inaccuracy. Patients do not test as often as they should because of the pain and hassle of finger pricks and many do not achieve optimal glycaemic control. However, the shift toward non-invasive continuous glucose monitoring is becoming increasingly imperative and a promising alternative. With current biotechnological advances, many techniques offer a non-invasive, continuous means of monitoring glucose levels and have garnered significant attention in recent years. The objective is to consolidate and summarize recent advancements in non-invasive continuous glucose monitoring, emphasizing integration into wearable platforms for seamless and real-time monitoring. Furthermore, paediatric patients with Type 1 Diabetes face elevated risks of severe hypoglycaemic and hyperglycaemic events due to challenges in glycaemic control. Frequently, monitoring blood glucose is crucial to mitigate these risks and achieve optimal glycaemic management. The objective of ongoing research is to validate AI-based algorithms utilizing ECG signals collected through non-invasive devices to detect glycaemic events. These advancements, once commercially available, have the potential to revolutionize glucose monitoring, offering a convenient, efficient, and less intrusive approach, particularly benefiting paediatric patients and improving overall healthcare management. Despite substantial research and development, challenges persist, including standardizing sweat collection methods, addressing sample degradation, accounting for variations in sweat composition among individuals, optimizing diverse detection methods, improving glucose detection sensitivity, and ensuring overall commercial viability. Overcoming these challenges is paramount to bridge the gap between research and market availability, paving the way for a technological revolution in glucose monitoring. In this study, we compared potential non-invasive glucose monitoring devices and techniques to evaluate the most accurate, pain-free, fast, and cost-friendly device. Upon examination and survey, we have theorized the drawbacks persisting in the existing devices and hypothesized techniques. Looking forward this study has a broader application in not only understanding the limitations and creating more accurate devices but also in continuous glucose monitoring for diabetic patient care.

Blood glucose monitoring devices: current considerations.

Measuring blood glucose concentrations via capillary (fingerprick) blood glucose monitoring or continuous (interstitial) glucose monitoring is an important aspect of management for many people with diabetes. Blood glucose monitoring informs patient self-management strategies, which can improve the patient's engagement in their own care and reduce barriers to achieving recommended blood glucose targets. Blood glucose monitoring also informs clinician-guided management plans. Compared to capillary blood glucose monitoring, continuous glucose monitoring in people using insulin significantly improves glycaemic metrics and is associated with improved patient-reported outcomes. Even with good glycaemic metrics, patients using continuous glucose monitoring should still have access to capillary blood glucose monitoring for correlation of hypoglycaemic readings when accuracy may be compromised or if there is a malfunction with the continuous blood glucose monitor.

A Triple-Band Broadband Miniature Antenna Design for Implantable Continuous Glucose Monitoring

This paper presents a miniaturized triband implantable planar antenna that covers the industrial, scientific, and medical (ISM) band and the Wireless Medical Telemetry Service (WMTS) band which can be used in a continuous blood glucose monitoring device. The antenna consists of a slotted radiating patch and a ground plane with a cross slot to miniaturize its size. The overall antenna size is only 51.35 mm3 (7.6 × 7.6 × 0.889 mm3) due to the reduced size by the slotting technique. Compared to other implantable antennas with similar performance, the proposed antenna is smaller in size, simple in construction, and easy to be fabricated. By cutting a cross slot in GND, impedance matching is improved, especially at the two higher frequency bands. We have fabricated the prototype and carried out measurements. The results show its gains are −32.2 dBi, −18.8 dBi, and −19.1 dBi at 0.9 GHz, 1.4 GHz, and 2.45 GHz, respectively. Its radiation patterns have good symmetry in the two lower operating frequency bands. In addition, the maximum SAR values comply with the IEEE standard safety guidelines (IEEE C95.1-2019).

Hypoglycemia avoidance behaviour in active Qatari adults with type 1 diabetes under blood glucose monitoring device

AimsThe present study aimed to explore the relationship between fear of hypoglycemia and exercise management strategies in active Qatari adults with T1D during the COVID-19 pandemic, and to explore the potential role of continuous glucose monitoring (CGM) devices in promoting safe physical activity practices. MethodsParticipants completed the Hypoglycemia Fear Survey (HFS) questionnaire and the International Physical Activity Questionnaire (IPAQ). Out of the 102 participants, 41 were considered "active" and under CGM and were included in the analysis. ResultsMultiple linear regression analysis revealed a significant positive correlation between the behavior dimension of the HFS scores and both vigorous physical activity and MET-minutes per week (R2 adj. = 0.055; β = 0.56; p = 0.05 and R2 adj. = 0.039; β = 0.38; p = 0.04). The results showed a significant positive association between HbA1c levels and the behavior dimension of the HFS (R = 0.39, p = 0.005), as well as between the number of episodes of severe hypoglycemia and the behavior dimension (R = 0.46, p = 0.042). ConclusionThese findings highlight the need for effective strategies to manage fear of hypoglycemia and promote physical activity in individuals with T1D. The use of CGM devices may provide added safety to physical activity practices by reducing the risk of hypoglycemia.

An Implementation of blood Glucose and cholesterol monitoring device using non-invasive technique

Invasive testing of glucose and cholesterol levels in the blood is the most prevalent procedure, which is uncomfortable, expensive, and risky since it can spread infections and harm skin cells. Diabetes and cholesterol are two of the most common diseases in the world, and they require constant monitoring to avoid health issues and organ damage. As a result, a non-invasive approach will allow for more regular testing and painless monitoring. The blood glucose and cholesterol levels can be assessed using the principle of reflecting and refractive properties of NIR light source against blood components. The MAX30100 sensor circuit gives SPO2 (Saturated Peripheral Oxygen Level) and BPM (beats per minute, or heart rate) information to the regression model, which is used to forecast blood glucose and cholesterol levels. The polynomial regression model is trained using preset datasets, and the trained model yields regression co-efficient values. For the fresh sample inputs from the sensor, the co-efficient values are used to estimate the new needed parameter value. The projected blood glucose and cholesterol levels are displayed on the LCD Display and delivered through Bluetooth HC-05 module via Serial communication to the mobile application.

Accuracy of Point-of-Care Blood Glucometers in Neonates and Critically Ill Adults

Inpatient glycemic management has become a common issue because of the increasing number of hospitalized patients with hyperglycemia. Point-of-care devices can enable timely inpatient glucose monitoring, which may lead to better outcomes. The accuracy of point-of-care testing in various clinical scenarios has been questioned, particularly in neonates and critically ill patients. This study aimed to evaluate the accuracy of the CONTOUR PLUS and CONTOUR PLUS ONE glucometers (new wireless systems that link to a smart mobile device) when used as point-of-care devices for blood glucose monitoring in neonates and critically ill adults in inpatient settings. This cross-sectional study was conducted at a medical center in central Taiwan and enrolled patients admitted to the neonatal intensive care unit, sick child room, or respiratory intensive care unit between November 2020 and April 2021. Neonates with suspected infection or abnormal blood coagulation and adults who had abnormal blood coagulation, were pregnant, had received organ transplants, or had undergone massive blood transfusions were excluded. The accuracy of the glucometers was determined based on the following criteria of the International Organization for Standardization (ISO) standard: 15197:2013. Overall, 114 neonates (mean age, 4.2 days [range, 0-28 days]; 65 boys [57.0%]) and 106 hospitalized critically ill adults (mean age, 68.2 years [range, 27-94 years]; 72 men [67.9%]) were enrolled in this study. The glucose values obtained with each glucometer had good precision, and all findings met the reference criteria of the within-lot results. All measurements of the neonates' venous blood by each glucometer met the accuracy criteria specified by ISO standard 15197:2013. Furthermore, 98.1% and 97.2% of the arterial blood glucose measurements for critically ill adults obtained with CONTOUR PLUS and CONTOUR PLUS ONE met the accuracy criteria, respectively. Both glucose management systems met the accuracy criteria for venous blood from neonates and arterial blood from critically ill adults. Thus, the use of these 2 point-of-care devices in inpatient settings, including for neonates and critically ill adults, can be recommended to minimize limitations associated with the clinical application of point-of-care testing in glucose management. The wireless connection may play a role in the subsequent development of institution-wide virtual glycemic management under the supervision of a team of endocrinologists.

Glucose diagnosis system combining machine learning and NIR photoacoustic multispectral using a low power CW laser.

Non-invasive, portable, economical, dynamic blood glucose monitoring device has become a functional requirement for diabetes in his regulating entire life. In a photoacoustic (PA) multispectral near-infrared diagnosis system, the glucose in aqueous solutions was excited by low power (order of milliwatts) CW laser whose wavelengths were from 1500 to 1630 nm. The glucose in aqueous solutions to be analyzed was contained within the photoacoustic cell (PAC). The PA multispectral signals were measured using a piezoelectric detector, and then the voltage signals from the piezoelectric detector were amplified with a precision Lock-in Amplifier (MFLI500K). The continuously tunable lasers were used to verify the various influencing factors of the PA signal, and the PA spectrum of the glucose solution was examined. Subsequently, six wavelengths with high power were selected at approximately equal intervals from 1500 to 1630 nm, and the gaussian process regression of the quadratic rational kernel was used to collect data through these wavelengths to predict the glucose concentration. The experimental results showed that the near-infrared PA multispectral diagnosis system could be engineered for the prediction of the glucose level (more than 92%, zone A of Clarke Error Grid). Subsequently, the model trained with glucose solution was used to predict serum glucose. With the increase of serum glucose content, the prediction results of the model also showed a high linear relationship, indicating that the photoacoustic method was sensitive to the detection of glucose concentration changes. The results of our study have the potential to not only better develop the PA blood glucose meter but also extend the viability into the detection of otherwise blood components.

Non-invasive method for blood glucose monitoring using ECG signal

Abstract Introduction: Tight glucose monitoring is crucial for diabetic patients by using a Continuous Glucose Monitor (CGM). The existing CGMs measure the Blood Glucose Concentration (BGC) from the interstitial fluid. These technologies are quite expensive, and most of them are invasive. Previous studies have demonstrated that hypoglycemia and hyperglycemia episodes affect the electrophysiology of the heart. However, they did not determine a cohort relationship between BGC and ECG parameters. Material and method: In this work, we propose a new method for determining the BGC using surface ECG signals. Recurrent Convolutional Neural Networks (RCNN) were applied to segment the ECG signals. Then, the extracted features were employed to determine the BGC using two mathematical equations. This method has been tested on 04 patients over multiple days from the D1namo dataset, using surface ECG signals instead of intracardiac signal. Results: We were able to segment the ECG signals with an accuracy of 94% using the RCNN algorithm. According to the results, the proposed method was able to estimate the BGC with a Mean Absolute Error (MAE) of 0.0539, and a Mean Squared Error (MSE) of 0.1604. In addition, the linear relationship between BGC and ECG features has been confirmed in this paper. Conclusion: In this paper, we propose the potential use of ECG features to determine the BGC. Additionally, we confirmed the linear relationship between BGC and ECG features. That fact will open new perspectives for further research, namely physiological models. Furthermore, the findings point to the possible application of ECG wearable devices for non-invasive continuous blood glucose monitoring via machine learning.

Update information on type 1 diabetes in children/adolescents and adults.

Update information on type 1 diabetes in children/adolescents and adults.

The Impact of the Affordable Care Act Medicaid Expansion on Acute Diabetes Complications Among Community Health Center Patients.

This study evaluates whether patients residing in expansion states have a greater increase in outpatient diagnoses of acute diabetes complications than those living in non-expansion states following the implementation of the Affordable Care Act (ACA). This retrospective cohort study uses electronic health records (EHR) from 10,665 non-pregnant patients, aged 19 to 64 years old who were diagnosed with diabetes in 2012 or 2013 from 347 community health centers (CHCs) across 16 states (11 expansion and 5 non-expansion states). Patients included had ≥1 outpatient ambulatory visit in each of these periods: pre-ACA: 2012 to 2013, post-ACA: 2014 to 2016, and post-ACA: 2017 to 2019. Acute diabetes-related complications were identified using International Classification Diseases (ICD-9-CM and ICD-10-CM) codes classification and could occur on or after diagnosis of diabetes. We performed difference-in-differences (DID) analysis using a generalized estimating equation to compare the change in rates of acute diabetes complications by year and by Medicaid expansion status. There was a greater increase after year 2015 in visits related to abnormal blood glucose among patient living in Medicaid expansion states than in non-expansion states (2017 DID = 0.041, 95% CI = 0.027-0.056). Although both visits due to any acute diabetes complications and infection-related diabetes complications were higher among patients living in Medicaid expansion states, there was no difference in the trend overtime between expansion and non-expansion states. We found a significantly greater rate of visits for abnormal blood glucose in patients receiving care in expansion states relative to patients in CHCs in non-expansion states starting in 2015. Additional resources for these clinics, such as the ability to provide blood glucose monitoring devices or mailed/delivered medications, could substantially benefit patients with diabetes.

A Critical Review on Current Devloping Non-Invasive Glucose Monitoring Technologies and Devices

Diabetes mellitus both type I and type II, is a dangerous and lifelong disorder marked by unusually high blood glucose levels caused by a failure of insulin synthesis or a loss in insulin sensitivity and function. Diabetes have become more common over time, and it is now considered one of the primary causes of high death and morbidity rates. Complications from diabetes can be avoided by regularly monitoring and keeping blood glucose levels within the normal range. Despite the fact that practically all commercially effective blood glucose monitoring devices are invasive, there is an urgent need to create non-invasive glucose monitoring (NGM) devices that would relieve diabetics' pain and suffering associated with repeated skin pricking for glucose testing. It also discusses the most common non-invasive glucose monitoring technologies as well as the most relevant devices. The technology name, the underlying physical principle, and the technological limitation in the human body. There are eleven technologies and five devices in all. Despite numerous fascinating and promising ideas and devices, the review concluded that a suitable solution to the non-invasive glucose monitoring problem still required more work.

Placement Optimization of Infrared Sensors as Non-Invasive Blood Sugar Measurements

In the light of the increasing prevalence of diabetes, research on non-invasive blood sugar measuring devices have begun to be developed, one of which utilizes infrared spectroscopy methods. This method uses a pair of IR LED and photodiode placed in line. In doing so, the location of its placement in the human body has to be considered, thereby enabling the photodiode to capture the light emitted by the IR LED. Therefore, the voltage data generated by the photodiode circuit in several parts of the body is taken as the representation of the ability of the photodiode to absorb infrared light. A higher voltage value is captured in the range of 1 Volt when the sensor is on the finger. Meanwhile, there is no voltage read on the wrist. The results of this study will be used as a reference to determine the location of the sensor placement in the designed blood glucose monitoring device.

The socio-economic burden of expenditure for diabetes mellitus treatment: A cross sectional study

Background: Diabetes mellitus is a chronic disorder, non-curable, only controlled by medicines and /or insulin therapy. The aim of this study was to evaluate the expenditure on diagnoses and treatment of diabetes mellitus patients with economic burden to households. Methodology: We collected data by directly interacting with the pre-informed diabatic patients regarding the duration of diabetes, types of insulin therapy and oral hypoglycemic agent, cost of medicine/month and cost of blood sugar test by glucometer/month. Results: A total of 254 patients were enrolled in the study of which 30.71% (n=78) belongs to upper cost family (UCF), 44.88% (n=114) belongs to middle cost family (MCF), and 24.41% (n=62) belongs to lower cost family (LCF), categorized according to their total score. While studying, it was found that the mean family income (rupees)/month of UCF, MCF and LCF are Rs. 33860.26, Rs. 9326.75 and Rs. 7551.79 respectively. The mean blood sugar test cost (rupees)/month for UCF, MCF and LCF are Rs. 377.44, Rs. 382.89 and Rs. 360.00 respectively. Whereas the mean medicine purchase cost (rupees)/month for UCF, MCF and LCF are Rs. 1004.81, Rs. 784.40 and Rs. 721.79 Respectively. The total cost (rupees)/month for sugar test and purchasing medicine that is taken from their family income are Rs. 1382.24, Rs. 1167.30 and Rs. 1081.79 for UCF, MCF and LCF respectively. We also derived that, the UCF, MCF, LCF spent 1.19%, 2.28%, 4.84% of their monthly income on blood sugar test respectively and spent 3.20%, 4.76%, 9.95% of their monthly income on medicine purchase respectively. The percentage of cost, the UCF, MCF, and LCF has spent on both the blood sugar test and medicine purchase is 4.39%, 7.04%, 14.80% respectively. Conclusion: The urgent need should be arisen for better health care policies for making low or no cost blood glucose monitoring device (alternative to glucometer) with low-cost anti-diabetic medicines by Government, for diabetes management.

Clinical and economic benefits of continuous blood glucose monitoring devices

The main intervention to reduce the macro-and microvascular complications of diabetes mellitus (DM) remains to achieve better long-term glycemic control. We have discussed the clinical and economic advantages of using continuous glucose monitoring (CGM) devices for type 1 DM and type 2 DM (T1DM and T2DM) based on data from relevant studies in the literature. Our findings show that using these modalities is associated with remarkable outcomes, including reduced HbA1c levels and enhanced glycemic control among patients with T1DM and T2DM. This can enhance the quality of care and life for diabetic patients and intervene against the development of serious complications and hypoglycemia-related adverse events. The cost of routinely using these devices might seem relatively high. However, the estimated cost benefits are usually higher as they can significantly reduce hospitalization rates due to hypoglycemia and the frequency of diabetic therapy malpractices, which are frequently encountered. However, not many studies have reported these outcomes, indicating the need to conduct future relevant studies.

On the use of fiber lasers in non-invasive blood glucose monitoring

Diabetes is a chronic metabolic disorder, which may lead to a series of serious complications and endanger human life in severe cases. Regular monitoring of blood sugar levels can help patients prevent diabetes complications. In this review, firstly, the causes and classification of diabetes, the background knowledge of non-invasive blood glucose monitoring, the classification of blood glucose monitoring methods, the basic theory of optical methods, and the process of non-invasive blood glucose monitoring are described. Then, the basic structure of the fiber laser, and the significant characteristics of the output light pulse are introduced. Most importantly, five optical methods that the fiber laser can be applied to non-invasive blood glucose monitoring are described in detail. Finally, this review describes the process of electrical signal processing in the non-invasive blood glucose monitoring device, some important algorithms, and the means of device performance evaluation.

Adherence of Insulin Therapy in Diabetic Mellitus Patients in a Tertiary Care Hospital

Aim and Objective: The aim of this study is to evaluate the adherence of Insulin therapy in Diabetic mellitus patients and to identify the factors leading to poor adherence of Insulin therapy among diabetic patients in a tertiary care hospital.
 Methodology: A prospective study was carried out in the department of medicine in Saveetha medical college from January to June 2021.
 50 diabetic patients were included in the study and their adherence to Insulin therapy was monitored and the patients with low adherence were assessed for the cause so that appropriate interventions can be taken to improve its adherence.
 Results: The study enrolled about 50 patients out of which 23 of them had low Insulin adherence. The main reasons for low adherence were expense of Insulin(40%),lack of knowledge of administration(36%), and others factors include family problems, having faith over alternative medicines and fear of side effects.
 Conclusion: Given the great prevalence of primary non-adherence and the variety of reasons for it, it is evident that these treatment barriers must be removed. Dedicated diabetes instructors at each diabetes clinic, as well as the availability of low-cost insulin and blood glucose monitoring devices for the disadvantaged, are essential to achieving this goal.