Blood Glucose Monitoring Methods Research Articles

Impaired Awareness of Hypoglycemia and its Risk Factors among Diabetic Patients in Jazan, Saudi Arabia: A Cross-Sectional Study.

Impaired awareness of hypoglycemia (IAH) is related to a three- to sixfold increase in the risk of severe hypoglycemia in adults with type 1 diabetes mellitus (T1D). This study aimed to assess the prevalence of IAH and its risk factors and determine the frequency of hypoglycemic symptoms. This study aimed to assess the prevalence of IAH and its risk factors and determine the frequency of hypoglycemic symptoms. A cross-sectional study was conducted among T1D patients attending Jazan Endocrine and Diabetes Center in Jazan province, Saudi Arabia. A total of 151 patients participated, using the interview-based Clarke questionnaire, a validated eight-item questionnaire to evaluate IAH. Scoring four or more answers as reduced awareness categorizes the participant as having IAH. The prevalence of IAH was 25.2% among the T1D patients. IAH was significantly associated with body mass index (BMI; p = 0.034), occupation (p = 0.014), and blood glucose monitoring methods (p = 0.027). Shaking and sweating were the most commonly reported symptoms of hypoglycemia. A BMI of <25 kg/m2 was higher linked to hunger and speech difficulty compared to a BMI of ≥25 kg/m2 (p < 0.05). Changing the insulin injection site was associated with confusion, odd behavior, and speech difficulty (p < 0.05). Monitoring blood glucose four times daily was associated with sweating, odd behavior, and incoordination (p = 0.024) compared to monitoring less than four times daily (p < 0.05). A hemoglobin A1c (HbA1c) reading of ≥7 was linked to odd behavior compared to an HbA1c reading of <7 (p = 0.032). Patients committed to insulin injections were more likely to experience palpitations than non-committed patients (p = 0.038). Each one-unit increase in age, monitoring blood glucose, and income was associated with a decrease in the odds of IAH (OR of Age = 0.89, 95% CI: 0.83-0.95) (OR of income = 0.10, 95% CI: 0.01-0.55). Moreover, individuals with a Body Mass Index (BMI) greater than or equal to 25 (OR = 2.99, 95% CI: 1.13-8.25), employed individuals (OR = 18.2, 95% CI: 3.75-105), and diabetes duration of more than ten years (OR = 3.96, 95% CI: 1.31- 13.2) exhibited an increase in the higher risk of IAH. IAH was prevalent among T1D patients attending Jazan Endocrine and Diabetes Center. The main associated factors included BMI, blood glucose monitoring method, and occupation. Future research should investigate the underlying causes of the observed associations and explore strategies to enhance the awareness of hypoglycemia.

The Self-Powered Thermoelectric System Driving an Electric Field for Raman-Spectrum Glucose Quantitative Analysis

For a long time, blood glucose monitoring has been a challenging issue in the field of medicine. Although it is possible to visit a hospital for regular blood tests to track blood sugar concentration, the physiological reactions triggered by blood collection might lead to feeling weak, dizzy, or even vomiting. Therefore, especially for diabetic patients, they need to frequently monitor their blood sugar concentration in their daily lives to ensure their health. Currently, the primary methods for blood glucose testing still rely on invasive techniques, such as using fingertip glucose meters and other methods which require skin puncture to obtain blood samples. Although these methods provide a quick assessment of current blood glucose concentration, they come with the pain and discomfort of blood collection process and the potential risk of infection. As a result, in recent years, many researchers have been dedicated to developing non-invasive blood glucose monitoring methods. However, accurately measuring glucose concentration inside the human body remains a challenging task. One of the primary issues is the presence of strong noise and background noise. To avoid this challenge, we have developed an innovative detection platform that is combines surface-enhanced Raman spectroscopy (SERS) and external electric field sensing technology. With the electromagnetic effect, we add external electric field in our platform to excite more the surface plasmon resonance. By using this method, we can achieve signal amplification to detect lower concentrations of glucose. Now, we can detect down to 0.001mM of glucose. We also exhibit self-powered electric field system, using the flexible themoelctric device to combine our platform. By the property of self-powered, we success to create a self-powered electric field system. We focus on driving themoelectric through the temperature different between body temperature and environment. The approach is aimed at generating power from the human body, providing a self-powered thermoelectric system for Raman-spectrum glucose sensors. This innovative approach holds promise for advancing non-invasive blood glucose monitoring and benefiting a larger population of diabetes patients in the future.

Review of Noninvasive Continuous Glucose Monitoring in Diabetics.

For diabetics, taking regular blood glucose measurements is crucial. However, traditional blood glucose monitoring methods are invasive and unfriendly to diabetics. Recent studies have proposed a biofluid-based glucose sensing technique that creatively combines wearable devices with noninvasive glucose monitoring technology to enhance diabetes management. This is a revolutionary advance in the diagnosis and management of diabetes, reflects the thoughtful modernization of medicine, and promotes the development of digital medicine. This paper reviews the research progress of noninvasive continuous blood glucose monitoring (CGM), with a focus on the biological liquids that replace blood in monitoring systems, the technical principles of continuous noninvasive glucose detection, and the output and calibration of sensor signals. In addition, the existing limits of noninvasive CGM systems and prospects for the future are discussed. This work serves as a resource for further promoting the development of noninvasive CGM systems.

Новые возможности наблюдения и ведения пациентов с сахарным диабетом

Diabetes mellitus is one of the most world’s common disease. Global digitalization reveals new opportunities in diabetes mellitus patient man-agement. Various applications and devices are currently available to improve patient’s glucose levels. Apart from continuous glucose monitoring devices traditional methods of blood glucose monitoring are widely used. The development of special applications and options for glucometers to connect with mobile devices essentially improved data analysis and allowed to improve treatment efficacy.

#3584 COMPLIANCE OF DIABETIC MONITORING IN PATIENTS WITH END-STAGE RENAL DISEASE ON MAINTENANCE HAEMODIALYSIS

Abstract Background and Aims Diabetic nephropathy is a major cause of end-stage kidney disease (ESKD) in the UK, accounting for nearly 30% of patients requiring dialysis and in some units over 40% of the people on dialysis have diabetes. The national reviewing and benchmarking committee (GIRFT NHS) had highlighted the disjointed and variable care received by these patients, with increasing risk of complications including blindness, foot ulcers and amputations from suboptimal care. Increased monitoring is shown to be cost-effective and co-ordination of a multi-disciplinary team focus can reduce complications especially lower limb amputation rates. Hence, we aimed to review the quality of care on our setting and compare it to national recommendations. Method We performed a cross-sectional review on patients with diabetes on haemodialysis in the satellite unit at a district general hospital to assess compliance with the Joint British Diabetes Societies (JBDS) and the UK Kidney Association (UKKA) recommendations on management of adults with diabetes. Subsequently we introduced monitoring protocols for the relevant key areas of diabetes monitoring (pre and post-dialysis glucose checks, HbA1c checks, check boxes for once weekly feet inspections, criteria for inpatient podiatry review), highlighted potential complications including hypoglycaemia, re-emphasised the importance of adequate documentation to allied healthcare teams, and updated the haemodialysis monitoring sheets. We worked with the unit manager to highlight the rationale for monitoring and provided brief education on complications to the team, and over repeated visits, gained the confidence and support of staff for the changes suggested despite an increased workload. Results We reviewed data from January to April 2021 followed by re-evaluation 12 months later after implementation of changes. Data for 25 patients were reviewed and re-assessed after a year. 7 patients passed away during this period. Initial review recognised the lack of awareness of good practice management of diabetic patients in the haemodialysis unit. Most patients have type 2 diabetes which carries a higher risk of ESKD. After a year of change in protocols there were significant improvements in monitoring parameters, with greatest improvements seen in glucose monitoring and routine feet inspections. Conclusion The review was based on care standards that included diabetes parameters as part of the recommended national care processes, and individualised treatment approach. The aims included were performing annual reviews, adequate glucose monitoring and rational glycaemic targets, and earlier targeted involvement of the diabetes specialist team. There was improvement in most of the monitoring parameters and clearer documentations from allied healthcare teams. Implementation of recommendations was initially challenging due to the COVID-19 pandemic and staff workload on the unit however with persistence we were able to obtain co-operation from the team. As expected, patients on insulin/sulphonylureas (SUs) had proper blood glucose monitoring methods. Most were on insulin, and the remaining were on SU and DPP-IV inhibitor, and those with HbA1c &amp;lt;58 mmol/mol declined. One-third of these patients used flash glucose monitoring and with increasing recognition and recommendation by the NHS hopefully more patients will benefit from this. This audit showed that simple interventions such as staff engagement and education can improve care and monitoring of patients in this population. With recovery of service provisions, more interventions can be put in place. Following this, we can reaudit amputation rates and gather patient feedback, plan interventions with the community team, and encourage involvement from general practitioners and their trainees to deliver better care to these patients. Hence, we emphasise the importance of clear protocols for the management and monitoring of each patient with diabetes mellitus in haemodialysis units to ensure care standards are met.

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.

A Concise and Systematic Review on Non-Invasive Glucose Monitoring for Potential Diabetes Management.

The current standard of diabetes management depends upon the invasive blood pricking techniques. In recent times, the availability of minimally invasive continuous glucose monitoring devices have made some improvements in the life of diabetic patients however it has its own limitations which include painful insertion, excessive cost, discomfort and an active risk due to the presence of a foreign body under the skin. Due to all these factors, the non-invasive glucose monitoring has remain a subject of research for the last two decades and multiple techniques of non-invasive glucose monitoring have been proposed. These proposed techniques have the potential to be evolved into a wearable device for non-invasive diabetes management. This paper reviews research advances and major challenges of such techniques or methods in recent years and broadly classifies them into four types based on their detection principles. These four methods are: optical spectroscopy, photoacoustic spectroscopy, electromagnetic sensing and nanomaterial based sensing. The paper primarily focuses on the evolution of non-invasive technology from bench-top equipment to smart wearable devices for personalized non-invasive continuous glucose monitoring in these four methods. With the rapid evolve of wearable technology, all these four methods of non-invasive blood glucose monitoring independently or in combination of two or more have the potential to become a reality in the near future for efficient, affordable, accurate and pain-free diabetes management.

Comparison of the Efficacy of Different Insulin Administration and Blood Glucose Monitoring Methods in the Treatment of Type 1 Diabetes Mellitus in Children.

Objective To compare the clinical efficacy of different insulin administration methods and blood glucose monitoring methods in treating type 1 diabetes mellitus in children. Methods Patients were divided into four groups: multiple daily injection (MDI) + fingertip blood glucose detection, continuous subcutaneous insulin infusion (CSII) + fingertip blood glucose detection, MDI + continuous glucose monitoring system (CGMS), and CSII + CGMS. After six months of treatment, followed by telephone and at least once a month in an outpatient clinic, insulin doses were adjusted according to the children's blood glucose levels. Blood glucose control and the daily dose of insulin were compared among the four groups after treatment, and the incidence of hypoglycemia in each group was recorded during the treatment. We also compare the incidence of the adverse event among the four groups. Results 6 months later, the levels of HbA1c, FBG, and two h PG in each group were lower than those before treatment. There were significant differences in HbA1c, two h PG, and the daily insulin dose among the four groups. There were differences in the frequency of hypoglycemia among all the groups. The frequency of hypoglycemia in groups C and D was lower than in group A. Conclusions CSII was better than MDI, and the blood glucose monitoring effect of CGMS was better than the fingertip blood glucose detection. The patients treated with CSII combined with CGMS had the best clinical efficacy. The patients treated with CSII combined with CGMS had the lowest adverse events incidence.

Monitoring Devices for glucose in critical patients during the COVID-19 pandemic

Background: Hyperglycemia is common in Intensive Care Unit (ICU) and was reported with high mortality and adverse patients’ outcomes. The infection of COVID-19 is identified as a main source of increase in the incidence of hyperglycemia and associated elevated mortality. In order to reduce the healthcare providers exposure and the personal protective equipment use during the pandemic, the US Food and Drug Administration (FDA) regulated the usage of continuous glucose monitoring (CGM) devices to address these concerns as well as control the glucose level at a desired range. What are the benefits of using CGM applications? The article updates knowledge on this topic. Methods：We did our search on the following databases: MEDLINE, EMBASE and Cochrane database, articles included were all recent and between January 2020 to July 2022. Our main focus was on articles with evidence concerning the effectiveness and the accuracy of continuous blood glucose monitoring methods in ICU during the COVID-19 pandemic. Results: A few recent articles were identified and scrutinized. These allow the article to present an overview of the most recent international evidence on the topic, ts benefits and a comparison between methods and devices. Main Contribution to Evidence-Based Practice: The article puts together the most recent evidence on the demonstrated benefits of continuous glucose monitoring and identifies the few glucose Monitoring Devices about which there is recent published scientific evidence on its application to critical care.

Non-invasive methods of home blood glucose monitoring

Diabetes is a worldwide health problem, a metabolic disorder that can lead to serious complications and damage to all vital organs. The resulting complications can be prevented with regular monitoring and maintenance of blood glucose level. The present review study aims to gather information on current methods for monitoring capillary blood glucose. Scientific articles were consulted in national and international journals, in addition to the Guidelines of the Brazilian Society of Diabetes and 9th Edition of the Diabetes Atlas of the International Diabetes Federation, American Diabetes Association, Ministry of Health and Brazilian Institute of Geography and Statistics (IBGE) data. Non-invasive methods include impedance spectroscopy, optical coherence tomography, photoacoustic spectroscopy, mid and near infrared spectroscopy, photoplethysmography. The advantages, in general, of non-invasive methods, seek ease of implementation and use, cost, accuracy in blood glucose measurement. The main disadvantages are physical parameters that can interfere with glucose measurement, as well as environmental variations. Interferences due to physiological factors can be eliminated using filtering processes, which suppress noise and increase effective information. With the present study, it is possible to conclude that there is a need to develop a non-invasive, painless, easily accessible method, without tissue damage, providing cost savings for the health system, considering quality of life, functional limitations, social and financial stress, emotional discomfort and depression in individuals with diabetes mellitus.

Non-invasively accuracy enhanced blood glucose sensor using shallow dense neural networks with NIR monitoring and medical features

Non-invasive and accurate method for continuous blood glucose monitoring, the self-testing of blood glucose is in quest for better diagnosis, control and the management of diabetes mellitus (DM). Therefore, this study reports a multiple photonic band near-infrared (mbNIR) sensor augmented with personalized medical features (PMF) in Shallow Dense Neural Networks (SDNN) for the precise, inexpensive and pain free blood glucose determination. Datasets collected from 401 blood samples were randomized and trained with ten-fold validation. Additionally, a cohort of 234 individuals not included in the model training set were investigated to evaluate the performance of the model. The model achieved the accuracy of 97.8% along with 96.0% precision, 94.8% sensitivity and 98.7% specificity for DM classification based on a diagnosis threshold of 126 mg/dL for diabetes in fasting blood glucose. For non-invasive real-time blood glucose monitoring, the model exhibited ± 15% error with 95% confidence interval and the detection limit of 60–400 mg/dL, as validated with the standard hexokinase enzymatic method for glucose estimation. In conclusion, this proposed mbNIR based SDNN model with PMF is highly accurate and computationally cheaper compared to similar previous works using complex neural network. Some groups proposed using complicated mixed types of sensors to improve noninvasive glucose prediction accuracy; however, the accuracy gain over the complexity and costs of the systems harvested is still in questioned (Geng et al. in Sci Rep 7:12650, 2017). None of previous works report on accuracy enhancement of NIR/NN using PMF. Therefore, the proposed SDNN over PMF/mbNIR is an extremely promising candidate for the non-invasive real-time blood glucose monitoring with less complexity and pain-free.

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.

Continuous Blood Glucose Monitoring Increases Vigorous Physical Activity Levels and Is Associated With Reduced Hypoglycemia Avoidance Behavior In Youth With Type 1 Diabetes.

The primary goal of this study was to explore physical activity (PA) levels, hypoglycemia fear scores and hypoglycemia episodes according to insulin administration and blood glucose monitoring methods in youth with type 1 diabetes (T1D). A self-administered questionnaire was completed by 28 children and 33 adolescents with T1D, and their PA was assessed. Hypoglycemia episodes, fear of hypoglycemia scores, insulin therapy (pump vs. injection) and blood glucose monitoring (continuous blood glucose monitors [CGMs] vs. blood glucose meters) methods are reported in the present work. There were no significant differences in the number of hypoglycemic episodes, child hypoglycemia fear survey behavior or total scores, or any components of the PA profile between youth using injections and those using a pump. However, these variables differed significantly when compared according to blood glucose monitoring method (CGMs vs. blood glucose meters): 41.2 vs. 81.8, p<0.01; 1.03 ± 0.05 vs. 2.6 ± 0.63, p<0.01; 1.09 ± 0.43 vs. 2.94 ± 0.22, p<0.01; and 222 ± 18 vs. 49 ± 11, p<0.01 (for total time in vigorous PA in minutes per week), respectively. CGM use correlated significantly with VPA levels (β=0.6; p=0.04). Higher VPA levels were associated with higher child hypoglycemia fear survey behavior scores (β=0.52; p=0.04). The latter correlates negatively with the number of episodes of hypoglycemia in the past 12 months in all category groups. The type of insulin injection was not associated with more activity in youth with T1D. In contrast, CGM use may be associated with increased vigorous PA among T1D youth. Those with higher hypoglycemia fear survey behavior scores engaged in more VPA and had fewer hypoglycemia episodes. Although CGM use ensures continuous monitoring of glycemia during exercise, increasing hypoglycemia avoidance behavior is still a necessary part of exercise management strategies in active youth with T1D.

A Multicenter Evaluation of a Point-of-Care Blood Glucose Meter System in Critically Ill Patients.

Our purpose was to evaluate the performance of the ACCU-CHEK® Inform II blood glucose monitoring system (Roche Diagnostics GmbH) compared with the perchloric acid hexokinase (PCA-HK) comparator method on the cobas® 6000 analyzer (Roche Diagnostics International Ltd) in critically ill patients. Overall, 476 arterial (376 pediatric/adult, 100 neonate), 375 venous, and 100 neonatal heel-stick whole-blood samples were collected and evaluated from critical care settings at 10 US hospitals, including the emergency department, medical and surgical intensive care units (ICUs), and neonatal and pediatric ICUs. The ACCU-CHEK Inform II system was evaluated at 2 cutoff boundaries: boundary 1 was ≥95% of results within ±12 mg/dL of the reference (samples with blood glucose <75 mg/dL) or ±12% of the reference (glucose ≥75 mg/dL), and boundary 2 was ≥98% of results within ±15 mg/dL or ±15% of the reference. Clinical performance was assessed by evaluating sample data using Parkes error grid, Monte Carlo simulation, and sensitivity and specificity analyses to estimate clinical accuracy and implications for insulin dosing when using the ACCU-CHEK Inform II system. Proportions of results within evaluation boundaries 1 and 2, respectively, were 96% and 98% for venous samples, 94% and 97% for pediatric and adult arterial samples, 84% and 98% for neonatal arterial samples, and 96% and 100% for neonatal heel-stick samples. Clinical evaluation demonstrated high specificity and sensitivity, with low risk of potential insulin-dosing errors. The ACCU-CHEK Inform II system demonstrated clinically acceptable performance against the PCA-HK reference method for blood glucose monitoring in a diverse population of critically ill patients in US care settings.

Understanding the Profiles of Blood Glucose Monitoring Among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Shandong, China.

BackgroundBlood glucose monitoring is essential in diabetic care and management. Monitoring using glucometers in home and in laboratories by professionals in certain health institutes were the common methods of blood glucose monitoring in clinical practice. This study aimed to characterize the profiles of blood glucose monitoring in the view of the discrepancy in methods and frequency conducted by the patients with type 2 diabetes mellitus (T2DM) in China, and to explore factors influencing the profiles.MethodsA cross-sectional, community-based study was conducted in Shandong province, China, with a multi-stage stratified sampling. A total of 2166 T2DM patients completed the structured questionnaires about the real-world status of blood glucose monitoring and other questions composed of demographic and clinical characteristic as well as the diabetes-related cognitive scales. Latent profile analysis (LPA) was used to identify the underlying profiles of blood glucose monitoring based on self-reported frequency of blood glucose monitoring through different methods. Univariate and multivariate logistic regression were used to analyze the characteristics of the profiles and to explore the factors associated with it.ResultsAmong the 2166 participants, the mean frequency of blood glucose monitoring was 2.77 times (standard deviation: 7.67) per month. LPA indicated that five-class model was the best solution for classifying the latent groups of blood glucose monitoring: Class 1 “Low frequency in all”, Class 2 “High frequency in hospitals”, Class 3 “High frequency in primary health institutes”, Class 4 “High frequency in pharmacies”, and Class 5 “High frequency in self-monitoring”. The proportions of the patients in class 1, class 2, class 3, class 4, and class 5 were 88.1% (n=1909), 1.3% (n=28), 3.1% (n=67), 6.1% (n=133) and 1.3% (n=29), respectively. Multivariate logistic regression showed that participants who had higher income (OR: 1.58, 95% CI: 1.04~2.41, p<0.05), had diabetes complication(s) (OR=1.37, 95% CI: 1.03~1.02, p=0.03) and had a good knowledge of blood glucose control (OR=1.59, 95% CI: 1.17~2.16, p<0.01) were more likely to have high frequency of blood glucose monitoring (in class 2, 3, 4, 5), and the rural patients were less likely to had high frequency of blood glucose monitoring (OR=0.47, 95% CI: 0.35~0.63, p<0.01).ConclusionLow frequency dominates the characteristics of the profiles of blood glucose monitoring among T2DM patients in China, though distinct blood glucose monitoring groups can be identified by LPA. Educational and financial supports were recommended to increase the frequency of blood glucose monitoring in patients with T2DM, focusing on the patients with low socioeconomic status.

Non-invasive glucose monitoring devices: A review

Diabetes is a growing chronic disease that affect millions of people in the world. Regular monitoring of blood glucose levels in patients is necessary to keep the disease under control. Current methods of blood glucose monitoring devices are typically invasive, causing discomfort to the patients. Non-invasive glucose monitoring devices are a possible game changer for diabetic patients as it reduces discomfort and provides continuous monitoring. This manuscript presents a review of non-invasive glucose biosensors with particular focus on leading technologies available in the market, such as microwave sensing, near-infrared spectroscopy, iontophoresis, and optical methods. This paper intends to describe non-invasive blood glucose monitoring methods using various biological fluids (sweat, saliva, interstitial fluid, urine), highlighting the advantages and drawbacks in latest device development. This review also discusses future trends of glucose detection devices and how it will improve patients’ quality of life.

Hybrid cellulose nanocrystal/magnetite glucose biosensors

There exists a high demand for simple and affordable blood glucose monitoring methods. For this purpose, new generations of biosensors are being developed for possible in vivo or dermal use. We present (non)sulphated cellulose nanocrystal/magnetite thin films to act as dermal and oral glucose biosensors. The biocompatible (N-CNC)-Fe3O4 and (S-CNC)-Fe3O4 hybrid systems exhibit peroxidase-like activity, indicated by an almost instant color change when in the presence of glucose and ABTS. Both types of biosensors detect glucose concentrations as low as 5 mM (which corresponds to the level of glucose in biological fluids), with (S-CNC)-Fe3O4 being 1.5 - 2 times as sensitive as (N-CNC)-Fe3O4. Hybrid catalytic activity is more pronounced at room temperature and in acidic environments. The hybrids can therefore be used to determine glucose levels by using sweat and saliva – non-blood bodily secretions which tend to be slightly to moderately acidic and have relatively low glucose levels.

886-P: Saliva 1,5-Anhydroglucitol Detected by Liquid Chromatography-Mass Spectrometry Is a New Marker for Diabetes Screening

Context: Unlike other commonly used invasive blood glucose monitoring methods, saliva detection prevents patients from suffering the physical uneasiness. Serum 1,5-anhydroglucitol (1,5-AG) is a new indicator for assessing short-term glycemic control. However, there are currently few studies on saliva 1,5-AG in diabetes mellitus (DM). Objective: This study aimed to evaluate the effectiveness of saliva 1,5-AG in diabetes screening in a Chinese population. Design and Participants: A total of 641 subjects without a valid diabetic history (251 men and 390 women) were recruited from September 2018 to June 2019 and underwent an oral glucose tolerance test (OGTT). Fasting saliva 1,5-AG (1,5-AG0) and postload 2-hour saliva 1,5-AG (1,5-AG120) were measured with liquid chromatography-mass spectrometry. Serum 1,5-AG0 and 1,5-AG120 were measured with enzymatic method. Results: Saliva 1,5-AG levels in DM subjects were lower than those in nondiabetes mellitus subjects (both P &amp;lt; 0.05). Saliva 1,5-AG was positively correlated with serum 1,5-AG and negatively correlated with blood glucose and glycated hemoglobin (HbA1c) (all P &amp;lt; 0.05). The optimal cutoff points of saliva 1,5-AG0 and 1,5-AG120 for diabetes screening were 0.436 μg/mL and 0.438 μg/mL, respectively. Fasting plasma glucose (FPG) combined with saliva 1,5-AG0 and HbA1c combined with saliva 1,5-AG120 reduced the proportion of people who required an OGTT by 47.22% and 51.41% compared with FPG alone and HbA1c combined with FPG, respectively. Conclusion: The optimal cutoff point of saliva 1,5-AG for diabetes screening was 0.44 μg/mL. Saliva 1,5-AG combined with FPG or HbA1c improved the efficiency of diabetes screening. Saliva 1,5-AG is robust in nonfasting measurements and a noninvasive and convenient tool for diabetes screening. Disclosure Y. Bao: None. C. Jian: None. A. Zhao: None. X. Ma: None. K. Ge: None. W. Lu: None. W. Zhu: None. Y. Wang: None. J. Zhou: None. W. Jia: None.

Design of Automatic Insulin Dosage Indicator for Diabetic Patients Using BMI

Diabetes Mellitus is a serious and chronic health disease. It occurs in all age group of people, especially in adults and aged persons. It is important to measure blood glucose level frequently for the diabetes affected persons which in need to determine the appropriate insulin dosage. Along with this, the continuous glucose monitoring is vital to know whether the glucose level is in normal range. The conventional method used to measure the glucose level in blood is invasive which is infectious and a painful process. Nowadays, the non-invasive blood glucose monitoring methods are widely used. In this work, the blood glucose level is measured non-invasively using IR sensor. Besides that, the indication of insulin dosage to be taken is done by determining blood glucose concentration (non- invasively) and comparing it with Body Mass Index (BMI) of the patient. The implementation is based on the variations in the intensity of the IR LED, BMI and blood density. Themethod ismore reliable than the invasive techniques.

Diabetes Screening: Detection and Application of Saliva 1,5-Anhydroglucitol by Liquid Chromatography-Mass Spectrometry.

Unlike other commonly used invasive blood glucose-monitoring methods, saliva detection prevents patients from suffering physical uneasiness. However, there are few studies on saliva 1,5-anhydroglucitol (1,5-AG) in patients with diabetes mellitus (DM). This study aimed to evaluate the effectiveness of saliva 1,5-AG in diabetes screening in a Chinese population. This was a population-based cross-sectional study. A total of 641 subjects without a valid diabetic history were recruited from September 2018 to June 2019. Saliva 1,5-AG was measured with liquid chromatography-mass spectrometry. DM was defined per American Diabetes Association criteria. The efficiency of saliva 1,5-AG for diabetes screening was analyzed by receiver operating characteristic curves, and the optimal cutoff point was determined according to the Youden index. Saliva 1,5-AG levels in subjects with DM were lower than those in subjects who did not have DM (both P < .05). Saliva 1,5-AG was positively correlated with serum 1,5-AG and negatively correlated with blood glucose and glycated hemoglobin (HbA1c) (all P < .05). The optimal cutoff points of saliva 1,5-AG0 and 1,5-AG120 for diabetes screening were 0.436 μg/mL (sensitivity: 63.58%, specificity: 60.61%) and 0.438 μg/mL (sensitivity: 62.25%, specificity: 60.41%), respectively. Fasting plasma glucose (FPG) combined with fasting saliva 1,5-AG reduced the proportion of people who required an oral glucose tolerance test by 47.22% compared with FPG alone. Saliva 1,5-AG combined with FPG or HbA1c improved the efficiency of diabetes screening. Saliva 1,5-AG is robust in nonfasting measurements and a noninvasive and convenient tool for diabetes screening.