Blood Glucose Test Strips Research Articles

Rational Design and Development of Phenazine-based Electron Mediators for Enzyme-based Biosensors: Advancing Clinical Diagnostics Through Computational Exploration

The advancement of clinical diagnostics critically depends on the development of efficient and reliable electron mediators. These mediators are pivotal in biosensors, facilitating electron transfer (ET) reactions between the redox-active centers of immobilized enzymes and a conductive electrode support, thus enhancing the sensitivity and selectivity of biosensor devices. In this study, we specifically investigate phenazine as innovative electron mediators with promising diagnostic potential. Through meticulous computational predictions, we identify candidates exhibiting not only high solubility and favorable enzyme binding energies, but also appropriate redox potentials conducive to efficient electron transfer processes. Subsequently, these selected candidates undergo rigorous validation processes to assess their performance in blood glucose test strips, demonstrating a wide linear range from 1.00mM to 32.49mM (R2=0.9976) in whole blood tests, and a strong selectivity of glucose over other interfering substances such as ascorbic acid, uric acid, xylitol and hemoglobin.

Utilisation of blood glucose test strips in insulin-requiring people with diabetes mellitus using continuous glucose monitoring in Saxony-Anhalt – Analysis of health insurance data

AimsContinuous glucose measurement (CGM) systems are increasingly utilised by people with diabetes mellitus (DM) and less is known about usage behaviour. Therefore, this study aims to analyse additionally utilisation of blood glucose measurement (BGM) for insurants who are using CGM. MethodsThe study used secondary data, health claims data from the AOK Saxony-Anhalt (Germany), from 2016 to 2021, analysing a sample of 52,296 individuals with insulin-requiring DM. ResultsNearly all CGM users reduced their utilisation of BGM test strips. 2,306 persons with CGM long-time utilisation, about half showed a mean usage behaviour, nearly one third did not use test strips anymore, about 8 % stopped using CGM, 9 % were intense users. A high test strip utilisation beside CGM was associated with younger age, T1DM, a high number of test strip before starting CGM, no contact with a general practitioner, and no enrolment in a disease management program. ConclusionsGreat differences in reductions and usage behaviour was revealed between insurants. The results can be used to better identify and offer more tailored CGM to people with DM, and to better tailor CGM trainings.

Determination of metformin from micro-liter plasma and blood glucose test strip using eco-friendly micro-extraction procedures for point-of-care diagnostics

Metformin is commonly used in the treatment of type 2 diabetes and polycystic ovary syndrome. Beyond these common applications, it also holds promise in treating chronic pain, and as an antiaging and anticancer agent. In addition, it has cardiovascular protective and neuroprotective effects. However, elevated concentrations of metformin in the plasma, such as in patients with renal impairment or with conditions that can disrupt lactate clearance, could cause metformin-associated lactic acidosis. Moreover, metformin can cause a deficiency of vitamin-B12 and folic acid and impact one-carbon metabolism negatively. This study employs micro-extraction procedures to extract metformin from the human plasma and blood glucose test strips followed by detection using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Under the optimized micro-extraction procedures and by using an eco-friendly base and solvent, the proposed method required only 10 µL of the human plasma and a small piece of the blood glucose test strip for metformin analysis. The method exhibits a linear range of 0.05–5 μg mL−1 with a coefficient of determination (r2) of 0.999 and a limit of detection of 0.01 μg mL−1. The relative standard deviation (RSD) and relative error (RE) were both below 6.7 %. The test strip is a disposable product; its reuse before disposal could increase its additional applicability. Furthermore, major blood proteins and their modifications could be identified using this tiny volume of blood by mass spectrometry after protein digestion. The proposed technique could be invaluable in point-of-care diagnostics, enabling rapid monitoring of metformin plasma concentration and major plasma proteins to help patients mitigate the risk of metformin-associated lactic acidosis. To reduce organic waste in clinical applications, micro-extraction is a simple and efficient protocol for sample preparation using minute volumes of blood samples.

Screening of seeds from wild Pennycress (Thlaspi arvense L.) populations for sinigrin levels using a blood glucose meter and test strips

Field pennycress, Thlaspi arvense L., is a new oil seed cover crop being commercialized as a source of biofuel in the United States. Along the path to commercialization, pennycress seed and meal will be marketed as animal feed. As a member of the Brassicacaeae family, pennycress seed is abundant in glucosinolates which are anti-nutritional factors that make the seed and meal less palatable to animals. More specifically, sinigrin has been identified as the only glucosinolate present in pennycress seed. As work continues to develop varieties low in glucosinolates, a rapid assay is needed to determine the sinigrin level in pennycress seed.The objective of this study was to develop and utilize a high throughput, rapid assay to screen pennycress seeds from wild populations for total sinigrin content. Pennycress seeds were ground in potassium phosphate buffer with endogenous myrosinase to catalyze the enzymatic hydrolysis of sinigrin to equimolar amounts of glucose. Glucose content was determined using a blood glucose meter and test strips. From the molar concentration of glucose, the molar concentration of sinigrin was known and the sinigrin level in seeds was calculated in µmol/g. The results were confirmed by HPLC/MS analysis.A rapid and inexpensive method was developed and used to screen seeds of 429 wild pennycress lines for sinigrin. Sinigrin levels in seed ranged from 25 to 85 μmol/g in the pennycress lines screened. Environmental factors also seemed to contribute to the levels of sinigrin in seeds found within the line ‘tt8-t/ARV1’ grown at ten different locations in the Midwest, USA.This rapid and inexpensive assay will allow breeders to efficiently screen lines and select for varieties that produce seeds with low sinigrin levels for improved feed value.

Liraglutide improved the reproductive function of obese mice by upregulating the testicular AC3/cAMP/PKA pathway.

The incidence of male reproductive dysfunction is increasing annually, and many studies have shown that obesity can cause severe harm to male reproductive function. The mechanism of male reproductive dysfunction caused by obesity is unclear, and there is no ideal treatment. Identification of effective therapeutic drugs and elucidation of the molecular mechanism involved in male reproductive health are meaningful. In this study, we investigated the effects of the GLP-1 receptor agonist liraglutide on sex hormones, semen quality, and testicular AC3/cAMP/PKA levels in high-fat-diet-induced obese mice. Obese mice and their lean littermates were treated with liraglutide or saline for 12weeks. Body weight was measured weekly. Fasting blood glucose (FBG) was measured using a blood glucose test strip. The serum levels of insulin (INS), luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), free testosterone (F-TESTO), estradiol (E2), and sex hormone binding globulin (SHBG) were detected using ELISA. The sperm morphology and sperm count were observed after Pap staining. The mRNA and protein expression levels of testicular GLP-1R and AC3 were measured by RT-qPCR and Western blot, respectively. Testicular cAMP levels and PKA activity were detected using ELISA. Liraglutide treatment can decrease body weight, FBG, INS, HOMA-IR, E2 and SHBG levels; increase LH, FSH, T, and F-TESTO levels; increase sperm count; decrease the sperm abnormality rate; and increase GLP-1R and AC3 expression levels and cAMP levels and PKA activity in testicular tissue. Liraglutide can improve the sex hormone levels and semen quality of obese male mice. In addition to its weight loss effect, liraglutide can improve the reproductive function of obese male mice, which may also be related to the upregulation of AC3/cAMP/PKA pathway in the testis. This work lays the groundwork for future clinical studies.

Examining 25-Year Trends of Type 1 Diabetes Incidence in Pediatric Population Aged 0-14 of the Republic of Srpska

<p><strong>Introduction. </strong>Data on newly diagnosed cases of type 1 diabetes and the incidence of this disease are very significant. Studies like this one, with an analysis of incidence over the past 25 years, help not only locally but also globally.<br /><strong>Methods.</strong> The primary source of data is hospital records from hospital centers in Republic of Srpska. The secondary, confirmatory source, is the data from the Health Insurance Fund of Republic of Srpska through which all newly diagnosed patients receive insulin and blood glucose testing strips. <br /><strong>Results.</strong> The average incidence for the entire period was 12.8/100,000 (95% CI: 10.40–15.22), with a total of 527 cases, of which 265 (50.3%) were boys. Positive linear trend was observed (R=0.747, R2=0.558, p=0.000018). The annual increase was 0.59 (95% CI: 0.37– 0.82) or 29.06%. There was no difference between sexes, and the highest incidence, number, and growth were in the age group of 10–14 years.<br /><strong>Discussion. </strong>Compared to the period 2001–2016 (11/100,000) and to the period 1998–2010 (7.5/100,000), there was the increase in incidence. Significant increase in incidence was observed in the period 2017–2022. There is no difference from the rest of the world regarding incidence by sex, but there is regarding age group, with the highest incidence in the 10–14 age group. <br /><strong>Conclusion.</strong> This research provides a good basis for future studies on the impact of environmental, medical, and other factors on the onset of type 1 diabetes, as well as potential local, national, and global diabetes prevention programs.</p>

HPR24 Utilisation and Expenditure on Blood Glucose Test Strips in Ireland—The Impact of Health Technology Management in Reducing and Containing Expenditure

HPR24 Utilisation and Expenditure on Blood Glucose Test Strips in Ireland—The Impact of Health Technology Management in Reducing and Containing Expenditure

Evolution of blood glucose self-monitoring technology

In 1838 G. Rees, a doctor from London (Guy's Hospital), for the first time isolated excess sugar from the blood serum of a patient with diabetes mellitus. Diagnosis of diabetes mellitus gradually developed. The next step was the understanding that regular monitoring of glucose levels by the patient himself is an integral part of diabetes mellitus therapy. The starting point of the technology for self-monitoring of diabetes mellitus was the determination of the sugar content in urine using chemical reactions. The method had no great clinical significance, it only indicated a progressive disease. The first Dextrostix blood glucose test strip (Ames-Mile's laboratories) was introduced in 1964. In 1970, the first automated blood glucose analysis system, the Ames Reflectance Meter (ARM), was created. Over time, the technology has been improved, accuracy, visibility, comfort, and an individual approach to glucometry have been formed. A new chapter was the development of remote technologies and the possibility of remote monitoring. More advanced data processing is now available in tabular and graphical form, with the calculation of 7-, 14-, 30-, and 90-day average glycemic values. A promising direction is the introduction of artificial intelligence in the management of diabetes mellitus.

The Impact of Blood Glucose Test Strips Reimbursement Limits on Utilization, Costs, and Health-care Utilization in British Columbia

ObjectivePeople living with diabetes and not using insulin may not derive clinically significant benefit from routine glucose self-monitoring. As a result, in 2015, British Columbia (BC) introduced quantity restrictions for blood glucose test strips (BGTS) coverage in public plans. We studied the impact of this policy on utilization, costs, and health-care utilization. MethodsWe identified a cohort of adults (≥18 years old) with diabetes between 2013 and 2019. Using BC’s administrative data, we studied utilization and costs among individuals with at least one PharmaCare-eligible BGTS claim. Using interrupted time-series analysis, we studied cost savings and determined the level of policy adherence. In addition, we investigated longitudinal changes in all-cause and diabetes-specific physician visits, all-cause hospitalizations, and health-care spending in the 3 to 5 years after policy implementation. ResultsOver the study period, 279.7 million BGTS were eligible for PharmaCare coverage, on which the government spent $124.3 million. After policy implementation, we observed an immediate decline in average utilization and PharmaCare expenditure on BGTS, leading to an estimated $44.6 million in savings between 2015 and 2019 (95% confidence interval $16.9 to $72.3 million). We found no association between the policy’s implementation and health services utilization or overall health-care spending over the long term. ConclusionsRestricting reimbursement for BGTS in BC resulted in significant cost savings without any attendant increase in health services utilization over the subsequent 5 years. This disinvestment freed up resources that could be channeled toward other interventions.

Audit of the use of continuous glucose monitoring in patients with type 1 diabetes at Broom Lane Medical Centre.

On 2 August 2022, it was announced by the NHS that all patients suffering from type 1 diabetes (T1DM) would be eligible for continuous glucose monitoring (CGM). Patients previously would have needed to scan or take a finger prick test at fixed time intervals to monitor their blood glucose. To investigate the number of patients registered to the practice who were eligible to switch over to CGM, and how many patients had already done so. Broom Lane Medical Centre (Rotherham, South Yorkshire) uses SystmOne to store patient notes. A search was conducted on 13 September 2022 generating data of 73 patients suffering from T1DM. The data were filtered to determine whether patients were using Libre glucose sensors or the traditional blood glucose testing strips. It was found that roughly half (50.7%) were on Freestyle Libre 1/2 sensors, which allow for flash glucose monitoring (FGM); 49.3% were using blood glucose testing strips. None of the patients was using CGM such as the Libre 3 sensor. It was noted that the group of individuals on the Libre sensor were of a younger age group (average age: 38.9) whereas the blood glucose testing strips age group were slightly older (average age: 45.8). Patients no longer need to live in fear of hyperglycaemia and maintain need for routine glucose measurements, allowing patients to live a more convenient and stress-free lifestyle.All of the T1DM patients (100%) registered at Broom Lane Medical Centre are eligible to be switched over to the CGM.

Comparison of Glucose Levels in Blood Samples Taken from Coccygeal, Jugular and Mammary Vein of Cows in Lactation

Blood glucose level is one of the most commonly used parameters in assessing the energy metabolism in dairy cows. The presented study aimed to compare the glucose concentrations in blood samples taken from the coccygeal vein, jugular vein, and mammary vein from the same animals at the same time. Healthy Holstein-Friesian dairy cows (n=25) in their second and third lactation were selected for the study. The blood samples were taken from the coccygeal vein, jugular vein, and V. subcutanea abdominis (mammary vein) at the same time from each animal. To analyze blood glucose, Free Style Optium Blood Glucose Test Strip (Abbott, Istanbul, TURKIYE) was used. In comparison to the blood taken from both the jugular vein and coccygeal vein, glucose levels in blood samples taken from the mammary vein were significantly low (P<0.001). As a result, the determination of glucose levels in blood samples taken from the mammary veins may cause erroneous interpretations. Therefore, the mammary vein for blood glucose must not be used as a sampling site.

Integrated Care for Type 1 Diabetes: The West Bengal Model.

A structured dedicated health programme for Type 1 diabetes mellitus (T1DM) has been initiated in the state of West Bengal, India. The aim is to provide comprehensive healthcare to all children, adolescents and young adults living with T1DM, along with the provision of free supply of insulin, glucose measuring devices, blood glucose test strips, and other logistics. The strategic framework for programme implementation is to utilise the infrastructure and manpower of the already existing non-communicable disease (NCD) clinic under National Health Mission. Establishing dedicated T1DM clinics in each district hospital by utilising existing healthcare delivery systems, intensive training and hand-holding of named human resources; providing comprehensive healthcare service and structured diabetes education to all T1DM patients; and building an electronic registry of patients are important components of the programme. T1DM clinics run once a week on the same day throughout the state. All T1DM patients are treated with the correct dose of insulin, both human regular insulin and glargine insulin. Patients are routinely monitored monthly to ensure good glycaemic control and prevent complications of the disease. Routine anthropometric examination and required laboratory investigations are conducted in the set-up of the already existing NCD clinic. Ongoing monitoring and evaluation of the T1DM programme are being conducted in terms of glycated haemoglobin (HbA1c) values, growth and development, complication rates, psychological well-being, quality of life, and direct and indirect expenditure incurred by families. Through this programme, any bottlenecks or gaps in service delivery will be identified and corrective measures will be adopted to ensure better health outcomes for those living with T1DM.

Analysis of competition and the level of dominance in the antidiabetics market of Russia

Introduction. Amid reports of a growing number of diabetic patients, the antidiabetics market players positioning is highly important for companies and the country’s leadership. The regulatory measures and management decisions depend on the competitive situation in the market. Aim. Analysis of the changes in the level of dominance on the markets for antidiabetics and blood glucose monitors and meters. Materials and methods. The distribution of these markets by product groups, as well as by commercial and public procurement segments has been taken into account. The Herfindahl-Hirschman and Linda indices, the adjusted Hall-Tideman index, concentration ratios and the SV matrix (strength/variety) were used as analysis tools, and the calculations were made on the basis of IQVIA data for the period from 2004 to the 3rd quarter of 2022. Results. The dominance of three foreign companies that fell into the B4 and G quadrants was detected in the insulin and insulin analogues market. The glucose-lowering drugs market is the most competitive, it fell into the RO quadrant more often than other markets, and the dominant group, depending on the segment, included foreign and domestic companies with different frequency. The dominance of both three foreign and one Russian companies in the B4 and G quadrants, as well as a larger number of companies, was identified in the market for other alimentary tract and metabolism products. Several foreign and one Russian company that were identified into the B4 and G quadrants steadily dominated in the markets for blood glucose test strips, glucose monitors and meters and accessories, and lancets. Conclusions. The antidiabetics market is highly concentrated in its segments. The results show the historical development of the studied markets, the role of the commercial and public procurement segments in them, and serve as the foundation for studying the impact of environmental events on the Russian antidiabetics market.

GlucoScreen

Blood glucose measurement is commonly used to screen for and monitor diabetes, a chronic condition characterized by the inability to effectively modulate blood glucose that can lead to heart disease, vision loss, and kidney failure. Early detection of prediabetes can forestall or reverse more serious illness if healthy lifestyle adjustments or medical interventions are made in a timely manner. Current diabetes screening methods require visits to a healthcare facility and use of over-the-counter glucose-testing devices (glucometers), both of which are costly or inaccessible for many populations, reducing the chances of early disease detection. We therefore developed GlucoScreen, a readerless glucose test strip that enables affordable, single-use, at-home glucose testing, leveraging the user's touchscreen cellphone for reading and displaying results. By integrating minimal, low-cost electronics with commercially available blood glucose testing strips, the GlucoScreen prototype introduces a new type of low-cost, battery-free glucose testing tool that works with any smartphone, obviating the need to purchase a separate dedicated reader. Our key innovation is using the phone's capacitive touchscreen for the readout of the minimally modified commercially available glucose test strips. In an in vitro evaluation with artificial glucose solutions, we tested GlucoScreen with five different phones and compared the findings to two common glucometers, AccuChek and True Metrix. The mean absolute error (MAE) for our GlucoScreen prototype was 4.52 mg/dl (Accu-Chek test strips) and 3.7 mg/dl (True Metrix test strips), compared to 4.98 mg/dl and 5.44 mg/dl for the AccuChek glucometer and True Metrix glucometer, respectively. In a clinical investigation with 75 patients, GlucoScreen had a MAE of 10.47 mg/dl, while the AccuChek glucometer had a 9.88 mg/dl MAE. These results indicate that GlucoScreen's performance is comparable to that of commonly available over-the-counter blood glucose testing devices. With further development and validation, GlucoScreen has the potential to facilitate large-scale and lower cost diabetes screening. This work employs GlucoScreen's smartphone-based technology for glucose testing, but it could be extended to build other readerless electrochemical assays in the future.

Clinical Accuracy of a Glucose Oxidase-Based Blood Glucose Test-Strip Across Extremes of Oxygen Partial Pressure.

Glucose oxidase (GOx)-based blood glucose monitors (BGMs) are influenced by the partial pressure of oxygen (Po2) within the applied sample. Limited in-clinic data exists regarding the quantitative effect of Po2 in unmanipulated capillary fingertip blood samples across physiologically representative glucose and Po2 ranges. Clinical accuracy data were collected as part of a BGM manufacturer's ongoing post-market surveillance program for a commercially available GOx-based BGM test-strip. The data set comprised 29 901 paired BGM-comparator readings and corresponding Po2 values from 5 428 blood samples from a panel of 975 subjects. A linear regression-calculated bias range of 5.22% (+0.72% [low Po2: 45 mm Hg] to -4.5% [high Po2: 105 mm Hg]); biases calculated as absolute at <100 mg/dL glucose was found. Below the nominal Po2 of 75 mm Hg, a linear regression bias of +3.14% was calculated at low Po2, while negligible impact on bias (regression slope: +0.002%) was observed at higher than nominal levels (>75 mm Hg). When evaluating BGM performance under corner conditions of low (<70 mg/dL) and high (>180 mg/dL) glucose, combined with low and high Po2, linear regression biases ranged from +1.52% to -5.32% within this small group of subjects and with no readings recorded at <70 mg/dL glucose at low and high Po2. Data from this large-scale clinical study, performed on unmanipulated fingertip capillary bloods from a diverse diabetes population, indicate Po2 sensitivity of the BGM to be markedly lower than published studies, which are mainly laboratory-based, requiring artificial manipulation of oxygen levels in aliquots of venous blood.

Paediatric Society and Hyperinsulinism Charity National Surveys on CGM Access for Patients With Recurrent Hypoglycaemia.

Recurrent hypoglycemia can result in significant neurological impairments in children and continuous glucose monitoring (CGM) technology has been shown to reduce recurrent hypoglycemia in conditions such as type 1 diabetes. In the United Kingdom, CGM devices are currently only recommended by the National Institute of Clinical Excellence (NICE) for patients with diabetes and not for other diagnoses. To examine access to CGM technology for children and young people with recurrent hypoglycemia in the United Kingdom. In 2021, the British Society of Paediatric Endocrinology and Diabetes (BSPED) conducted a national health professional survey in England, Wales, Scotland, and Northern Ireland looking at CGM access to funding for children and young people with recurrent hypoglycemia, without the diagnosis of diabetes. The UK Children's Hyperinsulinism Charity (UK CHC) also conducted a national patient survey. Responses from BSPED were received from 55 units while the UK CHC received 69 responses from individual families, the largest response to a survey carried out by the charity. The results of the BSPED and UK CHC surveys found that funding streams for CGM were highly variable. Only 29% were able to access CGM for recurrent hypoglycemia and from these, 65% were self-funding CGM. Quality of life benefits were evident from the UK CHC survey on the utility of CGM in reducing worry, improving sleep, lessening the burden of frequently finger-pricking and reducing out-of-hours appointments as a result of hypoglycemia. Patient-reported utilization rates of blood glucose test strips per week were significantly reduced. BSPED and UK CHC national surveys support a call and a consideration for CGM access to be widened to patients who suffer from recurrent hypoglycemia such as those with hyperinsulinism or metabolic conditions. The prevention of recurrent hypoglycemia and improving quality of life for patients and carers remain a cornerstone management for people who suffer from frequent hypoglycemia. CGM education is critical to support its use and understand its limitations. Further research is warranted to determine the safety and efficacy of CGM in detection and reduction of hypoglycemic events, impact of hospital stay, and long-term neurological outcomes in those who suffer from recurrent hypoglceamia.

Blood glucose sensing by back gated transistor strips sensitized by CuO hollow spheres and rGO

In this work, a highly sensitive flexible glucose sensor based on a field effect transistor (FET) has been fabricated. It is shown that the proposed flexible transistor can be used as new non-enzymatic blood glucose test strips. CuO hollow-spheres decorated with reduced graphene oxide have been synthesized using the hydrothermal method. The shells of the hollow micro-spheres are formed by nanostructures. The synthesized nanostructured hollow micro-spheres (rGO/CuO–NHS) are deposited on a flexible PET substrate between interdigitated electrodes as the channel of a back gate transistor. The channel concentration and the FET bias are optimized so that the sensor exhibits extremely low limit of detection and high sensitivity. The combination of selective porous CuO hollow spheres and the high surface to volume ratio of their nanostructured shells with the high mobility and high conductivity rGO led to faster and higher charge-transfer capability and superior electro-catalyst activity for glucose oxidation. The glucose-dependent electrical responses of the sensor is measured in both resistive and transistor action modes. The amplification of the current by the induced electric field of the gate in the proposed FET-based biosensor provides advantages such as higher sensitivity and lower limit of detection compared to the resistive sensor. The flexible glucose sensor has a sensitivity of 600 μA μM−1 and a limit of detection of 1 nM with high reproducibility, good stability, and highly selectivity. The high accuracy response of the biosensor towards the real blood serum samples showed that it can be used as a test strip for glucose detection in real blood samples.

Knowledge of School Nurses on the Basic Principles of Type 1 Diabetes Mellitus Self-Control and Treatment in Children

School nurses should participate in the care of children with type 1 diabetes mellitus. The aim of this study was to assess the level of knowledge of school nurses about the basic principles of self-control and the treatment of type 1 diabetes mellitus and to attempt to determine the factors that influence this level of knowledge. A cross-sectional survey was conducted among school nurses from October 2018 to November 2019 in the Pomeranian Voivodeship. The study was conducted using a self-constructed questionnaire. The survey included questions about the sociodemographic characteristics of the respondents, and a test of the knowledge and skills regarding the principles of self-control and the treatment of type 1 diabetes mellitus (16 test questions). This study included 168 Polish school nurses (mean age ± SD = 55.1 ± 8.9 years). Most of the nurses had a secondary education (81%), worked in a municipal educational institution (78.6%), and provided care to more than one student with type 1 diabetes mellitus at school (70.2%). The average level of knowledge of school nurses was 12.5 ± 2.0 points (maximum 16). The nurses working in a village school and those who worked only in one school had lower levels of knowledge. Only 85.7% of nurses reported that they could independently perform a blood glucose measurement with a glucometer, and as many as 56.5% were unable to determine the level of ketone bodies in the urine with Keto-Diastix test strips. Only 62.5% of nurses had a glucometer and glucometer strips in their nursing office. A total of 19.6% of nurses did not have glucagon (1 mg GlucaGen HypoKit®, Novo Nordisk A/S, Bagsværd, Denmark) or an ampoule with 20% glucose for an intravenous administration. The knowledge of school nurses about the principles of self-control and the treatment of type 1 diabetes mellitus is insufficient. Due to the strong increase in the incidence of type 1 diabetes mellitus among children and adolescents, it is important to organize permanent, continuous, and mandatory training on the principles of self-control and the treatment of type 1 diabetes mellitus for school nurses. The equipment in Polish school nurses' offices should be supplemented with a working glucometer and blood glucose test strips, and the set of obligatory medications in the school nurse's office should be supplemented with glucagon for students with type 1 diabetes mellitus.

30-Seconds Sars-Cov-2 Human Sample Diagnosis and Analytical Specificity Analysis Using Disposable Strips on a Metal-Oxide-Semiconductor Field-Effect Transistor Platform

A SARS-CoV-2 rapid detection technology employed commercially available test strips similar to the blood glucose test strips were developed with a detection time of 30 sec and the sensitivity as good as polymerase chain reaction (PCR). The analytical specificity of this technology was also investigated by testing the cross-reactivity and microbial interference on this biosensor platform using FDA suggested 31 different contaminants. Variants of SARS-CoV-2 have mutated along with the worldwide spread of the pandemic. Currently, the most common detection methods are PCR and lateral flow tests. The former takes more than an hour to obtain results and the latter has difficulty detecting the virus at low concentrations (for cycling threshold values, CT values, >25 to 27). Therefore, the demand for a fast, cost-effective, and low detection limit testing method has been significantly increased. In this work, 60 human saliva samples with 30 positive and 30 negative were collected and tested with PCR for SARS-CoV-2 prior to using our disposable strips. For this technology, the test strip was connected to the gate electrode of the MOSFET on the printed circuit board that serves to amplify signals. A synchronous double-pulsed bias voltages (around 1 ms) were sent to both the drain and gate of the MOSFET. The resulting change in drain waveforms was converted to digital readings and compared with cycling threshold (Ct) values of human samples to assess this sensor technology. The result signifies that positive human samples with a range of Ct values from 17.8 to 40 can be differentiated, along with proving none of those high-risk organisms would hinder the sensitivity of our system. Which demonstrated the potential of this system to be developed into a cost-effective and point-of-care rapid detection for SARS-CoV-2. Figure 1

Reduced Rate of Acute Diabetes Events with Flash Glucose Monitoring Is Sustained for 2 Years After Initiation: Extended Outcomes from the RELIEF Study.

Background: The RELIEF study has previously shown a fall in the rate of acute diabetes events (ADEs) in people living with type 1 diabetes (PwDT1) or people living with type 2 diabetes (PwDT2) in the 12 months after initiation of flash glucose monitoring (FLASH) in France. The 2-year follow-up has provided new insights on the frequency of ADEs, including severe hypoglycemia and diabetic ketoacidosis (DKA), during use of FLASH. Methods: The RELIEF study included 31,446 PwDT1 and 41,027 PwDT2 with a first delivery of FreeStyle Libre (FSL) between August 1 and December 31, 2017. Hospitalizations for DKA, severe hypoglycemia, diabetes-related coma, and hyperglycemia were recorded for the 12 months before and 24 months after FSL initiation. Persistence of the FSL system use was estimated through a Kaplan-Meier survival curve. Change in usual blood glucose monitoring was estimated through acquisition of blood glucose test strips. Results: In the 2 years after FSL initiation, hospitalizations for ADEs were reduced by 49% and by 48% in PwDT1 or PwDT2, respectively, driven by reductions in DKA. After 2 years, 88% of patients persisted with the system and estimated mean consumption of blood glucose test strips had fallen after 2 years by -82% and by -84% in type 1 diabetes mellitus and type 2 diabetes mellitus, respectively. Conclusion: Use of FSL consistently reduces the rates of hospitalization for ADEs, mainly DKA, 2 years after initiation, confirming this is not a transitory effect. Use of FSL also results in a clear and progressive drop in use of blood glucose test strips over the 2-year period.