Finger-prick Capillary Blood Research Articles

Effects of Curcuma longa (turmeric) on postprandial plasma glucose and insulin in healthy subjects

BackgroundPrevious animal studies have shown that Curcuma (C.) longa lowers plasma glucose. C. longa may thus be a promising ingredient in functional foods aimed at preventing type 2 diabetes. The purpose of the study is to study the effect of C. longa on postprandial plasma glucose, insulin levels and glycemic index (GI) in healthy subjects.MethodsFourteen healthy subjects were assessed in a crossover trial. A standard 75 g oral glucose tolerance test (OGTT) was administered together with capsules containing a placebo or C. longa. Finger-prick capillary and venous blood samples were collected before, and 15, 30, 45, 60, 90, and 120 min after the start of the OGTT to measure the glucose and insulin levels, respectively.ResultsThe ingestion of 6 g C. longa had no significant effect on the glucose response. The change in insulin was significantly higher 30 min (P = 0.03) and 60 min (P = 0.041) after the OGTT including C. longa. The insulin AUCs were also significantly higher after the ingestion of C. longa, 15 (P = 0.048), 30 (P = 0.035), 90 (P = 0.03), and 120 (P = 0.02) minutes after the OGTT.ConclusionsThe ingestion of 6 g C. longa increased postprandial serum insulin levels, but did not seem to affect plasma glucose levels or GI, in healthy subjects. The results indicate that C. longa may have an effect on insulin secretion.Trial registration numberNCT01029327

Evaluation of the PIMA Point-of-Care CD4 Analyzer in VCT Clinics in Zimbabwe

Point-of-care (POC) CD4 testing was implemented at a stand-alone HIV voluntary testing and counseling centre in Harare, Zimbabwe. To validate the use of this new technology, paired blood samples were collected from 165 patients either by a nurse or a laboratory technician and tested using POC and conventional laboratory CD4 machines. Finger prick (capillary) blood was collected directly into the PIMA POC CD4 Analyzer cartridges and tested immediately, whereas venous blood collected into evacuated tubes was used for CD4 enumeration on a Becton Dickinson FACSCalibur. There was no significant difference in mean absolute CD4 counts between the POC PIMA and Becton Dickinson FACSCalibur platforms (+7.6 cells/microL; P = 0.72). Additionally, there was no significant difference in CD4 counts between the platforms when run by either a nurse (+18.0 cells/microL; P = 0.49), or a laboratory technicians (-3.1 cells/microL; P = 0.93). This study demonstrates that POC CD4 testing can be conducted in a voluntary testing and counseling setting for staging HIV-positive clients. Both nurses and laboratory technicians performed the test accurately, thereby increasing the human resources available for POC CD4 testing. By producing same-day results, POC CD4 facilitates immediate decision-making, patient management and referral and may help improve patient care and retention. POC CD4 may also alleviate testing burdens at traditional central CD4 laboratories, hence improving test access in both rural and urban environments.

Wavesense technology glucometer Linus for routine self-monitoring and clinical practice

Conventional glucometer systems for plasma/blood glucose monitoring are based on colorimetry or static electrochemistry using a fixed input signal. The recent glucometer Linus, Wellion, Agamatrix, USA, based on wavesense dynamic electrochemistry, uses a time-varying input signal to give a more accurate glucose reading. The purpose of this study was to compare the plasma glucose (PG) readings obtained by nursing staff from glucometer Linus and PG values estimated on an approved analyzer Daytona™, Randox, Global Medical Instrumentation, Inc., MN, USA. In the course of 5weeks, 221 fingerprick capillary blood samples were taken from persons with diabetes at different times and investigated using glucometer Linus. Within two following minutes, blood from the same fingerprick was also collected in a tube and centrifuged; the plasma was analyzed on the Daytona™ analyzer. Statistical analysis was performed using the software SPSS v. 15.0, SPSS Inc., Chicago, IL, USA. A total of 221 paired PG values were plotted on the error grid diagram indicating that 218 values (98.6%) of the glucose readings (Linus vs. Daytona) were within the clinically accurate zone A (maximum difference ±20%) and 3 values (1.4%) within the acceptable zone B. Daytona showed 4 PG values <4.2mmol/l (75mg/dl) and their difference of respective Linus readings was always <0.83mmol/l (15mg/dl). Correlation of results was strong (r=0.992). Glucometer Linus readings correspond to the ISO and FDA standards. So, Linus appears to be an accurate device for PG-self-monitoring and clinical practice.

IMPACT OF BUCCAL GLUCOSE SPRAY, LIQUID SUGARS AND DEXTROSE TABLETS ON THE EVOLUTION OF PLASMA GLUCOSE CONCENTRATION IN HEALTHY PERSONS

The purpose of this prospective controlled trial was to assess the efficacy of three commercially available glucose products, (1) buccal glucose spray, (2) liquid sugars, and (3) dextrose tablet, on the evolution of plasma glucose concentration (PG). Sixteen healthy volunteers aged 21.8 +/- 0.78 y (mean +/- SE), BMI 23.5 +/- 0.84 kg/m(2), tested their PG over the course of 3 sets of 4 sessions (S) each: S(0)-control fasting, S(1)-buccal administration of 10 glucose spray-doses (0.84 g of glucose) without swallowing; S(2-) consumption of 1 sachet (13 ml) of liquid sugar (ca. 5.2 g glucose, 5.2 g fructose, 5.2 g sucrose); S(3-) consumption of one dextrose tablet (6 g). PG was tested in finger-prick capillary blood using a personal glucometer Linus at the start, and at 5, 10, 15, 20 and 30 min. The means of 3 respective sessions for each of the 16 subjects were analyzed. The Wilcoxon signed rank test revealed no significant differences between changes in the mean PG at the start vs. 5-minute interval either in control, or any intervention sessions. Analysis of regression coefficients after 30 min compared to the control session, demonstrated an increase in PG with the sachet of liquid sugars (0.068 mmol/l/min, p = 0.001) which was greater than a single dextrose tablet (0.052 mmol/l/min, p = 0.002), but no significant PG increase was found after buccal glucose spray. Liquid sugars or dextrose tablets, but not the buccal glucose spray, are effective means to increase PG within 10 minutes after ingestion.

Dexamethasone for postoperative nausea and vomiting prophylaxis: effect on glycaemia in obese patients with impaired glucose tolerance

Dexamethasone given to prevent postoperative nausea and vomiting may produce significant hyperglycaemia in the perioperative period. The effect of dexamethasone on patients with impaired glucose tolerance is unknown. Thirty obese patients with impaired glucose tolerance undergoing laparoscopic Roux-en-Y gastric bypass surgery were studied in a double-blind fashion. Patients were randomly distributed into two groups: the dexamethasone group (n = 15) received dexamethasone 8 mg intravenously after induction of anaesthesia; the control group (n = 15) received isotonic saline. Fingerprick capillary blood glucose concentrations were measured at baseline and every 2 h during the first 12 h after the start of surgery. In both groups, all blood glucose concentrations measured after the beginning of surgery were higher than baseline values. However, the dexamethasone group showed higher glucose concentrations than the control group from the 6th to the 12th hour of the study. In addition, the maximum blood glucose value in the dexamethasone group (10.4 +/- 1.6 mmol l(-1)) was higher than in the controls (8.8 +/- 1.7 mmol l(-1)) (P < 0.05). Dexamethasone, 8 mg, intravenously administered at the beginning of laparoscopic bariatric surgery in patients with impaired glucose tolerance is associated with significantly increased postoperative blood glucose concentrations.

β-Glucan from Two Sources of Oat Concentrates Affect Postprandial Glycemia in Relation to the Level of Viscosity

Objective: Soluble dietary fiber has been shown to attenuate the postprandial rise in blood glucose levels and reduce the risk of type 2 diabetes and cardiovascular disease. This effect seems to be related to its rheological properties including viscosity. We examined the intra-fiber variability between two different processing methods of concentrating β-glucan from oats (aqueous vs. enzymatic) in relation to the level of viscosity of β-glucan and its effect on postprandial glycemia in healthy individuals.Design: In an acute, randomized, double-blind, crossover study, 11 healthy subjects (gender: 5M:6F; age: 34 ± 5 years; BMI: 23 ± 0.8 kg/m2) were randomly assigned, on three separate occasions, to consume one of three fiber-matched treatments along with a 75g oral glucose drink. The enzymatically processed β-glucan (Oat-A) differed from β-glucan processed through the aqueous method (Oat-B) solely with regard to viscosity. Finger-prick capillary blood samples were obtained at fasting and at 15, 30, 45, 60, 90 and 120 min after the start of the test drink. The viscosities of the fiber drinks were determined (Paar Physica UDS200 viscometer).Results: Rheological measurements demonstrated that Oat-A had a significantly higher viscosity than Oat-B and control at 5, 15, 30, 60, and 120 min (p < 0.001). The incremental area under the glucose curve (AUC) on Oat-A was 19.6% and 17% lower than that of Oat-B and control, respectively (p < 0.01).Conclusions: This study shows that processing oat β-glucan through enzymatic, rather than by aqueous methods, preserves the viscosity and improves postprandial glycemic control.

Almonds and postprandial glycemia—a dose-response study

Almonds, together with other nuts, reduce serum cholesterol levels and may reduce the risk of coronary heart disease. There is much current interest in the relation of coronary heart disease to postprandial events. We have therefore assessed the effects of varying amounts of almonds on the postprandial blood glucose response to a carbohydrate meal. Our aim was to assess the effect of adding almonds to a bread meal. Nine healthy volunteers (2 women, 7 men; mean age, 27.8 years; mean body mass index, 22.9 kg/m 2) were randomly fed with 3 test meals and 2 white bread control meals on separate days. Subjects were fed the meals after a 10- to 12-hour overnight fast. Each meal contained 50 g of available carbohydrate from white bread eaten alone or with 30, 60, or 90 g (∼1, 2, or 3 oz) of almonds. Capillary finger-prick blood samples for glucose analysis were obtained at 0, 15, 30, 45, 60, 90, and 120 minutes. Glycemic responses were assessed by calculating the incremental area under the 2-hour blood glucose curve. The addition of almonds to white bread resulted in a progressive reduction in the glycemic index of the composite meal in a dose-dependent manner for the 30-g (105.8 ± 23.3), 60-g (63.0 ± 9.0), and 90-g (45.2 ± 5.8) doses of almonds ( r = −0.524, n = 36, P = .001). We conclude that, in addition to lowering serum cholesterol levels, almonds may also reduce the glycemic impact of carbohydrate foods with which they are eaten.

Glycemic responses of oat bran products in type 2 diabetic patients

Cereal products with low postprandial glycemic response are encouraged in the management of hyperglycemia. In this study, we determined the postprandial glycemic response of two different oat bran products in patients with type 2 diabetes. In addition, we investigated the effects of oat bran flour on postprandial glucose response following an oral glucose load. A randomized, controlled, repeated measures design with two test series was used. Twelve type 2 diabetic patients participated in five 2-h meal glucose tolerance tests on separate occasions. Volunteers were given in random order oat bran flour, oat bran crisp and glucose load providing 12.5 g glycemic carbohydrate (series 1), 25 g glucose load alone and 25 g glucose load with 30 g oat bran flour (series 2). Finger-prick capillary blood analysis was carried out fasting and then 15, 30, 45, 60, 90 and 120 min after the start of the meal. The oat bran flour had a lower 0-120 min area under the glucose response curve (AUC) (47+/-45 mmol min/L) than the glucose load (118+/-40 mmol min/L) (p<0.002), but there was no difference between the oat bran crisp (93+/-41 mmol min/L) and the glucose load in this respect. The oat bran flour decreased the glucose excursion from baseline by 1.6 mmol/l (2.4, 0.8) (mean (95% CI)) and 1.5 mmol/l (2.0, 1.1) at 30 and 45 min after the glucose load, respectively. Oat bran flour high in beta-glucan had a low glycemic response and acted as an active ingredient decreasing postprandial glycemic response of an oral glucose load in subjects with type 2 diabetes.

High (1→3,1→4)-β-Glucan Barley Fractions in Bread Making and their Effects on Human Glycemic Response

Barley flour (BF) from whole naked grain and two (1→3,1→4)-β-glucan-enriched fractions, a sieved fraction (SF) and a water-extracted fraction (WF), were produced and mixed with bread wheat flour (BW), for bread-making quality evaluation. Bread was baked in a pilot plant and analysed for sensory properties, proximate composition and (1→3,1→4)-β-glucan content. Four kinds of bread were produced from different mixtures of barley ingredients and bread wheat flour: a 100% BW ((1→3,1→4)-β-glucan content: total, 0·1%; soluble, 0·1%); a 50% BW and 50% BF (2·4%; 2·0%); a 50% BW and 50% SF (4·2%; 2·8%); an 80% BW and 20% WF (6·3%; 5·7%). Eight adults were fed test meals of each of the four breads, containing the same amount (50 g) of available carbohydrate, and glycemic indices calculated from finger-prick capillary blood samples. A linear decrease in glycemic index was found for increasing (1→3,1→4)-β-glucan content. The 20% WF bread had a 28% lower glycemic index than the plain BW and also showed the best scores for sensory attributes. This research confirms the effectiveness of viscous (1→3,1→4)-β-glucan in reducing postprandial blood glucose levels, even in foods with a high glycemic index. The enrichment technique, and water extraction/freeze-drying technique, could enable the use of barley as a source of a high-value fibre for reducing the glycemic index of traditional wheat-based foods such as bread, without negatively affecting their sensory characteristics.

Glycemic response to a rapidly digested starch is not affected by the addition of an indigestible dextrin in humans

To evaluate the effect of supplemental indigestible dextrin on the glycemic response to a rapidly digested starch, 30 healthy nondiabetic adult subjects were studied in a double-blind crossover design. After an overnight fast, subjects consumed a product containing either 67.5 g of corn syrup solids or the same plus 16 g of indigestible dextrin. Finger-prick capillary blood was obtained at baseline, 15, 30, 45, 60, 90, and 120 min postprandial for glucose measurement. The postprandial incremental change from baseline did not differ (P > 0.10) between treatments across all time points. Mean peak incremental change from baseline and net incremental area under the curve did not differ (P > 0.10) between treatments. Minimal effects on gastrointestinal symptoms (intensity and frequency of nausea, cramping, distention, and flatulence) were noted for both products, with no clinically significant difference between products. In conclusion, an acute challenge of 16 g supplemental indigestible dextrin did not affect the postprandial glycemic response to a rapidly digested starch and was well tolerated by fasting healthy adult subjects.

Decline in Blood Lead in Ontario Children Correlated to Decreasing Consumption of Leaded Gasoline, 1983–1992

Since 1980, the Ontario government has conducted several blood lead screening surveys in children in several cities and regions of Ontario, Canada (1)(2). The blood lead concentrations in Ontario children has declined in both rural and urban areas over the past decade, this decline coinciding with the complete phasing out of lead in gasoline in 1990. Here, we evaluate this decline in terms of the geometric mean of the blood lead concentrations of 6014 children. The collection procedure of capillary finger-prick blood samples and the method for blood lead analysis by Zeeman graphite furnace atomic absorption spectrophotometry were described previously (3) and were used identically in all our blood lead analyses. The blood lead screening and surveys evaluated were done in the Toronto Western Health Unit in 1984, 1985, and 1988; the Peel Region, 1987; the Niagara Region, 1987; Southern Ontario, covering more-urban areas (Toronto, Windsor, etc.), 1984 (1); and Northern Ontario, covering the less-settled areas (e.g., Thunder Bay and Moosonee), 1987 and 1992 (2)(4). Gasoline sales data in Ontario were taken …

Finger-prick—an alternative to venipuncture for the assessment of endocrine profiles in women

Traditionally, there has been a reliance on venipuncture to obtain peripheral blood endocrine levels for the assessment of infertility treatment cycles. We have assessed the viability of a finger-prick capillary blood collection method to provide an alternative to venipuncture, assisting in the treatment of patients for whom venous sampling may be difficult to perform. A direct one-to-one relationship was found between the two collection methods with respect to E2, P, and LH measurement. Finger-prick blood collection is simple and easy to perform and provides a viable alternative to venipuncture. It also alleviates the stress involved with multiple attempts at venous sampling in some patients.

Blood lead screening in Ontario children: Blood lead and free erythrocyte protoporphyrin levels

A blood lead survey was conducted on samples from 2459 children aged 3–6 years to determine the prevalence of lead poisoning in children of this age in the Province of Ontario. Lead poisoning, defined as a blood lead concentration ⩾ 1.21 μmol l −1 (25 μg dl −1), was found in 26 subjects (1.1% of the samples). The mean blood lead concentration for children from southern Ontario was 0.50 μmol l −1, and for those from northern Ontario it was 0.37 μmol l −1. Stringent quality controls and independent cross-checks of finger-prick capillary blood sampling were employed in the study. The free erythrocyte protoporphyrin levels were also monitored to detect the presence of iron deficiency in the children.

Glycosylated haemoglobin measurement on blood samples taken by patients: an additional aid to assessing diabetic control.

200 patients attending a diabetic outpatient clinic were each asked to post to the hospital, prior to their three-monthly routine clinic visit, a finger-prick capillary blood sample for glycosylated haemoglobin assay (HbA1). Patients took their own blood into UNISTEP bottles, which automatically measure a 53 microliters aliquot and mix it with 150 microliters of diluent suitable for transport to the laboratory. During 1 year 883 (84%) of 1046 bottles sent out were returned of which 776 (87%) were suitable for analysis. The availability of the result at the time of the patients' clinic visit aided assessment of diabetic control and was associated with a mean reduction of the HbA1 by 0.8% (p less than 0.001) over a twelve-month period. This simple system facilitates remote monitoring of HbA1 levels, is suitable for both hospital and general practice use and may allow a reduction in the number of patient visits.

Effectiveness of mass screening for diabetes mellitus using random capillary blood glucose measurements.

The results of 23 228 finger-prick capillary blood glucose tests (the taking of which was coordinated by the Diabetic Association of New South Wales) were reviewed. All non-diabetic persons (n = 860) with a blood glucose result of greater than or equal to 8.0 mmol/L were surveyed and 459 responded (53.4%). The responders were typical of the surveyed group with respect to age and capillary blood glucose level. Sixty-four new cases of diabetes were detected, representing 15.8% of the replies from persons who were not known to have diabetes and 0.28% of the total number of persons screened.

Comparison between Serum Levels of Oestriol in Venous and Capillary Blood from Pregnant Women

During pregnancy, estriol is formed by the placenta mainly from fetal precursors. Measurements of estriol excretion in urine or estriol concentration in blood are widely used for assessment of the fetoplacental function. This study was undertaken to determine the relationship between the concentration of estriol in venous and in capillary blood from pregnant women, and to decide whether the more practical method of finger-prick capillary blood sampling could replace venous blood sampling for estriol estimations in the management of high-risk pregnancies. Forty-one pregnant women with gestational ages ranging from 30 to 40 weeks volunteered for the study (Table 1). An excellent correlation was found between venous and capillary samples for unconjugated estriol (r = 0.92, P < 0.001). The correlation was the same for samples from women with uncomplicated pregnancies as for samples from women with complicated pregnancies. When the mean relative difference between the venous and capillary values of unconjugated estriol was calculated for samples from women with complicated pregnancies, no difference was observed. For samples from women with uncomplicated pregnancies, the values were slightly higher in the venous blood. In Table 2, the clinical information obtained from the estriol measurements of venous and capillary blood is compared. The information disagreed in only one of 78 samples. The day-to-day variability for unconjugated estriol was of the same order in the venous as in the capillary samples. Total estriol was measured in 28 samples. The correlation between values obtained in venous and in capillary blood was 0.78 (P < 0.05).

Comparative Study of a Micro-Scale Test for Lead in Blood, for Use in Mass Screening Programs

Abstract A procedure suitable for the mass screening of children for an undue body burden of lead was tested on 170 clinic patients. Capillary finger-prick blood, collected on filter paper, was analyzed for lead with an atomic absorption spectrophotometer with the Delves cup attachment. This method of analysis had first been judged to be accurate after a laboratory evaluation in which results were compared with those obtained by a dithizone procedure. In the present study, both capillary and venous bloods were obtained from the patients. Venous bloods were also analyzed by the filter paper disk method and by an atomic absorption spectrophotometric procedure requiring a 5-ml sample. Results show that the screening method described here will reliably identify those children with a significantly supranormal blood lead. Both sample collection and laboratory analysis are easier.