Portable Glucometer Research Articles

Diabetes Management and Future Trends

1. Michelle Renee Campbell, MLS (ASCP) 1. Medical Laboratory Sciences Program, Northern Illinois University, DeKalb, IL 2. Masih Shokrani, Ph.D. MT (ASCP)[⇑][1] 1. Medical Laboratory Sciences Program, Northern Illinois University, DeKalb, IL 1. Address for Correspondence: Masih Shokrani, Ph.D. MT (ASCP ), Associate Professor, Medical Laboratory Sciences Program, College of Health and Human Sciences, Northern Illinois University, DeKalb, IL, 60115-2828, 815-753-6323, mshokrani{at}niu.edu 1. Compare treatment options for type 1 versus type 2 diabetes mellitus 2. List and describe the advantages and disadvantages of the various classes of drugs used to treat diabetes mellitus 3. Identify future trends in diabetes mellitus research and treatment. INTRODUCTION Proper management of diabetes mellitus is crucial for the health and well-being of patients. Various options exist for the treatment of both type 1 and type 2 diabetes allowing tailored treatment toward each patient. Multiple classes of drugs developed to treat diabetes mellitus can be examined including sulfonylureas, biguanides, and alpha-glucosidase inhibitors. On the horizon for treatment and management of diabetes mellitus, new developments utilize concepts such as stem cell therapy, dietary management, metabolomics and education. Diabetes Management Treatment for type 1 diabetes mellitus may include multiple components. Blood sugar levels must be monitored throughout the day using a glucometer. Self-monitoring by the patient has become increasingly practical with the advent of small, portable glucometers and similar supplies.1 Treatment with insulin is required for those with type 1 diabetes mellitus to provide consistent blood glucose management and prevent diabetic ketoacidosis. Diabetic ketoacidosis, the buildup of harmful ketones in the body due to the utilization of fat for energy, is a serious threat for diabetic patients.2 Multiple brands of insulin exist, each producing products that vary in intensity and length of action. Rapid-acting, long-acting and intermediate forms of insulin are available and may be administered via insulin pump, injection or an insulin pen.3 Rapid-acting insulin treatments include insulin aspart, glulisine and lispro. Regular insulin is considered short-acting and insulin neutral protamine Hagedorn (NPH) is intermediate-acting. Insulin determir and glargine are both long-acting varieties of insulin.4 One or a combination of these insulin options are tailored for the patient based on… ABBREVIATIONS: NPH - Neutral protamine Hagedorn, ACE - Angiotensin-converting enzyme, ARBs - Angiotensin II receptor blockers, SGLT-2 - Sodium glucose cotransporter-2, DPP-4 - Dipeptidyl peptidase 4, GLP-1 - Glucagon-like peptide-1, CDC - Center for Disease Control and Prevention, DPCP - Diabetes Prevention and Control Program 1. Compare treatment options for type 1 versus type 2 diabetes mellitus 2. List and describe the advantages and disadvantages of the various classes of drugs used to treat diabetes mellitus 3. Identify future trends in diabetes mellitus research and treatment. [1]: #corresp-1

Variations in point prevalence of diabetes, basal metabolic rate, body mass index, blood pressure and peripheral oxygen saturation in non-smoking household cigar workers in comparison to non-smoking general population: a cross sectional comparative study

Background: The aim was to investigate the prevalence of diabetes in non-smoking cigar workers and non smoking general population. Additional Objective was to assess the variations in Basal Metabolic Rate (BMR), Body Mass Index (BMI), Blood Pressure, Peripheral Oxygen Saturation (SpO2) in non-smoking cigar workers and non smoking General Population. Methods: Anthrapometric variables (height, weight, BMI), BMR, Random Blood Glucose (by portable glucometer), Blood Pressure (digital sphygmomanometer), Peripheral Oxygen Saturation (portable fingertip oximeter) were determined. Results: 17% of non-smoking cigar workers and 7% of non-smoking general population were diabetic respectively. (p<0.05, χ2= 4.735). Overall increase in means of Random Blood Glucose Level, Systolic Blood Pressure, Diastolic Blood Pressure, Mean Arterial Pressure, Rate Pressure Product and decrease in means of Peripheral Oxygen Saturation was recorded in nonsmoking cigar workers compared to non smoking general population which was statistically significant with p<0.05. Prevalence rates of Prehypertension, Stage - I Hypertension, Stage - II Hypertension was found to be 27%, 44% and 13% in non smoking cigar workers and 37%, 21%, 9% in non-smoking general population.(p<0.001, χ2=24.228). Prevalence of Prehypertension and Hypertension was statistically significant with the period of service of cigar workers (p=0.05, χ2= 26.279). Conclusions: Increased prevalence of diabetes, prehypertension and hypertension were found in non-smoking cigar workers. Random Blood Glucose Levels, Systolic Blood Pressure, Diastolic Blood Pressure, Mean Arterial Pressure, Rate Pressure Product were increased and Peripheral Oxygen Saturation was decreased in cigar workers when compared to non smoking general population.

Blood metabolites as predictors to evaluate the body condition of Neopelma pallescens (Passeriformes: Pipridae) in northeastern Brazil

ABSTRACT Body condition is an important ecological attribute that can provide a measure of the energy stored by an animal or population. Body condition is traditionally ascertained with morphometric body condition indices (BCIs), but some researchers have used various physiological and biochemical parameters as predictors of body condition. This study aimed to test reliable biochemical predictors of body condition in individuals of Neopelma pallescens (Lafresnaye, 1853), found in an Atlantic forest patch. For this purpose we examined the relationship between body condition and the concentrations of blood glucose and ketones. We also verified correlations between blood metabolite concentrations and ecological variables, including time of day, seasons, breeding periods, and ectoparasite infestation. Birds were captured with mist nets at Reserva Biologica de Guaribas, state of Paraiba, Brazil. Blood samples were analyzed with a portable glucometer. The correlation between glucose and ketones was negative. Both metabolites showed significant variations according to time of day. Glucose levels were higher in the afternoon and ketones levels were higher in the morning, suggesting a correlation with daily food intake. The BCI of non-breeding birds was negatively correlated with glucose concentrations. However, the correlation between glucose and the BCI of incubating birds was a positive. Ketone bodies did not correlate with body condition. In relation to ectoparasite infestation, only ketones showed significant results, presenting a higher concentration in infested individuals. Glucose is a good predictor of the BCI of incubating birds since it correlates positively with it. However, the lack of seasonal variations in metabolites indicates that the nutritional status of tropical birds does not change when food is abundant. Thus, we conclude that glucose and ketone bodies can predict the nutritional status of birds but in a context-dependent fashion.

Glycated Hemoglobin (HbA1c): Clinical Applications of a Mathematical Concept.

Background and purpose:Glycated hemoglobin (HbA1c) reflects the cumulative glucose exposure of erythrocytes over a preceding time frame proportional to erythrocyte survival. HbA1c is thus an areal function of the glucose-time curve, an educationally useful concept to aid teaching and clinical judgment.Methods:An ordinary differential equation is formulated as a parsimonious model of HbA1c. The integrated form yields HbA1c as an area-under-the-curve (AUC) of a glucose-time profile. The rate constant of the HbA1c model is then derived using the validated regression equation in the ADAG study that links mean blood glucose and HbA1c with a very high degree of goodness-of-fit.Results:This model has didactic utility to enable patients, biomedical students and clinicians to appreciate how HbA1c may be conceptually inferred from discrete blood glucose values using continuous glucose monitoring system (CGMS) or self-monitored blood glucose (SMBG) glucometer readings as shown in the examples. It can be appreciated how hypoglycemia can occur with rapid HbA1c decline despite poor glycemic control.Conclusions:Being independent of laboratory assay pitfalls, computed ‘virtual’ HbA1c serves as an invaluable internal consistency cross-check against laboratory-measured HbA1c discordant with SMBG readings suggestive of inaccurate/fraudulent glucometer records or hematologic disorders including thalassemia and hemoglobinopathy. This model could be implemented within portable glucometers, CGMS devices and even smartphone apps for deriving tentative ‘virtual’ HbA1c from serial glucose readings as an adjunct to measured HbA1c. Such predicted ‘virtual’ HbA1c readily accessible via glucometers may serve as feedback to modify behavior and empower diabetic patients to achieve better glycemic control.

Niveles de glicemia en potros criollo colombiano durante sus primeras horas de vida

The blood glucose level is an important parameter for clinical dedicated toequine neonatology, especially in neonatal care units, where is critical asa prognostic indicator parameter, so you need to have parameters precisereference to assist the decision making. In the race Criollo Colombianowe have not found reference values, so in clinical practice are used valuesfor different races and backgrounds, and this is the first report in thisrace in Colombia. The study was conducted in the municipality of BolivarCity; where blood glucose levels were assessed in peripheral blood sampleusing a portable glucometer. They were evaluated 29 infants childrenfoals stabled mares, measurements were made before the first lactation(T0) and three measurements at intervals of three hours. (T3, T6 and T9).Confidence intervals for the population mean were determined, and a comparisonwas made between the sexes, a regression equation for predictingglucose was also determined by the measurement time. T0 was determinedthat an average of 81.76 ± 9.25 mg / dL, was presented to the T3 was88.97 ± 11.73 mg / dL, for the T6 112.31 ± 16.52 mg / dL and T9 118.52 ±13.59 was mg / dL. Polynomial regression equation was Glucose = 80.27 +1.617 tiempo2-0,127tiempo3 (R2 = 0.58). No statistically significant difference(p> 0.05) was found between the sexes.

Glucose determination in fish plasma by two different moderate methods

Teleost fish include many different species, having a large economic and environmental impact. Glucose is a key source of energy for most vertebrate organisms. Fish as well as mammals maintain a specific level of blood sugar – glycaemia, which is influenced by multiple factors such as hormone production, diet, and temperature. Therefore, it is a useful indicator for scientists who need to check the immediate state of an organism. The most frequently used method of measuring glycaemia in farmed fish is spectrophotometry; however, this method is often inconvenient for field experiments. Here we report that basic spectrophotometry using oxidation of blood beta D-glucose by glucose oxidase (used in laboratory conditions) can be easily substituted with portable glucometer measurements, primarily designed for human samples. The possibility of use outside the laboratory and its small sample volume demands make this method very useful. Field studies often require fast sample processing and conditions of measurement are limited. Using the glucometer is a simple and elegant option. We tested 74 blood plasma samples (29 males, 45 females) of tench (Tinca tinca) both spectrophotometrically and using the human glucometer. Our results show a significant linear correlation (P&lt; 0.001) between both methods. The main contribution of this study consists in comparability and interchangeability of results obtained from both presented methods.

COMPARAÇÃO ENTRE OS MÉTODOS LABORATORIAL E PORTÁTIL NA ANÁLISE DA GLICEMIA EM FELINOS COM AMOSTRAS DE SANGUE VENOSO CENTRAL E CAPILAR

The objective of this study was to compare the efficacy of portable blood glucose measurement method in relation to the laboratory reference method, using central venous and capillary blood samples from 20 cats. The value obtained by the laboratory method using central venous blood sample was considered as the standard reference value. Other two values were obtained from the portable blood glucose meter, in which a sample from the same central venous blood and another one sample from capillary blood were used. For the 20 cats, the blood glucose results obtained by the laboratory method had an average of 80mg/dL; and the results found by the glucometer had an average of 84.1mg/dL with central venous blood and of 73.1mg/dL with capillary blood. The glycemic averages obtained by the glucometer with both blood samples compared to that achieved by the laboratory method resulted in variations below the maximum established (20%) by associations that regulate portable glucometers and by the organization for standardization, as well as the variation between the glycemic averages obtained by the glucometer using different blood samples. In the comparative analysis, there was no significant difference between the methods (p<0.05). In conclusion, the portable glucometer is effective in measuring blood glucose in cats, both from central venous blood and capillary blood samples. Keywords: cat, glucometer, glucose, measurement.

Evaluación de la satisfacción del paciente diabético con la utilización del glucómetro portátil BGSTAR© mediante el cuestionario SATIGLU

ObjectivesTo assess satisfaction of patients diagnosed with Diabetes Mellitus (DM), type 1 and 2, with use of the portable glucometer BGStar© using the previously validated SATIGLU questionnaire. The relationships between satisfaction level and adherence to continuous glucose monitoring, insulin therapy, and with the level of glycemic control (% HbA1c), were also studied. Material and methodEpidemiological, multicenter, cross-sectional study that included 221 diabetic patients aged over 18 years, receiving treatment with insulin and using the BGStar© glucometer. Socio-demographic and clinical data were collected, as well as treatment and adherence data. Patients self-completed the SATIGLU questionnaire and Morisky-Green (M-G). A descriptive analysis was carried out on the SATIGLU scores and other study variables. An analysis was performed to calculate the association between satisfaction scores and the number of insulin injections and the number of glucose controls (Spearman rho), and with the adherence to treatment classification according to M-G, and with the glycemic control classification according to % HbA1c. Multiple Linear Regression analysis was conducted to identify the variables associated with SATIGLU scores. ResultsMean age (SD) 57.96 (15.60) years; 56.60% male; 80.82% T2DM; good glycemic control (% HbA1c≤7), 65.30%. Mean (SD) insulin injections/day, 2.35 (1.34), and blood glucose/day controls 2.56 (1.29), with 75.57% showing adherence to therapy (M-G). A positive correlation was found between the SATIGLU and the number of glycemic controls (rho=0.251; P=.001) and of insulin injections (rho = 0.235; P=.001). SATIGLU scores were higher in adherent patients and in those with better glycemic control (P<.0001). The regression model showed that the variables associated with satisfaction were: adherence (B= 7.006; P<.0001), and the number of glycemic controls (B= 3,214; P=.014). ConclusionsThe patients studied showed high satisfaction with the BGStar© glucometer, with a high level of adherence to insulin therapy. They also had more insulin injections, a higher number of glycemic controls, and a better DM control.

Low-cost and highly efficient DNA biosensor for heavy metal ion using specific DNAzyme-modified microplate and portable glucometer-based detection mode

A simple and low-cost DNA sensing platform based on Pb2+-specific DNAzyme-modified microplate was successfully developed for highly sensitive monitoring of lead ion (Pb2+, one kind of toxic heavy metal ion) in the environmental samples coupling with a portable personal glucometer (PGM)-based detection mode. The detection cell was first prepared simply by means of immobilizing the DNAzyme on the streptavidin-modified microplate. Gold nanoparticle labeled with single-stranded DNA and invertase (Enz-AuNP-DNA) was utilized as the signal-transduction tag to produce PGM substrate (glucose). Upon addition of lead ion into the microplate, the substrate strand of the immobilized DNAzyme was catalytically cleaved by target Pb2+, and the newly generated single-strand DNA in the microplate could hybridize again with the single-stranded DNA on the Enz-AuNP-DNA. Accompanying with the Enz-AuNP-DNA, the carried invertase could convert sucrose into glucose. The as-produced glucose could be monitored by using a widely accessible PGM for in situ amplified digital readout. Based on Enz-AuNP-DNA amplification strategy, as low as 1.0pM Pb2+ could be detected under the optimal conditions. Moreover, the methodology also showed good reproducibility and high selectivity toward target Pb2+ against other metal ions because of highly specific Pb2+-dependent DNAzyme, and was applicable for monitoring Pb2+ in the naturally contaminated sewage and spiked drinking water samples.

Low-cost and highly sensitive immunosensing platform for aflatoxins using one-step competitive displacement reaction mode and portable glucometer-based detection.

Aflatoxins are highly toxic secondary metabolites produced by a number of different fungi and present in a wide range of food and feed commodities. Herein, we designed a simple and low-cost immunosensing platform for highly sensitive detection of mycotoxins (aflatoxin B1, AFB1, used as a model) on polyethylenimine (PEI)-coated mesoporous silica nanocontainers (PEI-MSN). The assay was carried out by using a portable personal glucometer (PGM) as the readout based on a competitive displacement reaction mode between target AFB1 and its pseudo-hapten (PEI-MSN) for monoclonal anti-AFB1 antibody (mAb). To construct such an assay protocol, two nanostructures including mAb-labeled gold nanoparticle (mAb-AuNP) and PEI-MSN were initially synthesized, and then numerous glucose molecules were gated into the pores based on the interaction between negatively charged mAb-AuNP and positively charged PEI-MSN. In the presence of target AFB1, a competitive-type displacement reaction was implemented between mAb-AuNP and PEI-MSN by target AFB1 through the specific antigen-antibody reaction. Accompanying the reaction, target AFB1 could displace the mAb-AuNP from the surface of PEI-MSN, resulting in the release of the loading glucose from the pores due to the gate opened. The released glucose molecules could be quantitatively determined by using a portable PGM. Under optimal conditions, the PGM signal increased with the increment of AFB1 concentration in the range from 0.01 to 15 μg/kg (ppb) with a detection limit (LOD) of 5 ng/kg (5 ppt) at the 3sblank criterion. The selectivity and precision were acceptable. Importantly, the methodology was further validated for assaying naturally contaminated or spiked blank peanut samples, and consistent results between the PGM-based immunoassay and the referenced enzyme-linked immunosorbent assay (ELISA) were obtained. Therefore, the developed immunoassay provides a promising approach for rapid screening of organic pollutants because it is simple, low-cost, sensitive, specific, and without the need of multiple separation and washing steps.

Validity and Reliability of a Glucometer Against Industry Reference Standards.

As an appealing alternative to reference glucose analyzers, portable glucometers are recommended for self-monitoring at home, in the field, and in research settings. The purpose was to characterize the accuracy and precision, and bias of glucometers in biomedical research. Fifteen young (20-36 years; mean = 24.5), moderately to highly active men (n = 10) and women (n = 5), defined by exercising 2 to 3 times a week for the past 6 months, were given an oral glucose tolerance test (OGTT) after an overnight fast. Participants ingested 50, 75, or 150 grams of glucose over a 5-minute period. The glucometer was compared to a reference instrument. The glucometer had 39% of values within 15% of measurements made using the reference instrument ranging from 45.05 to 169.37 mg/dl. There was both a proportional (-0.45 to -0.39) and small fixed (5.06 and 0.90 mg/dl) bias. Results of the present study suggest that the glucometer provided poor validity and reliability results compared to the results provided by the reference laboratory analyzer. The portable glucometers should be used for patient management, but not for diagnosis, treatment, or research purposes.

Wrapping DNA-gated mesoporous silica nanoparticles for quantitative monitoring of telomerase activity with glucometer readout.

This work reports a simple and sensitive sensing protocol for the quantitative monitoring of telomerase activity based on target-responsive release of cargo from wrapping DNA-capped mesoporous silica nanoparticles (MSNs) by coupling with a portable personal glucometer (PGM). To construct such an assay system, glucose molecules are initially loaded into the pores of the aminated MSN, and the pores are then sealed with a specially designed wrapping DNA. Upon the addition of telomerase and dNTPs, the assembled wrapping DNA strands are prolonged with the assistance of telomerase on the aminated MSN. Accompanying the progression of telomerase, the extended DNA strands detach from the MSN, owing to the formation of rigid, hairpin-like DNA structures. The "molecular gates" are then opened, resulting in the release of glucose from MSN. The released glucose molecules can be quantitatively monitored using an external PGM. The PGM signal increases with the increment of telomerase activity. Under optimal conditions, the PGM-based sensing platform exhibits good analytical properties for the determination of telomerase activity and allows for the detection of telomerase activity in the HeLa extract at concentrations as low as 80 cells mL-1. Using somatic and tumor cell lines, the generality of the assay is evaluated with satisfactory results. The inhibition effect of 3'-azido-3'-deoxythymidine also receives a good performance in the telomerase-inhibitor screening research. The methodology affords good reproducibility and simple operations, thus providing a useful scheme for practical use in a quantitative telomerase activity assay for clinical application.

Desarrollo y validación de un cuestionario específico de evaluación de la satisfacción del paciente diabético con glucómetros

ObjectiveThe aim of the study was to develop a specific questionnaire to assess patient satisfaction with the use of glucometers, and to evaluate their psychometric properties (feasibility, reliability and validity). Material and methods(i) An initial 53 item bank was constructed from a systematic review of literature. A panel composed of 6 experts and 50 patients concluded a 25 item version of the questionnaire (dimensions: Satisfaction, inconveniences, added value and appearance). (ii) In order to evaluate the psychometric properties, an epidemiological multi-centred, cross-sectional and 2 month long study was designed, for which 283 patients 18 years or older who were suffering from DM (type 1 and 2) and using a portable glucometer were recruited. Responses to the questionnaire that was the purpose of the study were gathered, together with complementary variables in a single visit. To evaluate test-retest reliability, 51 patients responded again 15 days after initial visit. ResultsThere was high internal consistency (Cronbach alpha=.88). Moreover, it showed a positive and statistically significant correlation with patient overall satisfaction (SAT-Q), and with patient treatment-satisfaction (DTSQs©) questionnaires. Statistically significant differences were found in SATIGLU total score depending on the type of DM, in favour of type 1 DM patients (z=6.69; P=.000), and glycated haemoglobin favouring patients who observe a good control of their disease, HbA1c<7 (z=–3.13; P=.002). ConclusionThe SATIGLU Questionnaire showed adequate psychometric properties as an evaluation tool of patient satisfaction with the use of glucometers.

Glicemia do sangue capilar e venoso de cães saudáveis: mensuração por método eletroquímico versus enzimático laboratorial

Glucose evaluation with glucometer is important due to its high speed and low cost, being an important instrument to control glycemia alterations and allowing quick diagnostic and therapeutic decisions. In this work we have measured and compared the glycemia of capillary and venous blood of healthy dogs through digital glucometer, using, as reference, the values obtained by laboratorial enzymatic method with samples of venous blood. It was evaluated the glycemia of twenty dogs, of no specific breed, fasting for 12 hours. To evaluate the glycemia, with digital glucometer, it was used one blood drop from the ear’s border and cephalic vein, while for the evaluation through laboratorial enzymatic method it was collected 2 mL of blood from the cephalic vein. The glycemia average values, obtained by digital glucometer, from venous and capillary blood were, respectively, 84,60 mg/dL (± 11,15) and 76,65 mg/ dL (± 10,73), while the ones obtained from laboratorial enzymatic method were 80,7 mg/dL (± 9,97), with no statistical differences. It is concluded that the glucometer can be securely used in dogs, since the average values of capillary and venous glycemia, measured with portable digital glucometer, were similar to the values obtained by laboratorial method.

Dipstick urinalysis for diabetes screening in TB patients.

Diabetes knowledge among TB patients can contribute to improved TB treatment outcomes, but lack of diabetes diagnosis awareness is a limitation in developing countries. Given its low cost, the sensitivity of urine glucose dipsticks for diabetes screening in TB patients was assessed. Glycosuria was assessed in 90 newly diagnosed TB patients (38 with diabetes) in south Texas, USA (n = 20) and northeast Mexico (n = 70) during January 2009-December 2010. Glycosuria was detected in 65% of the diabetic patients with chronic hyperglycemia (positive predictive value 91%, negative predictive value 84%). We propose that TB clinics with limited budgets where portable glucometers may not be available conduct universal screening for diabetes with urine dipsticks. This could be followed by blood glucose or HbA1c testing in the subset of patients requiring confirmation or higher sensitivity assessment, to improve the comanagement of TB and diabetes.

Islet Transplantation in a Subarachnoid Cavity Surrounding Olfactory Bulb of Diabetic Rats

Islet Transplantation in a Subarachnoid Cavity Surrounding Olfactory Bulb of Diabetic Rats

팔, 손가락, 정맥에서 채취한 혈액의 혈당검사결과 비교 분석

팔부위에서 혈당을 측정하는 것은 모세혈관에서 혈액을 채취하는 동안 느끼는 통증을 줄일 수 있다. 본 연구에서는 팔부위 혈당검사의 임상적 유효성을 평가하기 위해 팔부위 혈당검사결과를 손가락 및 정맥에서의 혈당검사결과와 각각 비교하였다. 당뇨환자 61명이 포함된 555명의 피검자를 대상으로 금식 상태에서 휴대형 혈당계로 손가락과 팔 안쪽 부위에서 혈당검사를 수행하였으며, 1시간 이내에 피검자 514명의 정맥혈액으로 혈당검사를 수행하였다. 측정값들에 대해 선형회귀분석, 급내 상관분석(intraclass correlation), Passing-Bablok 회귀분석 기법으로 다양하게 비교 분석해 보았다. 팔부위 혈당값은 환자군에서 손가락 및 정맥 혈당값과의 상관계수(r)가 0.97(P<0.0001)로 높은 선형관계를 나타내었으며, 정상군에서도 r값이 약간 작았지만 유사하였다. 채혈 부위에 따른 혈당값의 평균 차이는 두 집단에서 모두 <TEX>${\pm}10mg/dL$</TEX> 이내이었다. 급내 상관계수는 r값에 비교하여 약간 작았지만 두 집단이 유사한 수치를 나타내었다. Passing-Bablok 분석에서 기울기의 95% 신뢰구간과 절편은 각각 < <TEX>${\pm}20%$</TEX>, < <TEX>${\pm}20mg/dL$</TEX>로서 임상 허용범위 이내의 값을 나타내었다. 본 연구에서 사용한 세 가지 통계분석 결과 팔부위 혈당값이 손가락과 정맥에서 측정한 혈당값과 충분히 일치함이 입증되었다. 팔부위 혈당검사가 표준방법인 손가락 혈당검사와 높은 일치성을 나타내었으므로 금식 상태에서의 임상적용 가능성을 확인할 수 있었다. Capillary blood sampling on the forearm reduces pain caused by skin puncture. The present study compared the blood glucose test results performed at different sampling sites of the forearm, finger, and vein to evaluate clinical validity of this alternative site blood sampling technique. Subjects numbered 555 including 61 diabetic patients participated to measure the glucose concentration on the finger (<TEX>$G_F$</TEX>) and the forearm (<TEX>$G_A$</TEX>) with a portable glucometer under overnight fasting state. Then, the venous glucose concentration (<TEX>$G_V$</TEX>) was measured in 514 subjects in less than 1 hour. The test results were analyzed by simple linear regression, intraclass correlation, and Passing-Bablok regression techniques. <TEX>$G_A$</TEX> was highly correlated with <TEX>$G_F$</TEX> or <TEX>$G_V$</TEX> showing the correlation coefficients (r) of approximately 0.97 (P<0.0001) in the normal group. The patient group also resulted similarly high correlation with only slightly lower r value. The mean differences in glucose concentration were less than <TEX>${\pm}10mg/dL$</TEX> regardless of the sampling sites. Intraclass correlation coefficients were slightly smaller than r but very much similar in value in both groups. The 95% confidence intervals of the slope as well as the intercept in the Passing-Bablok regression analysis were < <TEX>${\pm}20%$</TEX> and < <TEX>${\pm}20mg/dL$</TEX>, respectively, which were within the clinically acceptable ranges. These three statistical techniques introduced in the present study well demonstrated the consistency of <TEX>$G_A$</TEX> with <TEX>$G_F$</TEX> and <TEX>$G_V$</TEX>. Therefore, the forearm blood glucose test could be considered as clinically valid under fasting condition.

Accuracy of a portable glucose meter and of a Continuous Glucose Monitoring device used at home by patients with type 1 diabetes

BackgroundPatients with diabetes are recommended to self-monitor their blood glucose levels also at home. Accuracy of a hand-held glucometer and a Continuous Glucose Monitoring (CGM) device were comparatively evaluated. MethodsVenous blood samples (for reference laboratory determinations; n=428) were collected from 18 type 1 patients (35–65years old), immediately followed by capillary measurement (Bayer ContourLink meter) and CGM readings (Medtronic Paradigm). ResultsLaboratory values did not differ statistically from ContourLink and CGM readings, mean difference (±SD) being −0.05±1.06mmol/L and 0.10±1.84mmol/L glucose, respectively. A bias ((value−reference)/reference×100) ≥15% was observed in 27.7% and 54.9% of cases, respectively. Notably, below 3.9mmol/L glucose (hypoglycemic threshold), an absolute error>0.8mmol/L was found in 78.9% and 94.1% of cases. The absolute errors of the CGM device were inversely related to the rate of glucose change (r=0.598, p<0.001). ConclusionsA very large error was observed at the extreme glycemic values, which may lead to erroneous therapy. Consequently, performance of future portable glucometers should be focused in particular under hypo- and hyper-glycemia. Moreover, integrated CGM devices should not disregard the effect of the rate of blood glucose change on the sensor readings.

Evaluation of a portable glucose meter for use in cattle and sheep

In farm animal practice, determination of blood glucose concentration under field conditions is often necessary. As there is no portable glucose meter device developed for use in farm animals, the analytical accuracy of a portable glucometer designed for people was evaluated for its use in cattle and sheep. Blood samples from 90 cattle and 101 sheep were used in the study. Glucose concentration was determined in whole blood immediately after blood collection from the jugular vein with the One Touch Vita portable glucometer and in serum with an enzymatic colorimetric method. The agreement between methods was assessed by Passing and Bablok regression analysis. The precision and the accuracy of the measurements were determined using the concordance correlation coefficient. There was a strong linear relationship between the glucose values obtained using the portable glucometer and those obtained by the bench method in both cattle and sheep. Precision was 95% for cattle and 88% for sheep, whereas accuracy was 92% and 99%, respectively. The mean glucose values obtained using the portable glucometer were significantly lower by 8.3% in cattle and 3.2% in sheep than those determined by the bench method. The One Touch Vita portable glucometer can be used in clinical practice to determine blood glucose concentrations in cattle and sheep, but reference intervals (RI) must be corrected to allow for negative bias. Based on these equations the RI for blood glucose in cattle and sheep using the portable glucometer were corrected to 1.84-4.17 and 2.41-4.35 mmol/L, respectively.

Metabolic Syndrome Components and Living Habits According to Fasting Blood Sugar Measured by Glucometer in Workers

Background: Many studies have underlined the importance of the prevention and management of metabolic syndrome (MetS). Workplace can serve as an important place for prevention and control of MetS.Objective: This study was performed to compare the prevalence of MetS, its components and living habits according to Fasting Blood Sugar (FBS) measured by portable glucometer in workers under 40 years old. Results: Prevalence of MetS was 11.2% in male workers and 1.8% in female workers. There were significant differences in the number of MetS components in male workers according to FBS level (p<.05). Smoking and drinking showed significant relations with high FBS (≥126) in men and women respectively (p<.05). Conclusion: Occupational health manager should effort to manage and control the level of blood glucose of workers in workplace to prevent MetS. Also, effective intervention programs are needed to promote smoking cessation and alcohol-reducing.Keywords: Alcohol Drinking, Fasting Blood Sugar, Metabolic Syndrome Components, Smoking, Worker