Regular Blood Glucose Research Articles

Application of the Omaha System-Based Continuous Care Model in Diabetes Health Management for Outpatients within the Framework of "Internet +".

Aims/Background Diabetes is a chronic lifelong condition that requires consistent self-care and daily lifestyle adjustments. Effective disease management involves regular blood glucose monitoring and ongoing nursing support. Inadequate education and poor self-management are key factors contributing to increased mortality among diabetic individuals. Providing personalized guidance and behavioral interventions through continuous nursing care is crucial for achieving optimal glycemic control and fostering positive societal outcomes. This study aimed to evaluate the impact of an Omaha System-based continuous nursing model, implemented through the "Internet+" framework, on enhancing self-health management skills, glycemic control, and treatment adherence among patients with type 2 diabetes mellitus (T2DM). Methods This retrospective study analyzed clinical data of T2DM patients who visited the diabetes health management clinic of Zhang Ye People's Hospital affiliated to Hexi University between December 2023 and May 2024. Participants were categorized into intervention and control groups based on whether they received the "Internet+"-enabled Omaha System continuous nursing care model. Variables, including demographic characteristics, self-management behaviors, cognitive abilities, environmental factors, glycemic control indicators, and treatment adherence (medication compliance, dietary compliance, lifestyle adherence, and follow-up punctuality), were assessed and compared at baseline, 1 month, and 3 months post-intervention. Results The study included 52 patients in the intervention group and 68 in the control group. Baseline characteristics revealed no significant differences between the two groups (p > 0.05). At 1 and 3 months post-intervention, the intervention group exhibited significant improvements in self-management behaviors, cognitive abilities, environmental factors, and overall scores compared to baseline and the control group (p < 0.05). Fasting plasma glucose (FPG) levels were also significantly reduced in the intervention group compared to baseline and the control group (p < 0.05). 3 months post-intervention, the intervention group demonstrated significantly higher adherence rates to dietary recommendations, healthy lifestyle practices, and treatment compliance compared to the control group (p < 0.05). Conclusion The "Internet+"-based Omaha System continuous nursing model significantly enhances self-health management capabilities, stabilizes glycemic control, and promotes adherence to healthy behaviors among patients with T2DM. These findings highlight the potential of the model for broader clinical application in diabetes management.

Health-related quality of life and associated factors in people with Type 2 diabetes mellitus in Nepal: Baseline findings from a cluster-randomized controlled trial.

This study aims to assess the status of health-related quality of life (HRQOL) and its associated factors in people with Type 2 diabetes mellitus (T2DM) in Nepal. HRQOL of 481 participants with T2DM in Kavrepalanchok and Nuwakot was measured using European Quality of life Visual Analogue Scale (EQVAS) and European Quality of life 5 dimensions (EQ5D) index from the EQ5D-3L tool. Associated correlates of T2DM were examined using linear regression analyses. The study participants generally reported higher HRQOL. Being 60 years or older was associated with a significantly lower EQVAS whereas, urban residence, higher education, testing glycated haemoglobin regularly were significantly associated with a higher EQVAS. Not having depressive symptoms was significantly associated with higher EQVAS and EQ5D-3L index. Encouraging screening of depressive symptoms, improving awareness on the importance of regular blood glucose monitoring and T2DM self-management education should be incorporated within primary diabetes care to improve HRQOL in Nepal.

The Effect of Parental Collaboration on Diabetes Self-Efficacy, Quality of Life and HbA1c Level in Adolescents Diagnosed with Type 1 Diabetes.

Type 1 diabetes mellitus (T1D) is a chronic disease that is common in childhood and adolescence, where care and metabolic control are difficult for both adolescents and their parents. Parental participation in the care and treatment process, especially during adolescence when adolescents develop autonomy and take responsibility for self-care, affects both the adolescent's perception of autonomy and may cause difficulties in self-management. This study was conducted to determine the effect of parental support on adolescents' self-efficacy, quality of life (QoL) and glycaemic control in adolescents with T1D. This study was descriptive and cross-sectional. Descriptive questionnaires, The Collaborative Parental Involvement Scale for Adolescents with T1D, Diabetes Management Self-Efficacy Scale for Adolescents with T1D and QoL Scale in Children with Diabetes Mellitus (PedsQL 3.0) were administered to 79 adolescents with T1D. Adolescents were also asked about their HbA1c levels measured in the last 3 months. There was no relationship between parental collaboration and adolescent's HbA1c levels. However, it was concluded that there was a positive and moderate relationship between parental collaboration and adolescent's QoL (p=0.043) and a positive and strong relationship between parental collaboration and adolescent's diabetes management self-efficacy (p=0.000). It was found that adolescents who followed up diabetes with the support of themselves and both parents especially their fathers, who were not school absenteeism and had regular blood glucose measurements had better QoL, there was no relationship between HbA1c levels and QoL, and there was a strong relationship between parental cooperation and adolescent self-efficacy in the same direction.

New insights into gestational diabetes: genetic and epigenetic factors

ABSTRACT Gestational diabetes is generally diagnosed between the 24th and 28th weeks of pregnancy because of hormonal changes leading to insulin resistance. Key risk factors include obesity, a family history of diabetes and ethnicity, as well as genetic and epigenetic influences. Epigenetic modifications, such as DNA methylation and histone acetylation, alongside environmental factors like diet and exposure to endocrine disruptors, contribute to the risk. Effective management of gestational diabetes is crucial to prevent complications such as macrosomia, birth trauma, and an increased risk of caesarean delivery. This management requires dietary changes, regular blood glucose monitoring, and sometimes insulin therapy. Current research focuses on understanding genetic and epigenetic influences to improve prediction and develop targeted therapies, highlighting the necessity for personalised approaches to managing and preventing gestational diabetes. Advances in this area could lead to more effective and individualised treatment strategies, benefiting both mothers and their babies.

DIGITAL INTERVENTIONS ROLE IN SELF-MANAGEMENT OF DIABETES MELLITUS (DM): A NARRATIVE REVIEW

Diabetes mellitus (DM) is a chronic illness that raises morbidity and death rates worldwide and substantially negatively influences patients quality of life. Health authorities now teach patients and their families good behavioral changes and self-management techniques to enhance clinical therapy and lower complications. Diabetes requires a complicated set of everyday habits to manage, such as regular blood glucose testing, eating a balanced diet, exercising, and keeping a healthy weight. Patients now have the tools they need to effectively manage their conditions thanks to the development of e-health and mobile health (mHealth). These technologies help optimize and monitor glucose levels and have been warmly received. A meta-analysis by Captieux M., et al. (2016) found that application users attitudes toward self-care had improved, and their HbA1c levels had significantly decreased. The efficacy of these technologies varies, though, and obstacles to their broad adoption include low levels of literacy, privacy and security concerns, economic constraints, and the requirement for standardization across various demographics and technical platforms. Notwithstanding these obstacles, digital approaches have demonstrated the potential to enhance diabetic self-management and clinical outcomes. These include telemedicine, mobile health applications, and e-health systems. Applications like BlueStar and OneTouch Reveal, as well as programs like My Diabetes Coach, have been shown to improve glucose management and health-related quality of life. However, more investigation and creation are required to improve the usability and accessibility of these digital health solutions. This narrative review examines the current state of digital health technologies for diabetes self-management and highlights their benefits and drawbacks. It emphasizes the importance of addressing current challenges to fully achieve the potential of digital interventions in controlling type 2 diabetes and type 1 diabetes.

Trends of diabetes in Beijing, China.

The global rise in diabetes prevalence is a pressing concern. Despite initiatives like "The Healthy Beijing Action 2020-2030" advocating for increased awareness, treatment, and control, the specific situation in Beijing remains unexplored. This study aimed to analyze the trends in diabetes prevalence, awareness, treatment, and control among Beijing adults. Through a stratified multistage probability cluster sampling method, a series of representative cross-sectional surveys were conducted in Beijing from 2005 to 2022, targeting adults aged 18-79 years. A face-to-face questionnaire, along with body measurements and laboratory tests, were administered to 111,943 participants. Data from all survey were age- and/or gender-standardized based on the 2020 Beijing census population. Annual percentage rate change (APC) or average annual percentage rate change (AAPC) was calculated to determine prevalence trends over time. Complex sampling logistic regression models were employed to explore the relationship between various characteristics and diabetes. From 2005 to 2022, the total prevalence of diabetes among Beijing adults aged 18-79 years increased from 9.6% (95% CI: 8.8-10.4%) to 13.9% (95% CI: 13.1-14.7%), with an APC/AAPC of 2.1% (95% CI: 1.1-3.2%, P<0.05). Significant increases were observed among adults aged 18-39 years and rural residents. Undiagnosed diabetes rose from 3.5% (95% CI: 3.2-4.0%) to 7.2% (95% CI: 6.6-7.9%) with an APC/AAPC of 4.1% (95% CI: 0.5-7.3%, P<0.05). However, diabetes awareness and treatment rates showed annual declines of 1.4% (95% CI: -3.0% to -0.2%, P<0.05) and 1.3% (95% CI: -2.6% to -0.2%, P<0.05), respectively. The diabetes control rate decreased from 21.5% to 19.1%, although not statistically significant (APC/AAPC=-1.5%, 95% CI: -5.6% to 1.9%). Overweight and obesity were identified as risk factors for diabetes, with ORs of 1.65 (95% CI: 1.38-1.98) and 2.48 (95% CI: 2.07-2.99), respectively. The prevalence of diabetes in Beijing has significantly increased between 2005 and 2022, particularly among young adults and rural residents. Meanwhile, there has been a concerning decrease in diabetes awareness and treatment rates, while control rates have remained stagnant. Regular blood glucose testing, especially among adults aged 18-59 years, should be warranted. Furthermore, being male, elderly, overweight, or obese was associated with higher diabetes risk, suggesting the needs for targeted management strategies.

Long-Term Sulfonylurea Use and Impaired Awareness of Hypoglycemia Among Patients With Type 2 Diabetes in Taiwan.

We undertook a study to investigate the relationship between duration of medication use and prevalence of impaired awareness of hypoglycemia (IAH) among patients with insulin-treated or sulfonylurea-treated type 2 diabetes in Taiwan. A total of 898 patients (41.0% insulin users, 65.1% sulfonylurea users; mean [SD] age = 59.9 [12.3] years, 50.7% female) were enrolled in pharmacies, clinics, and health bureaus of Tainan City, Taiwan. Presence of IAH was determined with Chinese versions of the Gold questionnaire (Gold-TW) and Clarke questionnaire (Clarke-TW). Sociodemographics, disease and treatment histories, diabetes-related medical care, and health status were collected. We used multiple logistic regression models to assess the relationship between duration of medication use and IAH. Overall IAH prevalence was 41.0% (Gold-TW) and 28.2% (Clarke-TW) among insulin users, and 65.3% (Gold-TW) and 51.3% (Clarke-TW) among sulfonylurea users. Prevalence increased with the duration of sulfonylurea use, whereas it decreased with the duration of insulin use. After controlling for potential confounders, 5 or more years of sulfonylurea use was significantly associated with 3.50-fold (95% CI, 2.39-5.13) and 3.06-fold (95% CI, 2.11-4.44) increases in the odds of IAH based on the Gold-TW and Clarke-TW criteria, respectively. On the other hand, regular blood glucose testing and retinal examinations were associated with reduced odds in both insulin users and sulfonylurea users. The prevalence of IAH was high among patients using sulfonylureas long term, but the odds of this complication were attenuated for those who received regular diabetes-related medical care. Our study suggests that long-term sulfonylurea use and irregular follow-up increase risk for IAH. Further prospective studies are needed to confirm the observed associations.Annals Early Access article.

A Biomineralized Bifunctional Patient-Friendly Nanosystem for Sustained Glucose Monitoring and Control in Diabetes.

Regular blood glucose monitoring and control is necessary for people with type 1 or advanced type 2 diabetes, yet diagnosing and treating patients with diabetes in an accurate, sustained and patient-friendly manner remains limited. Here, a glucose-responsive bifunctional nanosystem (PGOxMns) is constructed via one-pot biomineralisation of manganese dioxide with glucose oxidase and ε-poly-L-lysine. Under hyperglycaemic conditions, the cascade reactions that occur when glucose interacts with PGOxMns can trigger the production of Mn(II), which enhances the magnetic resonance imaging signal. Simultaneously, manganese dioxide catalyses the decomposition of toxic hydrogen peroxide into oxygen, which also maintains glucose oxidase (GOx)activity. In an in vivo model of diabetes, PGOxMns is used to monitor glucose levels (0-20mm) and allowed identification of diabetic mice via T1-weighted MRI. Furthermore, PGOxMns is found to have a high insulin-loading capacity (83.6%), likely due to its positive charge. A single subcutaneous injection of insulin-loaded nanosystem (Ins-PGOxMns) into diabetic mice resulted in a rapid and efficient response to a glucose challenge and prolonged blood glucose level control (< 200mgdL-1) for up to 50h. Overall, this proof-of-concept study demonstrates the feasibility of using biomineralised nanosystems to develop patient-friendly strategies for glucose monitoring and control.

Assessment of Self-Care Practices among Type 2 Diabetes Mellitus Patients attending Health Care Centres of Urban Area of Hyderabad, India

Introduction: As per the International Diabetic Federation Atlas, 2021, 3 in 4 adults with type 2 diabetes mellitus live in low and middle income countries. This represents a tremendous burden on the healthcare system of these countries. Self-care practices can mitigate the disease burden. Objectives: To assess the self-care practices among the type 2 patients using Summary of Diabetes Self-Care Activities (SDSCA). Method: A facility based cross sectional study was undertaken among adults aged 25-60 years using a modified SDSCA, validated in Indian settings to study the self-care practices in diabetic patients. The modified domains included practices on dietary modifications, regular physical activity, foot care, regular blood glucose monitoring, drug adherence and addictions. Mean scores of these domains in SDSCA were compared with HbA1c measurements. Statistical tests performed included unpaired T test and chi-square. Results: Mean age of the patients was 49.60+ 11.13 Years. There were about 117(54.4%) patients with controlled HbA1c measurements. There was a statistically significant association of dietary modifications, regular physical activity, foot care, drug adherence and addictions with controlled HbA1c measurements. (p value=0.05) Conclusion: Self-care practices can significantly alter diabetes control and prevent complications. Regular glucose monitoring was lacking in several patients and led to poor glycemic controls. These results can inform clinical practice and patient care for better management of the type 2 diabetes mellitus.

Clinical Profile of Mucormycosis Patients during Coronavirus Disease 2019 Pandemic: A Retrospective Observational Study.

During the coronavirus disease (COVID-19) pandemic, an increased incidence of mucormycosis infection was noted globally, the majority being from India. We aimed to study the clinical profile of the mucormycosis patients during the COVID-19 pandemic admitted at tertiary care centers. This is a retrospective record-based observation study conducted at Gandhi Medical College, Bhopal. All suspected or laboratory-proven mucormycosis patients were included. Detailed data on demography, clinical features, risk factors, laboratory/radiological findings, and outcomes were recorded. A total of 288 patients were enrolled and 121(42%) showed mucormycosis on potassium hydroxide (KOH) mount. The mean age was 51.52 ± 10.88 years, male:female ratio was 2.3:1. Most common symptom was facial swelling/pain and fever. The most common risk factor was COVID-19 infection (78.5%) followed by the presence of diabetes mellitus (DM) (70.8%) out of which 152 (52.8%) patients were previously diagnosed cases and 52 (18%) patients were newly diagnosed, 159 (55.2%) had a history of corticosteroid use, 87 (30.2%) had a history of use of oxygen support and 67 (23.2%) had hypertension. Most patients had invasion limited to sinus (46.5%) but the presence of DM was associated with an increased risk of cerebral invasion. Out of 288 patients admitted with mucormycosis, 31 patients collapsed to death while the remaining 257 patients were discharged from the hospital. It is observed that during the COVID-19 pandemic, hyperglycemia and inappropriate use of corticosteroids were associated with an increased risk of development of mucormycosis in patients with or without DM. We conclude that regular blood glucose monitoring, adequate glycemic control, and judicious evidence-based use of corticosteroids and immunosuppressants in COVID-19 are recommended to reduce the emergence of mucormycosis in such circumstances.

Optimization of public health through counseling on diabetes mellitus

&#x0D; Counseling on diabetes mellitus is key in optimizing public health. Diabetes mellitus is a chronic disease that affects millions of people around the world, with serious impacts on health and quality of life. Counseling aims to increase public understanding of diabetes mellitus, including risk factors, symptoms, prevention, and management. In this counseling, we present information about a healthy diet, the importance of regular exercise, and regular blood glucose monitoring. We also highlight the importance of regular medical checkups, stress management, and understanding medication use. In addition, counseling on potential complications of diabetes mellitus, such as heart disease, visual impairment, and nerve damage, is very important to raise public awareness. Effective outreach methods include the use of easy-to-understand educational materials, interactive Q&amp;A sessions, practical demonstrations, and the provision of information through social media and printed materials. By actively involving the public, it is hoped that awareness about diabetes mellitus will increase and appropriate prevention and management measures can be taken. Through this outreach effort, it is hoped that people will have better knowledge about diabetes mellitus, adopt a healthy lifestyle, and adopt behaviors that support the prevention and management of this condition. Thus, counseling about diabetes mellitus becomes an important means in efforts to optimize public health.&#x0D;

Designing and Developing a Mobile App for Management and Treatment of Gestational Diabetes in Nepal: User-Centered Design Study.

Mobile apps can aid with the management of gestational diabetes mellitus (GDM) by providing patient education, reinforcing regular blood glucose monitoring and diet/lifestyle modification, and facilitating clinical and social support. This study aimed to describe our process of designing and developing a culturally tailored app, Garbhakalin Diabetes athawa Madhumeha-Dhulikhel Hospital (GDM-DH), to support GDM management among Nepalese patients by applying a user-centered design approach. A multidisciplinary team of experts, as well as health care providers and patients in Dhulikhel Hospital (Dhulikhel, Nepal), contributed to the development of the GDM-DH app. After finalizing the app's content and features, we created the app's wireframe, which illustrated the app's proposed interface, navigation sequences, and features and function. Feedback was solicited on the wireframe via key informant interviews with health care providers (n=5) and a focus group and in-depth interviews with patients with GDM (n=12). Incorporating their input, we built a minimum viable product, which was then user-tested with 18 patients with GDM and further refined to obtain the final version of the GDM-DH app. Participants in the focus group and interviews unanimously concurred on the utility and relevance of the proposed mobile app for patients with GDM, offering additional insight into essential modifications and additions to the app's features and content (eg, inclusion of example meal plans and exercise videos).The mean age of patients in the usability testing (n=18) was 28.8 (SD 3.3) years, with a mean gestational age of 27.2 (SD 3.0) weeks. The mean usability score across the 10 tasks was 3.50 (SD 0.55; maximum score=5 for "very easy"); task completion rates ranged from 55.6% (n=10) to 94.4% (n=17). Findings from the usability testing were reviewed to further optimize the GDM-DH app (eg, improving data visualization). Consistent with social cognitive theory, the final version of the GDM-DH app supports GDM self-management by providing health education and allowing patients to record and self-monitor blood glucose, blood pressure, carbohydrate intake, physical activity, and gestational weight gain. The app uses innovative features to minimize the self-monitoring burden, as well as automatic feedback and data visualization. The app also includes a social network "follow" feature to add friends and family and give them permission to view logged data and a progress summary. Health care providers can use the web-based admin portal of the GDM-DH app to enter/review glucose levels and other clinical measures, track patient progress, and guide treatment and counseling accordingly. To the best of our knowledge, this is the first mobile health platform for GDM developed for a low-income country and the first one containing a social support feature. A pilot clinical trial is currently underway to explore the clinical utility of the GDM-DH app.

PPG based Noninvasive Blood Glucose Monitoring using Multi-view Attention and Cascaded BiLSTM Hierarchical Feature Fusion Approach.

Diabetes is a chronic disease with exponential growth and poses significant challenges to global healthcare. Regular blood glucose (BG) monitoring is key for avoiding diabetic complications. Traditional BG measurement techniques are invasive and minimally invasive, causing pain, discomfort, cost, and infection risks. To address these issues, we developed a noninvasive BG monitoring approach on photoplethysmography (PPG) signals using multi-view attention and cascaded BiLSTM hierarchical feature fusion approach. Firstly, we implemented a convolutional multi-view attention block to extract the temporal features through adaptive contextual information aggregation. Secondly, we built a cascaded BiLSTM network to efficiently extract the fine-grained features through bidirectional learning. Finally, we developed a hierarchical feature fusion with bilinear polling through cross-layer interaction to obtain higher-order features for BG monitoring. For validation, we conducted comprehensive experimentation on up to 6 days of PPG and BG data from 21 participants. The proposed approach showed competitive results compared to existing approaches by RMSE of 1.67 mmol/L and MARD of 17.88%. Additionally, the clinical accuracy using Clarke error grid (CEG) analysis showed 98.80% of BG values in Zone A+B. Therefore, the proposed approach offers a favorable solution in diabetes management by noninvasively monitoring the BG levels.

Accuracy of a Non-Invasive Home Glucose Monitor for Measurement of Blood Glucose.

Patients with diabetes mellitus monitor their blood glucose at home with monitors that require a drop of blood or use a continuous glucose monitoring device that implants a small needle in the body. However, both cause discomfort to the patients which may inhibit them for regular blood glucose checks. Photoplethysmogram (PPG) sensing technology is an approach for non-invasive blood glucose measurement and PPG sensors can be used to predict hypoglycaemic episodes. InChcek is a PPG-based non-invasive glucose monitor. However, its accuracy has not been checked yet. Hence, this study aimed to evaluate the accuracy of InCheck, a non-invasive glucose monitor for the estimation of blood glucose. In a tertiary care hospital, patients who came for blood glucose estimation were tested for blood glucose non-invasively on the InCheck device and then by the laboratory method (glucose oxidase-peroxidase). These two readings were compared. We used International Organization for Standardization (ISO) 15197:2013 (95% of values should be within ± 15 mg/dL of reference reading if reference glucose <100 mg/dL or within ± 15% of reference reading if reference glucose ≥100 mg/dL and 99% of the values should be within zones A and B in consensus error grid), and Surveillance Error Grid for analyzing the accuracy. A total of 1223 samples were analyzed. There was a significant difference between the reference method glucose level (135 [Q1-Q3: 97 - 179] mg/dL) and monitor-measured glucose level (188.33 [Q1-Q3: 167.33-209.33] mg/dL) (P < 0.0001). A total of 18.5% of readings were following ISO 15197:2013 criteria and 67.25% of coordinates were within zone A and zone B of the consensus error grid. In the surveillance error grid analysis, about 29.4% of values were in the no-risk zone, 51.8% in slight risk, 18.6% in moderate risk, and 0.2% were in the severe risk zone. The accuracy of the InCheck device for the estimation of blood glucose by PPG signal is not following the recommended guidelines. Hence, further research is necessary for programming or redesigning the hardware and software for a better result from this optical sensor-based non-invasive home glucose monitor.

JUSTIFICATION OF THE COMPLEX TREATMENT OF PURULOUS COMPLICATIONS OF FOOT INJURIES IN PATIENTS WITH DIABETES MELLITUS

In recent years, despite the development of modern methods of diagnosis and treatment of foot injuries in patients with diabetes mellitus, there has been an increase in the number of purulent-necrotic complications with a significant percentage of generalization of the infection. Due to potentially "catastrophic" wound healing, uncontrolled, irrational use of antibiotics, lack of regular blood glucose control, implementation of long and complex surgical interventions leads to the development of complications, including infection. The aim of the study. To substantiate the expediency of using a complex treatment scheme for purulent complications of foot bone fractures in patients with diabetes. Materials and methods. The results of treatment of 25 diabetic patients with foot injuries complicated by a purulent process were analyzed. In order to restore homeostasis disorders, patients received a complex of medical measures, including surgical treatment, infusion therapy, immunotherapy, antibiotic therapy. Patients were under the constant control of an endocrinologist. The results. As a result of complex treatment of patients, the inflammatory process was stopped in 21 (84%) patients, however, in 1 (4%) patient with stage 3 diabetic foot syndrome and in 3 (12%) patients with stage 4 according to the F.W.Wagner classification, the inflammatory process spread on the shin, therefore amputation was performed in this patients. The use of the developed treatment tactics, which included drainage of the wound with the removal of destroyed bone fragments, fixators (pins, screws, plates) in the maximum possible volume is the most effective method of surgical treatment of patients with this form of inflammation and allows you to save the foot, avoid the progression of purulent process and repeated surgical intervention.

Review of Noninvasive Continuous Glucose Monitoring in Diabetics.

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

DiabeticSense: A Non-Invasive, Multi-Sensor, IoT-Based Pre-Diagnostic System for Diabetes Detection Using Breath.

Diabetes mellitus is a widespread chronic metabolic disorder that requires regular blood glucose level surveillance. Current invasive techniques, such as finger-prick tests, often result in discomfort, leading to infrequent monitoring and potential health complications. The primary objective of this study was to design a novel, portable, non-invasive system for diabetes detection using breath samples, named DiabeticSense, an affordable digital health device for early detection, to encourage immediate intervention. The device employed electrochemical sensors to assess volatile organic compounds in breath samples, whose concentrations differed between diabetic and non-diabetic individuals. The system merged vital signs with sensor voltages obtained by processing breath sample data to predict diabetic conditions. Our research used clinical breath samples from 100 patients at a nationally recognized hospital to form the dataset. Data were then processed using a gradient boosting classifier model, and the performance was cross-validated. The proposed system attained a promising accuracy of 86.6%, indicating an improvement of 20.72% over an existing regression technique. The developed device introduces a non-invasive, cost-effective, and user-friendly solution for preliminary diabetes detection. This has the potential to increase patient adherence to regular monitoring.

Utilization of glycemic index values of commonly consumed foods in the provision of nutrition care to patients with diabetes: a case study at Bungoma county referral Hospital

The estimated prevalence of diabetes in Kenya is around 2.2%. There is a lack of awareness on diabetes in Kenya, leading to delayed diagnosis and management. This lack of awareness hinders early intervention and control of the disease. The adoption of a more Westernized diet, which is often high in processed foods and low in nutritional value, coupled with a decrease in physical activity, has contributed to the rise in diabetes cases. Access to affordable medications, regular blood glucose testing, and specialized diabetes care can be challenging for many Kenyans. This can lead to inadequate glycemic control and increased risk of complications. Knowledge of the glycemic index is therefore key in managing the conditions; therefore, we explore how well healthcare providers understand and apply GI values of widely consumed foods together with the patients. Data was collected and analyzed using a descriptive cross-sectional study design, involving both care providers and patients. Most care providers had knowledge of GI but only 3/4 reported utilizing its utilization. Patients, therefore, had issues because of ignorance and consumed food with high GI. Healthcare providers should be better equipped and acquainted with the G.I concept to provide the right information to patients and follow up in management.

1826-PUB: Efficacy of Digital Diabetes Care Program in India—Retrospective Analysis

Background: Lack of knowledge in self-management and limited access to specialized healthcare services leads to uncontrolled diabetes. Continuous digital care delivered through a mobile healthcare app aid in metabolic control. Aims: To analyze the efficacy of BeatO’s digital diabetes care management program among people with diabetes Methods: A retrospective analysis of 721 participants enrolled in BeatO’s mobile app-based diabetes care program for 3 months, the period of enrollment was between 28th February to 31st August 2022. Participants received remote access to health professionals for diabetes education, nutritional guidance and doctor consultation through the BeatO app. Throughout the care program, they were connected with a dedicated health coach. The medication prescribed by the doctor was delivered to the participant’s home. Regular blood glucose monitoring was done using BeatO’s smartphone-connected glucometer that works in accordance with the BeatO app. The parameters like FBG, PPBG, HbA1c, lipid profile and weight was recorded at baseline and after 3 months. Results: Of the 721 participants, 96.5 % had Type 2 diabetes. The mean age of the participants was 47.5 years, and the majority (80.8%) were males. T2DM was present in 696, T1DM (11), LADA (9), Prediabetes (3) and GDM (2). Out of these, 704 participants completed the program. A significant improvement in blood glucose control was observed, as reflected by a mean decrease in FBG by 38 mg/dL (p &amp;lt;0.0001), PPBG by 37 mg/dL (p &amp;lt;0.0001) and HbA1c reduced by 2.16% (p &amp;lt; 0.0001) at the end of 3 months. There was a significant weight loss of about 1.8 kg (p = 0.01) and a reduction in total cholesterol by 15 mg/dl through this remote personalized care. Conclusions: BeatO's digital diabetes care management program among people with diabetes showed good efficacy in terms of glycemic control and weight loss. Hence, the implementation of digital technology in diabetes care can help in increasing access and awareness of diabetes care and achieving glycemic targets. Disclosure N.Agrawal: Advisory Panel; Biocon, Eris Lifesciences Ltd., Lupin Pharmaceuticals, Inc., Sanofi, USV Private Limited, Other Relationship; BeatO, Health Arx Technologies Pvt LTD. A.Panjabi: Advisory Panel; Torrent Pharmaceuticals Ltd, USV Private Limited, Consultant; BeatO, Health Arx Technologies. P.K.Dixit: Advisory Panel; USV Private Limited, Intas Pharmaceuticals Ltd., Consultant; Beato, Health Arx Technologies. B.D: Consultant; BEAT-O, HEALTH ARX TECHNOLOGIES.

Assessing the Influential Factors Associated with Medication Non-adherence and Self-care Practices Among Type 2 Diabetes Mellitus Patients in Tripoli, Libya

Influential factors causing poor adherence to antidiabetic medications and self-care practices among type 2 diabetes mellitus (T2DM) patients have not been reported before in Libya. To assess such factors that contribute to non-adherence, a single health facility, cross-sectional descriptive study was carried out on T2DM patients attending the NCDE in Tripoli/ Libya; using a pre-tested questionnaire. Crude odds ratios in the binary logistic regression were used to describe the associations between medication adherence and various independent factors using SPSS version 26. Adjusted odds ratios with their corresponding 95% confidence intervals were further generated in the multivariable analysis, to determine variables which were independently associated with medication adherence and were considered significant at a p-value of &lt;0.05. Of the 380 study participants, only 225(67.1%) were adherent. 159(41.8%) were non-adherence to physician recommendations and were careless when taking their medication, 200(52.6%) found difficulty maintaining recommended dietary restrictions, 211(55.5%) and 97(25.5%) didn’t adhere to regular exercise or blood glucose monitoring; respectively. Factors significant association with non-adherence were; medication being taken; especially patients who were prescribed OHA and insulin ([AOR] [95% CI] = 0.214[0.073-0.632]), being careless and not taking prescribed medication as recommended ([AOR] [95% CI] = 2.880 [1.387- 5.983]), forgetfulness ([AOR] [95% CI] =0.199 [0.070- 0.570], stop taking prescribed antidiabetic medication when feeling well ( [AOR] [95% CI] = 0.153[0.058- 0.402], medications side effects ( [AOR] [95% CI]=0.382 [0.181- 0.809] and unawareness of the consequences of not adhering to medication as recommended and the consequences skipping doses ([AOR] [95% CI] = 0.146 [0.037- 0.581]). Adherence to recommended medication and self-care practices in Libya is unsatisfactory. Diabetes education, awareness programs, and regular monitoring of T2DM individuals’ medication adherence and self-care practices are vitally required.