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Sample records for blood glucose self-monitoring

  1. [Blood glucose self monitoring].

    Science.gov (United States)

    Wascher, Thomas C; Stechemesser, Lars

    2016-04-01

    Self monitoring of blood glucose contributes to the integrated management of diabetes mellitus. It, thus, should be available for all patients with diabetes mellitus type-1 and type-2. Self monitoring of blood glucose improves patients safety, quality of life and glucose control. The current article represents the recommendations of the Austrian Diabetes Association for the use of blood glucose self monitoring according to current scientific evidence.

  2. Self-monitoring of blood glucose measurements and glycaemic ...

    African Journals Online (AJOL)

    Background. Intensive diabetes management requires intensive insulin treatment and self-monitoring of blood glucose (SMBG) measurements to obtain immediate information on the status of the blood glucose level and to obtain data for pattern analysis on which meal planning, insulin and lifestyle adjustments can be ...

  3. A Model of Self-Monitoring Blood Glucose Measurement Error.

    Science.gov (United States)

    Vettoretti, Martina; Facchinetti, Andrea; Sparacino, Giovanni; Cobelli, Claudio

    2017-07-01

    A reliable model of the probability density function (PDF) of self-monitoring of blood glucose (SMBG) measurement error would be important for several applications in diabetes, like testing in silico insulin therapies. In the literature, the PDF of SMBG error is usually described by a Gaussian function, whose symmetry and simplicity are unable to properly describe the variability of experimental data. Here, we propose a new methodology to derive more realistic models of SMBG error PDF. The blood glucose range is divided into zones where error (absolute or relative) presents a constant standard deviation (SD). In each zone, a suitable PDF model is fitted by maximum-likelihood to experimental data. Model validation is performed by goodness-of-fit tests. The method is tested on two databases collected by the One Touch Ultra 2 (OTU2; Lifescan Inc, Milpitas, CA) and the Bayer Contour Next USB (BCN; Bayer HealthCare LLC, Diabetes Care, Whippany, NJ). In both cases, skew-normal and exponential models are used to describe the distribution of errors and outliers, respectively. Two zones were identified: zone 1 with constant SD absolute error; zone 2 with constant SD relative error. Goodness-of-fit tests confirmed that identified PDF models are valid and superior to Gaussian models used so far in the literature. The proposed methodology allows to derive realistic models of SMBG error PDF. These models can be used in several investigations of present interest in the scientific community, for example, to perform in silico clinical trials to compare SMBG-based with nonadjunctive CGM-based insulin treatments.

  4. Evaluation of the Capillary Blood Glucose Self-monitoring Program

    Directory of Open Access Journals (Sweden)

    Mariana Cristina Augusto

    2014-10-01

    Full Text Available OBJECTIVE: to evaluate the structure, process and results of the Capillary Blood Glucose Self-monitoring Program in a Brazilian city.METHOD: epidemiological, cross-sectional study. The methodological framework of Donabedian was used to construct indicators of structure, process and outcome. A random sample (n = 288 of users enrolled and 96 health professionals who worked in the program was studied. Two questionnaires were used that were constructed for this study, one for professionals and one for users, both containing data for the evaluation of structure, process and outcome. Anthropometric measures and laboratory results were collected by consulting the patients' health records. The analysis involved descriptive statistics.RESULTS: most of the professionals were not qualified to work in the program and were not knowledgeable about the set of criteria for patient registration. None of the patients received complete and correct orientations about the program and the percentage with skills to perform conducts autonomously was 10%. As regards the result indicators, 86.4% of the patients and 81.3% of the professionals evaluated the program positively.CONCLUSION: the evaluation indicators designed revealed that one of the main objectives of the program, self-care skills, has not been achieved.

  5. Self-monitoring of blood glucose: Advice for providers and patients.

    Science.gov (United States)

    Knapp, Shannon; Manroa, Pooja; Doshi, Krupa

    2016-05-01

    Self-monitoring of blood glucose is a critical element in diabetes management. Providers must determine if and when patients are to perform glucose self-monitoring, set blood glucose targets, and help patients to interpret the results. Patients have a variety of continually evolving meters, supplies, and technology from which to choose. Making sense of these expectations and options is perhaps the greatest challenge for providers and patients. Working together, healthcare providers and certified diabetes educators can ensure that people with diabetes get the most out of self-monitoring of blood glucose. Copyright © 2016 Cleveland Clinic.

  6. The experiences of diabetics on self-monitoring of blood glucose: a qualitative metasynthesis.

    Science.gov (United States)

    Chen, Chen-Mei; Chang Yeh, Mei

    2015-03-01

    To interpret, describe and analyse the results of various qualitative studies and comprehensively elucidate the self-monitoring of blood glucose experiences of diabetic patients, and to make recommendations based on these findings for clinical practices. Patients exhibited both positive and negative perceptions towards the self-monitoring of blood glucose. Numerous recent qualitative studies have explored the self-monitoring of blood glucose experiences of diabetic patients; however, no integrated results have been provided. Qualitative metasynthesis. A systematic literature search of English and Chinese databases was undertaken, covering the period between January 2004 and April 2014. The following databases were searched: CINAHL, PubMed, MEDLINE, Cochrane Library, Airiti library and PsycInfo. Seven studies were assessed in the final analysis; the Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to evaluate these studies. The self-monitoring experiences of patients with diabetes were divided into five themes: perceived disease severity, effects on daily life, lifestyle adjustments after becoming aware of blood glucose levels, determining the meaning of self-monitoring, and the differences between diabetic patients who use and do not use insulin. Individual differences in blood glucose self-monitoring vary widely among diabetic patients. These differences result from personal cognition and feelings concerning blood glucose monitoring. Insights into and discussions regarding the self-monitoring of blood glucose experiences of diabetic patients enable health care professionals to understand the factors that influence the intentions of patients to perform self-monitoring of blood glucose and facilitate establishing customised self-monitoring of blood glucose treatment plans. Health care professionals must adopt flexible and individualised criteria to determine patient cognitive misconceptions, understand negative emotional reactions and

  7. The accuracy of self monitoring blood glucose meter systems in ...

    African Journals Online (AJOL)

    ... systems B and C in the Kampala environ. Conclusion: Some of the blood glucose monitoring systems in Kampala, Uganda are poor performers and may lead to the mismanagement of patients. There is need for a system to ensure national quality control of blood glucose monitoring systems. African Health Sciences 2003; ...

  8. The clinical performance of the EGV1 self-monitoring blood glucose system.

    Science.gov (United States)

    Chen, Chien-Chih; Lin, Jui-Jane; Hung, Sheng-tien; Chun, Peng-Ting; Lai, Yiu-Kay

    2012-07-11

    The novel technique of blood volume detection can improve the reliability and accuracy of a self-monitoring blood glucose system. Self-management of diabetes can be improved, and the glycemic range can be efficiently controlled. A total of 153 patients with diabetes mellitus participated in the clinical study. The accuracy, blood volume detection, interference, and altitude effect of the EGV1 self-monitoring blood glucose system were evaluated and compared among the fingerstick, alternative site testing, and venous blood. The EGV1 self-monitoring blood glucose system with fingertip demonstrated an excellent correlation with venous blood (linear regression analysis: slope=1.01, intercept=-0.8972 mg/dl, r(2)=0.96), and with other brands of glucose systems (linear regression analysis: slope=0.99, intercept=+3.5632 mg/dl, r(2)=0.94). The Clarke error grid analysis indicated that the results of fingertip and alternative sites were in the acceptable zones, A and B. The system required 0.6 ul of a blood sample to obtain an accurate reading, and was unaffected by several interferents and altitude. The EGV1 self-monitoring blood glucose system using various blood samples demonstrated acceptable accuracy and reliability compared to the laboratory reference and other self-monitoring blood glucose systems. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. Advances in Patient Self-Monitoring of Blood Glucose.

    Science.gov (United States)

    Pfützner, Andreas

    2015-11-29

    In 2 articles of the present issue, Bendini et al report about performance results obtained with 2 blood glucose monitoring systems of the Contour Next platform. Using several analysis methods, the authors demonstrate a very high accuracy, which meets all actual regulatory performance criteria. With consistent MARD results blood glucose meters during the Past 2 decades, starting with an MARD of 12-15% at the end of the past century and reaching an excellent accuracy < 5% today. © 2015 Diabetes Technology Society.

  10. Comparable efficacy of self-monitoring of quantitative urine glucose with self-monitoring of blood glucose on glycaemic control in non-insulin-treated type 2 diabetes.

    Science.gov (United States)

    Lu, J; Bu, R F; Sun, Z L; Lu, Q S; Jin, H; Wang, Y; Wang, S H; Li, L; Xie, Z L; Yang, B Q

    2011-08-01

    To assess whether self-monitoring of quantitative urine glucose or blood glucose is effective, convenient and safe for glycaemic control in non-insulin treated type 2 diabetes. Adults with non-insulin treated type 2 diabetes were recruited and randomized into three groups: Group A, self-monitoring with a quantitative urine glucose meter (n = 38); Group B, self monitoring with a blood glucose meter (n=35); Group C, the control group without self monitoring (n=35). All patients were followed up for six months, during which identical diabetes care was provided. There was a significant decrease in HbA1c within each group (p monitoring frequency was significantly higher in Group A than in Group B. The incidence of hypoglycaemia and quality of life scores were similar between the groups. This study suggests that self-monitoring of urine glucose has comparable efficacy on glycaemic control, and facilitates better compliance than blood self monitoring, without influencing the quality of life or risk of hypoglycaemia. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Self-monitoring of tear glucose: the development of a tear based glucose sensor as an alternative to self-monitoring of blood glucose.

    Science.gov (United States)

    La Belle, Jeffrey T; Adams, Anngela; Lin, Chi-En; Engelschall, Erica; Pratt, Breanna; Cook, Curtiss B

    2016-07-28

    Tear glucose sensing for diabetes management has long been sought as an alternative to more invasive self-monitoring of blood glucose (SMBG). However, tear glucose sensors were known to have limitations, including correlation issues with blood glucose due to low sample volume, low concentration of glucose in the tear fluid, and evaporation of the tear sample. An engineering design approach to solve these problems led to the development of an integrated device capable of collecting the tear sample from the ocular surface with little to no stress on the eye, with an extremely low limit of detection, broad dynamic range, and rapid detection and analysis of sample. Here we present the development of a prototypical self-monitoring of tear glucose (SMTG) sensor, summarizing bench studies on the enzymes and their specificity, the development of the fluid capture device and its manufacture and performance and results of system testing in an animal study where safety, lag time and tear glucose to blood glucose correlation were assessed.

  12. Self-Monitoring of Blood Glucose : Professional Advice and Daily Practice of Patients With Diabetes

    NARCIS (Netherlands)

    Hortensius, Johanna; van der Bijl, Jaap J.; Kleefstra, Nanne; Houweling, Sebastiaan T.; Bilo, Henk J. G.

    2012-01-01

    Purpose This study investigated the advice given by diabetes educators in Europe, and the daily practice of Dutch patients with diabetes regarding the use of the first or second drop of blood and other aspects concerning self-monitoring of blood glucose (SMBG). Method During a diabetes conference in

  13. Frequency and motives of blood glucose self-monitoring in type 1 diabetes

    DEFF Research Database (Denmark)

    Hansen, M V; Pedersen-Bjergaard, U; Heller, S R

    2009-01-01

    AIMS: Recommendations for self-monitoring of blood glucose (SMBG) from the DCCT have not been implemented with the same rigour as recommendations for intensifying insulin therapy. We assessed the frequency of and motives for SMBG and compared SMBG behaviour with clinical, behavioural and demograp......AIMS: Recommendations for self-monitoring of blood glucose (SMBG) from the DCCT have not been implemented with the same rigour as recommendations for intensifying insulin therapy. We assessed the frequency of and motives for SMBG and compared SMBG behaviour with clinical, behavioural...

  14. Perceptions of Caribbean type 2 diabetes patients on self-monitoring of blood glucose

    DEFF Research Database (Denmark)

    Ezenwaka, C. E.; Olukoga, A.; Onuoha, P.

    2012-01-01

    Context: The views of type 2 diabetes (T2DM) patients have not been considered in the debate on the role of self-monitoring of blood glucose (SMBG) in the management of T2DM. Objective: To assess the views of T2DM patients on SMBG. Methods: Two previously trained research assistants used a struct......Context: The views of type 2 diabetes (T2DM) patients have not been considered in the debate on the role of self-monitoring of blood glucose (SMBG) in the management of T2DM. Objective: To assess the views of T2DM patients on SMBG. Methods: Two previously trained research assistants used...

  15. Within-Individual Hematocrit Variations and Self-Monitoring of Blood Glucose

    OpenAIRE

    Topping, Kaila A.; Cembrowski, George S.

    2013-01-01

    Many self-monitoring of blood glucose (SMBG) systems have generated artefactually increased glucose results in low-hematocrit patients (e.g., intensive care unit and renal failure patients); conversely, these devices could produce artefactually decreased glucose results in high-hematocrit patients (e.g., neonates). The introduction of hematocrit-independent SMBG systems permits more accurate testing in anemic or polycythemic individuals. In this issue of Journal of Diabetes Science and Techno...

  16. The Health Behavior Schedule-II for Diabetes Predicts Self-Monitoring of Blood Glucose

    Science.gov (United States)

    Frank, Maxwell T.; Cho, Sungkun; Heiby, Elaine M.; Lee, Chun-I; Lahtela, Adrienne L.

    2006-01-01

    The Health Behavior Schedule-II for Diabetes (HBS-IID) is a 27-item questionnaire that was evaluated as a predictor of self-monitoring of blood glucose (SMBG). The HBS-IID was completed by 96 adults with Type 2 diabetes. Recent glycosylated hemoglobin HbA1c and fasting blood glucose results were taken from participants' medical records. Only 31.3%…

  17. Effect of self-monitoring of blood glucose on glycaemic outcome ...

    African Journals Online (AJOL)

    Background: Diabetes mellitus is a chronic metabolic disorder which leads to complications especially when not properly managed. The role of self-monitoring of blood glucose (SMBG) in type 2 diabetic patients using oral hypoglycaemic agents has been a source of controversy. Objective: The objective was to study the ...

  18. Effects of self-monitoring of blood glucose on diabetes control in a ...

    African Journals Online (AJOL)

    Background: Diabetes mellitus places an enormous burden upon both patients and countries' health systems. Integral to achieving control is patients assuming responsibility for their condition. Self-monitoring of blood glucose (SMBG) can serve as a powerful tool modifying lifestyle behaviour and can aid in achieving ...

  19. What do professionals recommend regarding the frequency of self-monitoring of blood glucose?

    NARCIS (Netherlands)

    Hortensius, J.; Kleefstra, N.; Houweling, S. T.; van der Bijl, J. J.; Gans, R. O. B.; Bilo, H. J. G.

    Background: Patients' adherence to guidelines regarding self-monitoring of blood glucose (SMBG) is limited. However, there are no previous reports about the recommendations that are given in clinical practice concerning SMBG. The aim of this study was to investigate what healthcare providers

  20. Self-monitoring of blood glucose during pregnancy: indications and limitations

    Directory of Open Access Journals (Sweden)

    Negrato Carlos Antonio

    2012-12-01

    Full Text Available Abstract Self-monitoring of blood glucose (SMBG is an important tool to treat diabetes during pregnancy. However, proper implementation of SMBG in pregnant women requires understanding of its applications and limitations. This article reviews issues related to the implementation, efficacy, and accuracy of SMBG and discusses factors that can confound results of SMBG during pregnancy.

  1. Self-monitoring of blood glucose in tablet-treated type 2 diabetic patients (ZODIAC)

    NARCIS (Netherlands)

    Kleefstra, Nanno; Hortensius, J.; Logtenberg, Susan; Slingerland, R. J.; Groenier, K. H.; Houweling, S. T.; Gans, R. O. B.; van Ballegooie, E; Bilo, H. J. G.

    2010-01-01

    Background: Whether self-monitoring of blood glucose (SMBG) improves glycaemic control in patients with type 2 diabetes mellitus (T2DM) not using insulin is questionable. Our aim was to investigate the effects of SMBG in patients with T2DM who were in persistent moderate glycaemic control whilst not

  2. Deciding between using the first or second drop of blood for the self monitoring of blood glucose.

    Science.gov (United States)

    Li, Min; Wang, Xiaoli; Shan, Zhongyan

    2014-12-01

    To explore whether the first or the second drop of blood is more suitable for the self-monitoring of blood glucose (SMBG). SMBG was employed in hospitalized patients using the first and second drop of blood. Venous blood glucose was measured meanwhile. The differences in blood glucose measurements were then compared in groups with different regions of blood glucose levels. There were 802 groups of blood glucose in 526 patients. There was no significant difference in the blood glucose levels of the first and second drop of blood and venous blood. However, after combining then dividing measurements into six groups according to blood glucose concentration, we found statistically significant differences between the blood glucose levels obtained from the first drop, second drop, and venous blood in the groups containing blood glucose values blood can be used for performing SMBG to assess real-time venous glucose. By categorizing blood glucose into different levels more accurately, we observed that there was no significant difference between the first or second drop of blood and the venous blood glucose value when blood glucose levels were maintained between 10 and 20 mmol/L. When blood glucose levels were below 10 mmol/L, the value obtained from first drop of blood was close to that from venous blood, whereas when the blood glucose level is >20 mmol/L, the blood glucose value from the second drop of blood was more accurate. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  3. Self-monitoring blood glucose--non-insulin-treated type 2 diabetes in Australian general practice.

    Science.gov (United States)

    Henderson, Joan; Valenti, Lisa; Bayram, Clare; Miller, Graeme

    2013-09-01

    Benefits of self-monitoring blood glucose (SMBG) in non-insulin-treated type 2 diabetes (T2D) are questionable. We investigated proportions of general practitioner (GP) patients who self-monitor, and associations between SMBG, glycosylated haemoglobin (HbA1c) and body mass index (BMI). Sub-studies of the Bettering the Evaluation and Care of Health (BEACH) program, involving 5 730 patients from 194 GPs. Outcomes Type 2 diabetes prevalence; HbA1c; BMI; blood glucose (BG) monitoring routine. Prevalence of non-insulin-treated T2D was 6.7%. Mean HbA1c level was 7.1%. Almost half (47.5%) of T2D patients were obese compared with 26.7% of patients at all BEACH encounters in 2011-2012. Of 344 non-insulin-treated T2D patients, 79.4% self-monitored fasting BG and 69.7% of 314 self-monitored post-prandial BG. For both groups, mean HbA1c was significantly higher for those who tested daily than for those who never tested. Patients with non-insulin-treated T2D who test BG daily may be those struggling for control. For others, benefits seem minimal for the proportion utilising self-monitoring.

  4. Historical achievements of self-monitoring of blood glucose technology development in Japan.

    Science.gov (United States)

    Yamada, Shigeki

    2011-09-01

    Japanese companies were the first in the world to achieve a colorimetric glucose measurement meter back in 1973. Over the following 40 or so years, they succeeded in achieving a much greater level of user-friendliness and performance and in so doing, have contributed to the spread of self-monitoring of blood glucose. This article aims to unravel the history of blood glucose measurement's technological developments; to look at the direction and features of the development path Japan is taking; as well as to introduce some Japanese products that are on the market. © 2011 Diabetes Technology Society.

  5. Frequency and motives of blood glucose self-monitoring in type 1 diabetes

    DEFF Research Database (Denmark)

    Hansen, M.V.; Pedersen-Bjergaard, U.; Heller, S.R.

    2009-01-01

    AIMS: Recommendations for self-monitoring of blood glucose (SMBG) from the DCCT have not been implemented with the same rigour as recommendations for intensifying insulin therapy. We assessed the frequency of and motives for SMBG and compared SMBG behaviour with clinical, behavioural and demograp......AIMS: Recommendations for self-monitoring of blood glucose (SMBG) from the DCCT have not been implemented with the same rigour as recommendations for intensifying insulin therapy. We assessed the frequency of and motives for SMBG and compared SMBG behaviour with clinical, behavioural......% of the patients and less than weekly by 24%. Sixty-seven percent reported to perform routine testing, while the remaining 33% only tested when hypo- or hyperglycaemia was suspected. Age, gender, and level of diabetes-related concern were associated with test pattern. Reported frequencies of mild and severe...

  6. Self-Monitoring of Blood Glucose in Type 2 Diabetes: Recent Studies

    Science.gov (United States)

    Schnell, Oliver; Alawi, Hasan; Battelino, Tadej; Ceriello, Antonio; Diem, Peter; Felton, Anne-Marie; Grzeszczak, Wladyslaw; Harno, Kari; Kempler, Peter; Satman, Ilhan; Vergès, Bruno

    2013-01-01

    The increasing role for structured and personalized self-monitoring of blood glucose (SMBG) in management of type 2 diabetes has been underlined by randomized and prospective clinical trials. These include Structured Testing Program (or STeP), St. Carlos, Role of Self-Monitoring of Blood Glucose and Intensive Education in Patients with Type 2 Diabetes Not Receiving Insulin, and Retrolective Study Self-Monitoring of Blood Glucose and Outcome in Patients with Type 2 Diabetes (or ROSSO)-in-praxi follow-up. The evidence for the benefit of SMBG both in insulin-treated and non-insulin-treated patients with diabetes is also supported by published reviews, meta-analyses, and guidelines. A Cochrane review reported an overall effect of SMBG on glycemic control up to 6 months after initiation, which was considered to subside after 12 months. Particularly, the 12-month analysis has been criticized for the inclusion of a small number of studies and the conclusions drawn. The aim of this article is to review key publications on SMBG and also to put them into perspective with regard to results of the Cochrane review and current aspects of diabetes management. PMID:23567007

  7. Quality assessment of patients’ self-monitoring of blood glucose in community pharmacies

    Directory of Open Access Journals (Sweden)

    Kjome RL

    2010-03-01

    Full Text Available Objective: To evaluate diabetes patients’ self-monitoring of blood glucose using a community pharmacy-based quality assurance procedure, to investigate whether the procedure improved the quality of the patient performance of self monitoring of blood glucose, and to examine the opinions of the patients taking part in the study. Methods: The results of patient blood glucose measurements were compared to the results obtained with HemoCue Glucose 201+ by pharmacy employees in 16 Norwegian community pharmacies. Patient performance was monitored using an eight item checklist. Patients whose blood glucose measurements differed from pharmacy measurements by more than 20% were instructed in the correct use of their glucometer. The patients then re-measured their blood glucose. If the results were still outside the set limits, the control procedure was repeated with a new lot of glucometer strips, and then with a new glucometer. The patients returned for a follow-up visit after three months. Results: During the first visit, 5% of the 338 patients had measurements that deviated from pharmacy blood glucose values by more than 20% and user errors were observed for 50% of the patients. At the second visit, there was no significant change in the analytical quality of patient measurements, but the percentage of patients who made user errors had decreased to 29% (p < 0.001. Eighty-five percent of the patients reported that they used their blood glucose results to adjust medication, exercise or meals. Fifty-one percent of the patients reported a greater trust in their measurements after the second visit. Eighty percent of patients wished to have their measurements assessed yearly. Of these patients, 83% preferred to have the assessment done at the community pharmacy. Conclusion: A community pharmacy-based quality assessment procedure of patients’ self monitoring of blood glucose significantly reduced the number of user errors. The analytical quality of the

  8. Effectiveness of exclusive self-monitoring of fasting capillary blood glucose in the treatment of diabetes

    Directory of Open Access Journals (Sweden)

    Henrique Amancio Ferreira

    2015-07-01

    Full Text Available The study aims to analyze the efficacy of the exclusive self-monitoring of the fasting capillary blood glucose in the control and treatment of diabetic patients. This is a quasi-experimental study, for which five individuals with diabetes were selected, who perform only the fasting capillary blood glucose monitoring, being added about seven other measurements, a variable number according to the individual availability of the volunteer, at different times throughout the day. It was verified that four individuals presented blood glucose values by the use of the fasting capillary blood glucose monitoring, within the parameters of normality for diabetics, between 70-130 mg dL-1 of blood (ADA, 2014b, although in the other measurements, they presented values far from the ideal goal, in a significant part of the time. The study outlines a trend that shows that the glycemic monitoring values based solely on the fasting capillary blood glucose is ineffective, since they can erroneously indicate satisfactory control of the blood glucose levels. Based on the results obtained, to a more effective monitoring and which denotes levels of reliability, it is required at least three measurements of capillary blood glucose throughout the day, and also, the importance of long laboratory tests for glycemic monitoring, such as glycated hemoglobin.

  9. The Effect of Blood Glucose Self-Monitoring Among Inmates With Diabetes.

    Science.gov (United States)

    Hunter Buskey, Robin N; Mathieson, Kathleen; Leafman, Joan S; Feinglos, Mark N

    2015-10-01

    The increasing prevalence and risk of complications from diabetes necessitate patient participation and attentiveness to select appropriate foods, perform regular physical activity, and be active in diabetes management and self-maintenance. Diabetes is often largely asymptomatic; consequently, early diagnosis and treatment are necessary. Inmates are a unique population challenged by the increased prevalence of chronic conditions including diabetes. Diabetes standards for inmates contain diagnostic and treatment management guidelines that incorporate personal glucose monitoring for insulin users. In December 2009, the Federal Bureau of Prisons initiated a program to distribute glucose meters to insulin-dependent inmates to facilitate self-monitoring blood glucose. The purpose of this study was to evaluate the effect of these glucose meters on hemoglobin A1c levels. © The Author(s) 2015.

  10. Within-Individual Hematocrit Variations and Self-Monitoring of Blood Glucose

    Science.gov (United States)

    Topping, Kaila A.; Cembrowski, George S.

    2013-01-01

    Many self-monitoring of blood glucose (SMBG) systems have generated artefactually increased glucose results in low-hematocrit patients (e.g., intensive care unit and renal failure patients); conversely, these devices could produce artefactually decreased glucose results in high-hematocrit patients (e.g., neonates). The introduction of hematocrit-independent SMBG systems permits more accurate testing in anemic or polycythemic individuals. In this issue of Journal of Diabetes Science and Technology, Ramljak and coauthors have created glucose bias graphs for 19 common SMBG devices and declared certain systems to be optimally accurate because of insensitivity to hematocrit variation over a broad hematocrit range. Luckily, the average within-individual variation of hematocrit is low (between 2.9 and 3.3%). As such, a larger spectrum of SMBG devices can be regarded as optimally hematocrit independent. PMID:23439177

  11. Frequency and motives of blood glucose self-monitoring in type 1 diabetes

    DEFF Research Database (Denmark)

    Hansen, M.V.; Pedersen-Bjergaard, U.; Heller, S.R.

    2009-01-01

    and demographic characteristics. METHODS: Cross-sectional Danish-British multicentre survey of 1076 consecutive patients with type 1 diabetes, who completed a detailed questionnaire on SMBG and related issues. The key variables were test frequency and motive. RESULTS: SMBG was performed daily by 39......AIMS: Recommendations for self-monitoring of blood glucose (SMBG) from the DCCT have not been implemented with the same rigour as recommendations for intensifying insulin therapy. We assessed the frequency of and motives for SMBG and compared SMBG behaviour with clinical, behavioural...

  12. The business of self-monitoring of blood glucose: a market profile.

    Science.gov (United States)

    Hughes, Mark D

    2009-09-01

    The market for self-monitoring of blood glucose (SMBG) approached $8.8 billion worldwide in 2008. Yet despite dramatic double-digit growth in sales of SMBG products since 1980, the business is now facing declining prices and slower dollar growth. Given that SMBG meters and test strips are viewed by consumers and insurers as essentially generic products, it will be extremely challenging for new market entrants to displace well-entrenched existing competitors without a truly innovative technology. Also, in the face of declining glucose test strip prices, market expansion can only occur through identification of more of the undiagnosed diabetes population and convincing existing diabetes patients to adopt glucose testing or to test more frequently. Ultimately, a combination of technology innovations, patient education, and economic incentives may be needed to significantly expand the SMBG market and build sustainable long-term dollar growth for SMBG vendors. 2009 Diabetes Technology Society.

  13. Evaluation of blood glucose fluctuation in Japanese patients with type 1 diabetes mellitus by self-monitoring of blood glucose and continuous glucose monitoring.

    Science.gov (United States)

    Kusunoki, Yoshiki; Katsuno, Tomoyuki; Nakae, Rie; Watanabe, Kahori; Akagami, Takafumi; Ochi, Fumihiro; Tokuda, Masaru; Murai, Kazuki; Miuchi, Masayuki; Miyagawa, Jun-ichiro; Namba, Mitsuyoshi

    2015-05-01

    Accurate assessment of blood glucose fluctuation is essential for managing blood glucose control while avoiding hypoglycemia in patients with diabetes mellitus. In this study, blood glucose was measured by continuous glucose monitoring (CGM) in patients with type 1 diabetes mellitus (T1DM) whom self-monitoring of blood glucose (SMBG) was carried out three or more times per day, and evaluation was performed using blood glucose fluctuation parameters obtained by CGM and SMBG. Twenty-nine insulin-depleted patients with T1DM were enrolled. Their blood glucose fluctuations were measured at the same time by SMBG and CGM, and the correlations were evaluated. Correlations were found between the following values obtained by SMBG and CGM: mean and standard deviation of blood glucose levels, average daily risk range, Morbus value and high-blood-glucose index. The hypoglycemia duration and the nocturnal hypoglycemia duration showed no correlation with any of the blood glucose fluctuation parameters obtained by SMBG. The findings suggest that routine SMBG and glycated hemoglobin (HbA1c) measurement are sufficient for evaluation of hyperglycemia in T1DM. On the other hand, blood glucose fluctuation parameters obtained by SMBG and HbA1c have been shown to have no correlations with either hypoglycemia duration or nocturnal hypoglycemia duration. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Analytical Performance Evaluation of Infopia Element™ Auto-coding Blood Glucose Monitoring System for Self-Monitoring of Blood Glucose.

    Science.gov (United States)

    Park, Hae-Il; Lee, Seong-Su; Son, Jang-Won; Kwon, Hee-Sun; Kim, Sung Rae; Chae, Hyojin; Kim, Myungshin; Kim, Yonggoo; Yoo, Soonjib

    2016-11-01

    Element™ Auto-coding Blood Glucose Monitoring System (BGMS; Infopia Co., Ltd., Anyang-si, Korea) was developed for self-monitoring of blood glucose (SMBG). Precision, linearity, and interference were tested. Eighty-four capillary blood samples measured by Element™ BGMS were compared with central laboratory method (CLM) results in venous serum. Accuracy was evaluated using ISO 15197:2013 criteria. Coefficients of variation (CVs; mean) were 2.4% (44.2 mg/dl), 3.7% (100.6 mg/dl), and 2.1% (259.8 mg/dl). Linearity was shown at concentrations 39.25-456.25 mg/l (y = 0.989 + 0.984x, SE = 17.63). Up to 15 mg/dl of galactose, ascorbic acid, and acetaminophen, interference > 10.4% was not observed. Element™ BGMS glucose was higher than CLM levels by 3.2 mg/dl (at 200 mg/dl) to 8.2 mg/dl (at 100 mg/dl). The minimum specification for bias (3.3%) was met at 140 and 200 mg/l glucose. In the Clarke and consensus error grids, 100% of specimens were within zone A and B. For Element™ BGMS values, 92.9% (78/84) to 94.0% (79/84) were within a 15 mg/dl ( 100 mg/dl) of the average CLM value. Element™ BGMS was considered an appropriate SMBG for home use; however, the positive bias at low-to-mid glucose levels requires further improvement. © 2016 Wiley Periodicals, Inc.

  15. Self-monitoring of blood glucose experiences of adults with type 2 diabetes.

    Science.gov (United States)

    Dlugasch, Lucie B; Ugarriza, Doris N

    2014-06-01

    The purpose of this study was to analyze the experiences of self-monitoring of blood glucose (SMBG) usage of adults with type 2 diabetes mellitus (T2DM) who are not using insulin. Nineteen adults were asked to describe their experiences with self-monitoring. Data were analyzed using the grounded theory method. The theory of "SMBG as a Cue in T2DM Self-Care" emerged from the data and is composed of four categories: (a) Engaging, (b) Checking, (c) Responding, and (d) Establishing a Pattern. Engaging marks the beginning. Frequent monitoring characterizes this stage. Checking involves evaluating and validating the blood glucose level. The most common item evaluated or validated was the effect of foods. Responding involves taking action or experiencing emotion. Actions taken centered on dietary changes. Emotions felt were dependent on the level and ranged from blame to happiness. Participants established a pattern and used SMBG regularly or sporadically. Frequency was based on obtaining "normal" patterns, the absence of symptoms, provider disinterest, and fingertip pain. Participants described many benefits and struggles when incorporating SMBG into their self-care. Information from this study could be used to develop effective guidelines for the use of SMBG in T2DM. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  16. Self-monitoring of blood glucose: a prerequisite for diabetes management in outcome trials.

    Science.gov (United States)

    Schnell, Oliver; Hanefeld, Markolf; Monnier, Louis

    2014-05-01

    Evidence for the value of self-monitoring of blood glucose (SMBG) with regard to the achievement of treatment targets, detection of postprandial glucose excursions, and minimization of glycemic variability is increasing. In large clinical trials, SMBG is a key component for the optimization of diabetes treatment in insulin-treated diabetes. It also plays an essential role in outcome studies. However, details of SMBG use in both the methods and results sections of clinical articles are frequently scarce. Also, a discussion of the SMBG data and its impact on insulin therapy is valuable. In the recently completed Outcome Reduction with an Initial Glargine INtervention (ORIGIN) trial, SMBG was described in detail and insulin titration was largely driven by SMBG. Both aspects largely contributed to the fact that near-normal control was achieved over a long-term period. © 2014 Diabetes Technology Society.

  17. Self-monitoring of blood glucose in noninsulin-treated type 2 diabetes: an overview

    Directory of Open Access Journals (Sweden)

    Nanne Kleefstra

    2009-09-01

    Full Text Available Nanne Kleefstra1, Johanna Hortensius1, Kornelis JJ van Hateren1, Susan JJ Logtenberg1, Sebastiaan T Houweling2, Rijk OB Gans3, Henk JG Bilo11Diabetes Centre, Isala Clinics, Zwolle, The Netherlands; 2Langerhans Medical Research Group, The Netherlands; 3Department of Internal Medicine, University Medical Center Groningen, Groningen, The NetherlandsIntroduction: The effectiveness of self-monitoring of blood glucose (SMBG in noninsulin-treated patients with type 2 diabetes (T2DM remains unclear. We aimed to review the trials investigating the effects of SMBG in this population.Methods: Medline was searched until June 29, 2009. Randomized controlled trials (RCTs of at least 12 weeks’ duration were included. Data on the following aspects were gathered: patient and study characteristics, effects on HbA1c, quality of life and treatment satisfaction, and methodological quality.Results: The search revealed 9 original RCTs. These studies were very heterogeneous, and 5 were classified as of high quality. The studies with the best methodology did not show an effect of SMBG on HbA1c, the studies with the worst methodological quality did. Two out of the 4 studies that assessed quality of life showed a significant change in favor of the control group, 1 study showed a significant change in favor of SMBG.Discussion and conclusion: We found an inverse relation between study quality and efficacy of SMBG. At this moment, there is no basis for general use of SMBG in noninsulin-treated T2DM patients.Keywords: blood glucose self-monitoring, diabetes mellitus, type 2, blood glucose, hemoglobin A, glycosylated

  18. Introduction of the glucose meter as a tool of self-monitoring of blood glucose for patients from Santos

    Directory of Open Access Journals (Sweden)

    Sílvia Corral de Arêa Leão Souza

    2014-04-01

    Introduction: the introduction of home blood glucose monitoring aimed autonomy for patient self-care, result in reducing the complications of Diabetes mellitus (DM. Objectives: evaluate and analyze the evolution of HbA1c levels in insulin-dependent patients in Santos/SP after the introduction of blood glucose self-monitoring. Methods: through a transversal study with patient forms, it has been selected a sample of 20% of insulin-dependent patients total (160/800 patients according to age range and sex. Those data was analyzed through the SPSS 15.0 software (SPSS Inc. Chicago-IL using ANOVA test with repeated measures, comparing the mean values from before the use of the home self-monitoring with the values of tests performed after its introduction, in order to identify reduction or not of the HbA1c patients' values. This study was approved by ethics committees of UNIFESP and by Secretaria Municipal de Saúde de Santos. Results: of the 157 used records, with a total of 471 HbA1c values, only five (3.2% belonged to the range of 21 - 40 years, the range of 41 - 60 years presented with higher population possessing 47 patients (30% and those over 60 years prevailed in the study with 105 patients listed (66.9%. The HbA1c values presented a statically significant reduction after 6 months from starting use the glucose meter with P < 0.05 (0.014, demonstrating that after six months of glucose meter use, it was noticed the statistic reduction in HbA1c levels. Conclusions: the home self-monitoring of blood glucose, coupled with drug intervention, reduces HbA1c levels in a six-month interval.

  19. Enhanced self-monitoring blood glucose in non-insulin requiring Type 2 diabetes: A qualitative study in primary care.

    Science.gov (United States)

    Brackney, Dana Elisabeth

    2018-03-31

    To contribute to both theoretical and practical understanding of the role of self-monitoring blood glucose for self-management by describing the experience of people with non-insulin requiring Type 2 diabetes in an enhanced structured self-monitoring blood glucose intervention. The complex context of self-monitoring blood glucose in Type 2 diabetes requires a deeper understanding of the clients' illness experience with structured self-monitoring of blood glucose. Clients' numeracy skills contribute to their response to blood glucose readings. Nurses' use of motivational interviewing to increase clients' regulatory self-efficacy is important to the theoretical perspective of the study. A qualitative descriptive study. A purposive sample of eleven adults recently (self-monitoring blood glucose intervention participated in this study. Audio recordings of semi-structured interviews and photos of logbooks were analyzed for themes using constant comparison and member checking. The illness experience states of Type 2 diabetes include 'Diagnosis', 'Behavior change', and 'Routine checking'. People check blood glucose to confirm their Type 2 diabetes diagnosis, to console their diabetes related fears, to create personal explanations of health behavior's impact on blood glucose, to activate behavior change and to congratulate their diabetes self-management efforts. These findings support the Transtheoretical model's stages of change and change processes. Blood glucose checking strengthens the relationships between theoretical concepts found in Diabetes Self-management Education-Support including: engagement, information sharing, and behavioral support. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  20. Self-Monitoring of Blood Glucose to Assess Dawn Phenomenon in Chinese People with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Wu, Wen; Huang, Yuxin; Qiu, Jieyuzhen; Sun, Jiao; Wang, Haidong

    2017-01-01

    Aims . We investigated whether self-monitoring of blood glucose could be used to assess dawn phenomenon in Chinese people with type 2 diabetes mellitus (T2DM). Methods . A total of 306 people with T2DM underwent continuous glucose monitoring and self-monitoring of blood glucose for 72 h. A linear model was used to fit the optimal linear formula of the magnitude of dawn phenomenon (ΔDawn) and self-monitoring of blood glucose values. Results . The prevalence of dawn phenomenon was similar within different oral antidiabetic drug groups (42.5%, 31.5%, and 40.9%, P = 0.216). Multiple variable linear regression showed that prebreakfast, prelunch, and predinner glucose measurements were independently and significantly correlated with ΔDawn. The linear formula between ΔDawn and blood glucose was as follows: ΔDawn (mg/dL) = 0.557 × prebreakfast - 0.065 × prelunch - 0.164 × predinner - 20.894 (mg/dL) (adjusted R 2 = 0.302, P = 0.000). Conclusions . Dawn phenomenon could be partly assessed by blood glucose self-monitoring in Chinese people with T2DM using the abovementioned formula. The incidence of dawn phenomenon was similar among patients in different oral antidiabetic drug groups.

  1. [Self-monitoring of blood glucose in France: data from a national survey].

    Science.gov (United States)

    Guerci, Bruno; Benhamou, Pierre-Yves; Durain, Danièle; Bahloul, Amar; Jeanbat, Viviane; Detournay, Bruno

    2017-04-27

    Objectives: To describe Self-Monitoring of Blood Glucose (SMBG) practices in France in patients with type 1 (T1DM) or type 2 (T2DM) diabetes, by estimating the proportion of patients performing SMBG at the recommended testing frequency and the proportion of patients complying with the current quality control guidelines on SMBG. Materials and methods: National cross-sectional study conducted in 238 pharmacies. A questionnaire was completed with adult diabetic patients buying SMBG devices or reagent strips for themselves, using a blood glucose meter for at least 6 months, treated with insulin or sulfonylurea/glinides ± other oral hypoglycaemic agents (HA). Results: Data from 449 patients were analysed: 85 T1DM and 121 T2DM patients treated by multiple basal-bolus injections ± HA (Group A and Group B), 123 T2DM patients treated by basal insulin ± HA (Group C), 102 patients treated by other insulin regimens ± HA (Group D) and 120 T2DM patients treated by sulfonylurea / glinides without insulin ± other HA (Group E). The recommended test frequency was observed by 29.8%, 36.4%, 61.8% and 69.2% of patients in Group A, Group B, Group C, and Group E, respectively. The quality of self-monitoring was insufficient in terms of device cleaning, storage conditions/expiry date of reagent strips, or use of control solutions. Patients displayed a limited capacity to take decisions in relation to their SMBG results (Group A: 56.5%, Group B: 70.2%, Group C: 49.2%, Group E: 36.0%) and limited knowledge about their glucose targets (Group A: 81%, Group B: 80.5%, Group C: 68.6%, Group E: 73.7%). Conclusion: SMBG use and compliance with quality guidelines must be improved, but healthcare professionals and patients must also focus their efforts on education to interpret SMBG results.

  2. Lived experience of blood glucose self-monitoring among pregnant women with gestational diabetes mellitus: a phenomenological research.

    Science.gov (United States)

    Youngwanichsetha, Sununta; Phumdoung, Sasitorn

    2017-10-01

    To explore and describe lived experience of blood glucose self-monitoring among pregnant Thai women with gestational diabetes mellitus. Self-monitoring of blood glucose is an essential practice among pregnant women with diabetes to prevent complications in pregnancy and the newborn infant. Phenomenological research was employed to understand lived experiences in glycemic control. Thirty participants were approached and interviewed using a semistructured interview guides. Qualitative data were analysed following Colaizzi's method. The findings revealed three themes: being worried about diabetes and blood testing, trying to control it and being patient for the child. Their worry comprised three dimensions: (1) wondering about the impacts of diabetes on the child, (2) concern about maternal health and (3) being worried about doing blood test. Trying to control diabetes was composed of three dimensions: (1) learning to test blood glucose, (2) being afraid of elevated blood sugar and (3) being aware of what to eat. Being patient for the child was composed of three dimensions: (1) overcoming food desires, (2) tolerating the fingerprick pain and (3) satisfaction with the outcomes. Women with gestational diabetes experienced being worried and afraid regarding blood glucose self-monitoring; however, they could overcome and tolerate this with some difficulties. These findings can be used to guide nursing practice in assessment of perception and response towards blood glucose self-monitoring in order to improve achievement of a good glycaemic control among pregnant women with gestational diabetes mellitus. © 2016 John Wiley & Sons Ltd.

  3. Perspectives of patients with non-insulin-treated type 2 diabetes on self-monitoring of blood glucose: A qualitative study.

    Science.gov (United States)

    Chen, Chen-Mei; Hung, Li-Chen; Chen, Yang-Lin; Yeh, Mei Chang

    2018-04-01

    To explore experiences of self-monitoring of blood glucose among patients with non-insulin-treated type 2 diabetes. Self-monitoring of blood glucose is essential to diabetes care and facilitates glycaemic control. Patients' perspectives of self-monitoring of blood glucose have seldom been discussed in the literature, and engagement in self-monitoring of blood glucose is consistently low. The descriptive phenomenological method was used. Purposive sampling was conducted to recruit participants from the endocrinology departments of medical institutions in Taiwan based on the following criteria: (i) having a medical diagnosis of type 2 diabetes, (ii) not being treated with insulin, (iii) having engaged in self-monitoring of blood glucose at least once within the preceding 6 months, (iv) being at least 20 years old and (v) not having any major mental or cognitive disorders. Data were collected in outpatient consultation rooms, the participants' homes and other settings where the participants felt secure and comfortable. In-depth interviews were conducted to collect data from 16 patients with diabetes. The participants perceived that lifestyle affected blood glucose levels and did not know how to handle high or low blood glucose levels. Their willingness to continue self-monitoring of blood glucose depended on whether healthcare professionals checked or discussed their blood glucose levels with them. The patients' knowledge regarding blood glucose variation and healthcare professionals' attitudes affected the patients' self-monitoring of blood glucose behaviours. The empirical findings illustrated self-monitoring of blood glucose experiences and recommended that healthcare professionals' closely attend to patients' requirements and responses to diabetes and incorporate the self-monitoring of blood glucose into therapy plans. Healthcare professionals should reinforce patients' knowledge on appropriate responses to high and low blood glucose levels, intervene

  4. Patterns of self-monitoring of blood glucose in insulin-treated diabetes: analysis of a Scottish population over time.

    Science.gov (United States)

    Cameron, D; Harris, F M; Evans, J M M

    2016-07-01

    Analysis of a diabetes clinical information system in Tayside, Scotland, shows that a significant proportion of insulin-treated patients with diabetes are not self-monitoring blood glucose according to current clinical guidance and recommendations, with some not self-monitoring their blood glucose at all. Although there has been an increase in the number of reagent strips dispensed over the past decade, this increase is mainly accounted for by increased testing frequency among people with diabetes already testing. © 2016 John Wiley & Sons Ltd.

  5. Blood glucose self-monitoring with a long-term subconjunctival glucose sensor.

    Science.gov (United States)

    Müller, Achim Josef; Knuth, Monika; Nikolaus, Katharina Sibylle; Krivánek, Roland; Küster, Frank; Hasslacher, Christoph; Auffarth, Gerd Uwe

    2013-01-01

    To evaluate the feasibility of an implantable subconjunctival glucose monitoring system (SGMS) for long-term glucose monitoring, we investigated the in vivo performance of the system. The SGMS consists of an implantable ocular mini implant (OMI) and a handheld fluorescence photometer. A clinical study was performed on 47 diabetes patients split into two cohorts. Two different types of OMI were used, with and without a biocompatible surface coating. Duration of the study was 1 year. Correlation between capillary blood glucose and SGMS-derived interstitial fluid glucose was investigated during the first 6 months of the study. Both OMI types were tolerated well in the eyes of the patients. At the beginning of the study, the SGMS of both cohorts revealed a high accuracy with mean absolute relative difference (MARD) values of 7-12%. The performance of the uncoated OMIs deteriorated within 3 months of wearing time, exhibiting a MARD value of 20%. The performance of the surface-coated OMIs was preserved longer. Glucose correlation measurement with reasonable results (MARD of 14%) could be performed for up to 6 months of wear. The biocompatible surface coating on the OMIs enabled a longer duration of action of up to 6 months compared with 3 months for uncoated implants in a clinical trial. © 2013 Diabetes Technology Society.

  6. Practical approaches for self-monitoring of blood glucose: an Asia-Pacific perspective.

    Science.gov (United States)

    Chowdhury, Subhankar; Ji, Linong; Suwanwalaikorn, Sompongse; Yu, Neng-Chun; Tan, Eng Kiat

    2015-03-01

    Comprehensive glycemic control is necessary to improve outcomes and avoid complications in individuals with diabetes. Self-monitoring of blood glucose (SMBG) is a key enabler of glycemic assessment, providing real-time information that complements HbA1c monitoring and supports treatment optimization. However, SMBG is under-utilized by patients and physicians within the Asia-Pacific region, because of barriers such as the cost of monitoring supplies, lack of diabetes self-management skills, or concerns about the reliability of blood glucose readings. Practice recommendations in international and regional guidelines vary widely, and may not be detailed or specific enough to guide SMBG use effectively. This contributes to uncertainty among patients and physicians about how best to utilize this tool: when and how often to test, and what action(s) to take in response to high or low readings. In developing a practical SMBG regimen, the first step is to determine the recommended SMBG frequency and intensity needed to support the chosen treatment regimen. If there are practical obstacles to monitoring, such as affordability or access, physicians should identify the most important aspects of glycemic control to target for individual patients, and modify monitoring patterns accordingly. This consensus paper proposes a selection of structured, flexible SMBG patterns that can be tailored to the clinical, educational, behavioral, and financial requirements of individuals with diabetes.

  7. Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin.

    NARCIS (Netherlands)

    Welschen, L. M.; Bloemendal, E.; Nijpels, G.; Dekker, J. M.; Heine, R. J.; Stalman, W. A.; Bouter, L. M.

    2005-01-01

    BACKGROUND: Self-monitoring of blood glucose (SMBG) has been found to be effective for patients with type 1 diabetes and for patients with type 2 diabetes using insulin. There is much debate on the effectiveness of SMBG as a tool in the self-management for patients with type 2 diabetes who are not

  8. Accuracy of devices for self-monitoring of blood glucose: A stochastic error model.

    Science.gov (United States)

    Vettoretti, M; Facchinetti, A; Sparacino, G; Cobelli, C

    2015-01-01

    Self-monitoring of blood glucose (SMBG) devices are portable systems that allow measuring glucose concentration in a small drop of blood obtained via finger-prick. SMBG measurements are key in type 1 diabetes (T1D) management, e.g. for tuning insulin dosing. A reliable model of SMBG accuracy would be important in several applications, e.g. in in silico design and optimization of insulin therapy. In the literature, the most used model to describe SMBG error is the Gaussian distribution, which however is simplistic to properly account for the observed variability. Here, a methodology to derive a stochastic model of SMBG accuracy is presented. The method consists in dividing the glucose range into zones in which absolute/relative error presents constant standard deviation (SD) and, then, fitting by maximum-likelihood a skew-normal distribution model to absolute/relative error distribution in each zone. The method was tested on a database of SMBG measurements collected by the One Touch Ultra 2 (Lifescan Inc., Milpitas, CA). In particular, two zones were identified: zone 1 (BG≤75 mg/dl) with constant-SD absolute error and zone 2 (BG>75mg/dl) with constant-SD relative error. Mean and SD of the identified skew-normal distributions are, respectively, 2.03 and 6.51 in zone 1, 4.78% and 10.09% in zone 2. Visual predictive check validation showed that the derived two-zone model accurately reproduces SMBG measurement error distribution, performing significantly better than the single-zone Gaussian model used previously in the literature. This stochastic model allows a more realistic SMBG scenario for in silico design and optimization of T1D insulin therapy.

  9. Evaluation of OneTouch Verio(®), a new blood glucose self-monitoring system for patients with diabetes

    DEFF Research Database (Denmark)

    Littmann, Karin; Petersen, Eva; Pussinen, Christel

    2013-01-01

    Introduction. Self-monitoring of blood glucose (SMBG) is important in diabetes management. Reliable and user-friendly instruments are essential. OneTouch Verio(®) is a new blood glucose concentration-measuring system designed to be used by patients with diabetes and healthcare professionals...... tested by laboratory personnel and within the goal of imprecision suggested by ADA. Mean CV% of repeatability for patient self-monitoring was 5.0% and 5.1% in the training- and the mail group, respectively. Total error was 6.4-10.0%. The OneTouch Verio(®) showed no hematocrit interference or variation...... routine method, imprecision and bias were calculated. User-friendliness was evaluated with a questionnaire. Results. Quality specifications for blood glucose concentration monitoring systems according to ISO 15197 were fulfilled. The mean coefficients of variation (CV%) of repeatability was 3.4% when...

  10. Evaluation of OneTouch Verio, a new blood glucose self-monitoring system for patients with diabetes

    DEFF Research Database (Denmark)

    Littman, Karin; Petersen, Eva R.B.; Pussinen, Christel

    2013-01-01

    Introduction. Self-monitoring of blood glucose (SMBG) is important in diabetes management. Reliable and user-friendly instruments are essential. OneTouch Verio® is a new blood glucose concentration-measuring system designed to be used by patients with diabetes and healthcare professionals...... personnel and within the goal of imprecision suggested by ADA. Mean CV% of repeatability for patient self-monitoring was 5.0% and 5.1% in the training- and the mail group, respectively. Total error was 6.4-10.0%. The OneTouch Verio® showed no hematocrit interference or variation between strip lots......, imprecision and bias were calculated. User-friendliness was evaluated with a questionnaire. Results. Quality specifications for blood glucose concentration monitoring systems according to ISO 15197 were fulfilled. The mean coefficients of variation (CV%) of repeatability was 3.4% when tested by laboratory...

  11. Barriers to self-monitoring of blood glucose among adults with diabetes in an HMO: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Barton Mary B

    2003-03-01

    Full Text Available Abstract Background Recent studies suggest that patients at greatest risk for diabetes complications are least likely to self-monitor blood glucose. However, these studies rely on self-reports of monitoring, an unreliable measure of actual behavior. The purpose of the current study was to examine the relationship between patient characteristics and self-monitoring in a large health maintenance organization (HMO using test strips as objective measures of self-monitoring practice. Methods This cross-sectional study included 4,565 continuously enrolled adult managed care patients in eastern Massachusetts with diabetes. Any self-monitoring was defined as filling at least one prescription for self-monitoring test strips during the study period (10/1/92–9/30/93. Regular SMBG among test strip users was defined as testing an average of once per day for those using insulin and every other day for those using oral sulfonylureas only. Measures of health status, demographic data, and neighborhood socioeconomic status were obtained from automated medical records and 1990 census tract data. Results In multivariate analyses, lower neighborhood socioeconomic status, older age, fewer HbA1c tests, and fewer physician visits were associated with lower rates of self-monitoring. Obesity and fewer comorbidities were also associated with lower rates of self-monitoring among insulin-managed patients, while black race and high glycemic level (HbA1c>10 were associated with less frequent monitoring. For patients taking oral sulfonylureas, higher dose of diabetes medications was associated with initiation of self-monitoring and HbA1c lab testing was associated with more frequent testing. Conclusions Managed care organizations may face the greatest challenges in changing the self-monitoring behavior of patients at greatest risk for poor health outcomes (i.e., the elderly, minorities, and people living in low socioeconomic status neighborhoods.

  12. What is so tough about self-monitoring of blood glucose? Perceived obstacles among patients with Type 2 diabetes.

    Science.gov (United States)

    Polonsky, W H; Fisher, L; Hessler, D; Edelman, S V

    2014-01-01

    To identify patient-reported obstacles to self-monitoring of blood glucose among those with Type 2, both insulin users and non-insulin users, and to investigate how obstacles are associated with frequency of self-monitoring and use of self-monitoring data. Patients with Type 2 diabetes (n = 886, 65% insulin users) who attended a 1-day diabetes education conference in cities across the USA completed a survey on current and recommended self-monitoring of blood glucose frequency, how they used self-monitoring results and perceived obstacles to self-monitoring use. Exploratory factor analysis examined 12 obstacle items to identify underlying factors. Regression analyses examined associations between self-monitoring of blood glucose use and the key obstacle factors identified in the exploratory factor analysis. Three obstacle factors emerged: Avoidance, Pointlessness and Burden. Avoidance was the only significant independent predictor of self-monitoring frequency (β = -0.23, P self-monitoring data were shared with healthcare professionals and whether or not data were used to make management adjustments (Avoidance: odds ratio = 0.74, P self-monitoring behavioural measures. Few differences between insulin users and non-insulin users were noted. Obstacles to self-monitoring of blood glucose use, both practical and emotional, were common. Higher levels of Avoidance and Pointlessness, but not Burden, were associated with less frequent self-monitoring use. Addressing patients' self-monitoring-related emotional concerns (Avoidance and Pointlessness) may be more beneficial in enhancing interest and engagement with self-monitoring of blood glucose than focusing on day-to-day, behavioural issues (Burden). © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

  13. Self-monitoring of blood glucose: use, frequency drivers, and cost in Argentina.

    Science.gov (United States)

    Elgart, Jorge F; González, Lorena; Rucci, Enzo; Gagliardino, Juan J

    2014-11-01

    Although test strips for self-monitoring of blood glucose (SMBG) represent around 50% of diabetes treatment cost in Argentina, little is known about their current use and relationship with different types of treatment. We therefore aimed to estimate the current use of test strips and identify the major use drivers and the percentage they represent of total prescription costs in 2 entities of the social security system (SSS) of Argentina. Observational retrospective study measuring test strip prescriptions delivered by pharmacies from the province of Buenos Aires (8115 records collected during 3 months provided by the Colegio de Farmacéuticos de la Provincia de Buenos Aires) of affiliates with type 2 diabetes (T2DM) from 2 large entities of the SSS system. The average monthly test strips/patient used for SMBG was 97.5 ± 70.1. This number varied according to treatment: monotherapy with oral antidiabetic drugs (OAD) < combined OAD therapy < insulin treatment. Test strips represented a higher percentage of the total prescription cost in people under OAD monotherapy (84.6%) and lower in those with insulin analogs (46.9%). In our population, the type of hyperglycemia treatment was the main driver of test strip use for SMBG and its impact on the total prescription cost depends on the kind of such treatment. Since it has been shown that patients' education and prescription audit can optimize test strip use and treatment outcomes, implementation of such strategies could appropriately support, optimize, and reduce ineffective test strip use in people with T2DM. © 2014 Diabetes Technology Society.

  14. Blood glucose self-monitoring and internet diabetes management on A1C outcomes in patients with type 2 diabetes

    OpenAIRE

    Chow, Nelson; Shearer, Daniel; Aydin Plaa, Jessica; Pottinger, Betty; Pawlowska, Monika; White, Adam; Tildesley, Hugh D

    2016-01-01

    Objectives The purpose of this study was to determine any correlation between frequency of self-monitoring of blood glucose (SMBG), frequency of patient-provider communication of SMBG (reporting), and hemoglobin A1C for patients with non-insulin-dependent diabetes solely on oral medications. Research design and methods 191 charts of patients with type 2 diabetes treated solely with oral hypoglycemic agents were reviewed retrospectively. A1C, SMBG frequency, and frequency of online communicati...

  15. 10th Annual Symposium on Self-Monitoring of Blood Glucose, April 27–29, 2017, Warsaw, Poland

    Science.gov (United States)

    Homberg, Anita; Hinzmann, Rolf

    2018-01-01

    Abstract International experts in the field of diabetes and diabetes technology met in Warsaw, Poland, for the 10th Annual Symposium on Self-Monitoring of Blood Glucose. The goal of these meetings is to establish a global network of experts to facilitate new collaborations and research projects that can improve the lives of people with diabetes. The 2017 meeting comprised a comprehensive scientific program, parallel interactive workshops, and four keynote lectures. PMID:29135283

  16. 8th Annual Symposium on Self-Monitoring of Blood Glucose (SMBG): April 16–18, 2015, Republic of Malta

    Science.gov (United States)

    Homberg, Anita; Hinzmann, Rolf

    2015-01-01

    Abstract International experts in the fields of diabetes, diabetes technology, endocrinology, mobile health, sport science, and regulatory issues gathered for the 8th Annual Symposium on Self-Monitoring of Blood Glucose (SMBG) with a focus on personalized diabetes management. The aim of this meeting was to facilitate new collaborations and research projects to improve the lives of people with diabetes. The 2015 meeting comprised a comprehensive scientific program, parallel interactive workshops, and two keynote lectures. PMID:26496678

  17. 7th Annual Symposium on Self-Monitoring of Blood Glucose (SMBG), May 8–10, 2014, Helsinki, Finland

    Science.gov (United States)

    Mlinac, Anita; Hinzmann, Rolf

    2014-01-01

    Abstract International experts in the fields of diabetes, diabetes technology, endocrinology, mobile health, sport science, and regulatory issues gathered for the 7th Annual Symposium on Self-Monitoring of Blood Glucose (SMBG). The aim of this meeting was to facilitate new collaborations and research projects to improve the lives of people with diabetes. The 2014 meeting comprised a comprehensive scientific program, parallel interactive workshops, and two keynote lectures. PMID:25211215

  18. 9th Annual Symposium on Self-Monitoring of Blood Glucose, April 28-30, 2016, Madrid, Spain.

    Science.gov (United States)

    Parkin, Christopher G; Homberg, Anita; Hinzmann, Rolf

    2016-11-01

    International experts in the field of diabetes and diabetes technology met in Madrid, Spain, for the 9th Annual Symposium on Self-Monitoring of Blood Glucose. The goal of these meetings is to establish a global network of experts, thus facilitating new collaborations and research projects to improve the lives of people with diabetes. The 2016 meeting comprised a comprehensive scientific program, parallel interactive workshops, and two keynote lectures.

  19. Glucose monitoring technologies - complementary or competitive? Role of continuous glucose monitoring versus flash glucose monitoring versus self-monitoring of blood glucose

    Directory of Open Access Journals (Sweden)

    Jothydev Kesavadev

    2017-01-01

    Full Text Available We have numerous technologies that can help keep a close watch on an individual's glycaemic status and thereby assist in developing successful diabetes management strategies. For more than five decades, self-monitoring of blood glucose (SMBG has remained as the gold standard tool to manage glycaemic status and has gained huge acceptance. Rigorous research further led to the development of more and more advanced technologies such as continuous glucose monitoring and flash glucose monitoring. These novel technologies are more promising in terms of revealing the complete glycaemic picture and even more user-friendly than the already established blood glucosemetres. However, they are yet to achieve remarkable accuracy and performance. There will also be a subgroup of patients who will be using these technologies only occasionally and thus will definitely require SMBG at other times. Again, with regard to the retrospective ones, glucose data can be obtained only once they are downloaded to the system and hence, real-time values will still have to be procured with the help of an SMBG. In future when the accuracy and performance of these newer technologies become equal to that of glucometres, the glucometres might vanish. Until then, all these technologies will definitely go hand-in-hand and supplement each other than competing each other. All the related literature were retrieved from various databases including 'PubMed' and 'Cochrane Database of Systematic Reviews' using specific search terms that were relevant to the topics discussed this manuscript.

  20. Factors associated to adherence to blood glucose self-monitoring in patients with diabetes treated with insulin. The dapa study.

    Science.gov (United States)

    Vidal Florc, Mercè; Jansà Morató, Margarita; Galindo Rubio, Mercedes; Penalba Martínez, Maite

    2018-02-01

    To assess adherence to self-monitoring of blood glucose and the main factors associated with it, particularly those related to self-perception of glycemia, in patients with diabetes on insulin therapy. An epidemiological, observational, prospective, multicenter study conducted in standard clinical practice in primary care, outpatient centers, and hospitals from different Spanish regions. Sociodemographic, clinical and treatment data were collected. Patients were considered adherent to self-monitoring if they performed the minimum number of controls recommended by the Spanish Society of Diabetes (SED). Adherence was shown in 61.6% of patients. Factors associated to adherence included treatment with less than three insulin injections daily (OR 2.678; 95% CI 2.048- 3.5029; p self-perception of glycemia was found in 21.4% of patients. Our results show a suboptimal adherence to the recommended protocol for blood glucose self-monitoring in patients with diabetes on insulin therapy. Independent variables associated to good adherence were treatment with less than three insulin injections dailyu, presence of peripheral vascular disease, alcohol abstinence, and collection of glucose test strips from the pharmacy. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Self-monitoring of blood glucose in Type 2 diabetes: cross-sectional analyses in 1993, 1999 and 2009.

    Science.gov (United States)

    Evans, J M M; Mackison, D; Emslie-Smith, A; Lawton, J

    2012-06-01

    To characterize the numbers of reagent strips dispensed for self-monitoring of blood glucose to patients with Type 2 diabetes in Tayside, Scotland, in 1993, 1999 and 2009. A diabetes clinical information system in Tayside, record-linked to electronic dispensed prescribing records, was used to collate all dispensed prescribing records for three cross-sectional samples of patients with Type 2 diabetes in 1993 (n = 5728), 1999 (n = 8109) and at 1 January 2009 (n = 16,450). The numbers of reagent strips dispensed during the relevant calendar year were calculated and patients stratified by treatment. We also explored whether age, sex or material and social deprivation were associated with whether a patient received strips. Proportions of people who received self-monitoring reagent strips increased from 15.5% in 1993, to 24.2% in 1999 to 29.8% in 2009, as did numbers of strips dispensed. While the proportion of diet-treated patients who received reagent strips was still very low in 2009 (5.6%), the proportion among those treated with oral agents tripled from 9.4 to 27.4% between 1993 and 2009. Over 90% of patients treated with insulin received reagent strips and, among non-insulin-treated patients, this was more common among women, younger people and less deprived groups. The numbers of reagent strips dispensed for self-monitoring of blood glucose has increased and almost all insulin-treated patients receive strips. While few diet-treated patients receive strips, they are more extensively dispensed to those treated with oral agents. Given that self-monitoring of blood glucose is no longer routinely recommended in non-insulin treated patients, strategies to reduce unnecessary dispensing of reagent strips are needed. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  2. Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin.

    Science.gov (United States)

    Malanda, Uriëll L; Welschen, Laura M C; Riphagen, Ingrid I; Dekker, Jacqueline M; Nijpels, Giel; Bot, Sandra D M

    2012-01-18

    Self-monitoring of blood glucose (SMBG) has been found to be effective for patients with type 1 diabetes and for patients with type 2 diabetes using insulin. There is much debate on the effectiveness of SMBG as a tool in the self-management for patients with type 2 diabetes who are not using insulin. To assess the effects of SMBG in patients with type 2 diabetes mellitus who are not using insulin. Multiple electronic bibliographic and ongoing trial databases were searched supplemented with handsearches of references of retrieved articles (date of last search: 07 July 2011). Randomised controlled trials investigating the effects of SMBG compared with usual care, self-monitoring of urine glucose (SMUG) or both in patients with type 2 diabetes who where not using insulin. Studies that used glycosylated haemoglobin A(1c) (HbA(1c)) as primary outcome were eligible for inclusion. Two authors independently extracted data from included studies and evaluated the studies' risk of bias. Data from the studies were compared to decide whether they were sufficiently homogeneous to pool in a meta-analysis. Primary outcomes were HbA(1c), health-related quality of life, well-being and patient satisfaction. Secondary outcomes were fasting plasma glucose level, hypoglycaemic episodes, morbidity, adverse effects and costs. Twelve randomised controlled trials were included and evaluated outcomes in 3259 randomised patients. Intervention duration ranged from 6 months (26 weeks) to 12 months (52 weeks). Nine trials compared SMBG with usual care without monitoring, one study compared SMBG with SMUG, one study was a three-armed trial comparing SMBG and SMUG with usual care and one study was a three-armed trial comparing less intensive SMBG and more intensive SMBG with a control group. Seven out of 11 studies had a low risk of bias for most indicators. Meta-analysis of studies including patients with a diabetes duration of one year or more showed a statistically significant SMBG induced

  3. Self-monitoring of blood glucose versus self-monitoring of urine glucose in adults with newly diagnosed Type 2 diabetes receiving structured education: a cluster randomized controlled trial.

    Science.gov (United States)

    Dallosso, H M; Bodicoat, D H; Campbell, M; Carey, M E; Davies, M J; Eborall, H C; Hadjiconstantinou, M; Khunti, K; Speight, J; Heller, S

    2015-03-01

    To compare the effectiveness and acceptability of self-monitoring of blood glucose with self-monitoring of urine glucose in adults with newly diagnosed Type 2 diabetes. We conducted a multi-site cluster randomized controlled trial with practice-level randomization. Participants attended a structured group education programme, which included a module on self-monitoring using blood glucose or urine glucose monitoring. HbA1c and other biomedical measures as well as psychosocial data were collected at 6, 12 and 18 months. A total of 292 participants with Type 2 diabetes were recruited from 75 practices. HbA1c levels were significantly lower at 18 months than at baseline in both the blood monitoring group [mean (se) -12 (2) mmol/mol; -1.1 (0.2) %] and the urine monitoring group [mean (se) -13 (2) mmol/mol; -1.2 (0.2)%], with no difference between groups [mean difference adjusted for cluster effect and baseline value = -1 mmol/mol (95% CI -3, 2); -0.1% (95% CI -0.3, 0.2)]. Similar improvements were observed for the other biomedical outcomes, with no differences between groups. Both groups showed improvements in total treatment satisfaction, generic well-being, and diabetes-specific well-being, and had a less threatening view of diabetes, with no differences between groups at 18 months. Approximately one in five participants in the urine monitoring arm switched to blood monitoring, while those in the blood monitoring arm rarely switched (18 vs 1% at 18 months; P self-monitoring. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  4. Evaluation of OneTouch Verio(®), a new blood glucose self-monitoring system for patients with diabetes.

    Science.gov (United States)

    Littmann, Karin; Petersen, Eva R B; Pussinen, Christel; Danielson, Kristin; Djurisic, Snezana; Eilertsen, Heidi; Garabet, Lamya; Greibe, Eva; Lauritzen, Trine; Olsen, Dorte A; Othman, Suher; Palimaru, Irina; Westerlund, Johanna

    2013-01-01

    Self-monitoring of blood glucose (SMBG) is important in diabetes management. Reliable and user-friendly instruments are essential. OneTouch Verio(®) is a new blood glucose concentration-measuring system designed to be used by patients with diabetes and healthcare professionals. The objective of the present study was to evaluate the analytical performance of the OneTouch Verio(®). The OneTouch Verio(®) was evaluated by the Scandinavian evaluation of laboratory equipment for primary healthcare (SKUP) according to a protocol based on ISO 15197 and the American Diabetes Association (ADA) quality goals. Blood samples were collected and measured on the OneTouch Verio(®) by laboratory personnel and patients with diabetes (n = 91, randomized into groups receiving personal training or mail instructions for the OneTouch Verio(®) system). Results were compared to a validated routine method, imprecision and bias were calculated. User-friendliness was evaluated with a questionnaire. Quality specifications for blood glucose concentration monitoring systems according to ISO 15197 were fulfilled. The mean coefficients of variation (CV%) of repeatability was 3.4% when tested by laboratory personnel and within the goal of imprecision suggested by ADA. Mean CV% of repeatability for patient self-monitoring was 5.0% and 5.1% in the training- and the mail group, respectively. Total error was 6.4-10.0%. The OneTouch Verio(®) showed no hematocrit interference or variation between strip lots. The OneTouch Verio(®) displayed sufficient analytical quality and satisfactory user-friendliness. It is suitable for point-of-care testing of blood glucose concentration when handled by patients and healthcare professionals.

  5. Effectiveness for self-monitoring of blood sugar on blood glucose control in Turkish patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Baltaci, Davut; Kutlucan, Ali; Ozturk, Serkan; Saritas, Ayhan; Celer, Ahmet; Celbek, Gokham; Deler, Harun; Aydin, Yusuf; Ankarali, Handan

    2012-08-01

    Diabetes mellitus (DM) is a chronic disease requiring continuous monitoring and treatment. Self-monitoring of blood glucose (SMBG) is frequently recommended. The purpose of the study was to evaluate effectiveness of SMBG on metabolic control in Turkish patients with type 2 DM. The cross-sectional study enrolled type 2 diabetic patients without insulin regimen. The participants were assigned to three groups according to status of SMBG: group 1- regular, group 2 - irregular and group 3 - never SMBG implementation. A total of 349 patients were enrolled. There was no significant difference in mean fasting and post-prandial blood glucose, lipid profile values between the groups. The number of patients with high education level in group 1 was higher than groups 2 and 3 (p = 0.001). HbA1c level was higher in groups 2 and 3 than group 1, but not significantly (p = 0.285). Mean spot urinary albumin- creatinine ratio (ACR) in group 1 is significantly lower than in groups 2 and 3 (p = 0.008 and p = 0.044, respectively), but no significant difference was observed between group 2 and 3 (p = 0.473). The study indicated that regular use of SMBG was not superior to irregular/never use of SMBG on glycemic control, but it seemed to be good intervention for prevention of diabetic nephropathy. We suggestively offered that SMBG should be recommended for patients with a high education level to meet the goal of its use, and it should be incorporated into self-management with effective educational intervention.

  6. Community pharmacy-based intervention to improve self-monitoring of blood glucose in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Müller U

    2006-12-01

    Full Text Available Self-monitoring of blood glucose (SMBG is clearly correlated with increased life expectancy and quality of life in type 2 diabetic patients. Objective: The objective of our study was to record and assess the errors patients make in preparing, performing, and processing self-monitoring of blood glucose (SMBG. Furthermore, the study aimed to determine to what extent a single standardized SMBG instruction session in a community pharmacy might reduce the number of patients making errors or the number of errors per patient. Methods: Between May and October 2005, SMBG of 462 randomly selected patients with type 2 diabetes was monitored in 32 pharmacies specialized in diabetes care. The patients performed blood glucose self-tests using their own blood glucose meters. Self-testing was monitored using a standardized documentation sheet on which any error made during the performance of the test was recorded. If necessary, patients were instructed in the accurate operation of their meter and the use of the necessary equipment. Additionally, patients obtained written instructions. Six weeks later, assessment of the quality of patient’s SMBG was repeated.Results: During the first observation, 383 patients (83% made at least one mistake performing SMBG. By the time of the second observation, this frequency had fallen to 189 (41% (p<0.001. The average number of mistakes fell from 3.1 to 0.8 per patient. Mistakes that may potentially have led to inaccurate readings were initially recorded for 283 (61% and at study end for 110 (24% patients (p<0.001. Conclusion: It is important to periodically instruct type 2 diabetic patients in the proper SMBG technique in order to ensure accurate measurements. In this study it was shown that community pharmacies specialized in diabetes care can provide this service effectively.

  7. Self-Monitoring Using Continuous Glucose Monitors with Real-Time Feedback Improves Exercise Adherence in Individuals with Impaired Blood Glucose: A Pilot Study.

    Science.gov (United States)

    Bailey, Kaitlyn J; Little, Jonathan P; Jung, Mary E

    2016-03-01

    Exercise helps individuals with prediabetes or type 2 diabetes (T2D) manage their blood glucose (BG); however, exercise adherence in this population is dismal. In this pilot study we tested the efficacy of a self-monitoring group-based intervention using continuous glucose monitors (CGMs) at increasing exercise adherence in individuals with impaired BG. Thirteen participants with prediabetes or T2D were randomized to an 8-week standard care exercise program (CON condition) (n = 7) or self-monitoring exercise intervention (SM condition) (n = 6). Participants in the SM condition were taught how to self-monitor their exercise and BG, to goal set, and to use CGM to observe how exercise influences BG. We hypothesized that compared with the CON condition, using a real-time CGM would facilitate self-monitoring behavior, resulting in increased exercise adherence. Repeated-measures analysis of variance revealed significant Condition × Time interactions for self-monitoring (P self-efficacy to self-monitor (P = 0.01), such that the SM condition showed greater increases in these outcomes immediately after the program and at the 1-month follow-up compared with the CON condition. The SM condition had higher program attendance rates (P = 0.03), and a greater proportion of participants reregistered for additional exercise programs (P = 0.048) compared with the CON condition. Participants in both conditions experienced improvements in health-related quality of life, waist circumference, and fitness (P values self-monitoring and exercise behavior in individuals living with prediabetes or T2D.

  8. Accuracy of blood glucose meters for self-monitoring affects glucose control and hypoglycemia rate in children and adolescents with type 1 diabetes.

    Science.gov (United States)

    Boettcher, Claudia; Dost, Axel; Wudy, Stefan A; Flechtner-Mors, Marion; Borkenstein, Martin; Schiel, Ralf; Weitzel, Dieter; Bechtold-Dalla Pozza, Susanne; Wolf, Johannes; Holl, Reinhard W

    2015-04-01

    This study investigated the accuracy of blood glucose meters for self-monitoring and its influence on glycated hemoglobin (HbA1c) levels and the frequency of hypoglycemic coma. Self-measured and simultaneously obtained laboratory blood glucose values from 9,163 patients with type 1 diabetes glucose control and hypoglycemia rates. Depending on the respective subgroup (defined by sex, age, duration of diabetes, mode of insulin therapy), 78.7-94.7% of the self-monitoring of blood glucose (SMBG) values met the old and 79.7-88.6% met the new ISO criteria. In Clarke and Parkes error grid analyses, the percentages of SMBG values in Zone A ranged between 92.8% and 94.6% (Clarke) and between 92.2% and 95.0% (Parkes). The patient group with SMBG devices measuring "far too low" (compared with the laboratory-obtained glucose levels) presented with a higher HbA1c level than those measuring "far too high," "too high," "identical/almost identical," or "too low" (based on quintiles of deviation). Performing "far too high" was associated with the highest rate of hypoglycemic coma in comparison with the other deviation quintiles. This study showed that current SMBG devices fulfilled neither the previous nor the new ISO criteria. Large deviations of the SMBG values from the "true" glucose levels resulted in higher HbA1c levels and markedly increased rates of hypoglycemic events.

  9. Blood glucose self-monitoring patterns in Mexican Americans: further lessons from the Starr County Border Health Initiative.

    Science.gov (United States)

    Cuevas, Heather E; Brown, Sharon A; García, Alexandra A; Winter, Mary; Brown, Adama; Hanis, Craig L

    2015-02-01

    The purpose was to describe patterns of home self-monitoring of blood glucose (SMBG) in Mexican Americans with type 2 diabetes mellitus enrolled in a diabetes self-management education protocol. Research questions were as follows: (1) What were the patterns and rates of home glucose self-monitoring over the 6-month course of the study? (2) What were the differences in monitoring rates between experimental and control groups? (3) What were the relationships between rates of monitoring and glycosylated hemoglobin (A1C), gender, and years with diabetes? We used a randomized (by group) repeated-measures pretest/posttest control group design. Glucometer data from an experimental group (diabetes self-management education plus nurse case management) and a comparison group (diabetes self-management education only) were analyzed. Data were collected at baseline and at 3 and 6 months. Overall average SMBG rates were low. Experimental and control group monitoring levels were not significantly different. More females than males never monitored glucose values, but more females than males checked at least one time per week. Those participants who checked their glucose levels more than once per week had diabetes for a longer period of time. Rates of monitoring were not strongly associated with A1C levels at 3 and 6 months, but at 6 months A1C levels were statistically significantly different based on whether or not individuals monitored their glucose levels (P=0.03, n=71). SMBG rates were low in this study despite SMBG education and access to free glucometers and test strips. The lower rates of SMBG may reflect the effects of unexpected environmental challenges, but exact causes remain unclear. Reasons for low rates of SMBG need to be explored further, especially in underserved communities.

  10. Determinants of self-monitoring of blood glucose in patients with Type 1 diabetes: a multi-centre study in Brazil.

    Science.gov (United States)

    Gomes, M B; Tannus, L R M; Cobas, R A; Matheus, A S M; Dualib, P; Zucatti, A T; Cani, C; Guedes, A D; Santos, F M; Sepulveda, J; Tolentino, M; Façanha, M C; Faria, A C R A; Lavigne, S; Montenegro, A P; Rodacki, M; de Fatima Guedes, M; Szundy, R; Cordeiro, M M; Santos, P T S; Negrato, C A

    2013-10-01

    The aim of this study was to determine the relationship between the daily frequency of self-monitoring of blood glucose and glycaemic control, demographic and socio-economic status in patients with Type 1 diabetes under routine clinical care in Brazil. This was a cross-sectional, multi-centre study conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. The data were obtained from 3176 patients, aged 22 ± 11.8 years, of whom 56.3% were female and 57.4% were Caucasian. The mean time since diabetes diagnosis was 11.7 ± 8.1 years. The prevalence of self-monitoring of blood glucose was 88.5%. There was a significant increase in self-monitoring frequency associated with female gender, lower ages, more intensive diabetes management and higher socio-economic status. A correlation between HbA(1c) levels and the daily frequency of self-monitoring was observed (r(s) = -0.13; P = 0.001). The mean HbA1c levels were related to the daily frequency of self-monitoring (P self-monitoring more than four times daily (9.2, 11.2, 10.2,15.2 and 15% for one, two, three, four, five or more self-monitoring tests daily, respectively; P self-monitoring tests daily, with more frequent testing reported by females, younger patients, those on intensive insulin regimens and of higher socio-economic status. No additional benefit was found in patients who performed self-monitoring more than four times daily. The diabetes care team must improve patients' education regarding self-monitoring of blood glucose and its benefits. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

  11. Effects of 50 mg vildagliptin twice daily vs. 50 mg sitagliptin once daily on blood glucose fluctuations evaluated by long-term self-monitoring of blood glucose.

    Science.gov (United States)

    Nomoto, Hiroshi; Kimachi, Kimihiko; Miyoshi, Hideaki; Kameda, Hiraku; Cho, Kyu Yong; Nakamura, Akinobu; Nagai, So; Kondo, Takuma; Atsumi, Tatsuya

    2017-04-29

    To date, several clinical trials have compared differences in glucose fluctuation observed with dipeptidyl peptidase-4 inhibitor treatment in patients with type 2 diabetes mellitus. However, most patients were assessed for limited periods or during hospitalization. The aim of the present study was to evaluate the effects of switching from sitagliptin to vildagliptin, or vice versa, on 12-week glucose fluctuations using self-monitoring of blood glucose in the standard care setting. We conducted a multicenter, prospective, open-label controlled trial in Japanese patients with type 2 diabetes. Thirty-two patients were treated with vildagliptin (50 mg) twice daily or sitagliptin (50 mg) once daily and were allocated to one of two groups: vildagliptin treatment for 12 weeks before switching to sitagliptin for 12 weeks, or vice versa. Daily profiles of blood glucose were assessed several times during each treatment period, and the mean amplitude of glycemic excursions and M-value were calculated. Metabolic biomarkers such as hemoglobin A1c (HbA1c), glycated albumin, and 1,5-anhydroglucitol were also assessed. With vildagliptin treatment, mean amplitude of glycemic excursions was significantly improved compared with sitagliptin treatment (57.9 ± 22.2 vs. 68.9 ± 33.0 mg/dL; p=0.0045). M-value (p=0.019) and mean blood glucose (p=0.0021) were also lower with vildagliptin, as were HbA1c, glycated albumin, and 1,5-anhydroglucitol. There were no significant differences in other metabolic parameters evaluated. Reduction of daily blood glucose profile fluctuations by vildagliptin was superior to that of sitagliptin in Japanese patients with type 2 diabetes.

  12. Consensus report: the current role of self-monitoring of blood glucose in non-insulin-treated type 2 diabetes.

    Science.gov (United States)

    Klonoff, David C; Blonde, Lawrence; Cembrowski, George; Chacra, Antonio Roberto; Charpentier, Guillaume; Colagiuri, Stephen; Dailey, George; Gabbay, Robert A; Heinemann, Lutz; Kerr, David; Nicolucci, Antonio; Polonsky, William; Schnell, Oliver; Vigersky, Robert; Yale, Jean-François

    2011-11-01

    The Coalition for Clinical Research--Self-Monitoring of Blood Glucose Scientific Board convened a meeting in San Francisco, CA, July 20-21, 2011, to discuss the current practice of self-monitoring of blood glucose (SMBG) in non-insulin-treated (NIT) type 2 diabetes mellitus (T2DM). Twelve physician panel members from academia, practice, and government attended this meeting. These experts came from the United States, Brazil, Canada, France, Germany, Italy, and the United Kingdom. In addition, three consultants from Australia, Germany, and the United States contributed to the group's final report. This coalition was organized by Diabetes Technology Society. Self-monitoring of blood glucose was studied from eight perspectives related to patients with NIT T2DM: (1) epidemiological studies; (2) randomized controlled trials (RCT)s and meta-analyses; (3) targets, timing, and frequency of SMBG use; (4) incidence and role of SMBG in preventing hypoglycemia with single-drug regimens and combination regimens consisting of antihyperglycemic agents other than secretagogues and insulin; (5) comparison of SMBG with continuous glucose monitoring; (6) technological capabilities and limitations of SMBG; (7) barriers to appropriate use of SMBG; and (8) methods and end points for appropriate future clinical trials. The panel emphasized recent studies, which reflect the current approach for applying this intervention. Among the participants there was consensus that: SMBG is an established practice for patients with NIT T2DM, and to be most effective, it should be performed in a structured format where information obtained from this measurement is used to guide treatment; New, high-quality efficacy data from RCTs have demonstrated efficacy of SMBG in NIT T2DM in trials reported since 2008; Both patients and health care professionals require education on how to respond to the data for SMBG to be effective; and Additional well-defined studies are needed to assess the benefits and costs of

  13. System accuracy evaluation of 43 blood glucose monitoring systems for self-monitoring of blood glucose according to DIN EN ISO 15197.

    Science.gov (United States)

    Freckmann, Guido; Schmid, Christina; Baumstark, Annette; Pleus, Stefan; Link, Manuela; Haug, Cornelia

    2012-09-01

    The accuracy of systems for self-monitoring of blood glucose is important, as reliable measurement results are a prerequisite for therapeutic decisions. This system accuracy evaluation study was performed according to DIN EN ISO 15197:2003 for 43 Conformité Européenne (CE)-labeled blood glucose (BG) monitoring systems. Measurement results of each system were compared with results of the designated comparison method (manufacturer's measurement procedure): glucose oxidase method (YSI 2300 glucose analyzer) or hexokinase method (Hitachi 917/ cobas 501). Complete assessment according to the International Organization for Standardization (ISO) standard was performed for 34 out of 43 systems, and 27 (79.4%) meet the requirements of the standard, i.e., ≥95% of their results showed at least the minimum acceptable accuracy. For 9 of the 43 systems, complete accuracy assessment was not performed due to an oxygen sensitivity (manufacturer's labeling). The bias (according to Bland and Altman) of all 43 evaluated systems ranged from -14.1% to +12.4%. From the 34 systems completely assessed, 7 systems did not fulfill the minimal accuracy requirements of the ISO standard. The CE mark apparently does not guarantee that all BG systems provide accuracy according to the standard. Because inaccurate systems bear the risk of false therapeutic decisions, regular and standardized evaluation of BG meters and test strips should be requested in order to ensure adherence to quality standards. © 2012 Diabetes Technology Society.

  14. Self-Monitoring of Blood Glucose : The Use of the First or the Second Drop of Blood

    NARCIS (Netherlands)

    Hortensius, Johanna; Slingerland, Robbert J.; Kleefstra, Nanne; Logtenberg, Susan J. J.; Groenier, Klaas H.; Houweling, Sebastiaan T.; Bilo, Henk J. G.

    OBJECTIVE-There is no general agreement regarding the use of the first or second drop of blood for glucose monitoring. This study investigated whether capillary glucose concentrations, as measured in the first and second drops of blood, differed >= 10% compared with a control glucose concentration

  15. Perspectives of patients with type 1 or insulintreated type 2 diabetes on self-monitoring of blood glucose : a qualitative study

    NARCIS (Netherlands)

    Hortensius, Johanna; Kars, Marijke C.; Wierenga, Willem S.; Kleefstra, Nanne; Bilo, Henk J. G.; van der Bijl, Jaap J.

    2012-01-01

    Background: Self-monitoring of blood glucose (SMBG), including self-regulation, is an important tool to achieve good glycemic control. However, many patients measure their glucose concentrations less often than is recommended. This study investigates patients' perspectives of SMBG and all relevant

  16. How people with diabetes integrate self-monitoring of blood glucose into their self-management strategies.

    Science.gov (United States)

    Bond, Carol S; Hewitt-Taylor, Jaqui

    2014-01-01

    The benefit of self-monitoring of blood glucose by patients has been questioned, and UK policy is generally not to support this, although it is identified that there may be unidentified subgroups of people who would benefit from being supported to self-monitor. The purpose of this paper is to explore the self-management approaches of people with diabetes, and how self-testing of blood glucose contributes to self-management strategies. This qualitative study of patients' experiences drew data from contributors to online discussion boards for people living with diabetes. The principles of qualitative content analysis were used on posts from a sample of four Internet discussion boards. Contributors described how they were using self-testing within their self-management strategies. Most saw it as a way of actively maintaining control of their condition. The amount of testing carried varied over time; more testing was done in the early days, when people were still learning how to stay in control of their diabetes. Some people had experienced a lack of support for self-testing from healthcare professionals, or had been expected to change their self-management to fit national policy changes. This was seen as unhelpful, demotivating, stressful, and harmful to the doctor-patient relationship. The Internet is a valuable source of information about peoples' self-management behaviours. Patients who are using, or who wish to use, self-testing as part of their self-management strategy are one of the subgroups for whom self-testing is beneficial and who should be supported to do so.

  17. Performance variability of seven commonly used self-monitoring of blood glucose systems: clinical considerations for patients and providers.

    Science.gov (United States)

    Brazg, Ronald L; Klaff, Leslie J; Parkin, Christopher G

    2013-01-01

    Blood glucose data are frequently used in clinical decision making, thus it is critical that self-monitoring of blood glucose (SMBG) systems consistently provide accurate results. Concerns about SMBG accuracy have prompted the development of newly proposed International Organization for Standardization (ISO) standards: ≥ 95% of individual glucose results shall fall within ± 15 mg/dl of the results of the manufacturer's reference procedure at glucose concentrations blood samples were collected from 100 subjects and tested on seven systems: Accu-Chek Aviva Plus, Advocate Redi-Code, Element, Embrace, Prodigy Voice, TRUEbalance, and WaveSense Presto. Results were compared with manufacturer's documented reference system, YSI or perchloric acid hexokinase; three different strip lots from each system were tested on each subject, in duplicate. Compared against current ISO criteria (≥ 95% within ± 15 mg/dl for values <75 mg/dl and ± 20% for values ≥ 75 mg/dl) the Accu-Chek Aviva Plus, Element, and WaveSense Presto systems met accuracy criteria. However, only the Accu-Chek Aviva Plus met the proposed ISO criteria (criterion A) in all three lots. The other six systems failed to meet the criteria in at least two of the three lots, showing lot-to-lot variability, high/low bias, and variations due to hematocrit. Inaccurate SMBG readings can potentially adversely impact clinical decision making and outcomes. Clinicians can reduce controllable variables by prescribing accurate SMBG systems. Adherence to the proposed ISO criteria should enhance patient safety by improving the accuracy of SMBG systems. © 2013 Diabetes Technology Society.

  18. Self-monitoring of blood glucose in patients with diabetes who do not use insulin--are guidelines evidence-based?

    Science.gov (United States)

    Aakre, K M; Watine, J; Bunting, P S; Sandberg, S; Oosterhuis, W P

    2012-10-01

    To evaluate if clinical practice guideline recommendations regarding self-monitoring of blood glucose in patients with diabetes not using insulin follow the principles of evidence-based medicine. After a search from 1999 to 2011, 18 clinical practice guidelines were included. Recommendations regarding self-monitoring of blood glucose were graded on a scale from one (strongly against self-monitoring) to four (strongly in favour of self-monitoring) and compared with the similarly graded conclusions of systematic reviews that were cited by the clinical practice guidelines. We also investigated how clinical practice guideline characteristics, for example funding sources, and quality of references cited could be related to the guideline recommendations. The clinical practice guidelines cited in total 15 systematic reviews, 14 randomized controlled trials, 33 non-randomized controlled trials papers and 18 clinical practice guidelines or position statements. The clinical practice guideline recommendations had an average grade of 3.4 (range 2.0-4.0). Higher grades were seen for clinical practice guidelines that acknowledged industry funding (mean value 4.0) or were issued by organizations depending on private funding (mean value 3.6 vs. 3.0 for governmental funding). The conclusions of the 15 systematic reviews had a mean grade of 2.2 (range 1.0-3.8). Systematic reviews with low grades were less cited. In total, 21 randomized controlled trials were included in the systematic reviews. Approximately half of these evaluated an educational intervention where the effect of self-monitoring of blood glucose could not be clearly isolated. Clinical practice guidelines were more in favour of self-monitoring use than the systematic reviews that were cited. The citation practice was non-systematic and industry funding seemingly led to a more positive attitude towards use of self-monitoring of blood glucose. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

  19. Can follow-up phone calls improve patients self-monitoring of blood glucose?

    Science.gov (United States)

    Brown-Deacon, Cheryl; Brown, Terri; Creech, Constance; McFarland, Marilyn; Nair, Anupama; Whitlow, Kevin

    2017-01-01

    To evaluate the effectiveness of follow-up phone calls in improving frequency of glucose monitoring over a three month period in two groups of patients with type 2 diabetes with the goal to lower haemoglobin A1C. Telephone intervention has been successfully used in improving adherence to diabetes self-management and other chronic disease conditions. A quality improvement study. Forty one Type 2 diabetic patients with HA1C ≥7·5% were included in the study. The patients were assigned to two groups. The first group of patients received standard diabetic care (Group 1) and the second group of patients (Group 2) received standard diabetic care plus follow-up phone calls within two weeks after a monthly clinic visit over a three month period. A haemoglobin A1C if indicated was done at the initial study visit. There were no statistically significant differences in the baseline haemoglobin A1C between the two groups or the three month haemoglobin A1C of the two groups. There were no statistically significant differences in mean haemoglobin A1C change between Group 1 and Group 2. The analysis revealed that there were no statistically significant differences between groups in the number of patients who kept logs of their blood glucose readings throughout the study. The intervention using telephone follow-up calls did not show a statistically significant improvement in overall HA1C, but there was a clinically significant change in HA1C in the group of patients that received follow-up phone calls. The clinical significance of the change in A1C in the follow-up phone call group (Group 2) supports that frequent contact by telephone may likely improve adherence to diabetes self-management. © 2016 John Wiley & Sons Ltd.

  20. Self-monitoring of blood glucose (SMBG) and glycaemic control in Cameroon: Results of the International Diabetes Management Practices Study (IDMPS).

    Science.gov (United States)

    Claude Mbanya, Jean; Aschner, Pablo; Chan, Juliana C N; Jose Gagliardino, Juan; Saji, Jude

    2017-04-01

    This study examined the relationship between self-monitoring of blood glucose (SMBG) and glycaemic control among patients from Cameroon. A minority of patients with diabetes owned a blood glucose meter; of these patients, most performed SMBG inconsistently. The lack of SMBG may be a contributing factor to the poor glycaemic control in the country. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Color record in self-monitoring of blood glucose improves glycemic control by better self-management.

    Science.gov (United States)

    Nishimura, Akiko; Harashima, Shin-ichi; Honda, Ikumi; Shimizu, Yoshiyuki; Harada, Norio; Nagashima, Kazuaki; Hamasaki, Akihiro; Hosoda, Kiminori; Inagaki, Nobuya

    2014-07-01

    Color affects emotions, feelings, and behaviors. We hypothesized that color used in self-monitoring of blood glucose (SMBG) is helpful for patients to recognize and act on their glucose levels to improve glycemic control. Here, two color-indication methods, color record (CR) and color display (CD), were independently compared for their effects on glycemic control in less frequently insulin-treated type 2 diabetes. One hundred twenty outpatients were randomly allocated to four groups with 2×2 factorial design: CR or non-CR and CD or non-CD. Blood glucose levels were recorded in red or blue pencil in the CR arm, and a red or blue indicator light on the SMBG meter was lit in the CD arm, under hyperglycemia or hypoglycemia, respectively. The primary end point was difference in glycated hemoglobin (HbA1c) reduction in 24 weeks. Secondary end points were self-management performance change and psychological state change. HbA1c levels at 24 weeks were significantly decreased in the CR arm by -0.28% but were increased by 0.03% in the non-CR arm (P=0.044). In addition, diet and exercise scores were significantly improved in the CR arm compared with the non-CR arm. The exercise score showed significant improvement in the CD arm compared with the non-CD arm but without a significant difference in HbA1c reduction. Changes in psychological states were not altered between the arms. CR has a favorable effect on self-management performance without any influence on psychological stress, resulting in improved glycemic control in type 2 diabetes patients using less frequent insulin injection. Thus, active but not passive usage of color-indication methods by patients is important in successful SMBG.

  2. Structured self monitoring of blood glucose in Iranian people with type 2 diabetes; A cost consequence analysis

    Directory of Open Access Journals (Sweden)

    Aghili Rokhsareh

    2012-09-01

    Full Text Available Abstract Background Self-Monitoring of Blood Glucose (SMBG is considered as a key factor in management of people with diabetes which is a growing and cost demanding health problem. The purpose of this study was to investigate the effect of comprehensive patient management using structured SMBG on metabolic control as well as its cost consequence analysis. Methods Sixty subjects were recruited in an observational study for a period of 6 months. They were provided with the ACCU-CHEK 360° View tool to fill in the values of the 7-point blood glucose profiles in three consecutive days during the study on a monthly basis. Changes in metabolic control were assessed by HbA1c and lipid profile measurement at the beginning and at the end of the study. In addition, cost consequence analysis was done considering different level of health care professionals with or without insurance coverage. The Average Cost Effectiveness Ratio (ACER as well as Cost saving analysis were calculated and compared. Results The analysis showed significant reduction in HbA1c during the 6-month period in all subjects (P = 0.000. Furthermore, a positive effect was observed on lipid profile. The cost of endocrinologist’s visit in private sector was estimated to be 265.76 USD while this figure was149.15 USD for general practitioner in public sector with insurance coverage. Total complications and mortality cost saving was 154.8 USD. The lowest ACER was calculated for intervention with general practitioner in public sector with insurance coverage. Conclusion Structured SMBG results in significant improvement of glycemic status. Moreover, it is more cost saving in public sector with insurance coverage. It seems that general practitioner visits with insurance coverage is the most affordable option for people with type 2 diabetes.

  3. Self monitoring of blood glucose - a survey of diabetes UK members with type 2 diabetes who use SMBG

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    Young Amanda J

    2010-11-01

    Full Text Available Abstract Background Aim - to survey members of Diabetes UK who had Type 2 diabetes and who used self monitoring of blood glucose (SMBG, to elicit their views on its usefulness in the management of their diabetes, and how they used the results. A questionnaire was developed for the Diabetes UK website. The questionnaire was posted on the Diabetes UK website until over 500 people had responded. Questions asked users to specify the benefits gained from SMBG, and how these benefits were achieved. We carried out both quantitative analysis and a thematic analysis for the open ended free-text questions. Findings 554 participants completed the survey, of whom 289 (52.2% were male. 20% of respondents were recently diagnosed ( 80% of respondents reported high satisfaction with SMBG, and reported feeling more 'in control' of their diabetes management using it. The most frequently reported use of SMBG was to make adjustments to food intake or confirm a hyperglycaemic episode. Women were significantly more likely to report feelings of guilt or self-chastisement associated with out of range readings (p = Conclusion SMBG was clearly of benefit to this group of confirmed users, who used the results to adjust diet, physical activity or medications. However many individuals (particularly women reported feelings of anxiety and depression associated with its use.

  4. Promoting health and reducing costs: a role for reform of self-monitoring of blood glucose provision within the National Health Service.

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    Leigh, S; Idris, I; Collins, B; Granby, P; Noble, M; Parker, M

    2016-05-01

    To determine the cost-effectiveness of all options for the self-monitoring of blood glucose funded by the National Health Service, providing guidance for disinvestment and testing the hypothesis that advanced meter features may justify higher prices. Using data from the Health and Social Care Information Centre concerning all 8 340 700 self-monitoring of blood glucose-related prescriptions during 2013/2014, we conducted a cost-minimization analysis, considering both strip and lancet costs, including all clinically equivalent technologies for self-monitoring of blood glucose, as determined by the ability to meet ISO-15197:2013 guidelines for meter accuracy. A total of 56 glucose monitor, test strip and lancet combinations were identified, of which 38 met the required accuracy standards. Of these, the mean (range) net ingredient costs for test strips and lancets were £0.27 (£0.14-£0.32) and £0.04 (£0.02-£0.05), respectively, resulting in a weighted average of £0.28 (£0.18-£0.37) per test. Systems providing four or more advanced features were priced equal to those providing just one feature. A total of £12 m was invested in providing 42 million self-monitoring of blood glucose tests with systems that fail to meet acceptable accuracy standards, and efficiency savings of £23.2 m per annum are achievable if the National Health Service were to disinvest from technologies providing lesser functionality than available alternatives, but at a much higher price. The study uncovered considerable variation in the price paid by the National Health Service for self-monitoring of blood glucose, which could not be explained by the availability of advanced meter features. A standardized approach to self-monitoring of blood glucose prescribing could achieve significant efficiency savings for the National Health Service, whilst increasing overall utilisation and improving safety for those currently using systems that fail to meet acceptable standards for measurement accuracy

  5. [Evaluation on the status quo of self monitoring of blood glucose and self-efficacy of diabetes patients in community].

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    Jiang, Yingying; Dong, Wenlan; Mao, Fan; Zhang, Chunhua; Ding, Xianbin; Pan, Xiaoqun; Zhang, Yongqing; Huang, Yanping; Dong, Jianqun

    2014-08-01

    To investigate the status quo and influence factors of self monitoring of blood glucose (SMBG) and self-efficacy of diabetes patients' that participated in community diabetes self management group. Beijing, Shanghai, Chongqing, Jiangsu, Guangdong, and Zhejiang were selected as the study sites considering patients management experiences they had. 1 401 adult diabetes patients were recruited from communities via health records system screening, telephone notification, poster advertisement, letters invitation ways. Face to face questionnaire survey was applied to obtain patients' general information, diabetes history, diabetes knowledge awareness, SMBG, and self-efficacy information. Multiple linear regression was used to analyze the relationship between factors and self efficacy. There were 519 male patients (37.0%) and 882 female patients (63.0%) with an average age of (64.9 ± 8.9) years old. Patients lived in city accounted for 48.0% (672/1 401) and rural patients accounted for 52.0% (729/1 401). Patients who conducted SMBG accounted for 79.9% (1 120/1 401) and 33.3% (446/1 401) patients conducted blood glucose monitoring 1-3 times per month. Rural patients, primary school educated, and new rural cooperative medical system (NCMS) covered patients had a higher proportion of never conducting SMBG which were 21.9% (160/729), 24.2% (160/662), and 26.3% (125/475) , respectively. Scores of self-efficacy was (69.24 ± 16.30) (hundred-mark system) with a relative lower score in monitoring of blood glucose (64.09 ± 20.08) and foot care (63.63 ± 21.40), as well as a highest score in taking medicine and insulin injections (76.10 ± 22.00). Multiple regression analysis on self-efficacy and its related factors show a negative correlation between patients' place of residence and self-efficacy (β' = -0.076) and a positive correlation between education and self-efficacy (β' = 0.114) as well as between diabetes knowledge awareness and self-efficacy (β' = 0.193)(t = -2.46, 3

  6. High incidence of hypoglycemia in stable insulin-treated type 2 diabetes mellitus: continuous glucose monitoring vs. self-monitored blood glucose. Observational prospective study.

    Science.gov (United States)

    Pazos-Couselo, Marcos; García-López, Jose Manuel; González-Rodríguez, Maria; Gude, Francisco; Mayán-Santos, Jose Manuel; Rodríguez-Segade, Santiago; Rodríguez-García, Javier; Casanueva, Felipe

    2015-10-01

    Hypoglycemia is a limiting factor in the achievement of strict glycemic control. The primary objective of this 9-week study was to determine the frequency of hypoglycemia in patients with stable insulin-treated type 2 diabetes mellitus by comparing self-monitored blood glucose (SMBG) measurement with continuous glucose monitoring (CGM). This was an observational prospective study. Included in the study were 63 stable, insulin-treated patients with type 2 diabetes. They were instructed to record 2 daily capillary blood glucose readings, pre- and/or postprandial, in a sequential way during 8 consecutive weeks. A CGM system was worn during an additional week. We evaluated the frequency of hypoglycemia using the 8-week SMBG profile and the 1 CGM week. SMBG revealed that 50% of the patients had experienced hypoglycemia. CGM found hypoglycemia in 59% of patients. Significantly higher percentages of hyperglycemic and hypoglycemic episodes were detected by CGM than by capillary blood glucose measurements (61.1% vs. 50.8%; p=0.047) and (3.8% vs. 1.7%; p=0.016); 33% of patients experienced nocturnal hypoglycemia, and 19% of patients who had no data concerning hypoglycemia recorded in the capillary blood glucose diary had experienced hypoglycemia as measured by CGM, and the hypoglycemia occurred mainly during the nocturnal period. In stable well-controlled, insulin-treated patients with type 2 diabetes, CGM showed higher numbers of hypoglycemic events than did SMBG, especially at night. CGM is a useful tool that provides clinically valuable information about glucose control in these patients. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  7. The effect of educational intervention based on continuous care model on self-monitoring of blood glucose in type 2 diabetics

    Directory of Open Access Journals (Sweden)

    Javad Esmaeilzade

    2016-11-01

    Full Text Available Background and Aim: Appropriate control of blood sugar delays the onset and progression of diabetes complications. Nurses have a decisive role in the education of self-care behaviors to diabetic patients, including self-monitoring of blood glucose. The current study aimed at assessing the effect of educational intervention based on continuous care model on self-monitoring of blood glucose is type 2 diabetics. Materials and Methods: This randomized controlled clinical trial study was conducted on 86 patients with type II DM referring to the Arian Diabetes Clinic of Torbat-e-heydaryyeh in 2015. The participants were randomly divided into intervention and control groups. Educational interventions based on continuous care model that has four basic steps: orientation, sensitization, control, and evaluation, was done on the intervention group for 3 months during 6 sessions. A reasearcher-designed questionnaire was completed before the intervention and two weeks after the last training session and the average scores of self-monitoring of blood glucose in both groups were evaluated. Finally,the obtained data was fed  into SPSS software (V: 16 and analyzed using descriptive and analytic statistical tests including Chi-square, paired T, independent t-tests P<0.05 was taken as the significant level. Results: Out of the total participants 59.3 percent were females; and their mean age was 48.6±8.4 years. Results showed significant difference between the two groups in terms of self-monitoring of blood glucose before and after the educational intervention based on continuous care model (P<0.001. It was found that mean and standard deviation of self-monitoring blood glucose in the intervention group before and after the intervention were 11.51±3.02 and 12.13±2.96  , and 18.13±3.93 and 13.25±3.74 ; respectively. Conclusion: The results showed that educational intervention based on continuous care model is effective on self-care behaviors of diabetic

  8. Meta-analysis of individual patient data in randomised trials of self monitoring of blood glucose in people with non-insulin treated type 2 diabetes.

    Science.gov (United States)

    Farmer, Andrew J; Perera, Rafael; Ward, Alison; Heneghan, Carl; Oke, Jason; Barnett, Anthony H; Davidson, Mayer B; Guerci, Bruno; Coates, Vivien; Schwedes, Ulrich; O'Malley, Simon

    2012-02-27

    To assess the effectiveness of self monitoring blood glucose levels in people with non-insulin treated type 2 diabetes compared with clinical management without self monitoring, and to explore the effects in specific patient groups. Meta-analysis based on individual participant data. Medline, Embase, and a recent systematic review of trials on self monitoring of blood glucose. Chief investigators of trials published since 2000 were approached for additional information and individual patient data. Randomised controlled trials in patients with non-insulin treated type 2 diabetes comparing an intervention using self monitoring of blood glucose with clinical management not using self monitoring. Trials published from 2000 with at least 80 participants were included. Individual patient data were collected from electronic files and checked for integrity. All randomised participants were analysed using the intention to treat principle. A random effects model of complete cases was used to assess efficacy, a sensitivity analysis comprised imputed data, and prespecified subgroup analyses were carried out for age, sex, previous use of self monitoring, duration of diabetes, and levels of glycated haemoglobin (HbA(1c)) at baseline. 2552 patients were randomised in the six included trials. A mean reduction in HbA(1c) level of -2.7 mmol/mol (95% confidence interval -3.9 to -1.6; 0.25%) was observed for those using self monitoring of blood glucose levels compared with no self monitoring at six months. The mean reduction in HbA(1c) level between groups was 2.0 mmol/mol (3.2 to 0.8; 0.25%) at three months (five trials) and 2.5 mmol/mol (4.1 to 0.9; 0.35%) at 12 months (three trials). These estimates were unchanged after imputing missing data, and estimates of effect in trials with higher loss to follow-up or a possibility of co-intervention compared with those with lower loss to follow-up and no co-intervention did not differ significantly (P=0.21). The difference in HbA(1c) levels

  9. Opportunity Cost and Policy: A Utilization Review of Self-monitoring of Blood Glucose in Manitoba, Canada.

    Science.gov (United States)

    Serwylo, Olena; Friesen, Kevin; Falk, Jamie; Bugden, Shawn

    2016-04-01

    Recently, there has been a re-evaluation of the frequency, benefits, and costs associated with self-monitoring of blood glucose (SMBG). Based on little evidence of the benefit of frequent SMBG in patients with diabetes not using insulin, new guidelines and test strip limit policies have been suggested and implemented in various Canadian jurisdictions to promote a more selective practice of SMBG. The objective of this study was to assess the overall utilization and cost associated with test strips and lancets for SMBG in Manitoba from 2000 to 2013 as well as to explore the policy implications of the implementation of test strip quantity limits and its impact on overall and government costs. An analysis of prescription claims for blood glucose test strips (BGTSs) and lancets for all patients with diabetes in Manitoba from 2000 to 2013 was conducted. In each year, patients were stratified into 4 mutually exclusive hierarchical groups according to most intensive diabetes treatment. Test strip and lancet utilization and cost were assessed for each group in each year, and the potential cost savings associated with implementation of a BGTS limit policy was projected using autoregressive integrated moving average models. In the year 2000, 8 million test strips were dispensed in Manitoba, increasing by 170% to 21.7 million test strips in 2013. Insulin users accounted for the majority of test strip use. However, based on potential implementation of test strip limit policies, 95% of the reduction of test strip use is predicted to occur in the groups not using insulin. Based on current trends, the 5-year predicted additional cost associated with not implementing a test strip limit policy similar to that implemented in other Canadian provinces was estimated to be a total of $12.35 million. Implementation of the guideline-based policy limits is predicted to produce considerable savings, with 95% of potential savings occurring in patients not using insulin. There is, therefore, a

  10. Analytical Performance Requirements for Systems for Self-Monitoring of Blood Glucose With Focus on System Accuracy

    Science.gov (United States)

    Freckmann, Guido; Schmid, Christina; Baumstark, Annette; Rutschmann, Malte; Haug, Cornelia; Heinemann, Lutz

    2015-01-01

    In the European Union (EU), the ISO (International Organization for Standardization) 15197 standard is applicable for the evaluation of systems for self-monitoring of blood glucose (SMBG) before the market approval. In 2013, a revised version of this standard was published. Relevant revisions in the analytical performance requirements are the inclusion of the evaluation of influence quantities, for example, hematocrit, and some changes in the testing procedures for measurement precision and system accuracy evaluation, for example, number of test strip lots. Regarding system accuracy evaluation, the most important change is the inclusion of more stringent accuracy criteria. In 2014, the Food and Drug Administration (FDA) in the United States published their own guidance document for the premarket evaluation of SMBG systems with even more stringent system accuracy criteria than stipulated by ISO 15197:2013. The establishment of strict accuracy criteria applicable for the premarket evaluation is a possible approach to further improve the measurement quality of SMBG systems. However, the system accuracy testing procedure is quite complex, and some critical aspects, for example, systematic measurement difference between the reference measurement procedure and a higher-order procedure, may potentially limit the apparent accuracy of a given system. Therefore, the implementation of a harmonized reference measurement procedure for which traceability to standards of higher order is verified through an unbroken, documented chain of calibrations is desirable. In addition, the establishment of regular and standardized post-marketing evaluations of distributed test strip lots should be considered as an approach toward an improved measurement quality of available SMBG systems. PMID:25872965

  11. Economic Value of Improved Accuracy for Self-Monitoring of Blood Glucose Devices for Type 1 Diabetes in Canada.

    Science.gov (United States)

    McQueen, R Brett; Breton, Marc D; Ott, Markus; Koa, Helena; Beamer, Bruce; Campbell, Jonathan D

    2015-08-14

    The objective was to simulate and compare clinical and economic outcomes of self-monitoring of blood glucose (SMBG) devices along error ranges and strip price. We programmed a type 1 diabetes natural history and treatment cost-effectiveness model. In phase 1, using past evidence from in silico modeling validated by the Food and Drug Administration, we associated changes in SMBG error to changes in hemoglobin A1c (HbA1c) and separately, changes in severe hypoglycemia requiring an inpatient stay. In phase 2, using Markov cohort simulation modeling, we estimated clinical and economic outcomes from the Canadian payer perspective. The primary comparison was a SMBG device with strip price $0.73 Canadian dollars (CAD) and 10% error (exceeding accuracy requirements by International Organization for Standardization (ISO) 15197:2013) versus a SMBG device with strip price $0.60 CAD and 15% error (accuracy meeting ISO 15197:2013). Outcomes for the average patient, were quality-adjusted life years (QALYs), incremental cost-effectiveness ratios (ICERs), and budget impact. Assuming benefits translate into HbA1c improvements only, the ICER with 10% error versus 15% was $11 500 CAD per QALY. Assuming the benefits translate into reduced severe hypoglycemia requiring an inpatient stay only, an SMBG device with 10% error dominated (ie, less costly, more effective) an SMBG device with 15% error. The 3-year budget impact findings ranged from $0.004 CAD per member per month for HbA1c improvements to cost-savings for severe hypoglycemia reductions. From efficiency (cost-effectiveness) and affordability (budget impact) payer perspectives, investing in devices with improved accuracy (less error) appears to be an efficient and affordable strategy. © 2015 Diabetes Technology Society.

  12. Self-monitoring of blood glucose among patients with diabetes in Jordan: Perception, adherence, and influential factors.

    Science.gov (United States)

    Al-Keilani, Maha S; Almomani, Basima A; Al-Sawalha, Nour A; Shhabat, Batool A

    2017-04-01

    To investigate the self-monitoring of blood glucose (SMBG) adherence among Jordanian patients with diabetes and to identify the predictive factors. A cross-sectional survey was carried out in 18 hospitals and healthcare centers covering south, north, and middle of Jordan. All patients with diabetes attending endocrinology clinics from May to December, 2015 were approached. The questionnaires were distributed by trained pharmacists and were self-administered. A total of 1079 participants completed the survey. Only 59% of participants were SMBG adherent. Predictors of SMBG adherence were treatment regimen; insulin with oral hypoglycemic agents (p=0.044, CI 1.023-5.274, OR=2.323) or insulin only (p=0.005, CI 1.225-3.115, OR=1.953), and health education on how to use the SMBG meter (p<0.001, CI 10.538-32.497, OR=18.506). The frequency of SMBG was significantly associated with the treatment regimen, with patients who were taking oral hypoglycemic agents (p<0.001) or insulin therapy (p=0.004) tested more frequently as compared to others. Additionally, the frequency of testing was significantly associated with the reason of performing SMBG (p<0.001). Frequency of daily testing was the highest among patients who performed SMBG to know if they were hypoglycemic (48.9%) or hyperglycemic (48.0%), or to inform their doctors (28.4%). SMBG adherence was suboptimal. Predictors of SMBG adherence were treatment regimen and health education about the SMBG meter. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Behavioral Analysis of Chinese Adult Patients with Type 1 Diabetes on Self-monitoring of Blood Glucose.

    Science.gov (United States)

    Qin, Zhao-Yi; Yan, Jin-Hua; Yang, Dai-Zhi; Deng, Hong-Rong; Yao, Bin; Weng, Jian-Ping

    The information-motivation-behavioral skills (IMB) model of health behavior is an effective tool to evaluate the behavior of diabetes self-management. The purpose of this study was to explore behavioral factors affecting the practice of self-monitoring of blood glucose (SMBG) within the frame of IMB model of health behavioral among adult patients with type 1 diabetes in a single diabetes clinic in China. A questionnaire with three subscales on SMBG information, motivation, and behavioral skills based on IMB model was developed. Validity and reliability of the measures were examined and guaranteed. Adult patients with type 1 diabetes visiting our diabetes clinic from January to March 2012 (n = 55) were consecutively interviewed. The self-completion questionnaires were administered and finished at face-to-face interviews among these patients. Both descriptive and correlational analyses were made. Fifty-five patients finished the questionnaires, with the median duration of diabetes 4.5 years and the median of SMBG frequency 2.00. Specific SMBG information deficits, motivation obstacles, and behavioral skill limitations were identified in a substantial proportion of participants. Scores of SMBG motivation (r = 0.299, P= 0.026) and behavioral skills (r = 0.425, P= 0.001) were significantly correlated with SMBG frequency. The multiple correlation of SMBG information, SMBG motivation, and SMBG behavioral skills with SMBG frequency was R = 0.411 (R2 = 0.169, P= 0.023). Adult patients with type 1 diabetes in our clinic had substantial SMBG information deficits, motivation obstacles, and skill limitations. This information provided potential-focused education targets for diabetes health-care providers.

  14. Frequency of self-monitoring blood glucose and attainment of HbA1c target values.

    Science.gov (United States)

    Elgart, Jorge F; González, Lorena; Prestes, Mariana; Rucci, Enzo; Gagliardino, Juan J

    2016-02-01

    Test strips for self-monitoring of blood glucose (SMBG) represent in Argentina, around 50 % of diabetes treatment cost; the frequency of their use is closely associated with hyperglycemia treatment. However, the favorable impact of SMBG on attainment of HbA1c goal in different treatment conditions remains controversial. We therefore attempted to estimate the relationship between use of SMBG test strips and degree of attainment of metabolic control in an institution of our social security subsector (SSS) in which provision is fully covered and submitted to a regular audit system. Observational retrospective study using information of 657 patients with T2DM (period 2009-2010) from the database of the Diabetes and Other Cardiovascular Risk Factors Program (DICARO) of one institution of our SSS. DICARO provides-with an audit system-100 % coverage for all drugs and keeps records of clinical, metabolic and treatment data from every patient. The average monthly test strips/patient used for SMBG increased as a function of treatment intensification: Monotherapy with oral antidiabetic drugs (OAD) < combined OAD therapy < insulin treatment. In every condition, the number was larger in people with target HbA1c levels. Test strips represented the larger percentage of total prescription cost. In our population, the type of hyperglycemia treatment was the main driver of test strip use for SMBG; in every condition tested, targeted HbA1c values were associated with greater strip use. Patient education and prescription audit may optimize its use and treatment outcomes.

  15. A signal processing application for evaluating self-monitoring blood glucose strategies in a software agent model.

    Science.gov (United States)

    Wang, Zhanle; Paranjape, Raman

    2015-07-01

    We propose the signal processing technique of calculating a cross-correlation function and an average deviation between the continuous blood glucose and the interpolation of limited blood glucose samples to evaluate blood glucose monitoring frequency in a self-aware patient software agent model. The diabetic patient software agent model [1] is a 24-h circadian, self-aware, stochastic model of a diabetic patient's blood glucose levels in a software agent environment. The purpose of this work is to apply a signal processing technique to assist patients and physicians in understanding the extent of a patient's illness using a limited number of blood glucose samples. A second purpose of this work is to determine an appropriate blood glucose monitoring frequency in order to have a minimum number of samples taken that still provide a good understanding of the patient's blood glucose levels. For society in general, the monitoring cost of diabetes is an extremely important issue, and these costs can vary tremendously depending on monitoring approaches and monitoring frequencies. Due to the cost and discomfort associated with blood glucose monitoring, today, patients expect monitoring frequencies specific to their health profile. The proposed method quantitatively assesses various monitoring protocols (from 6 times per day to 1 time per week) in nine predefined categories of patient agents in terms of risk factors of health status and age. Simulation results show that sampling 6 times per day is excessive, and not necessary for understanding the dynamics of the continuous signal in the experiments. In addition, patient agents in certain conditions only need to sample their blood glucose 1 time per week to have a good understanding of the characteristics of their blood glucose. Finally, an evaluation scenario is developed to visualize this concept, in which appropriate monitoring frequencies are shown based on the particular conditions of patient agents. This base line can

  16. Relationship between metabolic control and self-monitoring of blood glucose in insulin-treated patients with diabetes mellitus.

    Science.gov (United States)

    Soto González, Alfonso; Quintela Fernández, Niurka; Pumar López, Alfonso; Darias Garzón, Ricardo; Rivas Fernández, Margarita; Barberá Comes, Gloria

    2015-05-01

    To assess the relationship between metabolic control (MC) and frequency of self-monitoring of blood glucose (SMBG) in insulin-treated patients with type 1 (T1DM) and type 2 (T2DM) diabetes mellitus, and to analyze the factors associated to MC. A multicenter, cross-sectional, observational study was conducted in which endocrinologists enrolled diabetic patients treated with insulin who used a glucometer. The cut-off value for MC was HbA1c ≤ 7%. Grade of acceptance of the glucometer was assessed using a visual analogue scale (VAS). A total of 341 patients (53.5% males) with a mean age (SD) 52.8 (16.3) years, mean HbA1c of 7.69% (1.25) and 128 (37.5%) with T1DM and 211 (61.9%) with T2DM were evaluable. SMBG was done by 86.1% at least once weekly. No relationship was seen between MC and SMBG (P=.678) in the overall sample or in the T1DM (P=.940) or T2DM (P=.343) subgroups. In the logistic regression model, hyperglycemic episodes (Exp-b [risk] 1.794, P=0.022), falsely elevated HbA1c values (Exp-b 3.182, P=.005), and VAS (Exp-b 1.269, P=.008) were associated to poor MC in the total sample. Hyperglycemic episodes (Exp-b 2.538, P=.004), falsely elevated HbA1c values (Exp-b 3.125, P=.012), and VAS (Exp-b 1.316, P=.026) were associated to poor MC in the T2DM subgroup, while body mass index (Exp-b 1.143, P=.046) was associated to poor MC in the T1DM subgroup. In this retrospective, non-controlled study on patients with DM treated with insulin who used a glucometer, no relationship was seen between the degree of metabolic control and frequency of use of the glucometer. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  17. ROSES: role of self-monitoring of blood glucose and intensive education in patients with Type 2 diabetes not receiving insulin. A pilot randomized clinical trial.

    Science.gov (United States)

    Franciosi, M; Lucisano, G; Pellegrini, F; Cantarello, A; Consoli, A; Cucco, L; Ghidelli, R; Sartore, G; Sciangula, L; Nicolucci, A

    2011-07-01

    To estimate the efficacy of a self-monitoring-based disease management strategy in patients with Type 2 diabetes treated with oral agent monotherapy. This was an open-label, randomized, pilot study, primarily led by diabetes nurses. Patients were randomly allocated to either a self-monitoring-based disease management strategy or usual care (ratio 3:1) and followed up for 6 months. Education was centred on how to modify lifestyle according self-monitoring readings. Self-monitoring of blood glucose results were discussed during monthly telephone contact. The primary endpoint was mean change in HbA(1c) levels, estimated with an ANOVA for repeated measures. All analyses were intention to treat. Three diabetic clinics recruited 62 patients, of whom five were lost to follow-up. At baseline, both groups had a mean HbA(1c) value of 7.9% ± 0.6% (63 ± 6 mmol/mol). After 6 months, mean HbA(1c) reduction was 1.2 ± 0.1% (-13 ± 1 mmol/mol) in the intervention group and 0.7 ± 0.2 (-8 ± 2 mmol/mol) in the control group, with an absolute mean difference between groups of -0.5% (95% CI -0.9 to -0.0%; P = 0.04) (-5 mmol/mol, 95% CI -10 to 0). At study end, 61.9% of patients in the intervention group and 20.0% in the control group reached the target level of HbA(1c) self-monitoring disease management strategy, primarily led by diabetes nurses and allowing a timely and efficient use of self-monitoring readings, is able to improve metabolic control, primarily through lifestyle modifications leading to weight loss. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  18. System Accuracy Evaluation of Four Systems for Self-Monitoring of Blood Glucose Following ISO 15197 Using a Glucose Oxidase and a Hexokinase-Based Comparison Method.

    Science.gov (United States)

    Link, Manuela; Schmid, Christina; Pleus, Stefan; Baumstark, Annette; Rittmeyer, Delia; Haug, Cornelia; Freckmann, Guido

    2015-04-14

    The standard ISO (International Organization for Standardization) 15197 is widely accepted for the accuracy evaluation of systems for self-monitoring of blood glucose (SMBG). Accuracy evaluation was performed for 4 SMBG systems (Accu-Chek Aviva, ContourXT, GlucoCheck XL, GlucoMen LX PLUS) with 3 test strip lots each. To investigate a possible impact of the comparison method on system accuracy data, 2 different established methods were used. The evaluation was performed in a standardized manner following test procedures described in ISO 15197:2003 (section 7.3). System accuracy was assessed by applying ISO 15197:2003 and in addition ISO 15197:2013 criteria (section 6.3.3). For each system, comparison measurements were performed with a glucose oxidase (YSI 2300 STAT Plus glucose analyzer) and a hexokinase (cobas c111) method. All 4 systems fulfilled the accuracy requirements of ISO 15197:2003 with the tested lots. More stringent accuracy criteria of ISO 15197:2013 were fulfilled by 3 systems (Accu-Chek Aviva, ContourXT, GlucoMen LX PLUS) when compared to the manufacturer's comparison method and by 2 systems (Accu-Chek Aviva, ContourXT) when compared to the alternative comparison method. All systems showed lot-to-lot variability to a certain degree; 2 systems (Accu-Chek Aviva, ContourXT), however, showed only minimal differences in relative bias between the 3 evaluated lots. In this study, all 4 systems complied with the evaluated test strip lots with accuracy criteria of ISO 15197:2003. Applying ISO 15197:2013 accuracy limits, differences in the accuracy of the tested systems were observed, also demonstrating that the applied comparison method/system and the lot-to-lot variability can have a decisive influence on accuracy data obtained for a SMBG system. © 2015 Diabetes Technology Society.

  19. Comparative analysis of the efficacy of continuous glucose monitoring and self-monitoring of blood glucose in type 1 diabetes mellitus.

    Science.gov (United States)

    Floyd, Baraka; Chandra, Prakash; Hall, Stephanie; Phillips, Christopher; Alema-Mensah, Ernest; Strayhorn, Gregory; Ofili, Elizabeth O; Umpierrez, Guillermo E

    2012-09-01

    Self-monitoring of blood glucose (SMBG) and continuous glucose monitoring (CGM) have been proven effective in improving hemoglobin A1c (HbA1c) and in reducing hypoglycemia in patients with type 1 diabetes mellitus (T1DM). It is not clear, however, if CGM provides further efficacy and safety benefits beyond SMBG in the management of T1DM. MEDLINE (1966-November 2009), COCHRANE REGISTRY (all years), and EMBASE (1980-November 2009), and article bibliographies were searched for randomized controlled trials (RCTs) investigating the use of CGM in patients with T1DM, with clinical outcomes, including HbA1c and hypoglycemia and/or hyperglycemia. Fourteen RCTs met eligibility criteria [n = 1188 patients, 97.4% with T1DM, age 29.0 ± 14.3 years, diabetes duration 11.7 ± 7.0 years, and baseline HbA1c 8.3 ± 0.8% (mean ± standard deviation)]. Compared with SMBG, the use of CGM was associated with a greater reduction in HbA1c [-0.3% (confidence interval: 0.4, -0.2), p glucose monitoring also resulted in a shorter duration of hyperglycemia than SMBG (172 ± 125 versus 217 ± 152 min/day, p = .04). The use of CGM is associated with improvement in metabolic control in T1DM, with significant short- and long-term reductions in HbA1c and reduction in the duration of periods of hypoglycemia and hyperglycemia versus SMBG. © 2012 Diabetes Technology Society.

  20. Glycaemic control in type 1 diabetes during real time continuous glucose monitoring compared with self monitoring of blood glucose: meta-analysis of randomised controlled trials using individual patient data.

    Science.gov (United States)

    Pickup, John C; Freeman, Suzanne C; Sutton, Alex J

    2011-07-07

    To determine the clinical effectiveness of real time continuous glucose monitoring compared with self monitoring of blood glucose in type 1 diabetes. Meta-analysis of randomised controlled trials. Cochrane database for randomised controlled trials, Ovid Medline, Embase, Google Scholar, lists of papers supplied by manufacturers of continuous glucose monitors, and cited literature in retrieved articles. Studies reviewed Randomised controlled trials of two or more months' duration in men and non-pregnant women with type 1 diabetes that compared real time continuous glucose monitoring with self monitoring of blood glucose and where insulin delivery was the same in both arms. Analysis Two step meta-analysis of individual patient data with the primary outcome of final glycated haemoglobin (HbA(1c)) percentage and area under the curve of hypoglycaemia (glucose concentration glucose monitoring and 443 to self monitoring of blood glucose. The overall mean difference in HbA(1c) for continuous glucose monitoring versus self monitoring of blood glucose was -0.30% (95% confidence interval -0.43% to -0.17%) (-3.0, -4.3 to -1.7 mmol/mol). A best fit regression model of determinants of final HbA(1c) showed that for every one day increase of sensor usage per week the effect of continuous glucose monitoring versus self monitoring of blood glucose increased by 0.150% (95% credibility interval -0.194% to -0.106%) (1.5, -1.9 to -1.1 mmol/mol) and every 1% (10 mmol/mol) increase in baseline HbA(1c) increased the effect by 0.126% (-0.257% to 0.0007%) (1.3, -2.6 to 0.0 mmol/mol). The model estimates that, for example, a patient using the sensor continuously would experience a reduction in HbA(1c) of about 0.9% (9 mmol/mol) when the baseline HbA(1c) is 10% (86 mmol/mol). The overall reduction in area under the curve of hypoglycaemia was -0.28 (-0.46 to -0.09), corresponding to a reduction in median exposure to hypoglycaemia of 23% for continuous glucose monitoring compared with self

  1. Efficacy and safety comparison of continuous glucose monitoring and self-monitoring of blood glucose in type 1 diabetes: systematic review and meta-analysis.

    Science.gov (United States)

    Wojciechowski, Piotr; Ryś, Przemysław; Lipowska, Anna; Gawęska, Magdalena; Małecki, Maciej T

    2011-10-01

    Self-monitoring of blood glucose (SMBG) is a crucial element of clinical care in type 1 diabetes, but it may not provide adequate glucose control. A newer alternative approach is continuous glucose monitoring (CGM) system, which allows a more thorough metabolic control. However, the results of trials comparing CGM with SMBG are inconsistent. Based on a systematic review and meta-analysis, we aimed to assess the efficacy and safety of various CGM systems compared with SMBG. We searched major medical databases up to June 2011 for randomized controlled trials comparing CGM and SMBG in type 1 diabetes. Studies of at least 12-week duration were included. Weighted mean difference (WMD) or standardized mean difference (SMD) was calculated for continuous measures and dichotomous data were expressed as odds ratio (OR) or risk ratio. We identified 14 relevant trials including a total of 1268 type 1 diabetic patients, of whom 670 were randomized to the CGM group and 598 to the SMBG group. Patients using CGM had a greater decrease in hemoglobin A1c (HbA1c) from baseline compared with those using SMBG (WMD -0.26% [-0.34; -0.19]). We found that the magnitude of the effect was similar in the subset of children and adolescents (WMD -0.25% [-0.43; -0.08]) to that in adults (WMD -0.33% [-0.46; -0.2]). Only real-time devices for CGM improved glycemic control (WMD -0.27% [-0.34; -0.19]). The percentage of patients achieving target HbA1c was higher in the CGM group (OR 2.14 [1.41; 3.26]). Pooled results from 4 studies revealed a reduction in hypoglycemic events in the CGM group (SMD -0.32 [-0.52; -0.13]). CGM, partcicularly its real-time system, has a favorable effect on glycemic control and decreases the incidence of hypoglycemic episodes in both adult and pediatric patients with type 1 diabetes.

  2. Influence of Partial Pressure of Oxygen in Blood Samples on Measurement Performance in Glucose-Oxidase-Based Systems for Self-Monitoring of Blood Glucose

    Science.gov (United States)

    Baumstark, Annette; Schmid, Christina; Pleus, Stefan; Haug, Cornelia; Freckmann, Guido

    2013-01-01

    Background Partial pressure of oxygen (pO2) in blood samples can affect blood glucose (BG) measurements, particularly in systems that employ the glucose oxidase (GOx) enzyme reaction on test strips. In this study, we assessed the impact of different pO2 values on the performance of five GOx systems and one glucose dehydrogenase (GDH) system. Two of the GOx systems are labeled by the manufacturers to be sensitive to increased blood oxygen content, while the other three GOx systems are not. Methods Aliquots of 20 venous samples were adjusted to the following pO2 values: pO2 ~70 mmHg, which is considered to be similar to pO2 in capillary blood samples, and the mean BG result at pO2 pO2 pO2 ≥150 mmHg. For both pO2 levels, relative differences of all tested GOx systems were significant (p pO2 values pO2 variations lead to clinically relevant BG measurement deviations in GOx systems, even in GOx systems that are not labeled as being oxygen sensitive. PMID:24351177

  3. Efficacy of self-monitoring of blood glucose versus retrospective continuous glucose monitoring in improving glycaemic control in diabetic kidney disease patients.

    Science.gov (United States)

    Yeoh, Ester; Lim, Boon Khim; Fun, Sharon; Tong, Julia; Yeoh, Lee Ying; Sum, Chee Fang; Subramaniam, Tavintharan; Lim, Su Chi

    2018-03-01

    Patients with diabetic kidney disease (DKD) on anti-diabetic agents, are at greater risk of glycemic variations, both hypoglycemia and hyperglycemia. We aimed to compare glycemic control (using HbA1c) and hypoglycemia incidence in patients with Stage 3 DKD (eGFR 30-60 mL/min per 1.73 m 2 ), receiving retrospective CGM-guided anti-diabetic therapy versus self-monitoring of blood glucose (SMBG) over 3 months. Thirty patients with HbA1c >8% were randomized to 6-day retrospective CGM or SMBG. In the CGM group, CGM was worn at the beginning and 6 weeks. HbA1c, assessment of hypoglycaemia events (self-reported and BG 10 years and on insulin therapy (90%). HbA1c improved significantly from baseline 9.9 ± 1.2 to 9.0 ± 1.5% (P  10 mmol/L) reduced from baseline 65.4 ± 22.4% to 54.6 ± 23.6% (P = 0.033) at 6 weeks, with a non-significant rise in percentage duration in hypoglycaemia from 1.2 ± 2.2% to 4.0 ± 7.0% (P = 0.176). There was no difference in self-reported and documented hypoglycaemia events. In a pilot study of DKD patients, short-term episodic use of CGM reduced time spent in hyperglycaemia range without significantly increasing time-exposure to hypoglycaemia. However, both CGM and SMBG were equally effective in improving glycaemic control. © 2016 Asian Pacific Society of Nephrology.

  4. Assessing the analytical performance of systems for self-monitoring of blood glucose: concepts of performance evaluation and definition of metrological key terms.

    Science.gov (United States)

    Schnell, Oliver; Hinzmann, Rolf; Kulzer, Bernd; Freckmann, Guido; Erbach, Michael; Lodwig, Volker; Heinemann, Lutz

    2013-11-01

    Reliability of blood glucose (BG) measurements is a prerequisite for successful diabetes management. Publications on the evaluation of self-monitored glucose values, however, are frequently characterized by a confusion in terminology. We provide an inventory of key terms such as accuracy, trueness, precision, traceability, calibration, and matrix effect to avoid future misunderstanding. Definitions are taken from the metrological literature and international norms and explained in a language intended for nonspecialists in metrology. The terms are presented in light of the need to apply generally accepted definitions. In addition, a description of requirements and components for a sound evaluation of BG measurement systems is presented. These factors will also enable improvement in future comparisons of study results. © 2013 Diabetes Technology Society.

  5. Development of Cell Phone Application for Blood Glucose Self-Monitoring Based on ISO/IEEE 11073 and HL7 CCD.

    Science.gov (United States)

    Park, Hyun Sang; Cho, Hune; Kim, Hwa Sun

    2015-04-01

    The objectives of this research were to develop and evaluate a cell phone application based on the standard protocol for personal health devices and the standard information model for personal health records to support effective blood glucose management and standardized service for patients with diabetes. An application was developed for Android 4.0.3. In addition, an IEEE 11073 Manager, Medical Device Encoding Rule, and Bluetooth Health Device Profile Connector were developed for standardized health communication with a glucometer, and a Continuity of Care Document (CCD) Composer and CCD Parser were developed for CCD document exchange. The developed application was evaluated by five healthcare professionals and 87 users through a questionnaire comprising the following variables: usage intention, effort expectancy, social influence, facilitating condition, perceived risk, and voluntariness. As a result of the evaluation of usability, it was confirmed that the developed application is useful for blood glucose self-monitoring by diabetic patients. In particular, the healthcare professionals stated their own views that the application is useful to observe the trends in blood glucose change through the automatic function which records a blood glucose level measured using Bluetooth function, and the function which checks accumulated records of blood glucose levels. Also, a result of the evaluation of usage intention was 3.52 ± 0.42 out of 5 points. The application developed by our research team was confirmed by the verification of healthcare professionals that accurate feedback can be provided to healthcare professionals during the management of diabetic patients or education for glucose management.

  6. Higher accuracy of self-monitoring of blood glucose in insulin-treated patients in Germany: clinical and economical aspects.

    Science.gov (United States)

    Schnell, Oliver; Erbach, Michael; Wintergerst, Eva

    2013-07-01

    Accuracy standards of blood glucose (BG) meters are currently under review. Revised standards are expected to tighten accuracy requirements. Regarding clinical and financial impact of BG meter accuracy, very little data are available. The aim of this study was to analyze potential cost savings related to higher accuracy of glucose meters in Germany. As a model for calculation, a reduction of meter error from 20% to 5% was applied. The health economic analysis was based on four main pillars: (1) number of insulin-treated patients; (2) costs for glucose monitoring in Germany; (3) data of a modeling analysis on the impact on hypoglycemic episodes, glycosylated hemoglobin (HbA1c), and, subsequently, myocardial infarctions; and (4) costs of diabetes-related complications in Germany. A reduction of meter error from 20% to 5% was identified to be associated with a 10% reduction in severe hypoglycemic episodes and a 0.39% reduction in HbA1c, which translates into a 0.5% reduction of myocardial infarctions. According to the health economic analysis, the reduction in severe hypoglycemic episodes and myocardial infarctions led to cost savings of €24.14 per patient per year. Considering 390,000 type 1 diabetes patients or 2.3 million insulin-treated patients in Germany, these savings could be equal to a reduction in health care expenditures of more than €9.4 million and €55.5 million, respectively. Potential cost savings and clinical effects due to higher accuracy of BG meters should provide an impetus to implementation of tighter accuracy standards and development of glucose meters that provide highest possible accuracy. © 2013 Diabetes Technology Society.

  7. Rational use of blood glucose test strips for self-monitoring in patients with diabetes mellitus: Economic impact in the Portuguese healthcare system.

    Science.gov (United States)

    Risso, Teresa; Furtado, Cláudia

    2017-12-01

    Self-monitoring of blood glucose is important for diabetes management in insulin-treated patients, but its effectiveness in patients treated with oral glucose lowering drugs only is not fully supported by current evidence. This paper aims to characterise the prescription patterns of blood glucose test strips (BGTS) in Portugal and estimate the potential cost-savings from the rational use of BGTS. A retrospective analysis of the Portuguese database of electronic medical prescriptions to assess the patterns of BGTS prescription. The database was searched for prescription, from 01 January 2016 to 31 December 2016, of insulin and other antidiabetics, as well as the associated prescriptions of BGTS. 894,637 patients were prescribed antidiabetic medicines during 2016, 82.7% of which were prescribed oral glucose lowering drugs only. BGTS were prescribed to 456,179 patients, being more frequently prescribed in insulin-treated patients. Still, 42.8% of patients treated with oral glucose lowering drugs only were also prescribed BGTS, with large proportion of those being prescribed antidiabetic drugs with lower risk of causing hypoglycaemia and, even so, >200 BGTS/year. Several scenarios for a more rational use of BGTS were estimated to result in cost-savings of up to €9.5 million per year. BGTS were prescribed to more than a third of patients treated with oral glucose lowering drugs only, despite accumulating evidence of their limited effectiveness in this population, resulting in substantial economic burden to the healthcare system. Given the estimated potential cost-savings, rational use of BGTS should be encouraged in Portugal. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Correlation between parameters of self-monitoring of blood glucose and the perception of health-related quality of life in patients with type 1 diabetes mellitus.

    Science.gov (United States)

    Paula, Juliana Santos; Braga, Letícia Dinis; Moreira, Rodrigo Oliveira; Kupfer, Rosane

    2017-01-01

    The aim of this study was to evaluate how different parameters of short-term glycemic control would correlate with the perception of health-related quality of life (HRQoL) in patients with type 1 diabetes mellitus (T1D). A total of 50 T1D patients aged 18 to 50 years were evaluated with the questionnaires Problem Areas in Diabetes (PAID) scale and Diabetes Quality of Life (DQOL) measure after 30 days of self-monitoring of blood glucose (SMBG). Glycemic control was evaluated using glycated hemoglobin (HbA1c), mean glucose levels (MGL) in the prior month's data from SMBG (Accu-Check 360o), number of hypoglycemic episodes (glucose glucose < 50 mg/dL). After multiple linear regression, only MGL remained independently related to PAID scores. DQOL scores had a positive correlation with MGL (r = 0.45; p = 0.001), but not with HbA1c (r = 0.23; p = 0.09), GV (r = 0.20; p = 0.16), or number of hypoglycemic episodes (r = 0.06 p = 0.68). In T1D patients, MGL, but not HbA1c or number hypoglycemic episodes, was the glycemic control parameter that best correlated with short-term perception of HRQoL.

  9. Poor Reliability and Poor Adherence to Self-Monitoring of Blood Glucose Are Common in Women With Gestational Diabetes Mellitus and May Be Associated With Poor Pregnancy Outcomes.

    Science.gov (United States)

    Cosson, Emmanuel; Baz, Baz; Gary, Françoise; Pharisien, Isabelle; Nguyen, Minh Tuan; Sandre-Banon, Dorian; Jaber, Yahya; Cussac-Pillegand, Camille; Banu, Isabela; Carbillon, Lionel; Valensi, Paul

    2017-09-01

    To evaluate the compliance with self-monitoring of blood glucose (SMBG) and the reliability of diabetes logbooks in women with gestational diabetes mellitus (GDM), as well as the associated determinants and outcomes. We prospectively selected French-speaking women with newly diagnosed GDM who had been referred to our diabetes management program and understood SMBG principles. At the next follow-up visit, we collected SMBG results from glucose meters and logbooks. We analyzed pregnancy outcomes. Data were analyzed over 13 ± 3 days in 91 women. Only 61.5% had performed ≥80% of the required tests. Poor compliance was associated with a family history of diabetes, social deprivation, and non-European origin. The average time between pre- and postprandial tests was 141 ± 20 min, with 46.5% of women performing ≥80% of postprandial measurements 100-140 min after meals. Inadequate timing was associated with ethnicity and higher HbA 1c at baseline. A total of 23.1% of women had glucose meter memory to improve GDM management. © 2017 by the American Diabetes Association.

  10. Evolution of Data Management Tools for Managing Self-Monitoring of Blood Glucose Results: A Survey of iPhone Applications

    Science.gov (United States)

    Rao, Anoop; Hou, Philip; Golnik, Timothy; Flaherty, Joseph; Vu, Sonny

    2010-01-01

    Background Studies have indicated that sharing of self-monitoring of blood glucose (SMBG) data and subsequent feedback from the health care provider (HCP) can help achieve glycemic goals such as a reduction in glycated hemoglobin. Electronic SMBG data management and sharing tools for the PC and smartphones may help in reducing the effort to manage SMBG data. Methods We reviewed software and top-ranking applications (Apps) for the iPhone platform to document the variety of useful features. Additionally, in an attempt to assess metrics such as task analysis and user friendliness of diabetes Apps, we observed and surveyed patients with diabetes as they recorded and relayed sample SMBG results to their hypothetical HCP using three Apps. Results Observation and survey demonstrated that the WaveSense Diabetes Manager allowed the participants to complete preselected SMBG data entry and relay tasks faster than other Apps. The survey revealed patient behavior patterns that would be useful in future App development. Conclusion Being able to record, analyze, seamlessly share, and obtain feedback on the SMBG data using an iPhone/iTouch App might potentially benefit patients. Trends in SMBG data management and the possibility of having interoperability of blood glucose monitors and smartphones may open up new avenues of diabetes management for the technologically savvy patient. PMID:20663461

  11. Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study

    Directory of Open Access Journals (Sweden)

    Ong WM

    2014-02-01

    Full Text Available Woon May Ong,1 Siew Siang Chua,1 Chirk Jenn Ng2 1Department of Pharmacy, 2University of Malaya Primary Care Research Group (UMPCRG, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Background: Self-monitoring of blood glucose (SMBG helps to improve glycemic control and empowerment of people with diabetes. It is particularly useful for people with diabetes who are using insulin as it facilitates insulin titration and detection of hypoglycemia. Despite this, the uptake of SMBG remains low in many countries, including Malaysia. Purpose: This study aimed to explore the barriers and facilitators to SMBG, in people with type 2 diabetes using insulin. Patients and methods: Qualitative methodology was employed to explore participants’ experience with SMBG. Semistructured, individual in-depth interviews were conducted on people with type 2 diabetes using insulin who had practiced SMBG, in the primary care clinic of a teaching hospital in Malaysia. Participants were purposively sampled from different age groups, ethnicity, education level, and level of glycemic control (as reflected by the glycated hemoglobin [HbA1c], to achieve maximum variation in sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked, and analyzed using a thematic approach. Results: A total of 15 participants were interviewed, and thematic saturation was reached. The factors that influenced SMBG were mainly related to cost, participants' emotion, and the SMBG process. The barriers identified included: frustration related to high blood glucose reading; perception that SMBG was only for insulin titration; stigma; fear of needles and pain; cost of test strips and needles; inconvenience; unconducive workplace; and lack of motivation, knowledge, and self-efficacy. The facilitators were: experiencing hypoglycemic symptoms; desire to see the effects of dietary changes; desire to

  12. Advancing diabetes management in adolescents: Comparative effectiveness of mobile self-monitoring blood glucose technology and family-centered goal setting.

    Science.gov (United States)

    Hannon, Tamara S; Yazel-Smith, Lisa G; Hatton, Amy S; Stanton, Jennifer L; Moser, Elizabeth A S; Li, Xiaochun; Carroll, Aaron E

    2018-03-04

    As adolescents gain autonomy, it remains important for parents to be involved with diabetes management to avoid deterioration in glycemic control. Technologies for self-monitoring of blood glucose (SMBG) allow for remote monitoring in real-time by parents. This research compared 3 strategies for improving SMBG and diabetes self-care in the short-term. These strategies were: (1) health information technology (HIT)-enhanced blood glucose meter that shared blood glucose data among patients, their parent, and care providers, and allowed for text messaging; (2) family-centered goal setting; and (3) a combination of (1) and (2). One hundred twenty-eight participants enrolled; 97 adolescent-parent pairs attended clinic at 3-month intervals during the 6-month intervention. Differences between treatment groups were evaluated using analysis of variance (ANOVAs) for continuous variables and χ 2 tests for frequencies. Within patient changes were evaluated using paired t tests. Participants in the HIT-enhanced SMBG group had no change in mean glycosylated hemoglobin (HbA1c). Participants assigned to family-centered goal setting had a non-significant decrease in HbA1c of -0.3% (P = .26) from baseline to 6 months. Participants in the combined approach had a significant decrease in HbA1c of -0.6% (P = .02) from baseline to 3 months, but the decrease of -0.4% at 6 months was non-significant (P = .51). The change in HbA1c from baseline to 3 months was greater for the combined approach than for the HIT-enhanced SMBG (P = .05) or family-centered goal setting (P = .01). Our data suggest that utilizing the family-centered goal setting strategy when implementing HIT-enhanced diabetes technology deserves further study. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Self-Monitoring of Blood Glucose: Impact of Quantity Limits in Public Drug Formularies on Provincial Costs Across Canada.

    Science.gov (United States)

    Knowles, Sandra R; Lee, Kathy; Paterson, J Michael; Shah, Baiju R; Mamdani, Muhammad M; Juurlink, David N; Gomes, Tara

    2017-04-01

    For most patients with diabetes, routine use of blood glucose test strips (BGTS) has not been shown to be beneficial, yet the economic implications of broad publicly funded reimbursement for BGTS are substantial. We assessed the potential impact of BGTS quantity limits on utilization and costs for 6 publicly funded drug plans across Canada. A cross-sectional analysis was conducted in 6 provinces (Alberta, Saskatchewan, Manitoba, Nova Scotia, Newfoundland and Labrador and Prince Edward Island) for patients who received at least 1 prescription for BGTS in 2014 through the public drug program. We determined the number of BGTS that would have exceeded the quantity limits and the associated costs to the provincial drug program. A total of $38,051,026 was spent on BGTS reimbursed through public drug programs among the 6 provinces. In provinces where BGTS use is largely restricted to patients using insulin, the potential annual savings were minimal, ranging from 0.4% to 2.3%, whereas in provinces with more liberal listings, potential savings ranged from 12.4% to 19.8%. Combining these results with data from a previous analysis in Ontario and British Columbia, the cost savings associated with BGTS quantity limits for 8 provinces across Canada (capturing approximately three-quarters of the Canadian population) is estimated to be $30.3 million annually. The national implementation of a quantity limit policy for BGTS that aligns with evidence of efficacy, optimal prescribing and patient safety can lead to considerable savings for most public drug plans across Canada. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. The Rectangle Target Plot: A New Approach to the Graphical Presentation of Accuracy of Systems for Self-Monitoring of Blood Glucose.

    Science.gov (United States)

    Stephan, Peter; Schmid, Christina; Freckmann, Guido; Pleus, Stefan; Haug, Cornelia; Müller, Peter

    2015-10-09

    The measurement accuracy of systems for self-monitoring of blood glucose (SMBG) is usually analyzed by a method comparison in which the analysis results are displayed using difference plots or similar graphs. However, such plots become difficult to comprehend as the number of data points displayed increases. This article introduces a new approach, the rectangle target plot (RTP), which aims to provide a simplified and comprehensible visualization of accuracy data. The RTP is based on ISO 15197 accuracy evaluations of SMBG systems. Two-sided tolerance intervals for normally distributed data are calculated for absolute and relative differences at glucose concentrations <100 mg/dL and ≥100 mg/dL. These tolerance intervals provide an estimator of where a 90% proportion of results is found with a confidence level of 95%. Plotting these tolerance intervals generates a rectangle whose center indicates the systematic measurement difference of the investigated system relative to the comparison method. The size of the rectangle depends on the measurement variability. The RTP provides a means of displaying measurement accuracy data in a simple and comprehensible manner. The visualization is simplified by reducing the displayed information from typically 200 data points to just 1 rectangle. Furthermore, this allows data for several systems or several lots from 1 system to be displayed clearly and concisely in a single graph. © 2015 Diabetes Technology Society.

  15. Do diabetes mellitus patients adhere to self-monitoring of blood glucose (SMBG) and is this associated with glycemic control? Experiences from a SMBG program in western Kenya.

    Science.gov (United States)

    Wambui Charity, K; Kumar, Ajay M V; Hinderaker, Sven Gudmund; Chinnakali, Palanivel; Pastakia, Sonak D; Kamano, Jemimah

    2016-02-01

    Among diabetes mellitus (DM) patients with poor glycemic control enrolled into a self-monitoring of blood glucose (SMBG) program in Kenya, to assess the level of SMBG adherence, its associated factors and its relation to glycemic control (defined as HbA1c glucose tests performed by the number recommended. A level of ≥ 80% was considered 'good adherence'. Glycemic control was considered as absolute change from baseline of 2%. Of 164 patients (59% female; 76% rural), the proportions with good SMBG adherence were 34%, 17%, 15% and 10% during 0-6, 7-12, 13-18 and 19-24 months into the HGM program respectively. In multivariate analysis, male gender, urban place of residence and payment for glucostrips were associated with poor adherence during 0-12 months. The mean reduction in HbA1c compared to baseline was 1.2%, 1.1%, 0.8% and 0.7% at 6, 12, 18 and 24 months, respectively. We did not find any association between SMBG adherence and glycemic control. Adherence to SMBG was sub-optimal, especially among those who had to pay for glucostrips. Patient education and provision of free glucostrips are recommended to improve adherence and glycemic control. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  16. Improvement of Glycosylated Hemoglobin in Patients with Type 2 Diabetes Mellitus under Insulin Treatment by Reimbursement for Self-Monitoring of Blood Glucose.

    Science.gov (United States)

    Song, Young Shin; Koo, Bo Kyung; Kim, Sang Wan; Yi, Ka Hee; Shin, Kichul; Moon, Min Kyong

    2018-02-01

    In Korea, the costs associated with self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes mellitus (T2DM) under insulin treatment have been reimbursed since November 2015. We investigated whether this new reimbursement program for SMBG has improved the glycemic control in the beneficiaries of this policy. Among all adult T2DM patients with ≥3 months of reimbursement (n=854), subjects without any changes in anti-hyperglycemic agents during the study period were selected. The improvement of glycosylated hemoglobin (HbA1c) was defined as an absolute reduction in HbA1c ≥0.6% or an HbA1c level at follow-up improvement in HbA1c. Subjects covered under the Medical Aid system showed a higher prevalence of improvement in HbA1c than those with medical insurance (52.2% vs. 33.3%, respectively, P=0.012). In the improvement group, the baseline HbA1c (Pimprove in HbA1c compared to those with medical insurance (odds ratio, 2.459; 95% confidence interval, 1.138 to 5.314; P=0.022). The reimbursement for SMBG resulted in a significant improvement in HbA1c in T2DM subjects using insulin, which was more prominent in subjects with poor glucose control at baseline or covered under the Medical Aid system. Copyright © 2018 Korean Diabetes Association

  17. Both the frequency of HbA1c testing and the frequency of self-monitoring of blood glucose predict metabolic control: A multicentre analysis of 15 199 adult type 1 diabetes patients from Germany and Austria.

    Science.gov (United States)

    Schwandt, A; Best, F; Biester, T; Grünerbel, A; Kopp, F; Krakow, D; Laimer, M; Wagner, C; Holl, R W

    2017-10-01

    The objective of this study was to examine the association between metabolic control and frequency of haemoglobin A 1c (HbA 1c ) measurements and of self-monitoring of blood glucose, as well as the interaction of both. Data of 15 199 adult type 1 diabetes patients registered in a standardized electronic health record (DPV) were included. To model the association between metabolic control and frequency of HbA 1c testing or of self-monitoring of blood glucose, multiple hierarchic regression models with adjustment for confounders were fitted. Tukey-Kramer test was used to adjust P values for multiple comparisons. Vuong test was used to compare non-nested models. The baseline variables of the study population were median age 19.9 [Q1; Q3: 18.4; 32.2] years and diabetes duration 10.4 [6.8; 15.7] years. Haemoglobin A 1c was 60.4 [51.5; 72.5] mmol/mol. Frequency of HbA 1c testing was 8.0 [5.0; 9.0] within 2 years, and daily self-monitoring of blood glucose frequency was 5.0 [4.0; 6.0]. After adjustment, a U-shaped association between metabolic control and frequency of HbA 1c testing was observed with lowest HbA 1c levels in the 3-monthly HbA 1c testing group. There was an inverse relationship between self-monitoring of blood glucose and HbA 1c with lower HbA 1c associated with highest frequency of testing (>6 daily measurements). Quarterly HbA 1c testing and frequent self-monitoring of blood glucose were associated with best metabolic control. The adjusted Vuong Z statistic suggests that metabolic control might be better explained by HbA 1c testing compared to self-monitoring of blood glucose (P monitoring together with frequent self-monitoring of blood glucose in diabetes management to reach and maintain target HbA 1c . Copyright © 2017 John Wiley & Sons, Ltd.

  18. The effects of structured self-monitoring of blood glucose on therapeutic effectiveness and adherence in patients with type 2 diabetes mellitus initiating insulin treatment

    Directory of Open Access Journals (Sweden)

    Lyudmila Aleksandrovna Suvorova

    2013-12-01

    Full Text Available Aim. To compare the efficiency of standard and structured approaches to self-monitoring of blood glucose (SMBG in patients with type 2 diabetes mellitus (T2DM initiating insulin treatment.Materials and Methods. This open prospective randomized clinical trial included 51 T2DM patients who initiated insulin therapy in either outpatient or inpatient setting. Subjects were randomized in standard and structured SMBG groups, the structured group used an advanced Accu-Chek 360 View protocol. Evaluation included clinical examination and laboratory testing of HbA1c levels at the beginning of the treatment and after 3 months of the follow-up period.Results. 70% of the structured self-monitoring group and 32% of the control group achieved therapeutic goals (p=0.008. Higher adherence was associated with better glycemic control in both groups – and vice versa. However, among patients with low adherence, 73% of advanced SMBG group managed to achieve therapeutic goals vs. 19% in the control group (p=0.005. In addition, patients in the structured monitoring group gained less weight as compared to the control (1.0±2.88 kg vs. 3.2±2.56 kg; p=0.005.Conclusion. Structured SMBG commenced at the initiation of insulin therapy improves glycemic control in a greater fraction of patients, especially in those with low adherence to treatment. Structured SMBG also partially alleviates weight gain as side effect of insulin treatment.

  19. Compliance to self-monitoring of blood glucose among patients with type 2 diabetes mellitus and its influential factors: a real-world cross-sectional study based on the Tencent TDF-I blood glucose monitoring platform.

    Science.gov (United States)

    Hu, Zhi-De; Zhang, Kai-Ping; Huang, Ying; Zhu, Shu

    2017-01-01

    To investigate the compliance to self-monitoring of blood glucose (SMBG) among patients with type 2 diabetes mellitus (T2DM) and its influential factors. The real-world SMBG use over 90 days among 415 T2DM patients were recorded by using a blood glucose monitoring platform (TDF-I, Tencent, China). Clinical features including age, sex, duration of diabetes, insulin treatment or not, and use of oral antidiabetic drugs were collected. Poor compliance was defined as the average frequency of weekly SMBG use over 90 days was below the criteria established by the physicians, and otherwise the patients were regarded as with good compliance. Factors affecting the SMBG compliance were analyzed by using independent sample t -test, Mann-Whitney U test, and multivariate logistic regression analysis. Only 57.6% of patients in the study cohort had good compliance to SMBG. Multivariate logistic regression models showed that only the duration of T2DM and the use of oral antidiabetic agents were independently associated with SMBG compliance; more specifically, patients with longer course of disease had poorer SMBG compliance, and those had used oral antidiabetic agents had poorer SMBG compliance. SMBG compliance in T2DM patients needs to be further improved. For patients with a longer course of disease and/or under oral antidiabetic medication, interventions such as patient education should be adopted to increase the SMBG compliance.

  20. Testing quality of a self-monitoring blood glucose sensor with an auto-coding mechanism when used by patients versus technicians.

    Science.gov (United States)

    Hsu, Cheng-Teng; Wu, Ming-Hsun; Kuo, Chih-Yi; Zen, Jyh-Myng

    2014-11-01

    In response to the problem of erroneous readings due to miscoding when performing self-monitoring blood glucose (SMBG), this study introduces a user-friendly SMBG biosensor with an innovative auto-coding module on the meter and strip. Actual users characterized the performance of the SMBG systems. A total of 105 patients were incorporated in the study and Clarke error grid analysis (EGA) was administered to evaluate the clinical accuracy of the results obtained by the patients versus the technicians. All patients used the questionnaires to comment on the use of the auto-coding sensor. In the imprecision test, the total CV of the 5 BG levels was 2.1%. In the EGA plot, the results of the auto-coding sensor were 96.2%, both lots A and B, in zone A for the patients and 99.0% and 97.1% for the technician. The paired t-test demonstrated no statistically significant difference between the patient and technician measurements. Regression analysis also demonstrated that the measurements taken by the patients agreed with those obtained using the laboratory method. The patients achieved satisfactory performance using the auto-coding SMBG sensor and derived similar results with both laboratory reference and operation by a technician. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Randomized trial of technology-assisted self-monitoring of blood glucose by low-income seniors: improved glycemic control in type 2 diabetes mellitus.

    Science.gov (United States)

    Levine, Jason C; Burns, Edith; Whittle, Jeffrey; Fleming, Raymond; Knudson, Paul; Flax, Steve; Leventhal, Howard

    2016-12-01

    Self-monitoring of blood glucose (SMBG) has been recommended for people with type 2 diabetes mellitus. This trial tested an automated self-management monitor (ASMM) that reminds patients to perform SMBG, provides feedback on results of SMBG, and action tips for improved self-management. This delayed-start trial randomized participants to using the ASMM immediately (IG), or following a delay of 6 months (DG). Glycated hemoglobin (HgbA1c) level and survey data was collected at home visits every 3 months. 44 diabetic men and women, mean age 70, completed the 12-month trial. Baseline HgbA1c was 8.1 % ± 1.0, dropping to 7.3 ± 1.0 by 9 months, with a 3-month lag in the DG (F = 3.56, p = 0.004). Decrease in HgbA1c was significantly correlated to increased frequency of SMBG, R = 0.588, p < 0.01. Providing older diabetics with objective immediate contingent feedback resulted in more frequent SMBG that correlated with better glycemic control. This type of technology may provide real-time feedback not only to patient users, but to the health care system, allowing better integration of provider recommendations with patient-centered action.

  2. Impact of self-monitoring of blood glucose log reliability on long-term glycemic outcomes in children with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Chitra Selvan

    2017-01-01

    Full Text Available Introduction: Logbooks of self-monitoring of blood glucose (SMBG are useful in the modulation of insulin regimens, which aid in achieving glycemic control in type 1 diabetes mellitus (T1DM. However, discrepancies in SMBG charting may impede its utility. This study aimed to assess the accuracy of log entries and its impact on long-term glycemic control. Methods: SMBG in logbooks was compared with readings in glucometer memory and discrepancies between the two were evaluated in 101 children with T1DM. The relationship between these discrepancies and glycated hemoglobin (HbA1c over 44 months was assessed. Results: Errors in glucose charting were observed in 32.67% children. The most common observed error was omission (42.42%, followed by fabrication (27.27%, erroneous (18.18%, and others (12.12%. Age was not significantly different among children having accurate versus inaccurate SMBG logs. During follow-up of 44 months, children with accurate SMBG logs consistently had lower HbA1c as compared to children having inaccurate logs, which was statistically significant at 4, 16, 20, and 28 months' follow-up. The same was reflected in the proportion of children achieving HbA1c <7% and 7%–9%. Of the 14 children who had omissions, 9 had omission of high values only, 3 patients had omission of low values only, 1 had omission of both high and low values, and 1 had omission of normal values. Among logs with fabrication, parents were responsible in 2 of 9 incidents. In the remaining 7, it was the child himself/herself. Children with fabrication consistently had the highest HbA1c values among the different types of inaccurate blood glucose chartings, which was statistically significant at 32 and 36 months of follow-up. Conclusions: Reliability of SMBG logs is a significant problem among children with T1DM at our center. Children with accurate logs of SMBG readings were more likely to have better glycemic control on long-term follow-up.

  3. Self-monitoring of Blood Glucose in Non-Insulin Treated Type 2 Diabetes (The SMBG Study): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Parsons, Sharon; Luzio, Stephen; Bain, Stephen; Harvey, John; McKenna, Jillian; Khan, Atir; Rice, Sam; Watkins, Alan; Owens, David R

    2017-01-26

    The benefit of Self-monitoring of Blood Glucose (SMBG) in people with non-insulin treated type 2 diabetes remains unclear with inconsistent evidence from randomised controlled trials fuelling the continued debate. Lack of a consistent finding has been attributed to variations in study population and design, including the SMBG intervention. There is a growing consensus that structured SMBG, whereby the person with diabetes and health care provider are educated to detect patterns of glycaemic abnormality and take appropriate action according to the blood glucose profiles, can prove beneficial in terms of lowering HbA1c and improving overall well-being. Despite this, many national health agencies continue to issue guidelines restricting the use of SMBG in non-insulin treated type 2 diabetes. The SMBG Study is a 12 month, multi-centre, randomised controlled trial in people with type 2 diabetes not on insulin therapy who have poor glycaemic control (HbA1c ≥58 mmol/mol / 7.5%). The participants will be randomised into three comparative groups: Group 1 will act as a control group and receive their usual diabetes care; Group 2 will undertake structured SMBG with clinical review every 3 months; Group 3 will undertake structured SMBG with additional monthly telecare support from a trained study nurse. A total of 450 participants will be recruited from 16 primary and secondary care sites across Wales and England. The primary outcome measure will be HbA1c at 12 months with secondary measures to include weight, BMI, total cholesterol and HbA1c levels at 3, 6, 9 and 12 months. Participant well-being and attitude towards SMBG will be monitored throughout the course of the study. Recruitment began in December 2012 with the last participant visit due in September 2016. This study will attempt to answer the question of whether structured SMBG provides any benefits to people with poorly controlled type 2 diabetes who are not being treated with insulin. The data will also

  4. Self-monitoring of blood glucose in non-insulin-treated diabetic patients: a longitudinal evaluation of its impact on metabolic control.

    Science.gov (United States)

    Franciosi, M; Pellegrini, F; De Berardis, G; Belfiglio, M; Di Nardo, B; Greenfield, S; Kaplan, S H; Rossi, M C E; Sacco, M; Tognoni, G; Valentini, M; Nicolucci, A

    2005-07-01

    In the framework of a nationwide outcomes research programme, we assessed the impact of self-monitoring of blood glucose (SMBG) on metabolic control over 3 years in patients with Type 2 diabetes mellitus (DM2) not treated with insulin. The study involved 1896 patients who completed, at 6-month intervals for 3 years, a questionnaire investigating SMBG practice. Clinical information was collected by participating clinicians at the same time intervals. The predictive value of SMBG frequency on long-term metabolic control was estimated using multilevel analysis. The impact of SMBG on metabolic control was also evaluated in distinct and homogeneous subgroups of patients showing different likelihood of performing SMBG, identified using a tree-growing technique (RECPAM). Overall, 22% of the patients were on diet alone and 78% were treated with oral agents; 41% practiced SMBG > or = 1/week (10.3% > or = 1/day). The analysis of metabolic control according to the frequency of SMBG failed to show any significant impact of this practice on HbA1c levels over 3 years. Similarly, changes in SMBG frequency during the study were not related to significant changes in HbA1c levels. RECPAM analysis led to the identification of eight classes, characterized by substantial differences in the likelihood of performing SMBG with a frequency of at least 1/week. Nevertheless, in none of the RECPAM classes identified, did SMBG predict a better metabolic control over 3 years of follow-up. In those RECPAM classes indicating that SMBG was mainly performed to avoid hypoglycaemic episodes, SMBG was associated with a decrease in the frequency of hypoglycaemic episodes during the study. In a large sample of non-insulin-treated Type 2 diabetic patients, the performance and frequency of SMBG did not predict better metabolic control over 3 years. We could not identify any specific subgroups of patients for whom SMBG practice was associated with lower HbA1c levels during the study.

  5. Does self monitoring of blood glucose as opposed to urinalysis provide additional benefit in patients newly diagnosed with type 2 diabetes receiving structured education? The DESMOND SMBG randomised controlled trial protocol.

    Science.gov (United States)

    Dallosso, Helen M; Eborall, Helen C; Daly, Heather; Martin-Stacey, Lorraine; Speight, Jane; Realf, Kathryn; Carey, Marian E; Campbell, Michael J; Dixon, Simon; Khunti, Kamlesh; Davies, Melanie J; Heller, Simon

    2012-03-14

    The benefit of self-monitoring of blood glucose (SMBG) in people with type 2 diabetes on diet or oral agents other than sulphonylureas remains uncertain. Trials of interventions incorporating education about self-monitoring of blood glucose have reported mixed results. A recent systematic review concluded that SMBG was not cost-effective. However, what was unclear was whether a cheaper method of self-monitoring (such as urine glucose monitoring) could produce comparable benefit and patient acceptability for less cost. The DESMOND SMBG trial is comparing two monitoring strategies (blood glucose monitoring and urine testing) over 18 months when incorporated into a comprehensive self-management structured education programme. It is a multi-site cluster randomised controlled trial, conducted across 8 sites (7 primary care trusts) in England, UK involving individuals with newly diagnosed Type 2 diabetes.The trial has 80% power to demonstrate equivalence in mean HbA1c (the primary end-point) at 18 months of within ± 0.5% assuming 20% drop out and 20% non-consent. Secondary end-points include blood pressure, lipids, body weight and psychosocial measures as well as a qualitative sub-study.Practices were randomised to one of two arms: participants attend a DESMOND programme incorporating a module on self-monitoring of either urine or blood glucose. The programme is delivered by accredited educators who received specific training about equipoise. Biomedical data are collected and psychosocial scales completed at baseline, and 6, 12, and 18 months post programme. Qualitative research with participants and educators will explore views and experiences of the trial and preferences for methods of monitoring. The DESMOND SMBG trial is designed to provide evidence to inform the debate about the value of self-monitoring of blood glucose in people with newly diagnosed type 2 diabetes. Strengths include a setting in primary care, a cluster design, a health economic analysis, a

  6. Brazilian multicenter study for the evaluation of patients' satisfaction of blood glucose self-monitoring with BGStar(®) blood glucose meter in insulinized patients with diabetes mellitus type 1 and 2.

    Science.gov (United States)

    Hissa, Miguel Nasser

    2016-01-01

    Diabetes mellitus (DM) is considered a global epidemic, and patient self-management education and support are critical in preventing and reducing the risk of complications. Self-monitoring of blood glucose (SMBG) is essential for care of individuals with DM, helping patients to achieve and maintain target blood glucose levels. The purpose of this study is to compare the satisfaction of insulinized DM patients on SMBG with use of investigational blood glucose meter (BGM) versus their routine device. A national, multicenter, open-label, phase 4 study was conducted on patients with type 1 or 2 DM under insulin therapy regimen, who were asked to use investigational BGM instead of their usual BGM device. The study was performed in 12 centers in Brazil for 12 weeks, with an extension period of 12 weeks. The primary endpoint was to measure the variation on the patients' level of satisfaction with investigational versus routine BGM, between visits, using a Visual Analogue Scale (VAS). Secondary endpoints addressed handling aspects, satisfaction, adherence and level of functionality and safety of investigational BGM. The study included 292 patients (36.6 % DM1 and 63.4 % DM2), mean age 50.9 years old (±17.3 years), 57.5 % females. There was statistically significant improvement in global satisfaction with investigational BGM compared with routine BGM according to VAS [mean VAS score raised from 78.8 mm (SD = 18.0) to 90.8 mm (SD = 12.2) between visits]. After 12 weeks, level of satisfaction with investigational BGM according to questionnaires was superior to routine BGM regardless of age group (p < 0.001), type of DM (p < 0.001) or insulin regimen (p < 0.001). Investigational BGM was also regarded as safe, with 10 patients (3.4 %) reporting a total of 13 adverse events during the study. Levels of satisfaction during SMBG were higher with use of investigational BGM and the device was deemed safe and easy to handle.

  7. Improvement of Glycosylated Hemoglobin in Patients with Type 2 Diabetes Mellitus under Insulin Treatment by Reimbursement for Self-Monitoring of Blood Glucose

    Directory of Open Access Journals (Sweden)

    Young Shin Song

    2017-09-01

    Full Text Available BackgroundIn Korea, the costs associated with self-monitoring of blood glucose (SMBG for patients with type 2 diabetes mellitus (T2DM under insulin treatment have been reimbursed since November 2015. We investigated whether this new reimbursement program for SMBG has improved the glycemic control in the beneficiaries of this policy.MethodsAmong all adult T2DM patients with ≥3 months of reimbursement (n=854, subjects without any changes in anti-hyperglycemic agents during the study period were selected. The improvement of glycosylated hemoglobin (HbA1c was defined as an absolute reduction in HbA1c ≥0.6% or an HbA1c level at follow-up <7%.ResultsHbA1c levels significantly decreased from 8.5%±1.3% to 8.2%±1.2% during the follow-up (P<0.001 in all the study subjects (n=409. Among them, 35.5% (n=145 showed a significant improvement in HbA1c. Subjects covered under the Medical Aid system showed a higher prevalence of improvement in HbA1c than those with medical insurance (52.2% vs. 33.3%, respectively, P=0.012. In the improvement group, the baseline HbA1c (P<0.001, fasting C-peptide (P=0.016, and daily dose of insulin/body weight (P=0.024 showed significant negative correlations with the degree of HbA1c change. Multivariate analysis showed that subjects in the Medical Aid system were about 2.5-fold more likely to improve in HbA1c compared to those with medical insurance (odds ratio, 2.459; 95% confidence interval, 1.138 to 5.314; P=0.022.ConclusionThe reimbursement for SMBG resulted in a significant improvement in HbA1c in T2DM subjects using insulin, which was more prominent in subjects with poor glucose control at baseline or covered under the Medical Aid system.

  8. Structured self-monitoring of blood glucose regimens improve glycemic control in poorly controlled Chinese patients on insulin therapy: Results from COMPASS.

    Science.gov (United States)

    Ji, Linong; Su, Qing; Feng, Bo; Shan, Zhongyan; Hu, Renming; Xing, Xiaoping; Xue, Yaoming; Yang, Tao; Hua, Yanyin

    2017-05-01

    The use of self-monitoring of blood glucose (SMBG) among patients with insulin-treated, type 2 diabetes (T2DM) in China is suboptimal. Herein we evaluated the effectiveness of structured SMBG for improving glycemic control and increasing the frequency of SMBG. Insulin-treated (>3 months) T2DM patients aged ≥18 years with HbA1c >8.0 % (64 mmol/mol) were recruited to the study. They received SMBG materials and were advised on a structured SMBG regimen for their insulin therapy. Patients were trained to self-adjust insulin dosage according to SMBG readings and were seen by physicians at Months 3 and 6. Endpoints included changes in HbA1c, SMBG frequency, and hypoglycemia frequency. The study enrolled 820 patients, with mean (± SD) age 55.1 ± 9.8 years, body mass index 24.9 ± 3.6 kg/m 2 , HbA1c 9.7 ± 1.6 % (83 mmol/mol), and diabetes duration 9.8 ± 7.1 years, with median insulin therapy of 30.3 (3.0-274.1) months, from 19 Chinese clinics. By Month 3, 99.9 % of patients performed daily SMBG. At Months 3 and 6, HbA1c had decreased from baseline (-1.81 % and -1.73 %, respective; P < 0.0001 for both), with reduced hypoglycemia. In addition, 36.2 % and 39.9 % of patients achieved HbA1c <7.0 % (53 mmol/mol) at Months 3 and 6, respectively. The largest HbA1c improvements were for patients with a shorter duration of diabetes and insulin therapy. A structured SMBG regimen, with training on interpretation of and responses to SMBG readings, increased SMBG frequency and improved HbA1c and the management of insulin-treated T2DM. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  9. Cost effectiveness of self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes and not on insulin: impact of modelling assumptions on recent Canadian findings.

    Science.gov (United States)

    Tunis, Sandra L

    2011-11-01

    Canadian patients, healthcare providers and payers share interest in assessing the value of self-monitoring of blood glucose (SMBG) for individuals with type 2 diabetes but not on insulin. Using the UKPDS (UK Prospective Diabetes Study) model, the Canadian Optimal Prescribing and Utilization Service (COMPUS) conducted an SMBG cost-effectiveness analysis. Based on the results, COMPUS does not recommend routine strip use for most adults with type 2 diabetes who are not on insulin. Cost-effectiveness studies require many assumptions regarding cohort, clinical effect, complication costs, etc. The COMPUS evaluation included several conservative assumptions that negatively impacted SMBG cost effectiveness. Current objectives were to (i) review key, impactful COMPUS assumptions; (ii) illustrate how alternative inputs can lead to more favourable results for SMBG cost effectiveness; and (iii) provide recommendations for assessing its long-term value. A summary of COMPUS methods and results was followed by a review of assumptions (for trial-based glycosylated haemoglobin [HbA(1c)] effect, patient characteristics, costs, simulation pathway) and their potential impact. The UKPDS model was used for a 40-year cost-effectiveness analysis of SMBG (1.29 strips per day) versus no SMBG in the Canadian payer setting. COMPUS assumptions for patient characteristics (e.g. HbA(1c) 8.4%), SMBG HbA(1c) advantage (-0.25%) and costs were retained. As with the COMPUS analysis, UKPDS HbA(1c) decay curves were incorporated into SMBG and no-SMBG pathways. An important difference was that SMBG HbA(1c) benefits in the current study could extend beyond the initial simulation period. Sensitivity analyses examined SMBG HbA(1c) advantage, adherence, complication history and cost inputs. Outcomes (discounted at 5%) included QALYs, complication rates, total costs (year 2008 values) and incremental cost-effectiveness ratios (ICERs). The base-case ICER was $Can63 664 per QALY gained; approximately 56% of

  10. The DiGEM trial protocol – a randomised controlled trial to determine the effect on glycaemic control of different strategies of blood glucose self-monitoring in people with type 2 diabetes [ISRCTN47464659

    Directory of Open Access Journals (Sweden)

    Goyder Elizabeth

    2005-06-01

    Full Text Available Abstract Background We do not yet know how to use blood glucose self-monitoring (BGSM most effectively in the self-management of type 2 diabetes treated with oral medication. Training in monitoring may be most effective in improving glycaemic control and well being when results are linked to behavioural change. Methods/design DiGEM is a three arm randomised parallel group trial set in UK general practices. A total of 450 patients with type 2 diabetes managed with lifestyle or oral glucose lowering medication are included. The trial compares effectiveness of three strategies for monitoring glycaemic control over 12 months (1 a control group with three monthly HbA1c measurements; interpreted with nurse-practitioner; (2 A self-testing of blood glucose group; interpreted with nurse- practitioner to inform adjustment of medication in addition to 1; (3 A self-monitoring of blood glucose group with personal use of results to interpret results in relation to lifestyle changes in addition to 1 and 2. The trial has an 80% power at a 5% level of significance to detect a difference in change in the primary outcome, HbA1c of 0.5% between groups, allowing for an attrition rate of 10%. Secondary outcome measures include health service costs, well-being, and the intervention effect in sub-groups defined by duration of diabetes, current management, health status at baseline and co-morbidity. A mediation analysis will explore the extent to which changes in beliefs about self-management of diabetes between experimental groups leads to changes in outcomes in accordance with the Common Sense Model of illness. The study is open and has recruited more than half the target sample. The trial is expected to report in 2007. Discussion The DiGEM intervention and trial design address weaknesses of previous research by use of a sample size with power to detect a clinically significant change in HbA1c, recruitment from a well-characterised primary care population, definition

  11. Effects of self-monitoring of glucose in non-insulin treated patients with type 2 diabetes: design of the IN CONTROL-trial

    NARCIS (Netherlands)

    Malanda, U.L.; Bot, S.D.M.; Kostense, P.J.; Snoek, F.J.; Dekker, J.M.; Nijpels, M.G.A.A.M.

    2009-01-01

    or = 7.0%, and not using insulin will be recruited and randomized into 3 groups; Self-monitoring of Blood Glucose (SMBG), Self-monitoring of Urine Glucose (SMUG) and usual care (n = 200 per group). Participants are eligible if they have a known disease duration of over 1 year and have used SMBG or

  12. Lot-to-lot variability of test strips and accuracy assessment of systems for self-monitoring of blood glucose according to ISO 15197.

    Science.gov (United States)

    Baumstark, Annette; Pleus, Stefan; Schmid, Christina; Link, Manuela; Haug, Cornelia; Freckmann, Guido

    2012-09-01

    Accurate and reliable blood glucose (BG) measurements require that different test strip lots of the same BG monitoring system provide comparable measurement results. Only a small number of studies addressing this question have been published. In this study, four test strip lots for each of five different BG systems [Accu-Chek® Aviva (system A), FreeStyle Lite® (system B), GlucoCheck XL (system C), Pura™/mylife™ Pura (system D), and OneTouch® Verio™ Pro (system E)] were evaluated with procedures according to DIN EN ISO 15197:2003. The BG system measurement results were compared with the manufacturer's measurement procedure (glucose oxidase or hexokinase method). Relative bias according to Bland and Altman and system accuracy according to ISO 15197 were analyzed. A BG system consists of the BG meter itself and the test strips. The maximum lot-to-lot difference between any two of the four evaluated test strip lots per BG system was 1.0% for system E, 2.1% for system A, 3.1% for system C, 6.9% for system B, and 13.0% for system D. Only two systems (systems A and B) fulfill the criteria of DIN EN ISO 15197:2003 with each test strip lot. Considerable lot-to-lot variability between test strip lots of the same BG system was found. These variations add to other sources of inaccuracy with the specific BG system. Manufacturers should regularly and effectively check the accuracy of their BG meters and test strips even between different test strip lots to minimize risk of false treatment decisions. © 2012 Diabetes Technology Society.

  13. Evaluation of Hematocrit Influence on Self-Monitoring of Blood Glucose Based on ISO 15197:2013: Comparison of a Novel System With Five Systems With Different Hematocrit Ranges.

    Science.gov (United States)

    Hattemer, Andrew; Wardat, Sami

    2018-03-01

    ISO 15197:2013 recommends testing procedures and acceptance criteria for the evaluation of influence quantities such as hematocrit on measurement results with systems for self-monitoring of blood glucose (SMBG). In this study, hematocrit influence was evaluated for a novel SMBG system (system A) and five other systems with different hematocrit ranges based on ISO 15197:2013. Test procedures were performed with one test strip lot for each system. Each system was tested within the hematocrit range indicated in the manufacturer's labeling (system A: 10-65%, B: 15-65%, C: 20-60%, D: 35-60%, E: 30-60%, F: 30-55%). According to ISO 15197:2013, clause 6.4.2, venous blood samples were used for the evaluation of hematocrit influence. The evaluation was performed for three glucose concentration categories (30-50 mg/dL, 96-144 mg/dL, and 280-420 mg/dL). For each glucose concentration category, at least five different hematocrit levels were investigated. The novel system A and systems B, E, and F complied with the tested lot with the defined criteria and showed ≤10 mg/dL and ≤10% difference between the test sample and the respective control sample with a hematocrit value of 42% ± 2% for BG concentrations 10% difference at glucose concentrations ≥100 mg/dL. Remarkable hematocrit influence within the labeled hematocrit range was obtained in two systems with the tested reagent system lot. Adequate SMBG systems should be carefully chosen by patients and their health care professionals, particularly for patients with increased and decreased hematocrit values.

  14. Current concepts in blood glucose monitoring

    OpenAIRE

    Khadilkar, Kranti Shreesh; Bandgar, Tushar; Shivane, Vyankatesh; Lila, Anurag; Shah, Nalini

    2013-01-01

    Blood glucose monitoring has evolved over the last century. The concept of adequate glycemic control and minimum glycemic variability requires an ideal, accurate and reliable glucose monitoring system. The search for an ideal blood glucose monitoring system still continues. This review explains the various blood glucose monitoring systems with special focus on the monitoring systems like self- monitored blood glucose (SMBG) and continuous glucose monitoring system (CGMS). It also focuses on t...

  15. Self-Monitoring of Blood Glucose Levels: Evaluating the Impact of a Policy of Quantity Limits on Test-Strip Use and Costs.

    Science.gov (United States)

    Gomes, Tara; Martins, Diana; Tadrous, Mina; Paterson, J Michael; Shah, Baiju R; Juurlink, David N; Singh, Samantha; Mamdani, Muhammad M

    2016-10-01

    To evaluate the impact of new quantity limits for blood glucose test strips (BGTS) in August 2013 on utilization patterns and costs in the elderly population of Ontario, Canada. We conducted a population-based, cross-sectional time series analysis of all individuals 65 years of age and older who received publically funded BGTSs between August 1, 2010, and July 31, 2015, in Ontario, Canada. The number of BGTSs dispensed and the associated costs were measured for 4 diabetes therapy subgroups-insulin, hypoglycemia-inducing oral agents, non-hypoglycemia-inducing oral agents, and no drug therapy-each month during the study period. We used interventional autoregressive integrated moving average (ARIMA) models to assess the impact of Ontario's policy change on test strip use and costs. In the course of the study period, 657,338,177 test strips were dispensed to elderly patients in Ontario, at a total cost of CAN$482.3 million. Introduction of quantity limits was associated with significant reductions in the number of monthly strips dispensed and the associated costs (p<0.0001). In the year following the policy's implementation, test strip use decreased by 22.2% compared with the prior year (from 145,232,024 test strips to 113,007,795 test strips, a net decrease of 32,224,229 strips), resulting in a 22.5% reduction in costs (from $106.5 million to $82.6 million, a net cost reduction of approximately $24 million). The introduction of quantity limits, aligned with guidance from the Canadian Diabetes Association, led to immediate significant reductions in BGTS dispensing and costs. More research is needed to assess the impact of this policy on patient outcomes. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  16. Self-Monitoring of Blood Glucose in Diabetes: From Evidence to Clinical Reality in Central and Eastern Europe—Recommendations from the International Central-Eastern European Expert Group

    Science.gov (United States)

    Barkai, László; Bolgarska, Svetlana; Bronisz, Agata; Broz, Jan; Cypryk, Katarzyna; Honka, Marek; Janez, Andrej; Krnic, Mladen; Lalic, Nebojsa; Martinka, Emil; Rahelic, Dario; Roman, Gabriela; Tankova, Tsvetalina; Várkonyi, Tamás; Wolnik, Bogumił; Zherdova, Nadia

    2014-01-01

    Abstract Self-monitoring of blood glucose (SMBG) is universally considered to be an integral part of type 1 diabetes management and crucial for optimizing the safety and efficacy of complex insulin regimens. This extends to type 2 diabetes patients on intensive insulin therapy, and there is also a growing body of evidence suggesting that structured SMBG is beneficial for all type 2 diabetes patients, regardless of therapy. However, access to SMBG can be limited in many countries in Central and Eastern Europe. A consensus group of diabetes experts from 10 countries in this region (with overlapping historical, political, and social environments)—Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, Serbia, Slovakia, Slovenia, and Ukraine—was formed to discuss the role of SMBG across the spectrum of patients with diabetes. The group considered SMBG to be an essential tool that should be accessible to all patients with diabetes, including those with non–insulin-treated type 2 diabetes. The current article summarizes the evidence put forward by the consensus group and provides their recommendations for the appropriate use of SMBG as part of individualized patient management. The ultimate goal of these evidence-based recommendations is to help patients and providers in Central and Eastern Europe to make optimal use of SMBG in order to maximize the efficacy and safety of glucose-lowering therapies, to prevent complications, and to empower the patient to play a more active role in the management of their diabetes. PMID:24716890

  17. Current concepts in blood glucose monitoring.

    Science.gov (United States)

    Khadilkar, Kranti Shreesh; Bandgar, Tushar; Shivane, Vyankatesh; Lila, Anurag; Shah, Nalini

    2013-12-01

    Blood glucose monitoring has evolved over the last century. The concept of adequate glycemic control and minimum glycemic variability requires an ideal, accurate and reliable glucose monitoring system. The search for an ideal blood glucose monitoring system still continues. This review explains the various blood glucose monitoring systems with special focus on the monitoring systems like self- monitored blood glucose (SMBG) and continuous glucose monitoring system (CGMS). It also focuses on the newer concepts of blood glucose monitoring and their incorporation in routine clinical management of diabetes mellitus.

  18. Current concepts in blood glucose monitoring

    Directory of Open Access Journals (Sweden)

    Kranti Shreesh Khadilkar

    2013-01-01

    Full Text Available Blood glucose monitoring has evolved over the last century. The concept of adequate glycemic control and minimum glycemic variability requires an ideal, accurate and reliable glucose monitoring system. The search for an ideal blood glucose monitoring system still continues. This review explains the various blood glucose monitoring systems with special focus on the monitoring systems like self- monitored blood glucose (SMBG and continuous glucose monitoring system (CGMS. It also focuses on the newer concepts of blood glucose monitoring and their incorporation in routine clinical management of diabetes mellitus.

  19. Analytical Performance Requirements for Systems for Self-Monitoring of Blood Glucose With Focus on System Accuracy: Relevant Differences Among ISO 15197:2003, ISO 15197:2013, and Current FDA Recommendations.

    Science.gov (United States)

    Freckmann, Guido; Schmid, Christina; Baumstark, Annette; Rutschmann, Malte; Haug, Cornelia; Heinemann, Lutz

    2015-07-01

    In the European Union (EU), the ISO (International Organization for Standardization) 15197 standard is applicable for the evaluation of systems for self-monitoring of blood glucose (SMBG) before the market approval. In 2013, a revised version of this standard was published. Relevant revisions in the analytical performance requirements are the inclusion of the evaluation of influence quantities, for example, hematocrit, and some changes in the testing procedures for measurement precision and system accuracy evaluation, for example, number of test strip lots. Regarding system accuracy evaluation, the most important change is the inclusion of more stringent accuracy criteria. In 2014, the Food and Drug Administration (FDA) in the United States published their own guidance document for the premarket evaluation of SMBG systems with even more stringent system accuracy criteria than stipulated by ISO 15197:2013. The establishment of strict accuracy criteria applicable for the premarket evaluation is a possible approach to further improve the measurement quality of SMBG systems. However, the system accuracy testing procedure is quite complex, and some critical aspects, for example, systematic measurement difference between the reference measurement procedure and a higher-order procedure, may potentially limit the apparent accuracy of a given system. Therefore, the implementation of a harmonized reference measurement procedure for which traceability to standards of higher order is verified through an unbroken, documented chain of calibrations is desirable. In addition, the establishment of regular and standardized post-marketing evaluations of distributed test strip lots should be considered as an approach toward an improved measurement quality of available SMBG systems. © 2015 Diabetes Technology Society.

  20. On preventive blood pressure self-monitoring at home

    DEFF Research Database (Denmark)

    Verdezoto, Nervo; Gronvall, Erik

    2015-01-01

    Self-monitoring activities are increasingly becoming part of people’s everyday lives. Some of these measurements are taken voluntarily rather than being referred by a physician and conducted because of either a preventive health interest or to better understand the body and its functions (the so......-called Quantified Self). In this article, we explore socio-technical complexities that may occur when introducing preventive health-measurement technologies into older adults’ daily routines and everyday lives. In particular, the original study investigated blood pressure (BP) measurement in non-clinical settings...

  1. Self-monitoring of blood pressure during pregnancy

    DEFF Research Database (Denmark)

    Lihme, Frederikke F; Madsen, Mette E; Lykke, Jacob A

    2017-01-01

    OBJECTIVE: The aim of this study was to assess the feasibility of self-monitoring of blood pressure with a semiautomatic device in pregnant women. PARTICIPANTS AND METHODS: Women attending routine obstetrical ultrasound scanning were invited to participate. The hospital staff initially demonstrated...... were included in the study. Mean values of systolic, diastolic and MAP were 110.6, 69.7 and 83.3 mmHg, respectively, as assessed by the hospital staff. The corresponding self-measurements were 111.4, 70.2 and 83.9 mmHg, respectively. Mean differences between hospital and self-measurements were 0.79 mm......Hg for systolic [P=0.052, 95% confidence interval (CI)=-0.008 to 1.58], 0.49 mmHg for diastolic (P=0.056, 95% CI=-0.01 to 0.99) and 0.59 mmHg for MAP (P=0.019, 95% CI=0.099-1.08). The mean evaluation score was 9.2 of 10. CONCLUSION: Differences between hospital staff and self-measurements in systolic, diastolic...

  2. On preventive blood pressure self-monitoring at home

    DEFF Research Database (Denmark)

    Verdezoto, Nervo; Grönvall, Erik

    2015-01-01

    Self-monitoring activities are increasingly becoming part of people’s everyday lives. Some of these measurements are taken voluntarily rather than being referred by a physician and conducted because of either a preventive health interest or to better understand the body and its functions (the so......, to understand existing challenges, and uncover opportunities for self-monitoring technologies to support preventive healthcare activities among older adults. From our study, several important aspects emerged to consider when designing preventive self-monitoring technology, such as the complexity of guidelines...... for self-measuring, the importance of interpretation, understanding and health awareness, sharing self-monitoring information for prevention, various motivational factors, the role of the doctor in prevention, and the home as a distributed information space. An awareness of these aspects can help designers...

  3. Effects of self-monitoring of glucose on distress and self-efficacy in people with non-insulin-treated Type 2 diabetes: a randomized controlled trial

    NARCIS (Netherlands)

    Malanda, U. L.; Bot, S. D. M.; Kostense, P. J.; Snoek, F. J.; Dekker, J. M.; Nijpels, G.

    2016-01-01

    To investigate the effects of self-monitoring of glucose in blood or urine, on diabetes-specific distress and self-efficacy, compared with usual care in people with non-insulin-treated Type 2 diabetes mellitus. One hundred and eighty-one participants with non-insulin-treated Type 2 diabetes mellitus

  4. Hyperglycemia (High Blood Glucose)

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  5. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Español Hyperglycemia (High Blood Glucose) Hyperglycemia is the technical term for high blood glucose (blood sugar). High ... Type 2 Diabetes program to get help and support during your first year. Featured Book Type 2 ...

  6. Hyperglycemia (High Blood Glucose)

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  7. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... symptoms include the following: High blood glucose High levels of sugar in the urine Frequent urination Increased ... you should check and what your blood glucose levels should be. Checking your blood and then treating ...

  8. The Quantitative Relationship Between ISO 15197 Accuracy Criteria and Mean Absolute Relative Difference (MARD) in the Evaluation of Analytical Performance of Self-Monitoring of Blood Glucose (SMBG) Systems.

    Science.gov (United States)

    Pardo, Scott; Simmons, David A

    2016-09-01

    The relationship between International Organization for Standardization (ISO) accuracy criteria and mean absolute relative difference (MARD), 2 methods for assessing the accuracy of blood glucose meters, is complex. While lower MARD values are generally better than higher MARD values, it is not possible to define a particular MARD value that ensures a blood glucose meter will satisfy the ISO accuracy criteria. The MARD value that ensures passing the ISO accuracy test can be described only as a probabilistic range. In this work, a Bayesian model is presented to represent the relationship between ISO accuracy criteria and MARD. Under the assumptions made in this work, there is nearly a 100% chance of satisfying ISO 15197:2013 accuracy requirements if the MARD value is between 3.25% and 5.25%. © 2016 Diabetes Technology Society.

  9. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... and eAG Hypoglycemia (Low blood glucose) Hyperglycemia (High blood glucose) Dawn Phenomenon Checking for Ketones Tight Diabetes Control donate en -- A Future Without Diabetes - a-future- ...

  10. Blood Test: Glucose

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Blood Test: Glucose KidsHealth / For Parents / Blood Test: Glucose What's ... español Análisis de sangre: glucosa What Is a Blood Test? A blood test is when a sample of ...

  11. Accuracy of self-monitored blood pressure for diagnosing hypertension in primary care.

    Science.gov (United States)

    Nunan, David; Thompson, Matthew; Heneghan, Carl J; Perera, Rafael; McManus, Richard J; Ward, Alison

    2015-04-01

    To assess the diagnostic accuracy of recommendations for self-monitoring blood pressure (BP) for diagnosing hypertension in primary care. Two hundred and forty-seven consecutive participants with raised (≥130 mmHg systolic) BP measured by their general practitioner from four primary care practices in the United Kingdom underwent 28 days of self-monitoring followed by 24-h ambulatory BP monitoring (ABPM). Diagnostic accuracy of the first 7 days of self-monitored BP (minimum 4 days, discarding readings on day 1) in detecting hypertension with ambulatory blood pressure was taken as reference. Two hundred and three participants were included, 109 (53.7%) of whom were diagnosed with hypertension using daytime ambulatory BP. The average of days 2-7 self-monitored BP correctly classified 150 of 203 participants [sensitivity 93.6%, 95% confidence interval (CI) 87.2-97.4%; specificity 51.1%, 95% CI 40.5-61.5%). However, the average of days 2-5 self-monitoring correctly classified 152 of 203 participants due to better specificity (53.2%, 95% CI 42.6-63.6%). In sensitivity analysis, diagnostic accuracy was not improved by inclusion of readings beyond day 5, and inclusion of readings taken on day 1 had no impact on diagnostic accuracy. Self-monitoring in the clinic was more accurate than readings taken by the general practitioner, but not self-monitoring outside of the clinic. Hypertension can be ruled out in the majority of patients with elevated clinic BP using the average of the first 5 consecutive days of self-monitored BP, supporting lower limits for self-monitoring readings in current guidelines. Performing readings beyond day 5 and including readings taken on the first day had no clinical impact on diagnostic accuracy.

  12. Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily Self-Monitoring of ...

    Science.gov (United States)

    ... Years or Older with Diagnosed Diabetes Performing Daily Self-Monitoring of Blood Glucose, United States, 1994–2010 From ... years or older with diagnosed diabetes performing daily self-monitoring of blood glucose increased by 27.9 points, ...

  13. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... by Mail Close www.diabetes.org > Living With Diabetes > Treatment and Care > Blood Glucose Testing Share: Print Page ... and-how-tos, . In this section Living With Diabetes Treatment and Care Blood Glucose Testing Checking Your Blood ...

  14. [Intelligent interpretation of home monitoring blood glucose data].

    Science.gov (United States)

    Dió, Mihály; Deutsch, Tibor; Biczók, Tímea; Mészáros, Judit

    2015-07-19

    Self monitoring of blood glucose is the cornerstone of diabetes management. However, the data obtained by self monitoring of blood glucose have rarely been used with the highest advantage. Few physicians routinely download data from memory-equipped glucose meters and analyse these data systematically at the time of patient visits. There is a need for improved methods for the display and analysis of blood glucose data along with a modular approach for identification of clinical problems. The authors present a systematic methodology for the analysis and interpretation of self monitoring blood glucose data in order to assist the management of patients with diabetes. This approach utilizes the followings 1) overall quality of glycemic control; 2) severity and timing of hypoglycemia and hyperglycemia; 3) variability of blood glucose readings; 4) various temporal patterns extracted from recorded data and 5) adequacy of self monitoring blood glucose data. Based on reliable measures of the quality of glycaemic control and glucose variability, a prioritized problem list is derived along with the probable causes of the detected problems. Finally, problems and their interpretation are used to guide clinicians to choose therapeutic actions and/or recommend behaviour change in order to solve the problems that have been identified.

  15. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Complications Neuropathy Foot Complications DKA (Ketoacidosis) & Ketones Kidney Disease (Nephropathy) Gastroparesis Mental Health Step On Up Treatment & Care Blood Glucose Testing ...

  16. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Complications Neuropathy Foot Complications DKA (Ketoacidosis) & Ketones Kidney Disease (Nephropathy) Gastroparesis Mental Health Step On Up Treatment & Care Blood Glucose Testing Medication Doctors, Nurses & More ...

  17. Blood pressure self-monitoring in pregnancy: examining feasibility in a prospective cohort study.

    Science.gov (United States)

    Tucker, Katherine L; Taylor, Kathryn S; Crawford, Carole; Hodgkinson, James A; Bankhead, Clare; Carver, Tricia; Ewers, Elizabeth; Glogowska, Margaret; Greenfield, Sheila M; Ingram, Lucy; Hinton, Lisa; Khan, Khalid S; Locock, Louise; Mackillop, Lucy; McCourt, Christine; Pirie, Alexander M; Stevens, Richard; McManus, Richard J

    2017-12-28

    Raised blood pressure (BP) affects approximately 10% of pregnancies worldwide, and a high proportion of affected women develop pre-eclampsia. This study aimed to evaluate the feasibility of self-monitoring of BP in pregnancy in women at higher risk of pre-eclampsia. This prospective cohort study of self-monitoring BP in pregnancy was carried out in two hospital trusts in Birmingham and Oxford and thirteen primary care practices in Oxfordshire. Eligible women were those defined by the UK National Institute for Health and Care Excellence (NICE) guidelines as at higher risk of pre-eclampsia. A total of 201 participants were recruited between 12 and 16 weeks of pregnancy and were asked to take two BP readings twice daily three times a week through their pregnancy. Primary outcomes were recruitment, retention and persistence of self-monitoring. Study recruitment and retention were analysed with descriptive statistics. Survival analysis was used to evaluate the persistence of self-monitoring and the performance of self-monitoring in the early detection of gestational hypertension, compared to clinic BP monitoring. Secondary outcomes were the mean clinic and self-monitored BP readings and the performance of self-monitoring in the detection of gestational hypertension and pre-eclampsia compared to clinic BP. Of 201 women recruited, 161 (80%) remained in the study at 36 weeks or to the end of their pregnancy, 162 (81%) provided any home readings suitable for analysis, 148 (74%) continued to self-monitor at 20 weeks and 107 (66%) at 36 weeks. Self-monitored readings were similar in value to contemporaneous matched clinic readings for both systolic and diastolic BP. Of the 23 who developed gestational hypertension or pre-eclampsia and self-monitored, 9 (39%) had a raised home BP prior to a raised clinic BP. Self-monitoring of BP in pregnancy is feasible and has potential to be useful in the early detection of gestational hypertensive disorders but maintaining self-monitoring

  18. Hyperglycemia (High Blood Glucose)

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  19. Hyperglycemia (High Blood Glucose)

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  20. Hyperglycemia (High Blood Glucose)

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  1. Hyperglycemia (High Blood Glucose)

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  2. Hyperglycemia (High Blood Glucose)

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  4. Hyperglycemia (High Blood Glucose)

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  5. Hyperglycemia (High Blood Glucose)

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  6. Hyperglycemia (High Blood Glucose)

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  7. Hyperglycemia (High Blood Glucose)

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  12. Hyperglycemia (High Blood Glucose)

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  13. Self-monitoring and self-management: new interventions to improve blood pressure control.

    Science.gov (United States)

    McCartney, David E; McManus, Richard J

    2016-11-01

    This article reviews recent developments in self-monitoring and self-management of hypertension aimed at the improvement of blood pressure (BP) control. There is an increasing body of evidence examining the effects of self-monitoring on BP control. Several landmark studies in recent years have demonstrated clinically relevant benefit from self-monitoring based interventions. Self-management of BP with self-titration has shown particular promise, as has self-monitoring combined with intensive health-care led support. There is a lack of evidence on the benefits of self-monitoring for those with important comorbidity such as coronary heart disease, chronic kidney disease, diabetes and previous stroke, and future research should be directed towards this. There is a growing body of evidence supporting the use of self-monitoring along with additional intervention including telemonitoring and self-titration in improving BP control. Further research is needed to understand which patients are likely to benefit most and how this is best integrated with routine care.

  14. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Your Carbs Count Glycemic Index Low-Calorie Sweeteners Sugar and Desserts Fitness Exercise & Type 1 Diabetes Get Started Safely Get And Stay Fit Types ... the following: High blood glucose High levels of sugar in the ... Part of managing your diabetes is checking your blood glucose often. Ask your ...

  15. Blood Glucose Determination

    DEFF Research Database (Denmark)

    Lippi, Giuseppe; Nybo, Mads; Cadamuro, Janne

    2018-01-01

    The measurement of fasting plasma glucose may be biased by a time-dependent decrease of glucose in blood tubes, mainly attributable to blood cell metabolism when glycolysis is not rapidly inhibited or blood cells cannot be rapidly separated from plasma. Although glycolysis inhibitors such as sodium...... fluoride (NaF) in combination with potassium oxalate (KOx) are currently used for overcoming this drawback, their efficacy for stabilizing blood glucose is seemingly limited, and probably lower than that of newer additives such as the citrate buffer. Therefore, we performed a critical analysis...

  16. Effects of self-monitoring of glucose in non-insulin treated patients with type 2 diabetes: design of the IN CONTROL-trial

    Directory of Open Access Journals (Sweden)

    Kostense Piet J

    2009-04-01

    Full Text Available Abstract Background Diabetes specific emotional problems interfere with the demanding daily management of living with type 2 diabetes mellitus (T2DM. Possibly, offering direct feedback on diabetes management may diminish the presence of diabetes specific emotional problems and might enhance the patients' belief they are able to manage their illness. It is hypothesized that self-monitoring of glucose in combination with an algorithm how and when to act will motivate T2DM patients to become more active participants in their own care leading to a decrease in diabetes related distress and an increased self-efficacy. Methods and design Six hundred patients with T2DM (45 ≤ 75 years who receive care in a structured diabetes care system, HbA1c ≥ 7.0%, and not using insulin will be recruited and randomized into 3 groups; Self-monitoring of Blood Glucose (SMBG, Self-monitoring of Urine Glucose (SMUG and usual care (n = 200 per group. Participants are eligible if they have a known disease duration of over 1 year and have used SMBG or SMUG less than 3 times in the previous year. All 3 groups will receive standardized diabetes care. The intervention groups will receive additional instructions on how to perform self-monitoring of glucose and how to interpret the results. Main outcome measures are changes in diabetes specific emotional distress and self-efficacy. Secondary outcome measures include difference in HbA1c, patient satisfaction, occurrence of hypoglycaemia, physical activity, costs of direct and indirect healthcare and changes in illness beliefs. Discussion The IN CONTROL-trial is designed to explore whether feedback from self-monitoring of glucose in T2DM patients who do not require insulin can affect diabetes specific emotional distress and increase self-efficacy. Based on the self-regulation model it is hypothesized that glucose self-monitoring feedback changes illness perceptions, guiding the patient to reduce emotional responses to

  17. Hyperglycemia (High Blood Glucose)

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  18. Hyperglycemia (High Blood Glucose)

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  20. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Student Resources History of Diabetes Resources for School Projects How to Reference Our Site Diabetes Basics Myths ... the urine Frequent urination Increased thirst Part of managing your diabetes is checking your blood glucose often. ...

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  4. Hyperglycemia (High Blood Glucose)

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  6. Hyperglycemia (High Blood Glucose)

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  7. Hyperglycemia (High Blood Glucose)

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  14. Screening of gingival crevicular blood glucose and capillary finger blood glucose in the diagnosis of diabetes

    Directory of Open Access Journals (Sweden)

    Alka S Waghmare

    2011-01-01

    Full Text Available Aim: The study aimed at obtaining glucose readings using gingival crevicular blood (GCB to screen for undiagnosed diabetes during routine dental visits. Materials and Methods: The present study included 50 patients who were divided into two groups, i.e. Group A and Group B, based on bleeding on probing at the site of collection of GCB. Group A participants had blood collected from sites having adequate bleeding on probing, whereas Group B participants had blood collected from sites with little bleeding on probing. GCB and capillary finger-stick blood (CFB] glucose readings were obtained using a self-monitoring glucometer. Statistical Analysis: Correlations between both the samples were done using Pearson′s correlation. Results: Group A patients′ correlations between GCB and CFB glucose readings were high, whereas in Group B patients, correlations between glucose readings were low. Conclusion: GCB can be an excellent source for screening diabetes during routine dental visits.

  15. Young patients with type 1 diabetes poorly controlled and poorly compliant with self-monitoring of blood glucose: can technology help? Results of the i-NewTrend randomized clinical trial.

    Science.gov (United States)

    Di Bartolo, Paolo; Nicolucci, Antonio; Cherubini, Valentino; Iafusco, Diario; Scardapane, Marco; Rossi, Maria Chiara

    2017-04-01

    To compare iBGStar™ + DMApp (experimental meter + telemedicine system) (iBGStar) with a traditional glucose meter (Control) in type 1 diabetes adolescents/young adults. i-NewTrend was a multicenter, open-label, randomized trial involving subjects aged 14-24 years, on basal-bolus insulin, HbA1c ≥ 8.0%, and poorly compliant with SMBG (i.e., <30% of the recommended frequency). Primary end points were change in HbA1c and achievement of compliance with SMBG (≥30% of the recommended frequency) after 6 months. Quality of life was also evaluated. A post-trial observational phase was conducted, where both groups used the experimental device. Of 182 randomized patients (51.1% male; age 17.7 ± 3.0 years; diabetes duration 8.8 ± 4.7 years; HbA1c levels 10.0% ± 1.4), 92 were allocated to iBGStar and 90 to Control; 6.5% in iBGStar and 8.9% in Control dropped-out. After 6 months, HbA1c changes (±SE) were -0.44% ± 0.13 in iBGStar and -0.32% ± 0.13 in Control (p = 0.51). In the post-trial phase, HbA1c changes from 6 months (±SE) were -0.07% ± 0.14 in iBGStar and -0.31% ± 0.14 in Control (p = 0.24). Compliance end point was reached by 53.6% in iBGStar and 55.0% in Control (p = 0.86). Mean daily SMBG measurements increased from 1.1 to 2.3 in both groups without worsening quality of life. Compliant subjects showed a greater reduction in HbA1c levels (-0.60% ± 0.23 in iBGStar; -0.41% ± 0.21 in Control; p = 0.31). Within iBGStar group, telemedicine users (38.0%) reduced HbA1c by -0.58 ± 0.18. iBGStar was not superior to the traditional meter. Irrespective of the strategy, increasing from 1 to 2 SMBG tests/day was associated with HbA1c reduction in both groups, without pharmacologic interventions. Identifying new technologies effective and acceptable to patients is an option to improve adherence to diabetes care. The trial was registered at ClinicalTrials.gov (registration number NCT02073188).

  16. Hyperglycemia (High Blood Glucose)

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  18. Hyperglycemia (High Blood Glucose)

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  19. Hyperglycemia (High Blood Glucose)

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  20. Hyperglycemia (High Blood Glucose)

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  1. Hyperglycemia (High Blood Glucose)

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  2. Hyperglycemia (High Blood Glucose)

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  3. Blood pressure self-monitoring in pregnancy (BuMP) feasibility study; a qualitative analysis of women's experiences of self-monitoring.

    Science.gov (United States)

    Hinton, Lisa; Tucker, Katherine L; Greenfield, Sheila M; Hodgkinson, James A; Mackillop, Lucy; McCourt, Christine; Carver, Trisha; Crawford, Carole; Glogowska, Margaret; Locock, Louise; Selwood, Mary; Taylor, Kathryn S; McManus, Richard J

    2017-12-19

    Hypertensive disorders in pregnancy are a leading cause of maternal and fetal morbidity worldwide. Raised blood pressure (BP) affects 10% of pregnancies worldwide, of which almost half develop pre-eclampsia. The proportion of pregnant women who have risk factors for pre-eclampsia (such as pre-existing hypertension, obesity and advanced maternal age) is increasing. Pre-eclampsia can manifest itself before women experience symptoms and can develop between antenatal visits. Incentives to improve early detection of gestational hypertensive disorders are therefore strong and self-monitoring of blood pressure (SMBP) in pregnancy might be one means to achieve this, whilst improving women's involvement in antenatal care. The Blood Pressure Self-Monitoring in Pregnancy (BuMP) study aimed to evaluate the feasibility and acceptability of SMBP in pregnancy. To understand women's experiences of SMBP during pregnancy, we undertook a qualitative study embedded within the BuMP observational feasibility study. Women who were at higher risk of developing hypertension and/or pre-eclampsia were invited to take part in a study using SMBP and also invited to take part in an interview. Semi-structured interviews were conducted at the women's homes in Oxfordshire and Birmingham with women who were self-monitoring their BP as part of the BuMP feasibility study in 2014. Interviews were conducted by a qualitative researcher and transcribed verbatim. A framework approach was used for analysis. Fifteen women agreed to be interviewed. Respondents reported general willingness to engage with monitoring their own BP, feeling that it could reduce anxiety around their health during pregnancy, particularly if they had previous experience of raised BP or pre-eclampsia. They felt able to incorporate self-monitoring into their weekly routines, although this was harder post-partum. Self-monitoring of BP made them more aware of the risks of hypertension and pre-eclampsia in pregnancy. Feelings of

  4. Blood glucose in acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj

    2009-01-01

    Blood glucose is often elevated in acute stroke, and higher admission glucose levels are associated with larger lesions, greater mortality and poorer functional outcome. In patients treated with thrombolysis, hyperglycemia is associated with an increased risk of hemorrhagic transformation...... to the risk of inducing potentially harmful hypoglycemia has been raised. Still, basic and observational research is overwhelmingly in support of a causal relationship between blood glucose and stroke outcome and further research on glucose-lowering therapy in acute stroke is highly warranted....

  5. Telemonitoring and/or self-monitoring of blood pressure in hypertension (TASMINH4): protocol for a randomised controlled trial.

    Science.gov (United States)

    Franssen, Marloes; Farmer, Andrew; Grant, Sabrina; Greenfield, Sheila; Heneghan, Carl; Hobbs, Richard; Hodgkinson, James; Jowett, Susan; Mant, Jonathan; Martin, Una; Milner, Siobhan; Monahan, Mark; Ogburn, Emma; Perera-Salazar, Rafael; Schwartz, Claire; Yu, Ly-Mee; McManus, Richard J

    2017-02-13

    Self-monitoring of hypertension is associated with lower systolic blood pressure (SBP). However, evidence for the use of self-monitoring to titrate antihypertensive medication by physicians is equivocal. Furthermore, there is some evidence for the efficacy of telemonitoring in the management of hypertension but it is not clear what this adds over and above self-monitoring. This trial aims to evaluate whether GP led antihypertensive titration using self-monitoring results in lower SBP compared to usual care and whether telemonitoring adds anything to self-monitoring alone. This will be a pragmatic primary care based, unblinded, randomised controlled trial of self-monitoring of BP with or without telemonitoring compared to usual care. Eligible patients will have poorly controlled hypertension (>140/90 mmHg) and will be recruited from primary care. Participants will be individually randomised to either usual care, self-monitoring alone, or self-monitoring with telemonitoring. The primary outcome of the trial will be difference in clinic SBP between intervention and control groups at 12 months adjusted for baseline SBP, gender, BP target and practice. At least 1110 patients will be sufficient to detect a difference in SBP between self-monitoring with or without telemonitoring and usual care of 5 mmHg with 90% power with an adjusted alpha of 0.017 (2-sided) to adjust for all three pairwise comparisons. Other outcomes will include adherence of anti-hypertensive medication, lifestyle behaviours, health-related quality of life, and adverse events. An economic analysis will consider both within trial costs and a model extrapolating the results thereafter. A qualitative sub study will gain insights into the views, experiences and decision making processes of patients and health care professionals focusing on the acceptability of self-monitoring and telemonitoring in the routine management of hypertension. The results of the trial will be directly applicable to primary

  6. Sensing interstitial glucose to nudge active lifestyles (SIGNAL): feasibility of combining novel self-monitoring technologies for persuasive behaviour change.

    Science.gov (United States)

    Whelan, Maxine E; Kingsnorth, Andrew P; Orme, Mark W; Sherar, Lauren B; Esliger, Dale W

    2017-10-08

    Increasing physical activity (PA) reduces the risk of developing diabetes, highlighting the role of preventive medicine approaches. Changing lifestyle behaviours is difficult and is often predicated on the assumption that individuals are willing to change their lifestyles today to reduce the risk of developing disease years or even decades later. The self-monitoring technologies tested in this study will present PA feedback in real time, parallel with acute physiological data. Presenting the immediate health benefits of being more physically active may help enact change by observing the immediate consequences of that behaviour. The present study aims to assess user engagement with the self-monitoring technologies in individuals at moderate-to-high risk of developing type 2 diabetes. 45 individuals with a moderate-to-high risk, aged ≥40 years old and using a compatible smartphone, will be invited to take part in a 7-week protocol. Following 1 week of baseline measurements, participants will be randomised into one of three groups: group 1- glucose feedback followed by biobehavioural feedback (glucose plus PA); group 2-PA feedback followed by biobehavioural feedback; group 3-biobehavioural feedback. A PA monitor and a flash glucose monitor will be deployed during the intervention. Participants will wear both devices throughout the intervention but blinded to feedback depending on group allocation. The primary outcome is the level of participant engagement and will be assessed by device use and smartphone usage. Feasibility will be assessed by the practicality of the technology and screening for diabetes risk. Semistructured interviews will be conducted to explore participant experiences using the technologies. ISRCTN17545949. Registered on 15/05/2017. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis.

    Science.gov (United States)

    Tucker, Katherine L; Sheppard, James P; Stevens, Richard; Bosworth, Hayden B; Bove, Alfred; Bray, Emma P; Earle, Kenneth; George, Johnson; Godwin, Marshall; Green, Beverly B; Hebert, Paul; Hobbs, F D Richard; Kantola, Ilkka; Kerry, Sally M; Leiva, Alfonso; Magid, David J; Mant, Jonathan; Margolis, Karen L; McKinstry, Brian; McLaughlin, Mary Ann; Omboni, Stefano; Ogedegbe, Olugbenga; Parati, Gianfranco; Qamar, Nashat; Tabaei, Bahman P; Varis, Juha; Verberk, Willem J; Wakefield, Bonnie J; McManus, Richard J

    2017-09-01

    Self-monitoring of blood pressure (BP) appears to reduce BP in hypertension but important questions remain regarding effective implementation and which groups may benefit most. This individual patient data (IPD) meta-analysis was performed to better understand the effectiveness of BP self-monitoring to lower BP and control hypertension. Medline, Embase, and the Cochrane Library were searched for randomised trials comparing self-monitoring to no self-monitoring in hypertensive patients (June 2016). Two reviewers independently assessed articles for eligibility and the authors of eligible trials were approached requesting IPD. Of 2,846 articles in the initial search, 36 were eligible. IPD were provided from 25 trials, including 1 unpublished study. Data for the primary outcomes-change in mean clinic or ambulatory BP and proportion controlled below target at 12 months-were available from 15/19 possible studies (7,138/8,292 [86%] of randomised participants). Overall, self-monitoring was associated with reduced clinic systolic blood pressure (sBP) compared to usual care at 12 months (-3.2 mmHg, [95% CI -4.9, -1.6 mmHg]). However, this effect was strongly influenced by the intensity of co-intervention ranging from no effect with self-monitoring alone (-1.0 mmHg [-3.3, 1.2]), to a 6.1 mmHg (-9.0, -3.2) reduction when monitoring was combined with intensive support. Self-monitoring was most effective in those with fewer antihypertensive medications and higher baseline sBP up to 170 mmHg. No differences in efficacy were seen by sex or by most comorbidities. Ambulatory BP data at 12 months were available from 4 trials (1,478 patients), which assessed self-monitoring with little or no co-intervention. There was no association between self-monitoring and either lower clinic or ambulatory sBP in this group (clinic -0.2 mmHg [-2.2, 1.8]; ambulatory 1.1 mmHg [-0.3, 2.5]). Results for diastolic blood pressure (dBP) were similar. The main limitation of this work was that significant

  8. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Diagnosing Diabetes and Learning About Prediabetes Type 2 Diabetes Risk Test Lower Your Risk Healthy Eating Overweight Smoking High Blood Pressure Physical Activity High Blood ...

  9. Understanding Challenges and Opportunities of Preventive Blood Pressure Self-Monitoring at Home

    DEFF Research Database (Denmark)

    Grönvall, Erik; Verdezoto, Nervo

    2013-01-01

    methods to understand existing challenges and uncover opportunities of self-monitoring technologies to support preventive healthcare activities among older adults. Emerging challenges from our study were: rule complexity for self-measuring, reliability of measurements, interpretation, understanding...... to support people’s preventive self-monitoring needs compared with existing solutions. Furthermore, supporting the active and informed citizen can improve older adult’s care abilities, awareness and activation towards preventive care....

  10. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... little insulin or when the body can't use insulin properly. What Causes Hyperglycemia? A number of ... enough insulin. Without insulin, your body can't use glucose for fuel, so your body breaks down ...

  11. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Doctors, Nurses & More Oral Health & Hygiene Women A1C Insulin Pregnancy 8 Tips for Caregivers Health Insurance Health ... glucose happens when the body has too little insulin or when the body can't use insulin ...

  12. Hyperglycemia (High Blood Glucose)

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  13. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Diabetes Risk Test Lower Your Risk Healthy Eating Overweight Smoking High Blood Pressure Physical Activity High Blood ... For Parents & Kids Safe at School Everyday Life Children and Type 2 Diabetes Know Your Rights Employment ...

  14. Blood glucose in acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj

    2009-01-01

    Blood glucose is often elevated in acute stroke, and higher admission glucose levels are associated with larger lesions, greater mortality and poorer functional outcome. In patients treated with thrombolysis, hyperglycemia is associated with an increased risk of hemorrhagic transformation...... of infarcts. For a number of years, tight glycemic control has been regarded as beneficial in critically illness, but recent research has been unable to support this notion. The only completed randomized study on glucose-lowering therapy in stroke has failed to demonstrate effect, and concerns relating...... to the risk of inducing potentially harmful hypoglycemia has been raised. Still, basic and observational research is overwhelmingly in support of a causal relationship between blood glucose and stroke outcome and further research on glucose-lowering therapy in acute stroke is highly warranted....

  15. All about Blood Glucose

    Science.gov (United States)

    ... may need a change in your meal plan,physical activity,or diabetes medicines.Keep track of when you’ve had ... glucose events.Note possible causes,such as unplanned physical activity.Then talk it over with your ... Diabetes Association    1–800–DIABETES (342–2383)    www. diabetes. ...

  16. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... glucose) Dawn Phenomenon Checking for Ketones Tight Diabetes Control donate en -- A Future Without Diabetes - a-future- ... to the Association. Shopdiabetes.org: Your Stress-Free System for Family Dinners! - 2017-03-book-oclock-scramble. ...

  17. Severe hypoglycemia, impaired awareness of hypoglycemia, and self-monitoring in adults with type 1 diabetes

    DEFF Research Database (Denmark)

    Hendrieckx, Crystal; Jenkins, A; Hagger, Virginia

    2017-01-01

    AIMS: To assess prevalence of severe hypoglycemia, awareness and symptoms of hypoglycemia, and their associations with self-monitoring of blood glucose. METHODS: Diabetes MILES-Australia Study participants completed validated questionnaires and study-specific items. RESULTS: Of 642 adults with type...... autonomic symptoms, perceived at relatively low glucose levels. Frequent self-monitoring of blood glucose prompted early recognition and treatment of hypoglycemia, suggesting severe hypoglycemia risk can be minimized....

  18. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... 2 Diabetes Risk Test Lower Your Risk Healthy Eating Overweight Smoking High Blood Pressure Physical Activity High ... What Can I Drink? Fruit Dairy Food Tips Eating Out Quick Meal Ideas Snacks Nutrient Content Claims ...

  19. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... seconds someone new is diagnosed. Diabetes causes more deaths a year than breast cancer and AIDS combined. ... blood, which can lead to ketoacidosis. Ketoacidosis is life-threatening and needs immediate treatment. Symptoms include: Shortness ...

  20. Blood Glucose Monitoring Devices

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    ... follow the instructions for operating your meter. your hematocrit (the amount of red blood cells in the ... health care provider can tell you if your hematocrit is low or high, and can discuss with ...

  1. Effect of Self-monitoring and Medication Self-titration on Systolic Blood Pressure in Hypertensive Patients at High Risk of Cardiovascular Disease

    OpenAIRE

    McManus, Richard J.; Mant, Jonathan; Haque, M. Sayeed; Bray, Emma P.; Bryan, Stirling; Greenfield, Sheila M.; Jones, Miren I.; Jowett, Sue; Little, Paul; Penaloza, Cristina; Schwartz, Claire; Shackleford, Helen; Shovelton, Claire; Varghese, Jinu; Williams, Bryan

    2014-01-01

    IMPORTANCE: Self-monitoring of blood pressure with self-titration of antihypertensives (self-management) results in lower blood pressure in patients with hypertension, but there are no data about patients in high-risk groups.\\ud \\ud OBJECTIVE: To determine the effect of self-monitoring with self-titration of antihypertensive medication compared with usual care on systolic blood pressure among patients with cardiovascular disease, diabetes, or chronic kidney disease.\\ud \\ud DESIGN, SETTING, AN...

  2. Effects of self-monitoring of glucose on distress and self-efficacy in people with non-insulin-treated Type 2 diabetes: a randomized controlled trial.

    Science.gov (United States)

    Malanda, U L; Bot, S D M; Kostense, P J; Snoek, F J; Dekker, J M; Nijpels, G

    2016-04-01

    To investigate the effects of self-monitoring of glucose in blood or urine, on diabetes-specific distress and self-efficacy, compared with usual care in people with non-insulin-treated Type 2 diabetes mellitus. One hundred and eighty-one participants with non-insulin-treated Type 2 diabetes mellitus [diabetes duration ≥ 1 year, age 45-75 years, HbA1c ≥ 53.0 mmol/mol (7.0%), self-monitoring frequency self-monitoring (n = 60), urine self-monitoring (n = 59) or usual care (n = 62). Primary outcomes were between-group differences in diabetes-specific distress [Problem Areas in Diabetes scale (PAID)] and self-efficacy [Confidence in Diabetes Self-Care questionnaire (CIDS-2)] after 12 months. Secondary outcomes included changes in HbA1c , treatment satisfaction and depressive symptoms. There were no statistically significant between-group differences in changes in PAID and CIDS-2 after 12 months. Mean difference in PAID between blood monitoring and control was -2.2 [95% confidence interval (CI) -7.1 to 2.7], between urine monitoring and control was -0.9 (95% CI -4.4 to 2.5) and between blood monitoring and urine monitoring was -2.0 (95% CI -4.1 to 0.1). Mean difference in CIDS-2 between blood monitoring and control was 0.6 [95% CI (-2.0 to 2.1), between urine monitoring and control was 2.8 (95% CI -2.3 to 7.9)] and between blood monitoring and urine monitoring was -3.3 (95% CI -7.9 to 1.3). No statistically significant between-group differences in change in any of the secondary outcome measures were found. This study did not find statistical or clinical evidence for a long-term effect of self-monitoring of glucose in blood or urine on diabetes-specific distress and self-efficacy in people with moderately controlled non-insulin-treated Type 2 diabetes mellitus. (Current Controlled Trials ISRCTN84568563). © 2015 Diabetes UK.

  3. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Type 2 Diabetes Risk Test Lower Your Risk Healthy Eating Overweight Smoking High Blood Pressure Physical Activity High ... Holiday Meal Planning What Can I Eat? Making Healthy Food Choices Diabetes ... Tips Eating Out Quick Meal Ideas Snacks Nutrient Content Claims ...

  4. Self-monitoring blood pressure in patients with hypertension: an internet-based survey of UK GPs.

    Science.gov (United States)

    Fletcher, Benjamin R; Hinton, Lisa; Bray, Emma P; Hayen, Andrew; Hobbs, Fd Richard; Mant, Jonathan; Potter, John F; McManus, Richard J

    2016-11-01

    Previous research suggests that most GPs in the UK use self-monitoring of blood pressure (SMBP) to monitor the control of hypertension rather than for diagnosis. This study sought to assess current practice in the use of self-monitoring and any changes in practice following more recent guideline recommendations. To survey the views and practice of UK GPs in 2015 with regard to SMBP and compare them with a previous survey carried out in 2011. Web-based survey of a regionally representative sample of 300 UK GPs. GPs completed an online questionnaire concerning the use of SMBP in the management of hypertension. Analyses comprised descriptive statistics, tests for between-group differences (z, Wilcoxon signed-rank, and χ 2 tests), and multivariate logistic regression. Results were available for 300 GPs (94% of those who started the survey). GPs reported using self-monitoring to diagnose hypertension (169/291; 58%; 95% confidence interval (CI) = 52 to 64) and to monitor control (245/291; 84%; 95% CI = 80 to 88), the former having significantly increased since 2011 (from 37%; 95% CI = 33 to 41; Pmonitoring for control. More than half of GPs used higher systolic thresholds for diagnosis (118/169; 70%; 95% CI = 63 to 77) and treatment (168/225; 75%; 95% CI = 69 to 80) than recommended in guidelines, and under half (120/289; 42%; 95% CI = 36 to 47) adjusted the SMBP results to guide treatment decisions. Since new UK national guidance in 2011, GPs are more likely to use SMBP to diagnose hypertension. However, significant proportions of GPs continue to use non-standard diagnostic and monitoring thresholds. The use of out-of-office methods to improve the accuracy of diagnosis is unlikely to be beneficial if suboptimal thresholds are used. © British Journal of General Practice 2016.

  5. Frequency of blood glucose monitoring in relation to glycaemic control: observational study with diabetes database

    Science.gov (United States)

    Evans, Josie M M; Newton, Ray W; Ruta, Danny A; MacDonald, Thomas M; Stevenson, Richard J; Morris, Andrew D

    1999-01-01

    Objectives To investigate patterns of self monitoring of blood glucose concentration in diabetic patients who use insulin and to determine whether frequency of self monitoring is related to glycaemic control. Setting Diabetes database, Tayside, Scotland. Subjects Patients resident in Tayside in 1993-5 who were using insulin and were registered on the database and diagnosed with insulin dependent (type 1) or non-insulin dependent (type 2) diabetes before 1993. Main outcome measures Number of glucose monitoring reagent strips dispensed (reagent strip uptake) derived from records of prescriptions. First recorded haemoglobin A1c concentration in the study period, and reagent strips dispensed in the previous 6 months. Results Among 807 patients with type 1 diabetes, 128 (16%) did not redeem any prescriptions for glucose monitoring reagent strips in the 3 year study period. Only 161 (20%) redeemed prescriptions for enough reagent strips to test glucose daily. The corresponding figures for the 790 patients with type 2 diabetes who used insulin were 162 (21%; no strips) and 131 (17%; daily tests). Reagent strip uptake was influenced both by age and by deprivation category. There was a direct relation between uptake and glycaemic control for 258 patients (with recorded haemoglobin A1c concentrations) with type 1 diabetes. In a linear regression model the decrease in haemoglobin A1c concentration for every extra 180 reagent strips dispensed was 0.7%. For the 290 patients with type 2 diabetes who used insulin there was no such relation. Conclusions Self monitoring of blood glucose concentration is associated with improved glycaemic control in patients with type 1 diabetes. Regular self monitoring in patients with type 1 and type 2 diabetes is uncommon. Key messagesSeveral studies have indicated the importance of self monitoring of blood glucose concentration for prevention of complications in patients with diabetesUptake of reagent strips for self monitoring of blood glucose

  6. Hematocrit Compensation in Electrochemical Blood Glucose Monitoring Systems

    Science.gov (United States)

    Teodorczyk, Maria; Cardosi, Marco; Setford, Steven

    2012-01-01

    Background Hematocrit (Hct) is a common interferent in test strips used by diabetes patients to self-monitor blood glucose (BG), resulting in measurement bias. Described is an electrochemical BG monitoring system (OneTouch® Verio™) that uses a cofacial sensor design, soluble enzyme chemistry, and multiphasic waveform to effectively correct for patient Hct, delivering an accurate reading for whole BG. Methods The test strip comprises thin-film gold and palladium electrodes arranged cofacially and spatially separated with a thin spacer. Soluble glucose-sensing reagents are located on the lower palladium electrode and are hydrated on sample application. Blood glucose is oxidized by flavoprotein glucose dehydrogenase, with electron transfer via (reduced) potassium ferrocyanide mediator at the palladium electrode. Hematocrit levels are estimated by measuring oxidation of mediator diffusion to the upper gold electrode during the first portion of the assay. The Hct-corrected glucose levels are determined by an on-meter algorithm. Results In performance testing of blood samples at five glucose levels (30–560 mg/dl) and five Hct levels (19–61%), using 12 test meters and 3 test strip lots, 100% of results (N = 2700) met International Organization for Standardization accuracy criteria (within ± 15 mg/dl and ± 20% of reference results at glucose levels of <75 and ≥75 mg/dl, respectively). Furthermore, 99.9% (2698 of 2700) of results were within ±12 mg/dl and ± 15% of reference values at glucose levels <80 and ≥80 mg/dl, respectively. Conclusions The technology used in this system provides accurate BG measurements that are insensitive to Hct levels across the range 20–60%. PMID:22768896

  7. Assessment of Knowledge of Self Blood Glucose Monitoring and Extent of Self Titration of Anti-Diabetic Drugs among Diabetes Mellitus Patients - A Cross Sectional, Community Based Study.

    Science.gov (United States)

    Krishnan, V; Thirunavukkarasu, J

    2016-03-01

    Self blood glucose monitoring is an important context of self care in the management of diabetes mellitus. All the guidelines must be followed while performing self blood glucose monitoring and tracking of values is essential to facilitate the physician while titrating the drugs and /or doses of anti diabetes medication. Self titration by patients following self monitoring must be discouraged. To assess the knowledge and practice of self blood glucose monitoring among diabetes patients and extent of self titration of anti diabetes medicines among diabetes patients based on self blood glucose monitoring. This pilot, cross-sectional, observational study was conducted using a validated questionnaire among adult male and female diabetes patients performing self blood glucose monitoring at home. Diabetes patients with complications and juvenile diabetes patients were excluded. Out of 153 patients surveyed, only 37 (24.1%) (20 males, 17 females) patients were aware and have been following self blood glucose monitoring appropriately. About 116 (75.8%) (64 males, 52 females) of patients were devoid of adequate knowledge and did not practice self blood glucose monitoring in a proper way. Ninety eight (64.05%) accepted that they self titrate their anti diabetic medicines based on self monitoring. Self monitoring of blood glucose should be encouraged and patients should be taught importance of following correct steps and tracking of self monitoring by physician or diabetes educator.

  8. Why control blood glucose levels?

    Science.gov (United States)

    Rossini, A A

    1976-03-01

    The controversy as to the relationship between the degree of control of diabetes and the progression of the complications of the disease has not been solved. However, in this review, various studies suggesting a relationship between the metabolic abnormality and the diabetic complications are examined. The disadvantages of the uncontrolled diabetes mellitus can be divided into two major categories-short-term and long-term. The short-term disadvantages of controlled diabetes mellitus include the following: (1) ketoacidosis and hyperosmolar coma; (2) intracellular dehydration; (3) electrolyte imbalance; (4) decreased phagocytosis; (5) immunologic and lymphocyte activity; (6) impairment of wound healing; and (7) abnormality of lipids. The long-term disadvantages of uncontrolled diabetes melitus include the following: (1) nephropathy; (2) neuropathy; (3) retinopathy; (4) cataract formation; (5) effect on perinatal mortality; (6) complications of vascular disease; and (7) the evaluation of various clinical studies suggesting the relationship of elevated blood glucose levels and complications of diabetes mellitus. It is suggested that until the question of control can absolutely be resolved, the recommendation is that the blood glucose levels should be controlled as close to the normal as possible.

  9. Validation of the Oregon Scientific BPU 330 for self-monitoring of blood pressure according to the International Protocol

    Directory of Open Access Journals (Sweden)

    Li Li

    2008-10-01

    readings fell within the zones of 5, 10, and 15 mmHg, respectively. In phase 2.2, the last phase, 28 participants fell within the zone of two of the three comparisons, lying within 5 mmHg for SBP and 29 participants for DBP. No participants fell within the zone of all three of their comparisons over 5 mmHg apart for both SBP and DBP.Conclusion: The BPU 330 can be recommended for self-monitoring of blood pressure in the adult population, according to the International Protocol.Keywords: blood pressure, self-monitoring, hypertension, International Protocol

  10. Ex vivo changes in blood glucose levels seldom change blood glucose control algorithm recommendations

    NARCIS (Netherlands)

    de Groene, L.; Harmsen, R. E.; Binnekade, J. M.; Spronk, P. E.; Schultz, M. J.

    2010-01-01

    Background. Hyperglycemia and glycemic variabilities are associated with adverse outcomes in critically ill patients. Blood glucose control with insulin mandates an adequate and precise assessment of blood glucose levels. Blood glucose levels, however, can change ex vivo after sampling. The aim of

  11. Prediction Methods for Blood Glucose Concentration

    DEFF Research Database (Denmark)

    , but the insulin amount is chosen using factors that account for this expectation. The increasing availability of more accurate continuous blood glucose measurement (CGM) systems is attracting much interest to the possibilities of explicit prediction of future BG values. Against this background, in 2014 a two...... by the authors at the workshop but were written afterward which allowed to include the findings and conclusions of the various discussions and of course updates. The chapter "Alternative Frameworks for Personalized Insulin-Glucose Models" by Harald Kirchsteiger et al. asks the question whether more and more...... that focus not on the prediction of exact future blood glucose values, but rather on the prediction of changes in the patients’ blood glucose range. The chapter “Accuracy of BG Meters and CGM Systems: Possible Influence Factors for the Glucose Prediction Based on Tissue Glucose Concentrations” by Guido...

  12. A comprehensive evaluation of strip performance in multiple blood glucose monitoring systems.

    Science.gov (United States)

    Katz, Laurence B; Macleod, Kirsty; Grady, Mike; Cameron, Hilary; Pfützner, Andreas; Setford, Steven

    2015-05-01

    Accurate self-monitoring of blood glucose is a key component of effective self-management of glycemic control. Accurate self-monitoring of blood glucose results are required for optimal insulin dosing and detection of hypoglycemia. However, blood glucose monitoring systems may be susceptible to error from test strip, user, environmental and pharmacological factors. This report evaluated 5 blood glucose monitoring systems that each use Verio glucose test strips for precision, effect of hematocrit and interferences in laboratory testing, and lay user and system accuracy in clinical testing according to the guidelines in ISO15197:2013(E). Performance of OneTouch(®) VerioVue™ met or exceeded standards described in ISO15197:2013 for precision, hematocrit performance and interference testing in a laboratory setting. Performance of OneTouch(®) Verio IQ™, OneTouch(®) Verio Pro™, OneTouch(®) Verio™, OneTouch(®) VerioVue™ and Omni Pod each met or exceeded accuracy standards for user performance and system accuracy in a clinical setting set forth in ISO15197:2013(E).

  13. Blood glucose response to pea fiber

    DEFF Research Database (Denmark)

    Hamberg, O; Rumessen, J J; Gudmand-Høyer, E

    1989-01-01

    Two new fiber types, pea fiber (PF) and sugar beet fiber (BF), were compared with wheat bran (WB) to investigate the effect on postprandial blood glucose and serum insulin responses in normal subjects. The control meal consisted of 150 g ground beef mixed with 50 g glucose and 20 g lactulose. Only...... addition of PF (15 g pure fiber) reduced the area under the incremental blood glucose curve significantly (by 65%, p less than 0.05). None of the fibers affected the area under the insulin-response curve significantly although it was reduced by all fibers. Mouth-to-cecum transit time, assessed...

  14. Prediction Methods for Blood Glucose Concentration

    DEFF Research Database (Denmark)

    , but the insulin amount is chosen using factors that account for this expectation. The increasing availability of more accurate continuous blood glucose measurement (CGM) systems is attracting much interest to the possibilities of explicit prediction of future BG values. Against this background, in 2014 a two......-day workshop on the design, use and evaluation of prediction methods for blood glucose concentration was held at the Johannes Kepler University Linz, Austria. One intention of the workshop was to bring together experts working in various fields on the same topic, in order to shed light from different angles...... Freckmann et al. discusses performance metrics used to characterize the accuracy of continuous glucose measurement devices. This topic is highly relevant for prediction models since many of them rely on the data given by the continuous sensors which are previously calibrated with blood glucose meter...

  15. Diabetes Care in Community Pharmacy - Focus on Self-monitoring of Blood Glucose

    OpenAIRE

    Kjome, Reidun Lisbet Skeide

    2010-01-01

    Diabetes is a growing concern worldwide. Ideal management of the disease requires extensive self-care and broad follow-up by health care professionals. Considerable research has been done on involving the pharmacist in the healthcare of patients with diabetes, arguing that community pharmacists’ high availability to patients and specialized medication-focused education makes them a valuable asset to the diabetes team. This thesis consists of four papers. The work for these pape...

  16. Effects of self-monitoring of blood glucose on diabetes control in a ...

    African Journals Online (AJOL)

    Journal of Endocrinology, Metabolism and Diabetes of South Africa ... The number of patients achieving target glycaemic control increased substantially while the number of patients achieving target total cholesterol and ... Mean HDL cholesterol increased significantly between baseline and 12 months (1.20 ± 0.42 vs.

  17. Effects of self-monitoring of blood glucose on diabetes control in a ...

    African Journals Online (AJOL)

    The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more information about how to print, save, and work with PDFs, Highwire Press provides a helpful Frequently Asked Questions about PDFs.

  18. A Fixed Ratio Combination of Insulin Degludec and Liraglutide (IDegLira) Reduces Glycemic Fluctuation and Brings More Patients with Type 2 Diabetes Within Blood Glucose Target Ranges

    DEFF Research Database (Denmark)

    King, Allen B; Philis-Tsimikas, Athena; Kilpatrick, Eric S

    2017-01-01

    Lira) compared to insulin degludec (IDeg) and liraglutide alone. METHODS: We analyzed nine-point self-monitored blood glucose (SMBG) profiles from two randomized trials involving IDegLira in patients with type 2 diabetes (T2D), and continuous glucose monitoring (CGM) data from a subset of patients in one......BACKGROUND: Reducing glycemic fluctuation is important for optimal diabetes management. This post hoc analysis examined glycemic fluctuations and the proportion of subjects achieving recommended blood glucose targets with the fixed ratio combination of insulin degludec and liraglutide (IDeg...... liraglutide (P blood glucose within target ranges throughout the day than either IDeg or liraglutide alone....

  19. Prediction Methods for Blood Glucose Concentration

    DEFF Research Database (Denmark)

    “Recent Results on Glucose–Insulin Predictions by Means of a State Observer for Time-Delay Systems” by Pasquale Palumbo et al. introduces a prediction model which in real time predicts the insulin concentration in blood which in turn is used in a control system. The method is tested in simulation......Standard diabetes insulin therapy for type 1 diabetes and late stages of type 2 is based on the expected development of blood glucose (BG) both as a consequence of the metabolic glucose consumption as well as of meals and exogenous insulin intake. Traditionally, this is not done explicitly......, but the insulin amount is chosen using factors that account for this expectation. The increasing availability of more accurate continuous blood glucose measurement (CGM) systems is attracting much interest to the possibilities of explicit prediction of future BG values. Against this background, in 2014 a two...

  20. SPCE based glucose sensor employing novel thermostable glucose dehydrogenase, FADGDH: blood glucose measurement with 150nL sample in one second.

    Science.gov (United States)

    Yamaoka, Hideaki; Sode, Koji

    2007-01-01

    Self-monitoring of blood glucose (SMBG) is an important component of the modern therapy for diabetes mellitus. Thanks to the current progress in electronics and sensor fabrication technology, both the time and the blood sample volume required for the measurement have decreased drastically. However, devices that work with an even smaller sample volume and a shorter measurement time are in demand. A disposable glucose sensor that works with an ultra-small sample volume was developed employing the novel thermostable glucose-dehydrogenase (FADGDH) complex composed of a catalytic subunit, an electron transfer subunit (cytochrome c), and a small subunit. The electrode is a screen-printed carbon electrode (SPCE), and hexaammineruthenium (III) chloride (Ru complex) is utilized as the electron mediator. A disposable enzyme sensor was constructed by depositing the FADGDH complex and Ru complex onto the SPCE, and the sensor performance was evaluated. Whole-blood glucose can be measured within 1 sec using this enzyme sensor and a 150-nL whole-blood sample, with high precision (>0.99br>) and high reproducibility (CV) within the glucose concentration range of 0-533 mg/dL. The sensor reading was stable for more than 60 days even at 70 degrees C. The simplicity of the construction and the high precision of this FADGDH-based glucose biosensor makes it an alternative to previously reported commercially available glucose sensors. Especially the sample volume of 150 nL and the 1-sec measurement time are the highest specifications in the world for currently available glucose sensors designed for the SMBG.

  1. Blood glucose response to pea fiber

    DEFF Research Database (Denmark)

    Hamberg, O; Rumessen, J J; Gudmand-Høyer, E

    1989-01-01

    Two new fiber types, pea fiber (PF) and sugar beet fiber (BF), were compared with wheat bran (WB) to investigate the effect on postprandial blood glucose and serum insulin responses in normal subjects. The control meal consisted of 150 g ground beef mixed with 50 g glucose and 20 g lactulose. Only...... addition of PF (15 g pure fiber) reduced the area under the incremental blood glucose curve significantly (by 65%, p less than 0.05). None of the fibers affected the area under the insulin-response curve significantly although it was reduced by all fibers. Mouth-to-cecum transit time, assessed...... by the hydrogen breath technique, was decreased by WB and BF, (p less than 0.05) but not by PF. PF is palatable and may prove beneficial as a fiber supplement for diabetics....

  2. fasting blood glucose and glycosylated haemoglobin levels

    African Journals Online (AJOL)

    Prince Acheampong

    Diabetes Study Group 33). Even though the achievement and maintenance of blood glucose concentrations as near normal as possible are major targets of modern diabetic care (UK Prospective Diabetes Study Group, 1988), this increases the frequency of hypoglycaemia (Amiel 1998). Hypoglycaemia, the most common ...

  3. Random blood glucose testing in dental practice

    DEFF Research Database (Denmark)

    Barasch, Andrei; Safford, Monika M; Qvist, Vibeke

    2012-01-01

    The prevalence of diabetes mellitus (DM) has been increasing. Instances of patients' not having received a diagnosis have been reported widely, as have instances of poor control of DM or prediabetes among patient's who have the disease. These facts indicate that blood glucose screening is needed....

  4. Electromagnetic Radiofrequency Radiation Emitted from GSM Mobile Phones Decreases the Accuracy of Home Blood Glucose Monitors

    Science.gov (United States)

    Mortazavi, SMJ; Gholampour, M; Haghani, M; Mortazavi, G; Mortazavi, AR

    2014-01-01

    Mobile phones are two-way radios that emit electromagnetic radiation in microwave range. As the number of mobile phone users has reached 6 billion, the bioeffects of exposure to mobile phone radiation and mobile phone electromagnetic interference with electronic equipment have received more attention, globally. As self-monitoring of blood glucose can be a beneficial part of diabetes control, home blood glucose testing kits are very popular. The main goal of this study was to investigate if radiofrequency radiation emitted from a common GSM mobile phone can alter the accuracy of home blood glucose monitors. Forty five female nondiabetic students aged 17-20 years old participated in this study. For Control-EMF group (30 students), blood glucose concentration for each individual was measured in presence and absence of radiofrequency radiation emitted by a common GSM mobile phone (HTC touch, Diamond 2) while the phone was ringing. For Control- Repeat group (15 students), two repeated measurements were performed for each participant in the absence of electromagnetic fields. The magnitude of the changes between glucose levels in two repeated measurements (|ΔC|) in Control-Repeat group was 1.07 ± 0.88 mg/dl while this magnitude for Control-EMF group was 7.53 ± 4.76 mg/dl (P < 0.001, two-tailed test). To the best of our knowledge, this is the first study to assess the electromagnetic interference in home blood glucose monitors. It can be concluded that electromagnetic interference from mobile phones has an adverse effect on the accuracy of home blood glucose monitors. We suggest that mobile phones should be used at least 50 cm away from home blood glucose monitors. PMID:25505778

  5. Blood glucose monitoring in type 2 diabetes – Nepalese patients’ opinions and experiences

    Science.gov (United States)

    Sapkota, Sujata; Brien, Jo-anne E; Aslani, Parisa

    2017-01-01

    ABSTRACT Background: Blood glucose monitoring forms a vital component of diabetes care. Monitoring conducted at home using glucometers, and in laboratories by professionals, are two common methods of blood glucose monitoring in clinical practice. Objective: To investigate Nepalese patients’ perceptions and practices of blood glucose monitoring in diabetes. Methods: In-depth interviews were conducted with 48 Nepalese participants with type 2 diabetes in Sydney and Kathmandu. The interviews were audio-recorded, transcribed verbatim and thematically analysed. Results: In Australia, most participants perceived home monitoring as useful; and both home and laboratory monitoring were conducted at fairly regular intervals. In Nepal, only a small number conducted home monitoring and the laboratory method formed the primary method of day-to-day monitoring. The laboratory method was preferred due to easy access to laboratories, lack of faith in glucometers and perceptions that home monitoring is costlier. However, overall monitoring was irregular in Nepal. In addition to the healthcare system which enabled cheaper self-monitoring in Australia, Nepalese in Australia also tended to have a better understanding about the purpose of home monitoring. Conclusions: This study has highlighted the disparity in perceptions and practices related to blood glucose monitoring. Understanding the importance of blood glucose monitoring and access to affordable resources are critical facilitators for conducting regular monitoring. Both patient and health-system factors play a key role in ensuring continued diabetes monitoring and management. PMID:28585892

  6. How much do diabetic patients know about self monitoring of their ...

    African Journals Online (AJOL)

    Background: Diabetes mellitus (DM) is a chronic disease and a growing public health problem worldwide. Its management emphasizes patient education and participation. Self-monitoring of blood glucose (SMBG) has been shown to be beneficial in glycaemic controls and to reduce complications of DM. Aim: To critically ...

  7. The effect of an instant hand sanitizer on blood glucose monitoring results.

    Science.gov (United States)

    Mahoney, John J; Ellison, John M; Glaeser, Danielle; Price, David

    2011-11-01

    People with diabetes mellitus are instructed to clean their skin prior to self-monitoring of blood glucose to remove any dirt or food residue that might affect the reading. Alcohol-based hand sanitizers have become popular when soap and water are not available. The aim of this study was to determine whether a hand sanitizer is compatible with glucose meter testing and effective for the removal of exogenous glucose. We enrolled 34 nonfasting subjects [14 male/20 female, mean ages 45 (standard deviation, 9.4)] years, 2 with diagnosed diabetes/32 without known diabetes]. Laboratory personnel prepared four separate fingers on one hand of each subject by (1) cleaning the second finger with soap and water and towel drying (i.e., control finger), (2) cleaning the third finger with an alcohol-based hand sanitizer, (3) coating the fourth finger with cola and allowing it to air dry, and (4) coating the fifth finger with cola and then cleaning it with the instant hand sanitizer after the cola had dried. Finger sticks were performed on each prepared finger and blood glucose was measured. Several in vitro studies were also performed to investigate the effectiveness of the hand sanitizer for removal of exogenous glucose.z Mean blood glucose values from fingers cleaned with instant hand sanitizer did not differ significantly from the control finger (p = .07 and .08, respectively) and resulted in 100% accurate results. Blood glucose data from the fourth (cola-coated) finger were substantially higher on average compared with the other finger conditions, but glucose data from the fifth finger (cola-coated then cleaned with hand sanitizer) was similar to the control finger. The data from in vitro experiments showed that the hand sanitizer did not adversely affect glucose meter results, but when an exogenous glucose interference was present, the effectiveness of the hand sanitizer on glucose bias (range: 6% to 212%) depended on the surface area and degree of dilution. In our study

  8. Blood glucose control and monitoring in the critically ill

    NARCIS (Netherlands)

    van Hooijdonk, R.T.M.

    2015-01-01

    This thesis deals with blood glucose control and blood glucose monitoring in intensive care unit (ICU) patients: two important aspects of care for and monitoring of critically ill patients. While the precise targets of blood glucose control in ICU patients remain a matter of debate, currently many,

  9. Cutpoints for screening blood glucose concentrations in healthy senior cats.

    Science.gov (United States)

    Reeve-Johnson, Mia K; Rand, Jacquie S; Vankan, Dianne; Anderson, Stephen T; Marshall, Rhett; Morton, John M

    2017-12-01

    Objectives The objectives of this study were to determine the reference interval for screening blood glucose in senior cats, to apply this to a population of obese senior cats, to compare screening and fasting blood glucose, to assess whether screening blood glucose is predicted by breed, body weight, body condition score (BCS), behaviour score, fasting blood glucose and/or recent carbohydrate intake and to assess its robustness to changes in methodology. Methods The study included a total of 120 clinically healthy client-owned cats aged 8 years and older of varying breeds and BCSs. Blood glucose was measured at the beginning of the consultation from an ear/paw sample using a portable glucose meter calibrated for cats, and again after physical examination from a jugular sample. Fasting blood glucose was measured after overnight hospitalisation and fasting for 18-24 h. Results The reference interval upper limit for screening blood glucose was 189 mg/dl (10.5 mmol/l). Mean screening blood glucose was greater than mean fasting glucose. Breed, body weight, BCS, behaviour score, fasting blood glucose concentration and amount of carbohydrate consumed 2-24 h before sampling collectively explained only a small proportion of the variability in screening blood glucose. Conclusions and relevance Screening blood glucose measurement represents a simple test, and cats with values from 117-189 mg/dl (6.5-10.5 mmol/l) should be retested several hours later. Cats with initial screening blood glucose >189 mg/dl (10.5 mmol/l), or a second screening blood glucose >116 mg/dl (6.4 mmol/l) several hours after the first, should have fasting glucose and glucose tolerance measured after overnight hospitalisation.

  10. Explaining engagement in self-monitoring among participants of the DESMOND Self-monitoring Trial: a qualitative interview study.

    Science.gov (United States)

    Eborall, Helen C; Dallosso, Helen M; McNicol, Sarah; Speight, Jane; Khunti, Kamlesh; Davies, Melanie J; Heller, Simon R

    2015-10-01

    The Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) Self-monitoring Trial reported that people with newly diagnosed type 2 diabetes attending community-based structured education and randomized to self-monitoring of blood glucose (SMBG) or urine monitoring had comparable improvements in biomedical outcomes, but differences in satisfaction with, and continued use of monitoring method, well-being and perceived threat from diabetes. To explore experiences of SMBG and urine monitoring following structured education. We specifically addressed the perceived usefulness of each monitoring method and the associated well-being. Qualitative semi-structured interviews with 18 adults with newly diagnosed type 2 diabetes participating in the DESMOND Self-monitoring Trial (SMBG, N=10; urine monitoring, N=8)~12 months into the trial. Analysis was informed by the constant comparative approach. Interviewees reported SMBG as accurate, convenient and useful. Declining use was explained by having established a pattern of managing blood glucose with less frequent monitoring or lack of feedback or encouragement from health care professionals. Many initially positive views of urine monitoring progressively changed due to perceived inaccuracy, leading some to switch to SMBG. Perceiving diabetes as less serious was attributable to lack of symptoms, treatment with diet alone and-in the urine-monitoring group-consistently negative readings. Urine monitoring also provided less visible evidence of diabetes and of the effect of behaviour on glucose. The findings highlight the importance for professionals of considering patients' preferences when using self-monitoring technologies, including how these change over time, when supporting the self-care behaviours of people with type 2 diabetes. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Body fat content, distribution and blood glucose concentration ...

    African Journals Online (AJOL)

    About 50% of subject who had greater body fat content and waist hip ratio had impaired fasting blood glucose and impaired glucose tolerant. Body fat content within the body has significance effects on blood glucose concentration. Consequently, there is a need of increasing awareness about healthy food consumption ...

  12. Change in blood glucose level in rats after immobilization

    Science.gov (United States)

    Platonov, R. D.; Baskakova, G. M.; Chepurnov, S. A.

    1981-01-01

    Experiments were carried out on male white rats divided into four groups. In group one the blood glucose level was determined immediately after immobilization. In the other three groups, two hours following immobilization, the blood glucose level was determined every 20 minutes for 3 hours 40 minutes by the glucose oxidase method. Preliminary immobilization for 2 hours removed the increase in the blood glucose caused by the stress reaction. By the 2nd hour of immobilization in the presence of continuing stress, the blood glucose level stabilized and varied within 42 + or - 5.5 and 47 + or - 8.1 mg %. Within 2 hours after the immobilization, the differences in the blood glucose level of the rats from the control groups were statistically insignificant.

  13. System Accuracy Evaluation of the GlucoRx Nexus Voice TD-4280 Blood Glucose Monitoring System

    Directory of Open Access Journals (Sweden)

    Muhammad Khan

    2014-01-01

    Full Text Available Use of blood glucose (BG meters in the self-monitoring of blood glucose (SMBG significantly lowers the risk of diabetic complications. With several BG meters now commercially available, the International Organization for Standardization (ISO ensures that each BG meter conforms to a set degree of accuracy. Although adherence to ISO guidelines is a prerequisite for commercialization in Europe, several BG meters claim to meet the ISO guidelines yet fail to do so on internal validation. We conducted a study to determine whether the accuracy of the GlucoRx Nexus TD-4280 meter, utilized by our department for its cost-effectiveness, complied with ISO guidelines. 105 patients requiring laboratory blood glucose analysis were randomly selected and reference measurements were determined by the UniCel DxC 800 clinical system. Overall the BG meter failed to adhere to the ≥95% accuracy criterion required by both the 15197:2003 (overall accuracy 92.4% and 15197:2013 protocol (overall accuracy 86.7%. Inaccurate meters have an inherent risk of over- and/or underestimating the true BG concentration, thereby risking patients to incorrect therapeutic interventions. Our study demonstrates the importance of internally validating the accuracy of BG meters to ensure that its accuracy is accepted by standardized guidelines.

  14. Accuracy of handheld blood glucose meters at high altitude.

    Directory of Open Access Journals (Sweden)

    Pieter de Mol

    Full Text Available BACKGROUND: Due to increasing numbers of people with diabetes taking part in extreme sports (e.g., high-altitude trekking, reliable handheld blood glucose meters (BGMs are necessary. Accurate blood glucose measurement under extreme conditions is paramount for safe recreation at altitude. Prior studies reported bias in blood glucose measurements using different BGMs at high altitude. We hypothesized that glucose-oxidase based BGMs are more influenced by the lower atmospheric oxygen pressure at altitude than glucose dehydrogenase based BGMs. METHODOLOGY/PRINCIPAL FINDINGS: Glucose measurements at simulated altitude of nine BGMs (six glucose dehydrogenase and three glucose oxidase BGMs were compared to glucose measurement on a similar BGM at sea level and to a laboratory glucose reference method. Venous blood samples of four different glucose levels were used. Moreover, two glucose oxidase and two glucose dehydrogenase based BGMs were evaluated at different altitudes on Mount Kilimanjaro. Accuracy criteria were set at a bias 6.5 mmol/L and <1 mmol/L from reference glucose (when <6.5 mmol/L. No significant difference was observed between measurements at simulated altitude and sea level for either glucose oxidase based BGMs or glucose dehydrogenase based BGMs as a group phenomenon. Two GDH based BGMs did not meet set performance criteria. Most BGMs are generally overestimating true glucose concentration at high altitude. CONCLUSION: At simulated high altitude all tested BGMs, including glucose oxidase based BGMs, did not show influence of low atmospheric oxygen pressure. All BGMs, except for two GDH based BGMs, performed within predefined criteria. At true high altitude one GDH based BGM had best precision and accuracy.

  15. Correlation between blood glucose levels and salivary glucose levels with oral ulcer in diabetic patients

    Directory of Open Access Journals (Sweden)

    Fildzah Rahman

    2016-06-01

    Full Text Available Diabetes Mellitus (DM is a syndrome in metabolism of carbohydrates which indicated by the increased level of blood glucose and also may increase salivary glucose levels. Oral ulcer has been frequently recognized in diabetic patients, which can be due to increased glucose in oral fluids and immune dysfunction. This study aimed to determine the correlation of blood glucose levels and salivary glucose levels with oral ulcer in diabetic patients. Analytic observational study was carried out through the determination of blood glucose levels just by way of strip using a glucometer and salivary glucose levels with the method "GOD-PAP test enzymatic colorimetric". Oral ulcer was determined in presenting ulcer on 30 patients with DM. The results showed r = 0.228, which is higher salivary glucose levels followed by high levels of blood glucose, and intraoral examination of oral ulcer found in the whole sample and the most location commonly found in buccal mucosa and lingual. It was concluded that there is a correlation between blood glucose levels and salivary glucose levels, and glucose levels affect the occurrence of oral ulcer in patients with DM

  16. Accuracy of Handheld Blood Glucose Meters at High Altitude

    NARCIS (Netherlands)

    de Mol, Pieter; Krabbe, Hans G.; de Vries, Suzanna T.; Fokkert, Marion J.; Dikkeschei, Bert D.; Rienks, Rienk; Bilo, Karin M.; Bilo, Henk J. G.

    2010-01-01

    Background: Due to increasing numbers of people with diabetes taking part in extreme sports (e. g., high-altitude trekking), reliable handheld blood glucose meters (BGMs) are necessary. Accurate blood glucose measurement under extreme conditions is paramount for safe recreation at altitude. Prior

  17. Blood Glucose Lowering Activities Of Seed Of Persea Americana On ...

    African Journals Online (AJOL)

    The n-hexane, chloroform and methanol extracts of Persea americana seeds obtained by cold maceration were assessed for blood glucose lowering activity using two doses of alloxan. The different extracts caused significant blood glucose lowering effect than the glibenclamide in the single dose alloxanized rats but in the ...

  18. Embodied-self-monitoring

    DEFF Research Database (Denmark)

    Bagalkot, Naveen L.

    This thesis aligns with the field of designing and developing pervasive self-monitoring technology to encourage and support people undergoing physical rehabilitation comply with prescribed therapy at home. The works in this field are driven by an aim of integrating the technology as part of the ‘......This thesis aligns with the field of designing and developing pervasive self-monitoring technology to encourage and support people undergoing physical rehabilitation comply with prescribed therapy at home. The works in this field are driven by an aim of integrating the technology as part...... of the ‘context’ where compliance happens. However, field-based works within the field highlight how compliance is shaped by the particularities of the setting of a home. These works call for considering the way rehabilitees comply with their therapy in the design of pervasive self-monitoring technology....... In response to this call, I take an embodied interaction perspective in the design of pervasive self-monitoring technology. Taking the embodied interaction perspective means considering the context as being emergent and constantly shaped by the rehabilitee’s actions of compliance; it is a context...

  19. Prospective Study of Fasting Blood Glucose and Intracerebral Hemorrhagic Risk.

    Science.gov (United States)

    Jin, Cheng; Li, Guohong; Rexrode, Kathryn M; Gurol, Mahmut E; Yuan, Xiaodong; Hui, Ying; Ruan, Chunyu; Vaidya, Anand; Wang, Yanxiu; Wu, Shouling; Gao, Xiang

    2018-01-01

    Although diabetes mellitus is an established independent risk factor for ischemic stroke, the association between fasting blood glucose and intracerebral hemorrhage (ICH) is limited and inconsistent. The objective of the current study was to examine the potential impact of long-term fasting blood glucose concentration on subsequent risk of ICH. This prospective study included 96 110 participants of the Kailuan study, living in Kailuan community, Tangshan city, China, who were free of cardiovascular diseases and cancer at baseline (2006). Fasting blood glucose concentration was measured in 2006, 2008, 2010, and 2012. Updated cumulative average fasting blood glucose concentration was used as primary exposure of the current study. Incident ICH from 2006 to 2015 was confirmed by review of medical records. During 817 531 person-years of follow-up, we identified 755 incident ICH cases. The nadir risk of ICH was observed at fasting blood glucose concentration of 5.3 mmol/L. The adjusted hazard ratios and their 95% confidence intervals (CIs) of ICH were 1.59 (95% CI, 1.26-2.02) for diabetes mellitus or fasting blood glucose ≥7.00 mmol/L, 1.31 (95% CI, 1.02-1.69) for impaired fasting blood glucose (fasting blood glucose, 6.10-6.99 mmol/L), 0.98 (95% CI, 0.78-1.22) for fasting blood glucose 5.60 to 6.09 mmol/L, and 2.04 (95% CI, 1.23-3.38) for hypoglycemia (fasting blood glucose, fasting blood glucose 4.00 to 5.59 mmol/L. The results persisted after excluding individuals who used hypoglycemic, aspirin, antihypertensive agents, or anticoagulants, and those with intracerebral hemorrhagic cases occurred in the first 2 years of follow-up. In this large community-based cohort, low (fasting blood glucose concentrations were associated with higher risk of incident ICH, relative to fasting blood glucose concentrations of 4.00 to 6.09 mmol/L. © 2017 American Heart Association, Inc.

  20. Fasting Blood Glucose Levels in Different Haemoglobin Genotypes ...

    African Journals Online (AJOL)

    For the different Hb genotypes (HBAA, HBAS, HBSC and HBSS) the following mean fasting blood glucose levels were obtained respectively: 71.9±8.Omg/dl 73.4±7.4mgldl, 94.7±6.Imgldl and 94.6±5.9mgldl. There was a significant difference between the mean fasting blood glucose concentrations of blood groups O,A,B and ...

  1. Use of self-monitoring tools in a clinic sample of adults with type 2 diabetes.

    Science.gov (United States)

    Tanenbaum, Molly L; Bhatt, Harikrashna B; Thomas, Valerie A; Wing, Rena R

    2017-06-01

    Self-monitoring is an effective strategy for chronic disease management; many readily available mobile applications allow tracking of diabetes-related health behaviors but their use has not yet been integrated into routine clinical care. How patients engage with these applications in the real world is not well understood. The specific aim of this study is to survey adults with type 2 diabetes (T2D) regarding self-monitoring behaviors, including mobile application use. In 2015, we surveyed an adult diabetes clinic population (n = 96) regarding self-monitoring behaviors: diet, physical activity, weight, and blood glucose. Self-monitoring with any method ranged from 20-90 %. About half of the participants owned smartphones; few had mobile applications. The most common app-tracked behavior was physical activity, then weight and diet. Despite numerous available mobile health-tracking applications, few T2D adults from our sample used them, though many reported self-monitoring with other methods.

  2. Exponential increase in postprandial blood-glucose exposure with ...

    African Journals Online (AJOL)

    Background. Postprandial glucose excursions contribute significantly to average blood glucose, glycaemic variability and cardiovascular risk. Carbohydrate counting is a method of insulin dosing that balances carbohydrate load to insulin dose using a fixed ratio. Many patients and current insulin pumps calculate insulin ...

  3. Pharmaceutical care in diabetes: quantifying and evaluating community pharmacy’s support to patients performing blood glucose self-monitoring

    NARCIS (Netherlands)

    Storimans, M.J.

    2006-01-01

    The high prevalence and incidence of diabetes mellitus and its complications have led to a serious growth in the demand for diabetes-related health care in the Netherlands. Since self-management by the patient is a cornerstone of the treatment plan, self-management education has become an important

  4. Behavioral Analysis of Chinese Adult Patients with Type 1 Diabetes on Self-monitoring of Blood Glucose

    Directory of Open Access Journals (Sweden)

    Zhao-Yi Qin

    2017-01-01

    Conclusions: Adult patients with type 1 diabetes in our clinic had substantial SMBG information deficits, motivation obstacles, and skill limitations. This information provided potential-focused education targets for diabetes health-care providers.

  5. Corticosterone and exogenous glucose alter blood glucose levels, neurotoxicity, and vascular toxicity produced by methamphetamine.

    Science.gov (United States)

    Bowyer, John F; Tranter, Karen M; Sarkar, Sumit; George, Nysia I; Hanig, Joseph P; Kelly, Kimberly A; Michalovicz, Lindsay T; Miller, Diane B; O'Callaghan, James P

    2017-10-01

    Our previous studies have raised the possibility that altered blood glucose levels may influence and/or be predictive of methamphetamine (METH) neurotoxicity. This study evaluated the effects of exogenous glucose and corticosterone (CORT) pretreatment alone or in combination with METH on blood glucose levels and the neural and vascular toxicity produced. METH exposure consisted of four sequential injections of 5, 7.5, 10, and 10 mg/kg (2 h between injections) D-METH. The three groups given METH in combination with saline, glucose (METH+Glucose), or CORT (METH+CORT) had significantly higher glucose levels compared to the corresponding treatment groups without METH except at 3 h after the last injection. At this last time point, the METH and METH+Glucose groups had lower levels than the non-METH groups, while the METH+CORT group did not. CORT alone or glucose alone did not significantly increase blood glucose. Mortality rates for the METH+CORT (40%) and METH+Glucose (44%) groups were substantially higher than the METH (glucose during METH exposure increases lethality and may exacerbate neurodegeneration. Neuroinflammation, specifically microglial activation, was associated with degenerating neurons in the parietal cortex and thalamus after METH exposure. The activated microglia in the parietal cortex were surrounding vasculature in most cases and the extent of microglial activation was exacerbated by CORT pretreatment. Our findings show that acute CORT exposure and elevated blood glucose levels can exacerbate METH-induced vascular damage, neuroinflammation, neurodegeneration and lethality. Cover Image for this issue: doi. 10.1111/jnc.13819. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  6. Blood-Brain Glucose Transfer in Alzheimer's disease

    DEFF Research Database (Denmark)

    Gejl, Michael; Brock, Birgitte; Egefjord, Lærke

    2017-01-01

    There are fewer than normal glucose transporters at the blood-brain barrier (BBB) in Alzheimer's disease (AD). When reduced expression of transporters aggravates the symptoms of AD, the transporters become a potential target of therapy. The incretin hormone GLP-1 prevents the decline of cerebral...... metabolic rate for glucose (CMRglc) in AD, and GLP-1 may serve to raise transporter numbers. We hypothesized that the GLP-1 analog liraglutide would prevent the decline of CMRglc in AD by raising blood-brain glucose transfer, depending on the duration of disease. We randomized 38 patients with AD...

  7. Self-Monitoring

    DEFF Research Database (Denmark)

    Nielsen, Henriette Langstrup

    2003-01-01

    Initiatives in medical practice that are saidto re-insert the subject, thereby overcomingthe problems of objectifying practices inearlier times, often operate with a notion ofbodies and selves as pre-establishedentities. In this paper, I will try to showsome of the work it takes to produce...... orperform self-monitoring subjects whoparticipate in keeping their asthmaticbodies in control through the use of anonline control center. I argue that the bodiesin control and the competent selves relatedto this technology depend on theestablishment of a chronically ill body andon the decentering...

  8. Self-Monitoring

    DEFF Research Database (Denmark)

    Nielsen, Henriette Langstrup

    2003-01-01

    orperform self-monitoring subjects whoparticipate in keeping their asthmaticbodies in control through the use of anonline control center. I argue that the bodiesin control and the competent selves relatedto this technology depend on theestablishment of a chronically ill body andon the decentering...... dependson blurring other nodes in the network inthe day-to-day use of this technology, thesebeing, the physician, the technology, andthe scientific set-up. As such, I argue thatagency in the form of the self-monitoringcompetent ill, is best understood as asuccessful performance of invisiblepassages...

  9. Patient and health-care professional satisfaction with a new, simple, high accuracy blood glucose meter with color range indicator

    Directory of Open Access Journals (Sweden)

    Laurence B Katz

    2017-01-01

    Full Text Available Background: Accurate self-monitoring of blood glucose (BG is a key component of effective self-management of glycemic control. Methods: The OneTouch Select Plus Simple™ (OTSPS BG monitoring system (BGMS was evaluated for accuracy in a clinical setting. Results: OTSPS was accurate over a wide glucose range and met lay user and system accuracy BG standards described in ISO 15197:2013. Patients also used OTSPS for a 1-week trial period and reported their level of satisfaction with meter features. In a separate study, health-care professionals (HCPs in India naïve to OTSPS experienced OTSPS online using a variety of interactive demonstrations of the BGMS and answered questions about its potential utility to their patients. Summary: Patients and HCPs felt the features of OTSPS, including a color range indicator, could provide significant benefits to them and their patients.

  10. blood glucose level in Bufo gutturalis (power)

    African Journals Online (AJOL)

    a larger study dealing with glucose homeostasis in the toad Bufo gutturalis. Seven groups of seven toads each were acclimatized to laboratory conditions for one month. During this period the toads were fed daily on live insects and were housed in a large laboratory terrarium in which the natural habitat was simulated as ...

  11. Relationship between blood glucose levels and muscle strength in ...

    African Journals Online (AJOL)

    The prevalence of diabetes is increasing worldwide. High blood glucose has been associated with loss of muscle strength and mass in the lower extremities. However, in African children, little is known about the association between handgrip strength, flexed arm hang or other measures of muscle strength with blood ...

  12. Fasting blood glucose and haemoglobin concentrations of healthy ...

    African Journals Online (AJOL)

    Menstruation is associated with loss of blood monthly in women of reproductive age. In some women this physiological phenomenon is also associated with some complaints such as menstrual pain, vomiting, and tiredness. We investigated the fasting blood glucose concentration and hemoglobin concentration before and ...

  13. Measuring Blood Glucose Concentrations in Photometric Glucometers Requiring Very Small Sample Volumes.

    Science.gov (United States)

    Demitri, Nevine; Zoubir, Abdelhak M

    2017-01-01

    Glucometers present an important self-monitoring tool for diabetes patients and, therefore, must exhibit high accuracy as well as good usability features. Based on an invasive photometric measurement principle that drastically reduces the volume of the blood sample needed from the patient, we present a framework that is capable of dealing with small blood samples, while maintaining the required accuracy. The framework consists of two major parts: 1) image segmentation; and 2) convergence detection. Step 1 is based on iterative mode-seeking methods to estimate the intensity value of the region of interest. We present several variations of these methods and give theoretical proofs of their convergence. Our approach is able to deal with changes in the number and position of clusters without any prior knowledge. Furthermore, we propose a method based on sparse approximation to decrease the computational load, while maintaining accuracy. Step 2 is achieved by employing temporal tracking and prediction, herewith decreasing the measurement time, and, thus, improving usability. Our framework is tested on several real datasets with different characteristics. We show that we are able to estimate the underlying glucose concentration from much smaller blood samples than is currently state of the art with sufficient accuracy according to the most recent ISO standards and reduce measurement time significantly compared to state-of-the-art methods.

  14. Comparison of a human portable blood glucose meter, veterinary portable blood glucose meter, and automated chemistry analyzer for measurement of blood glucose concentrations in dogs.

    Science.gov (United States)

    Johnson, Beth M; Fry, Michael M; Flatland, Bente; Kirk, Claudia A

    2009-12-01

    To compare blood glucose concentrations measured with 2 portable blood glucose meters (PBGMs) validated for use in dogs (PBGM-D) and humans (PBGM-H) and an automated chemistry analyzer. Validation study. 92 samples of fresh whole blood and plasma from 83 dogs with various diseases. Each PBGM was used to measure whole blood glucose concentration, and the automated analyzer was used to measure plasma glucose concentration. Passing-Bablok linear regression and Bland-Altman plots were used to determine correlations and bias between the PBGMs and the automated analyzer. Calculated acceptability limits based on combined inherent instrument imprecision were used with Bland-Altman plots to determine agreement. Clinical relevance was assessed via error grid analysis. Although correlation between results of both PBGMs and the standard analyzer was > 0.90, disagreement was greater than could be explained by instrument imprecision alone. Mean difference between PBGM-H and chemistry-analyzer values was -15.8 mg/dL. Mean difference between PBGM-D and chemistry-analyzer values was 2.4 mg/dL. Linear regression analysis revealed proportional bias of PBGM-H (greater disagreement at higher glucose concentrations); no proportional bias was detected for PBGM-D. No constant bias was detected for either PBGM. Error grid analysis revealed all measurements from both PBGMs were within zones without an anticipated effect on clinical outcome. Neither PBGM had exact agreement with the automated analyzer; however, the disagreement detected did not have serious clinical consequences. Our findings stressed the importance of using the same device for monitoring trends in dogs and using instrument-specific reference ranges.

  15. Developing a chair side, safe and non-invasive procedure for assessment of blood glucose level using gingival crevicular bleeding in dental clinics.

    Science.gov (United States)

    Gupta, Amit; Gupta, Nidhi; Garg, Rakesh; Jain, Nitul; Atreja, Gaurav; Walia, Satinder S

    2014-07-01

    To study the accessibility of chair side blood glucose non-invasive screening method for diabetes mellitus during routine periodontal examination. Fifteen non-diabetics and 15 newly onset type 2 diabetics patients with moderate to severe periodontitis were selected after meeting inclusion and exclusion criteria. Periodontal pocket probing was performed using a Williams Graduated periodontal probe. Blood oozing from gingival sulcus of anterior teeth following periodontal pocket probing was collected with stick of a glucose self-monitoring device. As control, finger stick capillary blood was taken. A statistically significant correlation was observed between the blood glucose level of gingival crevicular blood (GCB) and peripheral fasting blood (PFB) of diabetic subjects. The mean GCB glucose level of the subjects in diabetic group was 172.27 ± 5.02 mg/dl while mean PFB glucose was 167.80 ± 8.87 mg/dl. The correlation coefficient of diabetic and non-diabetic subjects were r = +0.715 and r = +0.619, respectively. The results suggested that blood oozing during routine periodontal examination may be used for diabetic mellitus screening in a dental office setting without the need for any extra procedure.

  16. Evaluation of the agreement among three handheld blood glucose meters and a laboratory blood analyzer for measurement of blood glucose concentration in Hispaniolan Amazon parrots (Amazona ventralis).

    Science.gov (United States)

    Acierno, Mark J; Mitchell, Mark A; Schuster, Patricia J; Freeman, Diana; Sanchez-Migallon Guzman, David; Tully, Thomas N

    2009-02-01

    To determine the degree of agreement between 3 commercially available point-of-care blood glucose meters and a laboratory analyzer for measurement of blood glucose concentrations in Hispaniolan Amazon parrots (Amazona ventralis). 20 healthy adult Hispaniolan Amazon parrots. A 26-gauge needle and 3-mL syringe were used to obtain a blood sample (approx 0.5 mL) from a jugular vein of each parrot. Small volumes of blood (0.6 to 1.5 microL) were used to operate each of the blood glucose meters, and the remainder was placed into lithium heparin microtubes and centrifuged. Plasma was harvested and frozen at -30 degrees C. Within 5 days after collection, plasma samples were thawed and plasma glucose concentrations were measured by means of the laboratory analyzer. Agreement between pairs of blood glucose meters and between each blood glucose meter and the laboratory analyzer was evaluated by means of the Bland-Altman method, and limits of agreement (LOA) were calculated. None of the results of the 3 blood glucose meters agreed with results of the laboratory analyzer. Each point-of-care blood glucose meter underestimated the blood glucose concentration, and the degree of negative bias was not consistent (meter A bias, -94.9 mg/dL [LOA, -148.0 to -41.7 mg/dL]; meter B bias, -52 mg/dL [LOA, -107.5 to 3.5 mg/dL]; and meter C bias, -78.9 mg/dL [LOA, -137.2 to -20.6 mg/dL]). On the basis of these results, use of handheld blood glucose meters in the diagnosis or treatment of Hispaniolan Amazon parrots and other psittacines cannot be recommended.

  17. [A blood glucose slide chart for improving diabetes patient education].

    Science.gov (United States)

    Potteau, Marie-Hélène

    2015-03-01

    A blood glucose slide chart has been developed in order to help patients with type 2 diabetes who do not speak French or who have comprehension difficulties. Combined with pictograms to help patients visualise the action they need to take depending on the recorded glucose level, it constitutes a therapeutic education tool which can be useful on a day-to-day basis both for patients as well as caregivers.

  18. Repeated Plyometric Exercise Attenuates Blood Glucose in Healthy Adults.

    Science.gov (United States)

    Barillas, Saldiam R; Watkins, Casey M; Wong, Megan A; Dobbs, Ian J; Archer, David C; Munger, Cameron N; Galpin, Andrew J; Coburn, Jared W; Brown, Lee E

    2017-01-01

    Plyometric exercise is popular in commercial exercise programs aiming to maximize energy expenditure for weight loss. However, the effect of plyometric exercise on blood glucose is unknown. The purpose of this study was to investigate the effect of relatively high intensity plyometric exercise on blood glucose. Thirteen subjects (6 females age= 21.8 ± 1.0 yrs.; height= 163.7 ± 7.8 cm; mass= 60.8 ± 6.7 kg and 7 males age= 22.0 ± 2.6 yrs.; height= 182.3 ± 3.6 cm; mass= 87.4 ± 12.5 kg) volunteered to participate. Subjects completed two random conditions on two separate days, consisting of either five sets of 10 maximal effort countermovement squat jumps (SJ) with 50 seconds' rest between sets or quiet sitting (SIT) for the time equated to the SJ duration (~4min). Immediately after each condition, subjects drank 75g of anhydrous glucose (CHO) in 100ml of water. Blood glucose measurements were taken via finger prick pre and immediately post SJ or SIT, and 5, 15, 30, and 60 min post. A 2×6 (condition × time) ANOVA revealed a significant interaction where SJ blood glucose was lower at 15 (114.0 ± 14.6 mg/dl) and 30 (142.1 ± 22.5 mg/dl) min compared to SIT (15min 130.8 ± 14.0 mg/dl and 30min 159.3 ± 21.0 mg/dl). The current plyometric protocol attenuated CHO-induced blood glucose at 15 and 30 min. This may be due to increased physiological stress applied to the muscles, thus increasing muscular glucose uptake.

  19. Inhaled insulin for controlling blood glucose in patients with diabetes

    Directory of Open Access Journals (Sweden)

    Bernard L Silverman

    2008-01-01

    Full Text Available Bernard L Silverman1, Christopher J Barnes2, Barbara N Campaigne3, Douglas B Muchmore31Alkermes, Inc, Cambridge, MA, USA; 2i3 Statprobe, Ann Arbor, MI; 3Eli Lilly and Company, Indianapolis, IN, USAAbstract: Diabetes mellitus is a significant worldwide health problem, with the incidence of type 2 diabetes increasing at alarming rates. Insulin resistance and dysregulated blood glucose control are established risk factors for microvascular complications and cardiovascular disease. Despite the recognition of diabetes as a major health issue and the availability of a growing number of medications designed to counteract its detrimental effects, real and perceived barriers remain that prevent patients from achieving optimal blood glucose control. The development and utilization of inhaled insulin as a novel insulin delivery system may positively influence patient treatment adherence and optimal glycemic control, potentially leading to a reduction in cardiovascular complications in patients with diabetes.Keywords: diabetes, inhaled insulin, cardiovascular disease, blood glucose

  20. Evaluation of the effects of insufficient blood volume samples on the performance of blood glucose self-test meters.

    Science.gov (United States)

    Pfützner, Andreas; Schipper, Christina; Ramljak, Sanja; Flacke, Frank; Sieber, Jochen; Forst, Thomas; Musholt, Petra B

    2013-11-01

    incomplete blood filling of glucose meter strips is often associated with inaccurate reading. These findings underline the importance of appropriate patient education on this aspect of blood glucose self-monitoring. © 2013 Diabetes Technology Society.

  1. Effects of MDMA on blood glucose levels and brain glucose metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Soto-Montenegro, M.L.; Vaquero, J.J.; Garcia-Barreno, P.; Desco, M. [Hospital General Universitario Gregorio Maranon, Laboratorio de Imagen, Medicina Experimental, Madrid (Spain); Arango, C. [Hospital General Gregorio Maranon, Departamento de Psiquiatria, Madrid (Spain); Ricaurte, G. [Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD (United States)

    2007-06-15

    This study was designed to assess changes in glucose metabolism in rats administered single or repeated doses of MDMA. Two different experiments were performed: (1) A single-dose study with four groups receiving 20 mg/kg, 40 mg/kg, saline or heat, and (2) a repeated-dose study with two groups receiving three doses, at intervals of 2 h, of 5 mg/kg or saline. Rats were imaged using a dedicated small-animal PET scanner 1 h after single-dose administration or 7 days after repeated doses. Glucose metabolism was measured in 12 cerebral regions of interest. Rectal temperature and blood glucose were monitored. Peak body temperature was reached 1 h after MDMA administration. Blood glucose levels decreased significantly after MDMA administration. In the single-dose experiment, brain glucose metabolism showed hyperactivation in cerebellum and hypo-activation in the hippocampus, amygdala and auditory cortex. In the repeated-dose experiment, brain glucose metabolism did not show any significant change at day 7. These results are the first to indicate that MDMA has the potential to produce significant hypoglycaemia. In addition, they show that MDMA alters glucose metabolism in components of the motor, limbic and somatosensory systems acutely but not on a long-term basis. (orig.)

  2. Glycemic load, exercise, and monitoring blood glucose (GEM): A paradigm shift in the treatment of type 2 diabetes mellitus.

    Science.gov (United States)

    Cox, Daniel J; Taylor, Ann G; Singh, Harsimran; Moncrief, Matthew; Diamond, Anne; Yancy, William S; Hegde, Shefali; McCall, Anthony L

    2016-01-01

    This preliminary RCT investigated whether an integrated lifestyle modification program that focuses on reducing postprandial blood glucose through replacing high with low glycemic load foods and increasing routine physical activities guided by systematic self-monitoring of blood glucose (GEM) could improve metabolic control of adults with type 2 diabetes mellitus, without compromising other physiological parameters. Forty-seven adults (mean age 55.3 years) who were diagnosed with type 2 diabetes mellitus for less than 5 years (mean 2.1 years), had HbA1c ≥ 7% (mean 8.4%) and were not taking blood glucose lowering medications, were randomized to routine care or five 1-h instructional sessions of GEM. Assessments at baseline and 6 months included a physical exam, metabolic and lipid panels, and psychological questionnaires. The GEM intervention led to significant improvements in HbA1c (decreasing from 8.4 to 7.4% [69-57 mmol/mol] compared with 8.3 to 8.3% [68-68 mmol/mol] for routine care; Interaction ptype 2 diabetes mellitus. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Effect of self-monitoring and medication self-titration on systolic blood pressure in hypertensive patients at high risk of cardiovascular disease: the TASMIN-SR randomized clinical trial.

    Science.gov (United States)

    McManus, Richard J; Mant, Jonathan; Haque, M Sayeed; Bray, Emma P; Bryan, Stirling; Greenfield, Sheila M; Jones, Miren I; Jowett, Sue; Little, Paul; Penaloza, Cristina; Schwartz, Claire; Shackleford, Helen; Shovelton, Claire; Varghese, Jinu; Williams, Bryan; Hobbs, F D Richard; Gooding, Trevor; Morrey, Ian; Fisher, Crispin; Buckley, David

    2014-08-27

    Self-monitoring of blood pressure with self-titration of antihypertensives (self-management) results in lower blood pressure in patients with hypertension, but there are no data about patients in high-risk groups. To determine the effect of self-monitoring with self-titration of antihypertensive medication compared with usual care on systolic blood pressure among patients with cardiovascular disease, diabetes, or chronic kidney disease. A primary care, unblinded, randomized clinical trial involving 552 patients who were aged at least 35 years with a history of stroke, coronary heart disease, diabetes, or chronic kidney disease and with baseline blood pressure of at least 130/80 mm Hg being treated at 59 UK primary care practices was conducted between March 2011 and January 2013. Self-monitoring of blood pressure combined with an individualized self-titration algorithm. During the study period, the office visit blood pressure measurement target was 130/80 mm Hg and the home measurement target was 120/75 mm Hg. Control patients received usual care consisting of seeing their health care clinician for routine blood pressure measurement and adjustment of medication if necessary. The primary outcome was the difference in systolic blood pressure between intervention and control groups at the 12-month office visit. Primary outcome data were available from 450 patients (81%). The mean baseline blood pressure was 143.1/80.5 mm Hg in the intervention group and 143.6/79.5 mm Hg in the control group. After 12 months, the mean blood pressure had decreased to 128.2/73.8 mm Hg in the intervention group and to 137.8/76.3 mm Hg in the control group, a difference of 9.2 mm Hg (95% CI, 5.7-12.7) in systolic and 3.4 mm Hg (95% CI, 1.8-5.0) in diastolic blood pressure following correction for baseline blood pressure. Multiple imputation for missing values gave similar results: the mean baseline was 143.5/80.2 mm Hg in the intervention group vs 144.2/79.9 mm Hg in the control group, and

  4. Screening of Glucose-6-Phosphate Dehydrogenase Deficiency in Cord Blood

    Directory of Open Access Journals (Sweden)

    Can Acipayam

    2014-02-01

    Aim: Glucose-6-phosphate dehydrogenase deficiency is an important factor in etiology of pathologic neonatal jaundice. The aim of this study was to indicate the significance of screening glucose-6-phosphate dehydrogenase deficiency in the cord blood of neonates and the frequency of this deficiency in the etiology of neonatal hyperbilirubinemia. Material and Method: The study was performed consecutive 1015 neonates were included. Five hundred fifty six (54.8% of them were male and 459 (45.2% were female. The following parameters were recorded: Gender, birth weight, birth height, head circumference and gestational age. The glucose-6-phosphate dehydrogenase level of neonates were measured with quantitative method in cord blood. Also, hemoglobine, hematocrite, red blood cell count and blood group were measured. The following parameters were recorded in cases with jaundice: exchange transfusion, phototherapy, physiologic and pathologic jaundice, peak bilirubin day, maximum bilirubin level, total bilirubin level at the first day of jaundice, beginning time of jaundice. Results: Enzyme deficiency was detected in 133 (13.1% of neonates and 76 (57% of them were male, 57 (43% were female. Significant difference was detected in low glucose-6-phosphate dehydrogenase enzyme level with jaundice group for total bilirubin level at the first day of jaundice, maximum total bilirubin level and pathologic jaundice (p<0.05. Discussion: The ratio of glucose-6-phosphate dehydrogenase deficiency was found in Edirne in this study and this ratio was higher than other studies conducted in our country. For this reason, glucose-6-phosphate dehydrogenase enzyme level in cord blood of neonates should be measured routinely and high risk neonates should be followed up for hyperbilirubinemia and parents should be informed in our region.

  5. Umbilical cord blood glucose levels in full-term newborns

    Directory of Open Access Journals (Sweden)

    A. L. Karpova

    2014-01-01

    Full Text Available The purpose of the investigation was to determine the umbilical cord venous blood level of glucose in full-term newborns and its relationship to the mode of delivery. The investigation included 102 full-term newborn infants, including 33 and 69 babies born via cesar-ean and vaginal delivery, respectively. Umbilical cord serum glucose levels were determined by the glucose oxidase test using a Sap-phire-400 biochemical analyzer. In healthy full-term newborns, the mean umbilical cord blood glucose levels were 4,29±0,88 mmol/1 (minimum, 2,9 mmol/1 and maximum, 5,9 mmol/1. In the babies born via cesarean delivery, the umbilical cord blood concentration of glucose was ascertained to be significantly lower than in those born vaginally (3,84+0,71 mmol/1 versus 4,51+0,87 mmol/1; /><0,0001. Abdominal delivery can be apparently considered to be a risk factor for hypoglycemia in neonatal infants.

  6. Effect of Cola acuminate on Blood Glucose and Glycosylated ...

    African Journals Online (AJOL)

    The levels of blood glucose and glycosylated haemoglobin (GHB) were studied in 42 Wistar rats divided into three groups; controls, group A and group B. Control rats consumed only feeds, group A consumed 0.04g of Cola acuminate, while group B consumed 0.08g of Cola acuminate mixed with their feeds daily for six ...

  7. The relationship between serum cortisol, adrenaline, blood glucose ...

    African Journals Online (AJOL)

    Background: Stress is an extremely adaptive phenomenon in human beings and cortisol is a known stress hormone. Examination has been described as a naturalistic stressor capable of affecting human health. Objectives: To estimate the relationship between serum cortisol, adrenaline, fasting blood glucose (FBG) and ...

  8. Comparative effects of some medicinal plants on blood glucose ...

    African Journals Online (AJOL)

    The comparative effects of the chloroform extracts of the leaves of Psidium guajava (Myrtaceae), Anacardium occidentale (Anacardiaceae) and Eucalyptus globulus (Myrtaceae) and fruits of Xylopia aethiopica (Annonaceae) on blood glucose concentration and lipid levels of diabetic rats were investigated using standard ...

  9. Changes in blood glucose and plasma lipids during gestation in ...

    African Journals Online (AJOL)

    Ten female Chinchilla rabbits with mean weight (1.9±0.1kg) were randomly assigned into two groups comprising of five each, to evaluate the changes in blood glucose and lipid profile during pregnancy. Control Group A was mated without prior synchronization, while rabbits in group B were synchronized with 0.15mg/kg ...

  10. Daidzin decreases blood glucose and lipid in streptozotocin ...

    African Journals Online (AJOL)

    Purpose: To investigate the ameliorative effect of daidzin (DZ) on diabetes in streptozotocin (STZ)- induced diabetic Institute of Cancer Research (ICR) mice, with a view to determining its usefulness in the treatment of diabetes. Methods: The effect of DZ (100, 200 and 400 mg/kg) on blood glucose was investigated in both ...

  11. Blood plasma glucose regulation in Wahlberg's epauletted fruit bat ...

    African Journals Online (AJOL)

    Frugivores feed on fruits and nectars that contain different types of sugars in different proportions, which provide these animals with energy. Wahlberg's epauletted fruit bat (Epomophorus wahlbergi) has a high glucose intake irrespective of sugar concentration of nectar. It is not known how these bats regulate their blood ...

  12. Effects of selenium yeast on blood glucose and antioxidant ...

    African Journals Online (AJOL)

    At the end of the study period, the animals were sacrificed and the serum samples were collected and evaluated for estimation of antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx). The results showed a significant (P < 0.05) decrease in blood glucose level in the ...

  13. Haematological Indices, Blood glucose levels and lipid profile of rats ...

    African Journals Online (AJOL)

    This work was done as a part of safety assessment to determine the effects of Tartrazine E102 on some haematological indices, glucose levels and blood lipid profile in rats. An animal model was used as a basis for interpreting the situation in humans. Consequently, 40 albino rats were divided into 5 groups of 8 rats each.

  14. Effects of Watermelon ( Citrullus lanatus ) Seed on Blood Glucose ...

    African Journals Online (AJOL)

    Given the prevalence of diabetes worldwide, with its associated complications, this study is aimed at investigating the effect of citrullus lanatus seed extract on blood glucose concentration and electrolyte parameters. Citrullus lanatus is an antioxidant and has been shown to reduce oxidative stress (Khaki et al., 2013). Effects ...

  15. Adenosine deaminase activities and fasting blood glucose in obesity ...

    African Journals Online (AJOL)

    Background: A complex relationship seems to exist between adenosine deaminase (ADA) and insulin in obesity. Through its effect on adenosine, the enzyme can modulate the action of insulin and affect blood glucose while the administration of insulin is said to decrease the activities of the enzyme. Aim: To investigate the ...

  16. Blood-Brain Glucose Transfer in Alzheimer's disease

    DEFF Research Database (Denmark)

    Gejl, Michael; Brock, Birgitte; Egefjord, Lærke

    2017-01-01

    There are fewer than normal glucose transporters at the blood-brain barrier (BBB) in Alzheimer's disease (AD). When reduced expression of transporters aggravates the symptoms of AD, the transporters become a potential target of therapy. The incretin hormone GLP-1 prevents the decline of cerebral...

  17. Blood glucose response of normoglycemic adults fed breakfast ...

    African Journals Online (AJOL)

    Effect of high fibre leguminous products in breakfast porridges, made from Afzelia Africana (AA), Detarium microcarpum (DM), Sphenostylis stenocarpa (SS) and Zea mays on blood glucose level of humans was investigated in this study. The food items were processed into flour using African (Nigerian) traditional processing ...

  18. Effect of leaf extract of Pseudocedrela kotchyi on blood glucose ...

    African Journals Online (AJOL)

    The effect of leaf extract of Pseudocedrela kotchi (PK) on blood glucose of alloxan induced albino wistar rats was evaluated. Experimental animals received daily oral administration of extract of Pseudocedreala kotchi for 14 days. The effect of 200 mg/kg dose was studied during the treatment period. There was a significant ...

  19. Effect of extract of Abrs Precatorius on blood glucose concentration ...

    African Journals Online (AJOL)

    The effect of leaf extract of Abrus precatorius on blood glucose level of alloxan- induced diabetic albino wistar rats was evaluated. Experimental animals received daily oral administration of extract of Abrus precatorius for 14 days. The effect of 200 mg/kg dose was studied during the treatment period. There was a significant ...

  20. Data Mining Technologies for Blood Glucose and Diabetes Management

    NARCIS (Netherlands)

    Bellazzi, Riccardo; Abu-Hanna, Ameen

    2009-01-01

    Data mining is the process of selecting, exploring, and modeling large amounts of data to discover unknown patterns or relationships useful to the data analyst. This article describes applications of data mining for the analysis of blood glucose and diabetes mellitus data. The diabetes management

  1. Fasting blood glucose and glycosylated haemoglobin levels in ...

    African Journals Online (AJOL)

    This work involved the measurement of fasting blood glucose (FBG) and glycosylated haemoglobin (HbA1c) levels of diabetes mellitus patients as an index of glycaemic control. It was a prospective case-finding study using laboratory and general practice records. The subjects were confirmed diabetic patients, attending a ...

  2. Predictors of Daily Blood Glucose Monitoring in Appalachian Ohio

    Science.gov (United States)

    Raffle, Holly; Ware, Lezlee J.; Ruhil, Anirudh V. S.; Hamel-Lambert, Jane; Denham, Sharon A.

    2012-01-01

    Objective: To determine factors contributing to successful diabetes self-management in Appalachia, as evidenced by daily blood glucose monitoring. Methods: A telephone survey (N = 3841) was conducted to assess health status and health care access. The current investigation is limited to the subset of this sample who report having diabetes (N =…

  3. Variations of blood glucose in cancer patients during chemotherapy ...

    African Journals Online (AJOL)

    Purpose: The aim of this study was to analyze the blood glucose (BG) variations in cancer patients during chemotherapy according to tumor types and chemotherapeutic regimens. Materials and Methods: Patients were examined from the Department of Medical Oncology of Cancer Hospital and Institute, Chinese Academy ...

  4. Impact Of Administration Mulberry Juice On Blood Glucose, Lipid ...

    African Journals Online (AJOL)

    The aim of the present study was designed to study the effects of black and white mulberry juice on blood glucose, lipid profile and oxidative stress in normal and diabetic rats. Sprague Dawley male rats weighing (125 ± 12.2 g) were divided into eight groups (each of 12 rats). Four healthy control group include normal ...

  5. Reliability of bedside blood glucose estimating methods in detecting ...

    African Journals Online (AJOL)

    Background: Hypoglycaemia occurs in many disease states common in the tropics. Facilities and skilled manpower required for laboratory blood glucose measurement are not always available in health facilities in developing countries. Objective: The study was carried out to determine the validity of bedside methods of ...

  6. Blood glucose lowering activity of five Nigerian medicinal plants in ...

    African Journals Online (AJOL)

    The blood glucose lowering effects of the aqueous leaf extracts of Cassia alata, Acalypha torta and Breynia nivosa, and aqueous root extracts of Daniellia oliveri and Nauclea latifolia traditionally employed in Nigeria in the management of diabetes mellitus were compared in alloxan-induced diabetic Wistar rats. The same ...

  7. Participation in blood glucose test, knowledge and prevalence of ...

    African Journals Online (AJOL)

    Background: Diabetes mellitus causes great health complications which include cardiovascular diseases and nerve damage. Aim: To ascertain the participation in blood glucose test, knowledge of diabetes mellitus (DM) and prevalence of hyperglycemia among traders at New market, Enugu State. Methods: The study is a ...

  8. Variations of blood glucose in cancer patients during chemotherapy

    African Journals Online (AJOL)

    2016-05-23

    May 23, 2016 ... Purpose: The aim of this study was to analyze the blood glucose (BG) variations in cancer patients during chemotherapy ... Materials and Methods: Patients were examined from the Department of Medical Oncology of Cancer Hospital and .... 68 (LC, 20.5%), colon cancer 63 (CC, 19.0%), rectal cancer.

  9. Evaluation of portable blood glucose meters using canine and feline pooled blood samples.

    Science.gov (United States)

    Mori, A; Oda, H; Onozawa, E; Shono, S; Takahashi, T; Yamashita, S; Fujimoto, H; Sako, T

    2016-12-01

    This study evaluated the accuracy and reproducibility of a human portable blood glucose meter (PBGM) for canine and feline whole blood. Reference plasma glucose values (RPGV) were concurrently measured using glucose oxidation methods. Fifteen healthy dogs and 6 healthy cats were used for blood sampling. Blood glucose concentrations and hematocrits were adjusted using pooled blood samples for our targeted values. A positive correlation between the PBGM and RPGV was found for both dogs (y = 0.877, x = -24.38, r = 0.9982, n = 73) and cats (y = 1.048, x = -27.06, r = 0.9984, n = 69). Acceptable results were obtained in error grid analysis between PBGM and RPGV in both dogs and cats; 100% of these results were within zones A and B. Following ISO recommendations, a PBGM is considered accurate if 95% of the measurements are within ± 15 mg/dl of the RPGV when the glucose concentration is cats (39%, 27 of 69 cats). Blood samples with high hematocrits induced lower whole blood glucose values measured by the PBGM than RPGV under hypoglycemic, normoglycemic, and hyperglycemic conditions in both dogs and cats. Therefore, this device is not clinically useful in dogs and cats. New PBGMs which automatically compensate for the hematocrit should be developed in veterinary practice.

  10. Empirically establishing blood glucose targets to achieve HbA1c goals.

    Science.gov (United States)

    Wei, Nancy; Zheng, Hui; Nathan, David M

    2014-04-01

    OBJECTIVE To determine the average fasting, postprandial, and bedtime self-monitored blood glucose (SMBG) concentrations associated with specified HbA1c levels using data from the A1c-Derived Average Glucose (ADAG) study. RESEARCH DESIGN AND METHODS The ADAG study was a multicenter observational study that used continuous glucose monitoring and SMBG testing to determine the relationship between mean average glucose and HbA1c. We used the SMBG data from 470 of the ADAG study participants (237 with type 1 diabetes and 147 with type 2 diabetes) to determine the average fasting, premeal, 90-min postmeal, and bedtime blood glucose (BG) for predefined target HbA1c groups between 5.5 and 8.5% (37-69 mmol/mol). t Tests were used to compare mean BG values between type 1 and type 2 diabetes groups. RESULTS The average fasting BG needed to achieve predefined HbA1c target levels of 5.5-6.49% (37-47 mmol/mol), 6.5-6.99% (48-52 mmol/mol), 7.0-7.49% (52-58 mmol/mol), 7.5-7.99% (58-64 mmol/mol), and 8.0-8.5% (64-69 mmol/mol) were 122 mg/dL with 95% CI 117-127, 142 mg/dL (135-150), 152 mg/dL (143-162), 167 mg/dL (157-177), and 178 mg/dL (164-192), respectively. Postmeal BG to achieve the HbA1c level of 6.5-6.99% (48-52 mmol/mol) and 7.0-7.49% (52-58 mmol/mol) were 139 mg/dL (134-144) and 152 mg/dL (147-157), respectively. Bedtime BG was 153 mg/dL (145-161) and 177 mg/dL (166-188), respectively. CONCLUSIONS We have determined the average BG at premeal, postmeal, and bedtime to achieve a variety of HbA1c targets. These results, based on empirical data, will help patients and providers set realistic day-to-day SMBG targets to achieve individualized HbA1c goals.

  11. Postprandial Blood Glucose Outweighs Fasting Blood Glucose and HbA1c in screening Coronary Heart Disease.

    Science.gov (United States)

    Jiang, Jingjing; Zhao, Lin; Lin, Liu; Gui, Minghui; Aleteng, Qiqige; Wu, Bingjie; Wang, Shanshan; Pan, Baishen; Ling, Yan; Gao, Xin

    2017-10-27

    The objective of the present study is to assess the performance of fasting blood glucose (FBG), postprandial blood glucose (PBG), and glycated hemoglobin (HbA1c) as screening for coronary heart disease (CHD) in an inpatient population undergoing coronary angiography. 1852 consecutive patients scheduled for coronary angiography were classified into Normal Glucose Tolerance (NGT), Impaired Glucose Regulation (IGR), and diabetes, based on FBG, PBG, and HbA1c. Correlations of Gensini score with glucose metabolism and insulin resistance were analyzed. The associations between glycemic variables and Gensini score or the presence of CHD were analyzed by multiple linear regression and logistic regression, respectively. CHD was diagnosed in 488, 622, and 414 patients with NGT, IGR, and diabetes, respectively. Gensini score was positively correlated with FBG (r = 0.09, p PBG (r = 0.20, p PBG and HbA1c were pooled altogether, only PBG persisted in its association with Gensini score and the prevalence of CHD. The severity of CHD was associated with glucose rather than insulin resistance in this Chinese population. PBG was optimally correlated with the presence and severity of CHD.

  12. Discrete Blood Glucose Control in Diabetic Göttingen Minipigs

    Directory of Open Access Journals (Sweden)

    Berno J.E. Misgeld

    2016-07-01

    Full Text Available Despite continuous research effort, patients with type 1 diabetes mellitus (T1D experience difficulties in daily adjustments of their blood glucose concentrations. New technological developments in the form of implanted intravenous infusion pumps and continuous blood glucose sensors might alleviate obstacles for the automatic adjustment of blood glucose concentration. These obstacles consist, for example, of large time-delays and insulin storage effects for the subcutaneous/interstitial route. Towards the goal of an artificial pancreas, we present a novel feedback controller approach that combines classical loop-shaping techniques with gain-scheduling and modern H ∞ -robust control approaches. A disturbance rejection design is proposed in discrete frequency domain based on the detailed model of the diabetic Göttingen minipig. The model is trimmed and linearised over a large operating range of blood glucose concentrations and insulin sensitivity values. Controller parameters are determined for each of these operating points. A discrete H ∞ loop-shaping compensator is designed to increase robustness of the artificial pancreas against general coprime factor uncertainty. The gain scheduled controller uses subcutaneous insulin injection as a control input and determines the controller input error from intravenous blood glucose concentration measurements, where parameter scheduling is achieved by an estimator of the insulin sensitivity parameter. Thus, only one controller stabilises a family of animal models. The controller is validated in silico with a total number of five Göttingen Minipig models, which were previously obtained by experimental identification procedures. Its performance is compared with an experimentally tested switching PI-controller.

  13. Circulating Glucagon 1-61 Regulates Blood Glucose by Increasing Insulin Secretion and Hepatic Glucose Production

    DEFF Research Database (Denmark)

    Wewer Albrechtsen, Nicolai J.; Kuhre, Rune E.; Hornburg, Daniel

    2017-01-01

    that PG 1-61 dose-dependently increases levels of cAMP, through the glucagon receptor, and increases insulin secretion and protein levels of enzymes regulating glycogenolysis and gluconeogenesis. In rats, PG 1-61 increases blood glucose and plasma insulin and decreases plasma levels of amino acids in...

  14. Splanchnic blood flow and hepatic glucose production in exercising humans

    DEFF Research Database (Denmark)

    Bergeron, R; Kjaer, M; Simonsen, L

    2001-01-01

    -blockade group vs. the control group, hormones, metabolites, VO(2), and RER followed the same pattern of changes in ACE-blockade and control groups during exercise. Splanchnic blood flow (at rest: 1.67 +/- 0.12, ACE blockade; 1.59 +/- 0.18 l/min, control) decreased during moderate exercise (0.78 +/- 0.07, ACE......, no differences in the pattern of change of splanchnic blood flow and splanchnic glucose production were observed during ACE blockade compared with controls. This study demonstrates that the normal increase in ANG II levels observed during prolonged exercise in humans does not play a major role in the regulation......The study examined the implication of the renin-angiotensin system (RAS) in regulation of splanchnic blood flow and glucose production in exercising humans. Subjects cycled for 40 min at 50% maximal O(2) consumption (VO(2 max)) followed by 30 min at 70% VO(2 max) either with [angiotensin...

  15. Influence of Artificial Sweetener on Human Blood Glucose Concentration

    Directory of Open Access Journals (Sweden)

    Ilse Skokan

    2007-01-01

    Full Text Available Artificial sweeteners, such as saccharin or cyclamic acid are synthetically manufactured sweetenings. Known for their low energetic value they serve especially diabetic and adipose patients as sugar substitutes. It has been hypothesized that the substitution of sugar with artificial sweeteners may induce a decrease of the blood glucose. The aim of this study was to determine the reliability of this hypothesis by comparing the influence of regular table sugar and artificial sweeteners on the blood glucose concentration. In this pilot-study 16 patients were included suffering from adiposity, pre-diabetes and hypertension. In the sense of a cross-over design, three test trials were performed at intervals of several weeks. Each trial was followed by a test free interval. Within one test trial each patient consumed 150 ml test solution (water that contained either 6 g of table sugar (“Kandisin” with sweetener free serving as control group. Tests were performed within 1 hr after lunch to ensure conditions comparable to patients having a desert. Every participant had to determine their blood glucose concentration immediately before and 5, 15, 30 and 60 minutes after the intake of the test solution. For statistics an analysis of variance was performed. The data showed no significant changes in the blood glucose concentration. Neither the application of sugar (F4;60 = 1.645; p = .175 nor the consumption of an artificial sweetener (F2.068;31.023 = 1.551; p > .05 caused significant fluctuations in the blood sugar levels. Over a time frame of 60 minutes in the control group a significant decrease of the blood sugar concentration was found (F2.457;36.849 = 4.005; p = .020 as a physiological reaction during lunch digestion.

  16. Glucose predictability, blood capillary permeability, and glucose utilization rate in subcutaneous, skeletal muscle, and visceral fat tissues.

    Science.gov (United States)

    Koutny, Tomas

    2013-11-01

    This study suggests an approach for the comparison and evaluation of particular compartments with modest experimental setup costs. A glucose level prediction model was used to evaluate the compartment's glucose transport rate across the blood capillary membrane and the glucose utilization rate by the cells. The glucose levels of the blood, subcutaneous tissue, skeletal muscle tissue, and visceral fat were obtained in experiments conducted on hereditary hypertriglyceridemic rats. After the blood glucose level had undergone a rapid change, the experimenter attempted to reach a steady blood glucose level by manually correcting the glucose infusion rate and maintaining a constant insulin infusion rate. The interstitial fluid glucose levels of subcutaneous tissue, skeletal muscle tissue, and visceral fat were evaluated to determine the reaction delay compared with the change in the blood glucose level, the interstitial fluid glucose level predictability, the blood capillary permeability, the effect of the concentration gradient, and the glucose utilization rate. Based on these data, the glucose transport rate across the capillary membrane and the utilization rate in a particular tissue were determined. The rates obtained were successfully verified against positron emission tomography experiments. The subcutaneous tissue exhibits the lowest and the most predictable glucose utilization rate, whereas the skeletal muscle tissue has the greatest glucose utilization rate. In contrast, the visceral fat is the least predictable and has the shortest reaction delay compared with the change in the blood glucose level. The reaction delays obtained for the subcutaneous tissue and skeletal muscle tissue were found to be approximately equal using a metric based on the time required to reach half of the increase in the interstitial fluid glucose level. © 2013 Published by Elsevier Ltd.

  17. Insulin overlapping in whole blood FTIR spectroscopy in blood glucose measurements

    Science.gov (United States)

    Romo-Cárdenas, G.; Sánchez-López, J. de D.; Luque, P. A.; Cosío-León, M.; Nieto-Hipólito, Juan I.; Vázquez-Briseño, Mabel

    For the last decade, several studies on mid-IR spectroscopy for blood glucose quantification have not considered the compounds involved in the glucose regulation mechanism, in which insulin plays an important role. This work shows how insulin overlaps in the same mid-IR region in which glucose is quantified. This optical absorption interference is an important factor to be considered for this type of studies, in the scope of whole blood modeling for spectroscopy applications and the possible use of computer based metrics.

  18. A Deep Learning Approach to Diabetic Blood Glucose Prediction

    Directory of Open Access Journals (Sweden)

    Hrushikesh N. Mhaskar

    2017-07-01

    Full Text Available We consider the question of 30-min prediction of blood glucose levels measured by continuous glucose monitoring devices, using clinical data. While most studies of this nature deal with one patient at a time, we take a certain percentage of patients in the data set as training data, and test on the remainder of the patients; i.e., the machine need not re-calibrate on the new patients in the data set. We demonstrate how deep learning can outperform shallow networks in this example. One novelty is to demonstrate how a parsimonious deep representation can be constructed using domain knowledge.

  19. Raman Spectroscopy as a Promising Tool for Noninvasive Point-of-Care Glucose Monitoring

    NARCIS (Netherlands)

    Scholtes-Timmerman, M.J.; Bijlsma, S.; Fokkert, M.J.; Slingerland, R.; Veen, S.J.F. van

    2014-01-01

    Self-monitoring of glucose is important for managing diabetes. Noninvasive glucose monitors are not yet available, but patients would benefit highly from such a device. We present results that may lead to a novel, point-of-care noninvasive system to measure blood glucose based on Raman spectroscopy.

  20. Simultaneous control of blood glucose, blood pressure, and lipid ...

    African Journals Online (AJOL)

    2016-01-21

    Jan 21, 2016 ... A questionnaire was used to collect basic information and blood samples were drawn for laboratory measurements. Simultaneous control was defined as HbA1c <7%, BP <130/80 mmHg, and LDL‑C <2.6 mmol/L. Results: A total of 2274 individuals were included, of which 588 individuals (25.9%) achieved ...

  1. Comparison between adherence assessments and blood glucose monitoring measures to predict glycemic control in adults with type 1 diabetes: a cross-sectional study.

    Science.gov (United States)

    Telo, Gabriela Heiden; de Souza, Martina Schaan; Andrade, Thais Stürmer; Schaan, Beatriz D'Agord

    2016-01-01

    Adherence to treatment has been defined as the degree to which a patient's behavior corresponds to medical or health advice; however, the most appropriate method to evaluate adherence to diabetes care has yet to be identified. We conducted analyses to compare adherence assessments and blood glucose monitoring measures with regard to their ability to predict glycemic control in adults with type 1 diabetes. We analyzed four instruments to evaluate adherence: Self-Care Inventory-Revised, a self-administered survey; Diabetes Self-Monitoring Profile (DSMP), administered by trained researchers; a categorical (yes/no/sometimes) adherence self-evaluation; and a continuous (0-100) adherence self-evaluation. Blood glucose monitoring frequency was evaluated by self-report, diary, and meter download. Participants (n = 82) were aged 39.0 ± 13.1 years with a mean diabetes duration of 21.2 ± 11.1 years; 27 % monitored blood glucose >4 times/day. The DSMP score was the strongest predictor of glycemic control (r = -0.32, P = 0.004) among adherence assessments, while blood glucose monitoring frequency assessed by meter download was the strongest predictor among blood glucose monitoring measures (r = -40, P self-report assessments had a significant but weak correlation with glycemic control (r ≤ 0.28, P ≤ 0.02). The final adjusted model identified the assessment of blood glucose monitoring frequency by meter download as the most robust predictor of HbA1c (estimate effect size = -0.58, P = 0.003). In efforts to evaluate adherence, blood glucose monitoring frequency assessed by meter download has the strongest relationship with glycemic control in adults with type 1 diabetes.

  2. Glycated haemoglobin may in future be reported as estimated mean blood glucose concentration--secondary publication

    DEFF Research Database (Denmark)

    Borg, R.; Nerup, J.; Nathan, D.M.

    2009-01-01

    Glycated haemoglobin (HbA 1c ) is widely used to determine levels of chronic glycaemia, to judge the adequacy of diabetes treatment and to adjust therapy. HbA 1c results are expressed as the percentage of HbA that is glycated. Day-to-day management is guided by self-monitoring of capillary glucose...... concentrations in mmol/l. The ADAG study determined the relationship between HbA 1c and average glucose concentration (AG) and concluded that for most patients with diabetes, HbA 1c can - with reasonable precision - be expressed as an estimated AG in the same units as self-monitoring Udgivelsesdato: 2009/11/2...

  3. Facilitated transport of glucose from blood to brain in man and the effect of moderate hypoglycaemia on cerebral glucose utilization

    International Nuclear Information System (INIS)

    Blomqvist, G.; Widen, L.; Hellstrand, E.; Gutniak, M.; Grill, V.

    1991-01-01

    The effect of steady-state moderate hypoglycaemia on human brain homeostasis has been studied with positron emission tomography using D-glucose 11 C(ul) as tracer. To rule out any effects of insulin, the plasma insulin concentration was maintained at the same level under normo- and hypoglycaemic conditions. Reduction of blood glucose by 55% increased the glucose clearance through the blood-brain barrier by 50% and reduced brain glucose consumption by 40%. Blood flow was not affected. The results are consistent with facilitated transport of glucose from blood to brain in humans. The maximal transport rate of glucose from blood to brain was found to be 62±19 (mean±SEM) μmol hg -1 min -1 , and the half-saturation constant was found to be 4.1±3.2 mM. (orig.)

  4. Comparison of blood glucose test strips in the detection of neonatal hypoglycaemia

    OpenAIRE

    Wilkins, B H; Kalra, D

    1982-01-01

    Blood glucose levels were estimated in 101 neonatal blood samples using three glucose test strip methods and the results compared with those from a laboratory. BM-test-glycemie 20-800 test strips and Reflotest-hypoglycemie test strips gave a rapid and reliable estimate of blood glucose level in the range 0-8 mmol/l (0-140 mg/100 ml). Dextrostix test strips tended to overestimate all blood glucose levels.

  5. Application of chronic intravascular blood glucose sensor in dogs.

    Science.gov (United States)

    Armour, J C; Lucisano, J Y; McKean, B D; Gough, D A

    1990-12-01

    An intravenous glucose sensor was implanted in six dogs for 1-15 wk. The glucose sensor is a flexible cylinder, approximately 0.2 cm diam and 30 cm long, with a tip containing immobilized glucose oxidase and catalase coupled to a potentiostatic O2 sensor. The sensor and a similar O2 reference sensor were implanted in the superior vena cava near the entrance of the right atrium. The sensor response was conveyed externally either by a telemetry system implanted nearby, surgically accessed leads, or chronically maintained percutaneous leads. Summing over the six implants, there was a total implantation period of 333 days during which glucose sensors were functional on demand. The sensor response showed agreement with conventionally assayed blood samples after accounting for a response lag. Sensor response to glucose showed little change over the implant period. Biocompatibility, enzyme lifetime, O2 availability, O2 sensor stability, and biochemical interference were not limitations. Results demonstrated that this sensor can function effectively as an implant in dogs for a period of months and has the potential for long-term operation.

  6. The Period of Operation and Perioperative Blood Glucose ...

    African Journals Online (AJOL)

    Demographic data as well as duration of fast was obtained, blood glucose level was estimated by One touch glucometer (Life Scan Inc. USA) immediately after induction. The mean age of the children was 4.1±2.6 yr and the mean weight was 15.9±6.2 kg. The mean duration of preoperative fast was 13.1±4.2 h (5-23) h.

  7. Non-invasive Blood Glucose Quantification Using a Hybrid Sensor

    Directory of Open Access Journals (Sweden)

    Sundararajan JAYAPAL

    2009-02-01

    Full Text Available Diabetes Mellitus is a group of metabolic diseases characterized by high blood sugar (glucose levels which result from defects in insulin secretion. It is very important for the diabetics and normal people to have a correct blood glucose level. The HbA1c test is the most preferred test by renowned doctors for glucose quantification. But this test is an invasive one. At present, there are many available techniques for this purpose but these are mostly invasive or minimally non-invasive and most of these are under research. Among the different methods available, the photo acoustic (PA methods provide a reliable solution since the acoustical energy loss is much less compared to the optical or other techniques. Here a novel framework is presented for blood glucose level measurement using a combination of the HbA1c test and a PA method to get an absolutely consistent and precise, non-invasive technique. The setup uses a pulsed laser diode with pulse duration of 5-15 ns and at a repetition rate of 10 Hz as the source. The detector setup is based on the piezoelectric detection. It consists of a ring detector that includes two double ring sensors that are attached to the ring shaped module that can be worn around the finger. The major aim is to detect the photo acoustic signals from the glycated hemoglobin with the least possible error. The proposed monitoring system is designed with extreme consideration to precision and compatibility with the other computing devices. The results obtained in this research have been studied and analyzed by comparing these with those of in-vitro techniques like the HPLC. The comparison has been plotted and it shows a least error. The results also show a positive drive for using this concept as a basis for future extension in quantifying the other blood components.

  8. The effect of monosodium glutamate (MSG) on blood glucose in ...

    African Journals Online (AJOL)

    The animals were grouped into two: groups A (control) and B (Test B1 and Test B2). Group A received water and feed (grower's mash) with grass supplementation. Group B (Test B1 and B2) received 3.33mg/ml and 6.66mg/ml of MSG respectively at libitum. At the end of each week, fasting blood glucose levels were ...

  9. Techniques of monitoring blood glucose during pregnancy for women with pre-existing diabetes.

    Science.gov (United States)

    Moy, Foong Ming; Ray, Amita; Buckley, Brian S; West, Helen M

    2017-06-11

    Self-monitoring of blood glucose (SMBG) is recommended as a key component of the management plan for diabetes therapy during pregnancy. No existing systematic reviews consider the benefits/effectiveness of various techniques of blood glucose monitoring on maternal and infant outcomes among pregnant women with pre-existing diabetes. The effectiveness of the various monitoring techniques is unclear. To compare techniques of blood glucose monitoring and their impact on maternal and infant outcomes among pregnant women with pre-existing diabetes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2016), searched reference lists of retrieved studies and contacted trial authors. Randomised controlled trials (RCTs) and quasi-RCTs comparing techniques of blood glucose monitoring including SMBG, continuous glucose monitoring (CGM) or clinic monitoring among pregnant women with pre-existing diabetes mellitus (type 1 or type 2). Trials investigating timing and frequency of monitoring were also included. RCTs using a cluster-randomised design were eligible for inclusion but none were identified. Two review authors independently assessed study eligibility, extracted data and assessed the risk of bias of included studies. Data were checked for accuracy. The quality of the evidence was assessed using the GRADE approach. This review update includes at total of 10 trials (538) women (468 women with type 1 diabetes and 70 women with type 2 diabetes). The trials took place in Europe and the USA. Five of the 10 included studies were at moderate risk of bias, four studies were at low to moderate risk of bias, and one study was at high risk of bias. The trials are too small to show differences in important outcomes such as macrosomia, preterm birth, miscarriage or death of baby. Almost all the reported GRADE outcomes were assessed as being very low-quality evidence. This was due to design limitations in the studies, wide confidence intervals, small

  10. Flattening postprandial blood glucose responses with guar gum: acute effects.

    Science.gov (United States)

    McIvor, M E; Cummings, C C; Leo, T A; Mendeloff, A I

    1985-01-01

    It has been proposed that high-carbohydrate, high-fiber (HCF) diets might serve as useful therapeutic modality in non-insulin-dependent diabetes mellitus (NIDDM). One problem in evaluating clinical trials of this therapy is that, by their very nature, the trials cannot be double blinded. We have developed HCF and placebo granola-type bars using complex absorbable carbohydrate and guar gum fiber to circumvent this methodologic problem. The HCF bars, when consumed with an ad lib. diet, assure an HCF intake without imposing other dietary restrictions. To test the short-term efficacy of the bars, 9 normal adult volunteers, 2 women with impaired glucose tolerance, and 20 patients with NIDDM consumed the bars alone or with meals. Blood glucose responses when HCF bars were consumed alone were blunted when compared with the placebo response (P less than 0.0005 to P less than 0.002), with the most marked suppression occurring in the early postprandial period. In contrast, when the bars were consumed along with breakfast, HCF and placebo responses were virtually identical in the early postprandial period, but showed a progressively greater difference from 90 to 240 min (P less than 0.02 to P less than 0.0005). When consumed with lunch as well as breakfast, the HCF bars caused flattening of blood glucose responses during the late postprandial period after breakfast and maintained flattened responses during the early and late postprandial periods after lunch (P less than 0.05 to P less than 0.005). It is concluded that these HCF bars can be used to blunt postprandial blood glucose responses, in subjects with either normal or abnormal carbohydrate metabolism.

  11. Different training status may alter the continuous blood glucose kinetics in self-paced endurance running

    OpenAIRE

    SUZUKI, YOSHIO; SHIMIZU, TOMOMI; OTA, MAKOTO; HIRATA, RYUZO; SATO, KENJI; TAMURA, YOSHIFUMI; IMANISHI, AKIO; WATANABE, MASAYUKI; SAKURABA, KEISHOKU

    2015-01-01

    The main purpose of the systemic energy metabolism is to provide a source of energy, mainly glucose, for the brain; therefore, blood glucose levels would be expected to correlate with exercise performance. The individual training status may also affect the blood glucose levels. The aim of the present study was to assess the association between blood glucose levels and running velocity during prolonged running in athletes with different training statuses. Two female college athletes, a triathl...

  12. Development of a fluorescent method for simultaneous measurement of glucose concentrations in interstitial fluid and blood

    International Nuclear Information System (INIS)

    Shi, Ting; Li, Dachao; Li, Guoqing; Xu, Kexin; Chen, Limin; Lin, Yuan; Lu, Luo

    2013-01-01

    Continuous blood glucose monitoring is of great clinical significance to patients with diabetes. One of the effective methods to monitor blood glucose is to measure glucose concentrations of interstitial fluid (ISF). However, a time-delay problem exists between ISF and blood glucose concentrations, which results in difficulty in indicating real-time blood glucose concentrations. Therefore, we developed a fluorescent method to verify the accuracy and reliability of simultaneous ISF and blood glucose measurement, especially incorporating it into research on the delay relationship between blood and ISF glucose changes. This method is based on a competitive reaction among borate polymer, alizarin and glucose. When glucose molecules combine with borate polymers in alizarin–borate polymer competitively, changes in fluorescence intensity demonstrate changes in glucose concentrations. By applying the measured results to the blood and ISF glucose delay relationship, we were able to calculate the time delay as an average of 2.16 ± 2.05 min for ISF glucose changes with reference to blood glucose concentrations. (paper)

  13. Glucose Pump Test can be Used to Measure Blood Flow Rate of ...

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... Blood flow rates of AV fistula can be affected by osmotic and oncotic pressures of blood and arterial blood pressures. Sodium, glucose, hemoglobin, and albumin are significant effectors, created osmotic and oncotic pressures [Table 3]. Blood levels of hemoglobin. (Hb), albumin, sodium (Na), and glucose ...

  14. Spike in glucose levels after reperfusion during aortic surgery: assessment by continuous blood glucose monitoring using artificial endocrine pancreas.

    Science.gov (United States)

    Kawahito, Koji; Sato, Hirotaka; Kadosaki, Mamoru; Egawa, Atsushi; Misawa, Yoshio

    2018-03-01

    Although strict blood glucose control during cardiovascular surgery is essential to avoid postoperative complications, the various changes in glucose levels that occur during surgery have not been investigated in detail. In this study, we continuously monitored blood glucose changes during aortic surgery using the STG-55 Ⓡ artificial endocrine pancreas (Nikkiso Inc., Tokyo). Between December 2015 and 2016, we performed continuous blood glucose monitoring in 22 patients (14 men and 8 women, 72 ± 11 years old), who required hypothermic circulatory arrest during an ascending/aortic arch surgery, at the Jichi Medical University Hospital. Ascending aorta replacements were performed in two patients and partial/total arch replacement, in 20. All the patients required selective cerebral perfusion and hypothermic circulatory arrest (bladder temperature at 25-26 °C) during distal anastomosis. Closed-loop continuous blood glucose monitoring was performed during cardiopulmonary bypass using the STG-55 Ⓡ artificial endocrine pancreas (Nikkiso Co., LTD, Tokyo). Blood glucose concentrations did not increase significantly from the time of the commencement of cardiopulmonary bypass to lower body ischemia. However, they dramatically increased immediately after reperfusion following lower body ischemia, and this hyperglycemia was sustained until the end of cardiopulmonary bypass. The current study clarified the peak glucose concentration during aortic surgery. These data may contribute to the management of blood glucose levels during aortic surgery.

  15. Correlation between macrosomia body indices and maternal fasting blood glucose.

    Science.gov (United States)

    Song, Y; Zhang, S; Song, W

    2014-05-01

    To explore the significance of neonatal body indices in identifying pathological macrosomia, we implemented a retrospective study of 254 neonates, including: 100 macrosomia of diabetic pregnancies, 77 macrosomia of healthy pregnancies and 77 normal neonates of healthy pregnancies, using their birth weight, body length, head circumference and chest circumference, to calculate neonatal body indices, multiple regression analysis of the correlation between newborn body indices and maternal fasting blood glucose. The Quetelet Index and Kaup Index of diabetic macrosomia is higher than that of non-diabetic macrosomia; HC:CC (ratio between head circumference and chest circumference) is reversed (p macrosomia.

  16. Asymptotic tracking and disturbance rejection of the blood glucose regulation system.

    Science.gov (United States)

    Ashley, Brandon; Liu, Weijiu

    2017-07-01

    Type 1 diabetes patients need external insulin to maintain blood glucose within a narrow range from 65 to 108 mg/dl (3.6 to 6.0 mmol/l). A mathematical model for the blood glucose regulation is required for integrating a glucose monitoring system into insulin pump technology to form a closed-loop insulin delivery system on the feedback of the blood glucose, the so-called "artificial pancreas". The objective of this paper is to treat the exogenous glucose from food as a glucose disturbance and then develop a closed-loop feedback and feedforward control system for the blood glucose regulation system subject to the exogenous glucose disturbance. For this, a mathematical model for the glucose disturbance is proposed on the basis of experimental data, and then incorporated into an existing blood glucose regulation model. Because all the eigenvalues of the disturbance model have zero real parts, the center manifold theory is used to establish blood glucose regulator equations. We then use their solutions to synthesize a required feedback and feedforward controller to reject the disturbance and asymptotically track a constant glucose reference of 90  mg/dl. Since the regulator equations are nonlinear partial differential equations and usually impossible to solve analytically, a linear approximation solution is obtained. Our numerical simulations show that, under the linear approximate feedback and feedforward controller, the blood glucose asymptotically tracks its desired level of 90 mg/dl approximately. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Dietary thylakoids suppress blood glucose and modulate appetite-regulating hormones in pigs exposed to oral glucose tolerance test

    DEFF Research Database (Denmark)

    Montelius, Caroline; Szwiec, Katarzyna; Kardas, Marek

    2014-01-01

    , either with or without addition of 0.5 g/kg body weight of thylakoid powder. RESULTS: The supplementation of thylakoids to the oral glucose tolerance test resulted in decreased blood glucose concentrations during the first hour, increased plasma cholecystokinin concentrations during the first two hours...... metabolism and appetite-regulating hormones during an oral glucose tolerance test in pigs fed a high fat diet. METHODS: Six pigs were fed a high fat diet (36 energy% fat) for one month before oral glucose tolerance test (1 g/kg d-glucose) was performed. The experiment was designed as a cross-over study...

  18. Blood glucose concentrations in prehospital trauma patients with traumatic shock : A retrospective analysis

    NARCIS (Netherlands)

    Kreutziger, Janett; Lederer, Wolfgang; Schmid, Stefan; Ulmer, Hanno; Wenzel, Volker; Nijsten, Maarten W.; Werner, Daniel; Schlechtriemen, Thomas

    BACKGROUND: Deranged glucose metabolism after moderate to severe trauma with either high or low concentrations of blood glucose is associated with poorer outcome. Data on prehospital blood glucose concentrations and trauma are scarce. OBJECTIVES: The primary aim was to describe the relationship

  19. Is blood glucose predictable from previous values? A solicitation for data.

    Science.gov (United States)

    Bremer, T; Gough, D A

    1999-03-01

    An important question about blood glucose control in diabetes is, Can present and future blood glucose values be predicted from recent blood glucose history? If this is possible, new continuous blood glucose monitoring technologies under development may lead to qualitatively better therapeutic capabilities. Not only could continuous monitoring technologies alert a user when a hypoglycemic episode or other blood glucose excursion is underway, but measurements may also provide sufficient information to predict near-future blood glucose values. A predictive capability based only on recent blood glucose history would be advantageous because there would be no need to involve models of glucose and insulin distribution, with their inherent requirement for detailed accounting of vascular glucose loads and insulin availability. Published data analyzed here indicate that blood glucose dynamics are not random, and that blood glucose values can be predicted, at least for the near future, from frequently sampled previous values. Data useful in further exploring this concept are limited, however, and an appeal is made for collection of more.

  20. Effects of structured testing versus routine testing of blood glucose in diabetes self-management: A randomized controlled trial.

    Science.gov (United States)

    Nishimura, Akiko; Harashima, Shin-Ichi; Fujita, Yoshihito; Tanaka, Daisuke; Wang, Yu; Liu, Yanyan; Inagaki, Nobuya

    2017-01-01

    To compare the effects of structured and routine testing regimens used in self-monitoring of blood glucose (SMBG) on glycemic control and diabetes self-management in insulin-naïve type 2 diabetes patients. Sixty-two outpatients with insulin-naïve type 2 diabetes were randomly allocated into two less-frequent SMBG usage groups: a structured testing group (STG) and a routine testing group (RTG). Subjects in STG measured 7-points on SMBG for 3 consecutive days once every two months without daily testing; subjects in RTG measured SMBG 3 times each week before breakfast on Monday and Friday and before dinner on Wednesday. The primary endpoint was HbA1c reduction. The secondary endpoints were change in body weight, blood pressure, treatment change, and self-management performance change. HbA1c levels were significantly decreased by 0.32% (3.50mmol/mol) in STG, partly because physicians changed medications more actively. In contrast, body weight and systolic/diastolic blood pressure were significantly reduced by 0.94kg and 6.8/4.7mmHg, respectively, in RTG, possibly related to the increased diet and exercise score in RTG. Structured testing without daily testing is beneficial for glycemic control; routine testing 3 times a week is more helpful for daily self-management. In low SMBG frequency usage, these two regimens can be utilized according to individual diabetic conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. A meal replacement regimen improves blood glucose levels in prediabetic healthy individuals with impaired fasting glucose.

    Science.gov (United States)

    König, Daniel; Kookhan, Sadaf; Schaffner, Denise; Deibert, Peter; Berg, Aloys

    2014-01-01

    The aim of this study was to investigate the effect of a 6-wk intervention with either lifestyle intervention (increased physical activity and a low-calorie diet) or a meal replacement regimen on glycemic control in patients who are prediabetic and have impaired fasting glucose. Forty-two overweight or obese men and women (age 54 ± 8 y; weight 95.1 ± 11.9 kg; body mass index [BMI] 32.8 ± 2.89 kg/m(2)) were included in this randomized controlled clinical trial. Patients in the lifestyle group (LS; n = 14) received dietary counseling sessions (fat-restricted low-calorie diet) and instructions on how to increase physical activity. Patients in the meal replacement group (MR; n = 28) were instructed to replace two daily meals with a low-calorie, high soy-protein drink with a low glycemic index. Both interventions resulted in a significant decrease in body weight and BMI, although the reduction was more pronounced (P meal replacement is an effective intervention for rapid improvement of elevated fasting glucose and increased insulin concentrations, these being important biomarkers of the prediabetic state. The 6-wk intervention has shown that the effect of meal replacement on fasting blood glucose was comparable to the effect of lifestyle intervention. The alterations in BMI, insulin, and HOMA-IR were significantly more pronounced following the meal replacement regimen. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Analysis of an Electrochemical Blood Glucose Monitoring System with Hematocrit Compensation: Improved Accuracy by Design

    OpenAIRE

    Lyon, Martha E; Lyon, Andrew W

    2012-01-01

    The article entitled “Hematocrit Compensation in Electrochemical Blood Glucose Monitoring Systems” by Teodorczyk and colleagues in this issue of Journal of Diabetes Science and Technology demonstrates that the OneTouch® Verio™ glucose meter meets current regulatory expectations for glucose meter performance and is relatively free from interference by hematocrit. The lack of influence of hematocrit on whole blood glucose results is a valuable attribute for hospital applications, where greater ...

  3. Different training status may alter the continuous blood glucose kinetics in self-paced endurance running.

    Science.gov (United States)

    Suzuki, Yoshio; Shimizu, Tomomi; Ota, Makoto; Hirata, Ryuzo; Sato, Kenji; Tamura, Yoshifumi; Imanishi, Akio; Watanabe, Masayuki; Sakuraba, Keishoku

    2015-09-01

    The main purpose of the systemic energy metabolism is to provide a source of energy, mainly glucose, for the brain; therefore, blood glucose levels would be expected to correlate with exercise performance. The individual training status may also affect the blood glucose levels. The aim of the present study was to assess the association between blood glucose levels and running velocity during prolonged running in athletes with different training statuses. Two female college athletes, a triathlete and a tennis player, ran a course that was 247.4 m in circumference for 5 h while wearing a continuous glucose monitoring system. Blood was obtained at time-points of -1, 1, 3 and 5 h. The athletes had free access to food and fluids throughout the run. The athletes ran at almost the same pace without a sudden decrease in pace. The blood glucose levels increased and remained high in the triathlete, whereas the tennis player remained hypoglycemic throughout the run. Carbohydrate ingestion did not affect the blood glucose levels. The magnitude of hormonal changes, e.g. insulin, adrenaline and cortisol, was greater in the tennis player. The blood glucose concentration did not correlate with the running velocity or the carbohydrate ingestion; however, a discrepancy in blood glucose transition was observed between the triathlete and the tennis player, indicating a possible association between the adaptation to endurance exercise and the blood glucose kinetics during prolonged running.

  4. COMPARISON OF THE RESULTS OF BLOOD GLUCOSE SELFMONITORING AND CONTINUOUS GLUCOSE MONITORING IN PREGNANT WOMEN WITH PREVIOUS DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    A. V. Dreval'

    2015-01-01

    Full Text Available Background: Pregnancy is one of the indications for continuous glucose monitoring (CGM. The data on its efficiency in pregnant women are contradictory.Aim: To compare the results of blood glucose self-monitoring (SMBG and CGM in pregnant women with previous diabetes mellitus.Materials and methods: We performed a cross-sectional comparative study of glycemia in 18 pregnant women with previous type 1 (87.8% of patients and type 2 diabetes (22.2% of patients with various degrees of glycemic control. Their age was 27.7 ± 4.9 year. At study entry, the patients were at 17.2 ± 6.1 weeks of gestation. CGM and SMBG were performed in and by all patients for the duration of 5.4 ± 1.5 days. Depending on their HbA1c levels, all patients were divided into two groups: group 1 – 12 women with the HbA1c above the target (8.5 ± 1%, and group 2 – 6 women with the HbA1c levels within the target (5.6 ± 0.3%.Results: According to SMBG results, women from group 2 had above-the-target glycemia levels before breakfast, at 1 hour after breakfast and at bedtime: 6.2 ± 1.6, 8.7 ± 2.1, and 5.7 ± 1.9 mmol/L, respectively. According to CGM, patients from group 1 had higher postprandial glycemia than those from group 2 (8.0 ± 2.1 and 6.9 ± 1.8 mmol/L, respectively, p = 0.03. The analysis of glycemia during the day time revealed significant difference between the groups only at 1 hour after dinner (7.1 ± 1.4 mmol/L in group 1 and 5.8 ± 0.9 mmol/L in group 2, р = 0.041 and the difference was close to significant before lunch (6.0 ± 2.2 mmol/L in group 1 and 4.8 ± 1.0 mmol/L in group 2, р = 0.053. Comparison of SMBG and CGM results demonstrated significant difference only at one timepoint (at 1 hour after lunch and only in group 1: median glycemia was 7.4 [6.9; 8.1] mmol/L by SMBG and 6 [5.4; 6.6] mmol/L by CGM measurement (р = 0.001. Lower median values by CGM measurement could be explained by averaging of three successive measurements carried out in the

  5. Blood glucose kinetics and physiological changes in a type 1 diabetic finisher of the Ultraman triathlon: a case study.

    Science.gov (United States)

    Bach, Christopher W; Baur, Daniel A; Hyder, William S; Ormsbee, Michael J

    2017-05-01

    To investigate the blood glucose kinetics and physiological effects experienced by a type 1 diabetic (T1D) finisher of a 3-day, multi-stage ultra endurance triathlon consisting of a 10 km swim and 144.8 km bike (stage 1), a 275.4 km bike (stage 2), and an 84.4 km run (stage 3). The athlete self-monitored blood glucose (SMBG) levels via fingerstick blood draw and hand-held glucometer. Researchers evaluated blood glucose kinetics via a continuous glucose monitoring device. The athlete maintained normal dietary and insulin patterns before, during and after competition daily. Weight and body composition were measured via bioelectrical impedance and select biomarkers were measured in blood. The athlete spent 73.0, 3.4, and 15.1% of during race time in a hyperglycemic state (≥130 mg dL -1 ) during stages 1, 2, and 3, respectively, and 0.0, 78.6, and 33.6% in a hypoglycemic state (≤80 mg dL -1 ). Nocturnal glycemic levels showed the athlete spent 86.1, 83.0, and 84.8% of sleep in a hyperglycemic state during nights 1, 2, and 3, respectively, and 9.0, 0.0, and 0.0% in a hypoglycemic state. From pre- to post-race, body weight (73.2 to 76.9 kg) and total body water increased (49.2-51.6 kg). In addition, there were dramatic increases in creatine kinase (271.7-9252.8 µ L -1 ), cortisol (137.1-270.2 pg mL -1 ), CRP (188.3-8046.9 ng mL -1 ), and aldosterone (449.1-1679.6 pg mL -1 ). It is possible for a T1D athlete to complete a multi-stage ultraendurance triathlon and maintain glycemic control using SMBG methods. In addition, a T1D athlete participating in an ultraendurance triathlon results in substantial changes in body composition, hormones, and muscle damage.

  6. Elevated 1-h post-challenge plasma glucose levels in subjects with normal glucose tolerance or impaired glucose tolerance are associated with whole blood viscosity.

    Science.gov (United States)

    Marini, Maria Adelaide; Fiorentino, Teresa Vanessa; Andreozzi, Francesco; Mannino, Gaia Chiara; Perticone, Maria; Sciacqua, Angela; Perticone, Francesco; Sesti, Giorgio

    2017-08-01

    It has been suggested that glucose levels ≥155 mg/dl at 1-h during an oral glucose tolerance test (OGTT) may predict development of type 2 diabetes and cardiovascular events among adults with normal glucose tolerance (NGT 1 h-high). Studies showed a link between increased blood viscosity and type 2 diabetes. However, whether blood viscosity is associated with dysglycemic conditions such as NGT 1 h-high, impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) is unsettled. 1723 non-diabetic adults underwent biochemical evaluation and OGTT. A validated formula based on hematocrit and total plasma proteins was employed to estimate whole blood viscosity. Subjects were categorized into NGT with 1 h glucose h-low), NGT-1 h-high, IFG and/or IGT. Hematocrit and blood viscosity values appeared significantly higher in individuals with NGT 1 h-high, IFG and/or IGT as compared to NGT 1 h-low subjects. Blood viscosity was significantly correlated with age, waist circumference, blood pressure, HbA1c, fasting, 1- and 2-h post-challenge insulin levels, total cholesterol and low-density lipoprotein, triglycerides, fibrinogen, white blood cell, and inversely correlated with high-density lipoprotein and insulin sensitivity. Of the four glycemic parameters, 1-h post-challenge glucose showed the strongest correlation with blood viscosity (β = 0.158, P h post-challenge plasma glucose. They also suggest that a subgroup of NGT individuals with 1-h post-challenge plasma >155 mg/dl have increased blood viscosity comparable to that observed in subjects with IFG and/or IGT.

  7. The Effects of Blood Glucose Levels on Cognitive Performance: A Review of the Literature

    Science.gov (United States)

    Feldman, Jolene; Barshi, Immanuel

    2007-01-01

    The purpose of this review paper is to discuss the research literature on the effects of blood glucose levels on executive and non-executive functions in humans. The review begins with a brief description of blood glucose, how it has been studied, previous syntheses of prior studies, and basic results regarding the role of blood glucose on cognitive functioning. The following sections describe work that investigated the effect of blood glucose on both non-executive and executive functions (e.g., sensory processing, psychomotor functioning, attention, vigilance, memory, language and communication, judgement and decision-making, and complex task performance). Within each section, summaries of the findings and challenges to the literature are included. Measurement conversions of blood glucose levels, blood glucose values, and associated symptoms are depicted. References to the types of tests used to investigate blood glucose and cognitive performance are provided. For more detailed descriptions of references within (and in addition to) this paper, an annotated bibliography is also provided. Several moderator variables including individual differences and contextual variables related to the effects of blood glucose levels on performance (e.g., age, gender, time of day, familiarity with the task and symptom awareness, expectancy effects, dose dependent effects, time dependent effects, task specific effects, rising and falling blood glucose levels, and speed and/or accuracy trade-offs) are addressed later in the paper. Some suggestions for future experimental methodologies are also made.

  8. An artificial pancreas provided a novel model of blood glucose level variability in beagles.

    Science.gov (United States)

    Munekage, Masaya; Yatabe, Tomoaki; Kitagawa, Hiroyuki; Takezaki, Yuka; Tamura, Takahiko; Namikawa, Tsutomu; Hanazaki, Kazuhiro

    2015-12-01

    Although the effects on prognosis of blood glucose level variability have gained increasing attention, it is unclear whether blood glucose level variability itself or the manifestation of pathological conditions that worsen prognosis. Then, previous reports have not been published on variability models of perioperative blood glucose levels. The aim of this study is to establish a novel variability model of blood glucose concentration using an artificial pancreas. We maintained six healthy, male beagles. After anesthesia induction, a 20-G venous catheter was inserted in the right femoral vein and an artificial pancreas (STG-22, Nikkiso Co. Ltd., Tokyo, Japan) was connected for continuous blood glucose monitoring and glucose management. After achieving muscle relaxation, total pancreatectomy was performed. After 1 h of stabilization, automatic blood glucose control was initiated using the artificial pancreas. Blood glucose level varied for 8 h, alternating between the target blood glucose values of 170 and 70 mg/dL. Eight hours later, the experiment was concluded. Total pancreatectomy was performed for 62 ± 13 min. Blood glucose swings were achieved 9.8 ± 2.3 times. The average blood glucose level was 128.1 ± 5.1 mg/dL with an SD of 44.6 ± 3.9 mg/dL. The potassium levels after stabilization and at the end of the experiment were 3.5 ± 0.3 and 3.1 ± 0.5 mmol/L, respectively. In conclusion, the results of the present study demonstrated that an artificial pancreas contributed to the establishment of a novel variability model of blood glucose levels in beagles.

  9. User Performance Evaluation of Four Blood Glucose Monitoring Systems Applying ISO 15197:2013 Accuracy Criteria and Calculation of Insulin Dosing Errors.

    Science.gov (United States)

    Freckmann, Guido; Jendrike, Nina; Baumstark, Annette; Pleus, Stefan; Liebing, Christina; Haug, Cornelia

    2018-04-01

    The international standard ISO 15197:2013 requires a user performance evaluation to assess if intended users are able to obtain accurate blood glucose measurement results with a self-monitoring of blood glucose (SMBG) system. In this study, user performance was evaluated for four SMBG systems on the basis of ISO 15197:2013, and possibly related insulin dosing errors were calculated. Additionally, accuracy was assessed in the hands of study personnel. Accu-Chek ® Performa Connect (A), Contour ® plus ONE (B), FreeStyle Optium Neo (C), and OneTouch Select ® Plus (D) were evaluated with one test strip lot. After familiarization with the systems, subjects collected a capillary blood sample and performed an SMBG measurement. Study personnel observed the subjects' measurement technique. Then, study personnel performed SMBG measurements and comparison measurements. Number and percentage of SMBG measurements within ± 15 mg/dl and ± 15% of the comparison measurements at glucose concentrations performed by lay-users. The study was registered at ClinicalTrials.gov (NCT02916576). Ascensia Diabetes Care Deutschland GmbH.

  10. Comparison of glucose concentration and glucose absorption from the GI-tract in pigs in whole blood and in plasma

    DEFF Research Database (Denmark)

    Theil, Peter Kappel; Jørgensen, Henry; Larsen, Torben

    2010-01-01

    glucose measured in whole blood (x-variable) and in plasma (y-variable) gave the following equations: Y = 0.974 X + 0.55, n = 583 (Exp. 1) and Y = 0.949 X + 0.65, n = 655 (Exp. 2). The net absorption of glucose found in blood was in accordance with that found in plasma: Y = 1.012 X , n = 281 (no intercept......, P = 0.79; Exp. 1) and Y = 0.954 X, n = 316 (no intercept, P = 0.97; Exp. 2). It was concluded that glucose measured in blood and plasma were slightly biased whereas net glucose absorption in blood and in plasma were unbiased......The present investigation was undertaken to compare glucose absorption from the gastro-intestinal tract quantified in either whole blood or plasma using the arterio-venous differences and portal blood flow measurements. Pigs were surgically modified with catheters in the portal vein...

  11. Application of the reference method isotope dilution gas chromatography mass spectrometry (ID/GC/MS) to establish metrological traceability for calibration and control of blood glucose test systems.

    Science.gov (United States)

    Andreis, Elisabeth; Küllmer, Kai; Appel, Matthias

    2014-05-01

    Self-monitoring of blood glucose (BG) by means of handheld BG systems is a cornerstone in diabetes therapy. The aim of this article is to describe a procedure with proven traceability for calibration and evaluation of BG systems to guarantee reliable BG measurements. Isotope dilution gas chromatography mass spectrometry (ID/GC/MS) is a method that fulfills all requirements to be used in a higher-order reference measurement procedure. However, this method is not applicable for routine measurements because of the time-consuming sample preparation. A hexokinase method with perchloric acid (PCA) sample pretreatment is used in a measurement procedure for such purposes. This method is directly linked to the ID/GC/MS method by calibration with a glucose solution that has an ID/GC/MS-determined target value. BG systems are calibrated with whole blood samples. The glucose levels in such samples are analyzed by this ID/GC/MS-linked hexokinase method to establish traceability to higher-order reference material. For method comparison, the glucose concentrations in 577 whole blood samples were measured using the PCA-hexokinase method and the ID/GC/MS method; this resulted in a mean deviation of 0.1%. The mean deviation between BG levels measured in >500 valid whole blood samples with BG systems and the ID/GC/MS was 1.1%. BG systems allow a reliable glucose measurement if a true reference measurement procedure, with a noninterrupted traceability chain using ID/GC/MS linked hexokinase method for calibration of BG systems, is implemented. Systems should be calibrated by means of a traceable and defined measurement procedure to avoid bias. © 2014 Diabetes Technology Society.

  12. Effect of intrapleural oxytocin injection on blood glucose level in rat (rattus norvegicous).

    Science.gov (United States)

    Dezhkam, Y; Dezhkam, N

    2014-01-01

    The effect of Oxytocin on energy metabolism is still question. The aim of the present study was to investigate the effect of exogenous oxytocin injection in different dose and timetable on blood glucose level in rat. In this study 16 adult female rats were divided into 2 groups (Treatment 1(T1) and Treatment 2(T2)). T1 with 8 adult female rats received 0.2 IU/Kg oxytocin via intrapleural (IP) and blood glucose level was tested at 0th, 20th, 40th and 60th min after injection by collecting the blood from jugular vein. In T2 eight female rats received 0.4 IU/kg oxytocin via IP taking blood glucose measure at the same minutes as T1. The experiment tested in three replicates. Blood glucose meter (Model: 3TMSO1G) was used with glucose smart blood glucose monitoring system to the measurement of blood glucose level in rats. Data were analyzed using the GLM procedure of SAS (SAS, version 9) PDIFF was used to compare least square means among treatments adjusting by tukey test. There were hypoglycemic tendency in the changes of the blood glucose level in both T1 and T2, 20th min after injection (88.79 ± 3.28, 68.58 ± 3.63, respectively), while in the remaining subjects (4th and 60th min) blood glucose level increased (115.54 ± 4, 79.7 ± 2.09 and 136.33 ± 5.8, 123.54 ± 0.9, respectively). These results showed that blood glucose level in T1 significantly higher than T2 (p < 0.0001). These in vivo results showed that exogenous oxytocin can be good choice to decrease the blood glucose level very fast.

  13. Overnight Control of Blood Glucose in People with Type 1 Diabetes

    DEFF Research Database (Denmark)

    Boiroux, Dimitri; Duun-Henriksen, Anne Katrine; Schmidt, Signe

    2012-01-01

    In this paper, we develop and test a Model Predictive Controller (MPC) for overnight stabilization of blood glucose in people with type 1 diabetes. The controller uses glucose measurements from a continuous glucose monitor (CGM) and its decisions are implemented by a continuous subcutaneous insulin...

  14. The Impact of Opium Consumption on Blood Glucose, Serum Lipids and Blood Pressure, and Related Mechanisms

    Science.gov (United States)

    Najafipour, Hamid; Beik, Ahmad

    2016-01-01

    Aim: Substance abuse has become a universal crisis in our modern age. Among illegal substances, opium and its derivatives have been ranked second in terms of usage after cannabis in the world. In many Asian regions, the use of opium enjoys a high social acceptance; hence, some common people and even medical practitioners believe that opium lowers blood glucose and pressure and treat dyslipidemia. How much this belief is scientifically justified? Method: The results of available studies on both humans and animals searched in different search engines up to mid-2016 were integrated (78 articles). Upon the findings we try to offer a more transparent picture of the effects of opium on the mentioned factors along with the probable underlying mechanisms of its action. Results: Taken together, a variety of evidences suggest that the consumption of opium has no scientific justification for amendment of these biochemical variables. The mechanisms proposed so far for the action of opium in the three above disorders are summarized at the end of the article. Short term effects seems to be mostly mediated through central nervous system (neural and hormonal mechanisms), but long term effects are often due to the structural and functional alterations in some body organs. Conclusion: Although opium may temporarily reduce blood pressure, but it increases blood glucose and most of blood lipids. Moreover its long term use has negative impacts and thus it aggravates diabetes, dyslipidemia and hypertension. Accordingly, it is necessary to inform societies about the potential disadvantages of unauthorized opium consumption. PMID:27790151

  15. The Impact of Opium Consumption on Blood Glucose, Serum Lipids and Blood Pressure, and Related Mechanisms.

    Science.gov (United States)

    Najafipour, Hamid; Beik, Ahmad

    2016-01-01

    Aim: Substance abuse has become a universal crisis in our modern age. Among illegal substances, opium and its derivatives have been ranked second in terms of usage after cannabis in the world. In many Asian regions, the use of opium enjoys a high social acceptance; hence, some common people and even medical practitioners believe that opium lowers blood glucose and pressure and treat dyslipidemia. How much this belief is scientifically justified? Method: The results of available studies on both humans and animals searched in different search engines up to mid-2016 were integrated (78 articles). Upon the findings we try to offer a more transparent picture of the effects of opium on the mentioned factors along with the probable underlying mechanisms of its action. Results: Taken together, a variety of evidences suggest that the consumption of opium has no scientific justification for amendment of these biochemical variables. The mechanisms proposed so far for the action of opium in the three above disorders are summarized at the end of the article. Short term effects seems to be mostly mediated through central nervous system (neural and hormonal mechanisms), but long term effects are often due to the structural and functional alterations in some body organs. Conclusion: Although opium may temporarily reduce blood pressure, but it increases blood glucose and most of blood lipids. Moreover its long term use has negative impacts and thus it aggravates diabetes, dyslipidemia and hypertension. Accordingly, it is necessary to inform societies about the potential disadvantages of unauthorized opium consumption.

  16. The Impact of opium consumption on blood glucose, serum lipids and blood pressure, and related mechanisms

    Directory of Open Access Journals (Sweden)

    Hamid Najafipour

    2016-10-01

    Full Text Available AbstractAim: Substance abuse has become a universal crisisin our modern age. Among illegal substances, opium and its derivatives have been ranked second in terms of usage after cannabis in the world. In many Asian regions, the use of opium enjoys a high social acceptance; hence, some common people and even medical practitioners believe that opium lowers blood glucose and pressure and treat dyslipidemia. How much this belief is scientifically justified? Method: The results of available studies on both humans and animals searched in different search engines up to mid-2016 were integrated (77 articles. Upon the findings we try to offer a more transparent picture of the effects of opium on the mentioned factors along with the probable underlying mechanisms of its action. Results: Taken together, a variety of evidences suggest that the consumption of opium has no scientific justification for amendment of these biochemical variables. The mechanisms proposed so far for the action of opium in the three above disorders are summarized at the end of the article. Short term effects seems to be mostly mediated through central nervous system (neural and hormonal mechanisms, but long term effects are often due to the structural and functional alterations in some body organs. Conclusion: Although opium may temporarily reduce blood pressure, but it increases blood glucose and most of blood lipids. Moreover its long term use has negative impacts and thus it aggravates diabetes, dyslipidemia and hypertension. Accordingly, it is necessary to inform societies about the potential disadvantages of unauthorized opium consumption.

  17. The accuracy of blood glucose testing by children.

    Science.gov (United States)

    Strumph, P S; Odoroff, C L; Amatruda, J M

    1988-04-01

    While studies have evaluated the accuracy of adult patients and health personnel in reading various glucose oxidase impregnated strips to estimate blood glucose, there are no studies exclusively evaluating the accuracy of children with diabetes reading their own strips as compared to a staff member, and meter to meter variability in reading these strips. We evaluated the accuracy of reading chemstrip bG by children at a summer camp. The children's visual readings of their own strips were compared to the visual reading of a single staff member. A total of 356 Chemstrip bG's were visually read by diabetic children and a single trained staff member at a summer camp for diabetics. The strips were then analyzed by two Accu-Chek bG meters. Intermachine variability was found to be negligible over the entire bG range. For the purposes of this study, we define accurate visual readings as those within +/- 15 percent of the meter reading of a given strip. At low bG values (40-79 mg/dl), accuracy by children and staff is low, with underestimating occurring in 39 percent of staff readings and 57 percent of children's readings. At intermediate bG values (120-239 mg/dl) readings are more accurate, especially when read by the staff, with misreadings occurring in only 16-19 percent of the strips. At high bG values (240-399 mg/dl), accuracy by children is decreased, with underestimation 500 percent more often than staff. We conclude that children are less accurate at reading Chemstrip bG than a trained staff member (51% versus 33% misreading), especially at the upper and lower ranges of bG values when visual readings are least accurate, and the need for therapeutic intervention is the greatest.

  18. Lower fasting blood glucose in neurofibromatosis type 1

    Science.gov (United States)

    Martins, Aline Stangherlin; Jansen, Ann Kristine; Rodrigues, Luiz Oswaldo Carneiro; Matos, Camila Maria; Souza, Marcio Leandro Ribeiro; de Souza, Juliana Ferreira; Diniz, Maria de Fátima Haueisen Sander; Barreto, Sandhi Maria; Diniz, Leonardo Mauricio; de Rezende, Nilton Alves; Riccardi, Vincent Michael

    2015-01-01

    Studies indicate a lower occurrence of diabetes mellitus (DM) in patients with neurofibromatosis type 1 (NF1). Fasting blood glucose (FBG) level is the main criterion used to diagnose DM and glucose intolerance. Therefore, this study compared FBG level between adults with NF1 and non-NF1 controls. We selected clinical records of 57 out of 701 individuals attending the Neurofibromatosis Outpatient Reference Center of the Clinics Hospital of the Federal University of Minas Gerais in Brazil. The selected patients with NF1 were matched to non-NF1 controls selected from the Brazilian Longitudinal Study of Adult Health according to sex, age (range, 35–74 years) and BMI at a ratio of 1:3. In both groups, individuals with DM were excluded. Median FBG level in the NF1 group (86 mg/dl (range, 56–127 mg/dl)) was lower than that in the non-NF1 control group (102 mg/dl (range, 85–146 mg/dl)) (P<0.001). Prevalence of FBG level ≥100 mg/dl in the NF1 group (16%) was lower than that in the non-NF1 control group (63%) (P<0.05). The chance of a high FBG level was 89% lower in the NF1 group (odds ratio, 0.112; 95% CI, 0.067–0.188) (P<0.05). In conclusion, adults with NF1 showed a lower FBG level and a lower prevalence of high FBG level compared with non-NF1 controls. PMID:26631381

  19. Levels of Blood Glucose and Total Protein of Repeat Breeding Dairy Cows From Daerah Istimewa Yogyakarta

    Directory of Open Access Journals (Sweden)

    Dhasia Ramandani

    2015-11-01

    breeding case had lower blood glucose and total protein plasm concentrations than that of the normal. The average concentrations of blood glucose and total protein plasm were 48.58±6.675 mg/dl and 6.815±821 g/dl, respectively.

  20. Trends in practice of blood glucose control in critically ill patients in the Netherlands

    NARCIS (Netherlands)

    van Hooijdonk, R. T. M.; Eslami, S.; de Keizer, N. F.; Bakhshi-Raiez, F.; Bosman, R. J.; Dongelmans, D. A.; van der Voort, P. H. J.; Streefkerk, J. O.; Engelbrecht, W. J.; ten Cate, J.; Huissoon, S.; van Driel, E. M.; van Dijk, I.; Cimic, N.; Beck, O. F. T.; Snellen, F. T. F.; Holman, N. D.; Mulder, H. C.; Abu-Hanna, A.; Schultz, M. J.

    2015-01-01

    Publication of the Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) trial in 2009 and several observational studies caused a change in the recommendations for blood glucose control in intensive care patients. We evaluated local trends in blood

  1. Quantify Glucose Level in Freshly Diabetic's Blood by Terahertz Time-Domain Spectroscopy

    Science.gov (United States)

    Chen, Hua; Chen, Xiaofeng; Ma, Shihua; Wu, Xiumei; Yang, Wenxing; Zhang, Weifeng; Li, Xiao

    2018-04-01

    We demonstrate the capability of terahertz (THz) time-domain spectroscopy (TDS) to quantify glucose level in ex vivo freshly diabetic's blood. By investigating the THz spectra of different human blood, we find out THz absorption coefficients reflect a high sensitivity to the glucose level in blood. With a quantitative analysis of 70 patients, we demonstrate that the THz absorption coefficients and the blood glucose levels perform a linear relationship. A comparative experiment between THz measurement and glucometers is also conducted with another 20 blood samples, and the results confirm that the relative error is as less as 15%. Our ex vivo human blood study indicates that THz technique has great potential application to diagnose blood glucose level in clinical practice.

  2. Assessing differential attrition in clinical trials: self-monitoring of oral anticoagulation and type II diabetes

    Directory of Open Access Journals (Sweden)

    Fitzmaurice David

    2007-05-01

    Full Text Available Abstract Background Analyzing drop out rates and when they occur may give important information about the patient characteristics and trial characteristics that affect the overall uptake of an intervention. Methods We searched Medline and the Cochrane library from the beginning of the databases to May 2006 for published systematic reviews that compared the effects of self-monitoring (self-testing or self-management (self-testing and self-dosage of oral anticoagulation or self-monitored blood glucose in type 2 diabetics who were not using insulin. We assessed all study withdrawals pre-randomization and post randomization and sought information on the reasons for discontinuation of all participants. To measure the differential between groups in attrition we used the relative attrition (RA, which is equivalent to relative risk but uses attrition as the outcome (i.e. attrition in intervention group/attrition in control group. We determined the percentage drop outs for control and intervention groups and used DerSimonian and Laird random effects models to estimate a pooled relative attrition. L'abbe type plots created in R (version 2.0.2 were used to represent the difference in the relative attrition among the trials with 95% confidence areas and weights derived from the random effects model. Results With self-monitoring of blood glucose in type 2 diabetes, attrition ranged from 2.3% to 50.0% in the intervention groups and 0% to 40.4% in the control groups. There was no significant difference between the intervention and control, with an overall RA of 1.18 [95% CI, 0.70–2.01]. With self-monitoring of oral anticoagulation attrition ranged from 0% to 43.2% in the intervention groups and 0% to 21.4% in the control group. The RA was significantly greater in the intervention group, combined RA, 6.05 [95% CI, 2.53–14.49]. Conclusion This paper demonstrates the use of relative attrition as a new tool in systematic review methodology which has the

  3. Continuous non-invasive blood glucose monitoring by spectral image differencing method

    Science.gov (United States)

    Huang, Hao; Liao, Ningfang; Cheng, Haobo; Liang, Jing

    2018-01-01

    Currently, the use of implantable enzyme electrode sensor is the main method for continuous blood glucose monitoring. But the effect of electrochemical reactions and the significant drift caused by bioelectricity in body will reduce the accuracy of the glucose measurements. So the enzyme-based glucose sensors need to be calibrated several times each day by the finger-prick blood corrections. This increases the patient's pain. In this paper, we proposed a method for continuous Non-invasive blood glucose monitoring by spectral image differencing method in the near infrared band. The method uses a high-precision CCD detector to switch the filter in a very short period of time, obtains the spectral images. And then by using the morphological method to obtain the spectral image differences, the dynamic change of blood sugar is reflected in the image difference data. Through the experiment proved that this method can be used to monitor blood glucose dynamically to a certain extent.

  4. Evaluation of four portable blood glucose meters in diabetic and non-diabetic dogs and cats.

    Science.gov (United States)

    Kang, Min-Hee; Kim, Do-Hyung; Jeong, In-Seong; Choi, Gab-Chol; Park, Hee-Myung

    2016-01-01

    Monitoring of an animal's blood glucose concentration is critical for diagnostic and therapeutic decisions. Over the past few decades, portable blood glucose meters (PBGMs) have been used to monitor blood glucose concentrations in animals. Recently, new and improved PBGMs have been made available on the market. The purpose of this study was to evaluate four PBGMs for use in dogs and cats. A total of 155 venous blood samples of dogs and 85 venous blood samples of cats were tested using four PBGMs. Control solutions from manufacturers were used to determine the precision of each meter. The coefficient of variation was calculated to determine precision during a set of replicates. Pearson's correlation analysis, Passing-Bablok regression, and Bland-Altman analysis were used to determine the accuracy of four PBGMs against the hexokinase reference method. Error grid analysis was used to evaluate clinical relevance. All PBGMs, except CERA-PET®, were clinically acceptable for monitoring blood glucose concentrations; AlphaTrak® and VetMate® appeared to be the most accurate ones, demonstrating that to use PBGMs for glucose monitoring, it is important to understand the strengths or limitations of each meter. The difference in results between the PBGMs and the reference method increased at high glucose concentration ranges, which were also affected by the hematocrit. Although readings of the PBGMs and the reference method varied across glycemic ranges (low, normal, and high glucose concentrations), most PBGMs were clinically acceptable for monitoring blood glucose concentrations in dogs and cats.

  5. Clinical results from a noninvasive blood glucose monitor

    Science.gov (United States)

    Blank, Thomas B.; Ruchti, Timothy L.; Lorenz, Alex D.; Monfre, Stephen L.; Makarewicz, M. R.; Mattu, Mutua; Hazen, Kevin

    2002-05-01

    Non-invasive blood glucose monitoring has long been proposed as a means for advancing the management of diabetes through increased measurement and control. The use of a near-infrared, NIR, spectroscopy based methodology for noninvasive monitoring has been pursued by a number of groups. The accuracy of the NIR measurement technology is limited by challenges related to the instrumentation, the heterogeneity and time-variant nature of skin tissue, and the complexity of the calibration methodology. In this work, we discuss results from a clinical study that targeted the evaluation of individual calibrations for each subject based on a series of controlled calibration visits. While the customization of the calibrations to individuals was intended to reduce model complexity, the extensive requirements for each individual set of calibration data were difficult to achieve and required several days of measurement. Through the careful selection of a small subset of data from all samples collected on the 138 study participants in a previous study, we have developed a methodology for applying a single standard calibration to multiple persons. The standard calibrations have been applied to a plurality of individuals and shown to be persistent over periods greater than 24 weeks.

  6. Glucose control in pregnant women with type 1 diabetes mellitus: Studies using a continuous glucose monitoring system

    NARCIS (Netherlands)

    Kerssen, Anneloes

    2005-01-01

    Pregnancy in women with type 1 diabetes mellitus is associated with neonatal morbidity. It is commonly agreed that the morbidity decreases when diabetic control is tightened. The most common methods for the determination of diabetic control are the self-monitoring of blood glucose levels (SMBG) and

  7. A comprehensive compartmental model of blood glucose regulation for healthy and type 2 diabetic subjects

    DEFF Research Database (Denmark)

    Vahidi, O; Kwok, K E; Gopaluni, R B

    2016-01-01

    We have expanded a former compartmental model of blood glucose regulation for healthy and type 2 diabetic subjects. The former model was a detailed physiological model which considered the interactions of three substances, glucose, insulin and glucagon on regulating the blood sugar. The main...... variations of blood glucose concentrations following an oral glucose intake. Another model representing the incretins production in the gastrointestinal tract along with their hormonal effects on boosting pancreatic insulin production is also added to the former model. We have used two sets of clinical data...... obtained during oral glucose tolerance test and isoglycemic intravenous glucose infusion test from both type 2 diabetic and healthy subjects to estimate the model parameters and to validate the model results. The estimation of model parameters is accomplished through solving a nonlinear optimization...

  8. STRING BEAN JUICE DECREASES BLOOD GLUCOSE LEVEL PATIENTS WITH DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Harmayetty Harmayetty

    2017-07-01

    Full Text Available Introduction: Type 2 diabetes mellitus is deficiency of insulin and caused by decreases of insulin receptor or bad quality of insulin. As a result, insulin hormone does not work effectively in blood glucose regulation. String bean juice contains thiamin and fiber may regulate blood glucose level. The aim of this study was to analyze the effect of string bean juice to decrease blood glucose level of patients with type 2 diabetes mellitus. Method: This study employed a quasy-experimental pre-post test control group design and purposive sampling.  The population were all type 2 diabetes mellitus patients in Puskesmas Pacar Keling Surabaya. Sample were 12 patients who met inclusion criteria. The independent variable was string bean juice and dependent variable was blood glucose level. Data were analyzed by using Paired T-test with significance level of α≤ 0.05 and Independent T-test with significant level of α≤0.05. Result: The results showed that string bean juice has an effect on decreasing blood glucose between pre test and post test for blood glucose with independent T-test is p=0.003. Analysis: In conclusion, string bean juice has an effect on blood glucose level in patients with type 2 diabetes mellitus. Discussion: The possible explanation for this findings is string bean juice contains two ingredients: thiamine and fiber. Thiamine helps support insulin receptors and glucose transporter in cells hence GLUT-4 could translocated to the cell membrane brought glucouse enter to the  intracellular compartment, that leads to blood glucouse level well regulated.  Dietary fiber reduces food transit time so slowing the glucose absorption. Therefore blood glucose level will be decreased.

  9. Changes in blood glucose and insulin responses to intravenous glucose tolerance tests and blood biochemical values in adult female Japanese black bears (Ursus thibetanus japonicus).

    Science.gov (United States)

    Kamine, Akari; Shimozuru, Michito; Shibata, Haruki; Tsubota, Toshio

    2012-02-01

    The metabolic mechanisms to circannual changes in body mass of bears have yet to be elucidated. We hypothesized that the Japanese black bear (Ursus thibetanus japonicus) has a metabolic mechanism that efficiently converts carbohydrates into body fat by altering insulin sensitivity during the hyperphagic stage before hibernation. To test this hypothesis, we investigated the changes in blood biochemical values and glucose and insulin responses to intravenous glucose tolerance tests (IVGTT) during the active season (August, early and late November). Four, adult, female bears (5-17 years old) were anesthetized with 6 mg/kg TZ (tiletamine HCl and zolazepam HCl) in combination with 0.1 mg/kg acepromazine maleate. The bears were injected intravenously with glucose (0.5 g/kg of body mass), and blood samples were obtained before, at, and intermittently after glucose injection. The basal triglycerides concentration decreased significantly with increase in body mass from August to November. Basal levels of plasma glucose and serum insulin concentrations were not significantly different among groups. The results of IVGTT demonstrated the increased peripheral insulin sensitivity and glucose tolerance in early November. In contrast, peripheral insulin resistance was indicated by the exaggerated insulin response in late November. Our findings suggest that bears shift their glucose and lipid metabolism from the stage of normal activity to the hyperphagic stage in which they show lipogenic-predominant metabolism and accelerate glucose uptake by increasing the peripheral insulin sensitivity.

  10. [Mathematical Modeling of the Blood Glucose Regulation System in Diabetes Mellitus Patients].

    Science.gov (United States)

    Karpel'ev, V A; Filippov, Yu I; Tarasov, Yu V; Boyarsky, M D; Mayorov, A Yu; Shestakova, M V; Dedov, I I

    2015-01-01

    Interest in the mathematical modeling of the carbohydrate metabolism regulation system increases in recent years. This is associated with a "closed loop" insulin pump development (it controls an insulin infusion depending on the blood glucose level). To create an algorithm for the automatic control of insulin (and other hormones) infusion using an insulin pump it is necessary to accurately predict glycaemia level. So, the primary objective of mathematical modeling is to predict the blood glucose level changes, caused by the wide range of external factors. This review discusses the main mathematical models of blood glucose level control physiological system (simplified insulin-glucose system). The two major classes of models--empirical and theoretical--are described in detail. The ideal mathematical model of carbohydrate metabolism regulatory system is absent. However, the success in the field of blood glucose level control modeling and simulating is essentialfor the further development of diabetes prevention and treatment technologies, and creating an artificial pancreas in particular.

  11. Blood Glucose Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... about 4 screens]. Available from: http://americanpregnancy.org/prenatal-testing/glucose-tolerence-test/ Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health ...

  12. The relationships between blood pressure, blood glucose, and bone mineral density in postmenopausal Turkish women.

    Science.gov (United States)

    Cakmak, Huseyin Altug; Cakmak, Burcu Dincgez; Yumru, Ayse Ender; Aslan, Serkan; Enhos, Asim; Kalkan, Ali Kemal; Coskun, Ebru Inci; Acikgoz, Abdullah Serdar; Karatas, Suat

    2015-01-01

    Hypertension, diabetes mellitus, and osteoporosis are important comorbidities commonly seen in postmenopausal women. The aim of the present study was to investigate the relationships between blood pressure, blood glucose, and bone mineral density (BMD) in postmenopausal Turkish women. In this cross-sectional study, 270 consecutive patients who were admitted to an outpatient clinic with vasomotor symptoms and/or at least 1 year of amenorrhea were included. The patients were categorized into three groups according to their blood pressure and metabolic status as follows: normotensive, hypertensive nondiabetics, and hypertensive diabetics. The T- and z-scores of the proximal femur and lumbar vertebrae were measured with the dual-energy X-ray absorptiometry method to assess the BMD of the study groups. Lumbar vertebral T-scores (P<0.001), lumbar vertebral z-scores (P<0.003), and proximal femoral T-scores (P<0.001) were demonstrated to be significantly lower in the hypertensive diabetic group compared to the hypertensive nondiabetic and normotensive groups. Systolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.382; P=0.001), lumbar vertebral z-scores (r=-0.290; P=0.001), and proximal femoral T-scores (r=-0.340; P=0.001). Moreover, diastolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.318; P=0.001), lumbar vertebral z-scores (r=-0.340; P=0.001), and proximal femoral T-scores (r=-0.304; P=0.001). Hypertension (odds ratio [OR]: 2.541, 95% confidence interval [CI]: 1.46-3.48, P=0.003), diabetes mellitus (OR: 2.136, 95% CI: 1.254-3.678, P=0.006), and age (OR: 1.069, 95% CI: 1.007-1.163, P=0.022) were found to be significant independent predictors of osteopenia in a multivariate analysis, after adjusting for other risk parameters. The present study is the first to evaluate the relationships between blood pressure, blood glucose, and BMD in postmenopausal Turkish women. Moreover, both

  13. Once Daily Self-Monitoring of Blood Glucose (SMBG) Improves Glycemic Control in Oral Hypoglycemic Agents (OHA)-Treated Diabetes: SMBG-OHA Follow-Up Study.

    Science.gov (United States)

    Harashima, Shin-Ichi; Nishimura, Akiko; Ikeda, Kaori; Wang, Yu; Liu, Yanyan; Inagaki, Nobuya

    2015-10-01

    The aim of this study was to compare glycemic control between SMBG-continued and -discontinued subjects with type 2 diabetes in the SMBG-OHA study. Of the 96 subjects from the SMBG-OHA study, 59 were recruited for the 24-week, comparison follow-up study. The study outcomes were the differences in change in HbA1c levels at 24 weeks between the 2 groups, and change in SMBG frequency in SMBG-continued subjects. Although health insurance does not cover the cost of SMBG, 22.0% of subjects continued SMBG of their own will after the SMBG-OHA study was completed. HbA1c levels were maintained from 6.81 ± 0.55% to 6.64 ± 0.53% in SMBG-continued subjects. Conversely, HbA1c levels were increased from 7.18 ± 0.63% to 7.48 ± 0.84% in SMBG-discontinued subjects. HbA1c levels were significantly different by 0.83 ± 0.25% (95% CI: -1.33 to -0.36). The difference in change in HbA1c between the groups was -0.46% (95% CI: -0.78 to -0.15). SMBG frequency was decreased from 2.02 ± 1.06 to 1.53 ± 0.86 times a day. HbA1c levels were maintained in SMBG-continued subjects but increased in SMBG-discontinued subjects. The study implied that almost once daily SMBG is helpful to maintain glycemic control in non-insulin-treated type 2 diabetes. © 2015 Diabetes Technology Society.

  14. A comprehensive compartmental model of blood glucose regulation for healthy and type 2 diabetic subjects.

    Science.gov (United States)

    Vahidi, O; Kwok, K E; Gopaluni, R B; Knop, F K

    2016-09-01

    We have expanded a former compartmental model of blood glucose regulation for healthy and type 2 diabetic subjects. The former model was a detailed physiological model which considered the interactions of three substances, glucose, insulin and glucagon on regulating the blood sugar. The main drawback of the former model was its restriction on the route of glucose entrance to the body which was limited to the intravenous glucose injection. To handle the oral glucose intake, we have added a model of glucose absorption in the gastrointestinal tract to the former model to address the resultant variations of blood glucose concentrations following an oral glucose intake. Another model representing the incretins production in the gastrointestinal tract along with their hormonal effects on boosting pancreatic insulin production is also added to the former model. We have used two sets of clinical data obtained during oral glucose tolerance test and isoglycemic intravenous glucose infusion test from both type 2 diabetic and healthy subjects to estimate the model parameters and to validate the model results. The estimation of model parameters is accomplished through solving a nonlinear optimization problem. The results show acceptable precision of the estimated model parameters and demonstrate the capability of the model in accurate prediction of the body response during the clinical studies.

  15. A Meta-Analysis of Blood Glucose Effects on Human Decision Making

    DEFF Research Database (Denmark)

    Orquin, Jacob L.; Kurzban, Robert

    2016-01-01

    The academic and public interest in blood glucose and its relationship to decision making has been increasing over the last decade. To investigate and evaluate competing theories about this relationship, we conducted a psychometric meta-analysis on the effect of blood glucose on decision making. We...... and willingness to work when a situation is food related, but decrease willingness to pay and work in all other situations. Low levels of blood glucose increase the future discount rate for food; that is, decision makers become more impatient, and to a lesser extent increase the future discount rate for money...

  16. Internet-Based Contingency Management to Improve Adherence with Blood Glucose Testing Recommendations for Teens with Type 1 Diabetes

    Science.gov (United States)

    Raiff, Bethany R.; Dallery, Jesse

    2010-01-01

    The current study used Internet-based contingency management (CM) to increase adherence with blood glucose testing to at least 4 times daily. Four teens diagnosed with Type 1 diabetes earned vouchers for submitting blood glucose testing videos over a Web site. Participants submitted a mean of 1.7 and 3.1 blood glucose tests per day during the 2…

  17. Pre-germinated brown rice reduced both blood glucose concentration and body weight in Vietnamese women with impaired glucose tolerance.

    Science.gov (United States)

    Bui, Thi Nhung; Le, Thi Hop; Nguyen, Do Huy; Tran, Quang Binh; Nguyen, Thi Lam; Le, Danh Tuyen; Nguyen, Do Van Anh; Vu, Anh Linh; Aoto, Hiromichi; Okuhara, Yasuhide; Ito, Yukihiko; Yamamoto, Shigeru; Kise, Mitsuo

    2014-01-01

    We have reported that newly diagnosed type 2 diabetes mellitus (DM) patients in Vietnam have a low body mass index (BMI) of around 23 and that the major factor for this is high white rice (WR) intake. Brown rice (BR) is known to be beneficial in the control of blood glucose levels; however, it has the property of unpleasant palatability. Pre-germinated brown rice (PGBR) is slightly germinated by soaking BR in water as this reduces the hardness of BR and makes it easier to eat. This study was designed to evaluate the effect of a 4-mo PGBR administration on various parameters in Vietnamese women aged 45-65 y with impaired glucose tolerance (IGT). Sixty subjects were divided into a WR or PGBR group. For the first 2 wk, WR was replaced by 50% PGBR, then for 2 wk by 75% PGBR and from the second month 100%. Before the beginning of the study and at the end of the study, 1) anthropometric measurements, 2) a nutrition survey for 3 nonconsecutive days by the 24 h recall method and 3) blood biochemical examinations were conducted. Fasting plasma concentrations of glucose and lipids and the obesity-related measurements and blood pressure were favorably improved only in the PGBR diet group. The present results suggest that replacing WR with PGBR for 4 mo may be useful in controlling body weight as well as blood glucose and lipid levels in Vietnamese women with IGT.

  18. Application of optical lens of a CD writer for detecting the blood glucose semi-invasively

    Energy Technology Data Exchange (ETDEWEB)

    Meshram, N. D., E-mail: meshramnileshsd@gmail.com [Mathuradas Mohota College of Sciences, Nagpur-440009 (India); Dahikar, P. B., E-mail: pbdahikar@rediffmail.com [Kamla Nehru Mahavidyalaya, Sakkardara Square, Nagpur-440009 (India)

    2014-10-15

    Recent technological advancements in the photonics industry have led to a resurgence of interest in optical glucose sensing and to realistic progress toward the development of an optical glucose sensor. Such a sensor has the potential to significantly improve the quality of life for the estimated 16 million diabetics in this country by making routine glucose measurements more convenient. Currently over 100 small companies and universities are working to develop noninvasive or minimally invasive glucose sensing technologies, and optical methods play a large role in these efforts. It has become overwhelmingly clear that frequent monitoring and tight control of blood sugar levels are requisite for effective management of Diabetes mellitus and reduction of the complications associated with this disease. The pain and trouble associated with current “finger-stick” methods for blood glucose monitoring result in decreased patient compliance and a failure to control blood sugar levels. Thus, the development of a convenient noninvasive blood glucose monitor holds the potential to significantly reduce the morbidity and mortality associated with Diabetes. A method and apparatus for noninvasive measurement of blood glucose concentration based on transilluminated laser beam via the Index Finger has been reported in this paper. This method depends on photodiode based laser operating at 632.8 nm wavelength. During measurement, the index finger is inserted into the glucose sensing unit, the transilluminated optical signal is converted into an electrical signal, compared with the reference electrical signal, and the obtained difference signal is processed by signal processing unit which presents the results in the form of blood glucose concentration. This method would enable the monitoring blood glucose level of the diabetic patient continuously, safely and noninvasively.

  19. Application of optical lens of a CD writer for detecting the blood glucose semi-invasively

    Science.gov (United States)

    Meshram, N. D.; Dahikar, P. B.

    2014-10-01

    Recent technological advancements in the photonics industry have led to a resurgence of interest in optical glucose sensing and to realistic progress toward the development of an optical glucose sensor. Such a sensor has the potential to significantly improve the quality of life for the estimated 16 million diabetics in this country by making routine glucose measurements more convenient. Currently over 100 small companies and universities are working to develop noninvasive or minimally invasive glucose sensing technologies, and optical methods play a large role in these efforts. It has become overwhelmingly clear that frequent monitoring and tight control of blood sugar levels are requisite for effective management of Diabetes mellitus and reduction of the complications associated with this disease. The pain and trouble associated with current "finger-stick" methods for blood glucose monitoring result in decreased patient compliance and a failure to control blood sugar levels. Thus, the development of a convenient noninvasive blood glucose monitor holds the potential to significantly reduce the morbidity and mortality associated with Diabetes. A method and apparatus for noninvasive measurement of blood glucose concentration based on transilluminated laser beam via the Index Finger has been reported in this paper. This method depends on photodiode based laser operating at 632.8 nm wavelength. During measurement, the index finger is inserted into the glucose sensing unit, the transilluminated optical signal is converted into an electrical signal, compared with the reference electrical signal, and the obtained difference signal is processed by signal processing unit which presents the results in the form of blood glucose concentration. This method would enable the monitoring blood glucose level of the diabetic patient continuously, safely and noninvasively..

  20. Application of optical lens of a CD writer for detecting the blood glucose semi-invasively

    International Nuclear Information System (INIS)

    Meshram, N. D.; Dahikar, P. B.

    2014-01-01

    Recent technological advancements in the photonics industry have led to a resurgence of interest in optical glucose sensing and to realistic progress toward the development of an optical glucose sensor. Such a sensor has the potential to significantly improve the quality of life for the estimated 16 million diabetics in this country by making routine glucose measurements more convenient. Currently over 100 small companies and universities are working to develop noninvasive or minimally invasive glucose sensing technologies, and optical methods play a large role in these efforts. It has become overwhelmingly clear that frequent monitoring and tight control of blood sugar levels are requisite for effective management of Diabetes mellitus and reduction of the complications associated with this disease. The pain and trouble associated with current “finger-stick” methods for blood glucose monitoring result in decreased patient compliance and a failure to control blood sugar levels. Thus, the development of a convenient noninvasive blood glucose monitor holds the potential to significantly reduce the morbidity and mortality associated with Diabetes. A method and apparatus for noninvasive measurement of blood glucose concentration based on transilluminated laser beam via the Index Finger has been reported in this paper. This method depends on photodiode based laser operating at 632.8 nm wavelength. During measurement, the index finger is inserted into the glucose sensing unit, the transilluminated optical signal is converted into an electrical signal, compared with the reference electrical signal, and the obtained difference signal is processed by signal processing unit which presents the results in the form of blood glucose concentration. This method would enable the monitoring blood glucose level of the diabetic patient continuously, safely and noninvasively.

  1. Primary School Principals' Self-Monitoring Skills

    Science.gov (United States)

    Konan, Necdet

    2015-01-01

    The aim of the present study is to identify primary school principals' self-monitoring skills. The study adopted the general survey model and its population comprised primary school principals serving in the city of Diyarbakir, Turkey, while 292 of these constituted the sample. Self-Monitoring Scale was used as the data collection instrument. In…

  2. Control of Blood Glucose for People with Type 1 Diabetes: an in Vivo Study

    DEFF Research Database (Denmark)

    Boiroux, Dimitri; Schmidt, Signe; Duun-Henriksen, Anne Katrine

    2012-01-01

    Since continuous glucose monitoring (CGM) technology and insulin pumps have improved recent years, a strong interest in a closed-loop articial pancreas for people with type 1 diabetes has arisen. Presently, a fully automated controller of blood glucose must face many challenges, such as daily...... variations of patient's physiology and lack of accuracy of glucose sensors. In this paper we design and discuss an algorithm for overnight closed-loop control of blood glucose in people with type 1 diabetes. The algorithm is based on Model Predictive Control (MPC). We use an oset-free autoregressive model...... during daytime. These trials demonstrate the importance of observer design in ARMAX models and show the possibility of stabilizing blood glucose during the night....

  3. Non-invasive blood glucose monitor based on spectroscopy using a smartphone.

    Science.gov (United States)

    Dantu, Vishnu; Vempati, Jagannadh; Srivilliputhur, Srinivasan

    2014-01-01

    Development of a novel method for non-invasive measurement of blood glucose concentration using smartphone is discussed. Our research work has three major contributions to society and science. First, we modified and extended the Beer-Lambert's law in physics to accommodate for multiple wavelengths. This extension can aid researchers who wish to perform optical spectroscopy. Second, we successfully developed a creative and non-invasive way for diabetic patients to measure glucose levels via a smartphone. Researchers and chemists can now use their smartphones to determine the absorbance and, therefore, concentration of a chemical. Third, we created an inexpensive way to perform optical spectroscopy by using a smartphone. Monitoring blood glucose using a smartphone application that simply uses equipment already available on smartphones will improve the lives of diabetic patients who can continuously check their blood glucose levels while avoiding the current inconvenient, unhygienic, and costly invasive glucose meters.

  4. Performance Analysis of Fuzzy-PID Controller for Blood Glucose Regulation in Type-1 Diabetic Patients.

    Science.gov (United States)

    Yadav, Jyoti; Rani, Asha; Singh, Vijander

    2016-12-01

    This paper presents Fuzzy-PID (FPID) control scheme for a blood glucose control of type 1 diabetic subjects. A new metaheuristic Cuckoo Search Algorithm (CSA) is utilized to optimize the gains of FPID controller. CSA provides fast convergence and is capable of handling global optimization of continuous nonlinear systems. The proposed controller is an amalgamation of fuzzy logic and optimization which may provide an efficient solution for complex problems like blood glucose control. The task is to maintain normal glucose levels in the shortest possible time with minimum insulin dose. The glucose control is achieved by tuning the PID (Proportional Integral Derivative) and FPID controller with the help of Genetic Algorithm and CSA for comparative analysis. The designed controllers are tested on Bergman minimal model to control the blood glucose level in the facets of parameter uncertainties, meal disturbances and sensor noise. The results reveal that the performance of CSA-FPID controller is superior as compared to other designed controllers.

  5. Regional brain glucose metabolism and blood flow in streptozocin-induced diabetic rats

    International Nuclear Information System (INIS)

    Jakobsen, J.; Nedergaard, M.; Aarslew-Jensen, M.; Diemer, N.H.

    1990-01-01

    Brain regional glucose metabolism and regional blood flow were measured from autoradiographs by the uptake of [ 3 H]-2-deoxy-D-glucose and [ 14 C]iodoantipyrine in streptozocin-induced diabetic (STZ-D) rats. After 2 days of diabetes, glucose metabolism in the neocortex, basal ganglia, and white matter increased by 34, 37, and 8%, respectively, whereas blood flow was unchanged. After 4 mo, glucose metabolism in the same three regions was decreased by 32, 43, and 60%. This reduction was paralleled by a statistically nonsignificant reduction in blood flow in neocortex and basal ganglia. It is suggested that the decrease of brain glucose metabolism in STZ-D reflects increased ketone body oxidation and reduction of electrochemical work

  6. Increasing Blood Glucose Variability Is a Precursor of Sepsis and Mortality in Burned Patients

    OpenAIRE

    Pisarchik, Alexander N.; Pochepen, Olga N.; Pisarchyk, Liudmila A.

    2012-01-01

    High glycemic variability, rather than a mean glucose level, is an important factor associated with sepsis and hospital mortality in critically ill patients. In this retrospective study we analyze the blood glucose data of 172 nondiabetic patients 18-60 yrs old with second and third-degree burns of total body surface area greater than 30% and 5%, respectively, admitted to ICU in 2004-2008. The analysis identified significant association of increasing daily glucose excursion (DELTA) accompanie...

  7. Interstitial Glucose and Lactate Levels Are Inversely Correlated With the Body Mass Index: Need for In Vivo Calibration of Glucose Sensor Results With Blood Values in Obese Patients.

    Science.gov (United States)

    Enderle, Barbara; Moser, Isabella; Kannan, Cecil; Schwab, Karl Otfried; Urban, Gerald

    2018-03-01

    Continuously measured glucose and lactate levels in interstitial fluid (ISF) may markedly differ from their respective blood levels. Combining microdialysis with a bioanalytical microsystem, the interstitial glucose and lactate concentrations of eight male volunteers with different body mass index (BMI) were monitored during a 2-fold glucose tolerance test over the period of three hours. Significant correlations were found between abdominally measured sensor results and reference measurements ( R 2 = .967 for glucose and R 2 = .936 for lactate, P 34 kg/m 2 showed abdominally as well as the antebrachially significantly reduced tissue glucose values compared to blood glucose values ( P < .001). A very good correlation between abdominally measured sensor results and the results of the reference method verified the reliability of the BioMEMS. The abdominally measured glucose level in ISF decreased significantly with increasing BMI. Therefore, an in vivo calibration of glucose levels in ISF with blood levels seems to be necessary especially in markedly obese subjects.

  8. The associations of a marine diet with plasma lipids, blood glucose, blood pressure and obesity among the inuit in Greenland

    DEFF Research Database (Denmark)

    Bjerregaard, P; Pedersen, H S; Mulvad, G

    2000-01-01

    OBJECTIVE: To analyse the associations between the intake of fish and marine mammals and risk factors for cardiovascular disease, ie lipid profile, fasting blood glucose, blood pressure and obesity, in a population whose average consumption of n-3 fatty acids is high compared with Western countries...

  9. Accuracy Evaluation of Four Blood Glucose Monitoring Systems in the Hands of Intended Users and Trained Personnel Based on ISO 15197 Requirements.

    Science.gov (United States)

    Freckmann, Guido; Baumstark, Annette; Jendrike, Nina; Rittmeyer, Delia; Pleus, Stefan; Haug, Cornelia

    2017-04-01

    Self-monitoring of blood glucose (BG) is an integral part in the therapy of people with diabetes, which is why blood glucose monitoring systems (BGMS) have to fulfill minimum accuracy requirements. However, accuracy is often assessed by trained operators, although such assessments do not necessarily allow for drawing conclusions on accuracy in the hands of lay users. The accuracy of 4 different BGMS (Accu-Chek ® Active, Accu-Chek ® Performa, Contour ® Plus, and OneTouch ® SelectSimple™) in the hands of lay users and trained study personnel was assessed in this study. Procedures were based on International Organization for Standardization (ISO) 15197:2013, clause 8, requirements. BGMS measurement results were compared against results from a glucose oxidase and a hexokinase laboratory analyzer. Handling errors made by lay users were documented. Accuracy was evaluated applying ISO 15197:2013/EN ISO 15197:2015 criteria (percentage of results within ±15 mg/dL or ±15%), more stringent criteria (10 mg/dL or 10%, and 5 mg/dL or 5%, respectively), and ISO 15197:2003 system accuracy criteria. The level of accuracy differed among the four BGMS investigated independent from the operator. One system had less than 95% of the values within each of the limits and one system showed marked differences in accuracy when used by trained personnel and by lay users. Common lay user errors were not checking the test strip codes, incorrect application of blood, and not using the blood drop immediately. BGMS accuracy can differ when used by trained personnel and when used by lay users. It is important that BGMS manufacturers provide systems that are as insensitive to operator errors as technically possible and easy to use.

  10. Glucose Pump Test can be Used to Measure Blood Flow Rate of ...

    African Journals Online (AJOL)

    The aim of study is to determine whether glucose pump test (GPT) is used for surveillance of native AV fistulas by using Doppler US as reference. Methods: In 93 chronic hemodialysis patients with native AV fistula, blood flow rates were measured by Doppler US and GPT. For GPT, glucose was infused to 16 mL/min by ...

  11. Haematological Indices, Blood glucose levels and lipid profile of rats ...

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    2015-11-11

    dose ... hypoglycemic effect in rats, no negative effect was observed on lipid profile. KEY WORDS: Tartrazine E102; glucose; haematological; cholesterol; triacylglycerol ... sulfanilic acid and aminopyrazolone. The pyrazolone ...

  12. Effects of blood glucose level on FDG uptake by liver: a FDG-PET/CT study

    Energy Technology Data Exchange (ETDEWEB)

    Kubota, Kazuo, E-mail: kkubota@cpost.plala.or.j [Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo 162-8655 (Japan); Watanabe, Hiroshige; Murata, Yuji [Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519 (Japan); Yukihiro, Masashi; Ito, Kimiteru; Morooka, Miyako; Minamimoto, Ryogo [Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo 162-8655 (Japan); Hori, Ai [Department of Epidemiology and International Health, Research Institute, National Center for Global Health and Medicine, Tokyo 162-8655 (Japan); Shibuya, Hitoshi [Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519 (Japan)

    2011-04-15

    In FDG-PET for abdominal malignancy, the liver may be assumed as an internal standard for grading abnormal FDG uptake both in early images and in delayed images. However, physiological variables of FDG uptake by the liver, especially the effects of blood glucose level, have not yet been elucidated. Methods: FDG-PET studies of 70 patients examined at 50 to 70 min after injection (60{+-}10 min: early images) and of 68 patients examined at 80 to 100 min after injection (90{+-}10 min: delayed images) were analyzed for liver FDG uptake. Patients having lesions in the liver, spleen and pancreas; patients having bulk tumor in other areas; and patients early after chemotherapy or radiotherapy were excluded; also, patients with blood glucose level over 125 mg/dl were excluded. Results: Mean standardized uptake value (SUV) of the liver, blood glucose level and sex showed no significant differences between early images and delayed images. However, liver SUV in the delayed image showed a larger variation than that in the early image and showed significant correlation to blood glucose level. The partial correlation coefficient between liver SUV and blood glucose level in the delayed image with adjustment for sex and age was 0.73 (P<.0001). Multivariate regression coefficient (95% confidence interval) of blood glucose was 0.017 (0.013-0.021). Conclusion: Blood glucose level is an important factor affecting the normal liver FDG uptake in nondiabetic patients. In the case of higher glucose level, liver FDG uptake is elevated especially in the delayed image. This may be due to the fact that the liver is the key organ responsible for glucose metabolism through gluconeogenesis and glycogen storage.

  13. Effect of blood glucose level on 18F-FDG PET/CT imaging

    International Nuclear Information System (INIS)

    Tan Haibo; Lin Xiangtong; Guan Yihui; Zhao Jun; Zuo Chuantao; Hua Fengchun; Tang Wenying

    2008-01-01

    Objective: The aim of this study was to investigate the effect of blood glucose level on the image quality of 18 F-fluorodeoxyglucose (FDG) PET/CT imaging. Methods: Eighty patients referred to the authors' department for routine whole-body 18 F-FDG PET/CT check up were recruited into this study. The patients were classified into 9 groups according to their blood glucose level: normal group avg and SUV max ) of liver on different slices. SPSS 12.0 was used to analyse the data. Results: (1) There were significant differences among the 9 groups in image quality scores and image noises (all P avg and SUV max : 0.60 and 0.33, P<0.05). Conclusions: The higher the blood glucose level, the worse the image quality. When the blood glucose level is more than or equal to 12.0 mmol/L, the image quality will significantly degrade. (authors)

  14. 75 FR 2549 - Clinical Accuracy Requirements for Point of Care Blood Glucose Meters; Public Meeting; Request...

    Science.gov (United States)

    2010-01-15

    .... When registering, you must provide your name, title, company or organization (if applicable), address... and clinical use of blood glucose meters, to share ideas on the challenges associated with their use...

  15. Effects of yogic exercises on life stress and blood glucose levels in nursing students.

    Science.gov (United States)

    Kim, Sang Dol

    2014-12-01

    [Purpose] This study was performed to investigate the effects of yogic exercises on life stress and blood glucose levels in nursing students. [Subjects and Methods] The study was a randomized controlled trial. Twenty-seven undergraduate nursing students were randomly selected, with 12 assigned to an exercise group and 15 assigned to a control group. The yogic exercises intervention was undertaken for 60 minutes one day a week for 12 weeks. It consisted of physical exercise (surya namaskara) combined with relaxation and meditation (shavasana and yoga nidra). Life stress was measured by the Life Stress Scale for College Students, and postprandial blood glucose levels were measured with a digital glucometer. [Results] The exercise group measurements were significantly decreased in both life stress and postprandial blood glucose levels compared with the control group. [Conclusion] These findings indicate that yogic exercises would reduce life stress and lower postprandial blood glucose levels in nursing students.

  16. Blood Glucose and Cholesterol Concentrations in a Mediterranean Rural Population of Andros Island, Greece

    Directory of Open Access Journals (Sweden)

    Konstantinos T Tsaousis

    2014-01-01

    Conclusions: The present study confirms that dyslipidemia and high blood glucose levels are prevalent among the rural populations of Greece and therefore informative campaigns and structured screening programs are required to promote preventive health care.

  17. Assessing portable blood glucose meters for clinical use in cats in the United Kingdom.

    Science.gov (United States)

    Dobromylskyj, M J; Sparkes, A H

    2010-09-18

    The aims of this study were to evaluate six portable blood glucose meters for use in cats in a clinical setting and to identify potential sources of inaccuracy such as the effect of glucose concentration and haematocrit. Excess fluorinated whole-blood samples were obtained and were tested using the six meters and a reference laboratory method. Bland-Altman plots were constructed and an error grid analysis was performed, using a grid adapted in this study for diabetic cats. Error grids are a clinically oriented non-parametric approach to blood glucose data, and are designed to determine whether differences between glucometer and laboratory readings are clinically significant. All the meters studied had the potential to under- or overestimate blood glucose levels to varying degrees throughout the glycaemic range. This variation was not consistent enough to be predictable and correctable. The study failed to demonstrate any link between haematocrit and difference between laboratory and glucometer readings.

  18. Dimethylarginines, blood glucose, and C-reactive protein in patients with acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Aurélie Gudjoncik

    2016-04-01

    Conclusion: Our study showed that in patients with acute MI, SDMA, and only weakly ADMA, are associated with admission blood glucose, beyond traditional dimethylarginine determinants and may therefore have biological activity beyond renal function.

  19. Optical coherence tomography for blood glucose monitoring in vitro through spatial and temporal approaches

    Science.gov (United States)

    De Pretto, Lucas Ramos; Yoshimura, Tania Mateus; Ribeiro, Martha Simões; Zanardi de Freitas, Anderson

    2016-08-01

    As diabetes causes millions of deaths worldwide every year, new methods for blood glucose monitoring are in demand. Noninvasive approaches may increase patient adherence to treatment while reducing costs, and optical coherence tomography (OCT) may be a feasible alternative to current invasive diagnostics. This study presents two methods for blood sugar monitoring with OCT in vitro. The first, based on spatial statistics, exploits changes in the light total attenuation coefficient caused by different concentrations of glucose in the sample using a 930-nm commercial OCT system. The second, based on temporal analysis, calculates differences in the decorrelation time of the speckle pattern in the OCT signal due to blood viscosity variations with the addition of glucose with data acquired by a custom built Swept Source 1325-nm OCT system. Samples consisted of heparinized mouse blood, phosphate buffer saline, and glucose. Additionally, further samples were prepared by diluting mouse blood with isotonic saline solution to verify the effect of higher multiple scattering components on the ability of the methods to differentiate glucose levels. Our results suggest a direct relationship between glucose concentration and both decorrelation rate and attenuation coefficient, with our systems being able to detect changes of 65 mg/dL in glucose concentration.

  20. Opto-acoustic monitoring of blood optical properties as a function of glucose concentration

    Science.gov (United States)

    Bednov, Andrey A.; Savateeva, Elena V.; Oraevsky, Alexander A.

    2003-06-01

    Time-resolved optoacoustic (OA) method was employed to measure changes in glucose concentration in the whole and diluted blood. An increase of the glucose level in tissue results in a corresponding decrease of optical scattering. Relative changes in tissue optical scattering can be obtained by measuring the effective optical attenuation coefficient, μeff by exponential fitting of the time-resolved optoacoustic profiles. Glucose effects in blood have been investigated using the forward mode of OA detection performed in the visible (at the wavelength, λ=532 nm) and near infrared (λ=1064 nm) spectral ranges. In our previous set of experiments, the OA studies performed in model media in vitro and biological tissue (sclera) in vivo demonstrated gradual reduction of optical scattering with the increase in glucose level. The present study has supported our previous observations. However, one novel effect was observed comprised of a transient increase in μeff during the first 5-10 minutes after injection of glucose. This phenomenon may be explained by changes in erythrocytes shape and size as a result of their adaptation to hyperglycemic conditions. Our observation was supported by light microscopy images of red blood cells under normal and hyperglycemic conditions. With glucose concentration changing rapidly (osmotic shock), any small reduction in ´eff due to the glucose-induced decrease of relative refraction index of blood, can be compensated or even overwhelmed by the increase in ´eff due to erythrocyte shrinkage and/or spherulation. Further cellular adaptation to glucose make erythrocytes return to their normal shape of biconcave disks about 7-μm in diameter. The kinetics of the effective optical attenuation was studies in response to glucose injection in order to better understand the mechanisms of erythrocyte adaptation to osmotic shock and to determine the time course of RBCs adaptation to various glucose concentrations. Finally, Mannitol as alternative

  1. Clinical implication of blood glucose monitoring in general dental offices: the Ehime Dental Diabetes Study

    OpenAIRE

    Harase, Tadahiro; Nishida, Wataru; Hamakawa, Tomohiro; Hino, Satoshi; Shigematsu, Kenji; Kobayashi, Satoru; Sako, Hirofumi; Ito, Shirou; Murakami, Hajime; Nishida, Kei; Inoue, Hiroshi; Fujisawa, Masahito; Yoshizu, Hiroshi; Kawamura, Ryoichi; Takata, Yasunori

    2015-01-01

    Objective We examined whether general dentists can contribute to the detection of patients with undiagnosed diabetes and prediabetes by monitoring blood glucose in dental clinics. Research design and methods A total of 716 patients who visited clinics for dental treatment were enrolled and classified into 3 groups (mild, moderate, and severe) according to Kornman's criteria for periodontitis. The correlations between the casual blood glucose level, presence or absence of the history of diabet...

  2. Glucometer as a chairside device to assess blood glucose in periodontal patients

    Directory of Open Access Journals (Sweden)

    G N Bala Raghavendra

    2010-01-01

    Full Text Available Background: Diabetes mellitus is a common finding in the medical history of patients receiving treatment for periodontal disease. The incidence of diabetes is on the rise worldwide. Virtually, every dentist and especially the periodontist are likely to encounter an increasing number of undiagnosed diabetic patients. The conventional laboratory methods employed to detect blood glucose are time consuming and require elaborative equipment. The advent of blood glucose monitors allows the clinician to assess blood glucose at the chair side. Materials and Methods: The use of gingival capillary blood as a marker for blood glucose estimation using glucometer against the conventional laboratory method has been assessed in 60 diabetics and 70 controls. Results: The correlation between gingival and finger-stick blood was r = 0.996, P<0.001 in diabetics and controls. Correlation between gingival and laboratory method was r = 0.994, P<0.001 in cases and controls. Conclusion: The results suggest that capillary blood from the outer surface of gingiva provide an acceptable source for measuring blood glucose.

  3. Determination of glucose levels using dried filter paper blood spots: new perspective in home monitoring

    OpenAIRE

    Ward, Laura Sterian; Novis, Renata Britto; Nascimento, Veridiana Toledo; Nóbrega, Miriam Siesler; Saad, Mário José Abdalla

    1996-01-01

    We present a method for the determination of blood glucose using dried filter paper blood spots.To validate this method, we compared our results using filter paper and simultaneously collected venous blood. We demonstrated that there is a linear relationship between the filter paper glucose levels and those determined in whole blood (r=0.98). There was no significant difference between the results of the two methods (p>0.05).This method is a cheap alternative which may improve the control of ...

  4. Determination of glucose levels using dried filter paper blood spots: new perspective in home monitoring

    Directory of Open Access Journals (Sweden)

    Laura Sterian Ward

    Full Text Available We present a method for the determination of blood glucose using dried filter paper blood spots.To validate this method, we compared our results using filter paper and simultaneously collected venous blood. We demonstrated that there is a linear relationship between the filter paper glucose levels and those determined in whole blood (r=0.98. There was no significant difference between the results of the two methods (p>0.05.This method is a cheap alternative which may improve the control of diabetes mellitus, and may also be very useful in the diagnosis of postprandial hypoglycemia and other special situations.

  5. EFFECT OF SAPPAN WOOD (Caesalpinnia sappan L EXTRACT ON BLOOD GLUCOSE LEVEL IN WHITE RATS

    Directory of Open Access Journals (Sweden)

    Saefudin Saefudin

    2016-05-01

    Full Text Available Sappan wood or kayu secang (Caesalpinia sappan L. was reported of having medicinal properties, such as natural antioxidant, relieve vomiting of blood, and mix of ingredients for malaria drugs. The research was conducted to study the influence of ethanol extract from sappan wood on blood glucose level of white rats. The study of the blood glucose level in rats was carried out by using glucose tolerance method. It was measured by Refloluxs (Accutrend GC with Chloropropamide 50 mg/200 g BW (Body weight as positive control. The ethanol extracts were used in various concentrations 10, 20, 30, 40 and 50 mg/200 g BW per-oral and was observed every hour, beginning one hour before to 7 hours after the extract being administered. The results showed that treatment of ethanol extract of sappan wood by administer doses gave remarkable effect on the blood glucose level in white rat. It reduced the glucose level in the blood compared to the negative and positive control. Treatment of dose 30 mg/200 g BW gave similar effect to positive controls, while a dose of 50 mg/200 g BW gave lower blood glucose level (93 mg/dl than the positive controls.

  6. Cerebrospinal fluid ionic regulation, cerebral blood flow, and glucose use during chronic metabolic alkalosis

    Energy Technology Data Exchange (ETDEWEB)

    Schroeck, H.K.; Kuschinsky, W. (Univ. of Bonn (Germany, F.R.))

    1989-10-01

    Chronic metabolic alkalosis was induced in rats by combining a low K+ diet with a 0.2 M NaHCO3 solution as drinking fluid for either 15 or 27 days. Local cerebral blood flow and local cerebral glucose utilization were measured in 31 different structures of the brain in conscious animals by means of the iodo-(14C)antipyrine and 2-(14C)deoxy-D-glucose method. The treatment induced moderate (15 days, base excess (BE) 16 mM) to severe (27 days, BE 25 mM) hypochloremic metabolic alkalosis and K+ depletion. During moderate metabolic alkalosis no change in cerebral glucose utilization and blood flow was detectable in most brain structures when compared with controls. Cerebrospinal fluid (CSF) K+ and H+ concentrations were significantly decreased. During severe hypochloremic alkalosis, cerebral blood flow was decreased by 19% and cerebral glucose utilization by 24% when compared with the control values. The decrease in cerebral blood flow during severe metabolic alkalosis is attributed mainly to the decreased cerebral metabolism and to a lesser extent to a further decrease of the CSF H+ concentration. CSF K+ concentration was not further decreased. The results show an unaltered cerebral blood flow and glucose utilization together with a decrease in CSF H+ and K+ concentrations at moderate metabolic alkalosis and a decrease in cerebral blood flow and glucose utilization together with a further decreased CSF H+ concentration at severe metabolic alkalosis.

  7. Waist circumference as a predictor for blood glucose levels in adults

    Directory of Open Access Journals (Sweden)

    Shinta L Hardiman

    2016-02-01

    Full Text Available Anthropometric indexes such as body mass index (BMI, waist circumference (WC, hip ciucumference (HC, and waist–hip ratio (WHR, are all useful anthropometric measurements to provide important information on blood glucose concentrations. The aim of this study was to determine different anthropometric measurements, in particular BMI, waist circumference, hip circumference and waist-to-hip ratio, in their ability to predict the blood glucose levels in men and women 40 to 60. A cross-sectional study was conducted on a sample of 44 men and 127 women aged 40 to 50 who lived in Cipete Selatan subdistrict, South Jakarta. Blood glucose levels was assessed and anthropometric measurements comprising BMI, WC, HC, WHR were collected. Multiple linear regression analysis was used to determine the best predictor for blood glucose levels. The study showed that the prevalence of DM type 2 was 25.7% and the prevalence was higher in men (40.9% compared to women (23.5%. The significant predictive variables in the simple regression analysis were age and waist circumference. Multiple linear regression showed that after adjustment for age, WC was positively associated with blood glucose levels. Standardized a value was 0.172 (p=0.026. WC predict blood glucose levels, beyond that explained by traditional diabetic risk factors and BMI. These findings provide support for the recommendation that WC be a routine measure for identification of diabetes mellitus type 2 in men and women aged 40 to 60 years.

  8. Self-Monitoring and the Metatraits.

    Science.gov (United States)

    Wilmot, Michael P; DeYoung, Colin G; Stillwell, David; Kosinski, Michal

    2016-06-01

    Prior attempts at locating self-monitoring within general taxonomies of personality traits have largely proved unsuccessful. However, past research has typically neglected (a) the bidimensionality of the Self-Monitoring Scale and (b) the hierarchical nature of personality. The objective of this study was to test hypotheses that the two self-monitoring factors are located at the level of the metatraits. Using data from two large multi-informant samples, one community (Sample 1: N = 552, Mage  = 51.26, 61% female; NPeers  = 1,551, Mage  = 48.61, 37% female) and one online (Sample 2: N = 3,726, Mage  = 24.89, 59% female; NPeers  = 17,868, Mage  = 26.23, 64% female), confirmatory factor analysis was used to test the hypotheses. Results confirmed hypotheses that acquisitive self-monitoring would have a strong positive relation to metatrait Plasticity, whereas protective self-monitoring would have a moderate negative relation to metatrait Stability. In both samples, constraining the correlation between acquisitive self-monitoring and Plasticity to unity did not alter model fit indices, indicating that the two putatively distinct constructs are identical. Findings have wide-ranging implications, including integration of the construct of self-monitoring into the mainstream of personality research, as the latter moves toward the development of broad explanatory theories. © 2015 Wiley Periodicals, Inc.

  9. Low blood glucose precipitates spike-and-wave activity in genetically predisposed animals.

    Science.gov (United States)

    Reid, Christopher A; Kim, Tae Hwan; Berkovic, Samuel F; Petrou, Steven

    2011-01-01

    Absence epilepsies are common, with a major genetic contribution to etiology. Certain environmental factors can influence absence occurrence but a complete understanding of absence precipitation is lacking. Herein we investigate if lowering blood glucose increases spike-wave activity in mouse models with varying seizure susceptibility. Three mouse models were used: an absence seizure model based on the knockin of a human GABA(A) γ2(R43Q) mutation (DBA(R43Q)), the spike-wave discharge (SWD)-prone DBA/2J strain, and the seizure resistant C57Bl/6 strain. Electrocorticography (ECoG) studies were recorded to determine SWDs during hypoglycemia induced by insulin or overnight fasting. An insulin-mediated reduction in blood glucose levels to 4 mm (c.a. 40% reduction) was sufficient to double SWD occurrence in the DBA(R43Q) model and in the SWD-prone DBA/2J mouse strain. Larger reductions in blood glucose further increased SWDs in both these models. However, even with large reductions in blood glucose, no discharges were observed in the seizure-resistant C57Bl/6 mouse strain. Injection of glucose reversed the impact of insulin on SWDs in the DBA(R43Q) model, supporting a reduction in blood glucose as the modulating influence. Overnight fasting reduced blood glucose levels to 4.5 mm (c.a. 35% reduction) and, like insulin, caused a doubling in occurrence of SWDs. Low blood glucose can precipitate SWDs in genetically predisposed animal models and should be considered as a potential environmental risk factor in patients with absence epilepsy. Wiley Periodicals, Inc. © 2010 International League Against Epilepsy.

  10. Variations in Postprandial Blood Glucose Responses and Satiety after Intake of Three Types of Bread

    OpenAIRE

    Lunde, Marianne S. H.; Hjellset, Victoria T.; Holmboe-Ottesen, Gerd; Høstmark, Arne T.

    2011-01-01

    Background The burden of obesity, type 2 diabetes (T2D) and cardio-vascular diseases (CVD) is rapidly increasing worldwide. Impaired glucose tolerance (IGT), in which the blood glucose level is higher than normal but not as high as in diabetes, is also a major public health problem. People with IGT have a higher risk of developing T2D and CVD, and especially the magnitude and duration of the postprandial blood glucose concentration (PPG) seems of crucial importance. In Norway, immigrants from...

  11. The association between Western and Prudent dietary patterns and fasting blood glucose levels in type 2 diabetes and normal glucose metabolism in older Australian adults.

    Science.gov (United States)

    Walsh, Erin I; Jacka, Felice N; Butterworth, Peter; Anstey, Kaarin J; Cherbuin, Nicolas

    2017-06-01

    High blood glucose and type 2 diabetes are associated with a range of adverse health and cognitive outcomes. One factor that contributes to high blood glucose and type 2 diabetes is dietary intake. This study investigated the relationship between dietary patterns, fasting blood glucose and diabetes status in a sample of 209 participants aged 60-65. Blood plasma glucose was measured from venous blood samples. Individual Prudent and Western dietary patterns were estimated from a self-completed food frequency questionnaire. The relationship between dietary patterns, diabetes, and blood glucose was assessed via general linear model analyses controlling for age, sex, height, and total caloric intake. Results indicated that there was no association between Prudent diet and fasting blood glucose levels, or type 2 diabetes. In contrast, an individual in the upper tertile for Western dietary score had a significantly higher risk of having diabetes than an individual in the lower tertile for Western dietary score. However, there was no significant association between Western diet and fasting blood glucose. Western diet may be associated with type 2 diabetes through mechanisms beyond impacting blood plasma glucose directly. The fact that the association between Western diet and type 2 diabetes remained even when total caloric intake was controlled for highlights the need for policy and population health interventions targeting the reduction of unhealthy food consumption.

  12. Data Based Prediction of Blood Glucose Concentrations Using Evolutionary Methods.

    Science.gov (United States)

    Hidalgo, J Ignacio; Colmenar, J Manuel; Kronberger, Gabriel; Winkler, Stephan M; Garnica, Oscar; Lanchares, Juan

    2017-08-08

    Predicting glucose values on the basis of insulin and food intakes is a difficult task that people with diabetes need to do daily. This is necessary as it is important to maintain glucose levels at appropriate values to avoid not only short-term, but also long-term complications of the illness. Artificial intelligence in general and machine learning techniques in particular have already lead to promising results in modeling and predicting glucose concentrations. In this work, several machine learning techniques are used for the modeling and prediction of glucose concentrations using as inputs the values measured by a continuous monitoring glucose system as well as also previous and estimated future carbohydrate intakes and insulin injections. In particular, we use the following four techniques: genetic programming, random forests, k-nearest neighbors, and grammatical evolution. We propose two new enhanced modeling algorithms for glucose prediction, namely (i) a variant of grammatical evolution which uses an optimized grammar, and (ii) a variant of tree-based genetic programming which uses a three-compartment model for carbohydrate and insulin dynamics. The predictors were trained and tested using data of ten patients from a public hospital in Spain. We analyze our experimental results using the Clarke error grid metric and see that 90% of the forecasts are correct (i.e., Clarke error categories A and B), but still even the best methods produce 5 to 10% of serious errors (category D) and approximately 0.5% of very serious errors (category E). We also propose an enhanced genetic programming algorithm that incorporates a three-compartment model into symbolic regression models to create smoothed time series of the original carbohydrate and insulin time series.

  13. Energized by love: thinking about romantic relationships increases positive affect and blood glucose levels.

    Science.gov (United States)

    Stanton, Sarah C E; Campbell, Lorne; Loving, Timothy J

    2014-10-01

    We assessed the impact of thinking of a current romantic partner on acute blood glucose responses and positive affect over a short period of time. Participants in romantic relationships were randomly assigned to reflect on their partner, an opposite-sex friend, or their morning routine. Blood glucose levels were assessed prior to reflection, as well as at 10 and 25 min postreflection. Results revealed that individuals in the routine and friend conditions exhibited a decline in glucose over time, whereas individuals in the partner condition did not exhibit this decline (rather, a slight increase) in glucose over time. Reported positive affect following reflection was positively associated with increases in glucose, but only for individuals who reflected on their partner, suggesting this physiological response reflects eustress. These findings add to the literature on eustress in relationships and have implications for relationship processes. Copyright © 2014 Society for Psychophysiological Research.

  14. The relationships between blood pressure, blood glucose, and bone mineral density in postmenopausal Turkish women

    Directory of Open Access Journals (Sweden)

    Cakmak HA

    2015-10-01

    Full Text Available Huseyin Altug Cakmak,1 Burcu Dincgez Cakmak,2 Ayse Ender Yumru,3 Serkan Aslan,4 Asim Enhos,1 Ali Kemal Kalkan,4 Ebru Inci Coskun,5 Abdullah Serdar Acikgoz,6 Suat Karatas3 1Department of Cardiology, Mustafakemalpasa Government Hospital, Bursa, 2Department of Obstetric and Gynecology, Rize Kackar Government Hospital, Rize, 3Department of Obstetric and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital, 4Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 5Department of Obstetric and Gynecology, Inonu University, Malatya, 6Department of Obstetric and Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Background: Hypertension, diabetes mellitus, and osteoporosis are important comorbidities commonly seen in postmenopausal women. The aim of the present study was to investigate the relationships between blood pressure, blood glucose, and bone mineral density (BMD in postmenopausal Turkish women.Methods: In this cross-sectional study, 270 consecutive patients who were admitted to an outpatient clinic with vasomotor symptoms and/or at least 1 year of amenorrhea were included. The patients were categorized into three groups according to their blood pressure and metabolic status as follows: normotensive, hypertensive nondiabetics, and hypertensive diabetics. The T- and z-scores of the proximal femur and lumbar vertebrae were measured with the dual-energy X-ray absorptiometry method to assess the BMD of the study groups.Results: Lumbar vertebral T-scores (P<0.001, lumbar vertebral z-scores (P<0.003, and proximal femoral T-scores (P<0.001 were demonstrated to be significantly lower in the hypertensive diabetic group compared to the hypertensive nondiabetic and normotensive groups. Systolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.382; P=0.001, lumbar vertebral z-scores (r=-0.290; P=0.001, and

  15. Institutional point-of-care glucometer identifies population trends in blood glucose associated with war.

    Science.gov (United States)

    Boaz, Mona; Matas, Zipora; Chaimy, Tova; Landau, Zohar; Bar Dayan, Yosefa; Berlovitz, Yitzhak; Wainstein, Julio

    2013-11-01

    Acute physiological stress has been shown to impair glucose homeostasis. War is a period of acute psychological stress, and its effect on glucose control is unknown. In this study random point-of-care (POC) glucose levels were measured using an automated, institutional glucometer in hospitalized adult patients prior to versus during the Israeli Pillar of Defense campaign (November 7-10, 2012). Random POC glucose values measured with the institutional blood glucose monitoring system were obtained 1 week prior to the Pillar of Defense campaign (November 7-10, 2012) and compared with values to those obtained during the first 4 days of the war (November 14-17, 2012). In total, 3,573 POC glucose measures were included: 1,865 during the pre-war period and 1,708 during the campaign. POC glucose measures were significantly higher during the war compared with the week preceding the war: 9.7±4.7 versus 9.3±4.2 mmol/L (P=0.02). In a general linear model, period (pre-war vs. during war) persisted as a significant predictor of POC glucose even after controlling for age, sex, and department type (internal medicine vs. surgical). Acute stress, such as a wartime situation, is associated with a significant increase in random blood glucose values in a population of hospitalized adults. Long-term follow-up of the individuals hospitalized during these two periods can reveal differences in morbidity and mortality trends.

  16. Paper membrane-based SERS platform for the determination of glucose in blood samples.

    Science.gov (United States)

    Torul, Hilal; Çiftçi, Hakan; Çetin, Demet; Suludere, Zekiye; Boyacı, Ismail Hakkı; Tamer, Uğur

    2015-11-01

    In this report, we present a paper membrane-based surface-enhanced Raman scattering (SERS) platform for the determination of blood glucose level using a nitrocellulose membrane as substrate paper, and the microfluidic channel was simply constructed by wax-printing method. The rod-shaped gold nanorod particles were modified with 4-mercaptophenylboronic acid (4-MBA) and 1-decanethiol (1-DT) molecules and used as embedded SERS probe for paper-based microfluidics. The SERS measurement area was simply constructed by dropping gold nanoparticles on nitrocellulose membrane, and the blood sample was dropped on the membrane hydrophilic channel. While the blood cells and proteins were held on nitrocellulose membrane, glucose molecules were moved through the channel toward the SERS measurement area. Scanning electron microscopy (SEM) was used to confirm the effective separation of blood matrix, and total analysis is completed in 5 min. In SERS measurements, the intensity of the band at 1070 cm(-1) which is attributed to B-OH vibration decreased depending on the rise in glucose concentration in the blood sample. The glucose concentration was found to be 5.43 ± 0.51 mM in the reference blood sample by using a calibration equation, and the certified value for glucose was 6.17 ± 0.11 mM. The recovery of the glucose in the reference blood sample was about 88 %. According to these results, the developed paper-based microfluidic SERS platform has been found to be suitable for use for the detection of glucose in blood samples without any pretreatment procedure. We believe that paper-based microfluidic systems may provide a wide field of usage for paper-based applications.

  17. ( Myrciaria jaboticaba ) peel on blood glucose and cholesterol levels ...

    African Journals Online (AJOL)

    Berg) peel was lyophilized and the proximate composition, total anthocyanins and polyphenolic content were determined. The effect of the freeze-dried jaboticaba peels (FJP) in the plasmatic levels of glucose, lipid fractions, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in Wistar adult male rats was ...

  18. Examination of liver and muscle glycogen and blood glucose levels ...

    African Journals Online (AJOL)

    Administrator

    2011-09-05

    Sep 5, 2011 ... consist 1% of the total body weight. This source is sufficient to provide the energy need for a .... Atlantic salmon consists 0.5 to 9.5% of the liver weight. Ali and Jauncey (2005) stated that liver glycogen ..... Plasma glucose and liver glycogen of. African catfish (Clarias gariepinus) exposed to petrol. J. Fish. Int.

  19. Daidzin decreases blood glucose and lipid in streptozotocin ...

    African Journals Online (AJOL)

    Serum or hepatic levels of lipid, proinflammatory factors, malondialdehyde (MDA) .... Animals were housed under a constant 12-h light and dark cycle and in an environment of 21 - 23 °C. To test the effect of DZ in normal mice, the animals were randomly divided into ..... hepatic glucose and lipid metabolism in diabetic db/db.

  20. Blood glucose control in the intensive care unit: benefits and risks.

    Science.gov (United States)

    Gunst, Jan; Van den Berghe, Greet

    2010-01-01

    Abnormal blood glucose levels are common during critical illness and are associated with outcomes that correspond to a J-shaped curve, the lowest risk associated with normoglycemia. Three proof-of-concept randomized-controlled-trials performed in the surgical, medical, and pediatric intensive care units of the Leuven University Hospital in Belgium demonstrated that maintaining strict age-adjusted normal fasting levels of glycemia (80-110 mg/dl in adults, 70-100 mg/dl in children, 50-80 mg/dl in infants) with intensive insulin therapy reduced morbidity and mortality as compared with tolerating stress hyperglycemia as a potentially beneficial response. Recently, concern has risen about the safety of this intervention, as a multicenter adult study reported an, as yet unexplained, increased mortality with targeting normoglycemia as compared with an intermediate blood glucose level of around 140 mg/dl. This apparent contradiction may be explained by several methodological differences among studies, comprising, among others, different glucose target ranges in the control groups, different feeding policies, and variable accuracy of tools used for glucose measurement and insulin infusion. Hence, efficacy and safety of intensive insulin therapy may be affected by patient-related and ICU setting-related variables. Therefore, no single optimal blood glucose target range for ICU patients can be advocated. It appears safe not to embark on targeting "age-normal" levels in intensive care units (ICUs) that are not equipped to accurately and frequently measure blood glucose, and have not acquired extensive experience with intravenous insulin administration using a customized guideline. A simple fallback position could be to control blood glucose levels as close to normal as possible without evoking unacceptable blood glucose fluctuations, hypoglycemia, and hypokalemia.

  1. On the suitability of refractometry for the analysis of glucose in blood-derived fluids.

    Science.gov (United States)

    Zirk, K; Poetzschke, H

    2004-07-01

    Refractometry is the determination of the optical refractive index of a substance or a mixture of substances. It is a very sensitive method for the detection and quantification of dissolved analytes, but it is incapable of distinguishing between different analytes. The aim of this investigation was to determine the principle suitability of refractometry for the quantification of glucose (blood sugar) in blood and various blood fluids which can readily be obtained for medical diagnosis, in particular blood plasma, blood serum, and their ultrafiltrates. After the oral intake of freshly dissolved alpha-glucose, the in vivo blood contents of the alpha and beta anomers of glucose were found to be in an at least approximate equilibrium at all times. This observation is a prerequisite for a refractometrical determination of glucose due to the fact that both molecule forms have different refractive index increments. An assessment of the glucose content in untreated blood fluids was not possible, since no suitable relationship to the refractive index was found, most probably due to the influence of the many other substances present in blood on this parameter. However, after removal of certain macromolecules by ultrafiltration, value pairs showed a high level of correlation, providing the nominal molecular weight limit (cut-off) of the ultrafilter used possessed a maximum of 300 kDa. Besides macromolecules, the osmolality of the fluids undergoing measurement also proved to be a considerable interfering factor, particularly when values were outside the normal physiological range between 285 and 293 mmol/L. If a clinical application of this method is to be contemplated it is imperative (1) that blood cells are separated and removed, (2) that macromolecules present in plasma or serum are removed, e.g. by ultrafiltration, and (3) that beyond the results presented the influence of all small molecules other than glucose on the overall refractive index be determined and included in

  2. Social Inclusion Predicts Lower Blood Glucose and Low-Density Lipoproteins in Healthy Adults.

    Science.gov (United States)

    Floyd, Kory; Veksler, Alice E; McEwan, Bree; Hesse, Colin; Boren, Justin P; Dinsmore, Dana R; Pavlich, Corey A

    2017-08-01

    Loneliness has been shown to have direct effects on one's personal well-being. Specifically, a greater feeling of loneliness is associated with negative mental health outcomes, negative health behaviors, and an increased likelihood of premature mortality. Using the neuroendocrine hypothesis, we expected social inclusion to predict decreases in both blood glucose levels and low-density lipoproteins (LDLs) and increases in high-density lipoproteins (HDLs). Fifty-two healthy adults provided self-report data for social inclusion and blood samples for hematological tests. Results indicated that higher social inclusion predicted lower levels of blood glucose and LDL, but had no effect on HDL. Implications for theory and practice are discussed.

  3. The Coupling of Cerebral Metabolic Rate of Glucose and Cerebral Blood Flow In Vivo

    DEFF Research Database (Denmark)

    Hasselbalch, Steen; Paulson, Olaf Bjarne

    2012-01-01

    The energy supplied to the brain by metabolic substrate is largely utilized for maintaining synaptic transmission. In this regulation cerebral blood flow and glucose consumption is tightly coupled as well in the resting condition as during activation. Quantification of cerebral blood flow...... and metabolism was originally performed using the Kety-Schmidt method and this method still represent the gold standard by which subsequent methods have been evaluated. However, in its classical setting, the method overestimates cerebral blood flow. Studies of metabolic changes during activation must take...... difficulties due to limitation in resolution and partial volume effects. In contrast to the tight coupling between regional glucose metabolism and cerebral blood flow, there is an uncoupling between flow and oxygen consumption as the latter only increases to a limited extend. The excess glucose uptake is thus...

  4. Association of physical activity with blood pressure and blood glucose among Malaysian adults: a population-based study.

    Science.gov (United States)

    Teh, Chien Huey; Chan, Ying Ying; Lim, Kuang Hock; Kee, Chee Cheong; Lim, Kuang Kuay; Yeo, Pei Sien; Azahadi, Omar; Fadhli, Yusoff; Tahir, Aris; Lee, Han Lim; Nazni, Wasi Ahmad

    2015-12-03

    The health-enhancing benefits of physical activity (PA) on hypertension and diabetes have been well documented for decades. This study aimed to determine the association of PA with systolic and diastolic blood pressure as well as blood glucose in the Malaysian adult population. Data were extracted from the 2011 National Health and Morbidity Survey (NHMS), a nationally representative, cross-sectional study. A two-stage stratified sampling method was used to select a representative sample of 18,231 Malaysian adults aged 18 years and above. The PA levels of the respondents were categorised as low, moderate or high according to the International Physical Activity Questionnaire (IPAQ)-short form. Blood pressure and fasting blood glucose levels were measured using a digital blood pressure-measuring device and finger-prick test, respectively. Systolic blood pressure (SBP) level was positively associated with PA level (p = 0.02) whilst no significant association was noted between PA level and diastolic blood pressure (DBP). In contrast, respondents with low (adjusted coefficient = 0.17) or moderate (adjusted coefficient = 0.03) level of PA had significantly higher blood glucose level as compared to those who were highly active (p = 0.04). A significant negative association was observed between PA level and blood glucose only. Future studies should employ an objective measurement in estimating PA level in order to elucidate the actual relationship between PA, hypertension and diabetes for the development of effective interventions to combat the increasing burden of premature-mortality and cardiovascular disease-related morbidity in Malaysia.

  5. Comparison of breath gases, including acetone, with blood glucose and blood ketones in children and adolescents with type 1 diabetes.

    Science.gov (United States)

    Blaikie, Tom P J; Edge, Julie A; Hancock, Gus; Lunn, Daniel; Megson, Clare; Peverall, Rob; Richmond, Graham; Ritchie, Grant A D; Taylor, David

    2014-11-25

    Previous studies have suggested that breath gases may be related to simultaneous blood glucose and blood ketone levels in adults with type 2 and type 1 diabetes. The aims of this study were to investigate these relationships in children and young people with type 1 diabetes in order to assess the efficacy of a simple breath test as a non-invasive means of diabetes management. Gases were collected in breath bags and measurements were compared with capillary blood glucose and ketone levels taken at the same time on a single visit to a routine hospital clinic in 113 subjects (59 male, age 7 years 11 months-18 years 3 months) with type 1 diabetes. The patients were well-controlled with relatively low concentrations of the blood ketone measured (β hydroxybutyrate, 0-0.4 mmol l(-1)). Breath acetone levels were found to increase with blood β hydroxybutyrate levels and a significant relationship was found between the two (Spearman's rank correlation ρ = 0.364, p acetone (ρ = 0.16, p = 0.1), but led to the conclusion that single breath measurements of acetone do not provide a good measure of blood glucose levels in this cohort. This result suggests a potential to develop breath gas analysis to provide an alternative to blood testing for ketone measurement, for example to assist with the management of type 1 diabetes.

  6. Glycolysis in the control of blood glucose homeostasis

    OpenAIRE

    Xin Guo; Honggui Li; Hang Xu; Shihlung Woo; Hui Dong; Fuer Lu; Alex J. Lange; Chaodong Wu

    2012-01-01

    Glycolysis, a simple pathway of glucose metabolism, critically regulates insulin secretion and metabolic functions of various cells. Depending on cell types, rates of glycolysis are determined at various steps of glycolysis that are subjected to the control of key metabolic and regulatory enzyme(s), which include glucokinase, 6-phosphofructo-1-kinase, and 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase. These enzymes are regulated by both nutritional and hormonal signals at the levels of...

  7. Effects of exposure to malathion on blood glucose concentration: a meta-analysis.

    Science.gov (United States)

    Ramirez-Vargas, Marco Antonio; Flores-Alfaro, Eugenia; Uriostegui-Acosta, Mayrut; Alvarez-Fitz, Patricia; Parra-Rojas, Isela; Moreno-Godinez, Ma Elena

    2018-02-01

    Exposure to malathion (an organophosphate pesticide widely used around the world) has been associated with alterations in blood glucose concentration in animal models. However, the results are inconsistent. The aim of this meta-analysis was to evaluate whether malathion exposure can disturb the concentrations of blood glucose in exposed rats. We performed a literature search of online databases including PubMed, EBSCO, and Google Scholar and reviewed original articles that analyzed the relation between malathion exposure and glucose levels in animal models. The selection of articles was based on inclusion and exclusion criteria. The database search identified thirty-five possible articles, but only eight fulfilled our inclusion criteria, and these studies were included in the meta-analysis. The effect of malathion on blood glucose concentration showed a non-monotonic dose-response curve. In addition, pooled analysis showed that blood glucose concentrations were 3.3-fold higher in exposed rats than in the control group (95% CI, 2-5; Z = 3.9; p < 0.0001) in a random-effect model. This result suggested that alteration of glucose homeostasis is a possible mechanism of toxicity associated with exposure to malathion.

  8. Dapagliflozin-lowered blood glucose reduces respiratory Pseudomonas aeruginosa infection in diabetic mice.

    Science.gov (United States)

    Åstrand, Annika; Wingren, Cecilia; Benjamin, Audra; Tregoning, John S; Garnett, James P; Groves, Helen; Gill, Simren; Orogo-Wenn, Maria; Lundqvist, Anders J; Walters, Dafydd; Smith, David M; Taylor, John D; Baker, Emma H; Baines, Deborah L

    2017-05-01

    Hyperglycaemia increases glucose concentrations in airway surface liquid and increases the risk of pulmonary Pseudomonas aeruginosa infection. We determined whether reduction of blood and airway glucose concentrations by the anti-diabetic drug dapagliflozin could reduce P. aeruginosa growth/survival in the lungs of diabetic mice. The effect of dapagliflozin on blood and airway glucose concentration, the inflammatory response and infection were investigated in C57BL/6J (wild type, WT) or leptin receptor-deficient (db/db) mice, treated orally with dapagliflozin prior to intranasal dosing with LPS or inoculation with P. aeruginosa. Pulmonary glucose transport and fluid absorption were investigated in Wistar rats using the perfused fluid-filled lung technique. Fasting blood, airway glucose and lactate concentrations were elevated in the db/db mouse lung. LPS challenge increased inflammatory cells in bronchoalveolar lavage fluid from WT and db/db mice with and without dapagliflozin treatment. P. aeruginosa colony-forming units (CFU) were increased in db/db lungs. Pretreatment with dapagliflozin reduced blood and bronchoalveolar lavage glucose concentrations and P. aeruginosa CFU in db/db mice towards those seen in WT. Dapagliflozin had no adverse effects on the inflammatory response in the mouse or pulmonary glucose transport or fluid absorption in the rat lung. Pharmacological lowering of blood glucose with dapagliflozin effectively reduced P. aeruginosa infection in the lungs of diabetic mice and had no adverse pulmonary effects in the rat. Dapagliflozin has potential to reduce the use, or augment the effect, of antimicrobials in the prevention or treatment of pulmonary infection. © 2017 The Authors. British Journal of Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

  9. Glycolysis in the control of blood glucose homeostasis

    Directory of Open Access Journals (Sweden)

    Xin Guo

    2012-08-01

    Full Text Available Glycolysis, a simple pathway of glucose metabolism, critically regulates insulin secretion and metabolic functions of various cells. Depending on cell types, rates of glycolysis are determined at various steps of glycolysis that are subjected to the control of key metabolic and regulatory enzyme(s, which include glucokinase, 6-phosphofructo-1-kinase, and 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase. These enzymes are regulated by both nutritional and hormonal signals at the levels of transcription, translation, and post-translational modifications. In hepatocytes, glycolysis is involved in the control of hepatic glucose production. The latter, when excessive, contributes to hyperglycemia in diabetes. In pancreatic β cells, glycolysis couples glucose-stimulated insulin secretion. Absolute or relatively low levels of circulating insulin causes hyperglycemia. In adipocytes, glycolysis generates metabolites for lipogenesis and channels fatty acids from excessive oxidation to triglyceride synthesis, thereby reducing oxidative stress. With increased proinflammatory status, adipocytes produce pro-hyperglycemic factors and bring about hyperglycemia and insulin resistance. In hypothalamic neurons, glycolysis conveys nutrient sensing that is related to feeding control. Dysregulation of glycolysis occurs in conditions of insulin deficiency or resistance, and is attributable to inappropriate amount and/or activities of metabolic and regulatory enzymes of glycolysis. Targeting key metabolic and regulatory enzymes to enhance glycolysis may offer viable approaches for treatment of diabetes.

  10. Effect of decrease in both postprandial blood glucose (PBG) and fasting blood glucose (FBG) levels in normal beagle dogs with nateglinide enteric coated granules and immediate release tablets.

    Science.gov (United States)

    Makino, Chisato; Ninomiya, Nobutaka; Sakai, Hidetoshi; Orita, Haruo; Okano, Akira; Yabuki, Akira

    2006-04-01

    Nateglinide is a new quick action/short duration (QRSD) type of oral blood glucose regulator, and nateglinide immediate release tablets are used for patients with mild diabetes under the trade name of Fastic((R)) tablets. In this study, we attempted to determine if it was possible to control both post-prandial blood glucose level (PBG) and fasting blood glucose level (FBG) for moderate or severe diabetes through controlled release of nateglinide. Enteric coated granules were selected for the administration form for controlled release of nateglinide, and three types of enteric coated granules were prepared having dissolution pH values of 5.5, 6.5 and 7.2. The three types of enteric coated granules were each administered separately or the enteric coated granules having an dissolution pH of 6.5 were administered simultaneous to administration of nateglinide immediate release tablets to normal beagle dogs just before feeding followed by measurement of plasma nateglinide concentration, plasma insulin concentration and blood glucose level. In the case of administering enteric coated granules alone (nateglinide: 9 mg/kg), the absorption of nateglinide was confirmed to tend to be delayed as the dissolution pH increased. In the case of an dissolution pH of 5.5, decreases in both PBG and FBG were observed. In the case of dissolution pH values of 6.5 and 7.2, only decrease in FBG was observed. In case of nateglinide immediate release tablets (nateglinide: 9 mg/kg), only decrease in PBG was observed. Decreases in both PBG and FBG were observed in the case of simultaneous administration of dissolution pH 6.5 enteric coated granules and nateglinide immediate release tablets just before feeding (nateglinide: 90 mg/head+60 mg/head). A correlation was observed between plasma nateglinide concentrations and blood glucose levels. On the other hand, there were no correlations observed between changes in plasma insulin concentrations and blood glucose levels. In case of nateglinide

  11. Effect of transmucosal corn syrup application on postoperative blood glucose concentrations in kittens.

    Science.gov (United States)

    Cornell, Heather N; Shaver, Stephanie L; Semick, Danielle N; Bradley, Nancy C; Kreisler, Rachael E

    2018-04-01

    Objectives The aim of the study was to determine the effect of a common clinical practice, the transmucosal (TM) application of corn syrup, on postoperative blood glucose concentrations in kittens. Methods This study was designed as a randomized controlled trial. Seventy-five kittens between the age of 8 and 16 weeks scheduled for surgical sterilization by gonadectomy at an animal shelter were enrolled. Kittens were randomly assigned to either a routine treatment group that received the shelter's typical postoperative application of corn syrup immediately following gonadectomy or to a control group that did not receive typical treatment. Three blood glucose measurements were obtained per kitten: baseline reading prior to preoperative examination, immediately postoperatively and 20 mins postoperatively. The median values of the 20 min postoperative blood glucose reading for the control and treatment groups were compared using the Wilcoxon rank-sum test. Results Postoperative application of corn syrup to the oral mucosa of kittens did not result in significant elevations in blood glucose compared with controls. No kitten was hypoglycemic (⩽60 mg/dl) at any point during the study. Conclusions and relevance TM application of corn syrup did not affect postoperative blood glucose concentrations in kittens. Protocols that use routine TM administration of corn syrup in kittens should be re-evaluated.

  12. How Effective is Swedish Massage on Blood Glucose Level in Children with Diabetes Mellitus?

    Directory of Open Access Journals (Sweden)

    Firoozeh Sajedi

    2011-09-01

    Full Text Available "nThis study was conducted to determine the effect of Swedish massage on blood glucose level in children with diabetes mellitus (DM. It was prospective randomized controlled trial study that conducted on 36 children, 6-12 years old with DM, recruited from a hospital in Qom City, Iran. The children were randomly assigned to intervention and control groups. Swedish massage was performed 15 minutes, 3 times a week, for 3 months in intervention group. The blood glucose levels were evaluated immediately after every session of massage in two groups. The mean ages of children in the intervention (n=18 and control (n=18 groups were 9.05 ± 1.55 and 9.83 ±2.03 years respectively. There was statistically no significant difference in blood glucose levels before intervention between two groups (P=0.586, but the blood glucose levels were lower significantly in intervention group in comparison with control group after intervention (P<0.0001. Addition of Swedish massage to daily routines; exercise, diet and medication regimens, is an effective intervention to reduce blood glucose level in diabetic children.

  13. Accuracy and precision of the Prodigy AutoCode blood glucose monitor.

    Science.gov (United States)

    Prohaska, Emily S; Herring, Charles; Russell, Gregory B; Smith, Jennifer D

    2012-04-01

    To assess the accuracy and precision of the Prodigy AutoCode blood glucose monitor. This open-label, prospective equivalence study was conducted at Wilson Community Health Center in Wilson, North Carolina. Accuracy was assessed by comparing finger stick blood glucose values to venipuncture. Precision was assessed by comparing consecutive finger stick blood glucose values from 2 Prodigy AutoCode monitors. Data were analyzed using paired t tests, signed rank tests, regression, and mixed effect models. Fifty-three subjects completed the study. Meter 1 produced 14 (26%) and meter 2 produced 13 (25%) blood glucose readings outside the acceptable error margin of ±20% set by the International Organization for Standardization (ISO) and the Food and Drug Administration (FDA). Neither meter was accurate compared to venipuncture (P Prodigy AutoCode demonstrated precision between two different monitors but was inaccurate compared to venipuncture. Less than the required 95% of blood glucose values from each monitor fell within the acceptable 20% error margin relative to venipuncture. All readings outside the acceptable error margin were overestimations, indicating potentially significant safety concerns including untreated or undertreated hypoglycemia.

  14. Conversion of oral glucose to lactate in dogs. Primary site and relative contribution to blood lactate

    International Nuclear Information System (INIS)

    Youn, J.H.; Bergman, R.N.

    1991-01-01

    The authors evaluated the relative contribution of oral glucose to arterial lactate and the relative role of the splanchnic bed in converting glucose to lactate in dogs. After an oral glucose load (1.2 g/kg) spiked with [U-14C]glucose (16.9 muCi/kg; protocol 1, n = 7), arterial blood lactate increased from 0.43 ± 0.03 mM at basal to a peak of 1.04 ± 0.07 mM at 45 min and then slowly decreased to 0.47 ± 0.07 mM at 240 min. Arterial blood 14 Clactate peaked at 60 min and then decreased to ∼ 35% of the peak at 4 h. When arterial blood lactate peaked at 45 min, the proportion of arterial lactate that was derived from oral glucose was 34 ± 3%. The integrated area under the curve of lactate derived from exogenous glucose was 40 ± 2% of that of total lactate. The splanchnic bed released lactate and 14 Clactate during the initial 2 h after oral 14 Cglucose. Thus, the splanchnic bed apparently contributed to the conversion of exogenous glucose to lactate. In the matched experiments (protocol 2, n = 5), dogs were given the same amount of oral glucose but no 14 Cglucose, and [U-14C]lactate was infused into the right atrium to match the splanchnic 14 Clactate release from the first experiment. Despite a well-matched splanchnic 14 Clactate contribution, arterial concentrations of 14 Clactate were markedly lower in protocol 2 compared with protocol 1. The integrated area under the 14 Clactate profile in protocol 2 was only 11 ± 1% of that in protocol 1. These results indicate that the splanchnic bed is responsible for only 11% of arterial blood lactate that was derived from oral glucose. They concluded that (1) after oral glucose loading, a major portion of circulating lactate has its origin not in exogenous glucose but in endogenous sources, and (2) the splanchnic bed is not the major site of oral glucose conversion to lactate after glucose ingestion

  15. Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment

    Science.gov (United States)

    Vandersluis, Stacey; Kabali, Conrad; Djalalov, Sandjar; Gajic-Veljanoski, Olga; Wells, David; Holubowich, Corinne

    2018-01-01

    Background Type 1 diabetes is a condition in which the pancreas produces little or no insulin. People with type 1 diabetes must manage their blood glucose levels by monitoring the amount of glucose in their blood and administering appropriate amounts of insulin via injection or an insulin pump. Continuous glucose monitoring may be beneficial compared to self-monitoring of blood glucose using a blood glucose meter. It provides insight into a person's blood glucose levels on a continuous basis, and can identify whether blood glucose levels are trending up or down. Methods We conducted a health technology assessment, which included an evaluation of clinical benefit, value for money, and patient preferences related to continuous glucose monitoring. We compared continuous glucose monitoring with self-monitoring of blood glucose using a finger-prick and a blood glucose meter. We performed a systematic literature search for studies published since January 1, 2010. We created a Markov model projecting the lifetime horizon of adults with type 1 diabetes, and performed a budget impact analysis from the perspective of the health care payer. We also conducted interviews and focus group discussions with people who self-manage their type 1 diabetes or support the management of a child with type 1 diabetes. Results Twenty studies were included in the clinical evidence review. Compared with self-monitoring of blood glucose, continuous glucose monitoring improved the percentage of time patients spent in the target glycemic range by 9.6% (95% confidence interval 8.0–11.2) to 10.0% (95% confidence interval 6.75–13.25) and decreased the number of severe hypoglycemic events. Continuous glucose monitoring was associated with higher costs and small increases in health benefits (quality-adjusted life-years). Incremental cost-effectiveness ratios (ICERs) ranged from $592,206 to $1,108,812 per quality-adjusted life-year gained in analyses comparing four continuous glucose monitoring

  16. The fluctuation of blood glucose, insulin and glucagon concentrations before and after insulin therapy in type 1 diabetes

    Science.gov (United States)

    Arif, Idam; Nasir, Zulfa

    2015-09-01

    A dynamical-systems model of plasma glucose, insulin and glucagon concentrations has been developed to investigate the effects of insulin therapy on blood glucose, insulin and glucagon regulations in type 1 diabetic patients. Simulation results show that the normal regulation of blood glucose concentration depends on insulin and glucagon concentrations. On type 1 diabetic case, the role of insulin on regulating blood glucose is not optimal because of the destruction of β cells in pancreas. These β cells destructions cause hyperglycemic episode affecting the whole body metabolism. To get over this, type 1 diabetic patients need insulin therapy to control the blood glucose level. This research has been done by using rapid acting insulin (lispro), long-acting insulin (glargine) and the combination between them to know the effects of insulin therapy on blood glucose, insulin and glucagon concentrations. Simulation results show that these different types of insulin have different effects on blood glucose concentration. Insulin therapy using lispro shows better blood glucose control after consumption of meals. Glargin gives better blood glucose control between meals and during sleep. Combination between lispro and glargine shows better glycemic control for whole day blood glucose level.

  17. Association of physical activity with blood pressure and blood glucose among Malaysian adults: a population-based study

    OpenAIRE

    Teh, Chien Huey; Chan, Ying Ying; Lim, Kuang Hock; Kee, Chee Cheong; Lim, Kuang Kuay; Yeo, Pei Sien; Azahadi, Omar; Fadhli, Yusoff; Tahir, Aris; Lee, Han Lim; Nazni, Wasi Ahmad

    2015-01-01

    Background The health-enhancing benefits of physical activity (PA) on hypertension and diabetes have been well documented for decades. This study aimed to determine the association of PA with systolic and diastolic blood pressure as well as blood glucose in the Malaysian adult population. Methods Data were extracted from the 2011 National Health and Morbidity Survey (NHMS), a nationally representative, cross-sectional study. A two-stage stratified sampling method was used to select a represen...

  18. Non-invasive estimate of blood glucose and blood pressure from a photoplethysmograph by means of machine learning techniques.

    Science.gov (United States)

    Monte-Moreno, Enric

    2011-10-01

    This work presents a system for a simultaneous non-invasive estimate of the blood glucose level (BGL) and the systolic (SBP) and diastolic (DBP) blood pressure, using a photoplethysmograph (PPG) and machine learning techniques. The method is independent of the person whose values are being measured and does not need calibration over time or subjects. The architecture of the system consists of a photoplethysmograph sensor, an activity detection module, a signal processing module that extracts features from the PPG waveform, and a machine learning algorithm that estimates the SBP, DBP and BGL values. The idea that underlies the system is that there is functional relationship between the shape of the PPG waveform and the blood pressure and glucose levels. As described in this paper we tested this method on 410 individuals without performing any personalized calibration. The results were computed after cross validation. The machine learning techniques tested were: ridge linear regression, a multilayer perceptron neural network, support vector machines and random forests. The best results were obtained with the random forest technique. In the case of blood pressure, the resulting coefficients of determination for reference vs. prediction were R(SBP)(2)=0.91, R(DBP)(2)=0.89, and R(BGL)(2)=0.90. For the glucose estimation, distribution of the points on a Clarke error grid placed 87.7% of points in zone A, 10.3% in zone B, and 1.9% in zone D. Blood pressure values complied with the grade B protocol of the British Hypertension society. An effective system for estimate of blood glucose and blood pressure from a photoplethysmograph is presented. The main advantage of the system is that for clinical use it complies with the grade B protocol of the British Hypertension society for the blood pressure and only in 1.9% of the cases did not detect hypoglycemia or hyperglycemia. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. GLP-1 analog raises glucose transport capacity of blood-brain barrier in Alzheimer's disease

    DEFF Research Database (Denmark)

    Gejl, M.; Brock, B.; Egefjord, L.

    2017-01-01

    Objectives: Glucose enters the brain tissue from plasma by facilitated diffusion across the two membranes of the endothelium of the blood-brain barrier (BBB), mediated by the glucose transporter 1 (GLUT1). There is evidence in Alzheimer's disease (AD) of reduction of glucose transport across...... the blood-brain barrier, due to diminished GLUT1 translocation and expression at the BBB. Reduced BBB GLUT1 expression is known to aggravate AD pathology and further impair cognitive function, implying that GLUT1 may be a potential target of therapy directed towards AD neurovascular dysfunction...... and degeneration. Hypothesis: The incretin hormone GLP-1 prevents the decline of the cerebral metabolic rate of glucose that signifies cognitive impairment, synaptic dysfunction, and disease evolution in AD, and GLP-1 may directly activate GLUT1 transport in brain capillary endothelium. For this reason, we here...

  20. High activity enables life on a high-sugar diet : blood glucose regulation in nectar-feeding bats

    NARCIS (Netherlands)

    Kelm, Detlev H; Simon, Ralph; Kuhlow, Doreen; Voigt, Christian C; Ristow, Michael

    2011-01-01

    High blood glucose levels caused by excessive sugar consumption are detrimental to mammalian health and life expectancy. Despite consuming vast quantities of sugar-rich floral nectar, nectar-feeding bats are long-lived, provoking the question of how they regulate blood glucose. We investigated blood

  1. Increasing blood glucose variability is a precursor of sepsis and mortality in burned patients.

    Directory of Open Access Journals (Sweden)

    Alexander N Pisarchik

    Full Text Available High glycemic variability, rather than a mean glucose level, is an important factor associated with sepsis and hospital mortality in critically ill patients. In this retrospective study we analyze the blood glucose data of 172 nondiabetic patients 18-60 yrs old with second and third-degree burns of total body surface area greater than 30% and 5%, respectively, admitted to ICU in 2004-2008. The analysis identified significant association of increasing daily glucose excursion (DELTA accompanied by evident episodes of hyperglycemia (>11 mmol/l and hypoglycemia (<2.8 mmol/l, with sepsis and forthcoming death, even when the mean daily glucose was within a range of acceptable glycemia. No association was found in sepsis complication and hospital mortality with doses of intravenous insulin and glucose infusion. A strong increase in DELTA before sepsis and death is treated as fluctuation amplification near the onset of dynamical instability.

  2. Association between whole blood mercury and glucose intolerance among adult Inuit in Greenland.

    Science.gov (United States)

    Jeppesen, Charlotte; Valera, Beatriz; Nielsen, Nina O; Bjerregaard, Peter; Jørgensen, Marit E

    2015-11-01

    The Arctic diet is partly constituted by traditional food characterized by top predator animals such as whales, walrus, and seals with high mercury content. Mercury exposure has been associated with glucose intolerance in Western populations. We studied the association between whole blood mercury and glucose intolerance in a highly exposed non-Western population Cross-sectional study of 2640 Inuit (18+ years) with information on ancestry, smoking, waist circumference, total energy intake, and physical activity. Mercury, fasting- and 2-h plasma glucose, insulin, and c-peptide were measured in blood. Fasting participants without diabetes were classified into normal glucose tolerance, impaired glucose tolerance, impaired fasting glycemia, or type 2 diabetes. We calculated hepatic insulin resistance with homoeostatic model assessment - insulin resistance index, peripheral insulin sensitivity by ISI0,120., and relative beta cell function by c-peptide/insulin ratio. We conducted adjusted linear- and logistic regression analyses. For an increase in whole blood mercury of 5 µg/L we found a positive association with fasting glucose [% change=0.25 (95% CI: 0.20; 0.30); p<0.001], and 2-h glucose [% change=0.23 (95% CI: 0.05; 0.40); p=0.01]. Mercury was weakly associated with impaired fasting glycemia [OR=1.03 (95% CI: 1.02; 1.05)], and type 2 diabetes [OR=1.02 (95% CI: 1.01; 1.04)]. While the study found a weak but statistically significant association between whole blood mercury and both impaired fasting glycemia and type 2 diabetes, no associations were found with measures of underlying disturbances in glucose homoeostasis. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Chronotopic and blood pressure response to oral glucose load in chagas' disease

    Directory of Open Access Journals (Sweden)

    Maria Elena Guariento

    Full Text Available Cardiac chronotropic and pressor responses after an oral load of glucose were assessed in sixteen Chagasic subjects and 28 controls by means of blood pressure and pulse rate measurements. Cardiovascular response was correlated with serum insulin and glucose levels. The experiment identified a subgroup of Chagasic subjects (n=8 with a hypoinsulinemic behavior presenting less chronotropic and pressor responses than controls. This may indicate a lower insulin activity and/or an early Autonomic Nervous System dysfunction in this subgroup.

  4. Association between whole blood mercury and glucose intolerance among adult Inuit in Greenland

    DEFF Research Database (Denmark)

    Jeppesen, Charlotte; Valera, Beatriz; Nielsen, Nina O

    2015-01-01

    OBJECTIVES: The Arctic diet is partly constituted by traditional food characterized by top predator animals such as whales, walrus, and seals with high mercury content. Mercury exposure has been associated with glucose intolerance in Western populations. We studied the association between whole...... blood mercury and glucose intolerance in a highly exposed non-Western population METHODS: Cross-sectional study of 2640 Inuit (18+ years) with information on ancestry, smoking, waist circumference, total energy intake, and physical activity. Mercury, fasting- and 2-h plasma glucose, insulin, and c...

  5. Path modelling of antecedent of diabetes mellitus on blood glucose measurements

    Science.gov (United States)

    Latif, Humaira'Abdul; Hamid, Mohd Rashid Ab; Azizan, Nor Azlinna; Jemain, Abdul Aziz

    2017-05-01

    Diabetes Mellitus (DM) is one of the non-communicable diseases and public health problems facing the worldwide population that includes Malaysia. Hitherto, the prevalence of DM becomes worsening with an estimated of 3.4 million Malaysians are diabetes sufferers and expectedly increasing year by year. Thus, this study is of great importance by regressing the medical factors that affect the blood glucose level using structural equation modelling (SEM). The SEM with partial least squares (PLS) estimation was applied to a secondary data of 644 respondents, aged ≥ 18 years in Malaysia. The data were collected in 2011 by Ministry of Health Malaysia (MOH). The variables under study are blood glucose level, cholesterol level (CL), systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC) and body mass index (BMI). From the modelling analysis, it showed that the cholesterol level (CL), systolic blood pressure (SBP) and waist circumference (WC) showed a positive significant relationship p diabetes mellitus among adults.

  6. Smart point-of-care systems for molecular diagnostics based on nanotechnology: whole blood glucose analysis

    Science.gov (United States)

    Devadhasan, Jasmine P.; Kim, Sanghyo

    2015-07-01

    Complementary metal oxide semiconductor (CMOS) image sensors are received great attention for their high efficiency in biological applications. The present work describes a CMOS image sensor-based whole blood glucose monitoring system through a point-of-care (POC) approach. A simple poly-ethylene terephthalate (PET) film chip was developed to carry out the enzyme kinetic reaction at various concentrations of blood glucose. In this technique, assay reagent was adsorbed onto amine functionalized silica (AFSiO2) nanoparticles in order to achieve glucose oxidation on the PET film chip. The AFSiO2 nanoparticles can immobilize the assay reagent with an electrostatic attraction and eased to develop the opaque platform which was technically suitable chip to analyze by the camera module. The oxidized glucose then produces a green color according to the glucose concentration and is analyzed by the camera module as a photon detection technique. The photon number decreases with increasing glucose concentration. The simple sensing approach, utilizing enzyme immobilized AFSiO2 nanoparticle chip and assay detection method was developed for quantitative glucose measurement.

  7. A Microwave Metamaterial Inspired Sensor for Non-Invasive Blood Glucose Monitoring

    Directory of Open Access Journals (Sweden)

    J. Vrba

    2015-12-01

    Full Text Available In this paper, a microwave sensor based on an artificial transmission line is proposed for non-invasive blood glucose monitoring. A corresponding numerical model of the sensor implemented in microstrip technology is created in the commercial full-wave numerical simulation tool COMSOL Multiphysics and virtually tested by means of numerical simulations. Blood-glucose solution models with various blood glucose concentrations are used as a model of a biological tissue under test. Furthermore, a possible methodology for performing non-invasive tests is proposed. Sensitivity of the sensor developed here is compared to a sensor based on a section of a conventional microstrip transmission line of the same length and width.

  8. Control of blood glucose in type 2 diabetes without weight loss by modification of diet composition

    Directory of Open Access Journals (Sweden)

    Gannon Mary C

    2006-03-01

    Full Text Available Abstract Background Over the past several years our research group has taken a systematic, comprehensive approach to determining the effects on body function (hormonal and non-hormonal of varying the amounts and types of proteins, carbohydrates and fats in the diet. We have been particularly interested in the dietary management of type 2 diabetes. Our objective has been to develop a diet for people with type 2 diabetes that does not require weight loss, oral agents, or insulin, but that still controls the blood glucose concentration. Our overall goal is to enable the person with type 2 diabetes to control their blood glucose by adjustment in the composition rather than the amount of food in their diet. Methods This paper is a brief summary and review of our recent diet-related research, and the rationale used in the development of diets that potentially are useful in the treatment of diabetes. Results We determined that, of the carbohydrates present in the diet, absorbed glucose is largely responsible for the food-induced increase in blood glucose concentration. We also determined that dietary protein increases insulin secretion and lowers blood glucose. Fat does not significantly affect blood glucose, but can affect insulin secretion and modify the absorption of carbohydrates. Based on these data, we tested the efficacy of diets with various protein:carbohydrate:fat ratios for 5 weeks on blood glucose control in people with untreated type 2 diabetes. The results were compared to those obtained in the same subjects after 5 weeks on a control diet with a protein:carbohydrate:fat ratio of 15:55:30. A 30:40:30 ratio diet resulted in a moderate but significant decrease in 24-hour integrated glucose area and % total glycohemoglobin (%tGHb. A 30:20:50 ratio diet resulted in a 38% decrease in 24-hour glucose area, a reduction in fasting glucose to near normal and a decrease in %tGHb from 9.8% to 7.6%. The response to a 30:30:40 ratio diet was similar

  9. Blood plasma separation in ZnO nanoflowers-supported paper based microfluidic for glucose sensing

    Science.gov (United States)

    Muhimmah, Luthviyah Choirotul; Roekmono, Hadi, Harsono; Yuwono, Rio Akbar; Wahyuono, Ruri Agung

    2018-04-01

    Blood plasma separation is essential to analyze and quantify the bio-substances in the human blood and hence, allows for diagnosing various diseases. This paper presents the two layer paper-based microfluidic analytical devices coated with ZnO nanoflowers (ZnO NF-µPAD) for a rapid blood plasma separation and glucose sensing. Plasma separation in ZnO NF-µPAD was evaluated experimentally and numerically using computational fluid dynamics package for a flow over porous networks. Glucose detection was carried out using Fourier-transform infrared (FTIR) measurements. The glucose concentrations in the red blood samples investigated here vary in the range of 150 - 310 mg.dl-1. The plasma separation process on ZnO NF-μPAD requires 240 ± 93 s. The spectroscopic data reveals that the IR absorptions and Raman signals at the typical vibrational frequencies of glucose are increasing at higher glucose concentration. After subtraction from absorption background arising from ZnO NF and the paper, linearly increasing IR absorption (913 and 1349 cm-1) and Raman signals (1346 and 1461 cm-1) are observable with a relatively good sensitivity.

  10. Evaluation of day-to-day variability of serial blood glucose concentration curves in diabetic dogs.

    Science.gov (United States)

    Fleeman, Linda M; Rand, Jacquie S

    2003-02-01

    To evaluate day-to-day variability of serial blood glucose concentration curves in dogs with diabetes mellitus. Prospective clinical study. 10 dogs with diabetes mellitus. Paired 12-hour serial blood glucose concentration curves performed during 2 consecutive days were obtained on 3 occasions from each dog. Dogs received the same dose of insulin and meal every 12 hours on both days. For each pair of curves, comparison was made between the results of days 1 and 2. Mean absolute difference (without regard to sign) between days 1 and 2 for each parameter was significantly > 0, disproving the hypothesis that there is minimal day-to-day variability of serial blood glucose concentration curves when insulin dose and meals are kept constant. Coefficient of variation of the absolute difference between days 1 and 2 for each parameter ranged from 68 to 103%. Evaluation of the paired curves led to an opposite recommendation for adjustment of the insulin dose on day 2, compared with day 1, on 27% of occasions. Disparity between dosage recommendations was more pronounced when glucose concentration nadir was dogs. Day-to-day variability of serial blood glucose concentration curves has important clinical implications, particularly in dogs with good glycemic control.

  11. Postprandial blood glucose and insulin responses to pre-germinated brown rice in healthy subjects.

    Science.gov (United States)

    Ito, Yukihiko; Mizukuchi, Aya; Kise, Mitsuo; Aoto, Hiromichi; Yamamoto, Shigeru; Yoshihara, Rie; Yokoyama, Jyunichi

    2005-08-01

    Effects of pre-germinated brown rice (PGBR) on postprandial blood glucose and insulin concentrations were compared with brown rice (BR) and white rice (WR) in two studies. In the first study, we investigated the time course of postprandial blood glucose and insulin concentrations after ingesting 25% (W/V) glucose solution, PGBR, BR or WR in 19 healthy young subjects. In the second study, dose-dependent effect of PGBR on the time course of postprandial blood glucose concentrations was compared among 4 different mixtures of PGBR and WR in 13 healthy young subjects. They were solely PGBR, 2/3 PGBR (PGBR: WR = 2 : 1), 1/3 PGBR (PGBR : WR = 1 : 2) and solely WR. Each sample was studied on a different day. The samples were selected randomly by the subjects. All the rice samples contained 50 g of available carbohydrates. The previous day the subjects ate the assigned dinner by 9:00 pm and then were allowed only water until the examination. The next morning, they ingested each test rice sample with 150 ml of water in 5-10 min. Blood was collected into capillary tubes from finger at 0, 30, 60, 90 and 120 min after the ingestion. The incremental areas under the curve (IAUC) of blood glucose concentrations (IAUC-Glc) for 120 min after the administration of PGBR and BR were lower than those after WR. In contrast the IAUC-Glc of BR and PGBR were not different (Study 1). The higher the ratio of PGBR/WR, the lower the glycemic index became (Study 2). These results suggest that intake of PGBR instead of WR is effective for the control of postprandial blood glucose concentration without increasing the insulin secretion.

  12. The Effects of Blood Glucose Concentration on the Shivering Threshold in Rabbits.

    Science.gov (United States)

    Ino, Hirofumi; Masamune, Taishi; Sato, Hiroaki; Okuyama, Katsumi; Wada, Keiichi; Iwashita, Hironobu; Ishiyama, Tadahiko; Oguchi, Takeshi; Sessler, Daniel I; Matsukawa, Takashi

    2015-08-01

    Hyperglycemia is common in critically ill and surgical patients, as are core temperature disturbances. The effect of hyperglycemia on thermoregulatory defenses remains unknown. We determined the effect of blood glucose concentration on the shivering threshold in rabbits. Twenty-seven rabbits lightly anesthetized with isoflurane were randomly assigned to infusions of (1) saline, (2) insulin titrated to produce blood glucose concentrations 60 to 100 mg/dL, or (3) 50% dextrose titrated to produce blood glucose concentrations 200 to 300 mg/dL. Core temperature was reduced at a rate of 2 to 3°C/h by perfusing water at 10°C through a plastic tube positioned in the colon. Cooling continued until shivering was observed by an investigator blinded to treatment or until esophageal (core) temperature reached 34°C. Core temperatures at the onset of shivering defined the threshold. All analyses were conducted using SAS version 9.3 (SAS Institute Inc., Cary, NC). Rabbits given saline shivered at 37.2 ± 0.5°C (mean ± SD). Rabbits given insulin shivered at 36.3 ± 1.1°C. Rabbits given dextrose shivered at 38.0 ± 0.6°C. The shivering threshold increased as a function of blood glucose concentration: shivering threshold (°C) = 0.009 [blood glucose concentration (mg/dL)] + 35.6, r = 0.53. The shivering threshold thus increased approximately 1°C for each 100 mg/dL increase in blood glucose concentration. Hyperglycemia increases the threshold for shivering, whereas hypoglycemia lowers the threshold on rabbits.

  13. Carbohydrate ingestion before and during soccer match play and blood glucose and lactate concentrations.

    Science.gov (United States)

    Russell, Mark; Benton, David; Kingsley, Michael

    2014-01-01

    The ingestion of carbohydrate (CHO) before and during exercise and at halftime is commonly recommended to soccer players for maintaining blood glucose concentrations throughout match play. However, an exercise-induced rebound glycemic response has been observed in the early stages of the second half of simulated soccer-specific exercise when CHO-electrolyte beverages were consumed regularly. Therefore, the metabolic effects of CHO beverage consumption throughout soccer match play remain unclear. To investigate the blood glucose and blood lactate responses to CHOs ingested before and during soccer match play. Crossover study. Applied research study. Ten male outfield academy soccer players (age = 15.6 ± 0.2 years, height = 1.74 ± 0.02 m, mass = 65.3 ± 1.9 kg, estimated maximal oxygen consumption = 58.4 ± 0.8 mL·kg(-1)·min(-1)). Players received a 6% CHO-electrolyte solution or an electrolyte (placebo) solution 2 hours before kickoff, before each half (within 10 minutes), and every 15 minutes throughout exercise. Blood samples were obtained at rest, every 15 minutes during the match (first half: 0-15, 15-30, and 30-45 minutes; second half: 45-60, 60-75, and 75-90 minutes) and 10 minutes into the halftime break. Metabolic responses (blood glucose and blood lactate concentrations) and markers of exercise intensity (heart rate) were recorded. Supplementation influenced the blood glucose response to exercise (time × treatment interaction effect: P ≤ .05), such that glucose concentrations were higher at 30 to 45 minutes in the CHO than in the placebo condition. However, in the second half, blood glucose concentrations were similar between conditions because of transient reductions from peak values occurring in both trials at halftime. Blood lactate concentrations were elevated above those at rest in the first 15 minutes of exercise (time-of-sample effect: P < .001) and remained elevated throughout exercise. Supplementation did not influence the pattern of

  14. Treatment and blood glucose level control of diabetes patients aged 30 and above in Balcova

    Directory of Open Access Journals (Sweden)

    Kevser Tarı Selçuk

    2015-04-01

    Full Text Available AbstractObjective: This cross-sectional study aims to evaluate the treatment uptake and control rates of blood glucose, BMI, blood pressure, lipid levels in diabetes patients aged 30 and above in Balcova Heart Study. The association between treatment and blood glucose level control and socio-demographic characteristics will also be evaluated. Methods: The study included data from 1.643 diabetes patients aged 30 and above who participated in the baseline survey of Balcova’s Heart Project. Fasting blood glucose test was carried out for diagnosis of diabetes, and ADA 2011 diagnosis criteria were employed for the overall assessment. Descriptive statistics, chi-square, logistic regression analysis were used. The study was supported by Dokuz Eylul University Scientific Research Projects and Balcova Municipality. Results: Of all patients, 75.4% are receiving treatment, 32.6% of treated patients have blood glucose level, 21.8% have blood pressure, 9.4% have BMI, 34.7% have LDL, 45.2% have HDL, and 52.6% have triglyceride levels under control. According to logistic regression model, diabetes treatment is significantly high for 70 and above age group [OR=1.76, %95.0 CI:1.14-2.72]; for patients with social security[OR=2.21, %95.0 CI:1.39-3.52]; and for patients with coexisting chronic diseases[OR=2.24, %95.0 CI:1.74-2.89]. According to logistic regression model, blood glucose level control of treated patients is significantly high for patients with coexisting chronic diseases [OR=1.49, %95.0 GA:1.12-1.99]. Conclusions: One fourth of diabetes patients are not receiving treatment, and only one third of patients have blood glucose level under control. BMI, blood pressure, lipid control rates are below desired levels. Awareness of diabetes patient on importance of continuous follow-up should be raised, and quality follow-up should be improved.Key Words: Diabetes, diabetes treatment, blood glucose level

  15. Evaluation of the Blood-Glucose Reducing Effects of Aqueous ...

    African Journals Online (AJOL)

    Methods: All the aqueous extracts of (Caraway) CA, (Coriander) CO, (Cumin) CU, (Dill) DI and (Fennel) FE were administered at dose levels of 300 mg/kg body weight orally to different groups each containing 5 animals. A control group was also maintained simultaneously and received distilled water orally.Blood samples ...

  16. Risk Factors Associated with Elevated Blood Glucose Among Adults ...

    African Journals Online (AJOL)

    was increased risk for the prevalence of T2DM as it was attributed to high blood pressure. According to the study by Feldstein (2002), an estimated 35% to 75% of diabetic complications were triggered by hypertension. Hypertension and T2DM occured together so frequently that they are considered to be comorbidities likely.

  17. [Gestational diabetes mellitus: importance of blood glucose monitoring].

    Science.gov (United States)

    Flores Le-Roux, Juana A; Benaiges Boix, David; Pedro-Botet, Juan

    2013-01-01

    Gestational diabetes mellitus (GDM) is common during pregnancy, and is frequently associated with maternal and perinatal complications. Intensive treatment of hyperglycaemia during pregnancy has been shown to reduce perinatal morbidity. In women with pregestational type 1 or 2 diabetes, hyperglycaemia during labour and delivery is an important factor in the development of neonatal hypoglycaemia. There are no generally accepted recommendations for women with GDM. Recent studies evaluating patients with GDM show that peripartum glucose control can be achieved in these women without the need for insulin use in the majority of cases. Hyperglycaemia during labour is not related with treatment established during pregnancy but rather with non-compliance of endocrinological follow-up. Factors such as ethnic origin, neonatal hypoxaemia, and large for gestational age seem to play an important role in the development of neonatal hypoglycaemia. Copyright © 2012 Elsevier España, S.L. and SEA. All rights reserved.

  18. A Post-Marketing Surveillance Study to Evaluate Performance of the EXIMO™ Blood Glucose Monitoring System.

    Science.gov (United States)

    Chandnani, Sonia R; Ramakrishna, C D; Dave, Bhargav A; Kothavade, Pankaj S; Thakkar, Ashok S

    2017-05-01

    The performance of Blood Glucose Monitoring System (BGMS) is critical as the information provided by the system guide the patient or health care professional in making treatment decisions. However, besides evaluating accuracy of the BGMS in laboratory setting, it is equally important that the intended users (healthcare professionals and patients) should be able to achieve blood glucose measurements with similar level of high accuracy. To assess the performance of EXIMO™ (Meril Diagnostics Pvt. Ltd., Vapi, Gujarat, India) BGMS as per International Organization for Standardization (ISO) 15197:2013 section 8 user performance criteria. This was a non-randomized and post-marketing study conducted at a tertiary care centre of India. A total of 1005 patients with diabetes themselves performed fingertip blood glucose measurement using EXIMO™ BGMS. Immediately after capillary blood glucose measurement using the blood glucose monitoring system, venous blood sample from each patient was obtained by a trained technician which was assessed by reference laboratory method- Cobas Integra 400 plus (Roche Instrument Centre, Rotkreuz, Switzerland). All the blood glucose measurements assessed by EXIMO™ were compared with laboratory results. Performance of the system was assessed as per ISO 15197:2013 criteria using Bland-Altman plot, Parkes-Consensus Error Grid (CEG) and Surveillance Error Grid analyses (SEG). A total of 1005 patients participated in the study. Average age of the patients was 44.93±14.65 years. Evaluation of capillary fingertip blood glucose measurements demonstrated that 95.82% measurements fulfilled ISO 15197:2013 section 8 user performance criteria. All the results lie within clinically non-critical zones; Zone A (99.47%; n=1000) and Zone B (0.53%; n=05) of the CEG analysis. As per SEG analysis, majority of the results fell within "no-risk" zone (risk score 0 to 0.5; 90.42%). The result of the study confirmed that intended users are able to obtain accurate

  19. Effects of different levels of coconut fiber on blood glucose, serum insulin and minerals in rats.

    Science.gov (United States)

    Sindurani, J A; Rajamohan, T

    2000-01-01

    The effect of neutral detergent fiber (NDF) from coconut kernel (Cocos nucifera L) in rats fed 5%, 15% and 30% level on the concentration of blood glucose, serum insulin and excretion of minerals was studied. Increase in the intake of fiber resulted in significant decrease in the level of blood glucose and serum insulin. Faecal excretion of Cu, Cr, Mn, Mg, Zn and Ca was found to increase in rats fed different levels of coconut fiber when compared to fiber free group. The result of the present investigation suggest that inclusion of coconut fiber in the diet results in significant hypoglycemic action.

  20. Performance evaluation and labeling comprehension of a new blood glucose monitoring system with integrated information management.

    Science.gov (United States)

    List, Susan M; Starks, Nykole; Baum, John; Greene, Carmine; Pardo, Scott; Parkes, Joan L; Schachner, Holly C; Cuddihy, Robert

    2011-09-01

    This study evaluated performance and product labeling of CONTOUR® USB, a new blood glucose monitoring system (BGMS) with integrated diabetes management software and a universal serial bus (USB) port, in the hands of untrained lay users and health care professionals (HCPs). Subjects and HCPs tested subject's finger stick capillary blood in parallel using CONTOUR USB meters; deep finger stick blood was tested on a Yellow Springs Instruments (YSI) glucose analyzer for reference. Duplicate results by both subjects and HCPs were obtained to assess system precision. System accuracy was assessed according to International Organization for Standardization (ISO) 15197:2003 guidelines [within ±15 mg/dl of mean YSI results (samples system features and ease-of-use were evaluated by subject questionnaires. All subjects who completed the study (N = 74) successfully performed blood glucose measurements, connected the meter to a laptop computer, and used key features of the system. The system was accurate; 98.6% (146/148) of subject results and 96.6% (143/148) of HCP results exceeded ISO 15197:2003 criteria. All subject and HCP results were clinically accurate (97.3%; zone A) or associated with benign errors (2.7%; zone B). The majority of subjects rated features of the BGMS as "very good" or "excellent." CONTOUR USB exceeded ISO 15197:2003 system performance criteria in the hands of untrained lay users. Subjects understood the product labeling, found the system easy to use, and successfully performed blood glucose testing. © 2011 Diabetes Technology Society.

  1. Blood optical properties at various glucose level values in THz frequency range

    Science.gov (United States)

    Gusev, S. I.; Borovkova, M. A.; Strepitov, M. A.; Khodzitsky, M. K.

    2015-07-01

    The number of diabetics is rapidly growing every day in all parts of the world. By the year 2010, the number of patients suffering from diabetes had amounted to more than 230 million people, which is estimated as 3.5% of the whole world adult population [1]. According to expert forecasts, this number is projected to double by the year 2025, which is going to be 7% of whole Earth population. It was calculated that every 10 seconds someone in the world dies due to diabetes and its complications, which is 3 million people per year. The average life expectancy of children with diabetes is less than 28.3 years of onset. Diabetes is considered to be the fourth most common cause of death in industrialized countries. Vascular complications due to diabetes cause early disability and high mortality. Mortality from heart diseases and strokes is 2-3 times more likely for patients suffering from diabetes, whereas blindness, nephropathy and lower limbs gangrene happen respectively 10, 12-15 times, and almost 20 times more often for diabetics than general population. The number and strength of complications depend directly on the blood glucose level control quality. At the moment, the blood glucose level measurements are performed by glucometers [2,3]. This method requires that a patient makes a finger puncture for every measurement. About five punctures per day should be done for proper glucose monitoring, which is about 1,800 punctures per year. Besides, each measurement by glucometer requires a distinct test strip. Expenses for 1,800 test strips could be estimated as about 450 euros per year. It is also necessary to take into account that each puncture has a risk of blood poisoning. Using non-invasive techniques for glucose level control could reduce the amount of possible risky manipulations by 1800 per year. Moreover, it is worth mentioning that only eight of ten fingers are suitable for puncturing, and the constant skin damage which cannot be avoided is quite annoying for

  2. The food and drug administration is now preparing to establish tighter performance requirements for blood glucose monitors.

    Science.gov (United States)

    Klonoff, David C

    2010-05-01

    On March 16 and 17, 2010, the Food and Drug Administration (FDA) presented a public meeting about blood glucose monitoring at the Gaithersberg Hilton Hotel. The meeting was intended to present expert opinions and solicit input from the public about whether to develop new regulatory policies for blood glucose monitors. The meeting was divided into three sections: (1) Clinical Accuracy Requirements for Blood Glucose Monitors, (2) Interferences and Limitations of Blood Glucose Monitors, and (3) Tight Glycemic Control. Many officials from the Center for Devices and Radiologic Health and the Office of In Vitro Diagnostic Devices, which are the parts of FDA that regulate approval of blood glucose monitors, either spoke on the agenda or attended in the audience. Approximately 300 people attended; they were mostly clinicians (such as adult endocrinologists, pediatric endocrinologists, internists, clinical chemists, intensivists, surgeons, nurses, and diabetes educators) or industry officials from companies involved in glucose monitoring, pharmaceutical products, data analysis, or regulatory consulting. (c) 2010 Diabetes Technology Society.

  3. The Great Recession worsened blood pressure and blood glucose levels in American adults.

    Science.gov (United States)

    Seeman, Teresa; Thomas, Duncan; Merkin, Sharon Stein; Moore, Kari; Watson, Karol; Karlamangla, Arun

    2018-03-27

    Longitudinal, individual-specific data from the Multi-Ethnic Study of Atherosclerosis (MESA) provide support for the hypothesis that the 2008 to 2010 Great Recession (GR) negatively impacted the health of US adults. Results further advance understanding of the relationship by ( i ) illuminating hypothesized greater negative impacts in population subgroups exposed to more severe impacts of the GR and ( ii ) explicitly controlling for confounding by individual differences in age-related changes in health over time. Analyses overcome limitations of prior work by ( i ) employing individual-level data that avoid concerns about ecological fallacy associated with prior reliance on group-level data, ( ii ) using four waves of data before the GR to estimate and control for underlying individual-level age-related trends, ( iii ) focusing on objective, temporally appropriate health outcomes rather than mortality, and ( iv ) leveraging a diverse cohort to investigate subgroup differences in the GR's impact. Innovative individual fixed-effects modeling controlling for individual-level age-related trajectories yielded substantively important insights: ( i ) significant elevations post-GR for blood pressure and fasting glucose, especially among those on medication pre-GR, and ( ii ) reductions in prevalence and intensity of medication use post-GR. Important differences in the effects of the GR are seen across subgroups, with larger effects among younger adults (who are likely still in the labor force) and older homeowners (whose declining home wealth likely reduced financial security, with less scope for recouping losses during their lifetime); least affected were older adults without a college degree (whose greater reliance on Medicare and Social Security likely provided more protection from the recession).

  4. [Effects of blood glucose control on glucose variability and clinical outcomes in patients with severe acute pancreatitis in intensive care unit].

    Science.gov (United States)

    Wu, Jing; Sun, Qiuhong; Yang, Hua

    2015-05-19

    To explore the effects of blood glucose control on glucose variability and clinical outcomes in patients with severe acute pancreatitis in intensive care unit (ICU). A total of 72 ICU patients with severe acute pancreatitis were recruited and divided randomly into observation and control groups (n = 36 each). Both groups were treated conventionally. And the observation group achieved stable blood glucose at 6.1-8.3 mmol/L with intensive glucose control. The length of ICU and hospital stays, ICU mortality rate, transit operative rate, concurrent infection rate, admission blood glucose, glycosylated hemoglobin, mean insulin dose, mean blood glucose, blood glucose value standard deviation (GLUSD), glycemic liability index (GLUGLI) and mean amplitude of glycemic excursion (GLUMAGE) of two groups were compared. At the same time, the relationship between blood glucose variability, ICU mortality rate and its predictive value were analyzed by correlation analysis and receiver operating characteristic curve (ROC). The lengths of ICU and hospital stays of observation group were all significantly less than those of the control group [(11.7 ± 9.9) vs (15.9 ± 8.02) days, (21.8 ± 10.8) vs (28.2 ± 12.7) days, P control group (72.22%, 38.89%, P blood glucose value and GLUSD of observation group were significantly lower than those of control group [(7.4 ± 1.1) vs (9.6 ± 1.2), (1.8 ± 1.0) vs (2.5 ± 1.3) mmol/L]. The differences were statistically significant (P control group (P control in patients with severe acute pancreatitis helps reduce the blood sugar fluctuations, lower the risks of infectious complications and promote the patient rehabilitation. And GLUGLI is positively correlated with ICU mortality rate. It has good predictive values.

  5. Pre-analytical variation in glucose concentration due to atmospheric temperature and clot in blood specimens

    International Nuclear Information System (INIS)

    Butt, T.; Masud, K.; Khan, J.A.; Bhatti, M.S.

    2016-01-01

    Objective: To determine the effect of temperature and contact of clot with serum on laboratory results of glucose concentration in blood. Study Design: Quasi-experimental study. Place and Duration of Study: December 2014 to August 2015 at the laboratory of Shoaib Hospital, Fateh Jang, Attock Pakistan. Material and Methods: Samples were collected for estimation of blood glucose (Random) concentration from patients reporting to the hospital. Blood specimens (n=94) of such volunteers were analyzed for glucose level. Each sample was put up in five tubes. When the blood clotted the serum from tube-1 was analyzed for glucose level within 30 minutes. In tube-2 and tube-3 serum was kept for 24 hours at room temperature and refrigerator temperature respectively before glucose estimation. In tube-4 and tube-5 serum was not separated from clot and kept at room temperature and refrigerator temperature respectively before glucose estimation. The value of tube 1 was taken as reference value for comparison with other parts of the specimen. The equipment used for blood glucose level estimation was semi auto chemistry analyzer (Rayto, China). The kit used for analysis was Glucose - Liquizyme (Germany). Results: The difference between the mean reference value (tube-1) and refrigerated serum without clot (tube-3) was 4.63 mg/100 ml while that of unrefrigerated portion (tube-2) had a difference of 10.68 mg/100 ml. The mean of unrefrigerated (tube-4) and refrigerated (tube-5) portions of serum kept with the clot had difference of 42.05 mg/100 ml and 25.84 mg/100 ml respectively. The fall in the blood glucose level in all (n=94) the samples in the tube number 3 (serum separated and kept at refrigerated temperature) was 4.63 mg/100 ml +- 3.68 (Mean +- SD) and it ranged from 0 to 20 mg/100 ml whereas fall was maximum in the tube number 4 (serum with clotted blood and kept at room temperature) was 42.04 mg/100 ml +- 10.61 (Mean +- SD) and it ranged from 13 to 82 mg/100 ml. The sample in

  6. Effects on cognitive performance of modulating the postprandial blood glucose profile at breakfast.

    Science.gov (United States)

    Nilsson, A; Radeborg, K; Björck, I

    2012-09-01

    Considering the importance of glucose as a brain substrate, the postprandial rate of glucose delivery to the blood could be expected to affect cognitive functions. The purpose was to evaluate to what extent the rate of glucose absorption affected measures of cognitive performance in the postprandial period. In addition, cognitive performance was evaluated in relation to individual glucoregulation. A white wheat bread (WWB) enriched with guar gum (G-WWB) with the capacity to produce a low but sustained blood glucose net increment was developed. The G-WWB was evaluated in the postprandial period after breakfast with respect to effects on cognitive function (working memory and selective attention (SA)) in 40 healthy adults (49-71 years, body mass index 20-29 kg/m(2)), using a high glycaemic index WWB for comparison in a randomised crossover design. The G-WWB improved outcome in the cognitive tests (SA test) in the later postprandial period (75-225 min) in comparison with the WWB (Pimportance of carbohydrate foods that induces a low but sustained blood glucose profile in enhancing postprandial cognitive functions.

  7. Glucagon Receptor Blockade With a Human Antibody Normalizes Blood Glucose in Diabetic Mice and Monkeys.

    Science.gov (United States)

    Okamoto, Haruka; Kim, Jinrang; Aglione, JohnPaul; Lee, Joseph; Cavino, Katie; Na, Erqian; Rafique, Ashique; Kim, Jee Hae; Harp, Joyce; Valenzuela, David M; Yancopoulos, George D; Murphy, Andrew J; Gromada, Jesper

    2015-08-01

    Antagonizing glucagon action represents an attractive therapeutic option for reducing hepatic glucose production in settings of hyperglycemia where glucagon excess plays a key pathophysiological role. We therefore generated REGN1193, a fully human monoclonal antibody that binds and inhibits glucagon receptor (GCGR) signaling in vitro. REGN1193 administration to diabetic ob/ob and diet-induced obese mice lowered blood glucose to levels observed in GCGR-deficient mice. In diet-induced obese mice, REGN1193 reduced food intake, adipose tissue mass, and body weight. REGN1193 increased circulating levels of glucagon and glucagon-like peptide 1 and was associated with reversible expansion of pancreatic α-cell area. Hyperglucagonemia and α-cell hyperplasia was observed in fibroblast growth factor 21-deficient mice treated with REGN1193. Single administration of REGN1193 to diabetic cynomolgus monkeys normalized fasting blood glucose and glucose tolerance and increased circulating levels of glucagon and amino acids. Finally, administration of REGN1193 for 8 weeks to normoglycemic cynomolgus monkeys did not cause hypoglycemia or increase pancreatic α-cell area. In summary, the GCGR-blocking antibody REGN1193 normalizes blood glucose in diabetic mice and monkeys but does not produce hypoglycemia in normoglycemic monkeys. Thus, REGN1193 provides a potential therapeutic modality for diabetes mellitus and acute hyperglycemic conditions.

  8. Design andIn VitroInterference Test of Microwave Noninvasive Blood Glucose Monitoring Sensor.

    Science.gov (United States)

    Choi, Heungjae; Naylon, Jack; Luzio, Steve; Beutler, Jan; Birchall, James; Martin, Chris; Porch, Adrian

    2015-10-01

    A design of a microwave noninvasive continuous blood glucose monitoring sensor and its interference test results are presented. The novelty of the proposed sensor is that it comprises two spatially separated split-ring resonators, where one interacts with the change in glucose level of a sample under test while the other ring is used as a reference. The reference ring has a slightly different resonant frequency and is desensitized to the sample owing to its location, thus allowing changes in temperature to be calibrated out. From an oral glucose tolerance test with two additional commercially available sensors (blood strip and continuous glucose monitor) in parallel, we obtained encouraging performance for our sensor comparable with those of the commercial sensors. The effects of endogenous interferents common to all subjects, i.e., common sugars, vitamins (ascorbic acid), and metabolites (uric acid) have also been investigated by using a large Franz cell assembly. From the interference test, it is shown that the change in sensor response is dominated by changes in glucose level for concentrations relevant to blood, and the effects of interferents are negligible in comparison.

  9. Successful microsurgical lip replantation: Monitoring venous congestion by blood glucose measurements in the replanted lip

    OpenAIRE

    Kazufumi Tachi; Masanori Mori; Reiko Tsukuura; Rintaro Hirai

    2018-01-01

    Replantation of an amputated lip using microvascular anastomosis is the best option for restoration of the defect. However, the amputated region often lacks veins with appropriate diameters for microvascular anastomoses and typically necessitates both postoperative exsanguination using medicinal leeches and a blood transfusion. We present a case of the successful replantation of an avulsed lip in which postoperative congestion was evaluated objectively by measuring blood glucose levels in the...

  10. Correlation of salivary glucose, blood glucose and oral candidal carriage in the saliva of type 2 diabetics: A case-control study

    Directory of Open Access Journals (Sweden)

    Satish Kumar

    2014-01-01

    Full Text Available Objectives: To study the correlation between blood glucose levels and salivary glucose levels in type 2 diabetic patients, to study the relationship between salivary glucose levels and oral candidal carriage in type 2 diabetic patients and to determine whether salivary glucose levels could be used as a noninvasive tool for the measurement of glycemic control in type 2 diabetics. Study Design: The study population consisted of three groups: Group 1 consisted of 30 controlled diabetics and Group 2 consisted of 30 uncontrolled diabetics based on their random nonfasting plasma glucose levels. Group 3 consisted of 30 healthy controls. Two milliliters of peripheral blood was collected for the estimation of random nonfasting plasma glucose levels and glycosylated hemoglobin (HbA1c. Unstimulated saliva was collected for the estimation of salivary glucose. Saliva was collected by the oral rinse technique for the estimation of candidal counts. Results: The salivary glucose levels were significantly higher in controlled and uncontrolled diabetics when compared with controls. The salivary candidal carriage was also significantly higher in uncontrolled diabetics when compared with controlled diabetics and nondiabetic controls. The salivary glucose levels showed a significant correlation with blood glucose levels, suggesting that salivary glucose levels can be used as a monitoring tool for predicting glycemic control in diabetic patients. Conclusion: The present study found that estimation of salivary glucose levels can be used as a noninvasive, painless technique for the measurement of diabetic status of a patient in a dental set up. Increased salivary glucose levels leads to increased oral candidal carriage; therefore, oral diagnosticians are advised to screen the diabetic patients for any oral fungal infections and further management.

  11. Transdermally delivered peroxovanadium can lower blood glucose levels in diabetic rats.

    Science.gov (United States)

    Brand, R M; Hamel, F G

    1999-06-25

    The element vanadium can have insulin mimetic properties and therefore has been suggested as a possible therapeutic agent for treatment of diabetes. A series of peroxovanadium compounds that are more potent at lowering blood glucose levels than sodium metavanadate, sodium orthovanadate and vanadyl sulfate have recently been synthesized. These compounds probably will not be orally active so transdermal administration is a potential option. A patch containing either the peroxovanadium compound [VO(O2)2 1-10 phenanthroline], abbreviated bpV(phen), or placebo was placed on the back of streptozotocin induced diabetic rats and was delivered either passively (16 h) or iontophoretically (0.5 mA/cm2 for 4 h). Blood samples were analyzed for glucose and vanadium levels. Mean blood glucose levels were 83+/-1% and 109+/-1% of the starting values for animals iontophoretically treated with bpV(phen) and vehicle, respectively. The compound's insulin mimetic properties were evident within 60 min of current initiation. Blood glucose levels were reduced to 74+/-14% of the original level after 16 h of passive treatment. The compound was ineffective when fed to animals. Transdermal delivery of bpV(phen) resulted in significantly greater blood levels of vanadium than the orally delivered compound (P<0.05). Overall these experiments demonstrate that peroxovanadium delivered through the skin can lower blood glucose levels in rats. Further experiments are warranted to better characterize the nature of the response and to determine the potential for using these compounds in humans.

  12. Early blood glucose profile and neurodevelopmental outcome at two years in neonatal hypoxic-ischaemic encephalopathy

    LENUS (Irish Health Repository)

    Nadeem, Montasser

    2011-02-04

    Abstract Background To examine the blood glucose profile and the relationship between blood glucose levels and neurodevelopmental outcome in term infants with hypoxic-ischaemic encephalopathy. Methods Blood glucose values within 72 hours of birth were collected from 52 term infants with hypoxic-ischaemic encephalopathy. Hypoglycaemia [< 46.8 mg\\/dL (2.6 mmol\\/L)] and hyperglycaemia [> 150 mg\\/dL (8.3 mmol\\/L)] were correlated to neurodevelopmental outcome at 24 months of age. Results Four fifths of the 468 blood samples were in the normoglycaemic range (392\\/468:83.8%). Of the remaining 76 samples, 51.3% were in the hypoglycaemic range and (48.7%) were hyperglycaemic. A quarter of the hypoglycaemic samples (28.2%:11\\/39) and a third of the hyperglycaemic samples (32.4%:12\\/37) were recorded within the first 30 minutes of life. Mean (SD) blood glucose values did not differ between infants with normal and abnormal outcomes [4.89(2.28) mmol\\/L and 5.02(2.35) mmol\\/L, p value = 0.15] respectively. In term infants with hypoxic-ischaemic encephalopathy, early hypoglycaemia (between 0-6 hours of life) was associated with adverse outcome at 24 months of age [OR = 5.8, CI = 1.04-32)]. On multivariate analysis to adjust for grade of HIE this association was not statistically significant. Late hypoglycaemia (6-72 hours of life) was not associated with abnormal outcome [OR = 0.22, CI (0.04-1.14)]. The occurrence of hyperglycaemia was not associated with adverse outcome. Conclusion During the first 72 hours of life, blood glucose profile in infants with hypoxic-ischaemic encephalopathy varies widely despite a management protocol. Early hypoglycaemia (0-6 hours of life) was associated with severe HIE, and thereby; adverse outcome.

  13. Early blood glucose profile and neurodevelopmental outcome at two years in neonatal hypoxic-ischaemic encephalopathy.

    LENUS (Irish Health Repository)

    Nadeem, Montasser

    2012-01-31

    BACKGROUND: To examine the blood glucose profile and the relationship between blood glucose levels and neurodevelopmental outcome in term infants with hypoxic-ischaemic encephalopathy. METHODS: Blood glucose values within 72 hours of birth were collected from 52 term infants with hypoxic-ischaemic encephalopathy. Hypoglycaemia [< 46.8 mg\\/dL (2.6 mmol\\/L)] and hyperglycaemia [> 150 mg\\/dL (8.3 mmol\\/L)] were correlated to neurodevelopmental outcome at 24 months of age. RESULTS: Four fifths of the 468 blood samples were in the normoglycaemic range (392\\/468:83.8%). Of the remaining 76 samples, 51.3% were in the hypoglycaemic range and (48.7%) were hyperglycaemic. A quarter of the hypoglycaemic samples (28.2%:11\\/39) and a third of the hyperglycaemic samples (32.4%:12\\/37) were recorded within the first 30 minutes of life. Mean (SD) blood glucose values did not differ between infants with normal and abnormal outcomes [4.89(2.28) mmol\\/L and 5.02(2.35) mmol\\/L, p value = 0.15] respectively. In term infants with hypoxic-ischaemic encephalopathy, early hypoglycaemia (between 0-6 hours of life) was associated with adverse outcome at 24 months of age [OR = 5.8, CI = 1.04-32)]. On multivariate analysis to adjust for grade of HIE this association was not statistically significant. Late hypoglycaemia (6-72 hours of life) was not associated with abnormal outcome [OR = 0.22, CI (0.04-1.14)]. The occurrence of hyperglycaemia was not associated with adverse outcome. CONCLUSION: During the first 72 hours of life, blood glucose profile in infants with hypoxic-ischaemic encephalopathy varies widely despite a management protocol. Early hypoglycaemia (0-6 hours of life) was associated with severe HIE, and thereby; adverse outcome.

  14. Determination of time delay between blood and interstitial adipose tissue glucose concentration change by microdialysis in healthy volunteers

    NARCIS (Netherlands)

    Wientjes, KJC; Schoonen, AJM

    2001-01-01

    For the development and use of subcutaneous glucose sensors it is important to know the time lag between changes in blood glucose and subcutaneous interstitial glucose concentration. To determine the time lag we inserted a microdialysis probe into the abdominal subcutaneous adipose tissue of healthy

  15. Glucose-induced time-dependent potentiation of insulin release, but not islet blood perfusion, in anesthetized rats.

    Science.gov (United States)

    Jansson, Leif; Bodin, Birgitta; Källskog, Orjan

    2008-01-01

    Repeated administration of glucose in vivo leads to a time-dependent potentiation of insulin release. Glucose is also known to stimulate pancreatic islet blood flow, but whether this is associated with a time-dependent potentiation is unknown. We therefore repeatedly administered glucose to anesthetized rats and evaluated effects on insulin release and islet blood flow. Male Wistar-Furth rats, anesthetized with thiobutabarbital, were injected intravenously with 1 ml of saline or glucose at times 0, 30 and 60 min. The combinations used were saline + saline + saline (SSS), glucose + saline + saline (GSS), saline + saline + glucose (SSG) and glucose + glucose + glucose (GGG). Regional organ blood flow values were measured 3 min after the final injection with a microsphere technique, and at this time also serum insulin concentrations were determined with ELISA. Serum insulin concentrations as well as total pancreatic, pancreatic islet and duodenal blood flow were higher in SSG and GGG-treated rats when compared to those given SSS and GSS. However, only insulin concentrations, not blood flow values, were higher in GGG rats when compared to SSG animals. Glucose-induced time-dependent potentiation of insulin release occurs in vivo in thiobutabarbital-anesthetized rats, but is not associated with a further increase in islet blood flow.

  16. Non-invasive blood glucose monitoring with Raman spectroscopy: prospects for device miniaturization

    International Nuclear Information System (INIS)

    Wróbel, M.S.

    2016-01-01

    The number of patients with diabetes has reached over 350 million, and still continues to increase. The need for regular blood glucose monitoring sparks the interest in the development of modern detection technologies. One of those methods, which allows for noninvasive measurements, is Raman spectroscopy. The ability of infrared light to penetrate deep into tissues allows for obtaining measurements through the skin without its perforation. This paper presents the limitations and possibilities of non-invasive blood glucose monitoring with Raman spectroscopy. Especially focusing on the possibilities for device miniaturization. Such device incorporates a Raman spectrometer, a fiber-optical probe, and a computing device (microcontroller, smartphone, etc.) which calculates the glucose concentration using specialized algorithms. Simplification of device design, as well as turbidity correction technique and a new proposed method of synchronized detection are described

  17. GLUT-1 GLUCOSE TRANSPORTERS IN THE BLOOD-BRAIN BARRIER: DIFFERENTIAL PHOSPHORYLATION

    Science.gov (United States)

    Devraj, Kavi; Klinger, Marianne E.; Myers, Roland L.; Mokashi, Ashwini; Hawkins, Richard A.; Simpson, Ian A.

    2013-01-01

    Glucose is the primary metabolic fuel for the mammalian brain and a continuous supply is required to maintain normal CNS function. The transport of glucose across the blood-brain barrier (BBB) into the brain is mediated by the facilitative glucose transporter GLUT-1. Prior studies (Simpson et al. 2001) had revealed that the conformations of the GLUT-1 transporter were different in luminal (blood facing) and abluminal (brain facing) membranes of bovine cerebral endothelial cells, based on differential antibody recognition. In this study we have extended these observations and using a combination of 2D-PAGE/Western blotting and immunogold electron microscopy we determined that these different conformations are exhibited in vivo and arise from differential phosphorylation of GLUT-1 and not from alternative splicing or altered O- or N-linked glycosylation. PMID:21910135

  18. Radially oriented nanostrand electrodes to boost glucose sensing in mammalian blood.

    Science.gov (United States)

    Akhtar, Naeem; El-Safty, Sherif A; Abdelsalam, Mamdouh E; Shenashen, Mohamed A; Kawarada, Hiroshi

    2016-03-15

    Architecture of nanoscale electrochemical sensors for ultra-trace detection of glucose in blood is important in real-life sampling and analysis. To broaden the application of electrochemical sensing of glucose, we fabricated, for the first time, a glucose sensor electrode based on radially oriented NiO nanostrands (NSTs) onto 3D porous Ni foam substrate for monitoring, as well as selective and sensitive sensing of glucose in mammalian blood. The simple, scalable one-pot fabrication of this NST-Ni sensor design enabled control of the pattern of radially oriented NSTs onto 3D porous Ni foam substrate. The radial orientation of NST-Ni electrode onto the interior of the 3D porous substrate with controlled crystal structure size and atomic arrangement along the axis of the strands, intrinsic surface defects, and superior surface properties, such as hydrophilicity, high surface energy, and high density led to highly exposed catalytic active sites. The hierarchical NST-Ni electrode was used to develop a sensitive and selective sensor over a wide range of glucose concentrations among actively competitive ions, chemical species and molecular agents, and multi-cyclic sensing assays. The NST-Ni electrode shows significant glucose sensing performance in terms of unimpeded diffusion pathways, a wide range of concentration detection, and lower limit of detection (0.186 µM) than NiO nanosheet (NS)-Ni foam electrode pattern, indicating the effectiveness of the shape-dependent structural architecture of NST-Ni electrode. In this study, the NST-Ni electrode is fabricated to develop a simple, selective method for detecting glucose in physiological fluids (e.g., mammalian blood). Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Glucose Pump Test can be Used to Measure Blood Flow Rate of ...

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... Methods: In 93 chronic hemodialysis patients with native AV fistula, blood flow rates were measured by Doppler US and GPT. For GPT, glucose was infused to 16 mL/min by pump and was measured at basal before the infusion and 11 s after the start of ... Doppler US is expensive and time consuming,.

  20. Cinnamon intake lowers fasting blood glucose: an updated meta-analysis

    Science.gov (United States)

    OBJECTIVE – To determine if meta-analysis of recent clinical studies of cinnamon intake by people with Type II diabetes and/or prediabetes resulted in significant changes in fasting blood glucose. RESEARCH DESIGN AND METHODS -- Published clinical studies were identified using a literature search (P...

  1. Comparison electrical stimulation and passive stretching for blood glucose control type 2 diabetes mellitus patients

    Science.gov (United States)

    Arsianti, Rika Wahyuni; Parman, Dewy Haryanti; Lesmana, Hendy

    2018-04-01

    Physical exercise is one of the cornerstones for management and treatment type 2 diabetes mellitus. But not all people are able to perform physical exercise because of their physical limitation condition. The strategy for those people in this study is electrical stimulation and passive stretching. The aim of this study is to find out the effect of electrical stimulation and passive stretching to lowering blood glucose level. 20 subjects is divided into electrical stimulation and passive stretching group. The provision of electrical stimulation on lower extremities muscles for 30 minutes for electrical stimulation group (N=10). And other underwent passive stretching for 30 minutes (N=10). The result shows that blood glucose level is decrease from 192.9 ± 10.7087 mg/dL to 165.3 ± 10.527 mg/dL for electrical stimulation intervention group while for the passive stretching group the blood glucose decrease from 153 ± 12.468 mg/dL to 136.1 ± 12.346 mg/dL. Both electrical stimulation and passive stretching are effective to lowering blood glucose level and can be proposed for those people restricted to perform exercise.

  2. Higher Blood Glucose within the Normal Range Is Associated with More Severe Strokes

    DEFF Research Database (Denmark)

    Martin, Rolf J; Ratan, Rajiv R; Reding, Michael J

    2012-01-01

    Background. Higher fasting blood glucose (FBG) concentrations in the hyperglycemic range are associated with more severe strokes. Whether this association also extends into patients with FBG in the normoglycemic range is unclear. We studied the association of stroke severity and FBG in normoglyce...

  3. Trend Estimation of Blood Glucose Level Fluctuations Based on Data Mining

    Directory of Open Access Journals (Sweden)

    Masaki Yamaguchi

    2003-06-01

    Full Text Available We have fabricated calorie-calculating software that calculates and records the total calorific food intake by choosing a meal menu selected using a computer mouse. The purpose of this software was to simplify data collection throughout a person's normal life, even if they were inexperienced computer operators. Three portable commercial devices have also been prepared a blood glucose monitor, a metabolic rate monitor and a mobile-computer, and linked into the calorie-calculating software. Time-course changes of the blood glucose level, metabolic rate and food intake were measured using these devices during a 3 month period. Based on the data collected in this study we could predict blood glucose levels of the next morning (FBG by modeling using data mining. Although a large error rate was found for predicting the absolute value, conditions could be found that improved the accuracy of the predicting trends in blood glucose level fluctuations by up to 90 %. However, in order to further improve the accuracy of estimation it was necessary to obtain further details about the patients' life style or to optimise the input variables that were dependent on each patient rather than collecting data over longer periods.

  4. Change of blood glucose level and its possible mechanism in patients with cerebral stroke

    International Nuclear Information System (INIS)

    Chen Weizhen; Zhang Yong; Zhang Zikang; Mo Congjian

    2003-01-01

    To study the mechanism of the change of blood glucose levels in patients with cerebral stroke, the levels of blood glucose, cortisol, glucogen, insulin, growth hormone, triiodothyronine (T 3 ), thyroxine (T 4 ) and adrenocorticotropic hormone (ACTH) were dynamically measured in 90 patients with cerebral stroke. The circumstances of brain middle line movement, lateral ventricle oppression and entrance brain ventricle of burst hematoma of the patients were examines by CT scan. The total incidence of hyperglycemia in the patients was 42.22%. The blood glucose level was positively related to the cortisol and glucogen levels, and negatively related to the T 3 level. The changed level of blood glucose and its related hormones both returned to normal range in 10 days. Both the ACTH level and the rate of cerebral pathological change in hyperglycemia group were significantly higher than that in normoglycemia and control groups. The rate of cerebral pathological change in elevated ACTH level group was higher than that in normal ACTH level group. The mechanism of hyperglycemia in the patients with cerebral stroke might be related to the stimulation of the hypothalamus, which may induce the discharge of ACTH and glucagon releasing factor, and to that the level of cortisol and glucagon increased, the level of T 3 decreased

  5. Glucose-6-phosphate dehydrogenase activity decreases during storage of leukoreduced red blood cells

    NARCIS (Netherlands)

    Peters, Anna L.; van Bruggen, Robin; de Korte, Dirk; van Noorden, Cornelis J. F.; Vlaar, Alexander P. J.

    2016-01-01

    During storage, the activity of the red blood cell (RBC) antioxidant system decreases. Glucose-6-phosphate dehydrogenase (G6PD) is essential for protection against oxidative stress by producing NADPH. G6PD function of RBC transfusion products is reported to remain stable during storage, but activity

  6. Bihormonal control of blood glucose in people with type 1 diabetes

    DEFF Research Database (Denmark)

    Batora, Vladimir; Tárnik, Marían; Murgaš, Ján

    2015-01-01

    This paper presents a bihormonal artificial pancreas (AP) for people with type 1 diabetes (T1D) designed to provide a safe blood glucose control with minimal use of glucagon. The control algorithm uses insulin as well as glucagon to prevent hyper- and hypoglycemia. We employ a novel prediction...

  7. Bihormonal model predictive control of blood glucose in people with type 1 diabetes

    DEFF Research Database (Denmark)

    Batora, Vladimir; Tarnik, Marian; Murgas, Jan

    2014-01-01

    In this paper we present a bihormonal control system that controls blood glucose in people with type 1 diabetes (T1D). We use insulin together with glucagon to mitigate the negative effects of hyper- and hypoglycemia. The system consists of a Kalman filter, a micro-bolus insulin and glucagon...

  8. Comprehensive Experiment--Clinical Biochemistry: Determination of Blood Glucose and Triglycerides in Normal and Diabetic Rats

    Science.gov (United States)

    Jiao, Li; Xiujuan, Shi; Juan, Wang; Song, Jia; Lei, Xu; Guotong, Xu; Lixia, Lu

    2015-01-01

    For second year medical students, we redesigned an original laboratory experiment and developed a combined research-teaching clinical biochemistry experiment. Using an established diabetic rat model to detect blood glucose and triglycerides, the students participate in the entire experimental process, which is not normally experienced during a…

  9. Integration of Remote Blood Glucose Meter Upload Technology into a Clinical Pharmacist Medication Therapy Management Service

    OpenAIRE

    Schenk, Robert J.; Schenk, Jenna

    2011-01-01

    A pharmacist-delivered, outpatient-focused medication therapy management (MTM) program is using a remote blood glucose (BG) meter upload device to provide better care and to improve outcomes for its patients with diabetes. Sharing uploaded BG meter data, presented in easily comprehensible graphs and charts, enables patients, caregivers, and the medical team to better understand how the patients’ diabetes care is progressing.

  10. A Meta-Analysis of Blood Glucose Effects on Human Decision Making

    DEFF Research Database (Denmark)

    Orquin, Jacob L.; Kurzban, Robert

    2016-01-01

    and willingness to work when a situation is food related, but decrease willingness to pay and work in all other situations. Low levels of blood glucose increase the future discount rate for food; that is, decision makers become more impatient, and to a lesser extent increase the future discount rate for money...

  11. Blood Glucose Monitoring as a Teaching Tool for Endocrinology: A New Perspective

    Science.gov (United States)

    Moats, Robert K., II

    2009-01-01

    The education of new allied health professionals and nurses in proper endocrine evaluation and care has become critical in recent years, especially considering the greatly increased prevalence of diabetes in adults and children. The evaluation of blood glucose levels in human volunteers over time is a powerful teaching tool for endocrinology that…

  12. [Evaluation of hearing loss parameters in workers and its relationship with fasting blood glucose levels].

    Science.gov (United States)

    Vicente-Herrero, M Teofila; Lladosa Marco, Silvia; Ramírez-Iñiguez de La Torre, M Victoria; Terradillos-García, M Jesús; López-González, Ángel Arturo

    2014-05-01

    Hearing loss due to noise is considered within the prevention plans of the most common occupational diseases. In addition to evaluation of working conditions, other personal factors increasing the risk of hypoacusis, such as diabetes, should be taken into account. To explore hearing loss in the workplace and its relationship to impaired fasting baseline blood glucose levels. An observational, cross-sectional study enrolling 1636 workers from service companies was conducted. Full audiometric evaluation was performed at different frequencies: high frequency (HF), early loss index (ELI), speech average loss (SAL), and monaural and binaural loss. Results were categorized by baseline blood glucose levels: G1 (125mg/dl). Based on both HF and ELI, 11% of workers had clear indication of deafness. Women with G3 levels showed significant differences in the results of HF and ELI indexes as compared to the G1 group (P=.038 and .046, respectively). A positive association was found between hearing loss and G3 blood glucose levels in HF (OR: .338; p=.002), ELI (OR: .407; p=.007), and the monaural test in the left ear (OR: 4.77×10-5; p=.006). Despite the methodological limitations of this study, there is evidence for an increased risk of high frequency hearing loss in workers with high baseline blood glucose levels. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  13. SELF BLOOD GLUCOSE MONITORING UNDERESTIMATES HYPERGLYCEMIA AND HYPOGLYCEMIA AS COMPARED TO CONTINUOUS GLUCOSE MONITORING IN TYPE 1 AND TYPE 2 DIABETES.

    Science.gov (United States)

    Mangrola, Devna; Cox, Christine; Furman, Arianne S; Krishnan, Sridevi; Karakas, Sidika E

    2018-01-01

    When glucose records from self blood glucose monitoring (SBGM) do not reflect estimated average glucose from glycosylated hemoglobin (HgBA1) or when patients' clinical symptoms are not explained by their SBGM records, clinical management of diabetes becomes a challenge. Our objective was to determine the magnitude of differences in glucose values reported by SBGM versus those documented by continuous glucose monitoring (CGM). The CGM was conducted by a clinical diabetes educator (CDE)/registered nurse by the clinic protocol, using the Medtronic iPRO2 ™ system. Patients continued SBGM and managed their diabetes without any change. Data from 4 full days were obtained, and relevant clinical information was recorded. De-identified data sets were provided to the investigators. Data from 61 patients, 27 with type 1 diabetes (T1DM) and 34 with T2DM were analyzed. The lowest, highest, and average glucose recorded by SBGM were compared to the corresponding values from CGM. The lowest glucose values reported by SBGM were approximately 25 mg/dL higher in both T1DM ( P = .0232) and T2DM ( P = .0003). The highest glucose values by SBGM were approximately 30 mg/dL lower in T1DM ( P = .0005) and 55 mg/dL lower in T2DM ( Pglucose by SBGM and CGM. The lowest glucose values were seen most frequently during sleep and before breakfast; the highest were seen during the evening and postprandially. SBGM accurately estimates the average glucose but underestimates glucose excursions. CGM uncovers glucose patterns that common SBGM patterns cannot. CDE = certified diabetes educator; CGM = continuous glucose monitoring; HgBA1c = glycosylated hemoglobin; MAD = mean absolute difference; SBGM = self blood glucose monitoring; T1DM = type 1 diabetes; T2DM = type 2 diabetes.

  14. Impairment of brain endothelial glucose transporter by methamphetamine causes blood-brain barrier dysfunction

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    Murrin L Charles

    2011-03-01

    Full Text Available Abstract Background Methamphetamine (METH, an addictive psycho-stimulant drug with euphoric effect is known to cause neurotoxicity due to oxidative stress, dopamine accumulation and glial cell activation. Here we hypothesized that METH-induced interference of glucose uptake and transport at the endothelium can disrupt the energy requirement of the blood-brain barrier (BBB function and integrity. We undertake this study because there is no report of METH effects on glucose uptake and transport across the blood-brain barrier (BBB to date. Results In this study, we demonstrate that METH-induced disruption of glucose uptake by endothelium lead to BBB dysfunction. Our data indicate that a low concentration of METH (20 μM increased the expression of glucose transporter protein-1 (GLUT1 in primary human brain endothelial cell (hBEC, main component of BBB without affecting the glucose uptake. A high concentration of 200 μM of METH decreased both the glucose uptake and GLUT1 protein levels in hBEC culture. Transcription process appeared to regulate the changes in METH-induced GLUT1 expression. METH-induced decrease in GLUT1 protein level was associated with reduction in BBB tight junction protein occludin and zonula occludens-1. Functional assessment of the trans-endothelial electrical resistance of the cell monolayers and permeability of dye tracers in animal model validated the pharmacokinetics and molecular findings that inhibition of glucose uptake by GLUT1 inhibitor cytochalasin B (CB aggravated the METH-induced disruption of the BBB integrity. Application of acetyl-L-carnitine suppressed the effects of METH on glucose uptake and BBB function. Conclusion Our findings suggest that impairment of GLUT1 at the brain endothelium by METH may contribute to energy-associated disruption of tight junction assembly and loss of BBB integrity.

  15. Personalized blood glucose prediction: A hybrid approach using grammatical evolution and physiological models.

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    Iván Contreras

    Full Text Available The large patient variability in human physiology and the effects of variables such as exercise or meals challenge current prediction modeling techniques. Physiological models are very precise but they are typically complex and specific physiological knowledge is required. In contrast, data-based models allow the incorporation of additional inputs and accurately capture the relationship between these inputs and the outcome, but at the cost of losing the physiological meaning of the model. In this work, we designed a hybrid approach comprising physiological models for insulin and grammatical evolution, taking into account the clinical harm caused by deviations from the target blood glucose by using a penalizing fitness function based on the Clarke error grid. The prediction models were built using data obtained over 14 days for 100 virtual patients generated by the UVA/Padova T1D simulator. Midterm blood glucose was predicted for the 100 virtual patients using personalized models and different scenarios. The results obtained were promising; an average of 98.31% of the predictions fell in zones A and B of the Clarke error grid. Midterm predictions using personalized models are feasible when the configuration of grammatical evolution explored in this study is used. The study of new alternative models is important to move forward in the development of alarm-and-control applications for the management of type 1 diabetes and the customization of the patient's treatments. The hybrid approach can be adapted to predict short-term blood glucose values to detect continuous glucose-monitoring sensor errors and to estimate blood glucose values when the continuous glucose-monitoring system fails to provide them.

  16. International consensus on use of continuous glucose monitoring

    DEFF Research Database (Denmark)

    Danne, Thomas; Nimri, Revital; Battelino, Tadej

    2017-01-01

    microvascular and macrovascular complications. Continuous glucose monitoring (CGM), either from real-time use (rtCGM) or intermittently viewed (iCGM), addresses many of the limitations inherent in HbA1c testing and self-monitoring of blood glucose. Although both provide themeans to move beyond the HbA1c...... measurement as the sole marker of glycemic control, standardized metrics for analyzing CGM data are lacking. Moreover, clear criteria for matching people with diabetes to themost appropriate glucose monitoring methodologies, as well as standardized advice about howbest to use the new information they provide...

  17. Evaluation of the Efficacy and Correlation between Blood Glucose Measured Using Glucometers and Enzymatic Laboratory Methods

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    R Rasouli

    2012-05-01

    Full Text Available

    Background and Objectives: Diabetes Mellitus (DM is the most common chronic metabolic disease, with many complications including renal failure, blindness and non-traumatic amputation, so it is important to monitor and regulate blood glucose. Considering how easy home blood glucose monitoring is, we decided to evaluate the performance of two available glucometers for detection of blood glucose compared with standard laboratory methods.

     

    Methods: In this analytical study, we compared the capillary blood glucose levels of 60 volunteers with mean age of 32.8±9.6 years in Tabriz Mehr Laboratory as determined by test strips (two different Glucometers with venous blood glucose levels’ measurements by the enzymatic method (the standard laboratory kit. Data were analyzed using one way-ANOVA test, T-test, Pearson correlation and Bland and Altman plot.

     

    Results: The mean differences of No: 1 and No: 2 Glucometers with enzymatic laboratory method were 20.78±11.61 and 4.5±3.76mg/dl respectively. The one way ANOVA test indicated significant differences between three methods (p<0.05. Further Duncan's test revealed significant differences between two devices (p=0.001 and device No.1 and laboratory method (p=0.001; however, the differences between device No.2 and laboratory method were not statistically significant (p=0.83.

     

    Conclusion: According to the results, calibrating the devices with laboratory instruments in order to make major clinical decisions is recommended.

  18. Effect of Andrographolide‭ Extract on Blood Glucose and Lipid Profile in Rats with Secondary Iron Overload

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    َArash Mehri Pirayvatlo

    2017-01-01

    Full Text Available Background & objectives: Iron overload is involved in the pathophysiology of many diseases including diabetes. In fact, the excess iron by creating free radicals makes damage to pancreas and leads to insulin resistance and diabetes. Andrographolide extract has hypoglycemic and antioxidant properties. This study has surveyed the effects of andrographolide on blood glucose and lipid profile in rats with secondary iron overload. Methods: In this experimental study, 36 male Wistar rats were randomly divided into 6 groups: the healthy control group, secondary iron overload group, secondary iron overload groups treated with a dose of 3.5 and 7 mg/kg of andrographolide extract, and andrographolide groups treated with a dose of 3.5 and 7 mg/kg of extract. Iron and extract were injected for 6 and 12 days, respectively. Blood samples were taken for measurement of blood glucose and lipid profiles. Data were analyzed using ANOVA test. Results: The pathological results of samples from liver of animals receiving iron showed that the iron was deposited in the liver tissues. Iron injection significantly increased blood glucose levels compared to healthy control group (p<0.05. In the iron overload group, andrographolide extract with a dose of 3.5 mg/kg or 7 mg/kg significantly decreased blood glucose levels (p<0.05. Iron injections did not increase the serum triglyceride and cholesterollevels. Injections of andrographolide extract with a dose of 3.5 mg/kg and 7 mg/kg, significantly decreased the cholesterol levels compared to iron receiving group (p<0.05. Conclusion: Results of this study showed that the andrographolide with different doses may be effective in the treatment of diabetes by reducing serum glucose and cholesterol levels.

  19. Dynamic Electrochemistry Corrects for Hematocrit Interference on Blood Glucose Determinations with Patient Self-Measurement Devices

    Science.gov (United States)

    Musholt, Petra B; Schipper, Christina; Thomé, Nicole; Ramljak, Sanja; Schmidt, Marc; Forst, Thomas; Pfützner, Andreas

    2011-01-01

    Background It has been demonstrated that dynamic electrochemistry can be used to correct blood glucose measurement results for potentially interfering conditions, such as humidity, hematocrit (HCT) variations, and ascorbic acid. The purpose of this laboratory investigation was to assess the potential influence of hematocrit variations on a variety of blood glucose meters applying different measurement technologies. Methods Venous heparinized whole blood was drawn, immediately aliquoted, and manipulated to contain three different blood glucose concentrations (80, 155, and 310 mg/dl) and five different hematocrit levels (25%, 37%, 45%, 52%, and 60%). After careful oxygenation to normal blood oxygen pressure, each of the resulting 15 different samples was measured 8 times with the following devices: BGStar, Contour, Accu-Chek Aviva, Accu-Chek Aviva Nano, Breeze 2, Precision Xceed, OneTouch Ultra 2, OneTouch Verio, FreeStyle Freedom Lite, Glucocard G+, GlucoMen LX, GlucoMen GM, and StatStrip [point-of-care (POC) device]. Cobas (Roche Diagnostics, glucose hexokinase method) served as laboratory plasma reference method. Stability to hematocrit influence was assumed when less than 10% bias occurred between the highest and lowest hematocrit levels when analyzing mean deviations for all three glucose concentrations. Results Besides the POC StatStrip device, which is known to measure and correct for hematocrit (resulting in hematocrit variations occur in daily routine (e.g., because of smoking, exercise, hypermenorrhea, pregnancy, stay in mountains, and hemodialysis), our results may encourage use of meters with stable performance under these conditions. Dynamic electrochemistry as used in the BGStar device (sanofi-aventis) appears to be an effective technology to correct for potential hematocrit influence on the meter results. PMID:22027312

  20. The effect of food with different glycaemic index on the blood glucose level

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    Lenka Kouřimská

    2015-08-01

    Full Text Available Blood glucose levels are affected by many factors including the type of foods consumed, processing technology and cooking method. Hormone insulin lowers blood glucose to its constant level, while glucagon, growth hormone, adrenalin and glucocorticoids have the opposite effect. High steepness of the blood glucose level rise after meals may be unfavourable for the organism. Sugars are transferred into the blood at different speeds according to the type of food. Therefore the aim of this study was to confirm experimentally the effect of food on blood glucose levels in men and women of different ages. Two types of low, medium and high-glycaemic index (GI foods were given to 4 men and 4 women of different age (from 35 to 65 years. All volunteers were healthy, slightly overweight, and without any regular sporting activity. None of them had any idea about their daily carbohydrates consumption and what the term glycaemic index meant. The volunteers came to the GI determination fasted in the morning. Their rise in blood glucose level was monitored by glucometer before the meal and after 1 and 2 hours of the consumption of baked potatoes (GI 85, white bread bun (GI 70, boiled potatoes (GI 64, rye bread (GI 62, potato dumplings (GI 52 and white cooked spaghetti (GI 41. Fasting blood sugar levels of volunteers highly depended on their age (p <0.0001 and gender (p <0.0001. The blood glucose values increased with age and were higher in men than in women. Significant influence of food GI on blood glucose levels in both men and women in all the age categories was observed (p <0.0001. An interaction between age and gender was also statistically highly significant (p <0.0001. One hour after consuming food the blood glucose values were significantly different from the values of fasting (p = 0.0035. The differences of these values did not depend on the age (p = 0.0574 and sex (p = 0.8256 of volunteers, but there was a significant difference on the GI value of food