WorldWideScience

Sample records for glucose monitoring techniques

  1. Precision and costs of techniques for self-monitoring of serum glucose levels.

    OpenAIRE

    Chiasson, J. L.; Morrisset, R.; Hamet, P.

    1984-01-01

    The poor correlation between serum and urine glucose measurements has led to the development of new techniques for monitoring the blood glucose level in diabetic patients. Either a nurse or the patient can perform these tests, which involve spreading a single drop of blood onto a reagent strip. A colour change that is proportional to the serum glucose level can be read visually or with a reflectance meter. Evaluated against simultaneous serum glucose levels determined by the hospital biochemi...

  2. 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

  3. [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.

  4. Nocturnal continuous glucose monitoring

    DEFF Research Database (Denmark)

    Bay, Christiane; Kristensen, Peter Lommer; Pedersen-Bjergaard, Ulrik

    2013-01-01

    Abstract Background: A reliable method to detect biochemical nocturnal hypoglycemia is highly needed, especially in patients with recurrent severe hypoglycemia. We evaluated reliability of nocturnal continuous glucose monitoring (CGM) in patients with type 1 diabetes at high risk of severe...

  5. 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...

  6. Blood Glucose Monitoring Devices

    Science.gov (United States)

    ... are below 100 mg/dL before meals and fasting and are less than 140 mg/dL two hours after meals. People with diabetes should consult their doctor or health care provider to set appropriate blood glucose goals. ...

  7. 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.

  8. Current concepts in blood glucose monitoring

    Science.gov (United States)

    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 the newer concepts of blood glucose monitoring and their incorporation in routine clinical management of diabetes mellitus. PMID:24910827

  9. 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.

  10. Recent advances in noninvasive glucose monitoring

    Directory of Open Access Journals (Sweden)

    So CF

    2012-06-01

    Full Text Available Chi-Fuk So,1 Kup-Sze Choi,1 Thomas KS Wong,2 Joanne WY Chung2,31Centre for Integrative Digital Health, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, 2Department of Nursing and Health Sciences, Tung Wah College, Hong Kong, 3Department of Health and Physical Education, The Hong Kong Institute of Education, Hong KongAbstract: The race for the next generation of painless and reliable glucose monitoring for diabetes mellitus is on. As technology advances, both diagnostic techniques and equipment improve. This review describes the main technologies currently being explored for noninvasive glucose monitoring. The principle of each technology is mentioned; its advantages and limitations are then discussed. The general description and the corresponding results for each device are illustrated, as well as the current status of the device and the manufacturer; internet references for the devices are listed where appropriate. Ten technologies and eleven potential devices are included in this review. Near infrared spectroscopy has become a promising technology, among others, for blood glucose monitoring. Although some reviews have been published already, the rapid development of technologies and information makes constant updating mandatory. While advances have been made, the reliability and the calibration of noninvasive instruments could still be improved, and more studies carried out under different physiological conditions of metabolism, bodily fluid circulation, and blood components are needed.Keywords: noninvasive, glucose monitoring, diabetes mellitus, blood glucose measurement

  11. Optical coherence tomography for glucose monitoring in blood

    Science.gov (United States)

    Ullah, Hafeez; Hussain, Fayyaz; Ikram, Masroor

    2015-08-01

    In this review, we have discussed the potential application of the emerging imaging modality, i.e., optical coherence tomography (OCT) for glucose monitoring in biological tissues. OCT provides monitoring of glucose diffusion in different fibrous tissues like in sclera by determining the permeability rate with acceptable accuracy both in type 1 and in type 2 diabetes. The maximum precision of glucose measurement in Intralipid suspensions, for example, with the OCT technique yields the accuracy up to 4.4 mM for 10 % Intralipid and 2.2 mM for 3 % Intralipid.

  12. Non Invasive Glucose Monitoring System Using Nanosensors

    Directory of Open Access Journals (Sweden)

    Rajasekaran C.

    2016-03-01

    Full Text Available The most existing future technology is an outcome of the fields of computer science, electronics and Biology. Health inequalities have become the focus of a number of descriptive and analytical studies. One of the health related problem is diabetes. Diabetes at its serious stage leads to blindness. Monitoring glucose level in blood is one preventive measure to check diabetes. Increase in Glucose is a common risk factor which leads to hyperglycemia, Hypoglycemia, heart attack, stokes and aneurysms. A glucose monitoring system continuously measures and monitors the glucose level in a patient’s blood. Normal blood glucose level of human is 70-110 milligram/deciliter. The level is maintained by using the secretion of insulin inside the body. When the insulin level gets increased it leads to hyperglycemia, and hypoglycemia when the level gets decreased. Hyperglycemia disease includes cataract,edema, hypertension, polyuria and polydipsia. Hypoglycemaia disease includes confusion, giddiness, unconsciousness, coma and death. The proposed system finds a new way for measuring the glucose level. The work uses Nanopellets which measure’s the glucose level, when the glucose level gets increased or decreased, it will be automatically get monitored and processed using microcontroller (MSP430G2553. The information is then send to the doctor through GSM.

  13. Challenges and perspectives in continuous glucose monitoring.

    Science.gov (United States)

    van Enter, Benjamin Jasha; von Hauff, Elizabeth

    2018-04-24

    Diabetes is a global epidemic that threatens the health and well-being of hundreds of millions of people. The first step in patient treatment is to monitor glucose levels. Currently this is most commonly done using enzymatic strips. This approach suffers from several limitations, namely it requires a blood sample and is therefore invasive, the quality and the stability of the enzymatic strips vary widely, and the patient is burdened by performing the measurement themselves. This results in dangerous fluctuations in glucose levels often going undetected. There is currently intense research towards new approaches in glucose detection that would enable non-invasive continuous glucose monitoring (CGM). In this review, we explore the state-of-the-art in glucose detection technologies. In particular, we focus on the physical mechanisms behind different approaches, and how these influence and determine the accuracy and reliability of glucose detection. We begin by reviewing the basic physical and chemical properties of the glucose molecule. Although these play a central role in detection, especially the anomeric ratio, they are surprisingly often overlooked in the literature. We then review state-of-the art and emerging detection methods. Finally, we survey the current market for glucometers. Recent results show that past challenges in glucose detection are now being overcome, thereby enabling the development of smart wearable devices for non-invasive continuous glucose monitoring. These new directions in glucose detection have enormous potential to improve the quality of life of millions of diabetics, as well as offer insight into the development, treatment and even prevention of the disease.

  14. Toward CMOS image sensor based glucose monitoring.

    Science.gov (United States)

    Devadhasan, Jasmine Pramila; Kim, Sanghyo

    2012-09-07

    Complementary metal oxide semiconductor (CMOS) image sensor is a powerful tool for biosensing applications. In this present study, CMOS image sensor has been exploited for detecting glucose levels by simple photon count variation with high sensitivity. Various concentrations of glucose (100 mg dL(-1) to 1000 mg dL(-1)) were added onto a simple poly-dimethylsiloxane (PDMS) chip and the oxidation of glucose was catalyzed with the aid of an enzymatic reaction. Oxidized glucose produces a brown color with the help of chromogen during enzymatic reaction and the color density varies with the glucose concentration. Photons pass through the PDMS chip with varying color density and hit the sensor surface. Photon count was recognized by CMOS image sensor depending on the color density with respect to the glucose concentration and it was converted into digital form. By correlating the obtained digital results with glucose concentration it is possible to measure a wide range of blood glucose levels with great linearity based on CMOS image sensor and therefore this technique will promote a convenient point-of-care diagnosis.

  15. Accuracy of flash glucose monitoring and continuous glucose monitoring technologies: Implications for clinical practice.

    Science.gov (United States)

    Ajjan, Ramzi A; Cummings, Michael H; Jennings, Peter; Leelarathna, Lalantha; Rayman, Gerry; Wilmot, Emma G

    2018-02-01

    Continuous glucose monitoring and flash glucose monitoring technologies measure glucose in the interstitial fluid and are increasingly used in diabetes care. Their accuracy, key to effective glycaemic management, is usually measured using the mean absolute relative difference of the interstitial fluid sensor compared to reference blood glucose readings. However, mean absolute relative difference is not standardised and has limitations. This review aims to provide a consensus opinion on assessing accuracy of interstitial fluid glucose sensing technologies. Mean absolute relative difference is influenced by glucose distribution and rate of change; hence, we express caution on the reliability of comparing mean absolute relative difference data from different study systems and conditions. We also review the pitfalls associated with mean absolute relative difference at different glucose levels and explore additional ways of assessing accuracy of interstitial fluid devices. Importantly, much data indicate that current practice of assessing accuracy of different systems based on individualised mean absolute relative difference results has limitations, which have potential clinical implications. Healthcare professionals must understand the factors that influence mean absolute relative difference as a metric for accuracy and look at additional assessments, such as consensus error grid analysis, when evaluating continuous glucose monitoring and flash glucose monitoring systems in diabetes care. This in turn will ensure that management decisions based on interstitial fluid sensor data are both effective and safe.

  16. Recommending blood glucose monitors, a pharmacy perspective.

    Science.gov (United States)

    Carter, Alan

    2007-03-01

    Selection of what blood glucose monitoring system to utilize has become an issue for physicians, diabetes educators, pharmacists, and patients. The field of competing makes and models of blood glucose monitoring systems has become crowded, with manufacturers touting improvements in accuracy, ease of use/alternate site options, stored results capacity, software evaluation tools, and/or price point. Personal interviews of 12 pharmacists from community and academic practice settings about monitor preference, as well as results from a national survey of pharmacist recommendations, were compared to actual wholesale sales data to estimate the impact of such recommendations on final monitor selection by the patient. Accu-Chek monitors were recommended 34.65% of the time and represented 28.58% of sales, with a success rate of 82.48% of being the monitor selected. OneTouch monitors had 27.72% of recommendations but represented 31.43% of sales, indicating possible patient brand loyalty or formulary preference for that product. FreeStyle(R) monitors came in third for pharmacist recommendations and were selected by the patient 61.68% of the time when recommended. The category of "other monitor" choices was selected 60.89% of the time by patients given those suggestions. Included in the "other monitor" category was the new disposable monitor marketed as the Sidekick. Based on sales data provided, the Sidekick made up 2.87% of "other monitor" category sales, representing 68% of the "other monitor" segment. While patients frequently follow pharmacist monitoring system suggestions, the ultimate deciding factor is most often the final out-of-pocket cost to the patient. As a result, cost of supplies often becomes the most important determining factor in final monitor selection at the patient level. If the patient cannot afford to perform the recommended daily testing intervals, all other determining factors and suggestions become moot.

  17. Continuous glucose monitoring in acute coronary syndrome.

    Science.gov (United States)

    Rodríguez-Quintanilla, Karina Alejandra; Lavalle-González, Fernando Javier; Mancillas-Adame, Leonardo Guadalupe; Zapata-Garrido, Alfonso Javier; Villarreal-Pérez, Jesús Zacarías; Tamez-Pérez, Héctor Eloy

    2013-01-01

    Diabetes mellitus is an independent risk factor for cardiovascular disease. To compare the efficacy of devices for continuous glucose monitoring and capillary glucose monitoring in hospitalized patients with acute coronary syndrome using the following parameters: time to achieve normoglycemia, period of time in normoglycemia, and episodes of hypoglycemia. We performed a pilot, non-randomized, unblinded clinical trial that included 16 patients with acute coronary artery syndrome, a capillary or venous blood glucose ≥ 140 mg/dl, and treatment with a continuous infusion of fast acting human insulin. These patients were randomized into 2 groups: a conventional group, in which capillary measurement and recording as well as insulin adjustment were made every 4h, and an intervention group, in which measurement and recording as well as insulin adjustment were made every hour with a subcutaneous continuous monitoring system. Student's t-test was applied for mean differences and the X(2) test for qualitative variables. We observed a statistically significant difference in the mean time for achieving normoglycemia, favoring the conventional group with a P = 0.02. Continuous monitoring systems are as useful as capillary monitoring for achieving normoglycemia. Copyright © 2012 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  18. 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.

  19. Continuous glucose monitoring systems for type 1 diabetes mellitus

    NARCIS (Netherlands)

    Langendam, Miranda; Luijf, Yoeri M.; Hooft, Lotty; DeVries, J. Hans; Mudde, Aart H.; Scholten, Rob J. P. M.

    2012-01-01

    Background Self-monitoring of blood glucose is essential to optimise glycaemic control in type 1 diabetes mellitus. Continuous glucose monitoring (CGM) systems measure interstitial fluid glucose levels to provide semi-continuous information about glucose levels, which identifies fluctuations that

  20. Continuous glucose monitoring, oral glucose tolerance, and insulin - glucose parameters in adolescents with simple obesity.

    Science.gov (United States)

    El Awwa, A; Soliman, A; Al-Ali, M; Yassin, M; De Sanctis, V

    2012-09-01

    In obese adolescents pancreatic beta-cells may not be able to cope with insulin resistance leading to hyperglycemia and type2 diabetes (T2DM To assess oral glucose tolerance, 72-h continuous blood glucose concentrations (CGM) and calculate homeostatic model assessment (HOMA), and the quantitative insulin sensitivity check index (QUICKI) in 13 adolescents with simple obesity (BMI SDS=4 ± 1.06). OGTT performed in 13 obese adolescents (13.47 ± 3 years) revealed 3 cases (23%) with impaired fasting glucose (IFG: fasting glucose >5.6 mmol/L), 4 cases (30%) with impaired glucose tolerance (IGT: 2h blood glucose >7.8 continuous glucose monitoring system ( CGMS), IFG was detected in 4 cases, the maximum serum blood glucose (BG : 2h or more after meal) was >7.8 and 11.1 mmol/L (diabetes) in one case (7.6%). Five cases had a minimum BG recorded of 2.6 and QUICKI values obese adolescents, CGMS is superior to OGTT and HbA1C in detecting glycemic abnormalities, which appears to be secondary to insulin resistance.

  1. 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,

  2. The continuous glucose monitoring sensor in neonatal intensive care

    OpenAIRE

    Beardsall, K; Ogilvy-Stuart, A; Ahluwalia, J; Thompson, M; Dunger, D

    2005-01-01

    Objective: To determine the feasibility of continuous glucose monitoring in the very low birthweight baby requiring intensive care, as these infants are known to be at high risk of abnormalities of glucose control.

  3. Crosslinked basement membrane-based coatings enhance glucose sensor function and continuous glucose monitoring in vivo.

    Science.gov (United States)

    Klueh, Ulrike; Ludzinska, Izabela; Czajkowski, Caroline; Qiao, Yi; Kreutzer, Donald L

    2018-01-01

    Overcoming sensor-induced tissue reactions is an essential element of achieving successful continuous glucose monitoring (CGM) in the management of diabetes, particularly when used in closed loop technology. Recently, we demonstrated that basement membrane (BM)-based glucose sensor coatings significantly reduced tissue reactions at sites of device implantation. However, the biocompatible BM-based biohydrogel sensor coating rapidly degraded over a less than a 3-week period, which effectively eliminated the protective sensor coating. In an effort to increase the stability and effectiveness of the BM coating, we evaluated the impact of crosslinking BM utilizing glutaraldehyde as a crosslinking agent, designated as X-Cultrex. Sensor performance (nonrecalibrated) was evaluated for the impact of these X-Cultrex coatings in vitro and in vivo. Sensor performance was assessed over a 28-day time period in a murine CGM model and expressed as mean absolute relative difference (MARD) values. Tissue reactivity of Cultrex-coated, X-Cultrex-coated, and uncoated glucose sensors was evaluated over a 28-day time period in vivo using standard histological techniques. These studies demonstrated that X-Cultrex-based sensor coatings had no effect on glucose sensor function in vitro. In vivo, glucose sensor performance was significantly enhanced following X-Cultrex coating throughout the 28-day study. Histological evaluations of X-Cultrex-treated sensors demonstrated significantly less tissue reactivity when compared to uncoated sensors. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 7-16, 2018. © 2017 Wiley Periodicals, Inc.

  4. Continuous Glucose Monitoring in Newborn Infants

    Science.gov (United States)

    Thomas, Felicity; Signal, Mathew; Harris, Deborah L.; Weston, Philip J.; Harding, Jane E.; Shaw, Geoffrey M.

    2014-01-01

    Neonatal hypoglycemia is common and can cause serious brain injury. Continuous glucose monitoring (CGM) could improve hypoglycemia detection, while reducing blood glucose (BG) measurements. Calibration algorithms use BG measurements to convert sensor signals into CGM data. Thus, inaccuracies in calibration BG measurements directly affect CGM values and any metrics calculated from them. The aim was to quantify the effect of timing delays and calibration BG measurement errors on hypoglycemia metrics in newborn infants. Data from 155 babies were used. Two timing and 3 BG meter error models (Abbott Optium Xceed, Roche Accu-Chek Inform II, Nova Statstrip) were created using empirical data. Monte-Carlo methods were employed, and each simulation was run 1000 times. Each set of patient data in each simulation had randomly selected timing and/or measurement error added to BG measurements before CGM data were calibrated. The number of hypoglycemic events, duration of hypoglycemia, and hypoglycemic index were then calculated using the CGM data and compared to baseline values. Timing error alone had little effect on hypoglycemia metrics, but measurement error caused substantial variation. Abbott results underreported the number of hypoglycemic events by up to 8 and Roche overreported by up to 4 where the original number reported was 2. Nova results were closest to baseline. Similar trends were observed in the other hypoglycemia metrics. Errors in blood glucose concentration measurements used for calibration of CGM devices can have a clinically important impact on detection of hypoglycemia. If CGM devices are going to be used for assessing hypoglycemia it is important to understand of the impact of these errors on CGM data. PMID:24876618

  5. Noninvasive glucose monitoring using saliva nano-biosensor

    Directory of Open Access Journals (Sweden)

    Wenjun Zhang

    2015-06-01

    Full Text Available Millions of people worldwide live with diabetes and several millions die from it each year. A noninvasive, painless method of glucose testing would highly improve compliance and glucose control while reducing complications and overall disease management costs. To provide accurate, low cost, and continuous glucose monitoring, we have developed a unique, disposable saliva nano-biosensor. More than eight clinical trials on real-time noninvasive salivary glucose monitoring were carried out on two healthy individuals (a 2–3 h-period for each trial, including both regular food and standard glucose beverage intake with more than 35 saliva samples obtained. Excellent clinical accuracy was revealed as compared to the UV Spectrophotometer. By measuring subjects’ salivary glucose and blood glucose in parallel, we found the two generated profiles share the same fluctuation trend but the correlation between them is individual dependent. There is a time lag between the peak glucose values from blood and from saliva. However, the correlation between the two glucose values at fasting is constant for each person enabling noninvasive diagnosis of diabetes through saliva instead of blood. Furthermore, a good correlation of glucose levels in saliva and in blood before and 2 h after glucose intake was observed. Glucose monitoring before and 2 h after meals is usually prescribed by doctors for diabetic patients. Thus, this disposable biosensor will be an alternative for real-time salivary glucose tracking at any time.

  6. Continuous Glucose Monitoring (CGM) or Blood Glucose Monitoring (BGM): Interactions and Implications.

    Science.gov (United States)

    Heinemann, Lutz

    2018-04-01

    At the 2017 10th annual International Conference on Advanced Technologies and Treatments for Diabetes (ATTD) in Paris, France, four speakers presented their perspectives on the roles of continuous glucose monitoring (CGM) and of blood glucose monitoring (BGM) in patient management within one symposium. These presentations included discussions of the differences in the accuracy of CGM and BGM, a clinical perspective on the physiological reasons behind differences in CGM and BGM values, and an overview of the impact of variations in device accuracy on patients with diabetes. Subsequently a short summary of these presentations is given, highlighting the value of good accuracy of BGM or CGM systems and the ongoing need for standardization. The important role of both BGM and CGM in patient management was a theme across all presentations.

  7. Tritium monitoring techniques

    International Nuclear Information System (INIS)

    DeVore, J.R.; Buckner, M.A.

    1996-05-01

    As part of their operations, the U.S. Navy is required to store or maintain operational nuclear weapons on ships and at shore facilities. Since these weapons contain tritium, there are safety implications relevant to the exposure of personnel to tritium. This is particularly important for shipboard operations since these types of environments can make low-level tritium detection difficult. Some of these ships have closed systems, which can result in exposure to tritium at levels that are below normally acceptable levels but could still cause radiation doses that are higher than necessary or could hamper ship operations. This report describes the state of the art in commercial tritium detection and monitoring and recommends approaches for low-level tritium monitoring in these environments

  8. Continuous Glucose Monitoring in Patients with Abnormal Glucose Tolerance during Pregnancy: A Case Series

    Directory of Open Access Journals (Sweden)

    Mie Tonoike

    2016-01-01

    Full Text Available Abnormal glucose tolerance during pregnancy is associated with perinatal complications. We used continuous glucose monitoring (CGM in pregnant women with glucose intolerance to achieve better glycemic control and to evaluate the maternal glucose fluctuations. We also used CGM in women without glucose intolerance (the control cases. Furthermore, the standard deviation (SD and mean amplitude of glycemic excursions (MAGE were calculated for each case. For the control cases, the glucose levels were tightly controlled within a very narrow range; however, the SD and MAGE values in pregnant women with glucose intolerance were relativity high, suggesting postprandial hyperglycemia. Our results demonstrate that pregnant women with glucose intolerance exhibited greater glucose fluctuations compared with the control cases. The use of CGM may help to improve our understanding of glycemic patterns and may have beneficial effects on perinatal glycemic control, such as the detection of postprandial hyperglycemia in pregnant women.

  9. Comparison of Glucose Area Under the Curve Measured Using Minimally Invasive Interstitial Fluid Extraction Technology with Continuous Glucose Monitoring System in Diabetic Patients

    OpenAIRE

    Uemura, Mei

    2017-01-01

    Background: Continuous glucose monitoring (CGM) is reported to be a useful technique, but difficult or inconvenient for some patients and institutions. We are developing a glucose area under the curve (AUC) monitoring system without blood sampling using a minimally invasive interstitial fluid extraction technology (MIET). Here we evaluated the accuracy of interstitial fluid glucose (IG) AUC measured by MIET in patients with diabetes for an extended time interval and the potency of detecting h...

  10. Comparison of Glucose Area Under the Curve Measured Using Minimally Invasive Interstitial Fluid Extraction Technology with Continuous Glucose Monitoring System in Diabetic Patients

    OpenAIRE

    Mei Uemura; Yutaka Yano; Toshinari Suzuki; Taro Yasuma; Toshiyuki Sato; Aya Morimoto; Samiko Hosoya; Chihiro Suminaka; Hiromu Nakajima; Esteban C. Gabazza; Yoshiyuki Takei

    2017-01-01

    Background Continuous glucose monitoring (CGM) is reported to be a useful technique, but difficult or inconvenient for some patients and institutions. We are developing a glucose area under the curve (AUC) monitoring system without blood sampling using a minimally invasive interstitial fluid extraction technology (MIET). Here we evaluated the accuracy of interstitial fluid glucose (IG) AUC measured by MIET in patients with diabetes for an extended time interval and the potency of detecting hy...

  11. Wearable Contact Lens Biosensors for Continuous Glucose Monitoring Using Smartphones.

    Science.gov (United States)

    Elsherif, Mohamed; Hassan, Mohammed Umair; Yetisen, Ali K; Butt, Haider

    2018-05-17

    Low-cost, robust, and reusable continuous glucose monitoring systems that can provide quantitative measurements at point-of-care settings is an unmet medical need. Optical glucose sensors require complex and time-consuming fabrication processes, and their readouts are not practical for quantitative analyses. Here, a wearable contact lens optical sensor was created for the continuous quantification of glucose at physiological conditions, simplifying the fabrication process and facilitating smartphone readouts. A photonic microstructure having a periodicity of 1.6 μm was printed on a glucose-selective hydrogel film functionalized with phenylboronic acid. Upon binding with glucose, the microstructure volume swelled, which modulated the periodicity constant. The resulting change in the Bragg diffraction modulated the space between zero- and first-order spots. A correlation was established between the periodicity constant and glucose concentration within 0-50 mM. The sensitivity of the sensor was 12 nm mM -1 , and the saturation response time was less than 30 min. The sensor was integrated with commercial contact lenses and utilized for continuous glucose monitoring using smartphone camera readouts. The reflected power of the first-order diffraction was measured via a smartphone application and correlated to the glucose concentrations. A short response time of 3 s and a saturation time of 4 min was achieved in the continuous monitoring mode. Glucose-sensitive photonic microstructures may have applications in point-of-care continuous monitoring devices and diagnostics at home settings.

  12. Oral glucose tolerance test and continuous glucose monitoring to assess diabetes development in cystic fibrosis patients.

    Science.gov (United States)

    Clemente León, María; Bilbao Gassó, Laura; Moreno-Galdó, Antonio; Campos Martorrell, Ariadna; Gartner Tizzano, Silvia; Yeste Fernández, Diego; Carrascosa Lezcano, Antonio

    2018-01-01

    Patients with cystic fibrosis (CF) undergo a slow and progressive process toward diabetes. Oral glucose tolerance test (OGTT) is recommended to diagnose impaired glucose levels in these patients. Continuous glucose monitoring (CGM) measures glucose profiles under real-life conditions. To compare OGTT and CGM results in CF patients. Paired OGTT and 6-day CGM profiles (146.2±9.1h/patient) were performed in 30 CF patients aged 10-18 years. According to OGTT, 14 patients had normal glucose tolerance (NGT), 14 abnormal glucose tolerance (AGT), and two cystic fibrosis-related diabetes (CFRD). In 27 patients (13 NGT, 13 AGT, 1 CFRD), CGM showed glucose values ranging from 140 to 200mg/dL during similar monitoring times (2%-14% with NGT, 1%-16.9% with AGT, and 3% with CFRD). Glucose peak levels ≥200mg/dL were seen in seven patients (3 NGT, 3 AGT, 1 CFRD). According to CGM, two patients had all glucose values under 140mg/dL (1 NGT, 1 AGT). Seventeen patients had glucose levels ranging from 140 to 200mg/dL (10 NGT, 6 AGT, 1 CFRD). Ten patients (3 NGT, 7 AGT) had glucose values ≥200mg/dL for ≤1% of the monitoring time and one (CFRD) for >1% of the monitoring time. OGTT results did not agree with those of the CGM. CGM allows for diagnosis of glucose changes not detected by OGTT. Such changes may contribute to optimize pre-diabetes management in CF patients. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. 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 ...

  14. Evaluating clinical accuracy of continuous glucose monitoring devices: other methods

    NARCIS (Netherlands)

    Wentholt, Iris M. E.; Hart, August A.; Hoekstra, Joost B. L.; DeVries, J. Hans

    2008-01-01

    With more and more continuous glucose monitoring devices entering the market, the importance of adequate accuracy assessment grows. This review discusses pros and cons of Regression Analysis and Correlation Coefficient, Relative Difference measures, Bland Altman plot, ISO criteria, combined curve

  15. Evaluation of a Novel Glucose Area Under the Curve (AUC) Monitoring System: Comparison with the AUC by Continuous Glucose Monitoring.

    Science.gov (United States)

    Ugi, Satoshi; Maegawa, Hiroshi; Morino, Katsutaro; Nishio, Yoshihiko; Sato, Toshiyuki; Okada, Seiki; Kikkawa, Yasuo; Watanabe, Toshihiro; Nakajima, Hiromu; Kashiwagi, Atsunori

    2016-08-01

    Management of postprandial hyperglycemia is a key aspect in diabetes treatment. We developed a novel system to measure glucose area under the curve (AUC) using minimally invasive interstitial fluid extraction technology (MIET) for simple monitoring of postprandial glucose excursions. In this study, we evaluated the relationship between our system and continuous glucose monitoring (CGM) by comparing glucose AUC obtained using MIET with that obtained using CGM for a long duration. Twenty diabetic inpatients wearing a CGM system were enrolled. For MIET measurement, a plastic microneedle array was applied to the skin as pretreatment, and hydrogels were placed on the pretreated area to collect interstitial fluid. Hydrogels were replaced every 2 or 4 hours and AUC was predicted on the basis of glucose and sodium ion levels. AUC predicted by MIET correlated well with that measured by CGM (r=0.93). Good performances of both consecutive 2- and 4-hour measurements were observed (measurement error: 11.7%±10.2% for 2 hours and 11.1%±7.9% for 4 hours), indicating the possibility of repetitive measurements up to 8 hours. The influence of neither glucose fluctuation nor average glucose level over the measurement accuracy was observed through 8 hours. Our system showed good relationship with AUC values from CGM up to 8 hours, indicating that single pretreatment can cover a large portion of glucose excursion in a day. These results indicated possibility of our system to contribute to convenient monitoring of glucose excursions for a long duration.

  16. A technology roadmap of smart biosensors from conventional glucose monitoring systems.

    Science.gov (United States)

    Shende, Pravin; Sahu, Pratiksha; Gaud, Ram

    2017-06-01

    The objective of this review article is to focus on technology roadmap of smart biosensors from a conventional glucose monitoring system. The estimation of glucose with commercially available devices involves analysis of blood samples that are obtained by pricking finger or extracting blood from the forearm. Since pain and discomfort are associated with invasive methods, the non-invasive measurement techniques have been investigated. The non-invasive methods show advantages like non-exposure to sharp objects such as needles and syringes, due to which there is an increase in testing frequency, improved control of glucose concentration and absence of pain and biohazard materials. This review study is aimed to describe recent invasive techniques and major noninvasive techniques, viz. biosensors, optical techniques and sensor-embedded contact lenses for glucose estimation.

  17. Continuous tissue glucose monitoring correlates with measurement of intermittent capillary glucose in patients with distributive shock.

    Science.gov (United States)

    Ballesteros, D; Martínez, Ó; Blancas Gómez-Casero, R; Martín Parra, C; López Matamala, B; Estébanez, B; Chana, M

    2015-10-01

    Intermittent glycemic measurements in patients admitted to the intensive care unit (ICU) can result in episodes of severe hypoglycemia or in a poor control of glycemia range. We designed a study to assess accuracy and reliability of continuous monitoring of tissue glucose for patients with distributive shock. Consecutive patients admitted to the ICU with a diagnosis of distributive shock and the need of insulin infusion for glycemic control were included in the study. These patients were implanted a Continuous Glucose Control Monitoring System (CGMS) with the sensor inserted subcutaneously into the abdominal wall. CGMS values were recorded every 5min. Capillary glucose (CG) was monitored for adjusting insulin perfusion according to the ICU protocol. Correlation between both methods was assessed. A total of 11,673 CGMS and 348 CG values were recorded. In five patients, CGMS failed to detect tissue glucose. A glucose value <3.33mmol/l (<60mg/dl) was observed in 3.6% of CGMS and in 0.29% CG values. 295 pairs of measurements were included in the statistical analysis for correlation assessment. The intraclass correlation coefficient was 0.706. The Pearson correlation coefficient was 0.71 (p<0.0001, 95% CI 0.65-0.76). The mean of differences between both measurement methods was 0.22mmol/l (3.98mg/dl) (95% CI 0.66-7.31). When the Continuous Glucose Control Monitoring System (CGMS) is able to obtain data (75% of the patients), there is correlation between the values obtained by this method and capillary blood glucose in patients with distributive shock. CGMS can detect more episodes of glycemic excursions outside the normal range than intermittent capillary glucose monitoring. Variables that may impair glucose metabolism and peripheral soft tissues perfusion could impair CGMS measurements. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  18. Glucose metabolism disorder in obese children assessed by continuous glucose monitoring system.

    Science.gov (United States)

    Zou, Chao-Chun; Liang, Li; Hong, Fang; Zhao, Zheng-Yan

    2008-02-01

    Continuous glucose monitoring system (CGMS) can measure glucose levels at 5-minute intervals over a few days, and may be used to detect hypoglycemia, guide insulin therapy, and control glucose levels. This study was undertaken to assess the glucose metabolism disorder by CGMS in obese children. Eighty-four obese children were studied. Interstitial fluid (ISF) glucose levels were measured by CGMS for 24 hours covering the time for oral glucose tolerance test (OGTT). Impaired glucose tolerance (IGT), impaired fasting glucose (IFG), type 2 diabetic mellitus (T2DM) and hypoglycemia were assessed by CGMS. Five children failed to complete CGMS test. The glucose levels in ISF measured by CGMS were highly correlated with those in capillary samples (r=0.775, Pobese children who finished the CGMS, 2 children had IFG, 2 had IGT, 3 had IFG + IGT, and 2 had T2DM. Nocturnal hypoglycemia was noted during the overnight fasting in 11 children (13.92%). Our data suggest that glucose metabolism disorder including hyperglycemia and hypoglycemia is very common in obese children. Further studies are required to improve the precision of the CGMS in children.

  19. Application of optical coherence tomography for noninvasive blood glucose monitoring during hyperglycemia

    Science.gov (United States)

    Larin, Kirill V.; Ashitkov, Taras V.; Motamedi, Massoud; Esenaliev, Rinat O.

    2003-10-01

    Approximately 14 million people in the USA and more than 140 million people worldwide suffer from Diabetes Mellitus. The current glucose sensing technique involves a finger puncture several times a day to obtain a droplet of blood for chemical analysis. Recently we proposed to use optical coherence tomography (OCT) for continuous noninvasive blood glucose sensing through skin. In this paper we tested the OCT technique for noninvasive monitoring of blood glucose concentration in lip tissue of New Zealand rabbits and Yucatan micropigs during glucose clamping experiments. Obtained results show good agreement with results obtained in skin studies, good correlation of changes in the OCT signal slope measured at the depth of 250 to 500 μm with changes in blood glucose concentration, and higher stability of the OCT data points than that obtained from skin.

  20. Remote and unattended monitoring techniques

    International Nuclear Information System (INIS)

    Abedin-Zadeh, R.; Whichello, J.

    1998-01-01

    In the last years, there has been a tremendous growth in the number of unattended assay and monitoring systems in the field. These systems have enabled reduced presence of inspectors while increasing the verification coverage. As part of the Strengthened safeguards System and in particular as part of the measures to improve the cost-effectiveness of safeguards, the possibility of remote transfer of authenticated and encrypted video surveillance, seals and radiation sensor data via telephone or special satellite links have been demonstrated and the necessary arrangements and infrastructure have been prepared. The evaluation of field trials of the remote monitoring systems have shown that the systems are effective in monitoring events of safeguards relevance in near real times. The systems are competitive from a cost standpoint when compared to current methods. The reduction of inspection efforts can be realized by application of remote monitoring technique with scheduled inspections and more effectively with the short notice or unannounced random inspections. It is expected that, upon completion of the necessary arrangements with the Member States authorities, the safeguards department will implement the technique widely before the year 2000

  1. A new corrosion monitoring technique

    International Nuclear Information System (INIS)

    Brown, Gerald K.

    2000-01-01

    Internal Corrosion Monitoring has relied upon 5 basic techniques. Little improvement in performance has been achieved in any of these. Many newer internal corrosion monitoring techniques have proved of little value in the field although some have instances of success in the laboratory. Industry has many high value hydrocarbon applications requiring corrosion rate monitoring for real-time problem solving and control. The high value of assets and the cost of asset replacement makes it necessary to practice cost effective process and corrosion control with sensitivity beyond the 5 basic techniques. This new metal loss technology offers this sensitivity. Traditional metal loss technology today provides either high sensitivity with short life, or conversely, long life but with substantially reduced sensitivity. The new metal loss technology offers an improved working life of sensors without significantly compromising performance. The paper discusses the limitations of existing on-line technologies and describes the performance of a new technology. This new metal loss technology was introduced at NACE Corrosion 99'. Since that time several field projects have been completed or are ongoing. This paper will discuss the new metal loss technology and report on some of the data that has been obtained.(author)

  2. Systematic review and meta-analysis of the effectiveness of continuous glucose monitoring (CGM) on glucose control in diabetes

    OpenAIRE

    Poolsup, Nalinee; Suksomboon, Naeti; Kyaw, Aye Mon

    2013-01-01

    Diabetes mellitus is a chronic disease that necessitates continuing treatment and patient self-care education. Monitoring of blood glucose to near normal level without hypoglycemia becomes a challenge in the management of diabetes. Although self monitoring of blood glucose (SMBG) can provide daily monitoring of blood glucose level and help to adjust therapy, it cannot detect hypoglycemic unawareness and nocturnal hypoglycemia which occurred mostly in T1DM pediatrics. Continuous glucose monito...

  3. Glucose Monitoring System Based on Osmotic Pressure Measurements

    Directory of Open Access Journals (Sweden)

    Alexandra LEAL

    2011-02-01

    Full Text Available This paper presents the design and development of a prototype sensor unit for implementation in a long-term glucose monitoring system suitable for estimating glucose levels in people suffering from diabetes mellitus. The system utilizes osmotic pressure as the sensing mechanism and consists of a sensor prototype that is integrated together with a pre-amplifier and data acquisition unit for both data recording and processing. The sensor prototype is based on an embedded silicon absolute pressure transducer and a semipermeable nanoporous membrane that is enclosed in the sensor housing. The glucose monitoring system facilitates the integration of a low power microcontroller that is combined with a wireless inductive powered communication link. Experimental verification have proven that the system is capable of tracking osmotic pressure changes using albumin as a model compound, and thereby show a proof of concept for novel long term tracking of blood glucose from remote sensor nodes.

  4. Evaluation of a Novel Glucose Area Under the Curve (AUC Monitoring System: Comparison with the AUC by Continuous Glucose Monitoring

    Directory of Open Access Journals (Sweden)

    Satoshi Ugi

    2016-07-01

    Full Text Available BackgroundManagement of postprandial hyperglycemia is a key aspect in diabetes treatment. We developed a novel system to measure glucose area under the curve (AUC using minimally invasive interstitial fluid extraction technology (MIET for simple monitoring of postprandial glucose excursions. In this study, we evaluated the relationship between our system and continuous glucose monitoring (CGM by comparing glucose AUC obtained using MIET with that obtained using CGM for a long duration.MethodsTwenty diabetic inpatients wearing a CGM system were enrolled. For MIET measurement, a plastic microneedle array was applied to the skin as pretreatment, and hydrogels were placed on the pretreated area to collect interstitial fluid. Hydrogels were replaced every 2 or 4 hours and AUC was predicted on the basis of glucose and sodium ion levels.ResultsAUC predicted by MIET correlated well with that measured by CGM (r=0.93. Good performances of both consecutive 2- and 4-hour measurements were observed (measurement error: 11.7%±10.2% for 2 hours and 11.1%±7.9% for 4 hours, indicating the possibility of repetitive measurements up to 8 hours. The influence of neither glucose fluctuation nor average glucose level over the measurement accuracy was observed through 8 hours.ConclusionOur system showed good relationship with AUC values from CGM up to 8 hours, indicating that single pretreatment can cover a large portion of glucose excursion in a day. These results indicated possibility of our system to contribute to convenient monitoring of glucose excursions for a long duration.

  5. Comparison of optical coherence tomography, the pulsed photoacoustic technique, and the time-of-flight technique in glucose measurements in vitro

    OpenAIRE

    Kinnunen, M. (Matti)

    2006-01-01

    Abstract The development of a non-invasive glucose monitoring technique is very important because it would tremendously diminish the need to puncture the skin when taking blood samples and help diabetic patients in controlling their blood glucose levels and in treating Diabetes Mellitus. The focus of this thesis is on measuring the effect of glucose on the light scattering properties of a tissue-simulating phantom and biological tissues in vitro. Optical coherence tomography (OCT), the pul...

  6. PROFESSIONAL FLASH CONTINUOUS GLUCOSE MONITORING WITH AMBULATORY GLUCOSE PROFILE REPORTING TO SUPPLEMENT A1C: RATIONALE AND PRACTICAL IMPLEMENTATION.

    Science.gov (United States)

    Hirsch, Irl B; Verderese, Carol A

    2017-11-01

    Recent consensus statements strongly advocate downloading and interpreting continuous glucose data for diabetes management in patients with type 1 or 2 diabetes. Supplementing periodic glycated hemoglobin (A1C) testing with intermittent continuous glucose monitoring (CGM) using a standardized report form known as the ambulatory glucose profile (AGP) is an evolving standard of care. The rationale for this approach and its implementation with a recently approved novel monitoring technology are explored. Search of the medical literature, professional guidelines, and real-world evidence guided this introduction of an integrative practice framework that uses AGP in conjunction with intermittent flash continuous glucose monitoring (FCGM) as a supplement to A1C testing. The combination of intermittent continuous glucose pattern analysis, standardized glucose metrics, and a readily interpretable data report has the potential to practically extend the recognized benefits of CGM to more patients and clarify the relationship between A1C and average glucose levels in individual cases. Novel FCGM technologies portend greater use of continuous forms of glucose monitoring and wider adoption of AGP report analysis. Additional formal and empirical evidence is needed to more fully characterize best practice. A1C = glycated hemoglobin; AGP = ambulatory glucose profile; CGM = continuous glucose monitoring; FCGM = flash continuous glucose monitoring; IQR = interquartile range; SMBG = self-monitoring of blood glucose.

  7. 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

  8. Glucose-monitoring neurons in the mediodorsal prefrontal cortex.

    Science.gov (United States)

    Nagy, Bernadett; Szabó, István; Papp, Szilárd; Takács, Gábor; Szalay, Csaba; Karádi, Zoltán

    2012-03-20

    The mediodorsal prefrontal cortex (mdPFC), a key structure of the limbic neural circuitry, plays important roles in the central regulation of feeding. As an integrant part of the forebrain dopamine (DA) system, it performs complex roles via interconnections with various brain areas where glucose-monitoring (GM) neurons have been identified. The main goal of the present experiments was to examine whether similar GM neurons exist in the mediodorsal prefrontal cortex. To search for such chemosensory cells here, and to estimate their involvement in the DA circuitry, extracellular single neuron activity of the mediodorsal prefrontal cortex of anesthetized Wistar and Sprague-Dawley rats was recorded by means of tungsten wire multibarreled glass microelectrodes during microelectrophoretic administration of d-glucose and DA. One fourth of the neurons tested changed in firing rate in response to glucose, thus, proved to be elements of the forebrain GM neural network. DA responsive neurons in the mdPFC were found to represent similar proportion of all cells; the glucose-excited units were shown to display excitatory whereas the glucose-inhibited neurons were demonstrated to exert mainly inhibitory responses to dopamine. The glucose-monitoring neurons of the mdPFC and their distinct DA sensitivity are suggested to be of particular significance in adaptive processes of the central feeding control. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Nanosensors and nanomaterials for monitoring glucose in diabetes.

    Science.gov (United States)

    Cash, Kevin J; Clark, Heather A

    2010-12-01

    Worldwide, diabetes is a rapidly growing problem that is managed at the individual level by monitoring and controlling blood glucose levels to minimize the negative effects of the disease. Because of limitations in diagnostic methods, significant research efforts are focused on developing improved methods to measure glucose. Nanotechnology has impacted these efforts by increasing the surface area of sensors, improving the catalytic properties of electrodes and providing nanoscale sensors. Here, we discuss developments in the past several years on both nanosensors that directly measure glucose and nanomaterials that improve glucose sensor function. Finally, we discuss challenges that must be overcome to apply these developments in the clinic. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. 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 =…

  11. Cure Monitoring Techniques for Adhesive Bonding Techniques.

    Science.gov (United States)

    1980-11-01

    l TABLE OF CONTIW Section Pase I INTRODUCTION 1. Program Overviev 1 2. Smary 2 II MONITORING SYSTEM IMPROVEMENTS 3 1. Development of a...encountered in the electronics/signal/ computer interfaces, although solvable, have slowed progress and starting a bondline monitoring program to do a...AIWAL/MLBC) as Project Engineer. The program manager is Mr. C. A. May. The principal investigator is Dr. A. Wereta, Jr., assisted by Mass. W. G. Caple, J

  12. A fine pointed glucose oxidase immobilized electrode for low-invasive amperometric glucose monitoring.

    Science.gov (United States)

    Li, Jiang; Koinkar, Pankaj; Fuchiwaki, Yusuke; Yasuzawa, Mikito

    2016-12-15

    A low invasive type glucose sensor, which has a sensing region at the tip of a fine pointed electrode, was developed for continuous glucose monitoring. Platinum-iridium alloy electrode with a surface area of 0.045mm(2) was settled at the middle of pointed PEEK (Polyetheretherketone) tubing and was employed as sensing electrode. Electrodeposition of glucose oxidase in the presence of surfactant, Triton X-100, was performed for high-density enzyme immobilization followed by the electropolymerization of o-phenylenediamine for the formation of functional entrapping and permselective polymer membrane. Ag/AgCl film was coated on the surface of PEEK tubing as reference electrode. Amperometric responses of the prepared sensors to glucose were measured at a potential of 0.60V (vs. Ag/AgCl). The prepared electrode showed the sensitivity of 2.55μA/cm(2) mM with high linearity of 0.9986, within the glucose concentration range up to 21mM. The detection limit (S/N=3) was determined to be 0.11mM. The glucose sensor properties were evaluated in phosphate buffer solution and in vivo monitoring by the implantation of the sensors in rabbit, while conventional needle type sensors as a reference were used. The results showed that change in output current of the proposed sensor fluctuated similar with one in output current of the conventional needle type sensors, which was also in similar accordance with actual blood sugar level measured by commercially glucose meter. One-point calibration method was used to calibrate the sensor output current. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. A Fully Implantable, NFC Enabled, Continuous Interstitial Glucose Monitor

    OpenAIRE

    Anabtawi, Nijad; Freeman, Sabrina; Ferzli, Rony

    2016-01-01

    This work presents an integrated system-on-chip (SoC) that forms the core of a long-term, fully implantable, battery assisted, passive continuous glucose monitor. It integrates an amperometric glucose sensor interface, a near field communication (NFC) wireless front-end and a fully digital switched mode power management unit for supply regulation and on board battery charging. It uses 13.56 MHz (ISM) band to harvest energy and backscatter data to an NFC reader. System was implemented in 14nm ...

  14. Accuracy of a Flash Glucose Monitoring System in Diabetic Dogs

    OpenAIRE

    Corradini, S.; Pilosio, B.; Dondi, F.; Linari, G.; Testa, S.; Brugnoli, F.; Gianella, P.; Pietra, M.; Fracassi, F.

    2016-01-01

    Background A novel flash glucose monitoring system (FGMS) (FreeStyle Libre, Abbott, UK) was recently developed for humans. It continuously measures the interstitial glucose (IG) concentrations for 14 days. Objectives To assess the clinical and analytical accuracy of the FGMS in diabetic dogs. Animals Ten client?owned diabetic dogs on insulin treatment. Methods Prospective and observational study. The FGMS was placed on the neck for up to 14 days. During the 1st?2nd, 6?7th, and 13?14th days fr...

  15. A Fully Implantable, NFC Enabled, Continuous Interstitial Glucose Monitor.

    Science.gov (United States)

    Anabtawi, Nijad; Freeman, Sabrina; Ferzli, Rony

    2016-02-01

    This work presents an integrated system-on-chip (SoC) that forms the core of a long-term, fully implantable, battery assisted, passive continuous glucose monitor. It integrates an amperometric glucose sensor interface, a near field communication (NFC) wireless front-end and a fully digital switched mode power management unit for supply regulation and on board battery charging. It uses 13.56 MHz (ISM) band to harvest energy and backscatter data to an NFC reader. System was implemented in 14nm CMOS technology and validated with post layout simulations.

  16. Continuous Glucose Monitoring in the Cardiac ICU: Current Use and Future Directions.

    Science.gov (United States)

    Scrimgeour, Laura A; Potz, Brittany A; Sellke, Frank W; Abid, M Ruhul

    2017-11-01

    Perioperative glucose control is highly important, particularly for patients undergoing cardiac surgery. Variable glucose levels before, during and after cardiac surgery lead to increased post-operative complications and patient mortality. [1] Current methods for intensive monitoring and treating hyperglycemia in the Intensive Care Unit (ICU) usually involve hourly glucose monitoring and continuous intravenous insulin infusions. With the advent of more accurate subcutaneous glucose monitoring systems, the role of improved glucose control with newer systems deserves consideration for widespread adoption.

  17. Clinical use of continuous glucose monitoring in adults with type 1 diabetes

    OpenAIRE

    Slattery, David; Choudhary, Pratik

    2017-01-01

    With the emphasis on intensive management of type 1 diabetes, data from studies support frequent monitoring of glucose levels to improve glycemic control and reduce glucose variability, which can be related to an increase in macro and microvascular complications. However, few perform capillary blood glucose that frequently. There are currently two available alternatives that this review will discuss, continuous glucose monitoring (CGM) and flash glucose monitoring. CGM has become an important...

  18. 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

  19. Accuracy of a Flash Glucose Monitoring System in Diabetic Dogs.

    Science.gov (United States)

    Corradini, S; Pilosio, B; Dondi, F; Linari, G; Testa, S; Brugnoli, F; Gianella, P; Pietra, M; Fracassi, F

    2016-07-01

    A novel flash glucose monitoring system (FGMS) (FreeStyle Libre, Abbott, UK) was recently developed for humans. It continuously measures the interstitial glucose (IG) concentrations for 14 days. To assess the clinical and analytical accuracy of the FGMS in diabetic dogs. Ten client-owned diabetic dogs on insulin treatment. Prospective and observational study. The FGMS was placed on the neck for up to 14 days. During the 1st-2nd, 6-7th, and 13-14th days from application, the IG measurements were compared with the plasma (EDTA) glucose (PG) concentrations analyzed by a reference hexokinase based method. The application and the use of the FGMS were apparently painless, easy, and well tolerated by all dogs. Mild erythema at the site of the application was found in 5/10 dogs at the end of the wearing period. A good correlation between IG and PG concentrations (rho = 0.94; P blood glucose concentrations. Mean ± standard deviation difference from the reference method was 2.3 ± 46.8 mg/dL. The FGMS is easy to use and is accurate for IG glucose measurement in diabetic dogs. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  20. Noninvasive Monitoring of Blood Glucose with Raman Spectroscopy.

    Science.gov (United States)

    Pandey, Rishikesh; Paidi, Santosh Kumar; Valdez, Tulio A; Zhang, Chi; Spegazzini, Nicolas; Dasari, Ramachandra Rao; Barman, Ishan

    2017-02-21

    not only addressed the physiological lag between the actual blood glucose and the measured interstitial fluid glucose values but also offered a powerful tool for predictive measurements of hypoglycemia. This framework has recently been extended to provide longitudinal tracking of glucose concentration without necessitating extensive a priori concentration information. These findings are advanced by the results of recent glucose tolerance studies in human subjects, which also hint at the need for designing nonlinear calibration models that can account for subject-to-subject variations in skin heterogeneity and hematocrit levels. Together, the emerging evidence underscores the promise of a blood withdrawal-free optical platform-featuring a combination of high-throughput Raman spectroscopic instrumentation and data analysis of subtle variations in spectral expression-for diabetes screening in the clinic and, ultimately, for personalized monitoring.

  1. Multiple functional attributes of glucose-monitoring neurons in the medial orbitofrontal (ventrolateral prefrontal) cortex.

    Science.gov (United States)

    Szabó, István; Hormay, Edina; Csetényi, Bettina; Nagy, Bernadett; Lénárd, László; Karádi, Zoltán

    2018-02-01

    Multiple functional attributes of glucose-monitoring neurons in the medial orbitofrontal (ventrolateral prefrontal) cortex. NEUROSCI BIOBEHAV REV 73(1) XXX-XXX, 2017.- Special chemosensory cells, the glucose-monitoring (GM) neurons, reportedly involved in the central feeding control, exist in the medial orbitofrontal (ventrolateral prefrontal) cortex (mVLPFC). Electrophysiological, metabolic and behavioral studies reveal complex functional attributes of these cells and raise their homeostatic significance. Single neuron recordings, by means of the multibarreled microelectrophoretic technique, elucidate differential sensitivities of limbic forebrain neurons in the rat and the rhesus monkey to glucose and other chemicals, whereas gustatory stimulations demonstrate their distinct taste responsiveness. Metabolic examinations provide evidence for alteration of blood glucose level in glucose tolerance test and elevation of plasma triglyceride concentration after destruction of the local GM cells by streptozotocin (STZ). In behavioral studies, STZ microinjection into the mVLPFC fails to interfere with the acquisition of saccharin conditioned taste avoidance, does cause, however, taste perception deficit in taste reactivity tests. Multiple functional attributes of GM neurons in the mVLPFC, within the frame of the hierarchically organized central GM neuronal network, appear to play important role in the maintenance of the homeostatic balance. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Venous, Arterialized-Venous, or Capillary Glucose Reference Measurements for the Accuracy Assessment of a Continuous Glucose Monitoring System.

    Science.gov (United States)

    Kropff, Jort; van Steen, Sigrid C; deGraaff, Peter; Chan, Man W; van Amstel, Rombout B E; DeVries, J Hans

    2017-11-01

    Different reference methods are used for the accuracy assessment of continuous glucose monitoring (CGM) systems. The effect of using venous, arterialized-venous, or capillary reference measurements on CGM accuracy is unclear. We evaluated 21 individuals with type 1 diabetes using a capillary calibrated CGM system. Venous or arterialized-venous reference glucose samples were taken every 15 min at two separate visits and assessed per YSI 2300 STAT Plus. Arterialization was achieved by heated-hand technique. Capillary samples were collected hourly during the venous reference visit. The investigation sequence (venous or arterialized-venous) was randomized. Effectiveness of arterialization was measured by comparing free venous oxygen pressure (PO2) of both visit days. Primary endpoint was the median absolute relative difference (ARD). Median ARD using arterialized-venous reference samples was not different from venous samples (point estimated difference 0.52%, P = 0.181). When comparing the three reference methods, median ARD was also not different over the full glycemic range (venous 9.0% [n = 681], arterialized-venous 8.3% [n = 684], and capillary 8.1% [n = 205], P = 0.216), nor over the separate glucose ranges. Arterialization was successful (PO2 venous 5.4 kPa vs. arterialized-venous 8.9 kPa, P reference measurements did not significantly impact CGM accuracy. Venous reference seems preferable due to its ease of operation.

  3. Translating glucose variability metrics into the clinic via Continuous Glucose Monitoring: a Graphical User Interface for Diabetes Evaluation (CGM-GUIDE©).

    Science.gov (United States)

    Rawlings, Renata A; Shi, Hang; Yuan, Lo-Hua; Brehm, William; Pop-Busui, Rodica; Nelson, Patrick W

    2011-12-01

    Several metrics of glucose variability have been proposed to date, but an integrated approach that provides a complete and consistent assessment of glycemic variation is missing. As a consequence, and because of the tedious coding necessary during quantification, most investigators and clinicians have not yet adopted the use of multiple glucose variability metrics to evaluate glycemic variation. We compiled the most extensively used statistical techniques and glucose variability metrics, with adjustable hyper- and hypoglycemic limits and metric parameters, to create a user-friendly Continuous Glucose Monitoring Graphical User Interface for Diabetes Evaluation (CGM-GUIDE©). In addition, we introduce and demonstrate a novel transition density profile that emphasizes the dynamics of transitions between defined glucose states. Our combined dashboard of numerical statistics and graphical plots support the task of providing an integrated approach to describing glycemic variability. We integrated existing metrics, such as SD, area under the curve, and mean amplitude of glycemic excursion, with novel metrics such as the slopes across critical transitions and the transition density profile to assess the severity and frequency of glucose transitions per day as they move between critical glycemic zones. By presenting the above-mentioned metrics and graphics in a concise aggregate format, CGM-GUIDE provides an easy to use tool to compare quantitative measures of glucose variability. This tool can be used by researchers and clinicians to develop new algorithms of insulin delivery for patients with diabetes and to better explore the link between glucose variability and chronic diabetes complications.

  4. Techniques for monitoring pileated woodpeckers.

    Science.gov (United States)

    Evelyn L Bull; Richard S. Holthausen; Marie G. Henjum

    1990-01-01

    Methods of locating pileated woodpeckers (Dryocopus pileatus) are described, including imitating pileated woodpecker vocalizations, identifying nest and roost trees, and finding foraging signs. Populations of pileated woodpeckers can be monitored by using (1) density of breeding pairs, (2) reproduction, and (3) presence or absence of birds. The...

  5. 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.

  6. Evaluation of Postprandial Glucose Excursion Using a Novel Minimally Invasive Glucose Area-Under-the-Curve Monitoring System

    OpenAIRE

    Kuranuki, Sachi; Sato, Toshiyuki; Okada, Seiki; Hosoya, Samiko; Seko, Akinobu; Sugihara, Kaya; Nakamura, Teiji

    2013-01-01

    Objective: To develop a minimally invasive interstitial fluid extraction technology (MIET) to monitor postprandial glucose area under the curve (AUC) without blood sampling, we evaluated the accuracy of glucose AUC measured by MIET and compared with that by blood sampling after food intake. Methods: Interstitial fluid glucose AUC (IG-AUC) following consumption of 6 different types of foods was measured by MIET. MIET consisted of stamping microneedle arrays, placing hydrogel patches on the are...

  7. Continuous glucose monitoring systems for type 1 diabetes mellitus.

    Science.gov (United States)

    Langendam, Miranda; Luijf, Yoeri M; Hooft, Lotty; Devries, J Hans; Mudde, Aart H; Scholten, Rob J P M

    2012-01-18

    Self-monitoring of blood glucose is essential to optimise glycaemic control in type 1 diabetes mellitus. Continuous glucose monitoring (CGM) systems measure interstitial fluid glucose levels to provide semi-continuous information about glucose levels, which identifies fluctuations that would not have been identified with conventional self-monitoring. Two types of CGM systems can be defined: retrospective systems and real-time systems. Real-time systems continuously provide the actual glucose concentration on a display. Currently, the use of CGM is not common practice and its reimbursement status is a point of debate in many countries. To assess the effects of CGM systems compared to conventional self-monitoring of blood glucose (SMBG) in patients with diabetes mellitus type 1. We searched The Cochrane Library, MEDLINE, EMBASE and CINAHL for the identification of studies. Last search date was June 8, 2011. Randomised controlled trials (RCTs) comparing retrospective or real-time CGM with conventional self-monitoring of blood glucose levels or with another type of CGM system in patients with type 1 diabetes mellitus. Primary outcomes were glycaemic control, e.g. level of glycosylated haemoglobin A1c (HbA1c) and health-related quality of life. Secondary outcomes were adverse events and complications, CGM derived glycaemic control, death and costs. Two authors independently selected the studies, assessed the risk of bias and performed data-extraction. Although there was clinical and methodological heterogeneity between studies an exploratory meta-analysis was performed on those outcomes the authors felt could be pooled without losing clinical merit. The search identified 1366 references. Twenty-two RCTs meeting the inclusion criteria of this review were identified. The results of the meta-analyses (across all age groups) indicate benefit of CGM for patients starting on CGM sensor augmented insulin pump therapy compared to patients using multiple daily injections of

  8. Continuous Glucose Monitoring: A Review of Successes, Challenges, and Opportunities.

    Science.gov (United States)

    Rodbard, David

    2016-02-01

    Continuous glucose monitoring (CGM) provides information unattainable by intermittent capillary blood glucose, including instantaneous real-time display of glucose level and rate of change of glucose, alerts and alarms for actual or impending hypo- and hyperglycemia, "24/7" coverage, and the ability to characterize glycemic variability. Progressively more accurate and precise, reasonably unobtrusive, small, comfortable, user-friendly devices connect to the Internet to share information and are sine qua non for a closed-loop artificial pancreas. CGM can inform, educate, motivate, and alert people with diabetes. CGM is medically indicated for patients with frequent, severe, or nocturnal hypoglycemia, especially in the presence of hypoglycemia unawareness. Surprisingly, despite tremendous advances, utilization of CGM has remained fairly limited to date. Barriers to use have included the following: (1) lack of Food and Drug Administration approval, to date, for insulin dosing ("nonadjuvant use") in the United States and for use in hospital and intensive care unit settings; (2) cost and variable reimbursement; (3) need for recalibrations; (4) periodic replacement of sensors; (5) day-to-day variability in glycemic patterns, which can limit the predictability of findings based on retrospective, masked "professional" use; (6) time, implicit costs, and inconvenience for uploading of data for retrospective analysis; (7) lack of fair and reasonable reimbursement for physician time; (8) inexperience and lack of training of physicians and other healthcare professionals regarding interpretation of CGM results; (9) lack of standardization of software methods for analysis of CGM data; and (10) need for professional medical organizations to develop and disseminate additional clinical practice guidelines regarding the role of CGM. Ongoing advances in technology and clinical research have addressed several of these barriers. Use of CGM in conjunction with an insulin pump with

  9. A comparative effectiveness analysis of three continuous glucose monitors.

    Science.gov (United States)

    Damiano, Edward R; El-Khatib, Firas H; Zheng, Hui; Nathan, David M; Russell, Steven J

    2013-02-01

    To compare three continuous glucose monitoring (CGM) devices in subjects with type 1 diabetes under closed-loop blood glucose (BG) control. Six subjects with type 1 diabetes (age 52 ± 14 years, diabetes duration 32 ± 14 years) each participated in two 51-h closed-loop BG control experiments in the hospital. Venous plasma glucose (PG) measurements (GlucoScout, International Biomedical) obtained every 15 min (2,360 values) were paired in time with corresponding CGM glucose (CGMG) measurements obtained from three CGM devices, the Navigator (Abbott Diabetes Care), the Seven Plus (DexCom), and the Guardian (Medtronic), worn simultaneously by each subject. Errors in paired PG-CGMG measurements and data reporting percentages were obtained for each CGM device. The Navigator had the best overall accuracy, with an aggregate mean absolute relative difference (MARD) of all paired points of 11.8 ± 11.1% and an average MARD across all 12 experiments of 11.8 ± 3.8%. The Seven Plus and Guardian produced aggregate MARDs of all paired points of 16.5 ± 17.8% and 20.3 ± 18.0%, respectively, and average MARDs across all 12 experiments of 16.5 ± 6.7% and 20.2 ± 6.8%, respectively. Data reporting percentages, a measure of reliability, were 76% for the Seven Plus and nearly 100% for the Navigator and Guardian. A comprehensive head-to-head-to-head comparison of three CGM devices for BG values from 36 to 563 mg/dL revealed marked differences in performance characteristics that include accuracy, precision, and reliability. The Navigator outperformed the other two in these areas.

  10. 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

  11. Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment.

    Science.gov (United States)

    2018-01-01

    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. 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. 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 interventions to usual care

  12. Quantifying temporal glucose variability in diabetes via continuous glucose monitoring: mathematical methods and clinical application.

    Science.gov (United States)

    Kovatchev, Boris P; Clarke, William L; Breton, Marc; Brayman, Kenneth; McCall, Anthony

    2005-12-01

    Continuous glucose monitors (CGMs) collect detailed blood glucose (BG) time series, which carry significant information about the dynamics of BG fluctuations. In contrast, the methods for analysis of CGM data remain those developed for infrequent BG self-monitoring. As a result, important information about the temporal structure of the data is lost during the translation of raw sensor readings into clinically interpretable statistics and images. The following mathematical methods are introduced into the field of CGM data interpretation: (1) analysis of BG rate of change; (2) risk analysis using previously reported Low/High BG Indices and Poincare (lag) plot of risk associated with temporal BG variability; and (3) spatial aggregation of the process of BG fluctuations and its Markov chain visualization. The clinical application of these methods is illustrated by analysis of data of a patient with Type 1 diabetes mellitus who underwent islet transplantation and with data from clinical trials. Normative data [12,025 reference (YSI device, Yellow Springs Instruments, Yellow Springs, OH) BG determinations] in patients with Type 1 diabetes mellitus who underwent insulin and glucose challenges suggest that the 90%, 95%, and 99% confidence intervals of BG rate of change that could be maximally sustained over 15-30 min are [-2,2], [-3,3], and [-4,4] mg/dL/min, respectively. BG dynamics and risk parameters clearly differentiated the stages of transplantation and the effects of medication. Aspects of treatment were clearly visualized by graphs of BG rate of change and Low/High BG Indices, by a Poincare plot of risk for rapid BG fluctuations, and by a plot of the aggregated Markov process. Advanced analysis and visualization of CGM data allow for evaluation of dynamical characteristics of diabetes and reveal clinical information that is inaccessible via standard statistics, which do not take into account the temporal structure of the data. The use of such methods improves the

  13. Twenty-four-hour variations in blood glucose level in Japanese type 2 diabetes patients based on continuous glucose monitoring.

    Science.gov (United States)

    Hajime, Maiko; Okada, Yosuke; Mori, Hiroko; Otsuka, Takashi; Kawaguchi, Mayuko; Miyazaki, Megumi; Kuno, Fumi; Sugai, Kei; Sonoda, Satomi; Tanaka, Kenichi; Kurozumi, Akira; Narisawa, Manabu; Torimoto, Keiichi; Arao, Tadashi; Tanaka, Yoshiya

    2018-01-01

    High fluctuations in blood glucose are associated with various complications. The correlation between glycated hemoglobin (HbA1c) level and fluctuations in blood glucose level has not been studied in Japanese patients with type 2 diabetes. In the present study, blood glucose profile stratified by HbA1c level was evaluated by continuous glucose monitoring (CGM) in Japanese type 2 diabetes patients. Our retrospective study included 294 patients with type 2 diabetes who were divided by HbA1c level into five groups (≥6.0 to level and CGM data was analyzed. The primary end-point was the difference in blood glucose fluctuations among the HbA1c groups. The mean blood glucose level increased significantly with increasing HbA1c (P trend  levels of maximum blood glucose, minimum blood glucose, each preprandial blood glucose, each postprandial maximum blood glucose, range of increase in postprandial glucose from pre-meal to after breakfast, the area under the blood concentration-time curve >180 mg/dL and percentage of the area under the blood concentration-time curve >180 mg/dL were higher with higher HbA1c. Mean glucose level and pre-breakfast blood glucose level were significant and independent determinants of HbA1c. In Japanese patients treated for type 2 diabetes, the mean amplitude of glycemic excursions did not correlate with HbA1c, making it difficult to assess blood glucose fluctuations using HbA1c. Parameters other than HbA1c are required to evaluate fluctuations in blood glucose level in patients receiving treatment for type 2 diabetes. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  14. Experiences on MIC monitoring by electrochemical techniques

    DEFF Research Database (Denmark)

    Cristiani, P.; Perboni, G.; Hilbert, Lisbeth Rischel

    2002-01-01

    Some results of practical experiences on the performances of electrochemical and electric MIC monitoring techniques, coming from the discussion in the Brite-Euram thematic network "MIC of industrial materials", are presented in this paper.......Some results of practical experiences on the performances of electrochemical and electric MIC monitoring techniques, coming from the discussion in the Brite-Euram thematic network "MIC of industrial materials", are presented in this paper....

  15. Clinical assessment of blood glucose homeostasis in horses: comparison of a continuous glucose monitoring system with a combined intravenous glucose and insulin test protocol.

    Science.gov (United States)

    Johnson, P J; Wiedmeyer, C E; LaCarrubba, A; Messer, N T; Dingfelder, H A; Cogswell, A M; Amorim, J R R; Ganjam, V K

    2011-01-01

    The combined glucose-insulin test (CGIT) is helpful for evaluating insulin sensitivity. A continuous glucose monitoring system (CGMS) reports changes in interstitial glucose concentrations as they occur in the blood. Use of the CGMS minimizes animal contact and may be useful when performing a CGIT. Results obtained using a CGMS are useful for the evaluation of glucose responses during the evaluation of insulin sensitivity in equids. Seven mature, obese ponies. Ponies were equipped with CGMS for determination of interstitial glucose concentrations. Glucose (150 mg/kg, i.v.) and insulin (0.1 U/kg, i.v.) were administered and blood glucose concentrations determined at (minutes after time zero) 1, 5, 15, 25, 35, 45, 60, 75, 90, 105, and 120 with a hand-held glucometer. Blood chemistry results were compared with simultaneously obtained results using CGMS. Concordance coefficients determined for comparison of blood glucose concentrations determined by a hand-held glucometer and those determined by CGMS after the zero time point were 0.623, 0.764, 0.834, 0.854, and 0.818 (for delays of 0, 5, 10, 15, and 20 minutes, respectively). Interstitial glucose concentrations obtained by the CGMS compared favorably to blood glucose concentrations. CGMS may be useful for assessment of glucose dynamics in the CGIT. Copyright © 2010 by the American College of Veterinary Internal Medicine.

  16. Skin-like biosensor system via electrochemical channels for noninvasive blood glucose monitoring.

    Science.gov (United States)

    Chen, Yihao; Lu, Siyuan; Zhang, Shasha; Li, Yan; Qu, Zhe; Chen, Ying; Lu, Bingwei; Wang, Xinyan; Feng, Xue

    2017-12-01

    Currently, noninvasive glucose monitoring is not widely appreciated because of its uncertain measurement accuracy, weak blood glucose correlation, and inability to detect hyperglycemia/hypoglycemia during sleep. We present a strategy to design and fabricate a skin-like biosensor system for noninvasive, in situ, and highly accurate intravascular blood glucose monitoring. The system integrates an ultrathin skin-like biosensor with paper battery-powered electrochemical twin channels (ETCs). The designed subcutaneous ETCs drive intravascular blood glucose out of the vessel and transport it to the skin surface. The ultrathin (~3 μm) nanostructured biosensor, with high sensitivity (130.4 μA/mM), fully absorbs and measures the glucose, owing to its extreme conformability. We conducted in vivo human clinical trials. The noninvasive measurement results for intravascular blood glucose showed a high correlation (>0.9) with clinically measured blood glucose levels. The system opens up new prospects for clinical-grade noninvasive continuous glucose monitoring.

  17. Spectrum monitoring procedures and techniques

    Science.gov (United States)

    1990-07-01

    The first step towards operating an emitter on a test range is to contact the local frequency manager to establish a schedule. Since restricted radio frequency bands and operations are different at each test range location, most testing is accomplished by sharing the spectrum available with all range users. The telemetry bands in particular require spectrum activity scheduling. The objective is to resolve scheduling conflicts prior to operations. When two programs or projects request to use the same spectrum, their activity can be separated by quard bands, discrete frequencies, time, or operating locations (terrain masking). Priorities assigned to each program usually dictate which program will be scheduled first; however, use of priorities to schedule activities should be avoided and only considered as a last resort. When a scheduling conflict cannot be resolved using these techniques, it is brought to the attention of the responsible program managers. When scheduling activities involve other federal or nonfederal agencies, it is in the best interest of program managers to be as flexible as possible.

  18. Comparison of Glucose Area Under the Curve Measured Using Minimally Invasive Interstitial Fluid Extraction Technology with Continuous Glucose Monitoring System in Diabetic Patients.

    Science.gov (United States)

    Uemura, Mei; Yano, Yutaka; Suzuki, Toshinari; Yasuma, Taro; Sato, Toshiyuki; Morimoto, Aya; Hosoya, Samiko; Suminaka, Chihiro; Nakajima, Hiromu; Gabazza, Esteban C; Takei, Yoshiyuki

    2017-08-01

    Continuous glucose monitoring (CGM) is reported to be a useful technique, but difficult or inconvenient for some patients and institutions. We are developing a glucose area under the curve (AUC) monitoring system without blood sampling using a minimally invasive interstitial fluid extraction technology (MIET). Here we evaluated the accuracy of interstitial fluid glucose (IG) AUC measured by MIET in patients with diabetes for an extended time interval and the potency of detecting hyperglycemia using CGM data as a reference. Thirty-eight inpatients with diabetes undergoing CGM were enrolled. MIET comprised a pretreatment step using a plastic microneedle array and glucose accumulation step with a hydrogel patch, which was placed on two sites from 9:00 AM to 5:00 PM or from 10:00 PM to 6:00 AM. IG AUC was calculated by accumulated glucose extracted by hydrogel patches using sodium ion as standard. A significant correlation was observed between the predicted AUC by MIET and CGM in daytime (r=0.76) and nighttime (r=0.82). The optimal cutoff for the IG AUC value of MIET to predict hyperglycemia over 200 mg/dL measured by CGM for 8 hours was 1,067.3 mg·hr/dL with 88.2% sensitivity and 81.5% specificity. We showed that 8-hour IG AUC levels using MIET were valuable in estimating the blood glucose AUC without blood sampling. The results also supported the concept of using this technique for evaluating glucose excursion and for screening hyperglycemia during 8 hours in patients with diabetes at any time of day. Copyright © 2017 Korean Diabetes Association

  19. Comparison of Glucose Area Under the Curve Measured Using Minimally Invasive Interstitial Fluid Extraction Technology with Continuous Glucose Monitoring System in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Mei Uemura

    2017-07-01

    Full Text Available BackgroundContinuous glucose monitoring (CGM is reported to be a useful technique, but difficult or inconvenient for some patients and institutions. We are developing a glucose area under the curve (AUC monitoring system without blood sampling using a minimally invasive interstitial fluid extraction technology (MIET. Here we evaluated the accuracy of interstitial fluid glucose (IG AUC measured by MIET in patients with diabetes for an extended time interval and the potency of detecting hyperglycemia using CGM data as a reference.MethodsThirty-eight inpatients with diabetes undergoing CGM were enrolled. MIET comprised a pretreatment step using a plastic microneedle array and glucose accumulation step with a hydrogel patch, which was placed on two sites from 9:00 AM to 5:00 PM or from 10:00 PM to 6:00 AM. IG AUC was calculated by accumulated glucose extracted by hydrogel patches using sodium ion as standard. ResultsA significant correlation was observed between the predicted AUC by MIET and CGM in daytime (r=0.76 and nighttime (r=0.82. The optimal cutoff for the IG AUC value of MIET to predict hyperglycemia over 200 mg/dL measured by CGM for 8 hours was 1,067.3 mg·hr/dL with 88.2% sensitivity and 81.5% specificity.ConclusionWe showed that 8-hour IG AUC levels using MIET were valuable in estimating the blood glucose AUC without blood sampling. The results also supported the concept of using this technique for evaluating glucose excursion and for screening hyperglycemia during 8 hours in patients with diabetes at any time of day.

  20. A history of continuous glucose monitors (CGMs) in self-monitoring of diabetes mellitus.

    Science.gov (United States)

    Olczuk, David; Priefer, Ronny

    Self-monitoring of glucose for individuals afflicted with diabetes mellitus has allowed patients to take control of their disease and thus directly affect the outcomes related to it. It has been almost a century since the first test to monitor one's sugar was developed; that being a urine test. The most well-known and prominent medical device for monitor blood glucose for individuals with diabetes are the finger-prick devices. This itself is an approximately 50year old technology. More recently has been the introduction of continuous glucose monitors (CGMs) which entered the market place in the last year of the 20th century. As this technology has been further refined and improved, limitations associated with it have decreased. The scope of this review is to present a brief history of CGMs, both with the development of these medical devices and the challenges/limitations that they have shown. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  1. Evaluation of postprandial glucose excursion using a novel minimally invasive glucose area-under-the-curve monitoring system.

    Science.gov (United States)

    Kuranuki, Sachi; Sato, Toshiyuki; Okada, Seiki; Hosoya, Samiko; Seko, Akinobu; Sugihara, Kaya; Nakamura, Teiji

    2013-01-01

    To develop a minimally invasive interstitial fluid extraction technology (MIET) to monitor postprandial glucose area under the curve (AUC) without blood sampling, we evaluated the accuracy of glucose AUC measured by MIET and compared with that by blood sampling after food intake. Interstitial fluid glucose AUC (IG-AUC) following consumption of 6 different types of foods was measured by MIET. MIET consisted of stamping microneedle arrays, placing hydrogel patches on the areas, and calculating IG-AUC based on glucose levels in the hydrogels. Glycemic index (GI) was determined using IG-AUC and reference AUC measured by blood sampling. IG-AUC strongly correlated with reference AUC (R = 0.91), and GI determined using IG-AUC showed good correlation with that determined by reference AUC (R = 0.88). IG-AUC obtained by MIET can accurately predict the postprandial glucose excursion without blood sampling. In addition, feasibility of GI measurement by MIET was confirmed.

  2. Model Identification using Continuous Glucose Monitoring Data for Type 1 Diabetes

    DEFF Research Database (Denmark)

    Boiroux, Dimitri; Hagdrup, Morten; Mahmoudi, Zeinab

    2016-01-01

    This paper addresses model identification of continuous-discrete nonlinear models for people with type 1 diabetes using sampled data from a continuous glucose monitor (CGM). We compare five identification techniques: least squares, weighted least squares, Huber regression, maximum likelihood...... with extended Kalman filter and maximum likelihood with unscented Kalman filter. We perform the identification on a 24-hour simulation of a stochastic differential equation (SDE) version of the Medtronic Virtual Patient (MVP) model including process and output noise. We compare the fits with the actual CGM......, such as parameter tracking, population modeling and handling of outliers....

  3. 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.

  4. Economics important in selecting monitoring techniques

    International Nuclear Information System (INIS)

    Moore, D.P.; Byars, H.G.

    1990-01-01

    Failure/risk costs need to be considered when deciding on the type of corrosion monitoring and inspection. Locations with high-pressure, high-velocity streams need closer monitoring. This article discusses the risks associated with different types of fluid streams and the various inspection techniques that can range from a low-cost visual examination to mechanical calipers and electromagnetic, radiographic, and ultrasonic tools

  5. Fault and meal detection by redundant continuous glucose monitors and the unscented Kalman filter

    DEFF Research Database (Denmark)

    Mahmoudi, Zeinab; Nørgaard, Kirsten; Poulsen, Niels Kjølstad

    2017-01-01

    The purpose of this study is to develop a method for detecting and compensating the anomalies of continuous glucose monitoring (CGM) sensors as well as detecting unannounced meals. Both features, sensor fault detection/correction and meal detection, are necessary to have a reliable artificial pan...... is corrupted by PISA. The fault isolator can detect 199 out of 200 unannounced meals. The average change in the glucose concentrations between the meals and the detection time points is 46.3 mg/dL.......The purpose of this study is to develop a method for detecting and compensating the anomalies of continuous glucose monitoring (CGM) sensors as well as detecting unannounced meals. Both features, sensor fault detection/correction and meal detection, are necessary to have a reliable artificial...... from the two fault detectors differentiates between a sensor fault and an unannounced meal appearing as an anomaly in the CGM data. If the fault isolator indicates a sensor fault, a method based on the covariance matching technique tunes the covariance of the measurement noise associated...

  6. Acoustic Techniques for Structural Health Monitoring

    Science.gov (United States)

    Frankenstein, B.; Augustin, J.; Hentschel, D.; Schubert, F.; Köhler, B.; Meyendorf, N.

    2008-02-01

    Future safety and maintenance strategies for industrial components and vehicles are based on combinations of monitoring systems that are permanently attached to or embedded in the structure, and periodic inspections. The latter belongs to conventional nondestructive evaluation (NDE) and can be enhanced or partially replaced by structural health monitoring systems. However, the main benefit of this technology for the future will consist of systems that can be differently designed based on improved safety philosophies, including continuous monitoring. This approach will increase the efficiency of inspection procedures at reduced inspection times. The Fraunhofer IZFP Dresden Branch has developed network nodes, miniaturized transmitter and receiver systems for active and passive acoustical techniques and sensor systems that can be attached to or embedded into components or structures. These systems have been used to demonstrate intelligent sensor networks for the monitoring of aerospace structures, railway systems, wind energy generators, piping system and other components. Material discontinuities and flaws have been detected and monitored during full scale fatigue testing. This paper will discuss opportunities and future trends in nondestructive evaluation and health monitoring based on new sensor principles and advanced microelectronics. It will outline various application examples of monitoring systems based on acoustic techniques and will indicate further needs for research and development.

  7. Skin-like biosensor system via electrochemical channels for noninvasive blood glucose monitoring

    OpenAIRE

    Chen, Yihao; Lu, Siyuan; Zhang, Shasha; Li, Yan; Qu, Zhe; Chen, Ying; Lu, Bingwei; Wang, Xinyan; Feng, Xue

    2017-01-01

    Currently, noninvasive glucose monitoring is not widely appreciated because of its uncertain measurement accuracy, weak blood glucose correlation, and inability to detect hyperglycemia/hypoglycemia during sleep. We present a strategy to design and fabricate a skin-like biosensor system for noninvasive, in situ, and highly accurate intravascular blood glucose monitoring. The system integrates an ultrathin skin-like biosensor with paper battery–powered electrochemical twin channels (ETCs). The ...

  8. Glucose monitoring as a guide to diabetes management. Critical subject review.

    OpenAIRE

    Koch, B.

    1996-01-01

    PURPOSE: To encourage a balanced approach to blood glucose monitoring in diabetes by a critical review of the history, power and cost of glucose testing. DATA SOURCES: The Cambridge Data Base was searched and was supplemented by a random review of other relevant sources, including textbooks, company pamphlets, and laboratory manuals. STUDY SELECTION: Keywords used were "glucosuria diagnosis," "blood glucose self-monitoring," "glycosylated hemoglobin," and "fructosamine" for the 10-year period...

  9. 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.

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

    African Journals Online (AJOL)

    Many patients were referred to Kololo polyclinic laboratory to have their blood glucose checked because the values obtained on the patients' glucose meter systems did not tally with familiar clinical signs and symptoms. This prompted an experimental set up to check glucose meter systems using a larger number of patients.

  11. Blood Glucose Monitoring Before and After Type 1 Diabetes Clinic Visits.

    Science.gov (United States)

    Driscoll, Kimberly A; Johnson, Suzanne Bennett; Wang, Yuxia; Wright, Nancy; Deeb, Larry C

    2017-12-23

    To determine patterns of blood glucose monitoring in children and adolescents with type 1 diabetes (T1D) before and after routine T1D clinic visits. Blood glucose monitoring data were downloaded at four consecutive routine clinic visits from children and adolescents aged 5-18 years. Linear mixed models were used to analyze patterns of blood glucose monitoring in patients who had at least 28 days of data stored in their blood glucose monitors. In general, the frequency of blood glucose monitoring decreased across visits, and younger children engaged in more frequent blood glucose monitoring. Blood glucose monitoring increased before the T1D clinic visits in younger children, but not in adolescents. It declined after the visit regardless of age. Members of the T1D care team need to consider that a T1D clinic visit may prompt an increase in blood glucose monitoring when making treatment changes and recommendations. Tailored interventions are needed to maintain that higher level of adherence across time. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  12. In vivo glucose monitoring using dual-wavelength polarimetry to overcome corneal birefringence in the presence of motion.

    Science.gov (United States)

    Pirnstill, Casey W; Malik, Bilal H; Gresham, Vincent C; Coté, Gerard L

    2012-09-01

    Over the past 35 years considerable research has been performed toward the investigation of noninvasive and minimally invasive glucose monitoring techniques. Optical polarimetry is one noninvasive technique that has shown promise as a means to ascertain blood glucose levels through measuring the glucose concentrations in the anterior chamber of the eye. However, one of the key limitations to the use of optical polarimetry as a means to noninvasively measure glucose levels is the presence of sample noise caused by motion-induced time-varying corneal birefringence. In this article our group presents, for the first time, results that show dual-wavelength polarimetry can be used to accurately detect glucose concentrations in the presence of motion-induced birefringence in vivo using New Zealand White rabbits. In total, nine animal studies (three New Zealand White rabbits across three separate days) were conducted. Using the dual-wavelength optical polarimetric approach, in vivo, an overall mean average relative difference of 4.49% (11.66 mg/dL) was achieved with 100% Zone A+B hits on a Clarke error grid, including 100% falling in Zone A. The results indicate that dual-wavelength polarimetry can effectively be used to significantly reduce the noise due to time-varying corneal birefringence in vivo, allowing the accurate measurement of glucose concentration in the aqueous humor of the eye and correlating that with blood glucose.

  13. Translating Glucose Variability Metrics into the Clinic via Continuous Glucose Monitoring: A Graphical User Interface for Diabetes Evaluation (CGM-GUIDE©)

    Science.gov (United States)

    Rawlings, Renata A.; Shi, Hang; Yuan, Lo-Hua; Brehm, William; Pop-Busui, Rodica

    2011-01-01

    Abstract Background Several metrics of glucose variability have been proposed to date, but an integrated approach that provides a complete and consistent assessment of glycemic variation is missing. As a consequence, and because of the tedious coding necessary during quantification, most investigators and clinicians have not yet adopted the use of multiple glucose variability metrics to evaluate glycemic variation. Methods We compiled the most extensively used statistical techniques and glucose variability metrics, with adjustable hyper- and hypoglycemic limits and metric parameters, to create a user-friendly Continuous Glucose Monitoring Graphical User Interface for Diabetes Evaluation (CGM-GUIDE©). In addition, we introduce and demonstrate a novel transition density profile that emphasizes the dynamics of transitions between defined glucose states. Results Our combined dashboard of numerical statistics and graphical plots support the task of providing an integrated approach to describing glycemic variability. We integrated existing metrics, such as SD, area under the curve, and mean amplitude of glycemic excursion, with novel metrics such as the slopes across critical transitions and the transition density profile to assess the severity and frequency of glucose transitions per day as they move between critical glycemic zones. Conclusions By presenting the above-mentioned metrics and graphics in a concise aggregate format, CGM-GUIDE provides an easy to use tool to compare quantitative measures of glucose variability. This tool can be used by researchers and clinicians to develop new algorithms of insulin delivery for patients with diabetes and to better explore the link between glucose variability and chronic diabetes complications. PMID:21932986

  14. Flaw evolution monitoring by acoustic emission technique

    International Nuclear Information System (INIS)

    Ghia, S.; Sala, A.; Lucia, A.

    1986-01-01

    Flaw evolution monitoring during mechanical fatigue test has been performed by acoustic emission (AE) technique. Testing on 1:5 reduced scale vessel containing fabrication defects was carried out in the frame of an European program for pressure component residual life evaluation. Characteristics of AE signals associated to flaw evolution are discussed

  15. Detection of hypoglycemia with continuous interstitial and traditional blood glucose monitoring using the FreeStyle Navigator Continuous Glucose Monitoring System.

    Science.gov (United States)

    McGarraugh, Geoffrey; Bergenstal, Richard

    2009-03-01

    The objective of the analysis was to compare detection of hypoglycemic episodes (glucose 15 min) with the FreeStyle Navigator Continuous Glucose Monitoring System (FSN-CGM) (Abbott Diabetes Care, Alameda, CA) alarms to detection with traditional finger stick testing at an average frequency of eight tests per day. The performance of FSN-CGM alarms was evaluated in a clinic setting using 58 subjects with type 1 diabetes mellitus (T1DM) monitoring interstitial glucose concentration over a 5-day period compared to reference YSI measurements (instrument manufactured by YSI, Yellow Springs, OH) at 15-min intervals. Finger stick glucose testing was evaluated in the home environment with 91 subjects with TIDM monitoring with the blood glucose meter integrated into the FreeStyle Navigator (FSN-BG) over a 20-day period. The reference was FSN-CGM with results masked from the subjects. Blood glucose values glucose was <= 85 mg/dL 77.2% of the time. In the home environment, the average FSN-BG testing frequency was 7.9 tests per day. Hypoglycemia was verified within +/- 30 min by FSN-BG measurements <= 85 mg/dL at a rate of 27.5%. Even with a high rate of FSN-BG testing, hypoglycemia detected by FSN-CGM was verified by patients with T1DM very infrequently. A high rate of hypoglycemia detection with a moderate rate of unnecessary alarms can be attained using FSN-CGM.

  16. Continuous glucose monitoring microsensor with a nanoscale conducting matrix and redox mediator

    Science.gov (United States)

    Pesantez, Daniel

    The major limiting factor in kidney clinical transplantation is the shortage of transplantable organs. The current inability to distinguish viability from non-viability on a prospective basis represents a major obstacle in any attempt to expand organ donor criteria. Consequently, a way to measure and monitor a relevant analyte to assess kidney viability is needed. For the first time, the initial development and characterization of a metabolic microsensor to assess kidney viability is presented. The rate of glucose consumption appears to serve as an indicator of kidney metabolism that may distinguish reversible from irreversible kidney damage. The proposed MetaSense (Metabolic Sensor) microdevice would replace periodic laboratory diagnosis tests with a continuous monitor that provides real-time data on organ viability. Amperometry, a technique that correlates an electrical signal with analyte concentration, is used as a method to detect glucose concentrations. A novel two-electrode electrochemical sensing cell design is presented. It uses a modified metallic working electrode (WE) and a bare metallic reference electrode (RE) that acts as a pseudo-reference/counter electrode as well. The proposed microsensor has the potential to be used as a minimally invasive sensor for its reduced number of probes and very small dimensions achieved by micromachining and lithography. In order to improve selectivity of the microdevice, two electron transfer mechanisms or generations were explored. A first generation microsensor uses molecular oxygen as the electron acceptor in the enzymatic reaction and oxidizes hydrogen peroxide (H2O2) to get the electrical signal. The microsensor's modified WE with conductive polymer polypyrrole (PPy) and corresponding enzyme glucose oxidase (GOx) immobilized into its matrix, constitutes the electrochemical detection mechanism. Photoluminescence spectroscopic analysis confirmed and quantified enzyme immobilized concentrations within the matrix. In

  17. Clinical Use of Continuous Glucose Monitoring in Adults with Type 1 Diabetes.

    Science.gov (United States)

    Slattery, David; Choudhary, Pratik

    2017-05-01

    With the emphasis on intensive management of type 1 diabetes, data from studies support frequent monitoring of glucose levels to improve glycemic control and reduce glucose variability, which can be related to an increase in macro and microvascular complications. However, few perform capillary blood glucose that frequently. There are currently two available alternatives that this review will discuss, continuous glucose monitoring (CGM) and flash glucose monitoring. CGM has become an important diagnostic and therapeutic option in optimizing diabetes management. CGM systems are now more accurate, smaller, and easier to use compared to original models. Randomized controlled trials (RCTs) have demonstrated that CGM can improve Hemoglobin A1c (HbA1C) and reduce glucose variability in both continuous subcutaneous insulin infusion and multiple daily injection users. When used in an automated "insulin-suspend" system, reduced frequency of hypoglycemia and shorter time spent in hypoglycemic range have been demonstrated. Despite the potential benefits CGM has to offer in clinical practice, concerns exist on the accuracy of these devices and patient compliance with therapy, which may prevent the true clinical benefit of CGM being achieved, as observed in RCTs. Flash glucose monitoring systems FreeStyle ® Libre™ (Abbott Diabetes Care, Alameda, CA) are as accurate as many CGM systems available and have the added benefit of being factory calibrated. Studies have shown that flash glucose monitoring systems are very well tolerated by patients and effectively reduce glucose variability, increasing time in range.

  18. Is Continuous Glucose Monitoring Underappreciated in the UK?

    Science.gov (United States)

    Parkin, Christopher G; Holloway, Melissa; Truesdell, Jeffrey; C Walker, Tomas

    2017-08-01

    Information about continuous glucose monitoring (CGM) use in the UK is limited. We conducted an online survey of a representative sample of current CGM users in England, Scotland and Wales to address this deficit. The 29-item online survey was conducted between 29 December 2016 and 25 January 2017. Persons with type 1 diabetes (T1D) and caregivers of T1D children/adolescents were recruited from mailing lists, using Nielsen and Harris Polling databases. 315 patients and caregivers responded to the survey - 170 adult patients and 145 caregivers. Among respondents, 144 received full funding for CGM use, 72 received partial funding and 83 received no funding. Most reported improvements in glycated haemoglobin (HbA1c) (67.0%), fewer hypoglycaemia episodes (70.2%), improved hypoglycaemia awareness (77.5%) and better diabetes management (92.4%). Self-funders reported significantly higher CGM use (76.1%) than those who were fully funded (58.9%) and/or partially funded (65.9%), p=0.0008. Fewer than 50% of all respondents reported receiving guidance in interpreting CGM data from their diabetes care team; 30.1% of self-funders reported receiving no CGM support from their diabetes team compared with fully funded (2.8%) and partially funded (1.4%) respondents, p<0.0001. Patients with T1D and their caregivers are realising benefits from CGM use but are largely unsupported by the UK healthcare system.

  19. [Design and implementation of real-time continuous glucose monitoring instrument].

    Science.gov (United States)

    Huang, Yonghong; Liu, Hongying; Tian, Senfu; Jia, Ziru; Wang, Zi; Pi, Xitian

    2017-12-01

    Real-time continuous glucose monitoring can help diabetics to control blood sugar levels within the normal range. However, in the process of practical monitoring, the output of real-time continuous glucose monitoring system is susceptible to glucose sensor and environment noise, which will influence the measurement accuracy of the system. Aiming at this problem, a dual-calibration algorithm for the moving-window double-layer filtering algorithm combined with real-time self-compensation calibration algorithm is proposed in this paper, which can realize the signal drift compensation for current data. And a real-time continuous glucose monitoring instrument based on this study was designed. This real-time continuous glucose monitoring instrument consisted of an adjustable excitation voltage module, a current-voltage converter module, a microprocessor and a wireless transceiver module. For portability, the size of the device was only 40 mm × 30 mm × 5 mm and its weight was only 30 g. In addition, a communication command code algorithm was designed to ensure the security and integrity of data transmission in this study. Results of experiments in vitro showed that current detection of the device worked effectively. A 5-hour monitoring of blood glucose level in vivo showed that the device could continuously monitor blood glucose in real time. The relative error of monitoring results of the designed device ranged from 2.22% to 7.17% when comparing to a portable blood meter.

  20. 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

  1. First Clinical Experience with Retrospective Flash Glucose Monitoring (FGM) Analysis in South Africa: Characterizing Glycemic Control with Ambulatory Glucose Profile.

    Science.gov (United States)

    Distiller, Larry A; Cranston, Iain; Mazze, Roger

    2016-11-01

    In 2014, an innovative blinded continuous glucose monitoring system was introduced with automated ambulatory glucose profile (AGP) reporting. The clinical use and interpretation of this new technology has not previously been described. Therefore we wanted to understand its use in characterizing key factors related to glycemic control: glucose exposure, variability, and stability, and risk of hypoglycemia in clinical practice. Clinicians representing affiliated diabetes centers throughout South Africa were trained and subsequently were given flash glucose monitoring readers and 2-week glucose sensors to use at their discretion. After patient use, sensor data were collected and uploaded for AGP reporting. Complete data (sensor AGP with corresponding clinical information) were obtained for 50 patients with type 1 (70%) and type 2 diabetes (30%), irrespective of therapy. Aggregated analysis of AGP data comparing patients with type 1 versus type 2 diabetes, revealed that despite similar HbA1c values between both groups (8.4 ± 2 vs 8.6 ± 1.7%, respectively), those with type 2 diabetes had lower mean glucose levels (9.2 ± 3 vs 10.3 mmol/l [166 ± 54 vs 185 mg/dl]) and lower indices of glucose variability (3.0 ± 1.5 vs 5.0 ± 1.9 mmol/l [54 ± 27 vs 90 ± 34.2 mg/dl]). This highlights key areas for future focus. Using AGP, the characteristics of glucose exposure, variability, stability, and hypoglycemia risk and occurrence were obtained within a short time and with minimal provider and patient input. In a survey at the time of the follow-up visit, clinicians indicated that aggregated AGP data analysis provided important new clinical information and insights. © 2016 Diabetes Technology Society.

  2. Venous, Arterialized-Venous, or Capillary Glucose Reference Measurements for the Accuracy Assessment of a Continuous Glucose Monitoring System

    NARCIS (Netherlands)

    Kropff, Jort; van Steen, Sigrid C.; deGraaff, Peter; Chan, Man W.; van Amstel, Rombout B. E.; DeVries, J. Hans

    2017-01-01

    Background: Different reference methods are used for the accuracy assessment of continuous glucose monitoring (CGM) systems. The effect of using venous, arterialized-venous, or capillary reference measurements on CGM accuracy is unclear. Methods: We evaluated 21 individuals with type 1 diabetes

  3. 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

  4. Hydrogel-based electrochemical sensor for non-invasive and continuous glucose monitoring

    Science.gov (United States)

    Park, Habeen; Lee, Ji-Young; Kim, Dong-Chul; Koh, Younggook; Cha, Junhoe

    2017-07-01

    Monitoring blood glucose level of diabetic patients is crucial in diabetes care from life threating complications. Selfmonitoring blood glucose (SMBG) that involves finger prick to draw blood samples into the measurement system is a widely-used method of routine measurement of blood glucose levels to date. SMBG includes, however, unavoidable pain problems resulting from the repetitive measurements. We hereby present a hydrogel-based electrochemical (H-EC) sensor to monitor the glucose level, non-invasively. Glucose oxidase (GOx) was immobilized in the disc-type hydroxyethyl methacrylate (HEMA) based hydrogel and kept intact in the hydrogel. Fast electron transfer mediated by Prussian blue (PB, hexacyanoferrate) generated efficient signal amplifications to facilitate the detection of the extracted glucose from the interstitial fluid. The linear response and the selectivity against glucose of the H-EC sensor were validated by chronoamperometry. For the practical use, the outcomes from the correlation of the extracted glucose concentration and the blood glucose value by on-body extraction, as well as the validation of the hydrogel-based electrochemical (H-EC) device, were applied to the on-body glucose monitoring.

  5. [Glucose-monitoring neurons of the medial ventrolateral prefrontal (orbitofrontal) cortex are involved in the maintenance of homeostasis].

    Science.gov (United States)

    Szabó, István; Hormay, Edina; Csetényi, Bettina; Nagy, Bernadett; Karádi, Zoltán

    2017-05-01

    The medial orbitofrontal cortex is involved in the regulation of feeding and metabolism. Little is known, however, about the role of local glucose-monitoring neurons in these processes, and our knowledge is also poor about characteristics of these cells. The functional significance of these chemosensory neurons was to be elucidated. Electrophysiology, by the multibarreled microelectrophoretic technique, and metabolic investigations, after streptozotocin induced selective destruction of the chemosensory neurons, were employed. Fifteen percent of the neurons responded to glucose, and these chemosensory cells displayed differential neurotransmitter and taste sensitivities. In acute glucose tolerance test, at the 30th and 60th minutes, blood glucose level in the streptozotocin-treated rats was significantly higher than that in the controls. The plasma triglyceride concentrations were also higher in the streptozotocin-treated group. Glucose-monitoring neurons of the medial orbitofrontal cortex integrate internal and external environmental signals, and monitor metabolic processes, thus, are indispensable to maintain the healthy homeostasis. Orv Hetil. 2017; 158(18): 692-700.

  6. Radon monitoring technique with electret collecting

    International Nuclear Information System (INIS)

    Tian Zhiheng; Zuo Fuqi; Xiao Detao; Zhao Xkiuliang

    1991-12-01

    The integrating radon monitoring technique with electret collecting is a method which collects the 218 Po + positive ions by electrostatic field produced by electret. It has greatly improved the sensitivity of radon measurement. The response factor of this method reaches to 4.7 cm -2 Bq -1 m 3 h -1 , 1000 times larger than that of common passive sampling method. The monitoring device and its principle are introduced. The measuring results of radon concentration and radon flux rate and quality assurance system by using this method in the Qinshan Nuclear Power Plant, Human Environmental Monitoring Central Station and some uranium mines are also presented. The analytical results show that the radon concentration in the Qinshan Nuclear Power Plant is affected by wind direction. When wind directs toward sea, the radon concentration is high. If the wind is to the contrary, it is low. The radon concentration ratio of both is about 2

  7. Machine monitoring via current signature analysis techniques

    International Nuclear Information System (INIS)

    Smith, S.F.; Castleberry, K.N.; Nowlin, C.H.

    1992-01-01

    A significant need in the effort to provide increased production quality is to provide improved plant equipment monitoring capabilities. Unfortunately, in today's tight economy, even such monitoring instrumentation must be implemented in a recognizably cost effective manner. By analyzing the electric current drawn by motors, actuator, and other line-powered industrial equipment, significant insights into the operations of the movers, driven equipment, and even the power source can be obtained. The generic term 'current signature analysis' (CSA) has been coined to describe several techniques for extracting useful equipment or process monitoring information from the electrical power feed system. A patented method developed at Oak Ridge National Laboratory is described which recognizes the presence of line-current modulation produced by motors and actuators driving varying loads. The in-situ application of applicable linear demodulation techniques to the analysis of numerous motor-driven systems is also discussed. The use of high-quality amplitude and angle-demodulation circuitry has permitted remote status monitoring of several types of medium and high-power gas compressors in (US DOE facilities) driven by 3-phase induction motors rated from 100 to 3,500 hp, both with and without intervening speed increasers. Flow characteristics of the compressors, including various forms of abnormal behavior such as surging and rotating stall, produce at the output of the specialized detectors specific time and frequency signatures which can be easily identified for monitoring, control, and fault-prevention purposes. The resultant data are similar in form to information obtained via standard vibration-sensing techniques and can be analyzed using essentially identical methods. In addition, other machinery such as refrigeration compressors, brine pumps, vacuum pumps, fans, and electric motors have been characterized

  8. Patient satisfaction and barriers to initiating real-time continuous glucose monitoring in early pregnancy in women with diabetes

    DEFF Research Database (Denmark)

    Secher, A L; Madsen, A B; Nielsen, Lene Ringholm

    2012-01-01

    of initial monitoring). Ten women (15%) did not wish to use continuous glucose monitoring again in pregnancy. Main causes behind early removal of continuous glucose monitoring were self-reported skin irritation, technical problems and continuous glucose monitoring inaccuracy. No differences were found......Aim: To evaluate self-reported satisfaction and barriers to initiating real-time continuous glucose monitoring in early pregnancy among women with pregestational diabetes. Methods: Fifty-four women with Type 1 diabetes and 14 women with Type 2 diabetes were offered continuous glucose monitoring...

  9. Barriers to blood glucose monitoring in a multiethnic community.

    Science.gov (United States)

    Zgibor, Janice C; Simmons, David

    2002-10-01

    We studied a multiethnic community to determine factors associated with blood glucose monitoring (BGM) and to determine the independent association between barriers to diabetes care and BGM. A total of 323 participants (35.6% European, 32.2% Maori, and 32.2% Pacific Islander) from the South Auckland Diabetes Project (free of major complications by self-report) completed a qualitative survey to determine barriers to diabetes care. Five barriers to diabetes care categories were generated including internal psychological (self efficacy/health beliefs), external psychological (psychosocial environment), internal physical (comorbidities/side effects of treatment), external physical (finance/access to care), and educational (knowledge of diabetes/services) barriers. Characteristics associated with BGM greater than or equal to twice weekly were female sex, HbA(1c) >8%, higher diabetes knowledge scores, and insulin use. Multivariate analyses demonstrated that those reporting external physical barriers (OR 0.47, 95% CI 0.26-0.84), external psychological barriers (0.55, 0.30-1.0), and internal psychological barriers (0.56, 0.32-1.0) were less likely to perform BGM independent of ethnicity, insulin use, age, sex, diabetes knowledge, and glycemic control. Further multivariate analyses demonstrated that those reporting external physical barriers, particularly related to personal finance, were less likely to perform BGM. These data demonstrate that patient-reported barriers to diabetes care are associated with BGM, particularly in relation to financial, psychosocial, and self-efficacy issues. Understanding these barriers and overcoming them within the context of the patient's ethnic environment may lead to increased participation in self-care.

  10. The development of digital monitoring technique

    International Nuclear Information System (INIS)

    Koo, In Soo; Kim, D. H.; Kim, J. S.; Kim, C. H.; Kim, G. O.; Park, H. Y.; Suh, S. Y.; Sung, S. H.; Song, S. J.; Lee, C. K.; Jang, G. S.; Hur, S.

    1997-08-01

    A study has been performed for advanced DSP technology for the digital nuclear I and C systems for the monitoring and diagnosis techniques for high-pressurized structures integrity in NSSS. In the development of advanced DSP technology, real time process, communication network and signal validation were selected as the essential technologies of the digital signal process, and the requirements and methodology for the application of these technologies in NPP were established through technical analysis. Based on its results, the DPIS and the signal validation algorithm were developed. For the real-time process, the necessary requirements were define and the methodology of real-time software modeling was developed. For the communication network, the methodology of selection of the communication technique and developing procedure were established with an extraction of requirements. Functions, requirements, structure and technical specification were developed for the DPIS, and a real-time signal validation algorithm was developed and implemented for the signal validation. In a study on monitoring techniques for abnormal conditions, test and experimental facilities have been set up in order to carry out the required tests during research activities. Studies concentrated on how to acquire proper vibration or emission signals from mechanical structures and equipments, and to diagnose effectively the abnormal conditions of high pressure structure integrity. The algorithms of automatic signal analysis and diagnosis for abnormal conditions have been developed in this study to assist the operator's monitoring and diagnosis activities on structure integrity using new technologies. (author). 23 refs., 68 tabs., 196 figs

  11. Monitoring severe accidents using AI techniques

    International Nuclear Information System (INIS)

    No, Young Gyu; Ahn, Kwang Il; Kim, Ju Hyun; Na, Man Gyun; Lim, Dong Hyuk

    2012-01-01

    After the Fukushima nuclear accident in 2011, there has been increasing concern regarding severe accidents in nuclear facilities. Severe accident scenarios are difficult for operators to monitor and identify. Therefore, accurate prediction of a severe accident is important in order to manage it appropriately in the unfavorable conditions. In this study, artificial intelligence (AI) techniques, such as support vector classification (SVC), probabilistic neural network (PNN), group method of data handling (GMDH), and fuzzy neural network (FNN), were used to monitor the major transient scenarios of a severe accident caused by three different initiating events, the hot-leg loss of coolant accident (LOCA), the cold-leg LOCA, and the steam generator tube rupture in pressurized water reactors (PWRs). The SVC and PNN models were used for the event classification. The GMDH and FNN models were employed to accurately predict the important timing representing severe accident scenarios. In addition, in order to verify the proposed algorithm, data from a number of numerical simulations were required in order to train the AI techniques due to the shortage of real LOCA data. The data was acquired by performing simulations using the MAAP4 code. The prediction accuracy of the three types of initiating events was sufficiently high to predict severe accident scenarios. Therefore, the AI techniques can be applied successfully in the identification and monitoring of severe accident scenarios in real PWRs.

  12. Monitoring severe accidents using AI techniques

    Energy Technology Data Exchange (ETDEWEB)

    No, Young Gyu; Ahn, Kwang Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kim, Ju Hyun; Na, Man Gyun [Dept. of Nuclear Engineering, Chosun University, Gwangju (Korea, Republic of); Lim, Dong Hyuk [Korea Institute of Nuclear Nonproliferation and Control, Daejon (Korea, Republic of)

    2012-05-15

    After the Fukushima nuclear accident in 2011, there has been increasing concern regarding severe accidents in nuclear facilities. Severe accident scenarios are difficult for operators to monitor and identify. Therefore, accurate prediction of a severe accident is important in order to manage it appropriately in the unfavorable conditions. In this study, artificial intelligence (AI) techniques, such as support vector classification (SVC), probabilistic neural network (PNN), group method of data handling (GMDH), and fuzzy neural network (FNN), were used to monitor the major transient scenarios of a severe accident caused by three different initiating events, the hot-leg loss of coolant accident (LOCA), the cold-leg LOCA, and the steam generator tube rupture in pressurized water reactors (PWRs). The SVC and PNN models were used for the event classification. The GMDH and FNN models were employed to accurately predict the important timing representing severe accident scenarios. In addition, in order to verify the proposed algorithm, data from a number of numerical simulations were required in order to train the AI techniques due to the shortage of real LOCA data. The data was acquired by performing simulations using the MAAP4 code. The prediction accuracy of the three types of initiating events was sufficiently high to predict severe accident scenarios. Therefore, the AI techniques can be applied successfully in the identification and monitoring of severe accident scenarios in real PWRs.

  13. The development of digital monitoring technique

    Energy Technology Data Exchange (ETDEWEB)

    Koo, In Soo; Kim, D. H.; Kim, J. S.; Kim, C. H.; Kim, G. O.; Park, H. Y.; Suh, S. Y.; Sung, S. H.; Song, S. J.; Lee, C. K.; Jang, G. S.; Hur, S.

    1997-08-01

    A study has been performed for advanced DSP technology for the digital nuclear I and C systems for the monitoring and diagnosis techniques for high-pressurized structures integrity in NSSS. In the development of advanced DSP technology, real time process, communication network and signal validation were selected as the essential technologies of the digital signal process, and the requirements and methodology for the application of these technologies in NPP were established through technical analysis. Based on its results, the DPIS and the signal validation algorithm were developed. For the real-time process, the necessary requirements were define and the methodology of real-time software modeling was developed. For the communication network, the methodology of selection of the communication technique and developing procedure were established with an extraction of requirements. Functions, requirements, structure and technical specification were developed for the DPIS, and a real-time signal validation algorithm was developed and implemented for the signal validation. In a study on monitoring techniques for abnormal conditions, test and experimental facilities have been set up in order to carry out the required tests during research activities. Studies concentrated on how to acquire proper vibration or emission signals from mechanical structures and equipments, and to diagnose effectively the abnormal conditions of high pressure structure integrity. The algorithms of automatic signal analysis and diagnosis for abnormal conditions have been developed in this study to assist the operator`s monitoring and diagnosis activities on structure integrity using new technologies. (author). 23 refs., 68 tabs., 196 figs.

  14. Relationship between fluctuations in glucose levels measured by continuous glucose monitoring and vascular endothelial dysfunction in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Torimoto Keiichi

    2013-01-01

    Full Text Available Abstract Background Fluctuations in blood glucose level cause endothelial dysfunction and play a critical role in onset and/or progression of atherosclerosis. We hypothesized that fluctuation in blood glucose levels correlate with vascular endothelial dysfunction and that this relationship can be assessed using common bedside medical devices. Methods Fluctuations in blood glucose levels were measured over 24 hours by continuous glucose monitoring (CGM on admission day 2 in 57 patients with type 2 diabetes mellitus. The reactive hyperemia index (RHI, an index of vascular endothelial function, was measured using peripheral arterial tonometry (EndoPAT on admission day 3. Results The natural logarithmic-scaled RHI (L_RHI correlated with SD (r=−0.504; PPP=0.001 and percentage of time ≥200 mg/dl (r=−0.292; P=0.028. In 12 patients with hypoglycemia, L_RHI also correlated with the percentage of time at hypoglycemia (r=−0.589; P=0.044. L_RHI did not correlate with HbA1c or fasting plasma glucose levels. Furthermore, L_RHI did not correlate with LDL cholesterol, HDL cholesterol, and triglyceride levels or with systolic and diastolic blood pressures. Finally, multivariate analysis identified MAGE as the only significant determinant of L_RHI. Conclusions Fluctuations in blood glucose levels play a significant role in vascular endothelial dysfunction in type 2 diabetes. Trial registration UMIN000007581

  15. 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.

  16. Noradrenaline and acetylcholine responsiveness of glucose-monitoring and glucose-insensitive neurons in the mediodorsal prefrontal cortex.

    Science.gov (United States)

    Nagy, Bernadett; Szabó, István; Csetényi, Bettina; Hormay, Edina; Papp, Szilárd; Keresztes, Dóra; Karádi, Zoltán

    2014-01-16

    The mediodorsal prefrontal cortex (mdPFC), as part of the forebrain glucose-monitoring (GM) system, plays important role in several regulatory processes to control the internal state of the organism and to initiate behavioral outputs accordingly. Little is known, however, about the neurochemical sensitivity of neurons located in this area. Substantial evidence indicates that the locus ceruleus - noradrenaline (NA) projection system and the nucleus basalis magnocellularis - cholinergic projection system regulate behavioral state and state dependent processing of sensory information, various cognitive functions already associated with the mdPFC. The main goal of the present study was to examine noradrenergic and cholinergic responsiveness of glucose-monitoring and glucose-insensitive (GIS) neurons in the mediodorsal prefrontal cortex. One fifth of the neurons tested changed in firing rate to microelectrophoretically applied NA. Responsiveness of the GM cells to this catecholamine proved to be significantly higher than that of the GIS units. Microiontophoretic application of acetylcholine (Ach) resulted in activity changes (predominantly facilitation) of more than 40% of the mdPFC neurons. Proportion of Ach sensitive units among the GM and the GIS neurons was found to be similar. The glucose-monitoring neurons of the mdPFC and their distinct NA and remarkable Ach sensitivity are suggested to be of particular significance in prefrontal control of adaptive behaviors. © 2013 Published by Elsevier B.V.

  17. ONLINE MONITORING OF EXTRACELLULAR BRAIN GLUCOSE USING MICRODIALYSIS AND A NADPH-LINKED ENZYMATIC ASSAY

    NARCIS (Netherlands)

    VANDERKUIL, JHF; KORF, J

    A method to monitor extracellular glucose in freely moving rats, based on intracerebral microdialysis coupled to an enzyme reactor is described. The dialysate is continuously mixed with a solution containing the enzymes hexokinase and glucose-6-phosphate dehydrogenase, and the fluorescence of NADPH

  18. Monitoring Severe Accidents Using AI Techniques

    International Nuclear Information System (INIS)

    No, Young Gyu; Kim, Ju Hyun; Na, Man Gyun; Ahn, Kwang Il

    2011-01-01

    It is very difficult for nuclear power plant operators to monitor and identify the major severe accident scenarios following an initiating event by staring at temporal trends of important parameters. The objective of this study is to develop and verify the monitoring for severe accidents using artificial intelligence (AI) techniques such as support vector classification (SVC), probabilistic neural network (PNN), group method of data handling (GMDH) and fuzzy neural network (FNN). The SVC and PNN are used for event classification among the severe accidents. Also, GMDH and FNN are used to monitor for severe accidents. The inputs to AI techniques are initial time-integrated values obtained by integrating measurement signals during a short time interval after reactor scram. In this study, 3 types of initiating events such as the hot-leg LOCA, the cold-leg LOCA and SGTR are considered and it is verified how well the proposed scenario identification algorithm using the GMDH and FNN models identifies the timings when the reactor core will be uncovered, when CET will exceed 1200 .deg. F and when the reactor vessel will fail. In cases that an initiating event develops into a severe accident, the proposed algorithm showed accurate classification of initiating events. Also, it well predicted timings for important occurrences during severe accident progression scenarios, which is very helpful for operators to perform severe accident management

  19. [CGM-Continuous Glucose Monitoring--Statement of the Austrian Diabetes Association].

    Science.gov (United States)

    Schütz-Fuhrmann, Ingrid; Rami-Merhar, Birgit; Hofer, Sabine; Stadler, Marietta; Bischof, Martin; Zlamal-Fortunat, Sandra; Laimer, Markus; Weitgasser, Raimund; Prager, Rudolf

    2016-04-01

    This position statement represents the recommendations of the Austrian Diabetes Association regarding the clinical diagnostic and therapeutic application, safety and benefits of continuous subcutaneous glucose monitoring systems in patients with diabetes mellitus, based on current evidence.

  20. [CGM-continuous glucose monitoring - statement of the Austrian Diabetes Association].

    Science.gov (United States)

    Schütz-Fuhrmann, Ingrid; Schober, Edith; Rami, Birgit; Stadler, Marietta; Bischof, Martin; Fortunat, Sandra; Laimer, Markus; Weitgasser, Raimund; Prager, Rudolf

    2012-12-01

    This position statement represents the recommendations of the Austrian Diabetes Association regarding the clinical diagnostic and therapeutic application, safety and benefits of continuous subcutaneous glucose monitoring systems in patients with diabetes mellitus, based on current evidence.

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

    African Journals Online (AJOL)

    Methods:This study assessed the effect on diabetes control in patients who received glucometers and education ... Self-monitoring of blood glucose (SMBG) helps patients make ..... unhealthy eating habits could possibly be related to the low.

  2. Monitoring and evaluation techniques for airborne contamination

    Energy Technology Data Exchange (ETDEWEB)

    Yihua, Xia [China Inst. of Atomic Energy, Beijing (China)

    1997-06-01

    Monitoring and evaluation of airborne contamination are of great importance for the purpose of protection of health and safety of workers in nuclear installations. Because airborne contamination is one of the key sources to cause exposure to individuals by inhalation and digestion, and to cause diffusion of contaminants in the environment. The main objectives of monitoring and evaluation of airborne contamination are: to detect promptly a loss of control of airborne material, to help identify those individuals and predict exposure levels, to assess the intake and dose commitment to the individuals, and to provide sufficient documentation of airborne radioactivity. From the viewpoint of radiation protection, the radioactive contaminants in air can be classified into the following types: airborne aerosol, gas and noble gas, and volatile gas. In this paper, the following items are described: sampling methods and techniques, measurement and evaluation, and particle size analysis. (G.K.)

  3. Monitoring and evaluation techniques for airborne contamination

    International Nuclear Information System (INIS)

    Xia Yihua

    1997-01-01

    Monitoring and evaluation of airborne contamination are of great importance for the purpose of protection of health and safety of workers in nuclear installations. Because airborne contamination is one of the key sources to cause exposure to individuals by inhalation and digestion, and to cause diffusion of contaminants in the environment. The main objectives of monitoring and evaluation of airborne contamination are: to detect promptly a loss of control of airborne material, to help identify those individuals and predict exposure levels, to assess the intake and dose commitment to the individuals, and to provide sufficient documentation of airborne radioactivity. From the viewpoint of radiation protection, the radioactive contaminants in air can be classified into the following types: airborne aerosol, gas and noble gas, and volatile gas. In this paper, the following items are described: sampling methods and techniques, measurement and evaluation, and particle size analysis. (G.K.)

  4. On-line monitoring of Glucose and penicillin by sequential injection analysis

    DEFF Research Database (Denmark)

    Min, R.W.; Nielsen, Jens Bredal; Villadsen, John

    1996-01-01

    and a detector. The glucose analyzer is based on an enzymatic reaction using glucose oxidase, which converts glucose to glucono-lactone with formation of hydrogen peroxide and subsequent detection of H2O2 by a chemiluminescence reaction involving luminol. The penicillin analysis is based on formation......A sequential injection analysis (SIA) system has been developed for on-line monitoring of glucose and penicillin during cultivations of the filamentous fungus Penicillium chrysogenum. The SIA system consists of a peristaltic pump, an injection valve, two piston pumps, two multi-position valves...

  5. Evaluation of Postprandial Glucose Excursion Using a Novel Minimally Invasive Glucose Area-Under-the-Curve Monitoring System

    Directory of Open Access Journals (Sweden)

    Sachi Kuranuki

    2013-01-01

    Full Text Available Objective: To develop a minimally invasive interstitial fluid extraction technology (MIET to monitor postprandial glucose area under the curve (AUC without blood sampling, we evaluated the accuracy of glucose AUC measured by MIET and compared with that by blood sampling after food intake. Methods: Interstitial fluid glucose AUC (IG-AUC following consumption of 6 different types of foods was measured by MIET. MIET consisted of stamping microneedle arrays, placing hydrogel patches on the areas, and calculating IG-AUC based on glucose levels in the hydrogels. Glycemic index (GI was determined using IG-AUC and reference AUC measured by blood sampling. Results: IG-AUC strongly correlated with reference AUC (R = 0.91, and GI determined using IG-AUC showed good correlation with that determined by reference AUC (R = 0.88. Conclusions: IG-AUC obtained by MIET can accurately predict the postprandial glucose excursion without blood sampling. In addition, feasibility of GI measurement by MIET was confirmed.

  6. Effects of simulated altitude on blood glucose meter performance: implications for in-flight blood glucose monitoring.

    Science.gov (United States)

    Olateju, Tolu; Begley, Joseph; Flanagan, Daniel; Kerr, David

    2012-07-01

    Most manufacturers of blood glucose monitoring equipment do not give advice regarding the use of their meters and strips onboard aircraft, and some airlines have blood glucose testing equipment in the aircraft cabin medical bag. Previous studies using older blood glucose meters (BGMs) have shown conflicting results on the performance of both glucose oxidase (GOX)- and glucose dehydrogenase (GDH)-based meters at high altitude. The aim of our study was to evaluate the performance of four new-generation BGMs at sea level and at a simulated altitude equivalent to that used in the cabin of commercial aircrafts. Blood glucose measurements obtained by two GDH and two GOX BGMs at sea level and simulated altitude of 8000 feet in a hypobaric chamber were compared with measurements obtained using a YSI 2300 blood glucose analyzer as a reference method. Spiked venous blood samples of three different glucose levels were used. The accuracy of each meter was determined by calculating percentage error of each meter compared with the YSI reference and was also assessed against standard International Organization for Standardization (ISO) criteria. Clinical accuracy was evaluated using the consensus error grid method. The percentage (standard deviation) error for GDH meters at sea level and altitude was 13.36% (8.83%; for meter 1) and 12.97% (8.03%; for meter 2) with p = .784, and for GOX meters was 5.88% (7.35%; for meter 3) and 7.38% (6.20%; for meter 4) with p = .187. There was variation in the number of time individual meters met the standard ISO criteria ranging from 72-100%. Results from all four meters at both sea level and simulated altitude fell within zones A and B of the consensus error grid, using YSI as the reference. Overall, at simulated altitude, no differences were observed between the performance of GDH and GOX meters. Overestimation of blood glucose concentration was seen among individual meters evaluated, but none of the results obtained would have resulted in

  7. Performance Monitoring Techniques Supporting Cognitive Optical Networking

    DEFF Research Database (Denmark)

    Caballero Jambrina, Antonio; Borkowski, Robert; Zibar, Darko

    2013-01-01

    High degree of heterogeneity of future optical networks, such as services with different quality-of-transmission requirements, modulation formats and switching techniques, will pose a challenge for the control and optimization of different parameters. Incorporation of cognitive techniques can help...... to solve this issue by realizing a network that can observe, act, learn and optimize its performance, taking into account end-to-end goals. In this letter we present the approach of cognition applied to heterogeneous optical networks developed in the framework of the EU project CHRON: Cognitive...... Heterogeneous Reconfigurable Optical Network. We focus on the approaches developed in the project for optical performance monitoring, which enable the feedback from the physical layer to the cognitive decision system by providing accurate description of the performance of the established lightpaths....

  8. Analysis of Continuous Glucose Monitoring in Pregnant Women With Diabetes

    DEFF Research Database (Denmark)

    Law, Graham R; Ellison, George T H; Secher, Anna L

    2015-01-01

    with diabetes. RESEARCH DESIGN AND METHODS: Functional data analysis (FDA) was applied to 1.68 million glucose measurements from 759 measurement episodes, obtained from two previously published randomized controlled trials of CGM in pregnant women with diabetes. A total of 117 women with type 1 diabetes (n = 89...... developed LGA. LGA was associated with lower mean glucose (7.0 vs. 7.1 mmol/L; P FDA showed that glucose was significantly lower midmorning (0900-1100 h) and early...... evening (1900-2130 h) in trimester 1, significantly higher early morning (0330-0630 h) and throughout the afternoon (1130-1700 h) in trimester 2, and significantly higher during the evening (2030-2330 h) in trimester 3 in women whose infants were LGA. CONCLUSIONS: FDA of CGM data identified specific times...

  9. Why Have So Many Intravascular Glucose Monitoring Devices Failed?

    Science.gov (United States)

    Smith, John L; Rice, Mark J

    2015-07-01

    Secondary to the inherent limitations of both point-of-care and central laboratory glucose technologies, continuous glucose measurement has recently enjoyed a high level of investment. Because of the perceived advantages by some of measuring in the intravascular space compared to the subcutaneous tissue, a number of technologies have been developed. In this review, we evaluate nine systems that have shown promise, although only one of these has been cleared for sale in the United States. The detection methodology, regulatory status, technical issues, and company circumstance surrounding each technology are examined. © 2015 Diabetes Technology Society.

  10. Glucose monitoring as a guide to diabetes management. Critical subject review.

    Science.gov (United States)

    Koch, B

    1996-06-01

    To encourage a balanced approach to blood glucose monitoring in diabetes by a critical review of the history, power and cost of glucose testing. The Cambridge Data Base was searched and was supplemented by a random review of other relevant sources, including textbooks, company pamphlets, and laboratory manuals. Keywords used were "glucosuria diagnosis," "blood glucose self-monitoring," "glycosylated hemoglobin," and "fructosamine" for the 10-year period ending 1992, restricted to English language and human. About 200 titles were retrieved and reviewed according to the author's judgment of relevance. "Snapshot tests" (venous and capillary blood glucose) and "memory tests" (urine glucose, glycated hemoglobin fractions and fructosamine) must be employed according to individual patients treatment goals. Day-to-day metabolic guidance is facilitated by capillary blood glucose testing for patients receiving insulin and by urine glucose testing for others. Capillary blood glucose testing is mandatory in cases of hypoglycemia unawareness (inability to sense hypoglycemia because of neuropathy) but is not a substitute for a knowledge of clinical hypoglycemia self-care. Criteria by reason (clinical judgement and cost effectiveness) must be separated from criteria by emotion (preoccupation with technology and marketing). No randomized studies show that any of these tests consistently improve clinical outcome. Optimal metabolic control and cost savings can be expected from a rational selection of tests.

  11. Continuous glucose monitoring in subcutaneous tissue using factory-calibrated sensors: a pilot study.

    Science.gov (United States)

    Hoss, Udo; Jeddi, Iman; Schulz, Mark; Budiman, Erwin; Bhogal, Claire; McGarraugh, Geoffrey

    2010-08-01

    Commercial continuous subcutaneous glucose monitors require in vivo calibration using capillary blood glucose tests. Feasibility of factory calibration, i.e., sensor batch characterization in vitro with no further need for in vivo calibration, requires a predictable and stable in vivo sensor sensitivity and limited inter- and intra-subject variation of the ratio of interstitial to blood glucose concentration. Twelve volunteers wore two FreeStyle Navigator (Abbott Diabetes Care, Alameda, CA) continuous glucose monitoring systems for 5 days in parallel for two consecutive sensor wears (four sensors per subject, 48 sensors total). Sensors from a prototype sensor lot with a low variability in glucose sensitivity were used for the study. Median sensor sensitivity values based on capillary blood glucose were calculated per sensor and compared for inter- and intra-subject variation. Mean absolute relative difference (MARD) calculation and error grid analysis were performed using a single calibration factor for all sensors to simulate factory calibration and compared to standard fingerstick calibration. Sensor sensitivity variation in vitro was 4.6%, which increased to 8.3% in vivo (P glucose monitoring is feasible with similar accuracy to standard fingerstick calibration. Additional data are required to confirm this result in subjects with diabetes.

  12. Salivary glucose in monitoring glycaemia in patients with type 1 diabetes mellitus: a systematic review.

    Science.gov (United States)

    Naing, Cho; Mak, Joon Wah

    2017-01-01

    Incidence of type 1 diabetes mellitus is increasing worldwide. Monitoring glycaemia is essential for control of diabetes mellitus. Conventional blood-based measurement of glucose requires venepuncture or needle prick, which is not free from pain and risk of infection. The non-invasiveness, ease and low-cost in collection made saliva an attractive alternative sample. The objective of this review was to systematically review the evidence on the relationship between salivary glucose level and blood glucose level in monitoring glycaemia in patients with type 1 diabetes mellitus. We searched studies which evaluate salivary glucose levels and serum glycaemia in type 1 diabetes mellitus in electronic databases of MEDLINE, EMBASE, Ovid and Google Scholar. We selected the eligible studies, following the inclusion criteria set for this review. Due to heterogeneity of studies, we conducted qualitative synthesis of studies. Ten observational studies were included in this review, including a total of 321 cases and 323 controls with ages between 3 and 61 years and the majority were males (62%). Two studies were done exclusively on children below 17 years old. The significant difference between salivary glucose levels in type 1 diabetes mellitus and controls were reported in 6 studies with 8 data sets. Five studies with 7 datasets reported the correlation coefficient between salivary glucose and blood glucose in patients with diabetes. Findings suggest that salivary glucose concentrations may be helpful in monitoring glycaemia in type 1 diabetes mellitus. However, the utility of using salivary glucose level to monitor glycaemia should be evaluated in future well designed, prospective studies with adequate number of participants with type 1 diabetes mellitus.

  13. Optical biosensor optimized for continuous in-line glucose monitoring in animal cell culture.

    Science.gov (United States)

    Tric, Mircea; Lederle, Mario; Neuner, Lisa; Dolgowjasow, Igor; Wiedemann, Philipp; Wölfl, Stefan; Werner, Tobias

    2017-09-01

    Biosensors for continuous glucose monitoring in bioreactors could provide a valuable tool for optimizing culture conditions in biotechnological applications. We have developed an optical biosensor for long-term continuous glucose monitoring and demonstrated a tight glucose level control during cell culture in disposable bioreactors. The in-line sensor is based on a commercially available oxygen sensor that is coated with cross-linked glucose oxidase (GOD). The dynamic range of the sensor was tuned by a hydrophilic perforated diffusion membrane with an optimized permeability for glucose and oxygen. The biosensor was thoroughly characterized by experimental data and numerical simulations, which enabled insights into the internal concentration profile of the deactivating by-product hydrogen peroxide. The simulations were carried out with a one-dimensional biosensor model and revealed that, in addition to the internal hydrogen peroxide concentration, the turnover rate of the enzyme GOD plays a crucial role for biosensor stability. In the light of this finding, the glucose sensor was optimized to reach a long functional stability (>52 days) under continuous glucose monitoring conditions with a dynamic range of 0-20 mM and a response time of t 90  ≤ 10 min. In addition, we demonstrated that the sensor was sterilizable with beta and UV irradiation and only subjected to minor cross sensitivity to oxygen, when an oxygen reference sensor was applied. Graphical abstract Measuring setup of a glucose biosensor in a shake flask for continuous glucose monitoring in mammalian cell culture.

  14. Parsimonious model for blood glucose level monitoring in type 2 diabetes patients.

    Science.gov (United States)

    Zhao, Fang; Ma, Yan Fen; Wen, Jing Xiao; DU, Yan Fang; Li, Chun Lin; Li, Guang Wei

    2014-07-01

    To establish the parsimonious model for blood glucose monitoring in patients with type 2 diabetes receiving oral hypoglycemic agent treatment. One hundred and fifty-nine adult Chinese type 2 diabetes patients were randomized to receive rapid-acting or sustained-release gliclazide therapy for 12 weeks. Their blood glucose levels were measured at 10 time points in a 24 h period before and after treatment, and the 24 h mean blood glucose levels were measured. Contribution of blood glucose levels to the mean blood glucose level and HbA1c was assessed by multiple regression analysis. The correlation coefficients of blood glucose level measured at 10 time points to the daily MBG were 0.58-0.74 and 0.59-0.79, respectively, before and after treatment (Pblood glucose levels measured at 6 of the 10 time points could explain 95% and 97% of the changes in MBG before and after treatment. The three blood glucose levels, which were measured at fasting, 2 h after breakfast and before dinner, of the 10 time points could explain 84% and 86% of the changes in MBG before and after treatment, but could only explain 36% and 26% of the changes in HbA1c before and after treatment, and they had a poorer correlation with the HbA1c than with the 24 h MBG. The blood glucose levels measured at fasting, 2 h after breakfast and before dinner truly reflected the change 24 h blood glucose level, suggesting that they are appropriate for the self-monitoring of blood glucose levels in diabetes patients receiving oral anti-diabetes therapy. Copyright © 2014 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  15. The performance of flash glucose monitoring in critically ill patients with diabetes.

    Science.gov (United States)

    Ancona, Paolo; Eastwood, Glenn M; Lucchetta, Luca; Ekinci, Elif I; Bellomo, Rinaldo; Mårtensson, Johan

    2017-06-01

    Frequent glucose monitoring may improve glycaemic control in critically ill patients with diabetes. We aimed to assess the accuracy of a novel subcutaneous flash glucose monitor (FreeStyle Libre [Abbott Diabetes Care]) in these patients. We applied the FreeStyle Libre sensor to the upper arm of eight patients with diabetes in the intensive care unit and obtained hourly flash glucose measurements. Duplicate recordings were obtained to assess test-retest reliability. The reference glucose level was measured in arterial or capillary blood. We determined numerical accuracy using Bland- Altman methods, the mean absolute relative difference (MARD) and whether the International Organization for Standardization (ISO) and Clinical and Laboratory Standards Institute Point of Care Testing (CLSI POCT) criteria were met. Clarke error grid (CEG) and surveillance error grid (SEG) analyses were used to determine clinical accuracy. We compared 484 duplicate flash glucose measurements and observed a Pearson correlation coefficient of 0.97 and a coefficient of repeatability of 1.6 mmol/L. We studied 185 flash readings paired with arterial glucose levels, and 89 paired with capillary glucose levels. Using the arterial glucose level as the reference, we found a mean bias of 1.4 mmol/L (limits of agreement, -1.7 to 4.5 mmol/L). The MARD was 14% (95% CI, 12%-16%) and the proportion of measurements meeting ISO and CLSI POCT criteria was 64.3% and 56.8%, respectively. The proportions of values within a low-risk zone on CEG and SEG analyses were 97.8% and 99.5%, respectively. Using capillary glucose levels as the reference, we found that numerical and clinical accuracy were lower. The subcutaneous FreeStyle Libre blood glucose measurement system showed high test-retest reliability and acceptable accuracy when compared with arterial blood glucose measurement in critically ill patients with diabetes.

  16. 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 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

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

    Directory of Open Access Journals (Sweden)

    SMJ Mortazavi

    2014-09-01

    Full Text Available 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.

  18. Continuous glucose monitoring system and new era of early diagnosis of diabetes in high risk groups

    Directory of Open Access Journals (Sweden)

    Ashraf Soliman

    2014-01-01

    Full Text Available Continuous glucose monitoring (CGM systems are an emerging technology that allows frequent glucose measurements to monitor glucose trends in real time. Their use as a diagnostic tool is still developing and appears to be promising. Combining intermittent glucose self-monitoring (SGM and CGM combines the benefits of both. Significant improvement in the treatment modalities that may prevent the progress of prediabetes to diabetes have been achieved recently and dictates screening of high risk patients for early diagnosis and management of glycemic abnormalities. The use of CGMS in the diagnosis of early dysglycemia (prediabetes especially in high risk patients appears to be an attractive approach. In this review we searched the literature to investigate the value of using CGMS as a diagnostic tool compared to other known tools, namely oral glucose tolerance test (OGTT and measurement of glycated hemoglobin (HbA1C in high risk groups. Those categories of patients include adolescents and adults with obesity especially those with family history of type 2 diabetes mellitus, polycystic ovary syndrome (PCO, gestational diabetes, cystic fibrosis, thalassemia major, acute coronary syndrome (ACS, and after renal transplantation. It appears that the ability of the CGMS for frequently monitoring (every 5 min glucose changes during real-life settings for 3 to 5 days stretches the chance to detect more glycemic abnormalities during basal and postprandial conditions compared to other short-timed methods.

  19. Is type 2 diabetes really resolved after laparoscopic sleeve gastrectomy? Glucose variability studied by continuous glucose monitoring.

    Science.gov (United States)

    Capoccia, D; Coccia, F; Guida, A; Rizzello, M; De Angelis, F; Silecchia, G; Leonetti, F

    2015-01-01

    The study was carried out on type 2 diabetic obese patients who underwent laparoscopic sleeve gastrectomy (LSG). Patients underwent regular glycemic controls throughout 3 years and all patients were defined cured from diabetes according to conventional criteria defined as normalization of fasting glucose levels and glycated hemoglobin in absence of antidiabetic therapy. After 3 years of follow-up, Continuous Glucose Monitoring (CGM) was performed in each patient to better clarify the remission of diabetes. In this study, we found that the diabetes resolution after LSG occurred in 40% of patients; in the other 60%, even if they showed a normal fasting glycemia and A1c, patients spent a lot of time in hyperglycemia. During the oral glucose tolerance test (OGTT), we found that 2 h postload glucose determinations revealed overt diabetes only in a small group of patients and might be insufficient to exclude the diagnosis of diabetes in the other patients who spent a lot of time in hyperglycemia, even if they showed a normal glycemia (<140 mg/dL) at 120 minutes OGTT. These interesting data could help clinicians to better individualize patients in which diabetes is not resolved and who could need more attention in order to prevent chronic complications of diabetes.

  20. Nutrient Film Technique (NFT Hydroponic Monitoring System

    Directory of Open Access Journals (Sweden)

    Helmy Helmy

    2016-10-01

    Full Text Available Plant cultivation using hydroponic is very popular today. Nutrient Film Technique (NFT hydroponic system is commonly used by people. It can be applied indoor or outdoor. Plants in this systemneed nutrient solution to grow well. pH, TDS and temperature of the nutrient solution must be check to ensure plant gets sufficient nutrients. This research aims todevelop monitoring system of NFT hydroponic. Farmer will be able to monitor pH, TDS and temperature online. It will ease farmer to decide which plant is suitable to be cultivated and time to boost growth.Delay of the system will be measured to know system performance. Result shows that pH is directly proportional with TDS. Temperature value has no correlation with pH and TDS. System has highest delay during daylight and afternoon but it will decline in the night and morning. Average of delay in the morning is 11 s, 28.5 s in daylight, 32 s in the afternoon and 17.5 s in the night.

  1. 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.

  2. 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...

  3. Continuous glucose monitoring in newborn infants: how do errors in calibration measurements affect detected hypoglycemia?

    OpenAIRE

    Thomas, Felicity Louise; Signal, Mathew; Harris, Deborah L.; Weston, Philip J.; Harding, Jane E.; Shaw, Geoffrey M.; Chase, J. Geoffrey

    2014-01-01

    Neonatal hypoglycemia is common and can cause serious brain injury. Continuous glucose monitoring (CGM) could improve hypoglycemia detection, while reducing blood glucose (BG) measurements. Calibration algorithms use BG measurements to convert sensor signals into CGM data. Thus, inaccuracies in calibration BG measurements directly affect CGM values and any metrics calculated from them. The aim was to quantify the effect of timing delays and calibration BG measurement errors on hypoglycemia me...

  4. The Performance and Usability of a Factory-Calibrated Flash Glucose Monitoring System

    OpenAIRE

    Bailey, Timothy; Bode, Bruce W.; Christiansen, Mark P.; Klaff, Leslie J.; Alva, Shridhara

    2015-01-01

    Abstract Introduction: The purpose of the study was to evaluate the performance and usability of the FreeStyle? Libre? Flash glucose monitoring system (Abbott Diabetes Care, Alameda, CA) for interstitial glucose results compared with capillary blood glucose results. Materials and Methods: Seventy-two study participants with type 1 or type 2 diabetes were enrolled by four U.S. clinical sites. A sensor was inserted on the back of each upper arm for up to 14 days. Three factory-only calibrated s...

  5. 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.

  6. An Integrated Glucose Sensor with an All-Solid-State Sodium Ion-Selective Electrode for a Minimally Invasive Glucose Monitoring System

    Directory of Open Access Journals (Sweden)

    Junko Kojima

    2015-06-01

    Full Text Available We developed a minimally invasive glucose monitoring system that uses a microneedle to permeate the skin surface and a small hydrogel to accumulate interstitial fluid glucose. The measurement of glucose and sodium ion levels in the hydrogel is required for estimating glucose levels in blood; therefore, we developed a small, enzyme-fixed glucose sensor with a high-selectivity, all-solid-state, sodium ion-selective electrode (ISE integrated into its design. The glucose sensor immobilized glucose oxidase showed a good correlation between the glucose levels in the hydrogels and the reference glucose levels (r > 0.99, and exhibited a good precision (coefficient of variation = 2.9%, 0.6 mg/dL. In the design of the sodium ISEs, we used the insertion material Na0.33MnO2 as the inner contact layer and DD16C5 exhibiting high Na+/K+ selectivity as the ionophore. The developed sodium ISE exhibited high selectivity (\\( \\log \\,k^{pot}_{Na,K} = -2.8\\ and good potential stability. The sodium ISE could measure 0.4 mM (10−3.4 M sodium ion levels in the hydrogels containing 268 mM (10−0.57 M KCl. The small integrated sensor (ϕ < 10 mm detected glucose and sodium ions in hydrogels simultaneously within 1 min, and it exhibited sufficient performance for use as a minimally invasive glucose monitoring system.

  7. The Relationship Between a Balanced Time Perspective and Self-monitoring of Blood Glucose Among People With Type 1 Diabetes.

    Science.gov (United States)

    Baird, Harriet M; Webb, Thomas L; Martin, Jilly; Sirois, Fuschia M

    2018-05-10

    Self-monitoring of blood glucose helps people with type 1 diabetes to maintain glycemic control and reduce the risk of complications. However, adherence to blood glucose monitoring is often suboptimal. Like many health behaviors, self-monitoring of blood glucose involves exerting effort in the present to achieve future benefits. As such, the present research explored whether individual differences in time perspective-specifically, the extent to which people have a balanced time perspective-are associated with the frequency with which people with type 1 diabetes monitor their blood glucose and, thus, maintain glycemic control. Adults with type 1 diabetes completed measures of time perspective, feelings associated with monitoring, attitudes toward monitoring, and trait self-control. Objective data regarding the frequency with which participants monitored their blood glucose levels and their long-term glycemic control were extracted from their medical records. Hierarchical regression analyses and tests of indirect effects (N = 129) indicated that having a more balanced time perspective was associated with more frequent monitoring of blood glucose and, as a result, better glycemic control. Further analyses (N = 158) also indicated that there was an indirect relationship between balanced time perspective and monitoring of blood glucose via the feelings that participants associated with monitoring and their subsequent attitudes toward monitoring. These findings point to the importance and relevance of time perspective for understanding health-related behavior and may help to inform interventions designed to promote self-monitoring of blood glucose in people with type 1 diabetes.

  8. Differential Mueller matrix polarimetry technique for non-invasive measurement of glucose concentration on human fingertip.

    Science.gov (United States)

    Phan, Quoc-Hung; Lo, Yu-Lung

    2017-06-26

    A differential Mueller matrix polarimetry technique is proposed for obtaining non-invasive (NI) measurements of the glucose concentration on the human fingertip. The feasibility of the proposed method is demonstrated by detecting the optical rotation angle and depolarization index of tissue phantom samples containing de-ionized water (DI), glucose solutions with concentrations ranging from 0~500 mg/dL and 2% lipofundin. The results show that the extracted optical rotation angle increases linearly with an increasing glucose concentration, while the depolarization index decreases. The practical applicability of the proposed method is demonstrated by measuring the optical rotation angle and depolarization index properties of the human fingertips of healthy volunteers.

  9. Optimization of a Liquid Crystal-based Sensory Platform for Monitoring Enzymatic Glucose Oxidation

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Yibin; Jang, Chang-Hyun [Gachon University, Seongnam (Korea, Republic of)

    2016-05-15

    Managing glucose levels in human blood is extremely important for the treatment of diabetes. Here, an innovative sensory strategy has been developed to monitor the enzymatic activities of glucose and glucose oxidase by using confined liquid crystal (LC) birefringent droplet patterns. Acidic products released during the glucose oxidation process lead to a slight decrease in the pH of aqueous systems that can be monitored by pH-sensitive LC materials. Of the existing pH-sensitive LC materials, dodecanoic acid-doped 4-cyano-4'-pentylbiphenyl is inexpensive and easily adjusted to satisfy the 7.4 ± 0.05 pH requirement of human blood. Moreover, the orientational alignment of capillary-confined pH-responsive LCs can be disrupted at the aqueous/LC interface following a slight decrease in the critical pH of aqueous reaction systems, which results in an optical signal that can be observed with the naked eye by using polarizing optical microscopy. Based on the stable LC droplet patterns generated by the cylindrical confinement system, the functionalized LCs can selectively detect glucose at concentrations as low as 0.1 pM. This study further advances the previously reported LC-based glucose monitoring systems by reducing production costs and instituting a smarter LC sensory design. This improved system shows potential for the use in clinical bioassay applications.

  10. 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

  11. Reproducibility and reliability of hypoglycaemic episodes recorded with Continuous Glucose Monitoring System (CGMS) in daily life

    DEFF Research Database (Denmark)

    Høi-Hansen, T; Pedersen-Bjergaard, U; Thorsteinsson, B

    2005-01-01

    AIM: Continuous glucose monitoring may reveal episodes of unrecognized hypoglycaemia. We evaluated reproducibility and reliability of hypoglycaemic episodes recorded in daily life by the Medtronic MiniMed Continuous Glucose Monitoring System (CGMS). METHODS: Twenty-nine adult patients with Type 1...... data were recalibrated generating four different CGMS data sets [left-A (left side of abdomen, calibration set A), left-B, right-A and right-B]. Agreement between CGMS data sets was evaluated during hypoglycaemic events, comparing CGMS readings = 2.2 mmol/l with nadir values from corresponding CGMS...... data sets. CGMS readings were also compared with independent self-monitored blood glucose (SMBG) values. RESULTS: With hypoglycaemia (CGMS readings = 2.2 mmol/l) in calibration set left-A, values below 3.5 mmol/l were present in 99% (95% CI: 95-100%) of samples in left-B, 91% (95% CI: 84...

  12. In vivo Microscopic Photoacoustic Spectroscopy for Non-Invasive Glucose Monitoring Invulnerable to Skin Secretion Products.

    Science.gov (United States)

    Sim, Joo Yong; Ahn, Chang-Geun; Jeong, Eun-Ju; Kim, Bong Kyu

    2018-01-18

    Photoacoustic spectroscopy has been shown to be a promising tool for non-invasive blood glucose monitoring. However, the repeatability of such a method is susceptible to changes in skin condition, which is dependent on hand washing and drying due to the high absorption of infrared excitation light to the skin secretion products or water. In this paper, we present a method to meet the challenges of mid-infrared photoacoustic spectroscopy for non-invasive glucose monitoring. By obtaining the microscopic spatial information of skin during the spectroscopy measurement, the skin region where the infrared spectra is insensitive to skin condition can be locally selected, which enables reliable prediction of the blood glucose level from the photoacoustic spectroscopy signals. Our raster-scan imaging showed that the skin condition for in vivo spectroscopic glucose monitoring had significant inhomogeneities and large variability in the probing area where the signal was acquired. However, the selective localization of the probing led to a reduction in the effects of variability due to the skin secretion product. Looking forward, this technology has broader applications not only in continuous glucose monitoring for diabetic patient care, but in forensic science, the diagnosis of malfunctioning sweat pores, and the discrimination of tumors extracted via biopsy.

  13. 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...

  14. Measurement of glucose area under the curve using minimally invasive interstitial fluid extraction technology: evaluation of glucose monitoring concepts without blood sampling.

    Science.gov (United States)

    Sato, Toshiyuki; Okada, Seiki; Hagino, Kei; Asakura, Yoshihiro; Kikkawa, Yasuo; Kojima, Junko; Watanabe, Toshihiro; Maekawa, Yasunori; Isobe, Kazuki; Koike, Reona; Nakajima, Hiromu; Asano, Kaoru

    2011-12-01

    Monitoring postprandial hyperglycemia is crucial in treating diabetes, although its dynamics make accurate monitoring difficult. We developed a new technology for monitoring postprandial hyperglycemia using interstitial fluid (ISF) extraction technology without blood sampling. The glucose area under the curve (AUC) using this system was measured as accumulated ISF glucose (IG) with simultaneous calibration with sodium ions. The objective of this study was to evaluate this technological concept in healthy individuals. Minimally invasive ISF extraction technology (MIET) comprises two steps: pretreatment with microneedles and ISF accumulation over a specific time by contact with a solvent. The correlation between glucose and sodium ion levels using MIET was evaluated in 12 subjects with stable blood glucose (BG) levels during fasting. BG and IG time courses were evaluated in three subjects to confirm their relationship while BG was fluctuating. Furthermore, the accuracy of glucose AUC measurements by MIET was evaluated several hours after a meal in 30 subjects. A high correlation was observed between glucose and sodium ion levels when BG levels were stable (R=0.87), indicating that sodium ion is a good internal standard for calibration. The variation in IG and BG with MIET was similar, indicating that IG is an adequate substitute for BG. Finally, we showed a strong correlation (R=0.92) between IG-AUC and BG-AUC after a meal. These findings validate the adequacy of glucose AUC measurements using MIET. Monitoring glucose using MIET without blood sampling may be beneficial to patients with diabetes.

  15. High glycemic variability assessed by continuous glucose monitoring after surgical treatment of obesity by gastric bypass.

    Science.gov (United States)

    Hanaire, Helene; Bertrand, Monelle; Guerci, Bruno; Anduze, Yves; Guillaume, Eric; Ritz, Patrick

    2011-06-01

    Obesity surgery elicits complex changes in glucose metabolism that are difficult to observe with discontinuous glucose measurements. We aimed to evaluate glucose variability after gastric bypass by continuous glucose monitoring (CGM) in a real-life setting. CGM was performed for 4.2 ± 1.3 days in three groups of 10 subjects each: patients who had undergone gastric bypass and who were referred for postprandial symptoms compatible with mild hypoglycemia, nonoperated diabetes controls, and healthy controls. The maximum interstitial glucose (IG), SD of IG values, and mean amplitude of glucose excursions (MAGE) were significantly higher in operated patients and in diabetes controls than in healthy controls. The time to the postprandial peak IG was significantly shorter in operated patients (42.8 ± 6.0 min) than in diabetes controls (82.2 ± 11.1 min, P = 0.0002), as were the rates of glucose increase to the peak (2.4 ± 1.6 vs. 1.2 ± 0.3 mg/mL/min; P = 0.041). True hypoglycemia (glucose fasting state and 2 h postmeal. Glucose variability is exaggerated after gastric bypass, combining unusually high and early hyperglycemic peaks and rapid IG decreases. This might account for postprandial symptoms mimicking hypoglycemia but often seen without true hypoglycemia. Early postprandial hyperglycemia might be underestimated if glucose measurements are done 2 h postmeal.

  16. Development of a nanowire based titanium needle probe sensor for glucose monitoring

    Science.gov (United States)

    Deshpande, Devesh C.

    The need for continuous monitoring of various physiological functions such as blood glucose levels, neural functions and cholesterol levels has fostered the research and development of various schemes of biosensors to sense and help control the respective function. The needs of patients for sensors with minimal discomfort, longer life and better performance have necessitated the development towards smaller and more efficient sensors. In addition, the need for higher functionality from smaller sensors has led to the development of sensors with multiple electrodes, each electrode capable of sensing a different body function. Such multi-electrode sensors need to be fabricated using micro-fabrication processes in order to achieve precise control over the size, shape and placement of the electrodes. Multielectrode sensors fabricated using silicon and polymers have been demonstrated. One physiological function that attracts widespread interest is continuous glucose monitoring in our blood, since Diabetes affects millions of people all over the world. Significant deviations of blood glucose levels from the normal levels of 4-8 mM can cause fainting, coma and damage to the eyes, kidneys, nerves and blood vessels. For chronic patients, continuous monitoring of glucose levels is essential for accurate and timely treatment. A few continuous monitoring sensors are available in the market, but they have problems and cannot replace the strip type one-time glucose monitoring systems as yet. To address this need, large scale research efforts have been targeted towards continuous monitoring. The demand for higher accuracy and sensitivity has motivated researchers to evaluate the use of nanostructures in sensing. The large surface area-to-volume ratio of such structures could enable further miniaturization and push the detection limits, potentially enabling even single molecule detection. This research involved the development of a biocompatible titanium needle probe sensor for

  17. The validation of the Z-Scan technique for the determination of plasma glucose

    Science.gov (United States)

    Alves, Sarah I.; Silva, Elaine A. O.; Costa, Simone S.; Sonego, Denise R. N.; Hallack, Maira L.; Coppini, Ornela L.; Rowies, Fernanda; Azzalis, Ligia A.; Junqueira, Virginia B. C.; Pereira, Edimar C.; Rocha, Katya C.; Fonseca, Fernando L. A.

    2013-11-01

    Glucose is the main energy source for the human body. The concentration of blood glucose is regulated by several hormones including both antagonists: insulin and glucagon. The quantification of glucose in the blood is used for diagnosing metabolic disorders of carbohydrates, such as diabetes, idiopathic hypoglycemia and pancreatic diseases. Currently, the methodology used for this determination is the enzymatic colorimetric with spectrophotometric. This study aimed to validate the use of measurements of nonlinear optical properties of plasma glucose via the Z-Scan technique. For this we used samples of calibrator patterns that simulate commercial samples of patients (ELITech ©). Besides calibrators, serum glucose levels within acceptable reference values (normal control serum - Brazilian Society of Clinical Pathology and Laboratory Medicine) and also overestimated (pathological control serum - Brazilian Society of Clinical Pathology and Laboratory Medicine) were used in the methodology proposal. Calibrator dilutions were performed and determined by the Z-Scan technique for the preparation of calibration curve. In conclusion, Z-Scan method can be used to determinate glucose levels in biological samples with enzymatic colorimetric reaction and also to apply the same quality control parameters used in biochemistry clinical.

  18. New Criteria for Assessing the Accuracy of Blood Glucose Monitors meeting, October 28, 2011.

    Science.gov (United States)

    Walsh, John; Roberts, Ruth; Vigersky, Robert A; Schwartz, Frank

    2012-03-01

    Glucose meters (GMs) are routinely used for self-monitoring of blood glucose by patients and for point-of-care glucose monitoring by health care providers in outpatient and inpatient settings. Although widely assumed to be accurate, numerous reports of inaccuracies with resulting morbidity and mortality have been noted. Insulin dosing errors based on inaccurate GMs are most critical. On October 28, 2011, the Diabetes Technology Society invited 45 diabetes technology clinicians who were attending the 2011 Diabetes Technology Meeting to participate in a closed-door meeting entitled New Criteria for Assessing the Accuracy of Blood Glucose Monitors. This report reflects the opinions of most of the attendees of that meeting. The Food and Drug Administration (FDA), the public, and several medical societies are currently in dialogue to establish a new standard for GM accuracy. This update to the FDA standard is driven by improved meter accuracy, technological advances (pumps, bolus calculators, continuous glucose monitors, and insulin pens), reports of hospital and outpatient deaths, consumer complaints about inaccuracy, and research studies showing that several approved GMs failed to meet FDA or International Organization for Standardization standards in postapproval testing. These circumstances mandate a set of new GM standards that appropriately match the GMs' analytical accuracy to the clinical accuracy required for their intended use, as well as ensuring their ongoing accuracy following approval. The attendees of the New Criteria for Assessing the Accuracy of Blood Glucose Monitors meeting proposed a graduated standard and other methods to improve GM performance, which are discussed in this meeting report. © 2012 Diabetes Technology Society.

  19. Micro-Electromechanical Affinity Sensor for the Monitoring of Glucose in Bioprocess Media

    Directory of Open Access Journals (Sweden)

    Lorenz Theuer

    2017-06-01

    Full Text Available An affinity-viscometry-based micro-sensor probe for continuous glucose monitoring was investigated with respect to its suitability for bioprocesses. The sensor operates with glucose and dextran competing as binding partner for concanavalin A, while the viscosity of the assay scales with glucose concentration. Changes in viscosity are determined with a micro-electromechanical system (MEMS in the measurement cavity of the sensor probe. The study aimed to elucidate the interactions between the assay and a typical phosphate buffered bacterial cultivation medium. It turned out that contact with the medium resulted in a significant long-lasting drift of the assay’s viscosity at zero glucose concentration. Adding glucose to the medium lowers the drift by a factor of eight. The cglc values measured off-line with the glucose sensor for monitoring of a bacterial cultivation were similar to the measurements with an enzymatic assay with a difference of less than ±0.15 g·L−1. We propose that lectin agglomeration, the electro-viscous effect, and constitutional changes of concanavalin A due to exchanges of the incorporated metal ions may account for the observed viscosity increase. The study has demonstrated the potential of the MEMS sensor to determine sensitive viscosity changes within very small sample volumes, which could be of interest for various biotechnological applications.

  20. 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

  1. Tattoo-based noninvasive glucose monitoring: a proof-of-concept study.

    Science.gov (United States)

    Bandodkar, Amay J; Jia, Wenzhao; Yardımcı, Ceren; Wang, Xuan; Ramirez, Julian; Wang, Joseph

    2015-01-06

    We present a proof-of-concept demonstration of an all-printed temporary tattoo-based glucose sensor for noninvasive glycemic monitoring. The sensor represents the first example of an easy-to-wear flexible tattoo-based epidermal diagnostic device combining reverse iontophoretic extraction of interstitial glucose and an enzyme-based amperometric biosensor. In-vitro studies reveal the tattoo sensor's linear response toward physiologically relevant glucose levels with negligible interferences from common coexisting electroactive species. The iontophoretic-biosensing tattoo platform is reduced to practice by applying the device on human subjects and monitoring variations in glycemic levels due to food consumption. Correlation of the sensor response with that of a commercial glucose meter underscores the promise of the tattoo sensor to detect glucose levels in a noninvasive fashion. Control on-body experiments demonstrate the importance of the reverse iontophoresis operation and validate the sensor specificity. This preliminary investigation indicates that the tattoo-based iontophoresis-sensor platform holds considerable promise for efficient diabetes management and can be extended toward noninvasive monitoring of other physiologically relevant analytes present in the interstitial fluid.

  2. Pseudohyperglycemia: Effects of Unwashed Hand after Fruit Peeling or Handling on Fingertips Blood Glucose Monitoring Results.

    Science.gov (United States)

    Olamoyegun, M A; Oloyede, T; Adewoye, O G; Abdulkarim, S O; Adeleke, A A

    2016-01-01

    Self-monitoring of blood glucose (SMBG) is an important component of management for diabetes mellitus (DM), especially in T1DM and T2DM patients who are on insulin therapy. Adequate blood glucose monitoring and prompt intervention are necessary to prevent blood glucose (BG) fluctuation and delay long-term diabetes complications. People with DM are advised to clean their hands before SMBG to remove any dirt or food residue that might affect the reading. The study tested the hypothesis that falsely elevated BG levels from fingertip occur after peeling or handling fruits in an unwashed hand. Fifty apparently healthy nondiabetes volunteers were enrolled. Capillary BG samples were collected from the fingertips after peeling or handling apple, orange, banana, watermelon, and pawpaw, followed by no hand washing for 1 h, cleaning the fingertip with alcohol swab once, five times, and washing hand thoroughly with tap water and drying. These samples were then analyzed with two different glucose meters. The mean BG values, measured from fingertip blood samples after peeling, and handling any of the fruits followed by no hand washing were significantly high, even after cleaning fingertip with a swab of alcohol once. However, there were no significant difference in BG levels measured after peeling and handling fruits followed by hand washing and the level of BG before peeling and handling fruits. Handling of peeled fruits with no hand washing with tap water is associated with overestimation of capillary BG (Pseudohyperglycemia) monitored with glucose meters.

  3. Towards a continuous glucose monitoring system using tunable quantum cascade lasers

    Science.gov (United States)

    Haase, Katharina; Müller, Niklas; Petrich, Wolfgang

    2018-02-01

    We present a reagent-free approach for long-term continuous glucose monitoring (cgm) of liquid samples using midinfrared absorption spectroscopy. This method could constitute an alternative to enzymatic glucose sensors in order to manage the widespread disease of Diabetes. In order to acquire spectra of the liquid specimen, we use a spectrally tunable external-cavity (EC-) quantum cascade laser (QCL) as radiation source in combination with a fiber-based in vitro sensor setup. Hereby we achieve a glucose sensitivity in pure glucose solutions of 3 mg/dL (RMSEP). Furthermore, the spectral tunability of the EC-QCL enables us to discriminate glucose from other molecules. We exemplify this by detecting glucose among other saccharides with an accuracy of 8 mg/dL (within other monosaccharides, RMSEVC) and 14 mg/dL (within other mono- and disaccharides, RMSECV). Moreover, we demonstrate a characterization of the significance of each wavenumber for an accurate prediction of glucose among other saccharides using an evolutionary algorithm. We show, that by picking 10 distinct wavenumbers we can achieve comparable accuracies to the use of a complete spectrum.

  4. Evaluation of two methods of rapid blood-glucose monitoring by unskilled personnel during surgery

    DEFF Research Database (Denmark)

    Madsbad, S; Adelhøj, B; Bigler, Dennis Richard

    1984-01-01

    The accuracy of two rapid methods of blood-glucose monitoring without (Haemo-glucotest 1-44) and with a reflectance meter (Hypocount B) was compared using a laboratory method. The assessment was carried out by personnel with no previous experience in measuring blood glucose. Eighty-five percent...... of the 92 measurements obtained with the hypocount B were within +/- 20% of the laboratory glucose values. Using haemo-glucotest 1-44 strips, 74% of the readings were within +/- 20% of the reference laboratory values. For values below 5.5 mmol/l, there was a tendency for results to be too low, with 77......% of the readings below laboratory values -20%. All situations with severe hypoglycaemia were detected with both strips. The study also demonstrates the ineffectiveness of s.c. insulin regimens during surgery. Only 47% of the measured blood glucose values were within the range of 5.5-10 mmol/l and two of ten...

  5. Hypoglycemia in type 2 diabetes patients treated with insulin: the advantages of continuous glucose monitoring

    Directory of Open Access Journals (Sweden)

    Vadim Valer'evich Klimontov

    2014-03-01

    Full Text Available Aims.  To determine the incidence and risk factors for hypoglycemia in elderly insulin-treated type 2 diabetes mellitus (T2DM patients by means of continuous glucose monitoring (CGM. Materials and Methods.  We observed seventy-six hospitalized patients with T2DM, aged 65 to 79 years. Treatment with basal insulin (n=36, premixed insulin (n=12 or basal-bolus insulin regimen (n=28 was followed by metformin (n=44, glimepiride (n=14 and dipeptidyl peptidase-4 inhibitors (n=14. 2-days CGM with retrospective data analysis was performed in all patients. During CGM, three fasting and three 2-h postprandial finger-prick glucose values were obtained daily with portable glucose meter. Results.  Hypoglycemia (identified as blood glucose

  6. 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 goal setting (P = 0.01), and 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 exercise behavior in individuals living with prediabetes or T2D.

  7. Measuring techniques for continuous monitoring of bioreactors

    Energy Technology Data Exchange (ETDEWEB)

    Kuhlmann, W; Meyer, H D; Schuegerl, K

    1982-01-01

    Control apparatus for fermentation reactors is described. In the example of alcohol fermentation by Saccharomyces cerevisiae, mass spectrometry is used for measuring soluble volatile components (CO/sub 2/, EtOH, and H/sub 2/O) and low-molecular-weight soluble components are separated by cross flow membrane filtration for measurement: D glucose by polarimetry, phosphate by photometry, and NH/sup 4 +/ by potentiometry.

  8. Noninvasive glucose sensing in scattering media using OCT, PAS, and TOF techniques

    Science.gov (United States)

    Alarousu, Erkki; Hast, Jukka T.; Kinnunen, Matti T.; Kirillin, Mikhail Y.; Myllyla, Risto A.; Plucinski, Jerzy; Popov, Alexey P.; Priezzhev, Alexander V.; Prykari, Tuukka; Saarela, Juha; Zhao, Zuomin

    2004-08-01

    In this paper, optical measurement techniques, which enable non-invasive measurement, are superimposed to glucose sensing in scattering media. Used measurement techniques are Optical Coherence Tomography (OCT), Photoacoustic spectroscopy (PAS) and laser pulse Time-of-Flight (TOF) measurement using a streak camera. In parallel with measurements, a Monte-Carlo (MC) simulation models have been developed. Experimental in vitro measurements were performed using Intralipid fat emulsion as a tissue simulating phantom for OCT and TOF measurements. In PAS measurements, a pork meat was used as a subject but also preliminary in vivo measurements were done. OCT measurement results show that the slope of the OCT signal's envelope changes as a function of glucose content in the scattering media. TOF measurements show that the laser pulse full width of half maximum (FWHM) changes a little as function of glucose content. An agreement with MC-simulations and measurements with Intralipid was also found. Measurement results of PAS technique show that changes in glucose content in the pork meat tissue can be measured. In vivo measurements with a human volunteer show that other factors such as physiological change, blood circulation and body temperature drift may interfere the PA response of glucose.

  9. First Clinical Experience with Retrospective Flash Glucose Monitoring (FGM) Analysis in South Africa

    Science.gov (United States)

    Distiller, Larry A.; Cranston, Iain; Mazze, Roger

    2016-01-01

    Background: In 2014, an innovative blinded continuous glucose monitoring system was introduced with automated ambulatory glucose profile (AGP) reporting. The clinical use and interpretation of this new technology has not previously been described. Therefore we wanted to understand its use in characterizing key factors related to glycemic control: glucose exposure, variability, and stability, and risk of hypoglycemia in clinical practice. Methods: Clinicians representing affiliated diabetes centers throughout South Africa were trained and subsequently were given flash glucose monitoring readers and 2-week glucose sensors to use at their discretion. After patient use, sensor data were collected and uploaded for AGP reporting. Results: Complete data (sensor AGP with corresponding clinical information) were obtained for 50 patients with type 1 (70%) and type 2 diabetes (30%), irrespective of therapy. Aggregated analysis of AGP data comparing patients with type 1 versus type 2 diabetes, revealed that despite similar HbA1c values between both groups (8.4 ± 2 vs 8.6 ± 1.7%, respectively), those with type 2 diabetes had lower mean glucose levels (9.2 ± 3 vs 10.3 mmol/l [166 ± 54 vs 185 mg/dl]) and lower indices of glucose variability (3.0 ± 1.5 vs 5.0 ± 1.9 mmol/l [54 ± 27 vs 90 ± 34.2 mg/dl]). This highlights key areas for future focus. Conclusions: Using AGP, the characteristics of glucose exposure, variability, stability, and hypoglycemia risk and occurrence were obtained within a short time and with minimal provider and patient input. In a survey at the time of the follow-up visit, clinicians indicated that aggregated AGP data analysis provided important new clinical information and insights. PMID:27154973

  10. A label-free fiber-optic Turbidity Affinity Sensor (TAS) for continuous glucose monitoring.

    Science.gov (United States)

    Dutt-Ballerstadt, Ralph; Evans, Colton; Pillai, Arun P; Gowda, Ashok

    2014-11-15

    In this paper, we describe the concept of a novel implantable fiber-optic Turbidity Affinity Sensor (TAS) and report on the findings of its in-vitro performance for continuous glucose monitoring. The sensing mechanism of the TAS is based on glucose-specific changes in light scattering (turbidity) of a hydrogel suspension consisting of small particles made of crosslinked dextran (Sephadex G100), and a glucose- and mannose-specific binding protein - Concanavalin A (ConA). The binding of ConA to Sephadex particles results in a significant turbidity increase that is much greater than the turbidity contribution by the individual components. The turbidity of the TAS was measured by determining the intensity of light passing through the suspension enclosed within a small semi-permeable hollow fiber (OD: 220 μm, membrane thickness: 20 μm, molecular weight cut-off: 10 kDa) using fiber optics. The intensity of measured light of the TAS was proportional to the glucose concentration over the concentration range from 50mg/dL to 400mg/dL in PBS and whole blood at 37°C (R>0.96). The response time was approximately 4 min. The stability of the glucose response of the TAS decreased only slightly (by 20%) over an 8-day study period at 37°C. In conclusion, this study demonstrated proof-of-concept of the TAS for interstitial glucose monitoring. Due to the large signal amplitude of the turbidity change, and the lack of need for wavelength-specific emission and excitation filters, a very small, robust and compact TAS device with an extremely short optical pathlength could be feasibly designed and implemented for in-vivo glucose monitoring in people with diabetes. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Self-care among patients enrolled in a self-monitoring blood glucose program

    Directory of Open Access Journals (Sweden)

    Vivian Saraiva Veras

    Full Text Available This cross-sectional study checks specific self-care activities of patients with diabetes mellitus enrolled in a self-monitoring blood glucose program from August to December 2012 in two Primary Health Care units in the interior of São Paulo, Brazil. The sample was composed of 74 female and male individuals, aged 18 years old or older. The Summary of Diabetes Self-Care Activities Questionnaire was used. It contains six dimensions: general diet, specific diet, physical activity, blood glucose monitoring, foot care, medication usage, plus three items about smoking. Eight out of the 15 self-care activities were within desirable levels, namely: healthy diet, not eating sweets, blood glucose testing and as frequently as recommended, drying between toes after washing feet, and taking medications (three items. The results enabled the identification of gaps in specific self-care activities among patients with diabetes mellitus.

  12. Could Continuous Glucose Monitoring Facilitate Identifying Diabetes Patients with a Higher Risk of Hypoglycemia during Driving?

    Czech Academy of Sciences Publication Activity Database

    Brož, J.; Doničová, V.; Brabec, Marek; Janíčková Žďárská, D.; Polák, J.

    2013-01-01

    Roč. 7, č. 6 (2013), s. 1644-1645 ISSN 1932-2968 Institutional support: RVO:67985807 Keywords : continuous glucose monitoring * driving * hypoglycemia * insulin pump * prevention * type 1 diabetes mellitus Subject RIV: BB - Applied Statistics, Operational Research http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3876343/

  13. 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 ...

  14. Accuracy and reliability of continuous glucose monitoring systems: a head-to-head comparison

    NARCIS (Netherlands)

    Luijf, Yoeri M.; Mader, Julia K.; Doll, Werner; Pieber, Thomas; Farret, Anne; Place, Jerome; Renard, Eric; Bruttomesso, Daniela; Filippi, Alessio; Avogaro, Angelo; Arnolds, Sabine; Benesch, Carsten; Heinemann, Lutz; DeVries, J. Hans

    2013-01-01

    This study assessed the accuracy and reliability of three continuous glucose monitoring (CGM) systems. We studied the Animas® (West Chester, PA) Vibe™ with Dexcom® (San Diego, CA) G4™ version A sensor (G4A), the Abbott Diabetes Care (Alameda, CA) Freestyle® Navigator I (NAV), and the Medtronic

  15. Continuous glucose monitoring-enabled insulin-pump therapy in diabetic pregnancy

    DEFF Research Database (Denmark)

    Secher, Anna L; Schmidt, Signe; Nørgaard, Kirsten

    2010-01-01

    We describe the feasibility of continuous glucose monitoring (CGM)-enabled insulin-pump therapy during pregnancy in a woman with type 1 diabetes, who was treated with CGM-enabled insulin-pump therapy in her third pregnancy. During her first pregnancy, the woman was treated with multiple daily inj...

  16. 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

  17. Comparison of the clinical information provided by the FreeStyle Navigator continuous interstitial glucose monitor versus traditional blood glucose readings.

    Science.gov (United States)

    McGarraugh, Geoffrey V; Clarke, William L; Kovatchev, Boris P

    2010-05-01

    The purpose of the analysis was to compare the clinical utility of data from traditional self-monitoring of blood glucose (SMBG) to that of continuous glucose monitoring (CGM). A clinical study of the clinical accuracy of the FreeStyle Navigator CGM System (Abbott Diabetes Care, Alameda, CA), which includes SMBG capabilities, was conducted by comparison to the YSI blood glucose analyzer (YSI Inc., Yellow Springs, OH) using 58 subjects with type 1 diabetes. The Continuous Glucose-Error Grid Analysis (CG-EGA) was used as the analytical tool. Using CG-EGA, the "clinically accurate," "benign errors," and "clinical errors" were 86.8%, 8.7%, and 4.5% for SMBG and 92.7%, 3.7%, and 3.6% for CGM, respectively. If blood glucose is viewed as a process in time, SMBG would provide accurate information about this process 86.8% of the time, whereas CGM would provide accurate information about this process 92.7% of the time (P glucose values than CGM, control of blood glucose involves a system in flux, and CGM provides more detailed insight into the dynamics of that system. In the normal and elevated glucose ranges, the additional information about the direction and rate of glucose change provided by the FreeStyle Navigator CGM System increases the ability to make correct clinical decisions when compared to episodic SMBG tests.

  18. [Designing and implementation of a web-based quality monitoring system for plasma glucose measurement in multicenter population study].

    Science.gov (United States)

    Liu, Yong; Wang, Limin; Pang, Richard; Mo, Nanxun; Hu, Yan; Deng, Qian; Hu, Zhaohui

    2015-05-01

    The aim of this paper is to describe the designing and implementation of a web-based plasma glucose measurement quality monitoring system to assess the analytical quality of plasma glucose measurements in multicenter population study and provide evidence for the future studies. In the chronic non-communicable disease and related factor surveillance in China, a web based quality monitoring system for plasma glucose measurement was established to conduct evaluation on plasma glucose monitoring quality and effectiveness in 302 surveillance centers, including quality control data entry, transmission and feedback. The majority of the surveillance centers met the quality requirements and passed the evaluation of reproducibility and precision of plasma glucose measurement, only a few centers required intensive training and re-assessment. In order to ensure the completeness and reliability of plasma glucose measurement in the surveillance centers, the establishment of web-based plasma glucose measurement quality control system can facilitate the identification of the qualified surveillance centers and evaluation of plasma glucose measurement quality in different regions. Communication and training are important in ensuring plasma glucose measurement quality. It is necessary to further improve this web-based plasma glucose measurement quality monitoring system in the future to reduce the method specific plasma glucose measurement bias.

  19. The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy

    DEFF Research Database (Denmark)

    Battelino, T; Conget, I; Olsen, B

    2012-01-01

    The aim of this multicentre, randomised, controlled crossover study was to determine the efficacy of adding continuous glucose monitoring (CGM) to insulin pump therapy (CSII) in type 1 diabetes.......The aim of this multicentre, randomised, controlled crossover study was to determine the efficacy of adding continuous glucose monitoring (CGM) to insulin pump therapy (CSII) in type 1 diabetes....

  20. Innovative Remote Sensing techniques for vegetation monitoring

    International Nuclear Information System (INIS)

    Borfecchia, F.; De Cecco, L.; Della Rocca, A.B.; Farneti, A.; La Porta, L.; Martini, S.; Giordano, L.; Trotta, C.; Marcoccia, S.

    2008-01-01

    This paper describes methods developed for using ASPIS (Advanced Spectroscopic Imaging System) to monitor biophysical parameters in studying the effects of climatic change, desertification and land degradation on semi-natural and agricultural vegetation in the Mediterranean region [it

  1. Fluorescent blood glucose monitor by hemin-functionalized graphene quantum dots based sensing system

    Energy Technology Data Exchange (ETDEWEB)

    He, Yuezhen; Wang, Xiaoxun; Sun, Jian; Jiao, Shoufeng; Chen, Hongqi; Gao, Feng; Wang, Lun, E-mail: wanglun@mail.ahnu.edu.cn

    2014-01-31

    Graphical abstract: -- Highlights: •Hemin is assembled onto the surfaces of graphene quantum dots (GQDs). •With the aid of hemin, H{sub 2}O{sub 2} could quench the FL signal of GQDs obviously. •Based on this effect, a fluorescent platform is proposed for the sensing of glucose. •The proposed method provides a new pathway to explore practical application of GQDs. -- Abstract: In the present work, a highly sensitive and specific fluorescent biosensor for blood glucose monitoring is developed based on hemin-functionalized graphene quantum dots (GQDs) and glucose oxidase (GOx) system. The GQDs which are simply prepared by pyrolyzing citric acid exhibit strong fluorescence and good water-solubility. Due to the noncovalent assembly between hemin and GQDs, the addition of hemin can make hydrogen peroxide (H{sub 2}O{sub 2}) to destroy the passivated surface of GQDs, leading to significant fluorescence quenching of GQDs. Based on this effect, a novel fluorescent platform is proposed for the sensing of glucose. Under the optimized conditions, the linear range of glucose is from 9 to 300 μM, and the limit of detection is 0.1 μM. As unique properties of GQDs, the proposed biosensor is green, simple, cost-efficient, and it is successfully applied to the determination of glucose in human serum. In addition, the proposed method provides a new pathway to further design the biosensors based on the assembly of GQDs with hemin for detection of biomolecules.

  2. A contact lens with integrated telecommunication circuit and sensors for wireless and continuous tear glucose monitoring

    International Nuclear Information System (INIS)

    Yao, H; Liao, Y; Lingley, A R; Afanasiev, A; Lähdesmäki, I; Otis, B P; Parviz, B A

    2012-01-01

    We present an integrated functional contact lens, composed of a differential glucose sensor module, metal interconnects, sensor read-out circuit, antenna and telecommunication circuit, to monitor tear glucose levels wirelessly, continuously and non-invasively. The electrochemical differential sensor module is based on immobilization of activated and de-activated glucose oxidase. We characterized the sensor on a model polymer eye and determined that it showed good repeatability, molecular interference rejection and linearity in the range of 0–2 mM glucose, covering normal tear glucose concentrations (0.1–0.6 mM). We also report the temperature, ageing and protein-fouling sensitivity of the sensor. We report the design and implementation of a low-power (3 µW) sensor read-out and telecommunication circuit to deliver wireless power and transmit data for the sensor module. Using this small chip (0.36 mm 2 ), we produced an integrated contact lens with sensors and demonstrated wireless operation of the system and glucose read-out over the distance of several centimeters. (paper)

  3. Remote Blood Glucose Monitoring in mHealth Scenarios: A Review

    Directory of Open Access Journals (Sweden)

    Giordano Lanzola

    2016-11-01

    Full Text Available Glucose concentration in the blood stream is a critical vital parameter and an effective monitoring of this quantity is crucial for diabetes treatment and intensive care management. Effective bio-sensing technology and advanced signal processing are therefore of unquestioned importance for blood glucose monitoring. Nevertheless, collecting measurements only represents part of the process as another critical task involves delivering the collected measures to the treating specialists and caregivers. These include the clinical staff, the patient’s significant other, his/her family members, and many other actors helping with the patient treatment that may be located far away from him/her. In all of these cases, a remote monitoring system, in charge of delivering the relevant information to the right player, becomes an important part of the sensing architecture. In this paper, we review how the remote monitoring architectures have evolved over time, paralleling the progress in the Information and Communication Technologies, and describe our experiences with the design of telemedicine systems for blood glucose monitoring in three medical applications. The paper ends summarizing the lessons learned through the experiences of the authors and discussing the challenges arising from a large-scale integration of sensors and actuators.

  4. Accuracy evaluation of contour next compared with five blood glucose monitoring systems across a wide range of blood glucose concentrations occurring in a clinical research setting.

    Science.gov (United States)

    Klaff, Leslie J; Brazg, Ronald; Hughes, Kristen; Tideman, Ann M; Schachner, Holly C; Stenger, Patricia; Pardo, Scott; Dunne, Nancy; Parkes, Joan Lee

    2015-01-01

    This study evaluated the accuracy of Contour(®) Next (CN; Bayer HealthCare LLC, Diabetes Care, Whippany, NJ) compared with five blood glucose monitoring systems (BGMSs) across a wide range of clinically occurring blood glucose levels. Subjects (n=146) were ≥ 18 years and had type 1 or type 2 diabetes. Subjects' glucose levels were safely lowered or raised to provide a wide range of glucose values. Capillary blood samples were tested on six BGMSs and a YSI glucose analyzer (YSI Life Sciences, Inc., Yellow Springs, OH) as the reference. Extreme glucose values were achieved by glucose modification of the blood sample. System accuracy was assessed by mean absolute difference (MAD) and mean absolute relative difference (MARD) across several glucose ranges, with glucose range (Abbott Diabetes Care, Inc., Alameda, CA), 2.77 mg/dL; OneTouch(®) Ultra(®) 2 (LifeScan, Inc., Milpitas, CA), 10.20 mg/dL; OneTouch(®) Verio(®) Pro (LifeScan, Inc.), 4.53 mg/dL; and Truetrack(®) (Nipro Diagnostics, Inc., Fort Lauderdale, FL), 11.08 mg/dL. The lowest MAD in the low glucose range, from CN, was statistically significantly lower than those of the other BGMSs with the exception of the FSL. CN also had a statistically significantly lower MARD than all other BGMSs in the low glucose range. In the overall glucose range (21-496 mg/dL), CN yielded the lowest MAD and MARD values, which were statistically significantly lower in comparison with the other BGMSs. When compared with other BGMSs, CN demonstrated the lowest mean deviation from the reference value (by MAD and MARD) across multiple glucose ranges.

  5. Assessment of three frequently used blood glucose monitoring devices in clinical routine.

    Science.gov (United States)

    Zueger, Thomas; Schuler, Vanessa; Stettler, Christoph; Diem, Peter; Christ, Emanuel R

    2012-07-12

    Self-monitoring of blood glucose plays an important role in the management of diabetes and has been shown to improve metabolic control. The use of blood glucose meters in clinical practice requires sufficient reliability to allow adequate treatment. Direct comparison of different blood glucose meters in clinical practice, independent of the manufactures is scarce. We, therefore, aimed to evaluate three frequently used blood glucose meters in daily clinical practice. Capillary blood glucose was measured simultaneous using the following glucose meters: Contour® (Bayer Diabetes Care, Zürich, Switzerland), Accu-Chek® aviva (Roche Diagnostics, Rotkreuz, Switzerland), Free-Style® lite (Abbott Diabetes Care, Baar, Switzerland). The reference method consisted of the HemoCue® Glucose 201+ System (HemoCue® AB, Ängelholm, Sweden) with plasma conversion. The devices were assessed by comparison of the Mean Absolute Relative Differences (MARD), the Clarke Error Grid Analysis (EGA) and the compliance with the International Organization of Standardization criteria (ISO 15197:2003). Capillary blood samples were obtained from 150 patients. MARD was 10.1 ± 0.65%, 7.0 ± 0.62% and 7.8 ± 0.48% for Contour®, Accu-Chek® and Free-Style®, respectively. EGA showed 99.3% (Contour®), 98.7% (Accu-Chek®) and 100% (Free-Style®) of all measurements in zone A and B (clinically acceptable). The ISO criteria were fulfilled by Accu-Chek® (95.3%) and Free-Style® (96%), but not by Contour® (92%). In the present study the three glucose meters provided good agreement with the reference and reliable results in daily clinical routine. Overall, the Free-Style® and Accu-Chek® device slightly outperformed the Contour® device.

  6. Hematocrit correction does not improve glucose monitor accuracy in the assessment of neonatal hypoglycemia.

    Science.gov (United States)

    Wang, Li; Sievenpiper, John L; de Souza, Russell J; Thomaz, Michele; Blatz, Susan; Grey, Vijaylaxmi; Fusch, Christoph; Balion, Cynthia

    2013-08-01

    The lack of accuracy of point of care (POC) glucose monitors has limited their use in the diagnosis of neonatal hypoglycemia. Hematocrit plays an important role in explaining discordant results. The objective of this study was to to assess the effect of hematocrit on the diagnostic performance of Abbott Precision Xceed Pro (PXP) and Nova StatStrip (StatStrip) monitors in neonates. All blood samples ordered for laboratory glucose measurement were analyzed using the PXP and StatStrip and compared with the laboratory analyzer (ABL 800 Blood Gas analyzer [ABL]). Acceptable error targets were ±15% for glucose monitoring and ±5% for diagnosis. A total of 307 samples from 176 neonates were analyzed. Overall, 90% of StatStrip and 75% of PXP values met the 15% error limit and 45% of StatStrip and 32% of PXP values met the 5% error limit. At glucose concentrations ≤4 mmol/L, 83% of StatStrip and 79% of PXP values met the 15% error limit, while 37% of StatStrip and 38% of PXP values met the 5% error limit. Hematocrit explained 7.4% of the difference between the PXP and ABL whereas it accounted for only 0.09% of the difference between the StatStrip and ABL. The ROC analysis showed the screening cut point with the best performance for identifying neonatal hypoglycemia was 3.2 mmol/L for StatStrip and 3.3 mmol/L for PXP. Despite a negligible hematocrit effect for the StatStrip, it did not achieve recommended error limits. The StatStrip and PXP glucose monitors remain suitable only for neonatal hypoglycemia screening with confirmation required from a laboratory analyzer.

  7. Monitoring beach changes using GPS surveying techniques

    Science.gov (United States)

    Morton, Robert; Leach, Mark P.; Paine, Jeffrey G.; Cardoza, Michael A.

    1993-01-01

    A need exists for frequent and prompt updating of shoreline positions, rates of shoreline movement, and volumetric nearshore changes. To effectively monitor and predict these beach changes, accurate measurements of beach morphology incorporating both shore-parallel and shore-normal transects are required. Although it is possible to monitor beach dynamics using land-based surveying methods, it is generally not practical to collect data of sufficient density and resolution to satisfy a three-dimensional beach-change model of long segments of the coast. The challenge to coastal scientists is to devise new beach monitoring methods that address these needs and are rapid, reliable, relatively inexpensive, and maintain or improve measurement accuracy.

  8. Self-monitoring of blood glucose in diabetes mellitus: arguments for an individualized approach.

    Science.gov (United States)

    Nauck, Michael A; El-Ouaghlidi, Andrea; Vardarli, Irfan

    2009-09-01

    The utility of glucose self-monitoring in different types and stages of diabetes is controversial, as there is only sparse relevant evidence from randomized controlled clinical trials. In this analysis, the authors aim to develop individualized recommendations based on clinical needs and the available literature. The PubMed database was searched for articles that appeared up to 30 September 2008 containing the terms "measurement," "control","monitoring," and "hypoglycemia"; the retrieved articles were supplemented by other articles that were cited in them. A directed search was also made for the recommendations of the German, European, American, and international diabetological societies. Conclusions were then drawn about the useful modalities and extent of glucose self-monitoring on the basis of the clinical features of the major types of diabetes and the main treatment strategies for them. With the exception of intensified treatment strategies (which rely on blood-sugar regulation with insulin), only a few evidence-based recommendations can be derived from randomized clinical trials and meta-analyses. Nonetheless, a strategy for self-monitoring according to the patient's individual needs can be derived from the characteristics of therapeutic regimens: depending on the type of diabetes from which the patient suffers, the predicted number of glucometer strips required for self-monitoring will vary from almost none to roughly 400 per month. The decision to use glucose self-monitoring, as well as the type and extent of self-monitoring that will be used, should be based on the individual patient's type of diabetes, treatment regimen, and clinical characteristics. Like any other type of therapeutic intervention, self-monitoring should have a well-documented, rational justification.

  9. Monitoring of Glucose in Beer Brewing by a Carbon Nanotubes Based Nylon Nanofibrous Biosensor

    Directory of Open Access Journals (Sweden)

    Marco Mason

    2016-01-01

    Full Text Available This work presents the design, preparation, and characterization of a novel glucose electrochemical biosensor based on the immobilization of glucose oxidase (GOX into a nylon nanofibrous membrane (NFM prepared by electrospinning and functionalized with multiwalled carbon nanotubes (CNT. A disc of such GOX/CNT/NFM membrane (40 μm in thickness was used for coating the surface of a glassy carbon electrode. The resulting biosensor was characterized by cyclic voltammetry and chronoamperometry, with ferrocene methanol as mediator. The binding of GOX around the CNT/NFM greatly enhances the electron transfer, which results in a biosensor with a current five times higher than without CNT. The potential usefulness of the proposed biosensor was demonstrated with the analysis of glucose in commercial beverages and along the monitoring of the brewing process for making beer, from the mashing to the fermentation steps.

  10. Flash Glucose Monitoring: Differences Between Intermittently Scanned and Continuously Stored Data.

    Science.gov (United States)

    Pleus, Stefan; Kamecke, Ulrike; Link, Manuela; Haug, Cornelia; Freckmann, Guido

    2018-03-01

    The flash glucose monitoring system FreeStyle Libre (Abbott Diabetes Care Ltd., Witney, UK) measures interstitial glucose concentrations and continuously stores measurement values every 15 minutes. To obtain a current glucose reading, users have to scan the sensor with the reader. In a clinical trial, 5% of the scanned data showed relative differences of more than ±10% compared with continuously stored data points (median -0.5%). Such differences might impact results of studies using this system. It should be indicated whether scanned or continuously stored data were used for analyses. Health care professionals might have to differentiate between data reports from clinical software and the scanned data their patients are provided with. Additional information on these differences and their potential impact on therapeutic decisions would be helpful.

  11. Automated integration of continuous glucose monitor data in the electronic health record using consumer technology.

    Science.gov (United States)

    Kumar, Rajiv B; Goren, Nira D; Stark, David E; Wall, Dennis P; Longhurst, Christopher A

    2016-05-01

    The diabetes healthcare provider plays a key role in interpreting blood glucose trends, but few institutions have successfully integrated patient home glucose data in the electronic health record (EHR). Published implementations to date have required custom interfaces, which limit wide-scale replication. We piloted automated integration of continuous glucose monitor data in the EHR using widely available consumer technology for 10 pediatric patients with insulin-dependent diabetes. Establishment of a passive data communication bridge via a patient's/parent's smartphone enabled automated integration and analytics of patient device data within the EHR between scheduled clinic visits. It is feasible to utilize available consumer technology to assess and triage home diabetes device data within the EHR, and to engage patients/parents and improve healthcare provider workflow. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  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. Nanotechnology in glucose monitoring: advances and challenges in the last 10 years.

    Science.gov (United States)

    Scognamiglio, Viviana

    2013-09-15

    In the last decades, a wide multitude of research activity has been focused on the development of biosensors for glucose monitoring, devoted to overcome the challenges associated with smart analytical performances with commercial implications. Crucial issues still nowadays elude biosensors to enter the market, such as sensitivity, stability, miniaturisation, continuous and in situ monitoring in a complex matrix. A noteworthy tendency of biosensor technology is likely to push towards nanotechnology, which allows to reduce dimensions at the nanoscale, consenting the construction of arrays for high throughput analysis with the integration of microfluidics, and enhancing the performance of the biological components by using new nanomaterials. This review aims to highlight current trends in biosensors for glucose monitoring based on nanotechnology, reporting widespread representative examples of the recent approaches for nanobiosensors over the past 10 years. Progress in nanotechnology for the development of biosensing systems for blood glucose level monitoring will be discussed, in view of their design and construction on the bases of the new materials offered by nanotechnology. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Simultaneous Monitoring of Glucose and Lactate by Self-powered Biosensor

    Directory of Open Access Journals (Sweden)

    Ankit Baingane

    2017-07-01

    Full Text Available A dual self-powered biosensing system integrated with energy amplification circuit is described, for simultaneously monitoring glucose and lactate. The self-powered biosensing system is based on the conventional enzymatic biofuel cell equipped with three 4 mm x 4 mm massively dense mesh network of multi-walled carbon nanotubes (MWCNTs bioelectrodes in parallel configuration. The bioelectrodes employed pyroquinoline quinone glucose dehydrogenase (PQQ-GDH as the biocatalyst for the glucose oxidation and D-Lactate dehydrogenase (D-LDH as the biocatalyst for lactate oxidation. A common laccase modified-MWCNTs bioelectrode served as the cathode for the reduction of molecular oxygen. Two charge pump circuits were coupled with 0.1 mF capacitors functioning as transducers. The advantages of employing capacitors were coupled with the efficient energy amplification of the charge pump circuit to amplify the power output from each of the biofuel and charge/discharge the corresponding capacitor. Under operating conditions, the open circuit voltages and short circuit current densities for 180 mg/dL glucose and 25 mM lactate were 339.2 mV and 228.75 µA/cm2 and 370 mV and 66.17 µA/cm2, respectively. The responses for glucose and lactate were linear up to 630 mg/dL and 30 mM with sensitivities of 20.11 Hz/ mM cm-2 and 9.869 Hz/ mM cm-2, respectively. The potential of the described system was demonstrated to provide stable voltage and current output that was capable of driving the charge pump circuit integrated with the capacitor for simultaneously monitoring glucose and lactate. These results were in good agreement with those previously reported.

  15. Ambient and Unobtrusive Cardiorespiratory Monitoring Techniques.

    Science.gov (United States)

    Bruser, Christoph; Antink, Christoph Hoog; Wartzek, Tobias; Walter, Marian; Leonhardt, Steffen

    2015-01-01

    Monitoring vital signs through unobtrusive means is a goal which has attracted a lot of attention in the past decade. This review provides a systematic and comprehensive review over the current state of the field of ambient and unobtrusive cardiorespiratory monitoring. To this end, nine different sensing modalities which have been in the focus of current research activities are covered: capacitive electrocardiography, seismo- and ballistocardiography, reflective photoplethysmography (PPG) and PPG imaging, thermography, methods relying on laser or radar for distance-based measurements, video motion analysis, as well as methods using high-frequency electromagnetic fields. Current trends in these subfields are reviewed. Moreover, we systematically analyze similarities and differences between these methods with respect to the physiological and physical effects they sense as well as the resulting implications. Finally, future research trends for the field as a whole are identified.

  16. Exploiting Analytics Techniques in CMS Computing Monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Bonacorsi, D. [Bologna U.; Kuznetsov, V. [Cornell U.; Magini, N. [Fermilab; Repečka, A. [Vilnius U.; Vaandering, E. [Fermilab

    2017-11-22

    The CMS experiment has collected an enormous volume of metadata about its computing operations in its monitoring systems, describing its experience in operating all of the CMS workflows on all of the Worldwide LHC Computing Grid Tiers. Data mining efforts into all these information have rarely been done, but are of crucial importance for a better understanding of how CMS did successful operations, and to reach an adequate and adaptive modelling of the CMS operations, in order to allow detailed optimizations and eventually a prediction of system behaviours. These data are now streamed into the CERN Hadoop data cluster for further analysis. Specific sets of information (e.g. data on how many replicas of datasets CMS wrote on disks at WLCG Tiers, data on which datasets were primarily requested for analysis, etc) were collected on Hadoop and processed with MapReduce applications profiting of the parallelization on the Hadoop cluster. We present the implementation of new monitoring applications on Hadoop, and discuss the new possibilities in CMS computing monitoring introduced with the ability to quickly process big data sets from mulltiple sources, looking forward to a predictive modeling of the system.

  17. Monitoring power breakers using vibro acoustic techniques

    Directory of Open Access Journals (Sweden)

    Horia Balan

    2017-09-01

    Full Text Available Speaking about the commutation’s equipment, it can be said that the best solution in increasing reliability and lowering the maintenance costs is a continuous monitoring of the equipment. However, if the price/quality ratio is considered, it is obvious that, for the moment, the diagnosis can be also an acceptable solution. Nowadays the predictive maintenance for equipment’s diagnosis is currently replacing the preventive diagnosis. An efficient modality of lowering the maintenance costs is to online monitoring the power breakers, during their operation in the power systems. Consequently any connecting/disconnecting operations may be used in diagnosing a power breaker. Thus any supplementary and superfluous tests and/or maintenance maneuvers are avoided. The paper presents the operational maintenance in a power station with three high voltage active breakers, Areva type. The method of establishing the state of a breaker consists in the comparison between the signature of the acoustic signal provided by the manufacturer and the signal issued from the testing operation of the breaker’s state. The software processing procedure and the methodology of determining the faults of the monitored equipment are also developed. All the tests on the circuit breaker are made according the prescriptions of normative.

  18. Use of continuous glucose monitoring as an outcome measure in clinical trials.

    Science.gov (United States)

    Beck, Roy W; Calhoun, Peter; Kollman, Craig

    2012-10-01

    Although developed to be a management tool for individuals with diabetes, continuous glucose monitoring (CGM) also has potential value for the assessment of outcomes in clinical studies. We evaluated using CGM as such an outcome measure. Data were analyzed from six previously completed inpatient studies in which both CGM (Freestyle Navigator™ [Abbott Diabetes Care, Alameda, CA] or Guardian(®) [Medtronic, Northridge, CA]) and reference glucose measurements were available. The analyses included 97 days of data from 93 participants with type 1 diabetes (age range, 5-57 years; mean, 18 ± 12 years). Mean glucose levels per day were similar for the CGM and reference measurements (median, 148 mg/dL vs. 143 mg/dL, respectively; P = 0.92), and the correlation of the two was high (r = 0.89). Similarly, most glycemia metrics showed no significant differences comparing CGM and reference values, except that the nadir glucose tended to be slightly lower and peak glucose slightly higher with reference measurements than CGM measurements (respective median, 59 mg/dL vs. 66 mg/dL [P = 0.05] and 262 mg/dL vs. 257 mg/dL [P = 0.003]) and glucose variability as measured with the coefficient of variation was slightly lower with CGM than reference measurements (respective median, 31% vs. 35%; Pblood glucose measurements. CGM inaccuracy and underestimation of the extremes of hyperglycemia and hypoglycemia can be accounted for in a clinical trial's study design. Thus, in appropriate settings, CGM can be a very meaningful and feasible outcome measure for clinical trials.

  19. An In-Line Photonic Biosensor for Monitoring of Glucose Concentrations

    Directory of Open Access Journals (Sweden)

    Ala'aldeen Al-Halhouli

    2014-08-01

    Full Text Available This paper presents two PDMS photonic biosensor designs that can be used for continuous monitoring of glucose concentrations. The first design, the internally immobilized sensor, consists of a reactor chamber, micro-lenses and self-alignment structures for fiber optics positioning. This sensor design allows optical detection of glucose concentrations under continuous glucose flow conditions of 33 µL/h based on internal co-immobilization of glucose oxidase (GOX and horseradish peroxidase (HRP on the internal PDMS surface of the reactor chamber. For this design, two co-immobilization methods, the simple adsorption and the covalent binding (PEG methods were tested. Experiments showed successful results when using the covalent binding (PEG method, where glucose concentrations up to 5 mM with a coefficient of determination (R2 of 0.99 and a limit of detection of 0.26 mM are detectable. The second design is a modified version of the internally immobilized sensor, where a microbead chamber and a beads filling channel are integrated into the sensor. This modification enabled external co-immobilization of enzymes covalently onto functionalized silica microbeads and allows binding a huge amount of HRP and GOX enzymes on the microbeads surfaces which increases the interaction area between immobilized enzymes and the analyte. This has a positive effect on the amount and rate of chemical reactions taking place inside the chamber. The sensor was tested under continuous glucose flow conditions and was found to be able to detect glucose concentrations up to 10 mM with R2 of 0.98 and a limit of detection of 0.7 mM. Such results are very promising for the application in photonic LOC systems used for online analysis.

  20. Professional flash continuous glucose monitoring as a supplement to A1C in primary care.

    Science.gov (United States)

    Hirsch, Irl B

    2017-11-01

    Decreasing glycated hemoglobin (A1C) is the primary goal of current diabetes management due to intervention studies in type 1 and type 2 diabetes associating levels <7.0% (53 mmol/mol) with lower complication risk. Strategic self-monitoring of blood glucose (SMBG) is also recommended to achieve greater time in range, with fewer extremes of hypo- or hyperglycemia. Unlike A1C, SMBG can distinguish among fasting, prandial, and postprandial hyperglycemia; uncover glycemic variability, including potentially dangerous hypoglycemia; and provide feedback to patients about the effects of behavior and medication on glycemic control. However, it has the drawback of capturing only static glucose readings and users are often dependent on time-pressed clinicians to interpret numerous data points. A novel flash continuous glucose monitoring (FCGM) device used for a single 2-week period with a readily interpretable data report know as the ambulatory glucose profile (AGP) has the potential to overcome limitations of conventional technologies, with less cost and greater convenience. This review summarizes the rationale for using intermittent FCGM as a supplement to A1C in primary care, and provides a stepwise approach to interpreting the AGP visual display for efficient individualized therapy.

  1. Practical implementation, education and interpretation guidelines for continuous glucose monitoring: A French position statement.

    Science.gov (United States)

    Borot, S; Benhamou, P Y; Atlan, C; Bismuth, E; Bonnemaison, E; Catargi, B; Charpentier, G; Farret, A; Filhol, N; Franc, S; Gouet, D; Guerci, B; Guilhem, I; Guillot, C; Jeandidier, N; Joubert, M; Melki, V; Merlen, E; Penfornis, A; Picard, S; Renard, E; Reznik, Y; Riveline, J P; Rudoni, S; Schaepelynck, P; Sola-Gazagnes, A; Tubiana-Rufi, N; Verier-Mine, O; Hanaire, H

    2018-02-01

    The use by diabetes patients of real-time continuous interstitial glucose monitoring (CGM) or the FreeStyle Libre ® (FSL) flash glucose monitoring (FGM) system is becoming widespread and has changed diabetic practice. The working group bringing together a number of French experts has proposed the present practical consensus. Training of professionals and patient education are crucial for the success of CGM. Also, institutional recommendations must pay particular attention to the indications for and reimbursement of CGM devices in populations at risk of hypoglycaemia. The rules of good practice for CGM are the precursors of those that need to be enacted, given the oncoming emergence of artificial pancreas devices. It is necessary to have software combining user-friendliness, multiplatform usage and average glucose profile (AGP) presentation, while integrating glucose and insulin data as well as events. Expression of CGM data must strive for standardization that facilitates patient phenotyping and their follow-up, while integrating indicators of variability. The introduction of CGM involves a transformation of treatment support, rendering it longer and more complex as it also includes specific educational and technical dimensions. This complexity must be taken into account in discussions of organization of diabetes care. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  2. Different methods and settings for glucose monitoring for gestational diabetes during pregnancy.

    Science.gov (United States)

    Raman, Puvaneswary; Shepherd, Emily; Dowswell, Therese; Middleton, Philippa; Crowther, Caroline A

    2017-10-29

    Incidence of gestational diabetes mellitus (GDM) is increasing worldwide. Blood glucose monitoring plays a crucial part in maintaining glycaemic control in women with GDM and is generally recommended by healthcare professionals. There are several different methods for monitoring blood glucose which can be carried out in different settings (e.g. at home versus in hospital). The objective of this review is to compare the effects of different methods and settings for glucose monitoring for women with GDM on maternal and fetal, neonatal, child and adult outcomes, and use and costs of health care. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (30 September 2016) and reference lists of retrieved studies. Randomised controlled trials (RCTs) or quasi-randomised controlled trials (qRCTs) comparing different methods (such as timings and frequencies) or settings, or both, for blood glucose monitoring for women with GDM. Two authors independently assessed study eligibility, risk of bias, and extracted data. Data were checked for accuracy.We assessed the quality of the evidence for the main comparisons using GRADE, for:- primary outcomes for mothers: that is, hypertensive disorders of pregnancy; caesarean section; type 2 diabetes; and- primary outcomes for children: that is, large-for-gestational age; perinatal mortality; death or serious morbidity composite; childhood/adulthood neurosensory disability;- secondary outcomes for mothers: that is, induction of labour; perineal trauma; postnatal depression; postnatal weight retention or return to pre-pregnancy weight; and- secondary outcomes for children: that is, neonatal hypoglycaemia; childhood/adulthood adiposity; childhood/adulthood type 2 diabetes. We included 11 RCTs (10 RCTs; one qRCT) that randomised 1272 women with GDM in upper-middle or high-income countries; we considered these to be at a moderate to high risk of bias. We assessed the RCTs under five comparisons. For outcomes assessed using

  3. HBA1C AND MEAN GLUCOSE DERIVED FROM SHORT-TERM CONTINUOUS GLUCOSE MONITORING ASSESSMENT DO NOT CORRELATE IN PATIENTS WITH HBA1C >8.

    Science.gov (United States)

    Yamada, Eijiro; Okada, Shuichi; Nakajima, Yasuyo; Bastie, Claire C; Vatish, Manu; Tagaya, Yuko; Osaki, Aya; Shimoda, Yoko; Shibusawa, Ryo; Saito, Tsugumichi; Okamura, Takashi; Ozawa, Atsushi; Yamada, Masanobu

    2017-01-01

    Optimum therapy for patients with diabetes depends on both acute and long-term changes in plasma glucose, generally assessed by glycated hemoglobin (HbA1c) levels. However, the correlation between HbA1c and circulating glucose has not been fully determined. Therefore, we carefully examined this correlation when glucose levels were assessed by continuous glucose monitoring (CGM). Fifty-one patients (70% female, 30% male) were examined; among them were 28 with type 1 diabetes and 23 with type 2 diabetes. Clinically determined HbA1c levels were compared with blood glucose determined by CGM during a short time period. Changes in HbA1c levels up to 8.0% showed a clear and statistically strong correlation (R = 0.6713; PHbA1c and CGM-assessed glucose levels in our patient population when HbA1c was >8.0%. Short-term CGM appears to be a good clinical indicator of long-term glucose control (HbA1c levels); however, cautions should be taken while interpreting CGM data from patients with HbA1c levels >8.0%. Over- or underestimation of the actual mean glucose from CGM data could potentially increase the risks of inappropriate treatment. As such, our results indicate that a more accurate analysis of CGM data might be useful to adequately tailor clinical treatments. ADAG = A1c-Derived Average Glucose CGM = continuous glucose monitoring %CV = percent coefficient of variation HbA1c = glycated hemoglobin.

  4. Novel OSNR Monitoring Technique in Dense WDM Systems using Inherently Generated CW Monitoring Channels

    DEFF Research Database (Denmark)

    Petersen, Martin Nordal

    2007-01-01

    We present a simple, yet effective OSNR monitoring technique based on an inherent effect in the optical modulator. Highly accurate OSNR monitoring is demonstrated in a 40 Gb/s dense WDM system with 50 GHz channel spacing.......We present a simple, yet effective OSNR monitoring technique based on an inherent effect in the optical modulator. Highly accurate OSNR monitoring is demonstrated in a 40 Gb/s dense WDM system with 50 GHz channel spacing....

  5. Real-time continuous glucose monitoring during labour and delivery in women with Type 1 diabetes — observations from a randomized controlled trial

    DEFF Research Database (Denmark)

    Cordua, S; Secher, A L; Ringholm, L

    2013-01-01

    To explore whether real-time continuous glucose monitoring during labour and delivery supplementary to hourly self-monitored plasma glucose in women with Type 1 diabetes reduces the prevalence of neonatal hypoglycaemia.......To explore whether real-time continuous glucose monitoring during labour and delivery supplementary to hourly self-monitored plasma glucose in women with Type 1 diabetes reduces the prevalence of neonatal hypoglycaemia....

  6. Environmental pollutants monitoring network using nuclear techniques

    International Nuclear Information System (INIS)

    Cohen, D.D.

    1994-01-01

    The Australian Nuclear Science and Technology Organisation (ANSTO) in collaboration with the NSW Environment Protection Authority (EPA), Pacific Power and the Universities of NSW and Macquarie has established a large area fine aerosol sampling network covering nearly 60,000 square kilometres of NSW with 25 fine particle samplers. This network known as ASP commenced sampling on 1 July 1991. The cyclone sampler at each site has a 2.5 μm particle diameter cut off and samples for 24 hours using a stretched Teflon filter for each day. Accelerator-based Ion Beam Analysis(IBA) techniques are well suited to analyse the thousands of filter papers a year that originate from such a large scale aerosol sampling network. These techniques are fast multi-elemental and, for the most part, non-destructive so other analytical methods such as neutron activation and ion chromatography can be performed afterwards. Currently ANSTO receives 300 filters per month from this network for analysis using its accelerator based ion beam techniques on a 3 MV Van de Graaff accelerator. One week a month of accelerator time is dedicated to this analysis. This paper described the four simultaneous accelerator based IBA techniques used at ANSTO, to analyse for the following 24 elements H, C, N, O, F, Na, Al, Si, P, S, Cl, K, Ca, Ti, V, Cr, Mn, Fe, Cu, Ni, Co, Zn, Br and Pb. Each analysis requires only a few minutes of accelerator running time to complete. 15 refs., 9 figs

  7. Transformer ageing modern condition monitoring techniques and their interpretations

    CERN Document Server

    Purkait, Prithwiraj

    2017-01-01

    This book is a one-stop guide to state-of-the-art research in transformer ageing, condition monitoring and diagnosis. It is backed by rigorous research projects supported by the Australian Research Council in collaboration with several transmission and distribution companies. Many of the diagnostic techniques and tools developed in these projects have been applied by electricity utilities and would appeal to both researchers and practicing engineers. Important topics covered in this book include transformer insulation materials and their ageing behaviour, transformer condition monitoring techniques and detailed diagnostic techniques and their interpretation schemes. It also features a monitoring framework for smart transformers as well as a chapter on biodegradable oil.

  8. Recurrent potential pulse technique for improvement of glucose sensing ability of 3D polypyrrole

    Science.gov (United States)

    Cysewska, Karolina; Karczewski, Jakub; Jasiński, Piotr

    2017-07-01

    In this work, a new approach for using a 3D polypyrrole (PPy) conducting polymer as a sensing material for glucose detection is proposed. Polypyrrole is electrochemically polymerized on a platinum screen-printed electrode in an aqueous solution of lithium perchlorate and pyrrole. PPy exhibits a high electroactive surface area and high electrochemical stability, which results in it having excellent electrocatalytic properties. The studies show that using the recurrent potential pulse technique results in an increase in PPy sensing stability, compared to the amperometric approach. This is due to the fact that the technique, under certain parameters, allows the PPy redox properties to be fully utilized, whilst preventing its anodic degradation. Because of this, the 3D PPy presented here has become a very good candidate as a sensing material for glucose detection, and can work without any additional dopants, mediators or enzymes.

  9. Robust satellite techniques for monitoring volcanic eruptions

    Energy Technology Data Exchange (ETDEWEB)

    Pergola, N.; Pietrapertosa, C. [Consiglio Nazionale delle Ricerche, Istituto di Metodologie Avanzate, Tito Scalo, PZ (Italy); Lacava, T.; Tramutoli, V. [Potenza Universita' della Basilicata, Potenza (Italy). Dipt. di Ingegneria e Fisica dell' Ambiente

    2001-04-01

    Through this paper the robust approach to monitoring volcanic aerosols by satellite is applied to an extended set of events affecting Stromboli and Etna volcanoes to assess its performance in automated detection of eruptive clouds and in monitoring pre-eruptive emission activities. Using only NOAA/AVHRR data at hand (without any specific atmospheric model or ancillary ground-based measurements) the proposed method automatically discriminates meteorological from eruptive volcanic clouds and, in several cases, identified pre-eruptive anomalies in the emission rates not identified by traditional methods. The main merit of this approach is its effectiveness in recognising field anomalies also in the presence of a highly variable surface background as well as its intrinsic exportability not only on different geographic areas but also on different satellite instrumental packages. In particular, the possibility to extend the proposed method to the incoming new MSG/SEVIRI satellite package (which is going to fly next year) with its improved spectral (specific bands for SO{sub 2}) and temporal (up to 15 min) resolutions has been evaluated representing the natural continuation of this work.

  10. Continuous glucose monitoring and its relationship to hemoglobin A1c and oral glucose tolerance testing in obese and prediabetic youth.

    Science.gov (United States)

    Chan, Christine L; Pyle, Laura; Newnes, Lindsey; Nadeau, Kristen J; Zeitler, Philip S; Kelsey, Megan M

    2015-03-01

    The optimal screening test for diabetes and prediabetes in obese youth is controversial. We examined whether glycosylated hemoglobin (HbA1c) or the oral glucose tolerance test (OGTT) is a better predictor of free-living glycemia as measured by continuous glucose monitoring (CGM). This was a cross-sectional study of youth 10-18 years old, body mass index (BMI) 85th percentile or greater, with diabetes risk factors. Participants (n = 118) with BMI 85th percentile or greater, not on medications for glucose management, were recruited from primary care and pediatric endocrinology clinics around Denver, Colorado. HbA1c, fasting plasma glucose, and 2-hour glucose were collected and all participants wore a blinded CGM for 72 hours. CGM outcomes were determined and descriptive statistics calculated. Performance characteristics at current American Diabetes Association cutpoints were compared with CGM outcomes. CGM data were successfully collected on 98 obese youth. Those with prediabetes had significantly higher average glucose, area under the curve (AUC), peak glucose, and time greater than 120 and greater than 140 mg/dL (P obese youth, HbA1c and 2-hour glucose performed equally well at predicting free-living glycemia on CGM, suggesting that both are valid tests for dysglycemia screening.

  11. Environmental monitoring in Slovakia using nuclear techniques

    International Nuclear Information System (INIS)

    Florek, M.; Holy, K.; Sivo, A.; Sykora, I.; Chudy, M.; Richtarikova, M.; Polaskova, A.; Hola, O.; Meresova, J.; Ondo-Estok, D.; Mankovska, B.; Frontasyeva, M.V.; Ermakov, E.V.

    2005-01-01

    The contamination of the atmosphere of Slovakia by stable elements and also by-,radionuclides as 14 C, 7 Be, 210 Pb and 222 Rn were studied during the last decade using nuclear techniques. The main aims of this research were the better understanding of processes taking place in the atmosphere, the quantification of the atmospheric pollution and its trend, as well as the evaluation of the health risk from this pollution

  12. Comparison of lancing devices for self-monitoring of blood glucose regarding lancing pain.

    Science.gov (United States)

    Kocher, Serge; Tshiananga, J K Tshiang; Koubek, Richard

    2009-09-01

    Self-monitoring of blood glucose empowers diabetes patients to effectively control their blood glucose (BG) levels. A potential barrier to frequent BG controls is lancing pain, intrinsically linked to pricking the finger several times a day. In this study, we compared different state-of-the-art lancing devices from leading manufacturers regarding lancing pain, and we intended to identify lancing devices that are less painful. First, 165 subjects compared 6 different BG monitoring systems-consisting of a lancing device and a BG meter-at home for 36 days and at least 3 BG tests per day. Second, the subjects directly compared 6 different lancing devices-independent from a BG meter-in a laboratory setting. The test results were collected in questionnaires, and lancing pain was rated on a numerical rating scale. One hundred fifty-seven subjects were included in the analysis. Accu-Chek BG monitoring systems were significantly (p competitor BG monitoring systems and were rated by >50% of the subjects as "less painful" than competitor BG monitoring systems. Accu-Chek lancing devices were significantly (p competitor lancing devices and were rated by >60% of the subjects as "less painful" than competitor lancing devices. We found significant differences in lancing pain between lancing devices. Diabetes patients clearly preferred lancing devices that cause less lancing pain. In order to improve patient compliance with respect to an adequate glycemic control, the medical staff should preferentially prescribe lancing devices that cause less lancing pain. 2009 Diabetes Technology Society.

  13. 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.

  14. Correlation techniques in nuclear power plant monitoring

    International Nuclear Information System (INIS)

    Bastl, W.

    1976-01-01

    Ever increasing effects are recently being made to monitor the mechanical behaviour of the nuclear power plants during operation. For technical as well as economical reasons one is forced to make do with the smallest number of sensors. In order to still obtain efficient control systems, an attempt is made on the one hand to make use of the already existing operational instrumentation, on the other hand to obtain a maximum of information by specific use of few additional sensors. In both cases, correlation analysis plays a large role because an optimum positioning of the sensor is seldom possible and thus, as a rule, the interesting information must be separated from very noisy signals. (orig./LH) [de

  15. Accuracy of a real-time continuous glucose monitoring system in children with septic shock: A pilot study

    OpenAIRE

    Prabhudesai, Sumant; Kanjani, Amruta; Bhagat, Isha; Ravikumar, Karnam G.; Ramachandran, Bala

    2015-01-01

    Aims: The aim of this prospective, observational study was to determine the accuracy of a real-time continuous glucose monitoring system (CGMS) in children with septic shock. Subjects and Methods: Children aged 30 days to 18 years admitted to the Pediatric Intensive Care Unit with septic shock were included. A real-time CGMS sensor was used to obtain interstitial glucose readings. CGMS readings were compared statistically with simultaneous laboratory blood glucose (BG). Results: Nineteen chil...

  16. Continuous glucose monitoring for patients with diabetes: an evidence-based analysis.

    Science.gov (United States)

    2011-01-01

    To determine the effectiveness and cost-effectiveness of continuous glucose monitoring combined with self-monitoring of blood glucose compared with self-monitoring of blood glucose alone in the management of diabetes. CONDITION AND TARGET POPULATION Diabetes is a chronic metabolic disorder that interferes with the body's ability to produce or effectively use insulin. In 2005, an estimated 816,000 Ontarians had diabetes representing 8.8% of the province's population. Type 1 or juvenile onset diabetes is a life-long disorder that commonly manifests in children and adolescents. It represents about 10% of the total diabetes population and involves immune-mediated destruction of insulin producing cells in the pancreas. The loss of these cells necessitates insulin therapy. Type 2 or "adult-onset" diabetes represents about 90% of the total diabetes population and is marked by a resistance to insulin or insufficient insulin secretion. The risk of developing type 2 diabetes increases with age, obesity and lack of physical activity. Approximately 30% of patients with type 2 diabetes eventually require insulin therapy. Continuous glucose monitors (CGM) measure glucose levels in the interstitial fluid surrounding skin cells. These measurements supplement conventional self monitoring of blood glucose (SMBG) by monitoring the glucose fluctuations continuously over a stipulated period of time, thereby identifying fluctuations that would not be identified with SMBG alone. To use a CGM, a sensor is inserted under the skin to measure glucose in the interstitial fluid. The sensor is wired to a transmitter. The device requires calibration using a capillary blood glucose measurement. Each sensor continuously measures glucose every 5-10 seconds averaging these values every 5 minutes and storing this data in the monitors memory. Depending on the device used, the algorithm in the device can measure glucose over a 3 or 6 day period using one sensor. After the 3 or 6 day period, a new

  17. Acoustic surveillance techniques for SGU leak monitoring

    International Nuclear Information System (INIS)

    McKnight, J.A.; Rowley, R.; Beesley, M.J.

    1990-01-01

    The paper presents a brief review of the acoustic techniques applicable to the detection of steam generator unit leaks that have been studied in the UK. Before discussion of the acoustic detection methods a reference representation of the required performance as developed in the UK is given. The conclusion is made that preliminary specification for the acoustic leak detection of sodium/water leaks in steam generating units suggests that it will be necessary to detect better than a leak rate of 3 g/s within a few seconds. 10 refs, 12 figs

  18. Modern techniques for condition monitoring of railway vehicle dynamics

    International Nuclear Information System (INIS)

    Ngigi, R W; Pislaru, C; Ball, A; Gu, F

    2012-01-01

    A modern railway system relies on sophisticated monitoring systems for maintenance and renewal activities. Some of the existing conditions monitoring techniques perform fault detection using advanced filtering, system identification and signal analysis methods. These theoretical approaches do not require complex mathematical models of the system and can overcome potential difficulties associated with nonlinearities and parameter variations in the system. Practical applications of condition monitoring tools use sensors which are mounted either on the track or rolling stock. For instance, monitoring wheelset dynamics could be done through the use of track-mounted sensors, while vehicle-based sensors are preferred for monitoring the train infrastructure. This paper attempts to collate and critically appraise the modern techniques used for condition monitoring of railway vehicle dynamics by analysing the advantages and shortcomings of these methods.

  19. Characteristics of a multisensor system for non invasive glucose monitoring with external validation and prospective evaluation.

    Science.gov (United States)

    Caduff, Andreas; Mueller, Martin; Megej, Alexander; Dewarrat, Francois; Suri, Roland E; Klisic, Jelena; Donath, Marc; Zakharov, Pavel; Schaub, Dominik; Stahel, Werner A; Talary, Mark S

    2011-05-15

    The Multisensor Glucose Monitoring System (MGMS) features non invasive sensors for dielectric characterisation of the skin and underlying tissue in a wide frequency range (1 kHz-100 MHz, 1 and 2 GHz) as well as optical characterisation. In this paper we describe the results of using an MGMS in a miniaturised housing with fully integrated sensors and battery. Six patients with Type I Diabetes Mellitus (age 44±16 y; BMI 24.1±1.3 kg/m(2), duration of diabetes 27±12 y; HbA1c 7.3±1.0%) wore a single Multisensor at the upper arm position and performed a total of 45 in-clinic study days with 7 study days per patient on average (min. 5 and max. 10). Glucose changes were induced either orally or by i.v. glucose administration and the blood glucose was measured routinely. Several prospective data evaluation routines were applied to evaluate the data. The results are shown using one of the restrictive data evaluation routines, where measurements from the first 22 study days were used to train a linear regression model. The global model was then prospectively applied to the data of the remaining 23 study days to allow for an external validation of glucose prediction. The model application yielded a Mean Absolute Relative Difference of 40.8%, a Mean Absolute Difference of 51.9 mg dL(-1), and a correlation of 0.84 on average per study day. The Clarke error grid analyses showed 89.0% in A+B, 4.5% in C, 4.6% in D and 1.9% in the E region. Prospective application of a global, purely statistical model, demonstrates that glucose variations can be tracked non invasively by the MGMS in most cases under these conditions. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Differential photoacoustic spectroscopy with continuous wave lasers for non-invasive blood glucose monitoring

    Science.gov (United States)

    Tanaka, Y.; Tajima, T.; Seyama, M.

    2018-02-01

    We propose a differential photoacoustic spectroscopy (PAS), wherein two wavelengths of light with the same absorbance are selected, and differential signal is linearized by one of the two signals for a non-invasive blood glucose monitoring. PAS has the possibility to overcome the strong optical scattering in tissue, but there are still remaining issues: the water background and instability due to the variation in acoustic resonance conditions. A change in sample solution temperature is one of the causes of the variation in acoustic resonance conditions. Therefore, in this study, we investigated the sensitivity against glucose concentration under the condition where the temperature of the sample water solution ranges 30 to 40 °C. The glucose concentration change is simulated by shifting the wavelength of irradiated laser light, which can effectively change optical absorption. The temperature also affects optical absorption and the acoustic resonance condition (acoustic velocity). A distributed-feedback (DFB) laser, tunable wavelength laser (TWL) and an acoustic sensor were used to obtain the differential PAS signal. The wavelength of the DFB laser was 1.382 μm, and that of TWL was switched from 1.600 to 1.610 μm to simulate the glucose concentration change. Optical absorption by glucose occurs at around 1.600 μm. The sensitivities against temperature are almost the same: 1.9 and 1.8 %/°C for 1.600 and 1.610 μm. That is, the glucose dependence across the whole temperature range remains constant. This implies that temperature correction is available.

  1. Accuracy of subcutaneous continuous glucose monitoring in critically ill adults: improved sensor performance with enhanced calibrations.

    Science.gov (United States)

    Leelarathna, Lalantha; English, Shane W; Thabit, Hood; Caldwell, Karen; Allen, Janet M; Kumareswaran, Kavita; Wilinska, Malgorzata E; Nodale, Marianna; Haidar, Ahmad; Evans, Mark L; Burnstein, Rowan; Hovorka, Roman

    2014-02-01

    Accurate real-time continuous glucose measurements may improve glucose control in the critical care unit. We evaluated the accuracy of the FreeStyle(®) Navigator(®) (Abbott Diabetes Care, Alameda, CA) subcutaneous continuous glucose monitoring (CGM) device in critically ill adults using two methods of calibration. In a randomized trial, paired CGM and reference glucose (hourly arterial blood glucose [ABG]) were collected over a 48-h period from 24 adults with critical illness (mean±SD age, 60±14 years; mean±SD body mass index, 29.6±9.3 kg/m(2); mean±SD Acute Physiology and Chronic Health Evaluation score, 12±4 [range, 6-19]) and hyperglycemia. In 12 subjects, the CGM device was calibrated at variable intervals of 1-6 h using ABG. In the other 12 subjects, the sensor was calibrated according to the manufacturer's instructions (1, 2, 10, and 24 h) using arterial blood and the built-in point-of-care glucometer. In total, 1,060 CGM-ABG pairs were analyzed over the glucose range from 4.3 to 18.8 mmol/L. Using enhanced calibration median (interquartile range) every 169 (122-213) min, the absolute relative deviation was lower (7.0% [3.5, 13.0] vs. 12.8% [6.3, 21.8], P<0.001), and the percentage of points in the Clarke error grid Zone A was higher (87.8% vs. 70.2%). Accuracy of the Navigator CGM device during critical illness was comparable to that observed in non-critical care settings. Further significant improvements in accuracy may be obtained by frequent calibrations with ABG measurements.

  2. The Performance and Usability of a Factory-Calibrated Flash Glucose Monitoring System.

    Science.gov (United States)

    Bailey, Timothy; Bode, Bruce W; Christiansen, Mark P; Klaff, Leslie J; Alva, Shridhara

    2015-11-01

    The purpose of the study was to evaluate the performance and usability of the FreeStyle(®) Libre™ Flash glucose monitoring system (Abbott Diabetes Care, Alameda, CA) for interstitial glucose results compared with capillary blood glucose results. Seventy-two study participants with type 1 or type 2 diabetes were enrolled by four U.S. clinical sites. A sensor was inserted on the back of each upper arm for up to 14 days. Three factory-only calibrated sensor lots were used in the study. Sensor glucose measurements were compared with capillary blood glucose (BG) results (approximately eight per day) obtained using the BG meter built into the reader (BG reference) and with the YSI analyzer (Yellow Springs Instrument, Yellow Springs, OH) reference tests at three clinic visits (32 samples per visit). Sensor readings were masked to the participants. The accuracy of the results was demonstrated against capillary BG reference values, with 86.7% of sensor results within Consensus Error Grid Zone A. The percentage of readings within Consensus Error Grid Zone A on Days 2, 7, and 14 was 88.4%, 89.2%, and 85.2%, respectively. The overall mean absolute relative difference was 11.4%. The mean lag time between sensor and YSI reference values was 4.5±4.8 min. Sensor accuracy was not affected by factors such as body mass index, age, type of diabetes, clinical site, insulin administration, or hemoglobin A1c. Interstitial glucose measurements with the FreeStyle Libre system were found to be accurate compared with capillary BG reference values, with accuracy remaining stable over 14 days of wear and unaffected by patient characteristics.

  3. Accuracy evaluation of five blood glucose monitoring systems obtained from the pharmacy: a European multicenter study with 453 subjects

    NARCIS (Netherlands)

    Tack, C.J.; Pohlmeier, H.; Behnke, T.; Schmid, V.; Grenningloh, M.; Forst, T.; Pfutzner, A.

    2012-01-01

    BACKGROUND: This multicenter study was conducted to evaluate the performance of five recently introduced blood glucose (BG) monitoring (BGM) devices under daily routine conditions in comparison with the YSI (Yellow Springs, OH) 2300 Stat Plus glucose analyzer. METHODS: Five hundred one diabetes

  4. Monitoring of Concrete Structures Using Ofdr Technique

    Science.gov (United States)

    Henault, J. M.; Salin, J.; Moreau, G.; Delepine-Lesoille, S.; Bertand, J.; Taillade, F.; Quiertant, M.; Benzarti, K.

    2011-06-01

    Structural health monitoring is a key factor in life cycle management of infrastructures. Truly distributed fiber optic sensors are able to provide relevant information on large structures, such as bridges, dikes, nuclear power plants or nuclear waste disposal facilities. The sensing chain includes an optoelectronic unit and a sensing cable made of one or more optical fibers. A new instrument based on Optical Frequency Domain Reflectometry (OFDR), enables to perform temperature and strain measurements with a centimeter scale spatial resolution over hundred of meters and with a level of precision equal to 1 μstrain and 0.1 °C. Several sensing cables are designed with different materials targeting to last for decades in a concrete aggressive environment and to ensure an optimal transfer of temperature and strain from the concrete matrix to the optical fiber. Tests were carried out by embedding various sensing cables into plain concrete specimens and representative-scale reinforced concrete structural elements. Measurements were performed with an OFDR instrument; meanwhile, mechanical solicitations were imposed to the concrete element. Preliminary experiments are very promising since measurements performed with distributed sensing system are comparable to values obtained with conventional sensors used in civil engineering and with the Strength of Materials Modelling. Moreover, the distributed sensing system makes it possible to detect and localize cracks appearing in concrete during the mechanical loading.

  5. Continuous glucose monitoring--a study of the Enlite sensor during hypo- and hyperbaric conditions.

    Science.gov (United States)

    Adolfsson, Peter; Örnhagen, Hans; Eriksson, Bengt M; Cooper, Ken; Jendle, Johan

    2012-06-01

    The performance and accuracy of the Enlite(™) (Medtronic, Inc., Northridge, CA) sensor may be affected by microbubble formation at the electrode surface during hypo- and hyperbaric conditions. The effects of acute pressure changes and of prewetting of sensors were investigated. On Day 1, 24 sensors were inserted on the right side of the abdomen and back in one healthy individual; 12 were prewetted with saline solution, and 12 were inserted dry. On Day 2, this procedure was repeated on the left side. All sensors were attached to an iPro continuous glucose monitoring (CGM) recorder. Hypobaric and hyperbaric tests were conducted in a pressure chamber, with each test lasting 105 min. Plasma glucose values were obtained at 5-min intervals with a HemoCue(®) (Ängelholm, Sweden) model 201 glucose analyzer for comparison with sensor glucose values. Ninety percent of the CGM systems operated during the tests. The mean absolute relative difference was lower during hyperbaric than hypobaric conditions (6.7% vs. 14.9%, Phypobaric but not during hyperbaric conditions. Clarke Error Grid Analysis showed that 100% of the values were found in the A+B region. No differences were found between prewetted and dry sensors. The Enlite sensor performed adequately during acute pressure changes and was more accurate during hyperbaric than hypobaric conditions. Prewetting the sensors did not improve accuracy. Further studies on type 1 diabetes subjects are needed under various pressure conditions.

  6. Unannounced Meals in the Artificial Pancreas: Detection Using Continuous Glucose Monitoring

    Directory of Open Access Journals (Sweden)

    Charrise M. Ramkissoon

    2018-03-01

    Full Text Available The artificial pancreas (AP system is designed to regulate blood glucose in subjects with type 1 diabetes using a continuous glucose monitor informed controller that adjusts insulin infusion via an insulin pump. However, current AP developments are mainly hybrid closed-loop systems that include feed-forward actions triggered by the announcement of meals or exercise. The first step to fully closing the loop in the AP requires removing meal announcement, which is currently the most effective way to alleviate postprandial hyperglycemia due to the delay in insulin action. Here, a novel approach to meal detection in the AP is presented using a sliding window and computing the normalized cross-covariance between measured glucose and the forward difference of a disturbance term, estimated from an augmented minimal model using an Unscented Kalman Filter. Three different tunings were applied to the same meal detection algorithm: (1 a high sensitivity tuning, (2 a trade-off tuning that has a high amount of meals detected and a low amount of false positives (FP, and (3 a low FP tuning. For the three tunings sensitivities 99 ± 2%, 93 ± 5%, and 47 ± 12% were achieved, respectively. A sensitivity analysis was also performed and found that higher carbohydrate quantities and faster rates of glucose appearance result in favorable meal detection outcomes.

  7. Correlation of continuous glucose monitoring profiles with pregnancy outcomes in nondiabetic women.

    Science.gov (United States)

    Sung, Joyce F; Kogut, Elizabeth A; Lee, Henry C; Mannan, Jana L; Navabi, Kasra; Taslimi, M Mark; El-Sayed, Yasser Y

    2015-04-01

    To determine whether hyperglycemic excursions detected by continuous glucose monitoring (CGM) correlate with birth weight percentile and other pregnancy outcomes, and whether CGM correlates better with these outcomes than a single glucose value from a 1-hour glucose challenge test (GCT). This was a prospective observational study of 55 pregnant patients without preexisting diabetes, who wore a CGM device for up to 7 days, between 24 and 28 weeks' gestation. The area under the curve (AUC) of hyperglycemic excursions above various thresholds (110, 120, 130, 140, and 180 mg/dL) was calculated. These AUC values, and results from a standard 50-g GCT, were correlated with our primary outcome of birth weight percentile, and secondary outcomes of unplanned operative delivery, pregnancy complications, delivery complications, fetal complications, and neonatal complications. A consistent correlation was seen between all AUC thresholds and birth weight percentile (r = 0.29, p AUC-110, -120, -130, and -140; r = 0.25, p = 0.07 for AUC-180). This correlation was stronger than that of 1-hour oral GCT (r = -0.02, p = 0.88). There was no association between AUC values and other outcomes. Among nondiabetic pregnant patients, hyperglycemic excursions detected by CGM show a stronger correlation to birth weight percentile than blood glucose values obtained 1-hour after a 50-g oral GCT. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. Value of self-monitoring blood glucose pattern analysis in improving diabetes outcomes.

    Science.gov (United States)

    Parkin, Christopher G; Davidson, Jaime A

    2009-05-01

    Self-monitoring of blood glucose (SMBG) is an important adjunct to hemoglobin A1c (HbA1c) testing. This action can distinguish between fasting, preprandial, and postprandial hyperglycemia; detect glycemic excursions; identify and monitor resolution of hypoglycemia; and provide immediate feedback to patients about the effect of food choices, activity, and medication on glycemic control. Pattern analysis is a systematic approach to identifying glycemic patterns within SMBG data and then taking appropriate action based upon those results. The use of pattern analysis involves: (1) establishing pre- and postprandial glucose targets; (2) obtaining data on glucose levels, carbohydrate intake, medication administration (type, dosages, timing), activity levels and physical/emotional stress; (3) analyzing data to identify patterns of glycemic excursions, assessing any influential factors, and implementing appropriate action(s); and (4) performing ongoing SMBG to assess the impact of any therapeutic changes made. Computer-based and paper-based data collection and management tools can be developed to perform pattern analysis for identifying patterns in SMBG data. This approach to interpreting SMBG data facilitates rational therapeutic adjustments in response to this information. Pattern analysis of SMBG data can be of equal or greater value than measurement of HbA1c levels. 2009 Diabetes Technology Society.

  9. Monitoring Techniques for Microbially Influenced Corrosion of Carbon Steel

    DEFF Research Database (Denmark)

    Hilbert, Lisbeth Rischel

    2000-01-01

    corrosion rates, when biofilm and corrosion products cover the steel surface. However, EIS might be used for detection of MIC. EN is a suitable technique to characterise the type of corrosion attack, but is unsuitable for corrosion rate estimation. The concentric electrodes galvanic probe arrangement......Abstract Monitoring Techniques for Microbially Influenced Corrosion of Carbon Steel Microbially influenced corrosion (MIC) of carbon steel may occur in media with microbiological activity of especially sulphate-reducing bacteria, e.g. on pipelines buried in soil and on marine structures. MIC...... of carbon steel must be monitored on-line in order to provide an efficient protection and control the corrosion. A number of monitoring techniques is industrially used today, and the applicability and reliability of these for monitoring MIC is evaluated. Coupons and ER are recommended as necessary basic...

  10. Standard evaluation techniques for containment and surveillance radiation monitors

    International Nuclear Information System (INIS)

    Fehlau, P.E.

    1982-01-01

    Evaluation techniques used at Los Alamos for personnel and vehicle radiation monitors that safeguard nuclear material determine the worst-case sensitivity. An evaluation tests a monitor's lowest sensitivity regions with sources that have minimum emission rates. The result of our performance tests are analyzed as a binomial experiment. The number of trials that are required to verify the monitor's probability of detection is determined by a graph derived from the confidence limits for a binomial distribution. Our testing results are reported in a way that characterizes the monitor yet does not compromise security by revealing its routine performance for detecting process materials

  11. Effect of Continuous Glucose Monitoring Accuracy on Clinicians' Retrospective Decision Making in Diabetes: A Pilot Study

    DEFF Research Database (Denmark)

    Mahmoudi, Zeinab; Johansen, Mette Dencker; Nørgaard, Hanne Holdflod

    2015-01-01

    BACKGROUND: The use of continuous glucose monitoring (CGM) in clinical decision making in diabetes could be limited by the inaccuracy of CGM data when compared to plasma glucose measurements. The aim of the present study is to investigate the impact of CGM numerical accuracy on the precision...... of diabetes treatment adjustments. METHOD: CGM profiles with maximum 5-day duration from 12 patients with type 1 diabetes treated with a basal-bolus insulin regimen were processed by 2 CGM algorithms, with the accuracy of algorithm 2 being higher than the accuracy of algorithm 1, using the median absolute...... of the interclinician agreement and the intraclinician reproducibility of the decisions. The Cohen's kappa coefficient was used to assess the precision of the decisions. The study was based on retrospective and blind CGM data. RESULTS: For the interclinician agreement, in the first occasion, the kappa of algorithm 1...

  12. Comparison of three nonlinear filters for fault detection in continuous glucose monitors.

    Science.gov (United States)

    Mahmoudi, Zeinab; Wendt, Sabrina Lyngbye; Boiroux, Dimitri; Hagdrup, Morten; Norgaard, Kirsten; Poulsen, Niels Kjolstad; Madsen, Henrik; Jorgensen, John Bagterp

    2016-08-01

    The purpose of this study is to compare the performance of three nonlinear filters in online drift detection of continuous glucose monitors. The nonlinear filters are the extended Kalman filter (EKF), the unscented Kalman filter (UKF), and the particle filter (PF). They are all based on a nonlinear model of the glucose-insulin dynamics in people with type 1 diabetes. Drift is modelled by a Gaussian random walk and is detected based on the statistical tests of the 90-min prediction residuals of the filters. The unscented Kalman filter had the highest average F score of 85.9%, and the smallest average detection delay of 84.1%, with the average detection sensitivity of 82.6%, and average specificity of 91.0%.

  13. Accuracy evaluation of a new real-time continuous glucose monitoring algorithm in hypoglycemia

    DEFF Research Database (Denmark)

    Mahmoudi, Zeinab; Jensen, Morten Hasselstrøm; Johansen, Mette Dencker

    2014-01-01

    UNLABELLED: Abstract Background: The purpose of this study was to evaluate the performance of a new continuous glucose monitoring (CGM) calibration algorithm and to compare it with the Guardian(®) REAL-Time (RT) (Medtronic Diabetes, Northridge, CA) calibration algorithm in hypoglycemia. SUBJECTS...... AND METHODS: CGM data were obtained from 10 type 1 diabetes patients undergoing insulin-induced hypoglycemia. Data were obtained in two separate sessions using the Guardian RT CGM device. Data from the same CGM sensor were calibrated by two different algorithms: the Guardian RT algorithm and a new calibration...... algorithm. The accuracy of the two algorithms was compared using four performance metrics. RESULTS: The median (mean) of absolute relative deviation in the whole range of plasma glucose was 20.2% (32.1%) for the Guardian RT calibration and 17.4% (25.9%) for the new calibration algorithm. The mean (SD...

  14. Study of laser monitoring techniques of pollutants in atmosphere

    International Nuclear Information System (INIS)

    Hassan, T. A. A.

    2006-01-01

    There are several techniques used as a tool for monitoring the pollutions in the atmosphere, where the laser radiation sending through the sample of atmosphere to be investigated ether transmission or the scattering of the light, all the way through a variety of different techniques for monitoring the air quality. We are showed in this study the comparison of detection techniques through measuring the light scattered in some particular direction, rather than measuring direction the attenuation due to two type of scattering (Rayieh scattering and Mie scattering) during (optical Radar, Roman backscattering and Resonance fluorescence).(Author)

  15. Use of real time continuous glucose monitoring and intravenous insulin in type 1 diabetic mothers to prevent respiratory distress and hypoglycaemia in infants

    Directory of Open Access Journals (Sweden)

    Passaro Patrizia

    2008-07-01

    Full Text Available Abstract Background Pregnancy in Type 1 diabetic patients is a precarious condition, both for mother and fetus with increased the risk of prematurity and, immediately after delivery with risk of respiratory distress syndrome and hypoglycaemia in newborns. A strict control and monitoring of diabetes throughout pregnancy is important in reducing the impact of the disease on the fetus and newborn. In recent years many new technologies have been introduced to ameliorate diabetes monitoring, where the last is the Real-time Continuous Glucose Monitoring System (RT-CGMS. Methods In the last three years, 72 h continuous glucose monitoring system (RT-CGMS (Medtronic, CA was performed in 18 pregnant women with Type 1 diabetes in two moments of pregnancy: during treatment with betamethasone to prevent respiratory distress and during delivery. In both cases insulin was administered intravenous and the dose was changed on the basis of glycaemia. Results The results present the use of this new technique during two topics moments of pregnancy of type 1 diabetes patients when is very important intensively to monitor diabetes and to obtain the well being of the fetus. No infant experimented hypoglycaemia or respiratory distress syndrome at the moment and in the first hours after the birth. Conclusion We wish to stress the importance reducing glycaemia during administration of betamethasone and during labor. It is conceivable that the scarce attention paid to monitoring glucose levels in diabetic mothers during labor in gynaecological world may be due to the difficulty in glucose monitoring with the devices until now available. Hopefully, our anecdotal account may prompt improvements with RT-CGMS, and may lead to a better approach to the problem, thereby changing the prognosis of infants born to diabetic mothers.

  16. Accuracy and precision evaluation of seven self-monitoring blood glucose systems.

    Science.gov (United States)

    Kuo, Chih-Yi; Hsu, Cheng-Teng; Ho, Cheng-Shiao; Su, Ting-En; Wu, Ming-Hsun; Wang, Chau-Jong

    2011-05-01

    Self-monitoring blood glucose (SMBG) systems play a critical role in management of diabetes. SMBG systems should at least meet the minimal requirement of the World Health Organization's ISO 15197:2003. For tight glycemic control, a tighter accuracy requirement is needed. Seven SMBG systems were evaluated for accuracy and precision: Bionime Rightest(™) GM550 (Bionime Corp., Dali City, Taiwan), Accu-Chek(®) Performa (Roche Diagnostics, Indianapolis, IN), OneTouch(®) Ultra(®)2 (LifeScan Inc., Milpitas, CA), MediSense(®) Optium(™) Xceed (Abbott Diabetes Care Inc., Alameda, CA), Medisafe (TERUMO Corp., Tokyo, Japan), Fora(®) TD4227 (Taidac Technology Corp., Wugu Township, Taiwan), and Ascensia Contour(®) (Bayer HealthCare LLC, Mishawaka, IN). The 107 participants (44 men and 63 women) were between 23 and 91 years old. The analytical results of seven SMBG systems were compared with those of plasma analyzed with the hexokinase method (Olympus AU640, Olympus America Inc., Center Valley, PA). The imprecision of the seven blood glucose meters ranged from 1.1% to 4.7%. Three of the seven blood glucose meters (42.9%) fulfilled the minimum accuracy criteria of ISO 15197:2003. The mean absolute relative error value for each blood glucose meter was calculated and ranged from 6.5% to 12.0%. More than 40% of evaluated SMBG systems meet the minimal accuracy criteria requirement of ISO 15197:2003. However, considering tighter criteria for accuracy of ±15%, only the Bionime Rightest GM550 meets this requirement. Because SMBG systems play a critical role in management of diabetes, manufacturers have to strive to improve accuracy and precision and to ensure the good quality of blood glucose meters and test strips.

  17. Comparison of accuracy and safety of the SEVEN and the Navigator continuous glucose monitoring systems.

    Science.gov (United States)

    Garg, Satish K; Smith, James; Beatson, Christie; Lopez-Baca, Benita; Voelmle, Mary; Gottlieb, Peter A

    2009-02-01

    This study evaluated the accuracy and safety of two continuous glucose monitoring (CGM) systems, the SEVEN (DexCom, San Diego, CA) and the Navigator (Abbott Diabetes Care, Alameda, CA), with the YSI laboratory measurements of blood glucose (blood glucose meter manufactured by YSI, Yellow Springs, OH), when worn concurrently in adults with type 1 diabetes. Fourteen subjects with type 1 diabetes, 33 +/- 6 (mean +/- SD) years old, were enrolled in this study. All subjects wore both sensors concurrently over three consecutive 5-day CGM sessions (15-day wear). On Days 5, 10, and 15, subjects participated in an 8-h in-clinic session where measurements from the CGM systems were collected and compared with YSI measurements every 15 min. At the end of Day 5 and 10 in-clinic sessions, the sensors were removed, and new sensors were inserted for the following CGM session despite the SEVEN system's recommended use for up to 7 days. The mean absolute relative difference (ARD) for the two CGM devices versus YSI was not different: 16.8% and 16.1% for SEVEN and Navigator, respectively (P = 0.38). In the hypoglycemic region (YSI value blood glucose (SMBG) values. Thirteen additional Navigator replacement devices were issued compared to two for the SEVEN. A total of three versus 14 skin reactions were reported with the SEVEN and Navigator insertion area, respectively. Glucose measurements with the SEVEN and Navigator were found to be similar compared with YSI and SMBG measurements, with the exception of the hypoglycemic range where the SEVEN performed better. However, the Navigator caused more skin area reactions.

  18. Monitoring of glucose levels in mouse blood with noninvasive optical methods

    International Nuclear Information System (INIS)

    Ullah, H; Ikram, M; Ahmed, E

    2014-01-01

    We report the quantification/monitoring of glucose levels in a blood sample using optical diffuse reflectance (ODR) underlying variations in optical parameters with a white light source (at peak wavelength ∼600 nm and range 450–850 nm) and in blood in vivo using M-mode optical coherence tomography (OCT) in terms of the translational diffusion coefficient (D T ). In the ODR experiments, we have investigated two types of mono-dispersive particles, i.e. polystyrene microspheres (PMSs) with diameters of 1.4 μm (variable concentrations) and 2.6 μm (fixed concentration) in a water phantom by observing changes in the reduced scattering coefficient. We believe that these differences in optical properties will be helpful for the understanding and optimal use of laser applications in blood glucometry without piercing the skin. In the OCT experiments, this idea of glucose monitoring was applied on an in vivo normal mouse without injection of glucose intravenously to provide the threshold levels by envisioning/identifying a blood vessel by speckle variance (SV-OCT) using a dorsal skinfold mouse windows chamber model. We report an average value of translation decorrelation time τ T = 41.18 ± 1.92 ms and D T = 8.90 × 10 −14  m 2  s −1 underlying the dynamic light scattering (DLS). Our results have a potential application in the quantification of higher glucose levels in vivo administrated intravenously. (paper)

  19. [Usefulness of continuous glucose monitoring system (CGMS) in monitoring glycaemic profile in small children with diabetes type 1].

    Science.gov (United States)

    Głowińska-Olszewska, Barbara; Urban, Mirosława; Peczyńska, Jadwiga; Florys, Bozena; Kowalewski, Marek

    2005-01-01

    Improved methods of diabetes therapy result in a near normoglycaemic state in many patients. This leads however unfortunately to more frequent hypoglycaemic incidents. Particularly small children, whose nervous system is not fully mature, are at high risk of central nervous system damage in case of hypoglycaemia. A new method of detail monitoring of glycaemia provides CGMS system. The aim of the study was to compare the glycaemic profile, with high attention to hypoglycaemia in groups of young and older children with diabetes type 1, using CGMS and routine glucose meter. We studied 32 children with diabetes type 1. Children were divided into groups: group I--small children, n=17 (10 years of age), mean age--12 years, with disease duration--3 years, with HbA1c level--7,21%. Continuous glucose monitoring system (CGMS), by MiniMed, was applied in outpatient or hospital conditions, after short training of patient and parents; together with routine glucose meter measurements, 4-8 times/24 hours. In 9 patients from small children group CGMS was repeated after 2 months. Hypoglycaemic incidents detected with CGMS were similar in both groups: 4,6 in I group vs. 4,2 in II group (ns). Hypoglycaemic incidents found with meter were lower in I group--1,6 vs. 2,3 in II group (ns). Mean hypoglycaemic time/24 hour was longer in small children group: 101 min vs. 74 min in group II (p<00,05). In I group we found higher number of hypoglycaemic incidents during the night compared to group II--1,7 vs. 0,8 (p<00,05) and longer duration of night hypoglycaemia: in I group--56 min vs. 32 min in group II (p<00,05). Repeated CGMS study in 9 children from I group revealed decreased mean time of hypoglycaemia/24 hours from 134 min/24 h to 90 min/24 h (p<00,05) and decreased time of night hypoglycaemia from 65 min to 40 min (p<00,05), with a comparable number of hypoglycaemic incidents. Hypoglycaemic incidents found with routine meter measurements in small children were 1,6 vs. 4,6 hypoglycaemia

  20. 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

  1. 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.

  2. Web-based telemedicine system is useful for monitoring glucose control in pregnant women with diabetes.

    Science.gov (United States)

    Carral, Florentino; Ayala, María del Carmen; Fernández, Juan Jesús; González, Carmen; Piñero, Antonia; García, Gloria; Cañavate, Concepción; Jiménez, Ana Isabel; García, Concepción

    2015-05-01

    The aim of this study was to examine the impact of a Web-based telemedicine system for monitoring glucose control in pregnant women with diabetes on healthcare visits, metabolic control, and pregnancy outcomes. A prospective, single-center, interventional study with two parallel groups was performed in Puerto Real University Hospital (Cadiz, Spain). Women were assigned to two different glucose monitoring groups: the control group (CG), which was managed only by follow-ups with the Gestational Diabetes Unit (GDU), and the telemedicine group (TMG), which was monitored by both more spaced GDU visits and a Web-based telemedicine system. The number of healthcare visits, degree of metabolic control, and maternal and neonatal outcomes were evaluated. One hundred four pregnant women with diabetes (77 with gestational diabetes, 16 with type 1 diabetes, and 11 with type 2 diabetes) were included in the TMG (n=40) or in the CG (n=64). There were no significant differences in mean glycated hemoglobin level during pregnancy or after delivery, despite a significantly lower number of visits to the GDU (3.2±2.3 vs. 5.9±2.3 visits; P3.0±1.7 visits; PWeb-based telemedicine system can be a useful tool facilitating the management of pregnant diabetes patients, as a complement to conventional outpatient clinic visits.

  3. Pump failure leads to alternative vertical pump condition monitoring technique

    International Nuclear Information System (INIS)

    DeVilliers, Adriaan; Glandon, Kevin

    2011-01-01

    Condition monitoring and detecting early signs of potential failure mechanisms present particular problems in vertical pumps. Most often, the majority of the pump assembly is not readily accessible for visual or audible inspection or conventional vibration monitoring techniques using accelerometers and/or proximity sensors. The root cause failure analysis of a 2-stage vertical centrifugal service-water pump at a nuclear power generating facility in the USA is presented, highlighting this long standing challenge in condition monitoring of vertical pumps. This paper will summarize the major findings of the root cause analysis (RCA), highlight the limitations of traditional monitoring techniques, and present an expanded application of motor current monitoring as a means to gain insight into the mechanical performance and condition of a pump. The 'real-world' example of failure, monitoring and correlation of the monitoring technique to a detailed pump disassembly inspection is also presented. This paper will explain some of the reasons behind well known design principles requiring natural frequency separation from known forcing frequencies, as well as explore an unexpected submerged brittle fracture failure mechanism, and how such issues may be avoided. (author)

  4. 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 (diabetes who had experienced a structured 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.

  5. Long-term blood glucose monitoring with implanted telemetry device in conscious and stress-free cynomolgus monkeys.

    Science.gov (United States)

    Wang, B; Sun, G; Qiao, W; Liu, Y; Qiao, J; Ye, W; Wang, H; Wang, X; Lindquist, R; Wang, Y; Xiao, Y-F

    2017-09-01

    Continuous blood glucose monitoring, especially long-term and remote, in diabetic patients or research is very challenging. Nonhuman primate (NHP) is an excellent model for metabolic research, because NHPs can naturally develop Type 2 diabetes mellitus (T2DM) similarly to humans. This study was to investigate blood glucose changes in conscious, moving-free cynomolgus monkeys (Macaca fascicularis) during circadian, meal, stress and drug exposure. Blood glucose, body temperature and physical activities were continuously and simultaneously recorded by implanted HD-XG telemetry device for up to 10 weeks. Blood glucose circadian changes in normoglycemic monkeys significantly differed from that in diabetic animals. Postprandial glucose increase was more obvious after afternoon feeding. Moving a monkey from its housing cage to monkey chair increased blood glucose by 30% in both normoglycemic and diabetic monkeys. Such increase in blood glucose declined to the pre-procedure level in 30 min in normoglycemic animals and >2 h in diabetic monkeys. Oral gavage procedure alone caused hyperglycemia in both normoglycemic and diabetic monkeys. Intravenous injection with the stress hormones, angiotensin II (2 μg/kg) or norepinephrine (0.4 μg/kg), also increased blood glucose level by 30%. The glucose levels measured by the telemetry system correlated significantly well with glucometer readings during glucose tolerance tests (ivGTT or oGTT), insulin tolerance test (ITT), graded glucose infusion (GGI) and clamp. Our data demonstrate that the real-time telemetry method is reliable for monitoring blood glucose remotely and continuously in conscious, stress-free, and moving-free NHPs with the advantages highly valuable to diabetes research and drug discovery.

  6. 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......% 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...

  7. 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...

  8. Privacy and Security Issues Surrounding the Protection of Data Generated by Continuous Glucose Monitors.

    Science.gov (United States)

    Britton, Katherine E; Britton-Colonnese, Jennifer D

    2017-03-01

    Being able to track, analyze, and use data from continuous glucose monitors (CGMs) and through platforms and apps that communicate with CGMs helps achieve better outcomes and can advance the understanding of diabetes. The risks to patients' expectation of privacy are great, and their ability to control how their information is collected, stored, and used is virtually nonexistent. Patients' physical security is also at risk if adequate cybersecurity measures are not taken. Currently, data privacy and security protections are not robust enough to address the privacy and security risks and stymies the current and future benefits of CGM and the platforms and apps that communicate with them.

  9. Continuous glucose monitoring and HbA1c in the evaluation of glucose metabolism in children at high risk for type 1 diabetes mellitus.

    Science.gov (United States)

    Helminen, Olli; Pokka, Tytti; Tossavainen, Päivi; Ilonen, Jorma; Knip, Mikael; Veijola, Riitta

    2016-10-01

    Continuous glucose monitoring (CGM) parameters, self-monitored blood glucose (SMBG), HbA1c and oral glucose tolerance test (OGTT) were studied during preclinical type 1 diabetes mellitus. Ten asymptomatic children with multiple (⩾2) islet autoantibodies (cases) and 10 age and sex-matched autoantibody-negative controls from the Type 1 Diabetes Prediction and Prevention (DIPP) Study were invited to 7-day CGM with Dexcom G4 Platinum Sensor. HbA1c and two daily SMBG values (morning and evening) were analyzed. Five-point OGTTs were performed and carbohydrate intake was assessed by food records. The matched pairs were compared with the paired sample t-test. The cases showed higher mean values and higher variation in glucose levels during CGM compared to the controls. The time spent ⩾7.8mmol/l was 5.8% in the cases compared to 0.4% in the controls (p=0.040). Postprandial CGM values were similar except after the dinner (6.6mmol/l in cases vs. 6.1mmol/l in controls; p=0.023). When analyzing the SMBG values higher mean level, higher evening levels, as well as higher variation were observed in the cases when compared to the controls. HbA1c was significantly higher in the cases [5.7% (39mmol/mol) vs. 5.3% (34mmol/mol); p=0.045]. No differences were observed in glucose or C-peptide levels during OGTT. Daily carbohydrate intake was slightly higher in the cases (254.2g vs. 217.7g; p=0.034). Glucose levels measured by CGM and SMBG are useful indicators of dysglycemia during preclinical type 1 diabetes mellitus. Increased evening glucose values seem to be common in children with preclinical type 1 diabetes mellitus. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Acoustic monitoring techniques for corrosion degradation in cemented waste canisters

    International Nuclear Information System (INIS)

    Naish, C.C.; Buttle, D.; Wallace-Sims, R.; O'Brien, T.M.

    1991-01-01

    This report describes work to investigate acoustic emission as a non-intrusive monitor of corrosion and degradation of cemented wasteforms where the waste is a potentially reactive metal. The acoustic data collected shows good correlation with the corrosion rate as measured by hydrogen gas evolution rates and the electrochemically measured corrosion rates post cement hardening. The technique has been shown to be sensitive in detecting stress caused by expansive corrosion product within the cemented wasteform. The attenuation of the acoustic signal by the wasteform reduced the signal received by the monitoring equipment by a factor of 10 over a distance of approximately 150-400 mm, dependent on the water level in the cement. Full size packages were successfully monitored. It is concluded that the technique offers good potential for monitoring cemented containers of the more reactive metals, for example Magnox and aluminium. (author)

  11. Techniques for Non-Invasive Monitoring of Arterial Blood Pressure

    Directory of Open Access Journals (Sweden)

    Agnes S. Meidert

    2018-01-01

    Full Text Available Since both, hypotension and hypertension, can potentially impair the function of vital organs such as heart, brain, or kidneys, monitoring of arterial blood pressure (BP is a mainstay of hemodynamic monitoring in acutely or critically ill patients. Arterial BP can either be obtained invasively via an arterial catheter or non-invasively. Non-invasive BP measurement provides either intermittent or continuous readings. Most commonly, an occluding upper arm cuff is used for intermittent non-invasive monitoring. BP values are then obtained either manually (by auscultation of Korotkoff sounds or palpation or automatically (e.g., by oscillometry. For continuous non-invasive BP monitoring, the volume clamp method or arterial applanation tonometry can be used. Both techniques enable the arterial waveform and BP values to be obtained continuously. This article describes the different techniques for non-invasive BP measurement, their advantages and limitations, and their clinical applicability.

  12. Institutional blood glucose monitoring system for hospitalized patients: an integral component of the inpatient glucose control program.

    Science.gov (United States)

    Boaz, Mona; Landau, Zohar; Matas, Zipora; Wainstein, Julio

    2009-09-01

    The ability to measure patient blood glucose levels at bedside in hospitalized patients and to transmit those values to a central database enables and facilitates glucose control and follow-up and is an integral component in the care of the hospitalized diabetic patient. The goal of this study was to evaluate the performance of an institutional glucometer employed in the framework of the Program for the Treatment of the Hospitalized Diabetic Patient (PTHDP) at E. Wolfson Medical Center, Holon, Israel. As part of the program to facilitate glucose control in hospitalized diabetic patients, an institutional glucometer was employed that permits uploading of data from stands located in each inpatient department and downloading of that data to a central hospital-wide database. Blood glucose values from hospitalized diabetic patients were collected from August 2007 to October 2008. The inpatient glucose control program was introduced gradually beginning January 2008. During the follow-up period, more than 150,000 blood glucose measures were taken. Mean glucose was 195.7 +/- 99.12 mg/dl during the follow-up period. Blood glucose values declined from 206 +/- 105 prior to PTHDP (August 2007-December 2007) to 186 +/- 92 after its inception (January 2008-October 2008). The decline was associated significantly with time (r = 0.11, p < 0.0001). The prevalence of blood glucose values lower than 60 mg/dl was 1.48% [95% confidence interval (CI) 0.36%] prior to vs 1.55% (95% CI 0.37%) following implementation of the PTHDP. Concomitantly, a significant increase in the proportion of blood glucose values between 80 and 200 mg/dl was observed, from 55.5% prior to program initiation vs 61.6% after program initiation (p < 0.0001). The present study was designed to observe changes in institution-wide glucose values following implementation of the PTHDP. Information was extracted from the glucometer system itself. Because the aforementioned study was not a clinical trial, we cannot rule out

  13. Investigation progress of imaging techniques monitoring stem cell therapy

    International Nuclear Information System (INIS)

    Wu Jun; An Rui

    2006-01-01

    Recently stem cell therapy has showed potential clinical application in diabetes mellitus, cardiovascular diseases, malignant tumor and trauma. Efficient techniques of non-invasively monitoring stem cell transplants will accelerate the development of stem cell therapies. This paper briefly reviews the clinical practice of stem cell, in addition, makes a review of monitoring methods including magnetic resonance and radionuclide imaging which have been used in stem cell therapy. (authors)

  14. Glucose Fluctuations during Gestation: An Additional Tool for Monitoring Pregnancy Complicated by Diabetes

    Directory of Open Access Journals (Sweden)

    M. G. Dalfrà

    2013-01-01

    Full Text Available Continuous glucose monitoring (CGM gives a unique insight into magnitude and duration of daily glucose fluctuations. Limited data are available on glucose variability (GV in pregnancy. We aimed to assess GV in healthy pregnant women and cases of type 1 diabetes mellitus or gestational diabetes (GDM and its possible association with HbA1c. CGM was performed in 50 pregnant women (20 type 1, 20 GDM, and 10 healthy controls in all three trimesters of pregnancy. We calculated mean amplitude of glycemic excursions (MAGE, standard deviation (SD, interquartile range (IQR, and continuous overlapping net glycemic action (CONGA, as parameters of GV. The high blood glycemic index (HBGI and low blood glycemic index (LBGI were also measured as indicators of hyperhypoglycemic risk. Women with type 1 diabetes showed higher GV, with a 2-fold higher risk of hyperglycemic spikes during the day, than healthy pregnant women or GDM ones. GDM women had only slightly higher GV parameters than healthy controls. HbA1c did not correlate with GV indicators in type 1 diabetes or GDM pregnancies. We provided new evidence of the importance of certain GV indicators in pregnant women with GDM or type 1 diabetes and recommended the use of CGM specifically in these populations.

  15. A 3D paper-based enzymatic fuel cell for self-powered, low-cost glucose monitoring.

    Science.gov (United States)

    Fischer, Christopher; Fraiwan, Arwa; Choi, Seokheun

    2016-05-15

    In this work, we demonstrate a novel low-cost, self-powered paper-based biosensor for glucose monitoring. The device operating mechanism is based on a glucose/oxygen enzymatic fuel cell using an electrochemical energy conversion as a transducing element for glucose monitoring. The self-powered glucose biosensor features (i) a 3D origami paper-based structure for easy system integration onto paper, (ii) an air-cathode on paper for low-cost production and easy operation, and (iii) a screen printed chitosan/glucose oxidase anode for stable current generation as an analytical signal for glucose monitoring. The sensor showed a linear range of output current at 1-5mM glucose (R(2)=0.996) with a sensitivity of 0.02 µA mM(-1). The advantages offered by such a device, including a low cost, lack of external power sources/sophisticated external transducers, and the capacity to rapidly generate reliable results, are well suited for the clinical and social settings of the developing world. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Monitoring of civil engineering structures using Digital Image Correlation technique

    Science.gov (United States)

    Malesa, M.; Szczepanek, D.; Kujawińska, M.; Świercz, A.; Kołakowski, P.

    2010-06-01

    The Digital Image Correlation (DIC) technique enables full field, noncontact measurements of displacements and strains of a wide variety of objects. An adaptation of the DIC technique for monitoring of civil-engineering structures is presented in the paper. A general concept of the complex, automatic monitoring system, in which the DIC sensor plays an important role is described. Some new software features, which aim to facilitate outdoor measurements and speed up the correlation analysis, is also introduced. As an example of application, measurements of a railway bridge in Nieporet (Poland) are presented. The experimental results are compared with displacements of a FEM model of the bridge.

  17. Techniques for the generation and monitoring of vapors

    International Nuclear Information System (INIS)

    Nelson, G.O.

    1981-01-01

    Controlled test atmospheres can be produced using a variety of techniques. Gases are usually generated by using flow dilution methods while vapors are produced by using solvent injection and vaporization, saturation, permeation and diffusion techniques. The resulting gas mixtures can be monitored and measured using flame ionization, photoionization, electrochemical and infrared analytical systems. An ideal system for the production of controlled test atmospheres would not only be able to generate controlled test atmospheres, but also monitor all pertinent environmental parameters, such as temperature, humidity, and air flow

  18. Impurity monitoring by laser-induced fluorescence techniques

    International Nuclear Information System (INIS)

    Gelbwachs, J.A.

    1984-01-01

    Laser-induced fluorescence spectroscopy can provide a highly sensitive and selective means of detecting atomic and ionic impurities. Because the photodetector can be physically isolated from the laser-excited region, these techniques can be applied to monitoring in hostile environments. The basic concepts behind fluorescence detection are reviewed. Saturated optical excitation is shown to maximize impurity atom emission yield while mitigating effects of laser intensity fluctuations upon absolute density calibration. Monitoring in high- and low-pressure monitoring environments is compared. Methods to improve detection sensitivity by luminescence background suppression are presented

  19. Monitoring techniques for the manufacture of tapered optical fibers.

    Science.gov (United States)

    Mullaney, Kevin; Correia, Ricardo; Staines, Stephen E; James, Stephen W; Tatam, Ralph P

    2015-10-01

    The use of a range of optical techniques to monitor the process of fabricating optical fiber tapers is investigated. Thermal imaging was used to optimize the alignment of the optical system; the transmission spectrum of the fiber was monitored to confirm that the tapers had the required optical properties and the strain induced in the fiber during tapering was monitored using in-line optical fiber Bragg gratings. Tapers were fabricated with diameters down to 5 μm and with waist lengths of 20 mm using single-mode SMF-28 fiber.

  20. 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

  1. A comparative effectiveness analysis of three continuous glucose monitors: the Navigator, G4 Platinum, and Enlite.

    Science.gov (United States)

    Damiano, Edward R; McKeon, Katherine; El-Khatib, Firas H; Zheng, Hui; Nathan, David M; Russell, Steven J

    2014-07-01

    The effectiveness and safety of continuous glucose monitors (CGMs) is dependent on their accuracy and reliability. The objective of this study was to compare 3 CGMs in adult and pediatric subjects with type 1 diabetes under closed-loop blood-glucose (BG) control. Twenty-four subjects (12 adults) with type 1 diabetes each participated in one 48-hour closed-loop BG control experiment. Venous plasma glucose (PG) measurements obtained every 15 minutes (4657 values) were paired in time with corresponding CGM glucose (CGMG) measurements obtained from 3 CGMs (FreeStyle Navigator, Abbott Diabetes Care; G4 Platinum, Dexcom; Enlite, Medtronic) worn simultaneously by each subject. The Navigator and G4 Platinum (G4) had the best overall accuracy, with an aggregate mean absolute relative difference (MARD) of all paired points of 12.3 ± 12.1% and 10.8 ± 9.9%, respectively. Both had lower MARDs of all paired points than Enlite (17.9 ± 15.8%, P 50%) were less common with the G4 (0.5%) than with the Enlite (4.3%, P = .0001) while the number of very large errors with the Navigator (1.4%) was intermediate between the G4 and Enlite (P = .1 and P = .06, respectively). The average MARD for experiments in adolescent subjects were lower than in adult subjects for the Navigator and G4, while there was no difference for Enlite. All 3 devices had similar reliability. A comprehensive head-to-head-to-head comparison of 3 CGMs revealed marked differences in both accuracy and precision. The Navigator and G4 were found to outperform the Enlite in these areas. © 2014 Diabetes Technology Society.

  2. Evaluation of 12 blood glucose monitoring systems for self-testing: system accuracy and measurement reproducibility.

    Science.gov (United States)

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

    2014-02-01

    Systems for self-monitoring of blood glucose (SMBG) have to provide accurate and reproducible blood glucose (BG) values in order to ensure adequate therapeutic decisions by people with diabetes. Twelve SMBG systems were compared in a standardized manner under controlled laboratory conditions: nine systems were available on the German market and were purchased from a local pharmacy, and three systems were obtained from the manufacturer (two systems were available on the U.S. market, and one system was not yet introduced to the German market). System accuracy was evaluated following DIN EN ISO (International Organization for Standardization) 15197:2003. In addition, measurement reproducibility was assessed following a modified TNO (Netherlands Organization for Applied Scientific Research) procedure. Comparison measurements were performed with either the glucose oxidase method (YSI 2300 STAT Plus™ glucose analyzer; YSI Life Sciences, Yellow Springs, OH) or the hexokinase method (cobas(®) c111; Roche Diagnostics GmbH, Mannheim, Germany) according to the manufacturer's measurement procedure. The 12 evaluated systems showed between 71.5% and 100% of the measurement results within the required system accuracy limits. Ten systems fulfilled with the evaluated test strip lot minimum accuracy requirements specified by DIN EN ISO 15197:2003. In addition, accuracy limits of the recently published revision ISO 15197:2013 were applied and showed between 54.5% and 100% of the systems' measurement results within the required accuracy limits. Regarding measurement reproducibility, each of the 12 tested systems met the applied performance criteria. In summary, 83% of the systems fulfilled with the evaluated test strip lot minimum system accuracy requirements of DIN EN ISO 15197:2003. Each of the tested systems showed acceptable measurement reproducibility. In order to ensure sufficient measurement quality of each distributed test strip lot, regular evaluations are required.

  3. Performance of two updated blood glucose monitoring systems: an evaluation following ISO 15197:2013.

    Science.gov (United States)

    Pleus, Stefan; Baumstark, Annette; Rittmeyer, Delia; Jendrike, Nina; Haug, Cornelia; Freckmann, Guido

    2016-05-01

    Objective For patients with diabetes, regular self-monitoring of blood glucose (SMBG) is essential to ensure adequate glycemic control. Therefore, accurate and reliable blood glucose measurements with SMBG systems are necessary. The international standard ISO 15197 describes requirements for SMBG systems, such as limits within which 95% of glucose results have to fall to reach acceptable system accuracy. The 2013 version of this standard sets higher demands, especially regarding system accuracy, than the currently still valid edition. ISO 15197 can be applied by manufacturers to receive a CE mark for their system. Research design and methods This study was an accuracy evaluation following ISO 15197:2013 section 6.3 of two recently updated SMBG systems (Contour * and Contour TS; Bayer Consumer Care AG, Basel, Switzerland) with an improved algorithm to investigate whether the systems fulfill the requirements of the new standard. For this purpose, capillary blood samples of approximately 100 participants were measured with three test strip lots of both systems and deviations from glucose values obtained with a hexokinase-based comparison method (Cobas Integra † 400 plus; Roche Instrument Center, Rotkreuz, Switzerland) were determined. Percentages of values within the acceptance criteria of ISO 15197:2013 were calculated. This study was registered at clinicaltrials.gov (NCT02358408). Main outcome Both updated systems fulfilled the system accuracy requirements of ISO 15197:2013 as 98.5% to 100% of the results were within the stipulated limits. Furthermore, all results were within the clinically non-critical zones A and B of the consensus error grid for type 1 diabetes. Conclusions The technical improvement of the systems ensured compliance with ISO 15197 in the hands of healthcare professionals even in its more stringent 2013 version. Alternative presentation of system accuracy results in radar plots provides additional information with certain advantages. In addition

  4. Differential effects of vildagliptin and glimepiride on glucose fluctuations in patients with type 2 diabetes mellitus assessed using continuous glucose monitoring.

    Science.gov (United States)

    He, Y L; Foteinos, G; Neelakantham, S; Mattapalli, D; Kulmatycki, K; Forst, T; Taylor, A

    2013-12-01

    To assess whether there is a difference in the effects of vildagliptin and glimepiride on glucose fluctuation in patients with type 2 diabetes mellitus (T2DM) using continuous glucose monitoring (CGM). This was an open-label, randomized cross-over study conducted in T2DM patients. A total of 24 patients (age: 58.3 ± 5.56 years, baseline HbA1c: 7.6 ± 0.50%) who were on stable metformin monotherapy (500-3000 mg) were enrolled, and all completed the study. Each patient received two 5-day treatments (vildagliptin 50 mg b.i.d. or glimepiride 2 mg q.d.) in a cross-over manner. Various biomarkers and blood glucose concentrations were measured following breakfast. The 24-h glucose profiles were also measured using the CGM device at baseline and after 5 days of treatment, and fluctuations in glucose levels were estimated from CGM data. Both vildagliptin and glimepiride reduced postprandial glucose levels, based on both CGM data (15% vs. 16%) and measured plasma glucose (13% vs.17%). Vildagliptin showed lower glucose fluctuations than glimepiride as measured by mean amplitude of glycaemic excursions (MAGE, p = 0.1076), standard deviation (s.d., p = 0.1346) of blood glucose rate of change, but did not reach statistical significance attributed to the small sample size. MAGE was reduced by ∼20% with vildagliptin versus glimepiride. Vildagliptin led to statistically significant lowering of the rate of change in the median curve (RCMC) and interquartile range (IQR) of glucose. Treatment with vildagliptin significantly increased the levels of active glucagon-like peptide-1 by 2.36-fold (p ≤ 0.0001) and suppressed glucagon by 8% (p = 0.01), whereas glimepiride significantly increased the levels of insulin and C-peptide by 21% (p = 0.012) and 12% (p = 0.003), respectively. Vildagliptin treatment was associated with less fluctuation of glucose levels than glimepiride treatment as assessed by 24-h CGM device, suggesting vildagliptin may

  5. Early Glucose Derangement Detected by Continuous Glucose Monitoring and Progression of Liver Fibrosis in Nonalcoholic Fatty Liver Disease: An Independent Predictive Factor?

    Science.gov (United States)

    Schiaffini, Riccardo; Liccardo, Daniela; Alisi, Anna; Benevento, Danila; Cappa, Marco; Cianfarani, Stefano; Nobili, Valerio

    2016-01-01

    Glucose derangement has been reported to increase oxidative stress, one of the most important factors underlying the progression of hepatic fibrosis in adults with nonalcoholic fatty liver disease (NAFLD). To date, careful evaluation of the glucose profile in pediatric NAFLD has not been performed. A total of 30 severely obese children (15 males; mean age 12.87 ± 2.19 years) with biopsy-proven NAFLD were enrolled in this study from September to December 2013. All patients underwent anthropometric and laboratory evaluation, including the oral glucose tolerance test (OGTT) and continuous glucose monitoring (CGM). Our study reveals some differences between OGTT and CGM in detecting NAFLD children with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). OGTT showed 2 (6.67%) patients with IFG and 1 (3.34%) with IGT, while CGM showed 5 (16.67%) patients with IFG and 6 (20%) with IGT. The daily blood glucose profile positively correlated with the baseline blood glucose (r = 0.39, p = 0.04) and the homeostatic model assessment (r = 0.56, p = 0.05). A positive correlation between hyperglycemia and liver fibrosis was found (r = 0.65, p < 0.05). Mean glucose values (F3-F4 group: 163.2 ± 35.92 mg/dl vs. F1 group: 136.58 ± 46.83 mg/dl and F2 group: 154.12 ± 22.51 mg/dl) and the difference between the minimum and maximum blood glucose levels (F3-F4 group: 110.21 ± 25.26 mg/dl vs. F1 group: 91.67 ± 15.97 mg/dl and F2 group: 92 ± 15.48 mg/dl) were significantly (p < 0.05) higher in the F3-F4 group compared to the F1 and F2 groups. Glucose profile derangement as detected by CGM is associated with the severity of hepatic fibrosis in children with NAFLD. © 2015 S. Karger AG, Basel.

  6. Development of the Diabetes Technology Society Blood Glucose Monitor System Surveillance Protocol.

    Science.gov (United States)

    Klonoff, David C; Lias, Courtney; Beck, Stayce; Parkes, Joan Lee; Kovatchev, Boris; Vigersky, Robert A; Arreaza-Rubin, Guillermo; Burk, Robert D; Kowalski, Aaron; Little, Randie; Nichols, James; Petersen, Matt; Rawlings, Kelly; Sacks, David B; Sampson, Eric; Scott, Steve; Seley, Jane Jeffrie; Slingerland, Robbert; Vesper, Hubert W

    2016-05-01

    Inaccurate blood glucsoe monitoring systems (BGMSs) can lead to adverse health effects. The Diabetes Technology Society (DTS) Surveillance Program for cleared BGMSs is intended to protect people with diabetes from inaccurate, unreliable BGMS products that are currently on the market in the United States. The Surveillance Program will provide an independent assessment of the analytical performance of cleared BGMSs. The DTS BGMS Surveillance Program Steering Committee included experts in glucose monitoring, surveillance testing, and regulatory science. Over one year, the committee engaged in meetings and teleconferences aiming to describe how to conduct BGMS surveillance studies in a scientifically sound manner that is in compliance with good clinical practice and all relevant regulations. A clinical surveillance protocol was created that contains performance targets and analytical accuracy-testing studies with marketed BGMS products conducted by qualified clinical and laboratory sites. This protocol entitled "Protocol for the Diabetes Technology Society Blood Glucose Monitor System Surveillance Program" is attached as supplementary material. This program is needed because currently once a BGMS product has been cleared for use by the FDA, no systematic postmarket Surveillance Program exists that can monitor analytical performance and detect potential problems. This protocol will allow identification of inaccurate and unreliable BGMSs currently available on the US market. The DTS Surveillance Program will provide BGMS manufacturers a benchmark to understand the postmarket analytical performance of their products. Furthermore, patients, health care professionals, payers, and regulatory agencies will be able to use the results of the study to make informed decisions to, respectively, select, prescribe, finance, and regulate BGMSs on the market. © 2015 Diabetes Technology Society.

  7. Development of the Diabetes Technology Society Blood Glucose Monitor System Surveillance Protocol

    Science.gov (United States)

    Klonoff, David C.; Lias, Courtney; Beck, Stayce; Parkes, Joan Lee; Kovatchev, Boris; Vigersky, Robert A.; Arreaza-Rubin, Guillermo; Burk, Robert D.; Kowalski, Aaron; Little, Randie; Nichols, James; Petersen, Matt; Rawlings, Kelly; Sacks, David B.; Sampson, Eric; Scott, Steve; Seley, Jane Jeffrie; Slingerland, Robbert; Vesper, Hubert W.

    2015-01-01

    Background: Inaccurate blood glucsoe monitoring systems (BGMSs) can lead to adverse health effects. The Diabetes Technology Society (DTS) Surveillance Program for cleared BGMSs is intended to protect people with diabetes from inaccurate, unreliable BGMS products that are currently on the market in the United States. The Surveillance Program will provide an independent assessment of the analytical performance of cleared BGMSs. Methods: The DTS BGMS Surveillance Program Steering Committee included experts in glucose monitoring, surveillance testing, and regulatory science. Over one year, the committee engaged in meetings and teleconferences aiming to describe how to conduct BGMS surveillance studies in a scientifically sound manner that is in compliance with good clinical practice and all relevant regulations. Results: A clinical surveillance protocol was created that contains performance targets and analytical accuracy-testing studies with marketed BGMS products conducted by qualified clinical and laboratory sites. This protocol entitled “Protocol for the Diabetes Technology Society Blood Glucose Monitor System Surveillance Program” is attached as supplementary material. Conclusion: This program is needed because currently once a BGMS product has been cleared for use by the FDA, no systematic postmarket Surveillance Program exists that can monitor analytical performance and detect potential problems. This protocol will allow identification of inaccurate and unreliable BGMSs currently available on the US market. The DTS Surveillance Program will provide BGMS manufacturers a benchmark to understand the postmarket analytical performance of their products. Furthermore, patients, health care professionals, payers, and regulatory agencies will be able to use the results of the study to make informed decisions to, respectively, select, prescribe, finance, and regulate BGMSs on the market. PMID:26481642

  8. Assessing sensor accuracy for non-adjunct use of continuous glucose monitoring.

    Science.gov (United States)

    Kovatchev, Boris P; Patek, Stephen D; Ortiz, Edward Andrew; Breton, Marc D

    2015-03-01

    The level of continuous glucose monitoring (CGM) accuracy needed for insulin dosing using sensor values (i.e., the level of accuracy permitting non-adjunct CGM use) is a topic of ongoing debate. Assessment of this level in clinical experiments is virtually impossible because the magnitude of CGM errors cannot be manipulated and related prospectively to clinical outcomes. A combination of archival data (parallel CGM, insulin pump, self-monitoring of blood glucose [SMBG] records, and meals for 56 pump users with type 1 diabetes) and in silico experiments was used to "replay" real-life treatment scenarios and relate sensor error to glycemic outcomes. Nominal blood glucose (BG) traces were extracted using a mathematical model, yielding 2,082 BG segments each initiated by insulin bolus and confirmed by SMBG. These segments were replayed at seven sensor accuracy levels (mean absolute relative differences [MARDs] of 3-22%) testing six scenarios: insulin dosing using sensor values, threshold, and predictive alarms, each without or with considering CGM trend arrows. In all six scenarios, the occurrence of hypoglycemia (frequency of BG levels ≤50 mg/dL and BG levels ≤39 mg/dL) increased with sensor error, displaying an abrupt slope change at MARD =10%. Similarly, hyperglycemia (frequency of BG levels ≥250 mg/dL and BG levels ≥400 mg/dL) increased and displayed an abrupt slope change at MARD=10%. When added to insulin dosing decisions, information from CGM trend arrows, threshold, and predictive alarms resulted in improvement in average glycemia by 1.86, 8.17, and 8.88 mg/dL, respectively. Using CGM for insulin dosing decisions is feasible below a certain level of sensor error, estimated in silico at MARD=10%. In our experiments, further accuracy improvement did not contribute substantively to better glycemic outcomes.

  9. Invasiveness as a barrier to self-monitoring of blood glucose in diabetes.

    Science.gov (United States)

    Wagner, Julie; Malchoff, Carl; Abbott, Gina

    2005-08-01

    This study investigated the degree to which the invasive characteristic of glucose monitoring is a barrier to self-monitoring of blood glucose (SMBG). A paper-and-pencil Measure of Invasiveness as a reason for Skipping SMBG (MISS) was created and administered to 339 people with diabetes. The correlations between MISS scores and actual SMBG frequency, percent adherence to SMBG recommendations, SMBG anxiety, SMBG burden, and knowledge of the importance of glycemic control for avoiding diabetes complications were each explored. On a scale of 0-28, the average MISS score was M = 4.3 (SD = 5.4, range 0-28). Fully 63% (nearly two-thirds) of respondents reported skipping SMBG because of the invasiveness of the procedure. MISS scores were negatively related to percent adherence to healthcare provider SMBG recommendations as measured by memory function of automated meters (Spearman's r= -0.47, P diabetes vascular complications. Invasiveness is a common and serious barrier to SMBG. These findings suggest that people with diabetes would perform SMBG more frequently and have improved quality of life with non-invasive SMBG.

  10. Low dose monitoring by double implant technique in IC fabrication

    International Nuclear Information System (INIS)

    Ahmad, I.B.; Weidemann, J.

    1995-01-01

    The utilisation of low dose implant monitoring (using Boron) in a manufacturing line has been discussed. The utilisation of phosphorus ions as the second implant dose were also studied as comparison. The technique relies on the fact that the sheet resistant of doped layer will increase significantly when damaged by relatively low implant dose. The technique is very sensitive and applicable for adjusting the channel dose so that an accurate threshold voltage in MOS device could be achieved

  11. An intensity-monitoring technique for measuring ellipsometric transients

    NARCIS (Netherlands)

    Droog, J.M.M.; Bootsma, G.A.

    1979-01-01

    Intensity-monitoring techniques make possible the measurement of rapid changes in the ellipsometric parameters. Methods used hitherto have been suitable for measuring slight changes only and require prior knowledge of the Δ and Ψ values for the initial surface. It is shown that larger changes can

  12. Interim Report on Concrete Degradation Mechanisms and Online Monitoring Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Mahadevan, Sankaran [Idaho National Lab. (INL), Idaho Falls, ID (United States); Agarwal, Vivek [Idaho National Lab. (INL), Idaho Falls, ID (United States); Neal, Kyle [Idaho National Lab. (INL), Idaho Falls, ID (United States); Kosson, David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Adams, Douglas [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-09-01

    The existing nuclear power plants in the United States have initial operating licenses of 40 years, though most of these plants have applied for and received license extensions. As plant structures, systems, and components age, their useful life—considering both structural integrity and performance—is reduced as a result of deterioration of the materials. The research on online monitoring of concrete structures conducted under the Advanced Instrumentation, Information, and Control Systems Technologies Pathway of the Light Water Reactor Sustainability Program at Idaho National Laboratory will develop and demonstrate concrete structures health monitoring capabilities. Assessment and management of aging concrete structures in nuclear plants require a more systematic approach than simple reliance on existing code margins of safety. Therefore, structural health monitoring is required to produce actionable information regarding structural integrity that supports operational and maintenance decisions. Through this research project, several national laboratories and Vanderbilt University propose to develop a framework of research activities for the health monitoring of nuclear power plant concrete structures that includes the integration of four elements—damage modeling, monitoring, data analytics, and uncertainty quantification. This report briefly discusses available techniques and ongoing challenges in each of the four elements of the proposed framework with emphasis on degradation mechanisms and online monitoring techniques.

  13. Real-time continuous glucose monitoring shows high accuracy within 6 hours after sensor calibration: a prospective study.

    Directory of Open Access Journals (Sweden)

    Xiao-Yan Yue

    Full Text Available Accurate and timely glucose monitoring is essential in intensive care units. Real-time continuous glucose monitoring system (CGMS has been advocated for many years to improve glycemic management in critically ill patients. In order to determine the effect of calibration time on the accuracy of CGMS, real-time subcutaneous CGMS was used in 18 critically ill patients. CGMS sensor was calibrated with blood glucose measurements by blood gas/glucose analyzer every 12 hours. Venous blood was sampled every 2 to 4 hours, and glucose concentration was measured by standard central laboratory device (CLD and by blood gas/glucose analyzer. With CLD measurement as reference, relative absolute difference (mean±SD in CGMS and blood gas/glucose analyzer were 14.4%±12.2% and 6.5%±6.2%, respectively. The percentage of matched points in Clarke error grid zone A was 74.8% in CGMS, and 98.4% in blood gas/glucose analyzer. The relative absolute difference of CGMS obtained within 6 hours after sensor calibration (8.8%±7.2% was significantly less than that between 6 to 12 hours after calibration (20.1%±13.5%, p<0.0001. The percentage of matched points in Clarke error grid zone A was also significantly higher in data sets within 6 hours after calibration (92.4% versus 57.1%, p<0.0001. In conclusion, real-time subcutaneous CGMS is accurate in glucose monitoring in critically ill patients. CGMS sensor should be calibrated less than 6 hours, no matter what time interval recommended by manufacturer.

  14. [Applications of spectral analysis technique to monitoring grasshoppers].

    Science.gov (United States)

    Lu, Hui; Han, Jian-guo; Zhang, Lu-da

    2008-12-01

    Grasshopper monitoring is of great significance in protecting environment and reducing economic loss. However, how to predict grasshoppers accurately and effectively is a difficult problem for a long time. In the present paper, the importance of forecasting grasshoppers and its habitat is expounded, and the development in monitoring grasshopper populations and the common arithmetic of spectral analysis technique are illustrated. Meanwhile, the traditional methods are compared with the spectral technology. Remote sensing has been applied in monitoring the living, growing and breeding habitats of grasshopper population, and can be used to develop a forecast model combined with GIS. The NDVI values can be analyzed throughout the remote sensing data and be used in grasshopper forecasting. Hyper-spectra remote sensing technique which can be used to monitor grasshoppers more exactly has advantages in measuring the damage degree and classifying damage areas of grasshoppers, so it can be adopted to monitor the spatial distribution dynamic of rangeland grasshopper population. Differentialsmoothing can be used to reflect the relations between the characteristic parameters of hyper-spectra and leaf area index (LAI), and indicate the intensity of grasshopper damage. The technology of near infrared reflectance spectroscopy has been employed in judging grasshopper species, examining species occurrences and monitoring hatching places by measuring humidity and nutrient of soil, and can be used to investigate and observe grasshoppers in sample research. According to this paper, it is concluded that the spectral analysis technique could be used as a quick and exact tool in monitoring and forecasting the infestation of grasshoppers, and will become an important means in such kind of research for their advantages in determining spatial orientation, information extracting and processing. With the rapid development of spectral analysis methodology, the goal of sustainable monitoring

  15. Design of a prospective clinical study on the agreement between the Continuous GlucoseMonitor, a novel device for CONTinuous ASSessment of blood GLUcose levels, and the RAPIDLab® 1265 blood gas analyser: The CONTASSGLU study

    OpenAIRE

    Zimmermann Johannes B; Lehmann Monika; Hofer Stefan; Hüsing Johannes; Alles Catharina; Werner Jens; Stiller Jürgen; Künnecke Wolfgang; Luntz Steffen; Motsch Johann; Weigand Markus A

    2012-01-01

    Abstract Background Although a device is needed to continuously measure blood glucose levels within an intensive care setting, and several large-scale prospective studies have shown that patients might benefit from intensive insulin, potassium, or glucose therapy during intensive care, no devices are currently available to continuously assess blood glucose levels in critically ill patients. We conceived the study described here to evaluate the clinical use of the Continuous Glucose Monitor (C...

  16. Peculiarities of the Continuous Glucose Monitoring Data Stream and Their Impact on Developing Closed-Loop Control Technology

    OpenAIRE

    Kovatchev, Boris; Clarke, William

    2008-01-01

    Therapeutic advances in type 1 diabetes (T1DM) are currently focused on developing a closed-loop control system using a continuous glucose monitor (CGM), subcutaneous insulin delivery, and a control algorithm. Because a CGM assesses blood glucose indirectly (and therefore often inaccurately), it limits the effectiveness of the controller. In order to improve the quality of CGM data, a series of analyses are suggested. These analyses evaluate and compensate for CGM errors, assess risks associa...

  17. Blood glucose monitoring during aerobic and anaerobic physical exercise using a new artificial pancreas system.

    Science.gov (United States)

    Quirós, Carmen; Bertachi, Arthur; Giménez, Marga; Biagi, Lyvia; Viaplana, Judith; Viñals, Clara; Vehí, Josep; Conget, Ignacio; Bondia, Jorge

    To assess an artificial pancreas system during aerobic (AeE) and anaerobic exercise (AnE). A pilot clinical trial on five subjects with type 1 diabetes (4 males) aged 37±10.9 years, diabetes diagnosed 21.2±12.2 years before, insulin pump users, and with a mean HbA 1c level of 7.8±0.5%. Every subject did three AeE and three AnE sessions. Blood glucose levels were monitored by the artificial pancreas system during exercise and up to four hours later. Before the start of exercise, 23g of carbohydrates were administered orally. The mean glucose level was 124.0±25.1mg/dL in the AeE studies and 152.1±34.1mg/dL in the AnE studies. Percent times in the different glucose ranges of 70-180, >180 and 18.6% and 75.9±27.6%; 7.7±18.4% and 23.2±28.0%; and 2.5±6.3% and 1.0±3.6% during the AeE and AnE sessions, respectively. Only six rescues with carbohydrates (15g) were required during the studies (4 in AeE and 2 in AnE). Total insulin dose during the five hours of the study was 3.1±1.0IU in the AeE studies and 3.5±1.3IU in the AnE studies. Blood glucose response to AeE and AnE exercise is different. The evaluated artificial pancreas system appeared to achieve effective and safe blood glucose control during exercise and up to four hours later. However, new control strategies that minimize patient intervention should be designed. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Recent advances in nuclear techniques for environmental radioactivity monitoring

    International Nuclear Information System (INIS)

    Kumar, Ajay; Tripathi, R.M.

    2016-01-01

    The environmental radioactivity monitoring was first started in the late 1950s following the global fallout from testing of nuclear weapons in the atmosphere. Nuclear analytical techniques are generally classified into two categories: destructive and non-destructive. Destructive techniques are carried out through several analytical methods such as α-spectrometry, liquid Scintillation counting system, solid state nuclear track detector, spectrophotometry, fluorimetry, atomic absorption spectrometry (AAS), inductively coupled plasma mass spectrometry (ICP-MS), inductively coupled plasma optical emission spectrometry (ICP-OES), chromatography techniques, electro-analytical techniques etc. However, nondestructive methods include gamma spectrometry, X-Ray fluorescence (XRF) spectrometry, neutron activation analysis (NAA) etc. The development of radiochemical methods and measurement techniques using alpha and gamma spectrometry have been described in brief

  19. 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.

  20. Condition Monitoring of Cables Task 3 Report: Condition Monitoring Techniques for Electric Cables

    Energy Technology Data Exchange (ETDEWEB)

    Villaran, M.; Lofaro, R.; na

    2009-11-30

    For more than 20 years the NRC has sponsored research studying electric cable aging degradation, condition monitoring, and environmental qualification testing practices for electric cables used in nuclear power plants. This report summarizes several of the most effective and commonly used condition monitoring techniques available to detect damage and measure the extent of degradation in electric cable insulation. The technical basis for each technique is summarized, along with its application, trendability of test data, ease of performing the technique, advantages and limitations, and the usefulness of the test results to characterize and assess the condition of electric cables.

  1. Glucose Oxidase Adsorption on Sequential Adsorbed Polyelectrolyte Films Studied by Spectroscopic Techniques

    Science.gov (United States)

    Tristán, Ferdinando; Solís, Araceli; Palestino, Gabriela; Gergely, Csilla; Cuisinier, Frédéric; Pérez, Elías

    2005-04-01

    The adsorption of Glucose Oxidase (GOX) on layers of poly(allylamine hydrochloride) (PAH) and poly(acrylic acid) (PAA) deposited on Sequentially Adsorbed Polyelectrolyte Films (SAPFs) were studied by three different spectroscopic techniques. These techniques are: Optical Wave Light Spectroscopy (OWLS) to measure surface density; Fluorescence Resonance Energy Transfer (FRET) to verify the adsorption of GOX on the surface; and Fourier Transform Infrared Spectroscopy in Attenuated Total Reflection mode (FTIR-HATR) to inspect local structure of polyelectrolytes and GOX. Two positive and two negative polyelectrolytes are used: Cationic poly(ethyleneimine) (PEI) and poly(allylamine hydrochloride) (PAH) and anionic poly(sodium 4-styrene sulfonate) (PSS) and poly(acrylic acid) (PAA). These spectroscopic techniques do not require any labeling for GOX or SAPFs, specifically GOX and PSS are naturally fluorescent and are used as a couple donor-acceptor for the FRET technique. The SAPFs are formed by a (PEI)-(PSS/PAH)2 film followed by (PAA/PAH)n bilayers. GOX is finally deposited on top of SAPFs at different values of n (n=1..5). Our results show that GOX is adsorbed on positive ended SAPFs forming a monolayer. Contrary, GOX adsorption is not observed on negative ended film polyelectrolyte. GOX stability was tested adding a positive and a negative polyelectrolyte after GOX adsorption. Protein is partially removed by PAH and PAA, with lesser force by PAA.

  2. Mobile communication using a mobile phone with a glucometer for glucose control in Type 2 patients with diabetes: as effective as an Internet-based glucose monitoring system.

    Science.gov (United States)

    Cho, Jae-Hyoung; Lee, Hye-Chung; Lim, Dong-Jun; Kwon, Hyuk-Sang; Yoon, Kun-Ho

    2009-01-01

    A mobile phone with a glucometer integrated into the battery pack (the 'Diabetes Phone') was launched in Korea in 2003. We compared its effect on management of type 2 diabetes to the Internet-based glucose monitoring system (IBGMS), which had been studied previously. We conducted a randomized trial involving 69 patients for three months. Participants were assigned to an Internet group or a phone group. The phone group communicated with medical staff through the mobile phone only. Their glucose-monitoring data were automatically transferred to individual, web-based charts and they received medical recommendations by short message service. The Internet group used the IBGMS. There were no significant differences between the groups at baseline. After three months' intervention, HbA(1c) levels of both groups had decreased significantly, from 7.6% to 6.9% for the Internet group and from 8.3% to 7.1% for the phone group (P glucose control as the previously-studied Internet-based monitoring system and it was good for patient satisfaction and adherence.

  3. Effect of immobilization technique on performance ZnO nanorods based enzymatic electrochemical glucose biosensor

    Science.gov (United States)

    Shukla, Mayoorika; Pramila; Palani, I. A.; Singh, Vipul

    2017-11-01

    In this paper, ZnO Nanorods (ZNR) have been synthesized over Platinum (Pt) coated glass substrate with in-situ addition KMnO4 during hydrothermal growth process. Significant variation in ZnO nanostructures was observed by KMnO4 addition during the growth. Glucose oxidase was later immobilized over ZNRs. The as-prepared ZNRs were further utilized for glucose detection by employing amperometric electrochemical transduction method. In order to optimize the performance of the prepared biosensor two different immobilization techniques i.e. physical adsorption and cross linking have been employed and compared. Further investigations suggest that immobilization via cross linking method resulted in the improvement of the biosensor performance, thereby significantly affecting the sensitivity and linear range of the fabricated biosensor. Among the two types of biosensors fabricated using ZNR, the best performance was shown by cross linked electrodes. The sensitivity for the same was found to be 17.7 mA-cm-2-M-1, along with a wide linear range of 0.5-8.5 mM.

  4. Cross-validity of a portable glucose capillary monitors in relation to enzymatic spectrophotometer methods

    Directory of Open Access Journals (Sweden)

    William Alves Lima

    2006-09-01

    Full Text Available The glucose is an important substrate utilizaded during exercise. Accurate measurement of glucose is vital to obtain trustworthy results. The enzymatic spectrophotometer methods are generally considered the “goldstandard” laboratory procedure for measuring of glucose (GEnz, is time consuming, costly, and inappropriate for large scale field testing. Compact and portable glucose monitors (GAccu are quick and easy methods to assess glucose on large numbers of subjects. So, this study aimed to test the cross-validity of GAccu. The sample was composed of 107 men (aged= 35.4±10.7 years; stature= 168.4±6.9 cm; body mass= 73.4±11.2 kg; %fat= 20.9±8.3% – by dual energy x-ray absorptiometry. Blood for measuring fasting glucose was taken in basilar vein (Genz, Bioplus: Bio-2000 and in ring finger (GAccu: Accu-Chek© Advantage©, after a 12-hour overnight fast. GEnz was used as the criterion for cross-validity. Paired t-test shown differences (p RESUMO A glicose é um substrato importante utilizado durante o exercício físico. Medidas acuradas da glicose são fundamentais para a obtenção de resultados confiáveis. O método laboratorial de espectrofotometria enzimática geralmente é considerado o procedimento “padrão ouro” para medir a glicose (GEnz, o qual requer tempo, custo e é inapropriado para o uso em larga escala. Monitores portáteis de glicose (GAccu são rápidos e fáceis para medir a glicose em um grande número de sujeitos. Então, este estudo teve por objetivo testar a validade concorrente do GAccu. A amostra foi composta por 107 homens (idade= 35,4±10,7 anos; estatura= 168,4±6,9 cm; massa corporal= 73,4±11,2 kg; %gordura= 20,9±8,3% – por absortometria de raio-x de dupla energia. O sangue para mensurar a glicose em jejum foi tirado na veia basilar (Genz, Bioplus: Bio-2000 e no dedo anular (GAccu - Accu- Chek© Advantage©, depois de 12h de jejum noturno. O GEnz foi usado como critério para testar a validade

  5. Remote sensing techniques in monitoring areas affected by forest fire

    Science.gov (United States)

    Karagianni, Aikaterini Ch.; Lazaridou, Maria A.

    2017-09-01

    Forest fire is a part of nature playing a key role in shaping ecosystems. However, fire's environmental impacts can be significant, affecting wildlife habitat and timber, human settlements, man-made technical constructions and various networks (road, power networks) and polluting the air with emissions harmful to human health. Furthermore, fire's effect on the landscape may be long-lasting. Monitoring the development of a fire occurs as an important aspect at the management of natural hazards in general. Among the used methods for monitoring, satellite data and remote sensing techniques can be proven of particular importance. Satellite remote sensing offers a useful tool for forest fire detection, monitoring, management and damage assessment. Especially for fire scars detection and monitoring, satellite data derived from Landsat 8 can be a useful research tool. This paper includes critical considerations of the above and concerns in particular an example of the Greek area (Thasos Island). This specific area was hit by fires several times in the past and recently as well (September 2016). Landsat 8 satellite data are being used (pre and post fire imagery) and digital image processing techniques are applied (enhancement techniques, calculation of various indices) for fire scars detection. Visual interpretation of the example area affected by the fires is also being done, contributing to the overall study.

  6. 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.

  7. Autoregressive Modeling of Drift and Random Error to Characterize a Continuous Intravascular Glucose Monitoring Sensor.

    Science.gov (United States)

    Zhou, Tony; Dickson, Jennifer L; Geoffrey Chase, J

    2018-01-01

    Continuous glucose monitoring (CGM) devices have been effective in managing diabetes and offer potential benefits for use in the intensive care unit (ICU). Use of CGM devices in the ICU has been limited, primarily due to the higher point accuracy errors over currently used traditional intermittent blood glucose (BG) measures. General models of CGM errors, including drift and random errors, are lacking, but would enable better design of protocols to utilize these devices. This article presents an autoregressive (AR) based modeling method that separately characterizes the drift and random noise of the GlySure CGM sensor (GlySure Limited, Oxfordshire, UK). Clinical sensor data (n = 33) and reference measurements were used to generate 2 AR models to describe sensor drift and noise. These models were used to generate 100 Monte Carlo simulations based on reference blood glucose measurements. These were then compared to the original CGM clinical data using mean absolute relative difference (MARD) and a Trend Compass. The point accuracy MARD was very similar between simulated and clinical data (9.6% vs 9.9%). A Trend Compass was used to assess trend accuracy, and found simulated and clinical sensor profiles were similar (simulated trend index 11.4° vs clinical trend index 10.9°). The model and method accurately represents cohort sensor behavior over patients, providing a general modeling approach to any such sensor by separately characterizing each type of error that can arise in the data. Overall, it enables better protocol design based on accurate expected CGM sensor behavior, as well as enabling the analysis of what level of each type of sensor error would be necessary to obtain desired glycemic control safety and performance with a given protocol.

  8. Performance evaluations of continuous glucose monitoring systems: precision absolute relative deviation is part of the assessment.

    Science.gov (United States)

    Obermaier, Karin; Schmelzeisen-Redeker, Günther; Schoemaker, Michael; Klötzer, Hans-Martin; Kirchsteiger, Harald; Eikmeier, Heino; del Re, Luigi

    2013-07-01

    Even though a Clinical and Laboratory Standards Institute proposal exists on the design of studies and performance criteria for continuous glucose monitoring (CGM) systems, it has not yet led to a consistent evaluation of different systems, as no consensus has been reached on the reference method to evaluate them or on acceptance levels. As a consequence, performance assessment of CGM systems tends to be inconclusive, and a comparison of the outcome of different studies is difficult. Published information and available data (as presented in this issue of Journal of Diabetes Science and Technology by Freckmann and coauthors) are used to assess the suitability of several frequently used methods [International Organization for Standardization, continuous glucose error grid analysis, mean absolute relative deviation (MARD), precision absolute relative deviation (PARD)] when assessing performance of CGM systems in terms of accuracy and precision. The combined use of MARD and PARD seems to allow for better characterization of sensor performance. The use of different quantities for calibration and evaluation, e.g., capillary blood using a blood glucose (BG) meter versus venous blood using a laboratory measurement, introduces an additional error source. Using BG values measured in more or less large intervals as the only reference leads to a significant loss of information in comparison with the continuous sensor signal and possibly to an erroneous estimation of sensor performance during swings. Both can be improved using data from two identical CGM sensors worn by the same patient in parallel. Evaluation of CGM performance studies should follow an identical study design, including sufficient swings in glycemia. At least a part of the study participants should wear two identical CGM sensors in parallel. All data available should be used for evaluation, both by MARD and PARD, a good PARD value being a precondition to trust a good MARD value. Results should be analyzed and

  9. Continuous glucose monitoring in newborn infants: how do errors in calibration measurements affect detected hypoglycemia?

    Science.gov (United States)

    Thomas, Felicity; Signal, Mathew; Harris, Deborah L; Weston, Philip J; Harding, Jane E; Shaw, Geoffrey M; Chase, J Geoffrey

    2014-05-01

    Neonatal hypoglycemia is common and can cause serious brain injury. Continuous glucose monitoring (CGM) could improve hypoglycemia detection, while reducing blood glucose (BG) measurements. Calibration algorithms use BG measurements to convert sensor signals into CGM data. Thus, inaccuracies in calibration BG measurements directly affect CGM values and any metrics calculated from them. The aim was to quantify the effect of timing delays and calibration BG measurement errors on hypoglycemia metrics in newborn infants. Data from 155 babies were used. Two timing and 3 BG meter error models (Abbott Optium Xceed, Roche Accu-Chek Inform II, Nova Statstrip) were created using empirical data. Monte-Carlo methods were employed, and each simulation was run 1000 times. Each set of patient data in each simulation had randomly selected timing and/or measurement error added to BG measurements before CGM data were calibrated. The number of hypoglycemic events, duration of hypoglycemia, and hypoglycemic index were then calculated using the CGM data and compared to baseline values. Timing error alone had little effect on hypoglycemia metrics, but measurement error caused substantial variation. Abbott results underreported the number of hypoglycemic events by up to 8 and Roche overreported by up to 4 where the original number reported was 2. Nova results were closest to baseline. Similar trends were observed in the other hypoglycemia metrics. Errors in blood glucose concentration measurements used for calibration of CGM devices can have a clinically important impact on detection of hypoglycemia. If CGM devices are going to be used for assessing hypoglycemia it is important to understand of the impact of these errors on CGM data. © 2014 Diabetes Technology Society.

  10. 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.

  11. 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.

  12. Selected methods of waste monitoring using modern analytical techniques

    International Nuclear Information System (INIS)

    Hlavacek, I.; Hlavackova, I.

    1993-11-01

    Issues of the inspection and control of bituminized and cemented waste are discussed, and some methods of their nondestructive testing are described. Attention is paid to the inspection techniques, non-nuclear spectral techniques in particular, as employed for quality control of the wastes, waste concentrates, spent waste leaching solutions, as well as for the examination of environmental samples (waters and soils) from the surroundings of nuclear power plants. Some leaching tests used abroad for this purpose and practical analyses by the ICP-AES technique are given by way of example. The ICP-MS technique, which is unavailable in the Czech Republic, is routinely employed abroad for alpha nuclide measurements; examples of such analyses are also given. The next topic discussed includes the monitoring of organic acids and complexants to determine the degree of their thermal decomposition during the bituminization of wastes on an industrial line. All of the methods and procedures highlighted can be used as technical support during the monitoring of radioactive waste properties in industrial conditions, in the chemical and radiochemical analyses of wastes and related matter, in the calibration of nondestructive testing instrumentation, in the monitoring of contamination of the surroundings of nuclear facilities, and in trace analysis. (author). 10 tabs., 1 fig., 14 refs

  13. Limits to the Evaluation of the Accuracy of Continuous Glucose Monitoring Systems by Clinical Trials.

    Science.gov (United States)

    Schrangl, Patrick; Reiterer, Florian; Heinemann, Lutz; Freckmann, Guido; Del Re, Luigi

    2018-05-18

    Systems for continuous glucose monitoring (CGM) are evolving quickly, and the data obtained are expected to become the basis for clinical decisions for many patients with diabetes in the near future. However, this requires that their analytical accuracy is sufficient. This accuracy is usually determined with clinical studies by comparing the data obtained by the given CGM system with blood glucose (BG) point measurements made with a so-called reference method. The latter is assumed to indicate the correct value of the target quantity. Unfortunately, due to the nature of the clinical trials and the approach used, such a comparison is subject to several effects which may lead to misleading results. While some reasons for the differences between the values obtained with CGM and BG point measurements are relatively well-known (e.g., measurement in different body compartments), others related to the clinical study protocols are less visible, but also quite important. In this review, we present a general picture of the topic as well as tools which allow to correct or at least to estimate the uncertainty of measures of CGM system performance.

  14. Wireless connection of continuous glucose monitoring system to the electronic patient record

    Science.gov (United States)

    Murakami, Alexandre; Gutierrez, Marco A.; Lage, Silvia G.; Rebelo, Marina S.; Granja, Luiz A. R.; Ramires, Jose A. F.

    2005-04-01

    The control of blood sugar level (BSL) at near-normal levels has been documented to reduce both acute and chronic complications of diabetes mellitus. Recent studies suggested, the reduction of mortality in a surgical intensive care unit (ICU), when the BSL are maintained at normal levels. Despite of the benefits appointed by these and others clinical studies, the strict BSL control in critically ill patients suffers from some difficulties: a) medical staff need to measure and control the patient"s BSL using blood sample at least every hour. This is a complex and time consuming task; b) the inaccuracy of standard capillary glucose monitoring (fingerstick) in hypotensive patients and, if frequently used to sample arterial or venous blood, may lead to excess phlebotomy; c) there is no validated procedure for continuously monitoring of BSL levels. This study used the MiniMed CGMS in ill patients at ICU to send, in real-time, BSL values to a Web-Based Electronic Patient Record. The BSL values are parsed and delivered through a wireless network as an HL7 message. The HL7 messages with BSL values are collected, stored into the Electronic Patient Record and presented into a bed-side monitor at the ICU together with other relevant patient information.

  15. Cost calculation for a flash glucose monitoring system for UK adults with type 1 diabetes mellitus receiving intensive insulin treatment.

    Science.gov (United States)

    Hellmund, Richard; Weitgasser, Raimund; Blissett, Deirdre

    2018-04-01

    To estimate the costs associated with a flash glucose monitoring system as a replacement for routine self-monitoring of blood glucose (SMBG) in patients with type 1 diabetes mellitus (T1DM) using intensive insulin, from a UK National Health Service (NHS) perspective. The base-case cost calculation was created using the maximum frequency of glucose monitoring recommended by the 2015 National Institute for Health and Care Excellence guidelines (4-10 tests per day). Scenario analyses considered SMBG at the frequency observed in the IMPACT clinical trial (5.6 tests per day) and at the frequency of flash monitoring observed in a real-world analysis (16 tests per day). A further scenario included potential costs associated with severe hypoglycaemia. In the base case, the annual cost per patient using flash monitoring was £234 (19%) lower compared with routine SMBG (10 tests per day). In scenario analyses, the annual cost per patient of flash monitoring compared with 5.6 and 16 SMBG tests per day was £296 higher and £957 lower, respectively. The annual cost of severe hypoglycaemia for flash monitoring users was estimated to be £221 per patient, compared with £428 for routine SMBG users (based on 5.6 tests/day), corresponding to a reduction in costs of £207. The flash monitoring system has a modest impact on glucose monitoring costs for the UK NHS for patients with T1DM using intensive insulin. For people requiring frequent tests, flash monitoring may be cost saving, especially when taking into account potential reductions in the rate of severe hypoglycaemia. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  16. Hypoglycemic Exposure and Risk of Asymptomatic Hypoglycemia in Type 1 Diabetes assessed by Continuous Glucose Monitoring

    DEFF Research Database (Denmark)

    Henriksen, Marie Moth; Andersen, Henrik Ullits; Thorsteinsson, Birger

    2018-01-01

    : To explore the association between hypoglycemic exposure and proportion of asymptomatic hypoglycemia and relation to risk of severe hypoglycemia. Design: Prospective observational trial. Setting: Outpatient clinic. Patients: 153 unselected subjects with type 1 diabetes mellitus (T1D). Intervention: Six days...... of blinded continuous glucose monitoring (CGM) and recording of hypoglycemia symptoms. Main Outcome Measure: Proportion of asymptomatic hypoglycemic events (≤70 mg/dl). Results: Patients were grouped by the number of hypoglycemic events during the recording period (group 1: 1 event, group 2: 2-3 events...... positively associated with risk of severe hypoglycemia (incidence rate ratio (IRR) 1.3 (95% CI 1.1-1.5); p=0.003). Group 4 consisted of patients characterized by classical risk factors of severe hypoglycemia (longer duration of diabetes, lower HbA1c and more frequent impaired awareness of hypoglycemia...

  17. Continuous Glucose Monitoring: Current Use in Diabetes Management and Possible Future Applications.

    Science.gov (United States)

    Vettoretti, Martina; Cappon, Giacomo; Acciaroli, Giada; Facchinetti, Andrea; Sparacino, Giovanni

    2018-05-01

    The recent announcement of the production of new low-cost continuous glucose monitoring (CGM) sensors, the approval of marketed CGM sensors for making treatment decisions, and new reimbursement criteria have the potential to revolutionize CGM use. After briefly summarizing current CGM applications, we discuss how, in our opinion, these changes are expected to extend CGM utilization beyond diabetes patients, for example, to subjects with prediabetes or even healthy individuals. We also elaborate on how the integration of CGM data with other relevant information, for example, health records and other medical device/wearable sensor data, will contribute to creating a digital data ecosystem that will improve our understanding of the etiology and complications of diabetes and will facilitate the development of data analytics for personalized diabetes management and prevention.

  18. Fuel rod puncturing and fission gas monitoring system examination techniques

    International Nuclear Information System (INIS)

    Song, Woong Sup

    1999-02-01

    Fission gas products accumulated in irradiated fuel rod is 1-2 cm 3 in CANDU and 40-50 cm 3 in PWR fuel rod. Fuel rod puncturing and fission gas monitoring system can be used for both CANDU and PWR fuel rod. This system comprises puncturing device located at in cell part and monitoring device located at out cell part. The system has computerized 9 modes and can calculate both void volume and mass volume only single puncturing. This report describes techniques and procedure for operating fuel rod puncturing and gas monitoring system which can be play an important role in successful operation of the devices. Results obtained from the analysis can give more influence over design for fuel rods. (Author). 6 refs., 9 figs

  19. Self-monitoring of blood glucose is associated with problem-solving skills in hyperglycemia and hypoglycemia.

    Science.gov (United States)

    Wang, Jing; Zgibor, Janice; Matthews, Judith T; Charron-Prochownik, Denise; Sereika, Susan M; Siminerio, Linda

    2012-01-01

    The purpose of this study was to examine the association between self-monitoring of blood glucose (SMBG) and problem-solving skills in response to detected hyperglycemia and hypoglycemia among patients with type 2 diabetes. Data were obtained from the American Association of Diabetes Educators Outcome System, implemented in 8 diabetes self-management education programs in western Pennsylvania. SMBG was measured by asking patients how often they checked, missed checking, or checked blood glucose later than planned. Problem-solving skill was measured by asking how often they modified their behaviors after detecting high or low blood glucose. Most patients checked their blood glucose at least once per day. However, when blood glucose was high or low, many of them reported doing nothing, and only some of them resolved the problem. There were significant associations between self-monitoring of blood glucose and problem-solving skills for hyperglycemia and hypoglycemia, after controlling for age, gender, ethnicity, education, and time since diagnosis. Patients reported poor problem-solving skills when detecting hyperglycemia and hypoglycemia via SMBG. Patients need to learn problem-solving skills along with SMBG training to achieve glycemic control.

  20. Discrimination of the glucose and the white sugar based on the pulsed laser-induced photoacoustic technique

    Science.gov (United States)

    Ren, Zhong; Liu, Guodong

    2017-08-01

    In this study, to discriminate the glucose and the white sugar gradient in the food, a noninvasive optical detection system based on pulsed laser-induced photoacoustic technique was developed. Meanwhile, the Nd: YAG 532nm pumped OPO pulsed laser was used as the excitation light source to generate of the photoacoustic signals of the glucose and white sugar. The focused ultrasonic transducer with central detection frequency of 1MHz was used to capture the photoacoustic signals. In experiments, the real-time photoacoustic signals of the glucose and the white sugar aqueous solutions were gotten and compared with each other. In addition, to discriminate the difference of the characteristic photoacoustic signals between both of them, the difference spectrum and the first order derivative technique between the peak-to-peak photoacoustic signals of the water and that of the glucose and white sugar were employed. The difference characteristic photoacoustic wavelengths between the glucose and the white sugar were found based on the established photoacoustic detection system. This study provides the potential possibility for the discrimination of the glucose and the white sugar by using the photoacoustic detection method.

  1. Reliable glucose monitoring by ex-vivo blood microdialysis and infrared spectrometry for patients in critical care

    Science.gov (United States)

    Vahlsing, Thorsten; Delbeck, Sven; Budde, Janpeter; Ihrig, Dieter; Leonhardt, Steffen; Heise, H. Michael

    2017-02-01

    Blood glucose monitoring has been realised by biosensors in combination with micro-dialysis, using either subcutaneously or intravascularly implanted catheters. Another alternative is ex-vivo micro-dialysis of continuously sampled heparinized whole blood available from the patient even under critical care conditions. However, most devices suffer from inaccuracies due to variable recovery rates. Infrared spectrometry has been suggested for analyte quantification, since besides glucose other clinically relevant analytes can be simultaneously determined that are, e.g., important for intensive care patients. Perfusates with acetate and mannitol have been investigated as recovery markers (internal standards). In contrast to the previously used acetate, an almost linear dependency between mannitol loss and glucose recovery was observed for micro-dialysis of glucose spiked aqueous albumin solutions or porcine heparinized whole blood when testing flat membranes within a custom-made micro-dialysator. By this, a straightforward compensation of any dialysis recovery rate variation during patient monitoring is possible. The combination of microdialysis with infrared spectrometry provides a calibration-free assay for accurate continuous glucose monitoring, as reference spectra of dialysate components can be a-priori allocated.

  2. Continuous Blood Glucose Monitoring May Detect Carotid Occlusion Intolerance during Carotid Artery Stenting.

    Science.gov (United States)

    Hiramatsu, Ryo; Furuse, Motomasa; Yagi, Ryokichi; Ohmura, Tomohisa; Ohnishi, Hiroyuki; Ikeda, Naokado; Nonoguchi, Naosuke; Kawabata, Shinji; Miyachi, Shigeru; Kuroiwa, Toshihiko

    2018-02-05

    The frequency of the occurrence of adverse events associated with carotid artery stenting (CAS) is usually low, but serious adverse events such as cerebral hyperperfusion syndrome (CHS) may occur. Real-time monitoring is ideal for the early detection of adverse events during the surgical procedure. This study aimed to evaluate continuous blood glucose (BG) monitoring for the detection of adverse events during CAS. Forty patients undergoing scheduled CAS were prospectively enrolled. An artificial pancreas was used for continuous BG monitoring (once per minute), using venous blood extracted at a rate of 2 mL/hr during CAS. The primary endpoint was a correlation between BG change and adverse events. CAS was discontinued in 1 patient, and BG was not measured in 5 patients (12.5%) because of the inability to extract blood. Among 34 evaluable patients, no patient developed CHS, but 3 patients (9%) experienced carotid occlusion intolerance. During CAS, BG was significantly higher in patients with carotid occlusion intolerance (median: 5 mg/dL) than in patients without carotid occlusion intolerance (median: 0 mg/dL) (P = 0.0221). A cutoff BG value ≥4 mg/dL during CAS showed 50% sensitivity and 100% specificity for the detection of carotid occlusion intolerance. There was no significant correlation between BG change and other adverse events. BG elevation may help detect carotid occlusion intolerance although it is still unknown whether BG monitoring can detect CHS. Further studies should validate that a cutoff BG elevation value of ≥4 mg/dL during CAS indicates carotid occlusion intolerance. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Investigation of the Influence of the As-Grown ZnO Nanorods and Applied Potentials on an Electrochemical Sensor for In-Vitro Glucose Monitoring

    Directory of Open Access Journals (Sweden)

    Mohammed Marie

    2017-01-01

    Full Text Available The influence of the as-grown zinc oxide nanorods (ZnO NRs on the fabricated electrochemical sensor for in vitro glucose monitoring were investigated. A direct growth of ZnO NRs was performed on the Si/SiO2/Au electrode, using hydrothermal and sol-gel techniques at low temperatures. The structure, consisting of a Si/SiO2/Au/GOx/Nafion membrane, was considered as a baseline, and it was tested under several applied potential 0.1–0.8 V. The immobilized working electrode, with GOx and a nafion membrane, was characterized amperometrically using a source meter Keithely 2410, and an electrochemical impedance Gamry potentiostat. The sensor exhibited the following: a high sensitivity of ~0.468 mA/cm2 mM, a low detection limit in the order of 166.6 µM, and a fast and sharp response time of around 2 s. The highest sensitivity and the lowest limit of detection were obtained at 0.4 volt, after the growth of ZnO NRs. The highest net sensitivity was obtained after subtracting the sensitivity of the baseline, and it was in the order of 0.315 mA/cm2·mM. The device was tested with a range of glucose concentrations from 1–10 mM, showing a linear line from 3–8 mM, and the device was saturated after exceeding high concentrations of glucose. Such devices can be used for in vitro glucose monitoring, since glucose changes can be accurately detected.

  4. Evaluation of the Sealing Ability of Three Obturation Techniques Using a Glucose Leakage Test

    Directory of Open Access Journals (Sweden)

    Katarzyna Olczak

    2017-01-01

    Full Text Available The aim of this study was to evaluate the sealing ability of three different canal filling techniques. Sixty-four roots of extracted human maxillary anterior teeth were prepared using ProTaper® rotary instruments. The specimens were then randomly divided into 3 experimental groups (n=16 and 2 control groups (n=8. The root canals were filled using cold lateral compaction (CLC group, continuous wave condensation technique using the Elements Obturation Unit® (EOU group, and ProTaper obturators (PT group. For the negative control group, 8 roots were filled using lateral compaction as in the CLC group, and the teeth were covered twice with a layer of nail varnish (NCG group. Another 8 roots were filled using lateral compaction, but without sealer, and these were used as the positive control (PCG group. A glucose leakage model was used for quantitative evaluation of microleakage for 24 hours and 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12 weeks. No significant difference in the cumulative amount of leakage was found between the three experimental groups at all observation times. The lateral condensation of cold gutta-percha can guarantee a similar seal of canal fillings as can be achieved by using thermal methods, in the round canals.

  5. Development of techniques for monitoring corrosion in Magnox plant

    International Nuclear Information System (INIS)

    Haines, N.F.; Whittle, I.; Wilson, R.

    1974-01-01

    Steel oxidation in Magnox reactors has led to the development of techniques for measuring oxide thicknesses. An account is given of the methods used by the CEGB for making non-destructive measurements of oxide coatings both in the laboratory and remotely in the core regions of reactors. Specific techniques include β back-scattering which is compared with conventional microscope or weight gain methods for particular applications. The laser corrosion monitor and an ultrasonic method are described and compared as in-reactor techniques. An eddy current method is being developed for reactor regions where access is extremely restricted. A discussion considers the effect of oxide form upon the response of the instruments. The necessary further work is described which establishes the usefulness of each instrument over a range of oxide thicknesses and steels of different physical properties. (author)

  6. Health Monitoring of Composite Material Structures using a Vibrometry Technique

    Science.gov (United States)

    Schulz, Mark J.

    1997-01-01

    Large composite material structures such as aircraft and Reusable Launch Vehicles (RLVS) operate in severe environments comprised of vehicle dynamic loads, aerodynamic loads, engine vibration, foreign object impact, lightning strikes, corrosion, and moisture absorption. These structures are susceptible to damage such as delamination, fiber breaking/pullout, matrix cracking, and hygrothermal strain. To ensure human safety and load-bearing integrity, these structures must be inspected to detect and locate often invisible damage and faults before becoming catastrophic. Moreover, nearly all future structures will need some type of in-service inspection technique to increase their useful life and reduce maintenance and overall costs. Possible techniques for monitoring the health and indicating damage on composite structures include: c-scan, thermography, acoustic emissions using piezoceramic actuators or fiber-optic wires with gratings, laser ultrasound, shearography, holography, x-ray, and others. These techniques have limitations in detecting damage that is beneath the surface of the structure, far away from a sensor location, or during operation of the vehicle. The objective of this project is to develop a more global method for damage detection that is based on structural dynamics principles, and can inspect for damage when the structure is subjected to vibratory loads to expose faults that may not be evident by static inspection. A Transmittance Function Monitoring (TFM) method is being developed in this project for ground-based inspection and operational health monitoring of large composite structures as a RLV. A comparison of the features of existing health monitoring approaches and the proposed TFM method is given.

  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. Application of the Continuous-Discrete Extended Kalman Filter for Fault Detection in Continuous Glucose Monitors for Type 1 Diabetes

    DEFF Research Database (Denmark)

    Mahmoudi, Zeinab; Boiroux, Dimitri; Hagdrup, Morten

    2016-01-01

    The purpose of this study is the online detection of faults and anomalies of a continuous glucose monitor (CGM). We simulated a type 1 diabetes patient using the Medtronic virtual patient model. The model is a system of stochastic differential equations and includes insulin pharmacokinetics...

  9. Analysis of [U-13C6]glucose in human plasma using liquid chromatography/isotope ratio mass spectrometry compared with two other mass spectrometry techniques

    NARCIS (Netherlands)

    Schierbeek, H.; Moerdijk-Poortvliet, T.C.W.; van den Akker, C.H.P.; te Braake, F.W.J.; Boschker, H.T.S.; van Goudoever, J.B.

    2009-01-01

    The use of stable isotope labelled glucose provides insight into glucose metabolism. The 13C-isotopic enrichment of glucose is usually measured by gas chromatography/mass spectrometry (GC/MS) or gas chromatography/combustion/isotope ratio mass spectrometry (GC/C/IRMS). However, in both techniques

  10. Evaluation of an open access software for calculating glucose variability parameters of a continuous glucose monitoring system applied at pediatric intensive care unit.

    Science.gov (United States)

    Marics, Gábor; Lendvai, Zsófia; Lódi, Csaba; Koncz, Levente; Zakariás, Dávid; Schuster, György; Mikos, Borbála; Hermann, Csaba; Szabó, Attila J; Tóth-Heyn, Péter

    2015-04-24

    Continuous Glucose Monitoring (CGM) has become an increasingly investigated tool, especially with regards to monitoring of diabetic and critical care patients. The continuous glucose data allows the calculation of several glucose variability parameters, however, without specific application the interpretation of the results is time-consuming, utilizing extreme efforts. Our aim was to create an open access software [Glycemic Variability Analyzer Program (GVAP)], readily available to calculate the most common parameters of the glucose variability and to test its usability. The GVAP was developed in MATLAB® 2010b environment. The calculated parameters were the following: average area above/below the target range (Avg. AUC-H/L); Percentage Spent Above/Below the Target Range (PATR/PBTR); Continuous Overall Net Glycemic Action (CONGA); Mean of Daily Differences (MODD); Mean Amplitude of Glycemic Excursions (MAGE). For verification purposes we selected 14 CGM curves of pediatric critical care patients. Medtronic® Guardian® Real-Time with Enlite® sensor was used. The reference values were obtained from Medtronic®(')s own software for Avg. AUC-H/L and PATR/PBTR, from GlyCulator for MODD and CONGA, and using manual calculation for MAGE. The Pearson and Spearman correlation coefficients were above 0.99 for all parameters. The initial execution took 30 minutes, for further analysis with the Windows® Standalone Application approximately 1 minute was needed. The GVAP is a reliable open access program for analyzing different glycemic variability parameters, hence it could be a useful tool for the study of glycemic control among critically ill patients.

  11. Corrosion monitoring of insulated pipe using radiographic technique

    International Nuclear Information System (INIS)

    Azali Muhammad; Abd Aziz Mohamed; Abd Razak Hamzah; Mohd Pauzi Ismail; Abd Nassir Ibrahim; Shaharudin Sayuti; Shukri Ahmad

    2001-01-01

    In petrochemical and power plants, detection of corrosion and evaluation of deposit in insulated pipes using radiographic technique are considered as very challenging tasks. In general this degradation problem is attributed to water condensation. It causes the formation of deposit and scale inside the pipe, as well as between the insulation and pipe in cold temperature pipes. On the other hand, for hot temperature pipes the main problem is mainly due to corrosion/erosion attack inside the pipe. In the study of corrosion in pipelines, one of the most important parameters to be monitored and measured is he wall thickness. Currently, most pipeline corrosion monitoring and evaluation for both insulated and non-insulated pipes is performed using an ultrasonic method. The most common technique is that based on the A-Scan, using either a normal flaw detector or some form of dedicated equipment. However, with recent development of ultrasonic technology, more advance method, namely B-Scan and C-scan techniques are also available. The most notable disadvantage of using this method is that the insulation covering the pipe has to be removed before the inspection can be carried out and this is considered as not so cost effective. Due to this reason, the possibility of employing other alternative NDT method, namely radiographic testing method was studied. The technique used in this studied are known as tangential technique. In this study it was found that the result found using tangential technique is consistent with the actual thickness of the pipe. Result of this study is presented and discussed in this paper. (Author)

  12. Water sampling techniques for continuous monitoring of pesticides in water

    Directory of Open Access Journals (Sweden)

    Šunjka Dragana

    2017-01-01

    Full Text Available Good ecological and chemical status of water represents the most important aim of the Water Framework Directive 2000/60/EC, which implies respect of water quality standards at the level of entire river basin (2008/105/EC and 2013/39/EC. This especially refers to the control of pesticide residues in surface waters. In order to achieve the set goals, a continuous monitoring program that should provide a comprehensive and interrelated overview of water status should be implemented. However, it demands the use of appropriate analysis techniques. Until now, the procedure for sampling and quantification of residual pesticide quantities in aquatic environment was based on the use of traditional sampling techniques that imply periodical collecting of individual samples. However, this type of sampling provides only a snapshot of the situation in regard to the presence of pollutants in water. As an alternative, the technique of passive sampling of pollutants in water, including pesticides has been introduced. Different samplers are available for pesticide sampling in surface water, depending on compounds. The technique itself is based on keeping a device in water over a longer period of time which varies from several days to several weeks, depending on the kind of compound. In this manner, the average concentrations of pollutants dissolved in water during a time period (time-weighted average concentrations, TWA are obtained, which enables monitoring of trends in areal and seasonal variations. The use of these techniques also leads to an increase in sensitivity of analytical methods, considering that pre-concentration of analytes takes place within the sorption medium. However, the use of these techniques for determination of pesticide concentrations in real water environments requires calibration studies for the estimation of sampling rates (Rs. Rs is a volume of water per time, calculated as the product of overall mass transfer coefficient and area of

  13. Use of a real time continuous glucose monitoring system as an educational tool for patients with gestational diabetes.

    Science.gov (United States)

    Alfadhli, Eman; Osman, Eman; Basri, Taghreed

    2016-01-01

    Women with gestational diabetes mellitus (GDM) are required to control their blood glucose shortly after GDM diagnosis to minimize adverse pregnancy outcomes. A real time-continuous glucose monitoring system (RT-CGMS) provides the patient with continuous information about the alterations in levels of the blood glucose. This visibility may empower the patient to modify her lifestyle and engage in therapeutic management. The aim of this study was to determine whether a single application of RT-CGMS to pregnant women shortly after GDM diagnosis is useful as an educational and motivational tool. This study was a prospective open label randomized controlled study conducted at Maternity and Children Hospital, Medina, Saudi Arabia. A total of 130 pregnant women with GDM were randomised to either blood glucose self-monitor alone (SMBG group) (n = 62) or in addition to SMBG, patients wore a Guardian(®) REAL-Time Continuous Glucose Monitoring System (Medtronic MiniMed) once for 3-7 days, within 2 weeks of GDM diagnosis (RT-CGMS group) (n = 68). The primary outcomes were maternal glycemic control and pregnancy outcomes. Secondary outcomes were the changes in parameters of glucose variability, which includes mean sensor readings, standard deviation (SD) of blood glucose, and area under the curve for hyper and hypoglycaemia at the end of the RT-CGMS application. HbA1c, mean fasting and postprandial glucose levels were similar in both groups at the end of the pregnancy. Pregnancy outcomes were comparable. However, there was significant improvement in the parameters of glucose variability on the last day of sensor application; both mean glucose and the SD of mean glycaemia were reduced significantly; P = 0.016 and P = 0.034, respectively. The area under the curve for hyper and hypoglycaemia were improved, however, the results were not statistically significant. Although a single application of RT-CGMS shortly after GDM diagnosis is helpful as an educational tool, it

  14. Impact of retrospective calibration algorithms on hypoglycemia detection in newborn infants using continuous glucose monitoring.

    Science.gov (United States)

    Signal, Matthew; Le Compte, Aaron; Harris, Deborah L; Weston, Philip J; Harding, Jane E; Chase, J Geoffrey

    2012-10-01

    Neonatal hypoglycemia is common and may cause serious brain injury. Diagnosis is by blood glucose (BG) measurements, often taken several hours apart. Continuous glucose monitoring (CGM) could improve hypoglycemia detection, while reducing the number of BG measurements. Calibration algorithms convert sensor signals into CGM output. Thus, these algorithms directly affect measures used to quantify hypoglycemia. This study was designed to quantify the effects of recalibration and filtering of CGM data on measures of hypoglycemia (BG neonates. CGM data from 50 infants were recalibrated using an algorithm that explicitly recognized the high-accuracy BG measurements available in this study. CGM data were analyzed as (1) original CGM output, (2) recalibrated CGM output, (3) recalibrated CGM output with postcalibration median filtering, and (4) recalibrated CGM output with precalibration median filtering. Hypoglycemia was classified by number of episodes, duration, severity, and hypoglycemic index. Recalibration increased the number of hypoglycemic events (from 161 to 193), hypoglycemia duration (from 2.2% to 2.6%), and hypoglycemic index (from 4.9 to 7.1 μmol/L). Median filtering postrecalibration reduced hypoglycemic events from 193 to 131, with little change in duration (from 2.6% to 2.5%) and hypoglycemic index (from 7.1 to 6.9 μmol/L). Median filtering prerecalibration resulted in 146 hypoglycemic events, a total duration of hypoglycemia of 2.6%, and a hypoglycemic index of 6.8 μmol/L. Hypoglycemia metrics, especially counting events, are heavily dependent on CGM calibration BG error, and the calibration algorithm. CGM devices tended to read high at lower levels, so when high accuracy calibration measurements are available it may be more appropriate to recalibrate the data.

  15. 37Ar monitoring techniques and on-site inspection system

    International Nuclear Information System (INIS)

    Duan Rongliang; Chen Yinliang; Li Wei; Wang Hongxia; Hao Fanhua

    2001-01-01

    37 Ar is separated, purified and extracted from air sample with a low temperature gas-solid chromatographic purifying method, prepared into a radioactive measurement source and its radioactivity is measured with a proportional counter. Based on the monitoring result, a judgement can be made if an nuclear explosion event has happened recently in a spectabilis area. A series of element techniques that are associated the monitoring of the trace element 37 Ar have been investigated and developed. Those techniques include leaked gas sampling, 37 Ar separation and purification, 37 Ar radioactivity measurement and the on-site inspection of 37 Ar. An advanced 37 Ar monitoring method has been developed, with which 200 liters of air can be treated in 2 hours with sensitivity of 0.01 Bq/L for 37 Ar radioactivity measurement. A practical 37 Ar On-site Inspection system has been developed. This research work may provide technical and equipment support for the verification protection, verification supervision and CTBT verification

  16. 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

  17. ASSESSMENT OF CABLE AGING USING CONDITION MONITORING TECHNIQUES

    International Nuclear Information System (INIS)

    GROVE, E.; LOFARO, R.; SOO, P.; VILLARAN, M.; HSU, F.

    2000-01-01

    Electric cables in nuclear power plants suffer degradation during service as a result of the thermal and radiation environments in which they are installed. Instrumentation and control cables are one type of cable that provide an important role in reactor safety. Should the polymeric cable insulation material become embrittled and cracked during service, or during a loss-of-coolant-accident (LOCA) and when steam and high radiation conditions are anticipated, failure could occur and prevent the cables from fulfilling their intended safety function(s). A research program is being conducted at Brookhaven National Laboratory to evaluate condition monitoring (CM) techniques for estimating the amount of cable degradation experienced during in-plant service. The objectives of this program are to assess the ability of the cables to perform under a simulated LOCA without losing their ability to function effectively, and to identify CM techniques which may be used to determine the effective lifetime of cables. The cable insulation materials tested include ethylene propylene rubber (EPR) and cross-linked polyethylene (XLPE). Accelerated aging (thermal and radiation) to the equivalent of 40 years of service was performed, followed by exposure to simulated LOCA conditions. The effectiveness of chemical, electrical, and mechanical condition monitoring techniques are being evaluated. Results indicate that several of these methods can detect changes in material parameters with increasing age. However, each has its limitations, and a combination of methods may provide an effective means for trending cable degradation in order to assess the remaining life of cables

  18. Nocturnal hypoglycemia identified by a continuous glucose monitoring system in patients with primary adrenal insufficiency (Addison's Disease).

    Science.gov (United States)

    Meyer, Gesine; Hackemann, Annika; Reusch, Juergen; Badenhoop, Klaus

    2012-05-01

    Hypoglycemia can be a symptom in patients with Addison's disease. The common regimen of replacement therapy with oral glucocorticoids results in unphysiological low cortisol levels in the early morning, the time of highest insulin sensitivity. Therefore patients with Addison's disease are at risk for unrecognized and potentially severe nocturnal hypoglycemia also because of a disturbed counterregulatory function. Use of a continuous glucose monitoring system (CGMS) could help to adjust hydrocortisone treatment and to avoid nocturnal hypoglycemia in these patients. Thirteen patients with Addison's disease were screened for hypoglycemia wearing a CGMS for 3-5 days. In one patient we identified a hypoglycemic episode at 3:45 a.m. with a blood glucose level of 46 mg/dL, clearly beneath the 95% tolerance interval of minimal glucose levels between 2 and 4 a.m. (53.84 mg/dL). After the hydrocortisone replacement scheme was changed, the minimum blood glucose level between 2 and 4 a.m. normalized to 87 mg/dL. Continuous glucose monitoring can detect nocturnal hypoglycemia in patients with primary adrenal insufficiency and hence prevent in these patients an impaired quality of life and even serious adverse effects.

  19. Non-invasive method to detect the changes of glucose concentration in whole blood using photometric technique.

    Science.gov (United States)

    Rajan, Shiny Amala Priya; Towe, Bruce C

    2014-01-01

    A non-invasive method is developed to monitor rapid changes in blood glucose levels in diabetic patients. The system depends on an optical cell built with a LED that emits light of wavelength 535nm, which is a peak absorbance of hemoglobin. As the glucose concentration in blood decreases, its osmolarity also decreases and the Red Blood Cells (RBCs) swell and decrease the path length absorption coefficient. Decreasing absorption coefficient increases the transmission of light through the whole blood. The system was tested with a constructed optical cell that held whole blood in a capillary tube. As expected the light transmitted to the photodiode increases with decreasing glucose concentration. The average response time of the system was between 30-40 seconds.

  20. Mechanical seal monitoring technique by acoustic emission measurements

    Energy Technology Data Exchange (ETDEWEB)

    Kataoka, Tadashi; Fujita, Yoshihiro; Kawaguchi, Kazunori; Saito, Kazuhiro; Yokota, Setsuo; Hisada, Yasuhide; Masahiro, Komatsu

    1987-09-20

    This report describes a technique for mechanical seal monitoring through acoustic emission (AE) measurement. The equipment consists of an AE sensor, preamplifier, multiplexer, main amplifier, effective value transducer and computer system. When the sealed liquid pressure undergoes a large change, the seal surface configuration is monitored and evaluated accurately through AE measurement. If the mechanical seal surface id damaged or worn, the AE level is kept high or continues to fluctuate largely for a rather long period. When leak occurs, the AE value shows great fluctuations either at extremely low levels or at high levels. The former trend is considered to result from a decrease in solid contact due to an excessive amount of liquid film being formed at the seal surface during leak. In the latter case, the leak is attributed to severe damage to the seal surface. (18 figs, 1 tab, 5 photos, 3 refs)

  1. Analysis of ultrasonic techniques for monitoring milk coagulation during cheesemaking

    International Nuclear Information System (INIS)

    Budelli, E; Lema, P; Pérez, N; Negreira, C

    2012-01-01

    Experimental determination of time of flight and attenuation has been proposed in the literature as alternatives to monitoring the evolution of milk coagulation during cheese manufacturing. However, only laboratory scale procedures have been described. In this work, the use of ultrasonic time of flight and attenuation to determine cutting time and its feasibility to be applied at industrial scale were analyzed. Limitations to implement these techniques at industrial scale are shown experimentally. The main limitation of the use of time of flight is its strong dependence with temperature. Attenuation monitoring is affected by a thin layer of milk skin covering the transducer, which modifies the signal in a non-repetitive way. The results of this work can be used to develop alternative ultrasonic systems suitable for application in the dairy industry.

  2. A novel insulin resistance index to monitor changes in insulin sensitivity and glucose tolerance: the ACT NOW study.

    Science.gov (United States)

    Tripathy, Devjit; Cobb, Jeff E; Gall, Walter; Adam, Klaus-Peter; George, Tabitha; Schwenke, Dawn C; Banerji, MaryAnn; Bray, George A; Buchanan, Thomas A; Clement, Stephen C; Henry, Robert R; Kitabchi, Abbas E; Mudaliar, Sunder; Ratner, Robert E; Stentz, Frankie B; Reaven, Peter D; Musi, Nicolas; Ferrannini, Ele; DeFronzo, Ralph A

    2015-05-01

    The objective was to test the clinical utility of Quantose M(Q) to monitor changes in insulin sensitivity after pioglitazone therapy in prediabetic subjects. Quantose M(Q) is derived from fasting measurements of insulin, α-hydroxybutyrate, linoleoyl-glycerophosphocholine, and oleate, three nonglucose metabolites shown to correlate with insulin-stimulated glucose disposal. Participants were 428 of the total of 602 ACT NOW impaired glucose tolerance (IGT) subjects randomized to pioglitazone (45 mg/d) or placebo and followed for 2.4 years. At baseline and study end, fasting plasma metabolites required for determination of Quantose, glycated hemoglobin, and oral glucose tolerance test with frequent plasma insulin and glucose measurements to calculate the Matsuda index of insulin sensitivity were obtained. Pioglitazone treatment lowered IGT conversion to diabetes (hazard ratio = 0.25; 95% confidence interval = 0.13-0.50; P < .0001). Although glycated hemoglobin did not track with insulin sensitivity, Quantose M(Q) increased in pioglitazone-treated subjects (by 1.45 [3.45] mg·min(-1)·kgwbm(-1)) (median [interquartile range]) (P < .001 vs placebo), as did the Matsuda index (by 3.05 [4.77] units; P < .0001). Quantose M(Q) correlated with the Matsuda index at baseline and change in the Matsuda index from baseline (rho, 0.85 and 0.79, respectively; P < .0001) and was progressively higher across closeout glucose tolerance status (diabetes, IGT, normal glucose tolerance). In logistic models including only anthropometric and fasting measurements, Quantose M(Q) outperformed both Matsuda and fasting insulin in predicting incident diabetes. In IGT subjects, Quantose M(Q) parallels changes in insulin sensitivity and glucose tolerance with pioglitazone therapy. Due to its strong correlation with improved insulin sensitivity and its ease of use, Quantose M(Q) may serve as a useful clinical test to identify and monitor therapy in insulin-resistant patients.

  3. Development of infrared spectroscopy techniques for environmental monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Sandsten, Jonas

    2000-08-01

    Infrared spectroscopy techniques have long been utilized in identifying and quantifying species of interest to us. Many of the elementary molecules in the atmosphere interact with infrared radiation through their ability to absorb and emit energy in vibrational and rotational transitions. A large variety of methods for monitoring of molecules and aerosol particles by collecting samples or by using remote sensing methods are available. The objective of the work presented in this thesis was to develop infrared spectroscopic techniques to further enhance the amount of useful information obtained from gathering spectral data. A new method for visualization and quantification of gas flows based on gas-correlation techniques was developed. Real-time imaging of gas leaks and incomplete or erratic flare combustion of ethene was demonstrated. The method relies on the thermal background as a radiation source and the gas can be visualized in absorption or in emission depending on the temperature difference. Diode laser spectroscopy was utilized to monitor three molecular species at the same time and over the same path. Two near-infrared diode lasers beams were combined in a periodically poled lithium niobate crystal and by difference-frequency generation a third beam was created, enabling simultaneous monitoring of oxygen, water vapor and methane. Models of aerosol particle cross sections were used to simulate the diffraction pattern of light scattered by fibers, spherical particles and real particles, such as pollen, through a new aerosol particle sensing prototype. The instrument, using a coupled cavity diode laser, has been designed with a ray-tracing program and the final prototype was employed for single aerosol particle sizing and identification.

  4. Plants status monitor: Modelling techniques and inherent benefits

    International Nuclear Information System (INIS)

    Breeding, R.J.; Lainoff, S.M.; Rees, D.C.; Prather, W.A.; Fickiessen, K.O.E.

    1987-01-01

    The Plant Status Monitor (PSM) is designed to provide plant personnel with information on the operational status of the plant and compliance with the plant technical specifications. The PSM software evaluates system models using a 'distributed processing' technique in which detailed models of individual systems are processed rather than by evaluating a single, plant-level model. In addition, development of the system models for PSM provides inherent benefits to the plant by forcing detailed reviews of the technical specifications, system design and operating procedures, and plant documentation. (orig.)

  5. Monitoring of Corrientes facility using nuclear registers techniques

    International Nuclear Information System (INIS)

    Yesquen L, S.

    1994-01-01

    Knowledge of fluid movement in the reservoir is a key to enhanced production management. Direct measurement of water and oil saturation variations with time, is the most reliable method in determining the depletion profile of reservoirs with ample range of permeabilities. This paper illustrates how nuclear logging techniques aids proper management in strong water drive reservoir named Cetico Corrientes Field, in east Peru. Important production increase was obtained with work over and drilling program, based on reservoir monitoring using thermal decay tool. (author). 7 figs

  6. An integrated sensing technique for smart monitoring of water pipelines

    Science.gov (United States)

    Bernini, Romeo; Catapano, Ilaria; Soldovieri, Francesco; Crocco, Lorenzo

    2014-05-01

    Lowering the rate of water leakage from the network of underground pipes is one of the requirements that "smart" cities have to comply with. In fact, losses in the water supply infrastructure have a remarkable social, environmental and economic impact, which obviously conflicts with the expected efficiency and sustainability of a smart city. As a consequence, there is a huge interest in developing prevention policies based on state-of-art sensing techniques and possibly their integration, as well as in envisaging ad hoc technical solutions designed for the application at hand. As a contribution to this framework, in this communication we present an approach aimed to pursue a thorough non-invasive monitoring of water pipelines, with both high spatial and temporal resolution. This goal is necessary to guarantee that maintenance operations are performed timely, so to reduce the extent of the leakage and its possible side effects, and precisely, so to minimize the cost and the discomfort resulting from operating on the water supply network. The proposed approach integrates two sensing techniques that work at different spatial and temporal scales. The first one is meant to provide a continuous (in both space and time) monitoring of the pipeline and exploits a distributed optic fiber sensor based on the Brillouin scattering phenomenon. This technique provides the "low" spatial resolution information (at meter scale) needed to reveal the presence of a leak and call for interventions [1]. The second technique is based on the use of Ground Penetrating Radar (GPR) and is meant to provide detailed images of area where the damage has been detected. GPR systems equipped with suitable data processing strategies [2,3] are indeed capable of providing images of the shallow underground, where the pipes would be buried, characterized by a spatial resolution in the order of a few centimeters. This capability is crucial to address in the most proper way maintenance operations, by for

  7. First step toward near-infrared continuous glucose monitoring: in vivo evaluation of antibody coupled biomaterials

    Science.gov (United States)

    Gellynck, Karolien; Kodeck, Valérie; Van De Walle, Elke; Kersemans, Ken; De Vos, Filip; Declercq, Heidi; Dubruel, Peter; Vlaminck, Lieven

    2015-01-01

    Continuous glucose monitoring (CGM) is crucial in diabetic care. Long-term CGM systems however require an accurate sensor as well as a suitable measuring environment. Since large intravenous sensors are not feasible, measuring inside the interstitial fluid is considered the best alternative. This option, unfortunately, has the drawback of a lag time with blood glucose values. A good strategy to circumvent this is to enhance tissue integration and enrich the peri-implant vasculature. Implants of different optically transparent biomaterials (poly(methyl-methacrylate) [PMMA] and poly(dimethylsiloxane) [PDMS]) – enabling glucose monitoring in the near-infrared (NIR) spectrum – were surface-treated and subsequently implanted in goats at various implantation sites for up to 3 months. The overall in vivo biocompatibility, tissue integration, and vascularization at close proximity of the surfaces of these materials were assessed. Histological screening showed similar tissue reactions independent of the implantation site. No significant inflammation reaction was observed. Tissue integration and vascularization correlated, to some extent, with the biomaterial composition. A modification strategy, in which a vascular endothelial-cadherin antibody was coupled to the biomaterials surface through a dopamine layer, showed significantly enhanced vascularization 3 months after subcutaneous implantation. Our results suggest that the developed strategy enables the creation of tissue interactive NIR transparent packaging materials, opening the possibility of continuous glucose monitoring. PMID:25304314

  8. Optimal insulin pump dosing and postprandial glycemia following a pizza meal using the continuous glucose monitoring system.

    Science.gov (United States)

    Jones, Susan M; Quarry, Jill L; Caldwell-McMillan, Molly; Mauger, David T; Gabbay, Robert A

    2005-04-01

    We attempted to identify an optimal insulin pump meal bolus by comparing postprandial sensor glucose values following three methods of insulin pump meal bolusing for a consistent pizza meal. Twenty-four patients with type 1 diabetes participated in a study to compare postprandial glucose values following three meal bolus regimens for a consistent evening pizza meal. Each participant utilized the following insulin lispro regimens on consecutive evenings, and glucose values were tracked by the Continuous Glucose Monitoring System (CGMS, Medtronic MiniMed, Northridge, CA): (a) single-wave bolus (100% of insulin given immediately); (b) 4-h dual-wave bolus (50% of insulin given immediately and 50% given over a 4-h period); and (c) 8-h dual-wave bolus (50% of insulin given immediately and 50% given over a 8-h period). Total insulin bolus amount was kept constant for each pizza meal. Divergence in blood glucose among the regimens was greatest at 8-12 h. The 8-h dual-wave bolus provided the best glycemic control and lowest mean glucose values (singlewave bolus, 133 mg/dL; 4-h dual-wave bolus, 145 mg/dL; 8-h dual-wave bolus, 104 mg/dL), leading to a difference in mean glucose of 29 mg/dL for the single-wave bolus versus the 8-h dual-wave bolus and 42 mg/dL for the 4-h dual-wave bolus versus the 8-h dual-wave bolus. The lower mean glucose in the 8-h dual-wave bolus was not associated with any increased incidence of hypoglycemia. Use of a dual-wave bolus extended over an 8-h period following a pizza meal provided significantly less postprandial hyperglycemia in the late postprandial period (8-12 h) with no increased risk of hypoglycemia.

  9. Monitoring of Lactic Fermentation Process by Ultrasonic Technique

    Science.gov (United States)

    Alouache, B.; Touat, A.; Boutkedjirt, T.; Bennamane, A.

    The non-destructive control by using ultrasound techniques has become of great importance in food industry. In this work, Ultrasound has been used for quality control and monitoring the fermentation stages of yogurt, which is a highly consumed product. On the contrary to the physico-chemical methods, where the measurement instruments are directly introduced in the sample, ultrasound techniques have the advantage of being non-destructive and contactless, thus reducing the risk of contamination. Results obtained in this study by using ultrasound seem to be in good agreement with those obtained by physico-chemical methods such as acidity measurement by using a PH-meter instrument. This lets us to conclude that ultrasound method may be an alternative for a healthy control of yoghurt fermentation process.

  10. Data verification and evaluation techniques for groundwater monitoring programs

    International Nuclear Information System (INIS)

    Mercier, T.M.; Turner, R.R.

    1990-12-01

    To ensure that data resulting from groundwater monitoring programs are of the quality required to fulfill program objectives, it is suggested that a program of data verification and evaluation be implemented. These procedures are meant to supplement and support the existing laboratory quality control/quality assurance programs by identifying aberrant data resulting from a variety of unforeseen circumstances: sampling problems, data transformations in the lab, data input at the lab, data transfer, end-user data input. Using common-sense principles, pattern recognition techniques, and hydrogeological principles, a computer program was written which scans the data for suspected abnormalities and produces a text file stating sample identifiers, the suspect data, and a statement of how the data has departed from the expected. The techniques described in this paper have been developed to support the Y-12 Plant Groundwater Protection Program Management Plan

  11. Professional continuous glucose monitoring for the identification of type 1 diabetes mellitus among subjects with insulin therapy.

    Science.gov (United States)

    Chen, Yin-Chun; Huang, Yu-Yao; Li, Hung-Yuan; Liu, Shih-Wei; Hsieh, Sheng-Hwu; Lin, Chia-Hung

    2015-01-01

    The identification of type 1 diabetes in diabetic subjects receiving insulin therapy is sometimes difficult. The purpose of this study is to evaluate whether results of professional continuous glucose monitoring can improve the identification of type 1 diabetes.From 2007 to 2012, 119 adults receiving at least twice-daily insulin therapy and professional continuous glucose monitoring were recruited. Type 1 diabetes was diagnosed by endocrinologists according to American Diabetes Association standards, including a very low C-peptide level (diabetic ketoacidosis. Continuous glucose monitoring was applied for 3 days.Among 119 subjects, 86 were diagnosed with type 1 diabetes. Subjects with type 1 diabetes were younger (33.8 vs 52.3 years old, P 1), had lower body mass index (BMI, 21.95 vs 24.42, P = 0.003), lower serum creatinine (61.77  vs 84.65 μmol/L, P = 0.001), and higher estimated glomerular filtration rate (108.71 vs 76.48 mg/mL/min/1.73m2, P 1) than subjects with type 2 diabetes. Predictive scores for identification of type 1 diabetes were constructed, including age, BMI, average mean amplitude of glucose excursion in days 2 and 3, and the area under the curve of nocturnal hyperglycemic and hypoglycemic states. The area under the receiver operating characteristic curve was 0.90. With the cutoff of 0.58, the sensitivity was 86.7% and the specificity was 80.8%. The good performance was validated by the leave-one-out method (sensitivity 83.3%, specificity 73.1%).Professional continuous glucose monitoring is a useful tool that improves identification of type 1 diabetes among diabetic patients receiving insulin therapy.

  12. Non-contact remote monitoring technique of reactor structural elements

    International Nuclear Information System (INIS)

    Inoue, Hideo; Mori, Kazuo; Ozawa, Norimitsu; Akedo, Jun; Seimiya, Koichi; Chikamori, Kunio; Umezawa, Akihiko

    1998-01-01

    This study aims at development of technique to measure and estimate, at high precision, fine machining scratch, crack and so on formed on grinding tubular elements, especially inner faces of small diameter tube at an optical mirror grade, and at establishment of estimation technique on reliability and soundness of the tubular elements. In this fiscal year, on optical type non-contact monitoring technique, investigations on optical illumination condition and holding accuracy required for the non-contact holding mechanism were conducted by using a sensor head trially produced in 1995 fiscal year. And, in order to realize a high precision non-contact holding in a tube of optical detection system to upgrade static holding properties (holding stiffness, holding attitude, and so on) of pneumatic type inner tube non-contact holding mechanism, realization of increase in supplying air pressure and experiments using a holding mechanism to increase pore numbers of air injecting nozzle were conducted. And, on materials surface technique, effect of difference in pre-machining method (cutting and bright annealing) at inner face of small diameter stainless tube on their smooth machining property was examined. (G.K.)

  13. Real-time continuous glucose monitoring systems in the classroom/school environment.

    Science.gov (United States)

    Benassi, Kari; Drobny, Jessica; Aye, Tandy

    2013-05-01

    Children with type 1 diabetes (T1D) spend 4-7 h/day in school with very little supervision of their diabetes management. Therefore, families have become more dependent on technology, such as use of real-time continuous glucose monitoring (RT-CGM), to provide increased supervision of their diabetes management. We sought to assess the impact of RT-CGM use in the classroom/school environment. Children with T1D using RT-CGM, their parents, and teachers completed a questionnaire about RT-CGM in the classroom/school environment. The RT-CGM was tolerated well in the classroom/school environment. Seventy percent of parents, 75% of students, and 51% of teachers found RT-CGM useful in the classroom/school environment. The students found the device to be more disruptive than did their parents and teachers. However, all three groups agreed that RT-CGM increased their comfort with diabetes management at school. Our study suggests that RT-CGM is useful and not disruptive in the classroom/school environment. The development of education materials for teachers could further increase its acceptance in the classroom/school environment.

  14. Evaluation of subcutaneous glucose monitoring systems under routine environmental conditions in patients with type 1 diabetes.

    Science.gov (United States)

    Aberer, Felix; Hajnsek, Martin; Rumpler, Markus; Zenz, Sabine; Baumann, Petra M; Elsayed, Hesham; Puffing, Adelheid; Treiber, Gerlies; Pieber, Thomas R; Sourij, Harald; Mader, Julia K

    2017-07-01

    Continuous and flash glucose monitoring (GM) systems have been established in diabetes care. We compared the sensor performance of 3 commercially available GM systems. A total of 12 patients with type 1 diabetes were included in a single-centre, open-label study in which the sensor performance of the Abbott FreeStyle libre (Abbott), Dexcom G4 Platinum (Dexcom) and Medtronic MiniMed 640G (Medtronic) systems over 12 hours was compared during mimicked real-life conditions (meals, exercise, hypo- and hyperglycaemia). Sensor performance was determined by fulfilment of ISO 15197:2013 criteria, calculating mean absolute relative difference (MARD), and was also illustrated using Parkes error grid and Bland-Altman plots. Sensor performance during changes in metabolic variables (lactate, betahydroxybutyrate, glucagon, non-esterified-fatty-acids) was determined by Spearman's rank correlation coefficient testing. The systems fulfilled ISO 15197:2013 criteria by 73.2% (Abbott), 56.1% (Dexcom) and 52.0% (Medtronic). The MARDs ± standard deviation in the entire glycaemic range were 13.2% ± 10.9% (Abbott), 16.8% ± 12.3% (Dexcom) and 21.4% ± 17.6% (Medtronic), respectively. All sensors performed less accurately during hypoglycaemia and best during hyperglycaemia. We did not observe an influence of metabolic variables on sensor performance. © 2017 John Wiley & Sons Ltd.

  15. Continuous glucose monitoring technology for personal use: an educational program that educates and supports the patient.

    Science.gov (United States)

    Evert, Alison; Trence, Dace; Catton, Sarah; Huynh, Peter

    2009-01-01

    The purpose of this article is to describe the development and implementation of an educational program for the initiation of real-time continuous glucose monitoring (CGM) technology for personal use, not 3-day CGMS diagnostic studies. The education program was designed to meet the needs of patients managing their diabetes with either diabetes medications or insulin pump therapy in an outpatient diabetes education center using a team-based approach. Observational research, complemented by literature review, was used to develop an educational program model and teaching strategies. Diabetes educators, endocrinologists, CGM manufacturer clinical specialists, and patients with diabetes were also interviewed for their clinical observations and experience. The program follows a progressive educational model. First, patients learn in-depth about real-time CGM technology by attending a group presensor class that provides detailed information about CGM. This presensor class facilitates self-selection among patients concerning their readiness to use real-time CGM. If the patient decides to proceed with real-time CGM use, CGM initiation is scheduled, using a clinic-centered protocol for both start-up and follow-up. Successful use of real-time CGM involves more than just patient enthusiasm or interest in a new technology. Channeling patient interest into a structured educational setting that includes the benefits and limitations of real-time CGM helps to manage patient expectations.

  16. Data-driven strategies for robust forecast of continuous glucose monitoring time-series.

    Science.gov (United States)

    Fiorini, Samuele; Martini, Chiara; Malpassi, Davide; Cordera, Renzo; Maggi, Davide; Verri, Alessandro; Barla, Annalisa

    2017-07-01

    Over the past decade, continuous glucose monitoring (CGM) has proven to be a very resourceful tool for diabetes management. To date, CGM devices are employed for both retrospective and online applications. Their use allows to better describe the patients' pathology as well as to achieve a better control of patients' level of glycemia. The analysis of CGM sensor data makes possible to observe a wide range of metrics, such as the glycemic variability during the day or the amount of time spent below or above certain glycemic thresholds. However, due to the high variability of the glycemic signals among sensors and individuals, CGM data analysis is a non-trivial task. Standard signal filtering solutions fall short when an appropriate model personalization is not applied. State-of-the-art data-driven strategies for online CGM forecasting rely upon the use of recursive filters. Each time a new sample is collected, such models need to adjust their parameters in order to predict the next glycemic level. In this paper we aim at demonstrating that the problem of online CGM forecasting can be successfully tackled by personalized machine learning models, that do not need to recursively update their parameters.

  17. Alternating current techniques for corrosion monitoring in water reactor systems

    International Nuclear Information System (INIS)

    Isaacs, H.S.; Weeks, J.R.

    1977-01-01

    Corrosion in both nuclear and fossil fueled steam generators is generally a consequence of the presence of aggressive impurities introduced into the coolant system through condenser leakage. The impurities concentrate in regions of the steam generator protected from coolant flow, in crevices or under deposited corrosion products and adjacent to heat transfer surfaces. These three factors, the aggressive impurity, crevice type areas and heat transfer surfaces appear to be the requirements for the onset of rapid corrosion. Under conditions where coolant impurities do not concentrate the corrosion rates are low, easily measured and can be accounted for by allowances in the design of the steam generator. Rapid corrosion conditions cannot be designed for and must be suppressed. The condition of the surfaces when rapid corrosion develops must be markedly different from those during normal operation and these changes should be observable using electrochemical techniques. This background formed the basis of a design of a corrosion monitoring device, work on which was initiated at BNL. The basic principles of the technique are described. The object of the work is to develop a corrosion monitoring device which can be operated with PWR steam generator secondary coolant feed water

  18. A noninvasive multimodal technique to monitor brain tumor vascularization

    Science.gov (United States)

    Saxena, Vishal; Gonzalez-Gomez, Ignacio; Laug, Walter E.

    2007-09-01

    Determination of tumor oxygenation at the microvascular level will provide important insight into tumor growth, angiogenesis, necrosis and therapeutic response and will facilitate to develop protocols for studying tumor behavior. The non-ionizing near infrared spectroscopy (NIRS) technique has the potential to differentiate lesion and hemoglobin dynamics; however, it has a limited spatial resolution. On the other hand, magnetic resonance imaging (MRI) has achieved high spatial resolution with excellent tissue discrimination but is more susceptible to limited ability to monitor the hemoglobin dynamics. In the present work, the vascular status and the pathophysiological changes that occur during tumor vascularization are studied in an orthotopic brain tumor model. A noninvasive multimodal approach based on the NIRS technique, namely steady state diffuse optical spectroscopy (SSDOS) along with MRI, is applied for monitoring the concentrations of oxyhemoglobin, deoxyhemoglobin and water within tumor region. The concentrations of oxyhemoglobin, deoxyhemoglobin and water within tumor vasculature are extracted at 15 discrete wavelengths in a spectral window of 675-780 nm. We found a direct correlation between tumor size, intratumoral microvessel density and tumor oxygenation. The relative decrease in tumor oxygenation with growth indicates that though blood vessels infiltrate and proliferate the tumor region, a hypoxic trend is clearly present.

  19. A noninvasive multimodal technique to monitor brain tumor vascularization

    International Nuclear Information System (INIS)

    Saxena, Vishal; Gonzalez-Gomez, Ignacio; Laug, Walter E

    2007-01-01

    Determination of tumor oxygenation at the microvascular level will provide important insight into tumor growth, angiogenesis, necrosis and therapeutic response and will facilitate to develop protocols for studying tumor behavior. The non-ionizing near infrared spectroscopy (NIRS) technique has the potential to differentiate lesion and hemoglobin dynamics; however, it has a limited spatial resolution. On the other hand, magnetic resonance imaging (MRI) has achieved high spatial resolution with excellent tissue discrimination but is more susceptible to limited ability to monitor the hemoglobin dynamics. In the present work, the vascular status and the pathophysiological changes that occur during tumor vascularization are studied in an orthotopic brain tumor model. A noninvasive multimodal approach based on the NIRS technique, namely steady state diffuse optical spectroscopy (SSDOS) along with MRI, is applied for monitoring the concentrations of oxyhemoglobin, deoxyhemoglobin and water within tumor region. The concentrations of oxyhemoglobin, deoxyhemoglobin and water within tumor vasculature are extracted at 15 discrete wavelengths in a spectral window of 675-780 nm. We found a direct correlation between tumor size, intratumoral microvessel density and tumor oxygenation. The relative decrease in tumor oxygenation with growth indicates that though blood vessels infiltrate and proliferate the tumor region, a hypoxic trend is clearly present

  20. Development of structural health monitoring techniques using dynamics testing

    Energy Technology Data Exchange (ETDEWEB)

    James, G.H. III [Sandia National Labs., Albuquerque, NM (United States). Experimental Structural Dynamics Dept.

    1996-03-01

    Today`s society depends upon many structures (such as aircraft, bridges, wind turbines, offshore platforms, buildings, and nuclear weapons) which are nearing the end of their design lifetime. Since these structures cannot be economically replaced, techniques for structural health monitoring must be developed and implemented. Modal and structural dynamics measurements hold promise for the global non-destructive inspection of a variety of structures since surface measurements of a vibrating structure can provide information about the health of the internal members without costly (or impossible) dismantling of the structure. In order to develop structural health monitoring for application to operational structures, developments in four areas have been undertaken within this project: operational evaluation, diagnostic measurements, information condensation, and damage identification. The developments in each of these four aspects of structural health monitoring have been exercised on a broad range of experimental data. This experimental data has been extracted from structures from several application areas which include aging aircraft, wind energy, aging bridges, offshore structures, structural supports, and mechanical parts. As a result of these advances, Sandia National Laboratories is in a position to perform further advanced development, operational implementation, and technical consulting for a broad class of the nation`s aging infrastructure problems.

  1. Potential drop technique for monitoring stress corrosion cracking growth

    International Nuclear Information System (INIS)

    Neves, Celia F.C.; Schvartzman, Monica M.A.M.; Moreira, Pedro A.L.D.P.L.P.

    2002-01-01

    Stress corrosion cracking is one of most severe damage mechanisms influencing the lifetime of components in the operation of nuclear power plants. To assess the initiation stages and kinetics of crack growth as the main parameters coming to residual lifetime determination, the testing facility should allow active loading of specimens in the environment which is close to the real operation conditions of assessed component. Under cooperation of CDTN/CNEN and International Atomic Energy Agency a testing system has been developed by Nuclear Research Institute, Czech Republic, that will be used for the environmentally assisted cracking testing at CDTN/CNEN. The facility allows high temperature autoclave corrosion mechanical testing in well-defined LWR water chemistry using constant load, slow strain rate and rising displacement techniques. The facility consists of autoclave and refreshing water loop enabling testing at temperatures up to 330 deg C. Active loading system allows the maximum load on a specimen as high as 60 kN. The potential drop measurement is used to determine the instant crack length and its growth rate. The paper presents the facility and describes the potential drop technique, that is one of the most used techniques to monitor crack growth in specimens under corrosive environments. (author)

  2. Noble Gas Measurement and Analysis Technique for Monitoring Reprocessing Facilities

    International Nuclear Information System (INIS)

    William S. Charlton

    1999-01-01

    An environmental monitoring technique using analysis of stable noble gas isotopic ratios on-stack at a reprocessing facility was developed. This technique integrates existing technologies to strengthen safeguards at reprocessing facilities. The isotopic ratios are measured using a mass spectrometry system and are compared to a database of calculated isotopic ratios using a Bayesian data analysis method to determine specific fuel parameters (e.g., burnup, fuel type, fuel age, etc.). These inferred parameters can be used by investigators to verify operator declarations. A user-friendly software application (named NOVA) was developed for the application of this technique. NOVA included a Visual Basic user interface coupling a Bayesian data analysis procedure to a reactor physics database (calculated using the Monteburns 3.01 code system). The integrated system (mass spectrometry, reactor modeling, and data analysis) was validated using on-stack measurements during the reprocessing of target fuel from a U.S. production reactor and gas samples from the processing of EBR-II fast breeder reactor driver fuel. These measurements led to an inferred burnup that matched the declared burnup with sufficient accuracy and consistency for most safeguards applications. The NOVA code was also tested using numerous light water reactor measurements from the literature. NOVA was capable of accurately determining spent fuel type, burnup, and fuel age for these experimental results. Work should continue to demonstrate the robustness of this system for production, power, and research reactor fuels

  3. Development of sensing techniques for weaponry health monitoring

    Science.gov (United States)

    Edwards, Eugene; Ruffin, Paul B.; Walker, Ebonee A.; Brantley, Christina L.

    2013-04-01

    Due to the costliness of destructive evaluation methods for assessing the aging and shelf-life of missile and rocket components, the identification of nondestructive evaluation methods has become increasingly important to the Army. Verifying that there is a sufficient concentration of stabilizer is a dependable indicator that the missile's double-based solid propellant is viable. The research outlined in this paper summarizes the Army Aviation and Missile Research, Development, and Engineering Center's (AMRDEC's) comparative use of nanoporous membranes, carbon nanotubes, and optical spectroscopic configured sensing techniques for detecting degradation in rocket motor propellant. The first sensing technique utilizes a gas collecting chamber consisting of nanoporous structures that trap the smaller solid propellant particles for measurement by a gas analysis device. In collaboration with NASA-Ames, sensing methods are developed that utilize functionalized single-walled carbon nanotubes as the key sensing element. The optical spectroscopic sensing method is based on a unique light collecting optical fiber system designed to detect the concentration of the propellant stabilizer. Experimental setups, laboratory results, and overall effectiveness of each technique are presented in this paper. Expectations are for the three sensing mechanisms to provide nondestructive evaluation methods that will offer cost-savings and improved weaponry health monitoring.

  4. Clinical value of Flash glucose monitoring in patients with type 1 diabetes treated with continuous subcutaneous insulin infusion.

    Science.gov (United States)

    Moreno-Fernandez, Jesus; Pazos-Couselo, Marcos; González-Rodriguez, Maria; Rozas, Pedro; Delgado, Manuel; Aguirre, Miguel; Garcia-Lopez, Jose Manuel

    2018-06-12

    To analyze the clinical impact of the Flash glucose monitoring system in patients with type 1 diabetes mellitus (T1DM) treated with continuous subcutaneous insulin infusion (CSII). A 24-week retrospective cohort study in CSII-treated T1DM patients exposed (1:1) to the Flash glucose monitoring system vs. self-monitoring of capillary blood glucose (SMBG). The primary outcome was the difference in hemoglobin A1c (HbA1c) levels between both groups at the end of the study. Thirty-six patients with a mean age of 38.2 years (range 22-55) and a mean T1DM duration of 20.9±7.8 years, treated with CSII for 7.1±5.4 years, were enrolled into the study. At the end of the study, mean HbA1c levels improved in patients in the Flash group (7.1±0.7 vs. 7.8±1.0, p=0.04). Only the Flash group showed a significant decrease in HbA1c levels of -0.4% (95% CI, -0.6, -0.2; p=0.004) during follow-up. Flash patients captured 93.9% of data through 17.8±9.9 scans daily. In fact, the Flash cohort showed a three-fold increase in daily self-monitoring of glucose, while daily frequency of SMBG decreased during the study (-1.8 tests/24h (95% CI -3, -0.7; p=0.01). No safety issues related to Flash use were recorded. The Flash glucose monitoring system is a novel approach to improve blood glucose control in CSII-treated T1DM patients. Randomized controlled trials are needed to assess the effectiveness of this system in CSII-treated T1DM patients. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Smart telemedicine support for continuous glucose monitoring: the embryo of a future global agent for diabetes care.

    Science.gov (United States)

    Rigla, Mercedes

    2011-01-01

    Although current systems for continuous glucose monitoring (CGM) are the result of progressive technological improvement, and although a beneficial effect on glucose control has been demonstrated, few patients are using them. Something similar has happened to telemedicine (TM); in spite of the long-term experience, which began in the early 1980s, no TM system has been widely adopted, and presential visits are still almost the only way diabetologists and patients communicate. The hypothesis developed in this article is that neither CGM nor TM will ever be routinely implemented separately, and their consideration as essential elements for standard diabetes care will one day come from their integration as parts of a telemedical monitoring platform. This platform, which should include artificial intelligence for giving decision support to patients and physicians, will represent the core of a more complex global agent for diabetes care, which will provide control algorithms and risk analysis among other essential functions. © 2010 Diabetes Technology Society.

  6. 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.

  7. Volcanic Monitoring Techniques Applied to Controlled Fragmentation Experiments

    Science.gov (United States)

    Kueppers, U.; Alatorre-Ibarguengoitia, M. A.; Hort, M. K.; Kremers, S.; Meier, K.; Scharff, L.; Scheu, B.; Taddeucci, J.; Dingwell, D. B.

    2010-12-01

    ejection and that the evaluated results were mostly in good agreement. We will discuss the technical difficulties encountered, e.g. the temporal synchronisation of the different techniques. Furthermore, the internal data management of the DR prevents at present a continuous recording and only a limited number of snapshots is stored. Nonetheless, in at least three experiments the onset of particle ejection was measured by all different techniques and gave coherent results of up to 100 m/s. This is a very encouraging result and of paramount importance as it proofs the applicability of these independent methods to volcano monitoring. Each method by itself may enhance our understanding of the pressurisation state of a volcano, an essential factor in ballistic hazard evaluation and eruption energy estimation. Technical adaptations of the DR will overcome the encountered problems and allow a more refined data analysis during the next campaign.

  8. Usefulness of continuous glucose monitoring for the diagnosis of hypoglycemia after a gastric bypass in a patient previously treated for type 2 diabetes.

    Science.gov (United States)

    Hanaire, Hélène; Dubet, Audrey; Chauveau, Marie-Emilie; Anduze, Yves; Fernandes, Martine; Melki, Vincent; Ritz, Patrick

    2010-01-01

    Hypoglycemia is rare after a gastric bypass and can be taken for a dumping syndrome. There is no report in the literature of the contribution of continuous glucose monitoring to the diagnosis of hypoglycemia in these circumstances. The present case report shows that continuous glucose monitoring can be a useful tool for the diagnosis and the management of such episodes. Continuous glucose monitoring revealed hypoglycemic episodes in free living circumstances that were not present during 72-h fasting. These episodes followed wide hyperglycemic swings. No such episode resumed over 8 months after specific dietary advices and treatment by 50 mg TID of acarbose. Because hypoglycemia can be difficult to diagnose from dumping syndrome, continuous glucose monitoring is a very useful tool revealing the episodes in free living circumstances and can be used to monitor the treatment success.

  9. Instrumentation techniques for monitoring shock and detonation waves

    Science.gov (United States)

    Dick, R. D.; Parrish, R. L.

    1985-09-01

    CORRTEX (Continuous Reflectometry for Radius Versus Time Experiments), SLIFER (Shorted Location Indication by Frequency of Electrical Resonance), and pin probes were used to monitor several conditions of blasting such as the detonation velocity of the explosive, the functioning of the stemming column confining the explosive, and rock mass motion. CORRTEX is a passive device that employs time-domain reflectometry to interrogate the two-way transit time of a coaxial cable. SLIFER is an active device that monitors the changing frequency resulting from a change in length of a coaxial cable forming an element of an oscillator circuit. Pin probes in this application consist of RG-174 coaxial cables, each with an open circuit, placed at several known locations within the material. Each cable is connected to a pulse-forming network and a voltage source. When the cables are shorted by the advancing wave, time-distance data are produced from which a velocity can be computed. Each technique, installation of the gauge, examples of the signals, and interpretation of the records are described.

  10. Laser and optical techniques employed in enviromental monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Sunesson, A

    1988-03-01

    Monitoring of trace gases in the atmosphere has been performed with differential absorption lidar and differential optical absorption spectroscopy. A new mobile differential absorption lidar system has been constructed it is described in detail and examples of SO/sub 2/ and NO/sub 2/ measurements are given. Studies of the NO/sub 2/ concentration distribution in an urban area during a temperature inversion were performed. Detection of CI/sub 2/ with DIAL was investigated. Using a narrow-bandwidth laser system range-resolved measurements of NO and Hg were investigated. Mapping of NO and Hg plumes was performed. The use of mercury as a tracer gas for geothermal energy exploration was investigated during a field test in Iceland. Contrary to expectations very low mercury concentrations were detected. A high-resolution differential optical absorption system has been constructed and applied in longh-path monitoring of SO/sub 2/ and NO/sub 2/. Detection of atmospheric atomic mercury was investigated. A multipass absorption cell (White cell) has been constructed and used for spectroscopic measurements. Weak oxygen absorption lines in the vicinity of the Hg line were studied both with laser and optical techniques. (With 176 refs.)

  11. 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.

  12. Glucose concentration in capillary blood of dairy cows obtained by a minimally invasive lancet technique and determined with three different hand-held devices.

    Science.gov (United States)

    Mair, B; Drillich, M; Klein-Jöbstl, D; Kanz, P; Borchardt, S; Meyer, L; Schwendenwein, I; Iwersen, M

    2016-02-24

    Dairy cows have a massive demand for glucose at the onset of lactation. A poor adaption to this period leads to an excessive negative energy balance with an increased risk for ketosis and impaired animal health and production. Besides the measurement of ketones, analysing the glucose concentration in blood is reported as helpful instrument for diagnosis and differentiation of ketosis. Monitoring metabolic parameters requires multiple blood sampling. In other species, new blood sampling techniques have been introduced in which small amounts of blood are rapidly analysed using electronic hand-held devices. The objective of this study was to evaluate the suitability of capillary blood for blood glucose measurement in dairy cows using the hand-held devices FreeStyle Precision (FSP, Abbott), GlucoMen LX Plus (GLX, A. Menarini) and the WellionVet GLUCO CALEA, (WGC, MED TRUST). In total, 240 capillary blood samples were obtained from dry and fresh lactating Holstein-Friesian cows. Blood was collected from the skin of the exterior vulva by using a lancet. For method comparison, additional blood samples were taken from a coccygeal vessel and analyzed in a laboratory. Glucose concentrations measured by a standard laboratory method were defined as the criterion standard. The Pearson correlation coefficients between the glucose concentrations analyzed in capillary blood with the devices and the reference were 73% for the FSP, 81% for the GLX and 41% for the WGC. Bland-Altman plots showed biases of -18.8 mg/dL for the FSP, -11.2 mg/dL for the GLX and +20.82 mg/dL for the WGC. The optimized threshold determined by a Receiver Operating Characteristics analysis to detect hyperglycemia using the FSP was 43 mg/dL with a sensitivity (Se) and specificity (Sp) of 76 and 80%. Using the GLX and WGC optimized thresholds were 49 mg/dL (Se = 92%, Sp = 85%) and 95 mg/dL (Se = 39%, Sp = 92%). The results of this study demonstrate good performance characteristics for the GLX

  13. A calculation technique to improve continuous monitoring of containment integrity

    International Nuclear Information System (INIS)

    Dick, J.E.

    1990-01-01

    The containment envelope of nuclear plants is a passive and extremely effective safety feature. World experience indicates, however, that inadvertent breaches of envelope integrity can go undetected for substantial time periods. Consequently, continuous monitoring of integrity is being closely examined by many containment designers and operators. The most promising approach is to use sensors and systems that automatically measure changes in the mass of air in containment, time integrate any known air mass flow rates across containment boundaries, and perform a mass balance to obtain the air mass leaked. As fluctuations in such measurements are typically too large to enable leakage to be calculated to the desired precision, filtering and statistical techniques must be used to filter out random and time-dependent fluctuations. Current approaches cannot easily deal with nonrandom or systematic fluctuations in the measurements, including pressure changes within the containment. As a result, sampling periods must be kept short, or data measured during periods of varying containment pressure must be discarded. The technique described allows for much longer sampling periods under conditions of fluctuating containment pressure and eliminates the invalidation of data when the containment pressure fluctuation is nonrandom. It should therefore yield a much more precise value for the containment leakage characteristic. It also promises to be able to distinguish the presence of systematic errors unrelated to systematic pressure changes and to establish whether the containment leakage characteristic is laminar or turbulent

  14. An overview of environmental pollution and monitoring techniques

    International Nuclear Information System (INIS)

    Qureshi, I.H.

    1997-01-01

    Environmental pollution has become a world-wide concern as it is likely to affect the ecological system and human health. The indiscriminate release of harmful chemicals and toxic heavy metals in the environment by industrial, agricultural and other activities of man may adversely affect the quality of our air, water and food resources. These toxic chemicals may find their way to living organisms and human body through food chain and may induce various metabolic disorders. It is, therefore, necessary to assess the quality of environment by measuring the concentration of pollutants in air, water, soil and food materials and to establish base-line level. Since the pollutants are present in extremely small amounts, sensitive and accurate analytical techniques have to be employed to obtain reliable data. Studies on the measurement of essential and toxic inorganic elements in various food items and other materials have been carried out at PINSTECH with a view to assess the safety of diet and to establish baseline values. These values will he helpful, in future, to monitor the degree of pollution and to suggest possible remedial and control measures. The estimation of some of the inorganic pollutants and the techniques used in our laboratories and briefly discussed. (author)

  15. Monitoring arterio-venous differences of glucose and lactate in the anesthetized rat with or without brain damage with ultrafiltration and biosensor technology

    NARCIS (Netherlands)

    Leegsma-Vogt, G; Venema, K; Postema, F; Korf, J

    2001-01-01

    Continuous monitoring of arterio-venous glucose and lactate differences may serve as a diagnostic tool to assess normal brain function and brain pathology. We describe a method and some results obtained with arterio-venous measurements of glucose and lactate in the blood of the

  16. Comparative analisis of the dynamics of glycemia using continuos glucose monitoring during on-pump or off-pump coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Elena Zelikovna Golukhova

    2016-01-01

    Given the lack of significant differences between the laboratory glucose rates, data from CGM System Gold and OneTouch Ultra demonstrated that continuous glucose monitoring can reliably assess the presence or absence of metabolic changes in the perioperative period and thus reduce the likelihood of complications.

  17. 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

  18. 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 <0.001), presence of peripheral vascular disease (OR 1.529; 95% CI 1.077 - 2.171; p=0.018), alcohol abstinence (OR 1.442; 95% CI 1.118 - 1.858; p=0.005), and collection of the glucose test strips from the pharmacy (OR 1.275; 95% CI 1.026 - 1.584; p=0.028). Adequate 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.

  19. System health monitoring using multiple-model adaptive estimation techniques

    Science.gov (United States)

    Sifford, Stanley Ryan

    Monitoring system health for fault detection and diagnosis by tracking system parameters concurrently with state estimates is approached using a new multiple-model adaptive estimation (MMAE) method. This novel method is called GRid-based Adaptive Parameter Estimation (GRAPE). GRAPE expands existing MMAE methods by using new techniques to sample the parameter space. GRAPE expands on MMAE with the hypothesis that sample models can be applied and resampled without relying on a predefined set of models. GRAPE is initially implemented in a linear framework using Kalman filter models. A more generalized GRAPE formulation is presented using extended Kalman filter (EKF) models to represent nonlinear systems. GRAPE can handle both time invariant and time varying systems as it is designed to track parameter changes. Two techniques are presented to generate parameter samples for the parallel filter models. The first approach is called selected grid-based stratification (SGBS). SGBS divides the parameter space into equally spaced strata. The second approach uses Latin Hypercube Sampling (LHS) to determine the parameter locations and minimize the total number of required models. LHS is particularly useful when the parameter dimensions grow. Adding more parameters does not require the model count to increase for LHS. Each resample is independent of the prior sample set other than the location of the parameter estimate. SGBS and LHS can be used for both the initial sample and subsequent resamples. Furthermore, resamples are not required to use the same technique. Both techniques are demonstrated for both linear and nonlinear frameworks. The GRAPE framework further formalizes the parameter tracking process through a general approach for nonlinear systems. These additional methods allow GRAPE to either narrow the focus to converged values within a parameter range or expand the range in the appropriate direction to track the parameters outside the current parameter range boundary

  20. On-line monitoring of glucose and/or lactate in a fermentation process using an expanded micro-bed flow injection analyser.

    Science.gov (United States)

    Nandakumar, M P; Lali, A M; Mattiasson, B

    1999-01-01

    A novel flow injection biosensor system for monitoring fermentation processes has been developed using an expanded micro bed as the enzyme reactor. An expanded bed reactor is capable of handling a mobile phase containing suspended matter like cells and cell debris. Thus, while the analyte is free to interact with the adsorbent, the suspended particulate matter passes through unhindered. With the use of a scaled down expanded bed in the flow injection analysis (FIA) system, it was possible to analyse samples directly from a fermentor without the pretreatment otherwise required to extract the analyte or remove the suspended cells. This technique, therefore, provides a means to determine the true concentrations of the metabolites in a fermentor, with more ease than possible with other techniques. Glucose oxidase immobilised on STREAMLINE was used to measure glucose concentration in a suspension of dead yeast cells. There was no interference from the cell particles even at high cell densities such as 15 gm dry weight per litre. The assay time was about 6 min. Accuracy and reproducibility of the system was found to be good. In another scheme, lactate oxidase was covalently coupled to STREAMLINE for expanded bed operation. With the on-line expanded micro bed FIA it was possible to follow the fermentation with Lactobacillus casei.

  1. Optimizing insulin injection technique and its effect on blood glucose control

    Directory of Open Access Journals (Sweden)

    Giorgio Grassi, MD

    2014-12-01

    Conclusions: Targeted individualized training in IT, including the switch to a 4 mm needle, is associated with improved glucose control, greater satisfaction with therapy, better and simpler injection practices and possibly lower consumption of insulin after only a three month period.

  2. 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.

  3. Association of glycaemic variability evaluated by continuous glucose monitoring with diabetic peripheral neuropathy in type 2 diabetic patients.

    Science.gov (United States)

    Hu, Yu-Ming; Zhao, Li-Hua; Zhang, Xiu-Lin; Cai, Hong-Li; Huang, Hai-Yan; Xu, Feng; Chen, Tong; Wang, Xue-Qin; Guo, Ai-Song; Li, Jian-An; Su, Jian-Bin

    2018-05-01

    Diabetic peripheral neuropathy (DPN), a common microvascular complication of diabetes, is linked to glycaemic derangements. Glycaemic variability, as a pattern of glycaemic derangements, is a key risk factor for diabetic complications. We investigated the association of glycaemic variability with DPN in a large-scale sample of type 2 diabetic patients. In this cross-sectional study, we enrolled 982 type 2 diabetic patients who were screened for DPN and monitored by a continuous glucose monitoring (CGM) system between February 2011 and January 2017. Multiple glycaemic variability parameters, including the mean amplitude of glycaemic excursions (MAGE), mean of daily differences (MODD), standard deviation of glucose (SD), and 24-h mean glucose (24-h MG), were calculated from glucose profiles obtained from CGM. Other possible risks for DPN were also examined. Of the recruited type 2 diabetic patients, 20.1% (n = 197) presented with DPN, and these patients also had a higher MAGE, MODD, SD, and 24-h MG than patients without DPN (p diabetic duration, HOMA-IR, and hemoglobin A1c (HbA1c) were found to be independent contributors to DPN, and the corresponding odds ratios (95% confidence interval) were 4.57 (3.48-6.01), 1.10 (1.03-1.17), 1.24 (1.09-1.41), and 1.33 (1.15-1.53), respectively. Receiver operating characteristic analysis indicated that the optimal MAGE cutoff value for predicting DPN was 4.60 mmol/L; the corresponding sensitivity was 64.47%, and the specificity was 75.54%. In addition to conventional risks including diabetic duration, HOMA-IR and HbA1c, increased glycaemic variability assessed by MAGE is a significant independent contributor to DPN in type 2 diabetic patients.

  4. Association between the extent of urinary albumin excretion and glycaemic variability indices measured by continuous glucose monitoring.

    Science.gov (United States)

    Jin, S-M; Kim, T-H; Oh, S; Baek, J; Joung, J Y; Park, S-M; Cho, Y Y; Sohn, S Y; Hur, K Y; Lee, M-S; Lee, M-K; Kim, J H

    2015-02-01

    The contribution of glycaemic variability to the microvascular complication of diabetes has not been established. We examined whether there is an independent association between indices of glycaemic variability in continuous glucose monitoring and extent of albuminuria. A total of 173 patients with Type 2 diabetes (without insulin therapy, n = 96; with insulin therapy, n = 77) who had unexplained large fluctuations in blood glucose values underwent three-day continuous glucose monitoring. We used a multinomial logistic regression model to determine whether the indices of glycaemic variability independently affected the odds of having a spot urine albumin/creatinine ratio of 30-299 mg/g and ≥ 300 mg/g. Higher standard deviation (P = 0.002), mean of daily differences (P = 0.023) and mean amplitude of glycaemic excursion (P = 0.043) significantly increased the odds of having a urine albumin/creatinine ratio of ≥ 300 mg/g. In multivariable analysis, only higher standard deviation, but not mean amplitude of glycaemic excursion and mean of daily differences, independently increased the odds of having a urine albumin/creatinine ratio of ≥ 300 mg/g (P = 0.025). Coefficient of variation (sd/mean) was not associated with the odds of having a urine albumin/creatinine ratio of 30-299 or ≥ 300 mg/g. The independent association between standard deviation and the extent of albuminuria was lost when the measures were normalized by mean glucose level. At least in terms of relative measures of glycaemic variability, we failed to demonstrate an independent association between glycaemic variability and albuminuria extent in patients with inadequately controlled Type 2 diabetes. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  5. Accuracy of Continuous Glucose Monitoring Measurements in Normo-Glycemic Individuals

    DEFF Research Database (Denmark)

    Akintola, Abimbola A; Noordam, Raymond; Jansen, Steffy W

    2015-01-01

    a 24-hour period. Validity of CGM-derived individual glucose measurements, calculated measures of glycemia over daytime (09:00h-23:00h) and nighttime (23:00h-09:00h), and calculated measures of glycemic variability (e.g. 24h standard deviation [SD]) were assessed by Pearson correlation coefficients......, mean absolute relative difference (MARD) and paired t-tests. RESULTS: The median correlation coefficient between CGM and venous glucose measurements per participant was 0.68 (interquartile range: 0.40-0.78), and the MARD was 17.6% (SD = 17%). Compared with venous sampling, the calculated measure...

  6. A Novel Microdialysis Glucose Sensor System Based on Co-immobilizing on AU Micro-Electrode by SOL-GEL Technique

    National Research Council Canada - National Science Library

    Yu, Ping

    2001-01-01

    .... The sensor is based on co_immobilizing glucose oxidase (COD) with the catalase by sol-gel technique on the surface of the silicon bases with two pattern of An microelectrodes. A graduated ("sandwich...

  7. Seventy two-hour glucose monitoring profiles in mild gestational diabetes mellitus: differences from healthy pregnancies and influence of diet counseling.

    Science.gov (United States)

    Carreiro, Marina Pimenta; Lauria, Márcio W; Naves, Gabriel Nino T; Miranda, Paulo Augusto C; Leite, Ricardo Barsaglini; Rajão, Kamilla Maria Araújo Brandão; de Aguiar, Regina Amélia Lopes Pessoa; Nogueira, Anelise Impeliziere; Ribeiro-Oliveira, Antônio

    2016-09-01

    To study glucose profiles of gestational diabetes (GDM) patients with 72 h of continuous glucose monitoring (CGM) either before (GDM1) or after (GDM2) dietary counseling, comparing them with nondiabetic (NDM) controls. We performed CGM on 22 GDM patients; 11 before and 11 after dietary counseling and compared them to 11 healthy controls. Several physiological and clinical characteristics of the glucose profiles were compared across the groups, including comparisons for pooled 24-h measures and hourly median values, summary measures representing glucose exposure (area under the median curves) and variability (amplitude, standard deviation, interquartile range), and time points related to meals. Most women (81.8%) in the GDM groups had fasting glucose 0.05). Both GDM groups spent more time with glucose levels above 140mg/dL when compared with the NDM group. No differences among the groups were found for: pooled measurements and hourly comparisons, exposure, nocturnal, fasting, between lunch and dinner and before meals, as well as after lunch (P>0.05 for all). The main differences between the mild GDM1 group and healthy controls were related to glucose variability and excursions above 140mg/dL, while glucose exposure was similar. Glucose levels after breakfast and dinner also discerned the GDM1 group. Dietary counseling was able to keep glucose levels to those of healthy patients. © 2016 European Society of Endocrinology.

  8. CONTINUOUS GLUCOSE MONITORING: A CONSENSUS CONFERENCE OF THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY.

    Science.gov (United States)

    Fonseca, Vivian A; Grunberger, George; Anhalt, Henry; Bailey, Timothy S; Blevins, Thomas; Garg, Satish K; Handelsman, Yehuda; Hirsch, Irl B; Orzeck, Eric A; Roberts, Victor Lawrence; Tamborlane, William

    2016-08-01

    Barriers to continuous glucose monitoring (CGM) use continue to hamper adoption of this valuable technology for the management of diabetes. The American Association of Clinical Endocrinologists and the American College of Endocrinology convened a public consensus conference February 20, 2016, to review available CGM data and propose strategies for expanding CGM access. Conference participants agreed that evidence supports the benefits of CGM in type 1 diabetes and that these benefits are likely to apply whenever intensive insulin therapy is used, regardless of diabetes type. CGM is likely to reduce healthcare resource utilization for acute and chronic complications, although real-world analyses are needed to confirm potential cost savings and quality of life improvements. Ongoing technological advances have improved CGM accuracy and usability, but more innovations in human factors, data delivery, reporting, and interpretation are needed to foster expanded use. The development of a standardized data report using similar metrics across all devices would facilitate clinician and patient understanding and utilization of CGM. Expanded CGM coverage by government and private payers is an urgent need. CGM improves glycemic control, reduces hypoglycemia, and may reduce overall costs of diabetes management. Expanding CGM coverage and utilization is likely to improve the health outcomes of people with diabetes. A1C = glycated hemoglobin AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology ASPIRE = Automation to Simulate Pancreatic Insulin Response CGM = continuous glucose monitoring HRQOL = health-related quality of life ICER = incremental cost-effectiveness ratio JDRF = Juvenile Diabetes Research Foundation MARD = mean absolute relative difference MDI = multiple daily injections QALY = quality-adjusted life years RCT = randomized, controlled trial SAP = sensor-augmented pump SMBG = self-monitoring of blood glucose STAR = Sensor

  9. Acoustic monitoring techniques for corrosion degradation in cemented waste canisters

    International Nuclear Information System (INIS)

    Naish, C.C.; Buttle, D.; Wallace-Sims, R.; O'Brien, T.M.

    1991-01-01

    This report describes work carried out to investigate acoustic emission as a monitor of corrosion and degradation of wasteforms where the waste is potentially reactive metal. Electronic monitoring equipment has been designed, built and tested to allow long-term monitoring of a number of waste packages simultaneously. Acoustic monitoring experiments were made on a range of 1 litre cemented Magnox and aluminium samples cast into canisters comparing the acoustic events with hydrogen gas evolution rates and electrochemical corrosion rates. The attenuation of the acoustic signals by the cement grout under a range of conditions has been studied to determine the volume of wasteform that can be satisfactorily monitored by one transducer. The final phase of the programme monitored the acoustic events from full size (200 litre) cemented, inactive, simulated aluminium swarf wastepackages prepared at the AEA waste cementation plant at Winfrith. (Author)

  10. A low perfusion rate microreactor for the continous monitoring of enzyme characteristics: applications for glucose oxidase.

    NARCIS (Netherlands)

    Posthuma-Trumpie, G.A.; Venema, K.; Berkel, van W.J.H.; Korf, J.

    2007-01-01

    This report describes a versatile and robust microreactor for bioactive proteins physically immobilized on a polyether sulfone filter. The potential of the reactor is illustrated with glucose oxidase immobilized on a filter with a cut-off value of 30 kDa. A flow-injection system was used to deliver

  11. A low perfusion rate microreactor for continuous monitoring of enzyme characteristics : application to glucose oxidase

    NARCIS (Netherlands)

    Posthuma-Trumpie, G. A.; Venema, K.; van Berkel, W. J. H.; Korf, J.

    This report describes a versatile and robust microreactor for bioactive proteins physically immobilized on a polyether sulfone filter. The potential of the reactor is illustrated with glucose oxidase immobilized on a filter with a cut-off value of 30 kDa. A flow-injection system was used to deliver

  12. Comparison of Three Nonlinear Filters for Fault Detection in Continuous Glucose Monitors

    DEFF Research Database (Denmark)

    Mahmoudi, Zeinab; Wendt, Sabrina Lyngbye; Boiroux, Dimitri

    2016-01-01

    model of the glucose-insulin dynamics in people with type 1 diabetes. Drift is modelled by a Gaussian random walk and is detected based on the statistical tests of the 90-min prediction residuals of the filters. The unscented Kalman filter had the highest average F score of 85.9%, and the smallest...

  13. 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…

  14. Systematic review of economic evaluation studies and budget impact on ambulatory monitoring of capillary glucose in type 2 diabetics.

    Science.gov (United States)

    Olry de Labry Lima, Antonio; Moya Garrido, María Natividad; Espín Balbino, Jaime

    2014-04-01

    Realise a review of studies of economic evaluation about the ambulatory monitoring of capillary glucose (AMGC) in diabetic type II persons. A review of the literature was conducted, in MedLine, various websites, referenced paper and provided by expert's persons. Five studies concluded that the AMGC was a cost-effective strategic, of this papers use Kaiser Permanente data base, its make that these studies could be considered a solely one study. The rest of the papers did not find difference in the AMGC use. The use of AMGC has an uncertainty efficiency. More studies are needed. Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  15. Impact of continuous glucose monitoring on quality of life, treatment satisfaction, and use of medical care resources

    DEFF Research Database (Denmark)

    Hommel, E; Olsen, B; Battelino, T

    2014-01-01

    To investigate the impact of continuous glucose monitoring (CGM) on health-related quality of life (HRQOL), treatment satisfaction (TS) medical resource use, and indirect costs in the SWITCH study. SWITCH was a multicentre, randomized, crossover study. Patients with type 1 diabetes (n = 153) using...... longer during the sensor-On arm. Regarding indirect costs, children with >70 % sensor usage missed fewer school days, compared with the sensor-Off arm (P = 0.0046) but there was no significant difference in the adults days of work off. The addition of CGM to CSII resulted in better metabolic control...

  16. Evaluation of plutonium analysis techniques for a continuous alpha monitor

    International Nuclear Information System (INIS)

    McDonald, F.N.; Fernandez, S.J.; Motes, B.G.

    1979-03-01

    Present methods for alpha particle monitoring are described according to their capabilities, advantages, and disadvantages. The methods, evaluated according to sensitivity and simplicity of operation, suggest that a Phoswich detector is the most promisng method of alpha monitoring. The proposed monitor would be applicable to fuel reprocessing and waste solidification facilities. A plan for development and on-line demonstration of the Phoswich detector is described

  17. Performance of a new test strip for freestyle blood glucose monitoring systems.

    Science.gov (United States)

    Lock, John Paul; Brazg, Ronald; Bernstein, Robert M; Taylor, Elizabeth; Patel, Mona; Ward, Jeanne; Alva, Shridhara; Chen, Ting; Welsh, Zoë; Amor, Walter; Bhogal, Claire; Ng, Ronald

    2011-01-01

    a new strip, designed to enhance the ease of use and minimize interference of non-glucose sugars, has been developed to replace the current FreeStyle (Abbott Diabetes Care, Alameda, CA) blood glucose test strip. We evaluated the performance of this new strip. laboratory evaluation included precision, linearity, dynamic range, effects of operating temperature, humidity, altitude, hematocrit, interferents, and blood reapplication. System accuracy, lay user performance, and ease of use for finger capillary blood testing and accuracy for venous blood testing were evaluated at clinics. Lay users also compared the speed and ease of use between the new strip and the current FreeStyle strip. for glucose concentrations blood glucose results obtained by lay users fell within ± 5, 10, and 15 mg/dL, respectively, of the reference. For glucose concentrations ≥75 mg/dL, 68%, 95%, 99%, and 99% of the lay user results fell within  ±  5%, 10%, 15%, and 20%, respectively, of the reference. Comparable accuracy was obtained in the venous blood study. Lay users found the new test strip easy to use and faster and easier to use than the current FreeStyle strip. The new strip maintained accuracy under various challenging conditions, including high concentrations of various interferents, sample reapplication up to 60 s, and extremes in hematocrit, altitude, and operating temperature and humidity. our results demonstrated excellent accuracy of the new FreeStyle test strip and validated the improvements in minimizing interference and enhancing ease of use.

  18. A Multi-Technique Reconfigurable Electrochemical Biosensor: Enabling Personal Health Monitoring in Mobile Devices.

    Science.gov (United States)

    Sun, Alexander; Venkatesh, A G; Hall, Drew A

    2016-10-01

    This paper describes the design and characterization of a reconfigurable, multi-technique electrochemical biosensor designed for direct integration into smartphone and wearable technologies to enable remote and accurate personal health monitoring. By repurposing components from one mode to the next, the biosensor's potentiostat is able reconfigure itself into three different measurements modes to perform amperometric, potentiometric, and impedance spectroscopic tests all with minimal redundant devices. A [Formula: see text] PCB prototype of the module was developed with discrete components and tested using Google's Project Ara modular smartphone. The amperometric mode has a ±1 nA to [Formula: see text] measurement range. When used to detect pH, the potentiometric mode achieves a resolution of < 0.08 pH units. In impedance measurement mode, the device can measure 50 Ω-10 [Formula: see text] and has been shown to have of phase error. This prototype was used to perform several point-of-care health tracking assays suitable for use with mobile devices: 1) Blood glucose tests were conducted and shown to cover the diagnostic range for Diabetic patients (  ∼  200 mg/dL). 2) Lactoferrin, a biomarker for urinary tract infections, was detected with a limit of detection of approximately 1 ng/mL. 3) pH tests of sweat were conducted to track dehydration during exercise. 4) EIS was used to determine the concentration of NeutrAvidin via a label-free assay.

  19. 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.

  20. Thumb-size ultrasonic-assisted spectroscopic imager for in-situ glucose monitoring as optional sensor of conventional dialyzers

    Science.gov (United States)

    Nogo, Kosuke; Mori, Keita; Qi, Wei; Hosono, Satsuki; Kawashima, Natsumi; Nishiyama, Akira; Wada, Kenji; Ishimaru, Ichiro

    2016-03-01

    We proposed the ultrasonic-assisted spectroscopic imaging for the realization of blood-glucose-level monitoring during dialytic therapy. Optical scattering and absorption caused by blood cells deteriorate the detection accuracy of glucose dissolved in plasma. Ultrasonic standing waves can agglomerate blood cells at nodes. In contrast, around anti-node regions, the amount of transmitted light increases because relatively clear plasma appears due to decline the number of blood cells. Proposed method can disperse the transmitted light of plasma without time-consuming pretreatment such as centrifugation. To realize the thumb-size glucose sensor which can be easily attached to dialysis tubes, an ultrasonic standing wave generator and a spectroscopic imager are required to be small. Ultrasonic oscillators are ∅30[mm]. A drive circuit of oscillators, which now size is 41×55×45[mm], is expected to become small. The trial apparatus of proposed one-shot Fourier spectroscopic imager, whose size is 30×30×48[mm], also can be little-finger size in principal. In the experiment, we separated the suspension mixed water and micro spheres (Θ10[mm) into particles and liquid regions with the ultrasonic standing wave (frequency: 2[MHz]). Furthermore, the spectrum of transmitted light through the suspension could be obtained in visible light regions with a white LED.

  1. Satisfaction Survey on Information Technology-Based Glucose Monitoring System Targeting Diabetes Mellitus in Private Local Clinics in Korea

    Directory of Open Access Journals (Sweden)

    Hun-Sung Kim

    2017-06-01

    Full Text Available BackgroundPrivate local clinics in Korea have little experience with information technology (IT-based glucose monitoring (ITGM. Our aim is to examine user satisfaction and the possibility of using ITGM service practically.MethodsPatients sent their blood glucose levels to physicians in local clinics. The physicians reviewed the blood glucose values online and provided personal consultations through text messaging or phone calls. Thereafter, a satisfaction survey on the ITGM service, the modified Morisky scale, and patient assessment of chronic illness care were administered.ResultsOne hundred and seventy patients from seven private local clinics used the ITGM. Overall satisfaction, including that about the ITGM service, the device, and its usefulness, was rated higher than “mostly satisfied” (score 4.2±0.8 out of 5.0 and even higher among the elderly. Satisfaction was positively associated with age, especially in those older than 60 years. The main reason for intent for future use of the service was the time/place flexibility. Highly motivated patients tended to answer positively regarding information satisfaction (P=0.0377.ConclusionOur study is the first to investigate ITGM satisfaction in private local clinics. The feasibility of users utilizing ITGM should be clarified, and future clinical research on the service's clinical effects and cost-benefit analysis is needed.

  2. Glucose concentration in capillary blood of dairy cows obtained by a minimally invasive lancet technique and determined with three different hand-held devices

    OpenAIRE

    Mair, B.; Drillich, M.; Klein-J?bstl, D.; Kanz, P.; Borchardt, S.; Meyer, L.; Schwendenwein, I.; Iwersen, M.

    2016-01-01

    Background Dairy cows have a massive demand for glucose at the onset of lactation. A poor adaption to this period leads to an excessive negative energy balance with an increased risk for ketosis and impaired animal health and production. Besides the measurement of ketones, analysing the glucose concentration in blood is reported as helpful instrument for diagnosis and differentiation of ketosis. Monitoring metabolic parameters requires multiple blood sampling. In other species, new blood samp...

  3. Continuous glucose monitoring for patients with type 1 diabetes and impaired awareness of hypoglycaemia (IN CONTROL): a randomised, open-label, crossover trial

    NARCIS (Netherlands)

    van Beers, Cornelis A. J.; DeVries, J. Hans; Kleijer, Susanne J.; Smits, Mark M.; Geelhoed-Duijvestijn, Petronella H.; Kramer, Mark H. H.; Diamant, Michaela; Snoek, Frank J.; Serné, Erik H.

    2016-01-01

    Patients with type 1 diabetes who have impaired awareness of hypoglycaemia have a three to six times increased risk of severe hypoglycaemia. We aimed to assess whether continuous glucose monitoring (CGM) improves glycaemia and prevents severe hypoglycaemia compared with self-monitoring of blood

  4. 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

    (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. 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...... 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...

  5. Development of Chemically Amplified Optical Sensors for Continuous Blood Glucose Monitoring Final Report CRADA No. TSB-1162-95

    Energy Technology Data Exchange (ETDEWEB)

    Lane, Stephen M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Univ. of California, Livermore, CA (United States); Mastrototaro, John J. [Minimed Technologies, Inc., Sylmar, CA (United States)

    2018-01-22

    Diabetes is a chronic disease that affects 14 million people in the U.S. and more than 110 million people worldwide. Each year in this country 27,000 diabetic patients become blind, 15,000 have kidney failure, and over 54,000 have peripheral limb amputations. In 1992, total healthcare costs in the U.S. for diabetes were more than $105 billion, approximately 15% of our healthcare budget. Conventional therapy for the most severe form of diabetes, insulin-dependent diabetes mellitus (IDDM) or Type I diabetes, is to administer one or two injections per day of various forms of insulin while monitoring blood glucose levels twice or three times daily with commercial glucometers that require blood samples. Near normal blood sugar levels (glycemic control) is difficult to achieve with conventional therapy. In the fall of 1993, the results of the 10-year $165 million Diabetes Control and Complications Trial (DCCT) were published which showed that intensive insulin management would lead to dramatically fewer cases of retinopathy (which leads to blindness), nephropathy (which leads to kidney failure), and neuropathy (which can lead to limb amputations) [New England Journal of Medicine, Vo1239, No.14 977-986 (1993)]. If existing commercial insulin pumps could be combined with a continuous glucose sensor, a more physiological and fine-tuned therapy could be provided - in effect, an artificial biomechanical pancreas would be available. Existing research suggested that such a development would dramatically improve glucose control, thus greatly reducing morbidity and mortality from this disease. MiniMed Technologies in Sylmar, CA, identified a number of optically based sensor strategies as well as candidate chemical reactions that could be used to implement a minimally invasive opto-chemical glucose sensor. LLNL evaluated these sensor strategies and chemical reactions. These evaluations were the first steps leading to development of a sensor of considerable importance that could

  6. A comparative study of sampling techniques for monitoring carcass contamination

    NARCIS (Netherlands)

    Snijders, J.M.A.; Janssen, M.H.W.; Gerats, G.E.; Corstiaensen, G.P.

    1984-01-01

    Four bacteriological sampling techniques i.e. the excision, double swab, agar contract and modified agar contact techniques were compared by sampling pig carcasses before and after chilling. As well as assessing the advantages and disadvantages of the techniques particular attention was paid to

  7. 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...

  8. Successful microsurgical lip replantation: Monitoring venous congestion by blood glucose measurements in the replanted lip

    Directory of Open Access Journals (Sweden)

    Kazufumi Tachi

    2018-03-01

    Full Text Available 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 replanted region. The patient presented to our hospital with an upper lip avulsion that was caused by a dog bite. The lip was replanted by the microvascular anastomoses of one artery and two veins using interposed vein grafts. The replanted lip showed signs of congestion on postoperative day one; exsanguination using medicinal leeches was attempted, while blood glucose levels were measured every three hours. Critical congestion, which did not occur in this patient, was defined as a blood glucose level lower than 40 mg/dL. Lip replantation was successful without any complications in this patient.

  9. Diabetes Technology-Continuous Subcutaneous Insulin Infusion Therapy and Continuous Glucose Monitoring in Adults: An Endocrine Society Clinical Practice Guideline.

    Science.gov (United States)

    Peters, Anne L; Ahmann, Andrew J; Battelino, Tadej; Evert, Alison; Hirsch, Irl B; Murad, M Hassan; Winter, William E; Wolpert, Howard

    2016-11-01

    To formulate clinical practice guidelines for the use of continuous glucose monitoring and continuous subcutaneous insulin infusion in adults with diabetes. The participants include an Endocrine Society-appointed Task Force of seven experts, a methodologist, and a medical writer. The American Association for Clinical Chemistry, the American Association of Diabetes Educators, and the European Society of Endocrinology co-sponsored this guideline. The Task Force developed this evidence-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned one systematic review and used the best available evidence from other published systematic reviews and individual studies. One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, the American Association for Clinical Chemistry, the American Association of Diabetes Educators, and the European Society of Endocrinology reviewed and commented on preliminary drafts of these guidelines. Continuous subcutaneous insulin infusion and continuous glucose monitoring have an important role in the treatment of diabetes. Data from randomized controlled trials are limited on the use of medical devices, but existing studies support the use of diabetes technology for a wide variety of indications. This guideline presents a review of the literature and practice recommendations for appropriate device use.

  10. Time-Series Analysis of Continuously Monitored Blood Glucose: The Impacts of Geographic and Daily Lifestyle Factors

    Directory of Open Access Journals (Sweden)

    Sean T. Doherty

    2015-01-01

    Full Text Available Type 2 diabetes is known to be associated with environmental, behavioral, and lifestyle factors. However, the actual impacts of these factors on blood glucose (BG variation throughout the day have remained relatively unexplored. Continuous blood glucose monitors combined with human activity tracking technologies afford new opportunities for exploration in a naturalistic setting. Data from a study of 40 patients with diabetes is utilized in this paper, including continuously monitored BG, food/medicine intake, and patient activity/location tracked using global positioning systems over a 4-day period. Standard linear regression and more disaggregated time-series analysis using autoregressive integrated moving average (ARIMA are used to explore patient BG variation throughout the day and over space. The ARIMA models revealed a wide variety of BG correlating factors related to specific activity types, locations (especially those far from home, and travel modes, although the impacts were highly personal. Traditional variables related to food intake and medications were less often significant. Overall, the time-series analysis revealed considerable patient-by-patient variation in the effects of geographic and daily lifestyle factors. We would suggest that maps of BG spatial variation or an interactive messaging system could provide new tools to engage patients and highlight potential risk factors.

  11. Real-time monitoring of sucrose, sorbitol, d-glucose and d-fructose concentration by electromagnetic sensing.

    Science.gov (United States)

    Harnsoongnoen, Supakorn; Wanthong, Anuwat

    2017-10-01

    Magnetic sensing at microwave frequencies for real-time monitoring of sucrose, sorbitol, d-glucose and d-fructose concentrations is reported. The sensing element was designed based on a coplanar waveguide (CPW) loaded with a split ring resonator (SRR), which was fabricated on a DiClad 880 substrate with a thickness of 1.6mm and relative permittivity (ε r ) of 2.2. The magnetic sensor was connected to a Vector Network Analyzer (VNA) and the electromagnetic interaction between the samples and sensor was analyzed. The magnitude of the transmission coefficient (S 21 ) was used as an indicator to detect the solution sample concentrations ranging from 0.04 to 0.20g/ml. The experimental results confirmed that the developed system using microwaves for the real-time monitoring of sucrose, sorbitol, d-glucose and d-fructose concentrations gave unique results for each solution type and concentration. Moreover, the proposed sensor has a wide dynamic range, high linearity, fast operation and low-cost. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Development and use of a new perfusion technique to study glucose metabolism of the aortic wall in normal and alloxan-diabetic rabbits

    International Nuclear Information System (INIS)

    Brown, B.J.M.

    1985-01-01

    This study investigated (1) possible alterations in glucose uptake and utilization in the perfused, normal, and diabetic vascular wall of rabbits and (2) the effects thereon of insulin and exogenous glucose concentration. Part I involved development and characterization of an in vitro perfusion technique that closely reproduced predetermined in vivo conditions of aortic blood flow, arterial blood pressure, heart rate and pulse pressure. The responsiveness of the preparation to vasoactive agents was assessed with concentrations of norepinephrine (NE) from 10 -9 to 10 -4 M. In Part II, the effects of NE-induced tension development on glucose metabolism were determined by perfusion with oxygenated physiological salt solution (PSS) containing 7 mM glucose and tracer amounts of uniformly labeled 14 C-glucose. Aortas from 8 week-diabetic rabbits were perfused under similar conditions employing a NE infusion in the presence or absence of insulin (150 uU/ml) and variable levels of glucose. Effects of NE-induced tension development include an apparent increase (39%) in glucose uptake and a twofold increase in 14 CO 2 and lactate production. Aortas from diabetic rabbits perfused with PSS containing 7 mM glucose demonstrated marked decreases in glucose uptake (74%), 14 CO 2 (68%), lactate (30%), total tissue glycogen (75%) and labeled tissue phospholipids (70%). Insulin or elevation of exogenous glucose to 25 mM (diabetic levels) normalized glucose uptake, but had differential effects on the pattern of substrate utilization. The marked alterations of glucose metabolism in the diabetic state may contribute to the functional changes observed in diabetic blood vessels

  13. A Review of Field Corrosion Control and Monitoring Techniques of ...

    African Journals Online (AJOL)

    AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING ... to make informed decision and timely respond to corrosion threat before failures. Keywords: cathodic protection, corrosion mechanism, control and monitoring, ...

  14. Human monitoring, smart health and assisted living techniques and technologies

    CERN Document Server

    Longhi, Sauro; Freddi, Alessandro

    2017-01-01

    This book covers the three main scientific and technological areas critical for improving people's quality of life - namely human monitoring, smart health and assisted living - from both the research and development points of view.

  15. Glucose-responsive neurons in the subfornical organ of the rat--a novel site for direct CNS monitoring of circulating glucose.

    Science.gov (United States)

    Medeiros, N; Dai, L; Ferguson, A V

    2012-01-10

    Glucose-sensitive neurons have been identified in a number of CNS regions including metabolic control centers of the hypothalamus. The location of these regions behind the blood-brain barrier restricts them to sensing central, but not circulating glucose concentrations. In this study, we have used patch-clamp electrophysiology to examine whether neurons in a specialized region lacking the blood-brain barrier, the subfornical organ (SFO), are also glucose sensitive. In dissociated SFO neurons, altering the bath concentration of glucose (1 mM, 5 mM, 10 mM) influenced the excitability of 49% of neurons tested (n=67). Glucose-inhibited (GI) neurons depolarized in response to decreased glucose (n=10; mean, 4.6±1.0 mV) or hyperpolarized in response to increased glucose (n=8; mean,-4.4±0.8 mV). In contrast, glucose-excited (GE) neurons depolarized in response to increased glucose (n=9; mean, 6.4±0.4 mV) or hyperpolarized in response to decreased glucose (n=6; mean,-4.8±0.6 mV). Using voltage-clamp recordings, we also identified GI (outward current to increased glucose) and GE (inward current to increased glucose) SFO neurons. The mean glucose-induced inward current had a reversal potential of -24±12 mV (n=5), while GE responses were maintained during sodium-dependent glucose transporter inhibition, supporting the conclusion that GE properties result from the activation of a nonselective cation conductance (NSCC). The glucose-induced outward current had a mean reversal potential of -78±1.2 mV (n=5), while GI responses were not observed in the presence of glibenclamide, suggesting that these properties result from the modulation of K(ATP) channels. These data demonstrate that SFO neurons are glucose responsive, further emphasizing the potential roles of this circumventricular organ as an important sensor and integrator of circulating signals of energy status. Copyright © 2011 IBRO. Published by Elsevier Ltd. All rights reserved.

  16. IDegLira Improves Both Fasting and Postprandial Glucose Control as Demonstrated Using Continuous Glucose Monitoring and a Standardized Meal Test.

    Science.gov (United States)

    Holst, Jens J; Buse, John B; Rodbard, Helena W; Linjawi, Sultan; Woo, Vincent C; Boesgaard, Trine Welløv; Kvist, Kajsa; Gough, Stephen C

    2015-10-06

    IDegLira is a novel, fixed-ratio combination of the long-acting basal insulin, insulin degludec, and the long-acting glucagon-like peptide-1 analog liraglutide. We studied the effect of IDegLira versus its components on postprandial glucose (PPG) in type 2 diabetes. In this substudy, 260 (15.6%) of the original 1663 patients with inadequate glycemic control participating in a 26-week, open-label trial (DUAL I) were randomized 2:1:1 to once-daily IDegLira, insulin degludec or liraglutide. Continuous glucose monitoring (CGM) for 72 hours and a meal test were performed. At week 26, IDegLira produced a significantly greater decrease from baseline in mean PPG increment (normalized iAUC0-4h) than insulin degludec (estimated treatment difference [ETD] -12.79 mg/dl [95% CI: -21.08; -4.68], P = .0023) and a similar magnitude of decrease as liraglutide (ETD -1.62 mg/dl [95% CI: -10.09; 6.67], P = .70). CGM indicated a greater reduction in change from baseline in PPG increment (iAUC0-4h) for IDegLira versus insulin degludec over all 3 main meals (ETD -6.13 mg/dl [95% CI: -10.27, -1.98], P = .0047) and similar reductions versus liraglutide (ETD -1.80 mg/dl [95% CI: -2.52, 5.95], P = .4122). Insulin secretion ratio and static index were greater for IDegLira versus insulin degludec (P = .048 and P = .006, respectively) and similar to liraglutide (P = .45 and P = .895, respectively). Once-daily IDegLira provides significantly better PPG control following a mixed meal test than insulin degludec. The improvement is at least partially explained by higher endogenous insulin secretion and improved beta cell function with IDegLira. The benefits of liraglutide on PPG control are maintained across all main meals in the combination. © 2015 Diabetes Technology Society.

  17. Detection and Processing Techniques of FECG Signal for Fetal Monitoring

    Directory of Open Access Journals (Sweden)

    Hasan MA

    2009-03-01

    Full Text Available Abstract Fetal electrocardiogram (FECG signal contains potentially precise information that could assist clinicians in making more appropriate and timely decisions during labor. The ultimate reason for the interest in FECG signal analysis is in clinical diagnosis and biomedical applications. The extraction and detection of the FECG signal from composite abdominal signals with powerful and advance methodologies are becoming very important requirements in fetal monitoring. The purpose of this review paper is to illustrate the various methodologies and developed algorithms on FECG signal detection and analysis to provide efficient and effective ways of understanding the FECG signal and its nature for fetal monitoring. A comparative study has been carried out to show the performance and accuracy of various methods of FECG signal analysis for fetal monitoring. Finally, this paper further focused some of the hardware implementations using electrical signals for monitoring the fetal heart rate. This paper opens up a passage for researchers, physicians, and end users to advocate an excellent understanding of FECG signal and its analysis procedures for fetal heart rate monitoring system.

  18. Monitoring HIV-infected Patients with Diabetes: Hemoglobin A1c, Fructosamine, or Glucose?

    Directory of Open Access Journals (Sweden)

    So-Young Kim

    2014-01-01

    Full Text Available Background Published studies report inappropriately low hemoglobin A1C (HbA1c values that underestimate glycemia in HIV patients. Methods We reviewed the charts of all HIV patients with diabetes mellitus (DM at our clinic. Fifty-nine patients had HbA1c data, of whom 26 patients also had fructosamine data. We compared the most recent HbA1c to finger-stick (FS glucose averaged over three months, and fructosamine to FS averaged over six weeks. Predicted average glucose (pAG was calculated as reported by Nathan et al: pAG (mg/dL = 28.7 × A1C% – 46.7. Data were analyzed using the Statistical Analysis System (SAS and Kruskal–Wallis test. Results HbA1c values underestimated (UE actual average glucose (aAG in 19% of these patients and overestimated (OE aAG in 27%. HbA1c estimated aAG within the established range in only 54% of the patients. There were no statistical differences in the types of HIV medication used in patients with UE, OE, or accurately estimated (AE glycemia. A Spearman correlation coefficient between HbA1c and aAG was r = 0.53 ( P < 0.0001. Correlation between fructosamine and aAG was r = 0.47 ( P = 0.016. Conclusions The correlations between HbA1c and aAG and between fructosamine and aAG were weaker than expected, and fructosamine was not more accurate than HbA1c.

  19. Accuracy evaluation of five blood glucose monitoring systems obtained from the pharmacy: a European multicenter study with 453 subjects.

    Science.gov (United States)

    Tack, Cornelius; Pohlmeier, Harald; Behnke, Thomas; Schmid, Volkmar; Grenningloh, Marco; Forst, Thomas; Pfützner, Andreas

    2012-04-01

    This multicenter study was conducted to evaluate the performance of five recently introduced blood glucose (BG) monitoring (BGM) devices under daily routine conditions in comparison with the YSI (Yellow Springs, OH) 2300 Stat Plus glucose analyzer. Five hundred one diabetes patients with experience in self-monitoring of BG were randomized to use three of five different BGM devices (FreeStyle Lite® [Abbott Diabetes Care Inc., Alameda, CA], FreeStyle Freedom Lite [Abbott Diabetes Care], OneTouch® UltraEasy® [LifeScan Inc., Milpitas, CA], Accu-Chek® Aviva [Roche Diagnostics, Mannheim, Germany], and Contour® [Bayer Vital GmbH, Leverkusen, Germany]) in a daily routine setting. All devices and strips were purchased from local regular distribution sources (pharmacies, four strip lots per device). The patients performed the finger prick and the glucose measurement on their own. In parallel, a healthcare professional performed the glucose assessment with the reference method (YSI 2300 Stat Plus). The primary objective was the comparison of the mean absolute relative differences (MARD). Secondary objectives were compliance with the International Organization for Standardization (ISO) accuracy criteria under these routine conditions and Clarke and Parkes Error Grid analyses. MARD ranged from 4.9% (FreeStyle Lite) to 9.7% (OneTouch UltraEasy). The ISO 15197:2003 requirements were fulfilled by the FreeStyle Lite (98.8%), FreeStyle Freedom Lite (97.5%), and Accu-Chek Aviva (97.0%), but not by the Contour (92.4%) and OneTouch UltraEasy (91.1%). The number of values in Zone A of the Clarke Error Grid analysis was highest for the FreeStyle Lite (98.8%) and lowest for the OneTouch Ultra Easy (90.4%). FreeStyle Lite, FreeStyle Freedom Lite, and Accu-Chek Aviva performed very well in this study with devices and strips purchased through regular distribution channels, with the FreeStyle Lite achieving the lowest MARD in this investigation.

  20. Behavior change techniques implemented in electronic lifestyle activity monitors: a systematic content analysis.

    Science.gov (United States)

    Lyons, Elizabeth J; Lewis, Zakkoyya H; Mayrsohn, Brian G; Rowland, Jennifer L

    2014-08-15

    Electronic activity monitors (such as those manufactured by Fitbit, Jawbone, and Nike) improve on standard pedometers by providing automated feedback and interactive behavior change tools via mobile device or personal computer. These monitors are commercially popular and show promise for use in public health interventions. However, little is known about the content of their feedback applications and how individual monitors may differ from one another. The purpose of this study was to describe the behavior change techniques implemented in commercially available electronic activity monitors. Electronic activity monitors (N=13) were systematically identified and tested by 3 trained coders for at least 1 week each. All monitors measured lifestyle physical activity and provided feedback via an app (computer or mobile). Coding was based on a hierarchical list of 93 behavior change techniques. Further coding of potentially effective techniques and adherence to theory-based recommendations were based on findings from meta-analyses and meta-regressions in the research literature. All monitors provided tools for self-monitoring, feedback, and environmental change by definition. The next most prevalent techniques (13 out of 13 monitors) were goal-setting and emphasizing discrepancy between current and goal behavior. Review of behavioral goals, social support, social comparison, prompts/cues, rewards, and a focus on past success were found in more than half of the systems. The monitors included a range of 5-10 of 14 total techniques identified from the research literature as potentially effective. Most of the monitors included goal-setting, self-monitoring, and feedback content that closely matched recommendations from social cognitive theory. Electronic activity monitors contain a wide range of behavior change techniques typically used in clinical behavioral interventions. Thus, the monitors may represent a medium by which these interventions could be translated for

  1. Statistical techniques for sampling and monitoring natural resources

    Science.gov (United States)

    Hans T. Schreuder; Richard Ernst; Hugo Ramirez-Maldonado

    2004-01-01

    We present the statistical theory of inventory and monitoring from a probabilistic point of view. We start with the basics and show the interrelationships between designs and estimators illustrating the methods with a small artificial population as well as with a mapped realistic population. For such applications, useful open source software is given in Appendix 4....

  2. Real-time continuous glucose monitoring as a tool to prevent severe hypoglycaemia in selected pregnant women with Type 1 diabetes

    DEFF Research Database (Denmark)

    Secher, A L; Stage, E; Ringholm, Lene

    2014-01-01

    AIMS: Among women with Type 1 diabetes who have had severe hypoglycaemia the year before pregnancy, 70% also experience this complication in pregnancy, and particularly in the first half of pregnancy. We evaluated whether routine use of real-time continuous glucose monitoring from early pregnancy...... onwards could prevent severe hypoglycaemia in these women. METHODS: All 136 consecutive pregnant women with Type 1 diabetes referred to our centre were asked about severe hypoglycaemic events in the year before pregnancy and early in pregnancy at their first antenatal visit. Women with a relevant recent...... history were informed about their additional high risk of severe hypoglycaemia, their treatment was focused on restricted insulin doses during the first 16 gestational weeks, and they were offered real-time continuous glucose monitoring on top of self-monitored plasma glucose measurements. RESULTS: Among...

  3. Effectiveness of Continuous Glucose Monitoring for Managing Type-1 Diabetic Patients and Barrier to Its Use: A Quasi Interventional Trial

    Directory of Open Access Journals (Sweden)

    Hassan M. Al-Musa

    2018-04-01

    Full Text Available Background: Type-1 diabetes is one of the largest endocrine and metabolic health issues among children and young adults. Diabetes mellitus is associated with many long-term complications. Aim and Objectives: To compare outcomes in groups monitored either by real time continuous glucose monitoring or by Self Monitoring of Blood Glucose (SMBG; 3-4 blood glucose measurements per day. Also we studied barrier for the use of CMG. Material and Methods: It is a prospective quasi experimental controlled trial at diabetic center in Abha, KSA. Out of 307 patients registered, 60 T1DM patients agreed to participate; out of them 30 patients were enrolled in intervention cohort, they used CGM sensor continuously while 30 patients were in the control group they used SMBG. All were followed for 6 months; HbA1c was measured at 3 and 6 months. Barrier to use of sensor was evaluated with a questionnaire. Results: At baseline no significant difference was observed in the average HbA1c between the groups (10.57 % vs 10.73 %. HbA1c reduction compared to baseline levels in the intervention cohort was 2.15% and 2.36% at 3 and 6 months. In control group, HbA1c reduced to 1.07% and 1.22% at 3 and 6 months showing significant difference (p=0.002 and p=0.001 at 3 and 6 months. Younger patients age <20 years had significantly better reduction of HbA1c (2.28% vs 1.27%, p=0.015 and 2.47% vs 1.98%, p=0.004 at 3 and 6 months. The hypoglycemic events were statistically reduced in the intervention group (p<0.001 and also the ketoacidosis and hospital admissions (20.0% vs, 3.3%, p<0.001. Conclusion: We found that the use of CGM sensor was associated with significant HbA1c reductions and improved glycaemic control.

  4. Accuracy and precision of flash glucose monitoring sensors inserted into the abdomen and upper thigh compared with the upper arm.

    Science.gov (United States)

    Charleer, Sara; Mathieu, Chantal; Nobels, Frank; Gillard, Pieter

    2018-06-01

    Nowadays, most Belgian patients with type 1 diabetes use flash glucose monitoring (FreeStyle Libre [FSL]; Abbott Diabetes Care, Alameda, California) to check their glucose values, but some patients find the sensor on the upper arm too visible. The aim of the present study was to compare the accuracy and precision of FSL sensors when placed on different sites. A total of 23 adults with type 1 diabetes used three FSL sensors simultaneously for 14 days on the upper arm, abdomen and upper thigh. FSL measurements were compared with capillary blood glucose (BG) measurements obtained with a built-in FSL BG meter. The aggregated mean absolute relative difference was 11.8 ± 12.0%, 18.5 ± 18.4% and 12.3 ± 13.8% for the arm, abdomen (P = .002 vs arm) and thigh (P = .5 vs arm), respectively. Results of Clarke error grid analysis for the arm and thigh were similar (zone A: 84.9% vs 84.5%; P = .6), while less accuracy was seen for the abdomen (zone A: 69.4%; P = .01). Apart from the first day, the accuracy of FSL sensors on the arm and thigh was more stable across the 14-day wear duration than accuracy of sensors on the abdomen, which deteriorated mainly during week 2 (P < .0005). The aggregated precision absolute relative difference was markedly lower for the arm/thigh (10.9 ± 11.9%) compared with the arm/abdomen (20.9 ± 22.8%; P = .002). Our results indicate that the accuracy and precision of FSL sensors placed on the upper thigh are similar to the upper arm, whereas the abdomen performed unacceptably poorly. © 2018 John Wiley & Sons Ltd.

  5. 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.

  6. Flash glucose monitoring system may benefit children and adolescents with type 1 diabetes during fasting at Ramadan.

    Science.gov (United States)

    Al-Agha, Abdulmoein E; Kafi, Shahd E; Zain Aldeen, Abdullah M; Khadwardi, Raghdah H

    2017-04-01

    To assess the benefit of using the flash glucose monitoring system (FGMS) in children and adolescents with type 1 diabetes mellitus (T1DM) during Ramadan fasting. Methods: A prospective pilot study of 51 participants visited the pediatric diabetes clinic at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from between June until and July 2016. The FreeStyle® Libre™ FGMS (Abbott Diabetes Care, Alameda, CA, USA) was used. Hypoglycemia was defined as glucose values of less than 70 mg/dL, while hyperglycemia as glucose values of more than 150 mg/dL for all participants based on our institute's protocol. Results: Participants were able to fast for 67.0% of the total days eligible for fasting, whereas they did not fast on 33% of the days due to either hypoglycemia (15.4%) or non-diabetes-related reasons (17.6 %). None of the participants developed severe hypoglycemia. The mean number of hyperglycemic episodes during fasting hours was 1.29, per day, which was higher than that of hypoglycemic episodes (0.7). None of the participants developed diabetic ketoacidosis (DKA). Glycemic control with mean of estimated hemoglobin A1C reading during Ramadan (8.16 ± 1.64% [pre study]) to 8.2 ± 1.63% [post study] p=0.932. Conclusions: Children and adolescents with T1DM who use the FGMS could fast without the risk of life-threatening episodes of severe hypoglycemia (namely seizure, coma), or DKA during Ramadan. Adequate education and good glycemic control prior to Ramadan are important strategies in combination with the use of an FGMS to achieve better outcome.

  7. Flash glucose monitoring system may benefit children and adolescents with type 1 diabetes during fasting at Ramadan

    Directory of Open Access Journals (Sweden)

    Abdulmoein E. Al-Agha

    2017-04-01

    Full Text Available Objectives: To assess the benefit of using the flash glucose monitoring system (FGMS in children and adolescents with type 1 diabetes mellitus (T1DM during Ramadan fasting. Methods: A prospective pilot study of 51 participants visited the pediatric diabetes clinic at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from between June until and July 2016. The FreeStyle® Libre™ FGMS (Abbott Diabetes Care, Alameda, CA, USA was used. Hypoglycemia was defined as glucose values of less than 70 mg/dL, while hyperglycemia as glucose values of more than 150 mg/dL for all participants based on our institute’s protocol. Results: Participants were able to fast for 67.0% of the total days eligible for fasting, whereas they did not fast on 33% of the days due to either hypoglycemia (15.4% or non-diabetes-related reasons (17.6 %. None of the participants developed severe hypoglycemia. The mean number of hyperglycemic episodes during fasting hours was 1.29, per day, which was higher than that of hypoglycemic episodes (0.7. None of the participants developed diabetic ketoacidosis (DKA. Glycemic control with mean of estimated hemoglobin A1C reading during Ramadan (8.16 ± 1.64% [pre study] to 8.2 ± 1.63% [post study] p=0.932. Conclusions: Children and adolescents with T1DM who use the FGMS could fast without the risk of life-threatening episodes of severe hypoglycemia (namely seizure, coma, or DKA during Ramadan. Adequate education and good glycemic control prior to Ramadan are important strategies in combination with the use of an FGMS to achieve better outcome.

  8. Accuracy Evaluation of 19 Blood Glucose Monitoring Systems Manufactured in the Asia-Pacific Region: A Multicenter Study.

    Science.gov (United States)

    Yu-Fei, Wang; Wei-Ping, Jia; Ming-Hsun, Wu; Miao-O, Chien; Ming-Chang, Hsieh; Chi-Pin, Wang; Ming-Shih, Lee

    2017-09-01

    System accuracy of current blood glucose monitors (BGMs) in the market has already been evaluated extensively, yet mostly focused on European and North American manufacturers. Data on BGMs manufactured in the Asia-Pacific region remain to be established. In this study, we sought to assess the accuracy performance of 19 BGMs manufactured in the Asia-pacific region. A total of 19 BGMs were obtained from local pharmacies in China. The study was conducted at three hospitals located in the Asia-Pacific region. Measurement results of each system were compared with results of the reference instrument (YSI 2300 PLUS Glucose Analyzer), and accuracy evaluation was performed in accordance to the ISO 15197:2003 and updated 2015 guidelines. Radar plots, which is a new method, are described herein to visualize the analytical performance of the 19 BGMs evaluated. Consensus error grid is a tool for evaluating the clinical significance of the results. The 19 BGMs resulted in a satisfaction rate between 83.5% and 100.0% within ISO 15197:2003 error limits, and between 71.3% and 100.0% within EN ISO 15197:2015 (ISO 15197:2013) error limits. Of the 19 BGMs evaluated, 12 met the minimal accuracy requirement of the ISO 15197:2003 standard, whereas only 4 met the tighter EN ISO 15197:2015 (ISO 15197:2013) requirements. Accuracy evaluation of BGMs should be performed regularly to maximize patient safety.

  9. Environmental monitoring with advanced data transfer and presentation techniques

    International Nuclear Information System (INIS)

    Toivonen, H.; Lahtinen, J.; Koivukoski, J.; Rantanen, H.; Haaslahti, J.

    1995-01-01

    In an emergency, the needs for information are overwhelming, as was shown during the Chernobyl accident in 1986. To improve environmental radiation monitoring and to make communication easy, the Finnish authorities launched an extensive development project in 1991. VTKK Group Ltd took over the software design. A brief description of system architecture, automatic data collection, manual input, mobile units, transfer of results and handling of alarms is given. 2 figs

  10. Biological water quality monitoring using chemiluminescent and bioluminescent techniques

    Science.gov (United States)

    Thomas, R. R.

    1978-01-01

    Automated chemiluminescence and bioluminescence sensors were developed for the continuous monitoring of microbial levels in water supplies. The optimal chemical procedures were determined for the chemiluminescence system to achieve maximum sensitivity. By using hydrogen peroxide, reaction rate differentiation, ethylene diamine tetraacetic acid (EDTA), and carbon monoxide pretreatments, factors which cause interference were eliminated and specificity of the reaction for living and dead bacteria was greatly increased. By employing existing technology with some modifications, a sensitive and specific bioluminescent system was developed.

  11. 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

    2013-11-01

    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. Aliquots of 20 venous samples were adjusted to the following pO2 values: oxygen sensitive. © 2013 Diabetes Technology Society.

  12. AN EVALUATION OF CONDITION MONITORING TECHNIQUES FOR LOW-VOLTAGE ELECTRIC CABLES

    International Nuclear Information System (INIS)

    LOFARO, R.J.; GROVE, E.; SOO, P.

    2000-01-01

    Aging of systems and components in nuclear power plants is a well known occurrence that must be managed to ensure the continued safe operation of these plants. Much of the degradation due to aging is controlled through periodic maintenance and/or component replacement. However, there are components that do not receive periodic maintenance or monitoring once they are installed; electric cables are such a component. To provide a means of monitoring the condition of electric cables, research is ongoing to evaluate promising condition monitoring (CM) techniques that can be used in situ to monitor cable condition and predict remaining life. While several techniques are promising, each has limitations that must be considered in its application. This paper discusses the theory behind several of the promising cable CM techniques being studied, along with their effectiveness for monitoring aging degradation in typical cable insulation materials, such as cross-linked polyethylene and ethylene propylene rubber. Successes and limitations of each technique are also presented

  13. Measurement and instrumentation techniques for monitoring plutonium and uranium particulates released from nuclear facilities

    International Nuclear Information System (INIS)

    Nero, A.V. Jr.

    1976-08-01

    The purpose of this work has been an analysis and evaluation of the state-of-the-art of measurement and instrumentation techniques for monitoring plutonium and uranium particulates released from nuclear facilities. The occurrence of plutonium and uranium in the nuclear fuel cycle, the corresponding potential for releases, associated radiological protection standards and monitoring objectives are discussed. Techniques for monitoring via decay radiation from plutonium and uranium isotopes are presented in detail, emphasizing air monitoring, but also including soil sampling and survey methods. Additionally, activation and mass measurement techniques are discussed. The availability and prevalence of these various techniques are summarized. Finally, possible improvements in monitoring capabilities due to alterations in instrumentation, data analysis, or programs are presented

  14. 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

    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...... 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...... between strip lots. Conclusion. 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....

  15. Numerical and clinical precision of continuous glucose monitoring in Colombian patients treated with insulin infusion pump with automated suspension in hypoglycemia.

    Science.gov (United States)

    Gómez, Ana M; Marín Sánchez, Alejandro; Muñoz, Oscar M; Colón Peña, Christian Alejandro

    2015-12-01

    Insulin pump therapy associated with continuous glucose monitoring has shown a positive clinical impact on diabetes control and reduction of hypoglycemia episodes. There are descriptions of the performance of this device in other populations, but its precision and accuracy in Colombia and Latin America are unknown, especially in the routine outpatient setting. Data from 33 type 1 and type 2 diabetes patients with sensor-augmented pump therapy with threshold suspend automation, MiniMed Paradigm® Veo™ (Medtronic, Northridge, California), managed at Hospital Universitario San Ignacio (Bogotá, Colombia) and receiving outpatient treatment, were analyzed. Simultaneous data from continuous glucose monitoring and capillary blood glucose were compared, and their precision and accuracy were calculating with different methods, including Clarke error grid. Analyses included 2,262 continuous glucose monitoring -reference paired glucose values. A mean absolute relative difference of 20.1% was found for all measurements, with a value higher than 23% for glucose levels ≤75mg/dL. Global compliance with the ISO criteria was 64.9%. It was higher for values >75mg/dl (68.3%, 1,308 of 1,916 readings), than for those ≤ 75mg/dl (49.4%, 171 of 346 readings). Clinical accuracy, as assessed by the Clarke error grid, showed that 91.77% of data were within the A and B zones (75.6% in hypoglycemia). A good numerical accuracy was found for continuous glucose monitoring in normo and hyperglycemia situations, with low precision in hypoglycemia. The clinical accuracy of the device was adequate, with no significant safety concerns for patients. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  16. Alizarin Complexone Functionalized Mesoporous Silica Nanoparticles: A Smart System Integrating Glucose-Responsive Double-Drugs Release and Real-Time Monitoring Capabilities.

    Science.gov (United States)

    Zou, Zhen; He, Dinggeng; Cai, Linli; He, Xiaoxiao; Wang, Kemin; Yang, Xue; Li, Liling; Li, Siqi; Su, Xiaoya

    2016-04-06

    The outstanding progress of nanoparticles-based delivery systems capable of releasing hypoglycemic drugs in response to glucose has dramatically changed the outlook of diabetes management. However, the developed glucose-responsive systems have not offered real-time monitoring capabilities for accurate quantifying hypoglycemic drugs released. In this study, we present a multifunctional delivery system that integrates both delivery and monitoring issues using glucose-triggered competitive binding scheme on alizarin complexone (ALC) functionalized mesoporous silica nanoparticles (MSN). In this system, ALC is modified on the surface of MSN as the signal reporter. Gluconated insulin (G-Ins) is then introduced onto MSN-ALC via benzene-1,4-diboronic acid (BA) mediated esterification reaction, where G-Ins not only blocks drugs inside the mesopores but also works as a hypoglycemic drug. In the absence of glucose, the sandwich-type boronate ester structure formed by BA binding to the diols of ALC and G-Ins remains intact, resulting in an fluorescence emission peak at 570 nm and blockage of pores. Following a competitive binding, the presence of glucose cause the dissociation of boronate ester between ALC and BA, which lead to the pores opening and disappearance of fluorescence. As proof of concept, rosiglitazone maleate (RSM), an insulin-sensitizing agent, was doped into the MSN to form a multifunctional MSN (RSM@MSN-ALC-BA-Ins), integrating with double-drugs loading, glucose-responsive performance, and real-time monitoring capability. It has been demonstrated that the glucose-responsive release behaviors of insulin and RSM in buffer or in human serum can be quantified in real-time through evaluating the changes of fluorescence signal. We believe that this developed multifunctional system can shed light on the invention of a new generation of smart nanoformulations for optical diagnosis, individualized treatment, and noninvasive monitoring of diabetes management.

  17. Development of a scale to measure adherence to self-monitoring of blood glucose with latent variable measurement.

    Science.gov (United States)

    Wagner, J A; Schnoll, R A; Gipson, M T

    1998-07-01

    Adherence to self-monitoring of blood glucose (SMBG) is problematic for many people with diabetes. Self-reports of adherence have been found to be unreliable, and existing paper-and-pencil measures have limitations. This study developed a brief measure of SMBG adherence with good psychometric properties and a useful factor structure that can be used in research and in practice. A total of 216 adults with diabetes responded to 30 items rated on a 9-point Likert scale that asked about blood monitoring habits. In part I of the study, items were evaluated and retained based on their psychometric properties. The sample was divided into exploratory and confirmatory halves. Using the exploratory half, items with acceptable psychometric properties were subjected to a principal components analysis. In part II of the study, structural equation modeling was used to confirm the component solution with the entire sample. Structural modeling was also used to test the relationship between these components. It was hypothesized that the scale would produce four correlated factors. Principal components analysis suggested a two-component solution, and confirmatory factor analysis confirmed this solution. The first factor measures the degree to which patients rely on others to help them test and thus was named "social influence." The second component measures the degree to which patients use physical symptoms of blood glucose levels to help them test and thus was named "physical influence." Results of the structural model show that the components are correlated and make up the higher-order latent variable adherence. The resulting 15-item scale provides a short, reliable way to assess patient adherence to SMBG. Despite the existence of several aspects of adherence, this study indicates that the construct consists of only two components. This scale is an improvement on previous measures of adherence because of its good psychometric properties, its interpretable factor structure, and its

  18. Effectiveness of continuous glucose monitoring during diabetic pregnancy (GlucoMOMS trial); a randomised controlled trial

    NARCIS (Netherlands)

    Voormolen, Daphne N.; DeVries, J. Hans; Franx, Arie; Mol, Ben W. J.; Evers, Inge M.

    2012-01-01

    Background: Hyperglycemia in pregnancy is associated with poor perinatal outcome. Even if pregnant women with diabetes are monitored according to current guidelines, they do much worse than their normoglycaemic counterparts, marked by increased risks of pre-eclampsia, macrosomia, and caesarean

  19. Educational intervention together with an on-line quality control program achieve recommended analytical goals for bedside blood glucose monitoring in a 1200-bed university hospital.

    Science.gov (United States)

    Sánchez-Margalet, Víctor; Rodriguez-Oliva, Manuel; Sánchez-Pozo, Cristina; Fernández-Gallardo, María Francisca; Goberna, Raimundo

    2005-01-01

    Portable meters for blood glucose concentrations are used at the patients bedside, as well as by patients for self-monitoring of blood glucose. Even though most devices have important technological advances that decrease operator error, the analytical goals proposed for the performance of glucose meters have been recently changed by the American Diabetes Association (ADA) to reach nurses in a 1200-bed University Hospital to achieve recommended analytical goals, so that we could improve the quality of diabetes care. We used portable glucose meters connected on-line to the laboratory after an educational program for nurses with responsibilities in point-of-care testing. We evaluated the system by assessing total error of the glucometers using high- and low-level glucose control solutions. In a period of 6 months, we collected data from 5642 control samples obtained by 14 devices (Precision PCx) directly from the control program (QC manager). The average total error for the low-level glucose control (2.77 mmol/l) was 6.3% (range 5.5-7.6%), and even lower for the high-level glucose control (16.66 mmol/l), at 4.8% (range 4.1-6.5%). In conclusion, the performance of glucose meters used in our University Hospital with more than 1000 beds not only improved after the intervention, but the meters achieved the analytical goals of the suggested ADA/National Academy of Clinical Biochemistry criteria for total error (<7.9% in the range 2.77-16.66 mmol/l glucose) and optimal total error for high glucose concentrations of <5%, which will improve the quality of care of our patients.

  20. Efficacy of Additional Canagliflozin Administration to Type 2 Diabetes Patients Receiving Insulin Therapy: Examination of Diurnal Glycemic Patterns Using Continuous Glucose Monitoring (CGM).

    Science.gov (United States)

    Matsumura, Mihoko; Nakatani, Yuki; Tanka, Seiichi; Aoki, Chie; Sagara, Masaaki; Yanagi, Kazunori; Suzuki, Kunihiro; Aso, Yoshimasa

    2017-08-01

    The efficacy of administering a sodium-glucose cotransporter 2 inhibitor during insulin therapy has not been established. In this study, we examined its effects based on diurnal glycemic patterns using continuous glucose monitoring (CGM). The subjects were 15 patients who had received insulin therapy for 1 year or more. A CGM device was attached to all subjects for 1 week. The administration of canagliflozin at 100 mg was started 4 days after attachment. The mean glucose concentrations, standard deviation (SD), mean amplitude of glycemic excursions (MAGE), mean of daily difference of blood glucose (MODD), and area under the curve (AUC) (≥180, glucose concentrations decreased from 161.1 to 139.1 mg/dL (P AUC of ≥180, i.e., the total area of blood glucose levels at or above 180 on the blood glucose curve of CGM, decreased from 339.1 to 113.6 mg/dL (P AUC of blood glucose levels below 70 on the blood glucose curve of CGM, slightly decreased from 1.6 to 0.3 mg/dL (P = 0.08). The total number of basal insulin units decreased from 128 to 76, and that of bolus insulin decreased from 266 to 154; the dose of insulin could be markedly decreased. In addition, the mean 8-OHdG level decreased from 11.4 to 10.8 ng/mg Cre (P blood glucose changes in type 2 diabetes using insulin. In addition, the results suggest its antioxidant actions. University Hospital Medical Information Network (UMIN no. 000019429).

  1. Personalized State-space Modeling of Glucose Dynamics for Type 1 Diabetes Using Continuously Monitored Glucose, Insulin Dose, and Meal Intake: An Extended Kalman Filter Approach

    OpenAIRE

    Wang, Qian; Molenaar, Peter; Harsh, Saurabh; Freeman, Kenneth; Xie, Jinyu; Gold, Carol; Rovine, Mike; Ulbrecht, Jan

    2014-01-01

    An essential component of any artificial pancreas is on the prediction of blood glucose levels as a function of exogenous and endogenous perturbations such as insulin dose, meal intake, and physical activity and emotional tone under natural living conditions. In this article, we present a new data-driven state-space dynamic model with time-varying coefficients that are used to explicitly quantify the time-varying patient-specific effects of insulin dose and meal intake on blood glucose fluctu...

  2. Gastric submucosal microdialysis in the detection of rat stomach ischemia—a comparison of the 3H2O efflux technique with metabolic monitoring

    International Nuclear Information System (INIS)

    Cibicek, Norbert; Palicka, Vladimir; Zivna, Helena; Vrublova, Eva; Cibicek, Jaroslav; Cermakova, Eva

    2010-01-01

    Microdialysis has been utilized for nutritive blood flow measurements, but both the advantages and disadvantages of various approaches have not been evaluated in parallel in the stomach yet. Our aim was to compare the 3 H 2 O efflux technique with biochemical monitoring during temporary celiac artery occlusion in anesthetized rats. Microdialysis probes were implanted in the gastric submucosa and perfused with 3 H 2 O; samples were analyzed for β-activity, glucose, lactate, pyruvate and glycerol. Gastric mucosa and plasma were subjected to morphometry and analysis of myeloperoxidase, total thiols and lactatdehydrogenase. The most dramatic responses to ischemia were observed in lactate/pyruvate and lactate/glucose (%) ratios (6.1–9.3×, p 3 H 2 O efflux and glycerol were less pronounced (1.1–1.7×, p 3 H 2 O efflux correlated best with the lactate/glucose ratio and glucose alone (r = 0.693 and −0.681, respectively, p −1 , p −1 , p 3 H 2 O efflux technique. The results question the efficacy of the utilized model to produce standardized major gastric damage

  3. Monitoring of the Syrian rift valley using radon technique

    International Nuclear Information System (INIS)

    Al-Hilal, M.; Al-Ali, A.; Jubeli, Y.

    1997-02-01

    Groundwater radon data were recorded once every two months from six monitoring sites of the Syrian rift valley during the year 1996. Radon samples were measured from deep artesian wells and from continuously-flowing springs that are distributed along this most active seismic zone in Syria. The available data were integrated with previously measured groundwater radon data from the same stations in order to estimate the range of normal radon fluctuations in the region. The estimation of such range may enable the separation between usual groundwater radon variations from other outliers which may indicate possible tectonic activities or earthquake hazards in the study area. Periodical radon measurements based on two months intervals and long distance between sampling stations does not enable us to trust with high level of confidence the connection between radon values and any possible earth dynamics. Therefore, shorter measuring time with closer monitoring sites are highly recommended to achieve the optimum advantage of such application. (Author). 8 Figs., 2 Tabs., 10 Refs

  4. Novel Monitoring Techniques for Characterizing Frictional Interfaces in the Laboratory

    Directory of Open Access Journals (Sweden)

    Paul A. Selvadurai

    2015-04-01

    Full Text Available A pressure-sensitive film was used to characterize the asperity contacts along a polymethyl methacrylate (PMMA interface in the laboratory. The film has structural health monitoring (SHM applications for flanges and other precision fittings and train rail condition monitoring. To calibrate the film, simple spherical indentation tests were performed and validated against a finite element model (FEM to compare normal stress profiles. Experimental measurements of the normal stress profiles were within −7.7% to 6.6% of the numerical calculations between 12 and 50 MPa asperity normal stress. The film also possessed the capability of quantifying surface roughness, an important parameter when examining wear and attrition in SHM applications. A high definition video camera supplied data for photometric analysis (i.e., the measure of visible light of asperities along the PMMA-PMMA interface in a direct shear configuration, taking advantage of the transparent nature of the sample material. Normal stress over individual asperities, calculated with the pressure-sensitive film, was compared to the light intensity transmitted through the interface. We found that the luminous intensity transmitted through individual asperities linearly increased 0.05643 ± 0.0012 candelas for an increase of 1 MPa in normal stress between normal stresses ranging from 23 to 33 MPa.

  5. Imaging monitoring techniques applications in the transient gratings detection

    Science.gov (United States)

    Zhao, Qing-ming

    2009-07-01

    Experimental studies of Degenerate four-wave mixing (DFWM) in iodine vapor at atmospheric pressure and 0℃ and 25℃ are reported. The Laser-induced grating (LIG) studies are carried out by generating the thermal grating using a pulsed, narrow bandwidth, dye laser .A new image processing system for detecting forward DFWM spectroscopy on iodine vapor is reported. This system is composed of CCD camera, imaging processing card and the related software. With the help of the detecting system, phase matching can be easily achieved in the optical arrangement by crossing the two pumps and the probe as diagonals linking opposite corners of a rectangular box ,and providing a way to position the PhotoMultiplier Tube (PMT) . Also it is practical to know the effect of the pointing stability on the optical path by monitoring facula changing with the laser beam pointing and disturbs of the environment. Finally the effects of Photostability of dye laser on the ration of signal to noise in DFWM using forward geometries have been investigated in iodine vapor. This system makes it feasible that the potential application of FG-DFWM is used as a diagnostic tool in combustion research and environment monitoring.

  6. [Current status and recommendations on the use of continuous blood glucose monitoring systems in children and adolescents with type 1 diabetes mellitus].

    Science.gov (United States)

    Torres Lacruz, M; Barrio Castellanos, R; García Cuartero, B; Gómez Gila, A; González Casado, I; Hermoso López, F; Luzuriaga Tomás, C; Oyarzabal Irigoyen, M; Rica Etxebarria, I; Rodríguez Rigual, M

    2011-08-01

    Glucose monitoring methods have made great advances in the last decade with the appearance of the continuous glucose monitoring systems (CGMS) that measure the glucose levels in the interstitial liquid, providing information about glucose patterns and trends, but do not replace the self-monitoring of capillary glucose. Improvement in diabetes control using the CGMS depends on the motivation and training received by the patient and family and on the continuity in its use. Due to the development and widespread use of these systems in clinical practice, the diabetes group of the Sociedad Española de Endocrinología Pediátrica has drafted a document of consensus for their indication and use in children and adolescents. Only a limited number of trials have been performed in children and adolescent populations. More data are needed on the use of this technology in order to define the impact on metabolic control. Copyright © 2010 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  7. Miscoding and other user errors: importance of ongoing education for proper blood glucose monitoring procedures.

    Science.gov (United States)

    Schrock, Linda E

    2008-07-01

    This article reviews the literature to date and reports on a new study that documented the frequency of manual code-requiring blood glucose (BG) meters that were miscoded at the time of the patient's initial appointment in a hospital-based outpatient diabetes education program. Between January 1 and May 31, 2007, the type of BG meter and the accuracy of the patient's meter code (if required) and procedure for checking BG were checked during the initial appointment with the outpatient diabetes educator. If indicated, reeducation regarding the procedure for the BG meter code entry and/or BG test was provided. Of the 65 patients who brought their meter requiring manual entry of a code number or code chip to the initial appointment, 16 (25%) were miscoded at the time of the appointment. Two additional problems, one of dead batteries and one of improperly stored test strips, were identified and corrected at the first appointment. These findings underscore the importance of checking the patient's BG meter code (if required) and procedure for testing BG at each encounter with a health care professional or providing the patient with a meter that does not require manual entry of a code number or chip to match the container of test strips (i.e., an autocode meter).

  8. Detection of glycemic abnormalities in adolescents with beta thalassemia using continuous glucose monitoring and oral glucose tolerance in adolescents and young adults with β-thalassemia major: Pilot study

    Directory of Open Access Journals (Sweden)

    Ashraf T Soliman

    2013-01-01

    Full Text Available Background: Both insulin deficiency and resistance are reported in patients with β-thalassemia major (BTM. The use of continuous blood glucose monitoring (CGM, among the different methods for early detection of glycemic abnormalities, has not been studied thoroughly in these adolescents. Materials and Methods: To assess the oralglucose tolerance (OGT and 72-h continuous glucose concentration by the continuous glucose monitoring system (CGMS and calculate homeostatic model assessment (HOMA, and the quantitative insulin sensitivity check index (QUICKI was conducted in 16 adolescents with BTM who were receiving regular blood transfusions every 2-4 weeks and iron-chelation therapy since early childhood. Results: Sixteen adolescents with BTM (age: 19.75 ± 3 years were investigated. Using OGTT, (25% had impaired fasting blood (plasma glucose concentration (BG (>5.6 mmol/L. 2-h after the glucose load, one of them had BG = 16.2 mmol/L (diabetic and two had impaired glucose tolerance (IGT (BG > 7.8 and 11.1 mmol/L and 9 with IGT (56%. HOMA and QUICKI revealed levels 0.33 (0.36 ± 0.03, respectively, ruling out significant insulin resistance in these adolescents. There was a significant negative correlation between the β-cell function (B% on one hand and the fasting and the 2-h BG (r=−0.6, and − 0.48, P < 0.01, respectively on the other hand. Neither fasting serum insulin nor c-peptide concentrations were correlated with fasting BG or ferritin levels. The average and maximum blood glucose levels during CGM were significantly correlated with the fasting BG (r = 0.68 and 0.39, respectively, with P < 0.01 and with the BG at 2-hour after oral glucose intake (r = 0.87 and 0.86 respectively, with P < 0.001. Ferritin concentrations were correlated with the fasting BG and the 2-h blood glucose levels in the OGTT (r = 0.52, and r = 0.43, respectively, P < 0.01 as well as with the average BG recorded by CGM (r = 0.75, P < 0.01. Conclusion: CGM has proven to

  9. Opportunities for Process Monitoring Techniques at Delayed Access Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Curtis, Michael M.; Gitau, Ernest TN; Johnson, Shirley J.; Schanfein, Mark; Toomey, Christopher

    2013-09-20

    Except for specific cases where the International Atomic Energy Agency (IAEA) maintains a continuous presence at a facility (such as the Japanese Rokkasho Reprocessing Plant), there is always a period of time or delay between the moment a State is notified or aware of an upcoming inspection, and the time the inspector actually enters the material balance area or facility. Termed by the authors as “delayed access,” this period of time between inspection notice and inspector entrance to a facility poses a concern. Delayed access also has the potential to reduce the effectiveness of measures applied as part of the Safeguards Approach for a facility (such as short-notice inspections). This report investigates the feasibility of using process monitoring to address safeguards challenges posed by delayed access at a subset of facility types.

  10. A simple air sampling technique for monitoring nitrous oxide pollution

    Energy Technology Data Exchange (ETDEWEB)

    Austin, J C; Shaw, R; Moyes, D; Cleaton-Jones, P E

    1981-01-01

    A simple, inexpensive device for the continuous low-flow sampling of air was devised to permit monitoring of pollution by gaseous anaesthetics. The device consisted of a water-filled Perspex cylinder in which a double-walled flexible-film gas sample collection bag was suspended. Air samples could be aspirated into the collection bag at flow rates of as low as 1 ml min-1 by allowing the water to drain from the cylinder at a controlled rate. The maintenance of sample integrity with aspiration and storage of samples of nitrous oxide in air at concentrations of 1000, 100 and 30 p.p.m. v/v was examined using gas chromatography. The sample bags retained a mean 94% of the nitrous oxide in air samples containing nitrous oxide 25 p.p.m. over a 72-h storage period.

  11. Automatic measurement for monitoring crack growth with electric potential technique

    International Nuclear Information System (INIS)

    Nakajima, Nobuya; Kikuchi, Masaaki; Shima, Seishi

    1981-10-01

    In the study of fracture mechanics, it is one of the most important problems to monitor the crack growth phenomena. Recently, many experimental methods have been developed. In this report, the Direct Current (DC) potential method is employed for measuring the crack growth length in the pressuried high temperature water. The objective of the current investigation is to develop an experimental method to quantify the sensitivity of this method in the air environment using the Compact Tension (CT) specimen. The main results obtained are as follows: 1) It is ignored that the electrical potential changes with plastic deformation at the crack tip of the specimen. 2) Using the Reversible Direct Current (RDC) Method, the measurement system gives no effect on the electrical stability for a long time. 3) For the fatigue and statical crack growth length, good relation is observed between the crack length-to-specimen width ratio (a/W) and potential ratio (Va/Vo). (author)

  12. Monitoring well design and sampling techniques at NAPL sites

    International Nuclear Information System (INIS)

    Collins, M.; Rohrman, W.R.; Drake, K.D.

    1992-01-01

    The existence of Non-Aqueous Phase Liquids (NAPLs) at many Superfund and RCRA hazardous waste sites has become a recognized problem in recent years. The large number of sites exhibiting this problem results from the fact that many of the most frequently used industrial solvents and petroleum products can exist as NAPLs. Hazardous waste constituents occurring as NAPLs possess a common characteristic that causes great concern during groundwater contamination evaluation: while solubility in water is generally very low, it is sufficient to cause groundwater to exceed Maximum Contamination Levels (MCLs). Thus, even a small quantity of NAPL within a groundwater regime can act as a point source with the ability to contaminate vast quantities of groundwater over time. This property makes it imperative that groundwater investigations focus heavily on characterizing the nature, extent, and migration pathways of NAPLs at sites where it exists. Two types of NAPLs may exist in a groundwater system. Water-immiscible liquid constituents having a specific gravity greater than one are termed Dense Non-Aqueous Phase Liquids, while those with a specific gravity less than one are considered Light Non-Aqueous Phase Liquids. For a groundwater investigation to properly characterize the two types of NAPLs, careful consideration must be given to the placement and sampling of groundwater monitoring wells. Unfortunately, technical reviewers at EPA Region VII and the Corps of Engineers find that many groundwater investigations fall short in characterizing NAPLs because several basic considerations were overlooked. Included among these are monitoring well location and screen placement with respect to the water table and significant confining units, and the ability of the well sampling method to obtain samples of NAPL. Depending on the specific gravity of the NAPL that occurs at a site, various considerations can substantially enhance adequate characterization of NAPL contaminants

  13. South Africa improves exclusive breastfeeding monitoring using nuclear technique

    International Nuclear Information System (INIS)

    Henriques, Sasha

    2015-01-01

    Babies in South Africa that would once be at high risk of malnutrition, disease and even death, now have brighter futures as nuclear techniques help mothers become more diligent about exclusive breastfeeding for the baby’s first six months. Breastfed children are more resistant to disease and infection compared to formula-fed children, points out the World Health Organization, which recommends that from birth up to six months of age babies should drink only breast milk. Research indicates that breastfed babies are less likely to develop diabetes, cardiovascular disease and cancer later in life.

  14. Robotic Spent Fuel Monitoring – It is time to improve old approaches and old techniques!

    Energy Technology Data Exchange (ETDEWEB)

    Tobin, Stephen Joseph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dasari, Venkateswara Rao [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Trellue, Holly Renee [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-12-13

    This report describes various approaches and techniques associated with robotic spent fuel monitoring. The purpose of this description is to improve the quality of measured signatures, reduce the inspection burden on the IAEA, and to provide frequent verification.

  15. WS-010: EPR-First Responders: Personal monitoring techniques and protective clothing

    International Nuclear Information System (INIS)

    2011-01-01

    The purpose of this working session is that the participant can apply their knowledge in relation to the personal monitoring techniques and protective clothing. They have to know the use of the radiation measurement instrumentation available in each region

  16. Detection of Atmospheric Explosions at IMS Monitoring Stations using Infrasound Techniques

    National Research Council Canada - National Science Library

    Christie, Douglas R; Kennett, Brian L; Tarlowski, Chris

    2006-01-01

    Work is continuing on the development of infrasound techniques that can be used to improve detection, location and discrimination capability for atmospheric nuclear explosions at International Monitoring System (IMS...

  17. Utilizing distributional analytics and electronic records to assess timeliness of inpatient blood glucose monitoring in non-critical care wards

    Directory of Open Access Journals (Sweden)

    Ying Chen

    2016-04-01

    Full Text Available Abstract Background Regular and timely monitoring of blood glucose (BG levels in hospitalized patients with diabetes mellitus is crucial to optimizing inpatient glycaemic control. However, methods to quantify timeliness as a measurement of quality of care are lacking. We propose an analytical approach that utilizes BG measurements from electronic records to assess adherence to an inpatient BG monitoring protocol in hospital wards. Methods We applied our proposed analytical approach to electronic records obtained from 24 non-critical care wards in November and December 2013 from a tertiary care hospital in Singapore. We applied distributional analytics to evaluate daily adherence to BG monitoring timings. A one-sample Kolmogorov-Smirnov (1S-KS test was performed to test daily BG timings against non-adherence represented by the uniform distribution. This test was performed among wards with high power, determined through simulation. The 1S-KS test was coupled with visualization via the cumulative distribution function (cdf plot and a two-sample Kolmogorov-Smirnov (2S-KS test, enabling comparison of the BG timing distributions between two consecutive days. We also applied mixture modelling to identify the key features in daily BG timings. Results We found that 11 out of the 24 wards had high power. Among these wards, 1S-KS test with cdf plots indicated adherence to BG monitoring protocols. Integrating both 1S-KS and 2S-KS information within a moving window consisting of two consecutive days did not suggest frequent potential change from or towards non-adherence to protocol. From mixture modelling among wards with high power, we consistently identified four components with high concentration of BG measurements taken before mealtimes and around bedtime. This agnostic analysis provided additional evidence that the wards were adherent to BG monitoring protocols. Conclusions We demonstrated the utility of our proposed analytical approach as a monitoring

  18. Can the Accuracy of Home Blood Glucose Monitors be affected by the Received Signal Strength of 900 MHz GSM Mobile Phones?

    Science.gov (United States)

    Eslami, J; Ghafaripour, F; Mortazavi, S A R; Mortazavi, S M J; Shojaei-Fard, M B

    2015-12-01

    People who use home blood glucose monitors may use their mobile phones in the close vicinity of medical devices. This study is aimed at investigating the effect of the signal strength of 900 MHz GSM mobile phones on the accuracy of home blood glucose monitors. Sixty non-diabetic volunteer individuals aged 21 - 28 years participated in this study. Blood samples were analyzed for glucose level by using a common blood glucose monitoring system. Each blood sample was analyzed twice, within ten minutes in presence and absence of electromagnetic fields generated by a common GSM mobile phone during ringing. Blood samples were divided into 3 groups of 20 samples each. Group 1: exposure to mobile phone radiation with weak signal strength. Group2: exposure to mobile phone radiation with strong signal strength. Group3: exposure to a switched-on mobile phone with no signal strength. The magnitude of the changes in the first, second and third group between glucose levels of two measurements (׀ΔC׀) were 7.4±3.9 mg/dl, 10.2±4.5 mg/dl, 8.7±8.4 mg/dl respectively. The difference in the magnitude of the changes between the 1st and the 3rd groups was not statistically significant. Furthermore, the difference in the magnitude of the changes between the 2nd and the 3rd groups was not statistically significant. Findings of this study showed that the signal strength of 900 MHz GSM mobile phones cannot play a significant role in changing the accuracy of home blood glucose monitors.

  19. Can the Accuracy of Home Blood Glucose Monitors be affected by the Received Signal Strength of 900 MHz GSM Mobile Phones?

    Directory of Open Access Journals (Sweden)

    Eslami J.

    2015-12-01

    Full Text Available Background: People who use home blood glucose monitors may use their mobile phones in the close vicinity of medical devices. This study is aimed at investigating the effect of the signal strength of 900 MHz GSM mobile phones on the accuracy of home blood glucose monitors. Methods: Sixty non-diabetic volunteer individuals aged 21 - 28 years participated in this study. Blood samples were analyzed for glucose level by using a common blood glucose monitoring system. Each blood sample was analyzed twice, within ten minutes in presence and absence of electromagnetic fields generated by a common GSM mobile phone during ringing. Blood samples were divided into 3 groups of 20 samples each. Group 1: exposure to mobile phone radiation with weak signal strength. Group2: exposure to mobile phone radiation with strong signal strength. Group3: exposure to a switched–on mobile phone with no signal strength. Results: The magnitude of the changes in the first, second and third group between glucose levels of two measurements (׀ΔC׀ (were 7.4±3.9 mg/dl, 10.2±4.5 mg/ dl, 8.7±8.4 mg/dl respectively. The difference in the magnitude of the changes between the 1st and the 3rd groups was not statistically significant. Furthermore, the difference in the magnitude of the changes between the 2nd and the 3rd groups was not statistically significant. Conclusion: Findings of this study showed that the signal strength of 900 MHz GSM mobile phones cannot play a significant role in changing the accuracy of home blood glucose monitors.

  20. Can the Accuracy of Home Blood Glucose Monitors be affected by the Received Signal Strength of 900 MHz GSM Mobile Phones?

    Science.gov (United States)

    Eslami, J.; Ghafaripour, F.; Mortazavi, S.A.R.; Mortazavi, S.M.J.; Shojaei-fard, M.B.

    2015-01-01

    Background People who use home blood glucose monitors may use their mobile phones in the close vicinity of medical devices. This study is aimed at investigating the effect of the signal strength of 900 MHz GSM mobile phones on the accuracy of home blood glucose monitors. Methods Sixty non-diabetic volunteer individuals aged 21 - 28 years participated in this study. Blood samples were analyzed for glucose level by using a common blood glucose monitoring system. Each blood sample was analyzed twice, within ten minutes in presence and absence of electromagnetic fields generated by a common GSM mobile phone during ringing. Blood samples were divided into 3 groups of 20 samples each. Group 1: exposure to mobile phone radiation with weak signal strength. Group2: exposure to mobile phone radiation with strong signal strength. Group3: exposure to a switched–on mobile phone with no signal strength. Results The magnitude of the changes in the first, second and third group between glucose levels of two measurements (׀ΔC׀) were 7.4±3.9 mg/dl, 10.2±4.5 mg/dl, 8.7±8.4 mg/dl respectively. The difference in the magnitude of the changes between the 1st and the 3rd groups was not statistically significant. Furthermore, the difference in the magnitude of the changes between the 2nd and the 3rd groups was not statistically significant. Conclusion Findings of this study showed that the signal strength of 900 MHz GSM mobile phones cannot play a significant role in changing the accuracy of home blood glucose monitors. PMID:26688798

  1. Continuous glucose monitoring adds information beyond HbA1c in well-controlled diabetes patients with early cardiovascular autonomic neuropathy

    DEFF Research Database (Denmark)

    Fleischer, Jesper; Laugesen, Esben; Cichosz, Simon Lebech

    2017-01-01

    AIMS: Hyperglycemia as evaluated by HbA1c is a risk factor for the development of cardiovascular autonomic neuropathy (CAN). The aim of the present study was to investigate whether continuous glucose monitoring (CGM) may add information beyond HbA1c in patients with type 2 diabetes and CAN. METHO...

  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

    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

  3. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY 2018 POSITION STATEMENT ON INTEGRATION OF INSULIN PUMPS AND CONTINUOUS GLUCOSE MONITORING IN PATIENTS WITH DIABETES MELLITUS.

    Science.gov (United States)

    Grunberger, George; Handelsman, Yehuda; Bloomgarden, Zachary T; Fonseca, Vivian A; Garber, Alan J; Haas, Richard A; Roberts, Victor L; Umpierrez, Guillermo E

    2018-03-01

    This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician. AACE/ACE Task Force on Integration of Insulin Pumps and Continuous Glucose Monitoring in the Management of Patients With Diabetes Mellitus Chair George Grunberger, MD, FACP, FACE Task Force Members Yehuda Handelsman, MD, FACP, FNLA, MACE Zachary T. Bloomgarden, MD, MACE Vivian A. Fonseca, MD, FACE Alan J. Garber, MD, PhD, FACE Richard A. Haas, MD, FACE Victor L. Roberts, MD, MBA, FACP, FACE Guillermo E. Umpierrez, MD, CDE, FACP, FACE Abbreviations: AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology A1C = glycated hemoglobin BGM = blood glucose monitoring CGM = continuous glucose monitoring CSII = continuous subcutaneous insulin infusion DM = diabetes mellitus FDA = Food & Drug Administration MDI = multiple daily injections T1DM = type 1 diabetes mellitus T2DM = type 2 diabetes mellitus SAP = sensor-augmented pump SMBG = self-monitoring of blood glucose STAR 3 = Sensor-Augmented Pump Therapy for A1C Reduction phase 3 trial.

  4. Validation of New Crack Monitoring Technique for Victoria Class High-Pressure Air Bottles

    Science.gov (United States)

    2014-06-01

    Defence Research and Development Canada Recherche et développement pour la défense Canada Validation of new crack monitoring technique for Victoria ...Validation of new crack monitoring technique for Victoria class high-pressure air bottles Ian Thompson John R. MacKay Defence Research and Development...Canada Scientific Report DRDC-RDDC-2014-R81 June 2014 © Her Majesty the Queen in Right of Canada (Department of National Defence), 2014 © Sa Majesté

  5. A Wireless Fatigue Monitoring System Utilizing a Bio-Inspired Tree Ring Data Tracking Technique

    OpenAIRE

    Bai, Shi; Li, Xuan; Xie, Zhaohui; Zhou, Zhi; Ou, Jinping

    2014-01-01

    Fatigue, a hot scientific research topic for centuries, can trigger sudden failure of critical structures such as aircraft and railway systems, resulting in enormous casualties as well as economic losses. The fatigue life of certain structures is intrinsically random and few monitoring techniques are capable of tracking the full life-cycle fatigue damage. In this paper, a novel in-situ wireless real-time fatigue monitoring system using a bio-inspired tree ring data tracking technique is propo...

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

    Science.gov (United States)

    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

  7. Detection of uranium enrichment activities using environmental monitoring techniques

    International Nuclear Information System (INIS)

    Belew, W.L.; Carter, J.A.; Smith, D.H.; Walker, R.L.

    1993-01-01

    Uranium enrichment processes have the capability of producing weapons-grade material in the form of highly enriched uranium. Thus, detection of undeclared uranium enrichment activities is an international safeguards concern. The uranium separation technologies currently in use employ UF 6 gas as a separation medium, and trace quantities of enriched uranium are inevitably released to the environment from these facilities. The isotopic content of uranium in the vegetation, soil, and water near the plant site will be altered by these releases and can provide a signature for detecting the presence of enriched uranium activities. This paper discusses environmental sampling and analytical procedures that have been used for the detection of uranium enrichment facilities and possible safeguards applications of these techniques

  8. Evaluation of the uranium double spike technique for environmental monitoring

    International Nuclear Information System (INIS)

    Hemberger, P.H.; Rokop, D.J.; Efurd, D.W.; Roensch, F.R.; Smith, D.H.; Turner, M.L.; Barshick, C.M.; Bayne, C.K.

    1998-01-01

    Use of a uranium double spike in analysis of environmental samples showed that a 235 U enrichment of 1% ( 235 U/ 238 U = 0.00732) can be distinguished from natural ( 235 U/ 238 U = 0.00725). Experiments performed jointly at Los Alamos National Laboratory (LANL) and Oak Ridge National Laboratory (ORNL) used a carefully calibrated double spike of 233 U and 236 U to obtain much better precision than is possible using conventional analytical techniques. A variety of different sampling media (vegetation and swipes) showed that, provided sufficient care is exercised in choice of sample type, relative standard deviations of less than ± 0.5% can be routinely obtained. This ability, unavailable without use of the double spike, has enormous potential significance in the detection of undeclared nuclear facilities

  9. Cost-effectiveness of G5 Mobile continuous glucose monitoring device compared to self-monitoring of blood glucose alone for people with type 1 diabetes from the Canadian societal perspective.

    Science.gov (United States)

    Chaugule, Shraddha; Graham, Claudia

    2017-11-01

    To evaluate the cost-effectiveness of real-time continuous glucose monitoring (CGM) compared to self-monitoring of blood glucose (SMBG) alone in people with type 1 diabetes (T1DM) using multiple daily injections (MDI) from the Canadian societal perspective. The IMS CORE Diabetes Model (v.9.0) was used to assess the long-term (50 years) cost-effectiveness of real-time CGM (G5 Mobile CGM System; Dexcom, Inc., San Diego, CA) compared with SMBG alone for a cohort of adults with poorly-controlled T1DM. Treatment effects and baseline characteristics of patients were derived from the DIAMOND randomized controlled clinical trial; all other assumptions and costs were sourced from published research. The accuracy and clinical effectiveness of G5 Mobile CGM is the same as the G4 Platinum CGM used in the DIAMOND randomized clinical trial. Base case assumptions included (a) baseline HbA1c of 8.6%, (b) change in HbA1c of -1.0% for CGM users vs -0.4% for SMBG users, and (c) disutilities of -0.0142 for non-severe hypoglycemic events (NSHEs) and severe hypoglycemic events (SHEs) not requiring medical intervention, and -0.047 for SHEs requiring medical resources. Treatment costs and outcomes were discounted at 1.5% per year. The incremental cost-effectiveness ratio for the base case G5 Mobile CGM vs SMBG was $33,789 CAD/quality-adjusted life-year (QALY). Sensitivity analyses showed that base case results were most sensitive to changes in percentage reduction in hypoglycemic events and disutilities associated with hypoglycemic events. The base case results were minimally impacted by changes in baseline HbA1c level, incorporation of indirect costs, changes in the discount rate, and baseline utility of patients. The results of this analysis demonstrate that G5 Mobile CGM is cost-effective within the population of adults with T1DM using MDI, assuming a Canadian willingness-to-pay threshold of $50,000 CAD per QALY.

  10. Personalized State-space Modeling of Glucose Dynamics for Type 1 Diabetes Using Continuously Monitored Glucose, Insulin Dose, and Meal Intake

    Science.gov (United States)

    Molenaar, Peter; Harsh, Saurabh; Freeman, Kenneth; Xie, Jinyu; Gold, Carol; Rovine, Mike; Ulbrecht, Jan

    2014-01-01

    An essential component of any artificial pancreas is on the prediction of blood glucose levels as a function of exogenous and endogenous perturbations such as insulin dose, meal intake, and physical activity and emotional tone under natural living conditions. In this article, we present a new data-driven state-space dynamic model with time-varying coefficients that are used to explicitly quantify the time-varying patient-specific effects of insulin dose and meal intake on blood glucose fluctuations. Using the 3-variate time series of glucose level, insulin dose, and meal intake of an individual type 1 diabetic subject, we apply an extended Kalman filter (EKF) to estimate time-varying coefficients of the patient-specific state-space model. We evaluate our empirical modeling using (1) the FDA-approved UVa/Padova simulator with 30 virtual patients and (2) clinical data of 5 type 1 diabetic patients under natural living conditions. Compared to a forgetting-factor-based recursive ARX model of the same order, the EKF model predictions have higher fit, and significantly better temporal gain and J index and thus are superior in early detection of upward and downward trends in glucose. The EKF based state-space model developed in this article is particularly suitable for model-based state-feedback control designs since the Kalman filter estimates the state variable of the glucose dynamics based on the measured glucose time series. In addition, since the model parameters are estimated in real time, this model is also suitable for adaptive control. PMID:24876585

  11. Personalized State-space Modeling of Glucose Dynamics for Type 1 Diabetes Using Continuously Monitored Glucose, Insulin Dose, and Meal Intake: An Extended Kalman Filter Approach.

    Science.gov (United States)

    Wang, Qian; Molenaar, Peter; Harsh, Saurabh; Freeman, Kenneth; Xie, Jinyu; Gold, Carol; Rovine, Mike; Ulbrecht, Jan

    2014-03-01

    An essential component of any artificial pancreas is on the prediction of blood glucose levels as a function of exogenous and endogenous perturbations such as insulin dose, meal intake, and physical activity and emotional tone under natural living conditions. In this article, we present a new data-driven state-space dynamic model with time-varying coefficients that are used to explicitly quantify the time-varying patient-specific effects of insulin dose and meal intake on blood glucose fluctuations. Using the 3-variate time series of glucose level, insulin dose, and meal intake of an individual type 1 diabetic subject, we apply an extended Kalman filter (EKF) to estimate time-varying coefficients of the patient-specific state-space model. We evaluate our empirical modeling using (1) the FDA-approved UVa/Padova simulator with 30 virtual patients and (2) clinical data of 5 type 1 diabetic patients under natural living conditions. Compared to a forgetting-factor-based recursive ARX model of the same order, the EKF model predictions have higher fit, and significantly better temporal gain and J index and thus are superior in early detection of upward and downward trends in glucose. The EKF based state-space model developed in this article is particularly suitable for model-based state-feedback control designs since the Kalman filter estimates the state variable of the glucose dynamics based on the measured glucose time series. In addition, since the model parameters are estimated in real time, this model is also suitable for adaptive control. © 2014 Diabetes Technology Society.

  12. Performance of a new meter designed for assisted monitoring of blood glucose and point-of-care testing.

    Science.gov (United States)

    Macrury, Sandra; Srinivasan, Aparna; Mahoney, John J

    2013-03-01

    Blood glucose (BG) meters used for assisted monitoring of blood glucose (AMBG) require different attributes compared with meters designed for home use. These include safety considerations (i.e., minimized risk of blood-borne pathogen transmission), capability for testing multiple blood sample types, and enhanced performance specifications. The OneTouch® Verio™Pro+ BG meter is designed to incorporate all of these attributes. Meter accuracy was assessed in clinical studies with arterial, venous, and capillary blood samples with a hematocrit range of 22.9-59.8%. The effect of interferents, including anticoagulants, on accuracy was evaluated. The meter disinfection protocol was validated, and instructions for use and user acceptance of the system were assessed. A total of 97% (549/566) of BG measures from all blood sample types and 95.5% (191/200) of arterial blood samples were within ±12 mg/dl or 12.5% of reference measurements. The system was unaffected by 4 anticoagulants and 57 of 59 endogenous and exogenous compounds; it was affected by 2 compounds: pralidoxime iodide and xylose. Bleach wipes were sufficient to disinfect the meter. Users felt that the meter's quality control (QC) prompts would help them to comply with regulatory requirements. The meter provided accurate measurements of different blood samples over a wide hematocrit range and was not affected by 57 physiologic and therapeutic compounds. The QC prompts and specific infection-mitigating design further aid to make this meter system practical for AMBG in care facilities. © 2013 Diabetes Technology Society.

  13. 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.

  14. A novel calorimetry technique for monitoring electron beam curing of polymer resins

    International Nuclear Information System (INIS)

    Chen, J.H.; Johnston, A.; Petrescue, L.; Hojjati, M.

    2006-01-01

    This paper describes the development of a calorimetry-based technique for monitoring of the curing of electron beam (EB) curable resins, including design of the calorimeter hardware and the development of an analytical model for calculating resin cure rates and radiation dose. Factors affecting the performance of the calorimeter were investigated. Experimental trials monitoring the curing of epoxy resin were conducted under single pass and multiple passes of EB irradiation. Results show that the developed calorimeter is a simple, inexpensive and reasonably accurate technique for monitoring the EB curing of cationic epoxies

  15. Toward an optimisation technique for dynamically monitored environment

    Science.gov (United States)

    Shurrab, Orabi M.

    2016-10-01

    The data fusion community has introduced multiple procedures of situational assessments; this is to facilitate timely responses to emerging situations. More directly, the process refinement of the Joint Directors of Laboratories (JDL) is a meta-process to assess and improve the data fusion task during real-time operation. In other wording, it is an optimisation technique to verify the overall data fusion performance, and enhance it toward the top goals of the decision-making resources. This paper discusses the theoretical concept of prioritisation. Where the analysts team is required to keep an up to date with the dynamically changing environment, concerning different domains such as air, sea, land, space and cyberspace. Furthermore, it demonstrates an illustration example of how various tracking activities are ranked, simultaneously into a predetermined order. Specifically, it presents a modelling scheme for a case study based scenario, where the real-time system is reporting different classes of prioritised events. Followed by a performance metrics for evaluating the prioritisation process of situational awareness (SWA) domain. The proposed performance metrics has been designed and evaluated using an analytical approach. The modelling scheme represents the situational awareness system outputs mathematically, in the form of a list of activities. Such methods allowed the evaluation process to conduct a rigorous analysis of the prioritisation process, despite any constrained related to a domain-specific configuration. After conducted three levels of assessments over three separates scenario, The Prioritisation Capability Score (PCS) has provided an appropriate scoring scheme for different ranking instances, Indeed, from the data fusion perspectives, the proposed metric has assessed real-time system performance adequately, and it is capable of conducting a verification process, to direct the operator's attention to any issue, concerning the prioritisation capability

  16. IDegLira Improves Both Fasting and Postprandial Glucose Control as Demonstrated Using Continuous Glucose Monitoring and a Standardized Meal Test

    DEFF Research Database (Denmark)

    Holst, Jens J; Buse, John B; Rodbard, Helena W

    2016-01-01

    OBJECTIVE: IDegLira is a novel, fixed-ratio combination of the long-acting basal insulin, insulin degludec, and the long-acting glucagon-like peptide-1 analog liraglutide. We studied the effect of IDegLira versus its components on postprandial glucose (PPG) in type 2 diabetes. METHODS: In this su...

  17. Comparison of vildagliptin twice daily vs. sitagliptin once daily using continuous glucose monitoring (CGM: Crossover pilot study (J-VICTORIA study

    Directory of Open Access Journals (Sweden)

    Sakamoto Masaya

    2012-08-01

    Full Text Available Abstract Background No previous studies have compared the DPP-4 inhibitors vildagliptin and sitagliptin in terms of blood glucose levels using continuous glucose monitoring (CGM and cardiovascular parameters. Methods Twenty patients with type 2 diabetes mellitus were randomly allocated to groups who received vildagliptin then sitagliptin, or vice versa. Patients were hospitalized at 1 month after starting each drug, and CGM was used to determine: 1 mean (± standard deviation 24-hour blood glucose level, 2 mean amplitude of glycemic excursions (MAGE, 3 fasting blood glucose level, 4 highest postprandial blood glucose level and time, 5 increase in blood glucose level after each meal, 6 area under the curve (AUC for blood glucose level ≥180 mg/dL within 3 hours after each meal, and 7 area over the curve (AOC for daily blood glucose level Results The mean 24-hour blood glucose level was significantly lower in patients taking vildagliptin than sitagliptin (142.1 ± 35.5 vs. 153.2 ± 37.0 mg/dL; p = 0.012. In patients taking vildagliptin, MAGE was significantly lower (110.5 ± 33.5 vs. 129.4 ± 45.1 mg/dL; p = 0.040, the highest blood glucose level after supper was significantly lower (206.1 ± 40.2 vs. 223.2 ± 43.5 mg/dL; p = 0.015, the AUC (≥180 mg/dL within 3 h was significantly lower after breakfast (484.3 vs. 897.9 mg/min/dL; p = 0.025, and urinary CPR level was significantly higher (97.0 ± 41.6 vs. 85.2 ± 39.9 μg/day; p = 0.008 than in patients taking sitagliptin. There were no significant differences in plasma HbA1c, GA, 1,5AG, IRI, CPR, BNP, or PAI-1 levels between patients taking vildagliptin and sitagliptin. Conclusions CGM showed that mean 24-h blood glucose, MAGE, highest blood glucose level after supper, and hyperglycemia after breakfast were significantly lower in patients with type 2 diabetes mellitus taking vildagliptin than those taking sitagliptin. There

  18. Cutaneous respirometry as novel technique to monitor mitochondrial function: A feasibility study in healthy volunteers

    NARCIS (Netherlands)

    F.A. Harms (Floor A.); R.J. Stolker (Robert); E.G. Mik (Egbert)

    2016-01-01

    textabstractBackground: The protoporphyrin IX-triplet state lifetime technique (PpIX-TSLT) is proposed as a potential clinical non-invasive tool to monitor mitochondrial function. This technique has been evaluated in several animal studies. Mitochondrial respirometry allows measurement in vivo of

  19. Design of a prospective clinical study on the agreement between the Continuous GlucoseMonitor, a novel device for CONTinuous ASSessment of blood GLUcose levels, and the RAPIDLab® 1265 blood gas analyser: The CONTASSGLU study.

    Science.gov (United States)

    Zimmermann, Johannes B; Lehmann, Monika; Hofer, Stefan; Hüsing, Johannes; Alles, Catharina; Werner, Jens; Stiller, Jürgen; Künnecke, Wolfgang; Luntz, Steffen; Motsch, Johann; Weigand, Markus A

    2012-09-22

    Although a device is needed to continuously measure blood glucose levels within an intensive care setting, and several large-scale prospective studies have shown that patients might benefit from intensive insulin, potassium, or glucose therapy during intensive care, no devices are currently available to continuously assess blood glucose levels in critically ill patients. We conceived the study described here to evaluate the clinical use of the Continuous Glucose Monitor (CGM) performed via a central vein, and to determine the impact of phenomena, such as drift and shift, on the agreement between the CGM and a RAPIDLab® 1265 blood gas analyser (BGA). In the CONTinuous ASSessment of blood GLUcose (CONTASSGLU) study, up to 130 patients under intensive care will be fitted with the CGM, an ex vivo device that continuously measures blood glucose and lactate levels. Readings from the device taken 8 h after initial placement and calibration will be compared with values measured by a BGA. For this study, we chose the BGA as it is an established standard point-of-care device, instead of the devices used in certified central laboratories. Nevertheless, we will also independently compare the results from the point-of-care BGA with those determined by a central laboratory-based device. Blood samples will be collected from each patient from the same site in which the CGM will measure blood glucose. Consequently, each participant will serve as their own control, and no randomisation is necessary. The 95% limits of agreement and the corresponding confidence intervals will be calculated and compared with a prespecified clinically acceptable relative difference of 20%. Several attempts have been made to develop a device to continuously measure blood glucose levels within an intensive care setting or to use the devices that were originally designed for diabetes management, as several of these devices are already available. However, none of these devices were successful in

  20. Design of a prospective clinical study on the agreement between the Continuous GlucoseMonitor, a novel device for CONTinuous ASSessment of blood GLUcose levels, and the RAPIDLab® 1265 blood gas analyser: The CONTASSGLU study

    Directory of Open Access Journals (Sweden)

    Zimmermann Johannes B

    2012-09-01

    Full Text Available Abstract Background Although a device is needed to continuously measure blood glucose levels within an intensive care setting, and several large-scale prospective studies have shown that patients might benefit from intensive insulin, potassium, or glucose therapy during intensive care, no devices are currently available to continuously assess blood glucose levels in critically ill patients. We conceived the study described here to evaluate the clinical use of the Continuous Glucose Monitor (CGM performed via a central vein, and to determine the impact of phenomena, such as drift and shift, on the agreement between the CGM and a RAPIDLab® 1265 blood gas analyser (BGA. Methods/design In the CONTinuous ASSessment of blood GLUcose (CONTASSGLU study, up to 130 patients under intensive care will be fitted with the CGM, an ex vivo device that continuously measures blood glucose and lactate levels. Readings from the device taken 8 h after initial placement and calibration will be compared with values measured by a BGA. For this study, we chose the BGA as it is an established standard point-of-care device, instead of the devices used in certified central laboratories. Nevertheless, we will also independently compare the results from the point-of-care BGA with those determined by a central laboratory-based device. Blood samples will be collected from each patient from the same site in which the CGM will measure blood glucose. Consequently, each participant will serve as their own control, and no randomisation is necessary. The 95% limits of agreement and the corresponding confidence intervals will be calculated and compared with a prespecified clinically acceptable relative difference of 20%. Discussion Several attempts have been made to develop a device to continuously measure blood glucose levels within an intensive care setting or to use the devices that were originally designed for diabetes management, as several of these devices are already

  1. Tumor response to ionizing radiation and combined 2-deoxy-D-glucose application in EATC tumor bearing mice: monitoring of tumor size and microscopic observations

    International Nuclear Information System (INIS)

    Latz, D.; Thonke, A.; Jueling-Pohlit, L.; Pohlit, W.

    1993-01-01

    The present study deals with the changes induced by two fractionation schedules (5x9 Gy and 10x4.5 Gy; 30 MeV-electrons) of ionizing radiations and 2-Deoxy-D-Glucose (2-DG) application on EATC tumor bearing swiss albino mice. The monitoring of tumor response was carried out by means of calliper measurement on the macroscopic level and by histopathological examination of tumor preparations stained with hematoxiline and eosine on the microscopic level. The tumor material was assessed at suitable intervals after treatment by killing the animals. The tumor response was analysed in the histological preparations and the thickness of the tumor band was determined quantitatively by an ocularmicrometric technique. Tumor damage was most extensive in the combined treated animals (5x9 Gy + 2-DG). Only in this group local tumor control was achievable. The histological analysis of tumor preparations revealed additional data about treatment-induced changes in the tumor compared to the measurement of the tumor volume with mechanical callipers. We also found that the treatment outcome could be predicted from the histopathological analysis. It is concluded that studies involving histopathological examinations may give some insight into the way cancer is controlled by radiotherapy and may be of value in prognosis and selection of treatment in patients. (orig.) [de

  2. Research on monitoring and management information integration technique in waste treatment and management

    International Nuclear Information System (INIS)

    Kong Jinsong; Yu Ren; Mao Wei

    2013-01-01

    The integration of the waste treatment process and the device status monitoring information and management information is a key problem required to be solved in the information integration of the waste treatment and management. The main content of the monitoring and management information integration is discussed in the paper. The data exchange techniques, which are based on the OPC, FTP and data push technology, are applied to the different monitoring system respectively, according to their development platform, to realize the integration of the waste treatment process and device status monitoring information and management information in a waste treatment center. (authors)

  3. Continuous monitoring of back-wall stress corrosion cracking propagation by means of potential drop techniques

    International Nuclear Information System (INIS)

    Sato, Yasumoto; Atsumi, Takeo; Shoji, Tetsuo

    2006-01-01

    In order to investigate the applicability of the potential drop techniques to the continuous monitoring of stress corrosion cracking (SCC) propagation, SCC tests were performed in a sodium thiosulfate solution at room temperature using plate specimens with weldments. The SCC propagation was monitored using the techniques of direct current potential drop (DCPD), alternating current potential drop (ACPD) and modified induced current potential drop (MICPD) on the reverse side that on which the SCC existed and effectiveness of each technique for the continuous monitoring from the reverse side of SCC was compared from the viewpoints of sensitivity to the crack propagation and measurement stability. The MICPD and DCPD techniques permit continuous monitoring of the back-wall SCC propagation, which initiates from a fatigue pre-crack at a depth of about 4 mm, from which it propagates through more than 80% of the specimen thickness. The MICPD technique can decrease the effect of the current flowing in the direction of the crack length by focusing the induced current into the local area of measurement using induction coils, so that the sensitivity of the continuous monitoring of the back wall SCC propagation is higher than that of the DCPD and ACPD techniques. (author)

  4. Fundamental and assessment of concrete structure monitoring by using acoustic emission technique testing: A review

    Science.gov (United States)

    Desa, M. S. M.; Ibrahim, M. H. W.; Shahidan, S.; Ghadzali, N. S.; Misri, Z.

    2018-04-01

    Acoustic emission (AE) technique is one of the non-destructive (NDT) testing, where it can be used to determine the damage of concrete structures such as crack, corrosion, stability, sensitivity, as structure monitoring and energy formed within cracking opening growth in the concrete structure. This article gives a comprehensive review of the acoustic emission (AE) technique testing due to its application in concrete structure for structural health monitoring (SHM). Assessment of AE technique used for structural are reviewed to give the perception of its structural engineering such as dam, bridge and building, where the previous research has been reviewed based on AE application. The assessment of AE technique focusing on basic fundamental of parametric and signal waveform analysis during analysis process and its capability in structural monitoring. Moreover, the assessment and application of AE due to its function have been summarized and highlighted for future references

  5. A Monte Carlo technique for signal level detection in implanted intracranial pressure monitoring.

    Science.gov (United States)

    Avent, R K; Charlton, J D; Nagle, H T; Johnson, R N

    1987-01-01

    Statistical monitoring techniques like CUSUM, Trigg's tracking signal and EMP filtering have a major advantage over more recent techniques, such as Kalman filtering, because of their inherent simplicity. In many biomedical applications, such as electronic implantable devices, these simpler techniques have greater utility because of the reduced requirements on power, logic complexity and sampling speed. The determination of signal means using some of the earlier techniques are reviewed in this paper, and a new Monte Carlo based method with greater capability to sparsely sample a waveform and obtain an accurate mean value is presented. This technique may find widespread use as a trend detection method when reduced power consumption is a requirement.

  6. A novel technique for determination of the fructose, glucose and sucrose distribution in nectar from orchids by HPLC-ELSD.

    Science.gov (United States)

    Lindqvist, Dan Nybro; Pedersen, Henrik Ærenlund; Rasmussen, Lars Holm

    2018-04-01

    The dominant components in floral nectar is fructose, glucose and sucrose. The concentration and the ratio between the sugars are indicative for plant species and play an important part in the interplay between plants and pollinators. In this paper we present a novel HPLC-ELSD based analytical method for sugar characterization of nectar from orchids. Nectar was collected on Whatman No. 1 paper and preserved in the field by 70 v/v% ethanol. The analytical method had a linear range up to at least 3000 mg L -1 for all 3 sugars with a precision of 1.5-1.7%. Correlation coefficients were 0.9999 to 1.0000. The LOD of all sugars were 5-7 mg L -1 and the LOQ were 17-19 mg L -1 . Field samples were stable for min. 7 weeks at -18 °C. The technique was applied to two species of Platanthera (Orchidaceae) in order to test whether species-related differences in sugar composition could be observed. No differences were found between the two species, which were sucrose-dominant (53.5-100%) though with high variation within species and between individual flowers. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Recent advances in electronic nose techniques for monitoring of fermentation process.

    Science.gov (United States)

    Jiang, Hui; Zhang, Hang; Chen, Quansheng; Mei, Congli; Liu, Guohai

    2015-12-01

    Microbial fermentation process is often sensitive to even slight changes of conditions that may result in unacceptable end-product quality. Thus, the monitoring of the process is critical for discovering unfavorable deviations as early as possible and taking the appropriate measures. However, the use of traditional analytical techniques is often time-consuming and labor-intensive. In this sense, the most effective way of developing rapid, accurate and relatively economical method for quality assurance in microbial fermentation process is the use of novel chemical sensor systems. Electronic nose techniques have particular advantages in non-invasive monitoring of microbial fermentation process. Therefore, in this review, we present an overview of the most important contributions dealing with the quality control in microbial fermentation process using the electronic nose techniques. After a brief description of the fundamentals of the sensor techniques, some examples of potential applications of electronic nose techniques monitoring are provided, including the implementation of control strategies and the combination with other monitoring tools (i.e. sensor fusion). Finally, on the basis of the review, the electronic nose techniques are critically commented, and its strengths and weaknesses being highlighted. In addition, on the basis of the observed trends, we also propose the technical challenges and future outlook for the electronic nose techniques.

  8. Blood glucose monitoring and glycemic control in adolescents with type 1 diabetes: meter downloads versus self-report.

    Science.gov (United States)

    Guilfoyle, Shanna M; Crimmins, Nancy A; Hood, Korey K

    2011-09-01

    Reported frequencies of blood glucose monitoring (BGM) by both adolescents and their caregivers serve as adherence proxies when meter downloads are not available. Yet, correlates of reported BGM frequencies and their predictive utility are understudied. To identify sociodemographic, psychological, and disease-specific correlates of reported BGM frequencies in adolescents with type 1 diabetes and to explore the predictive utility of BGM indices on glycemic control. Study participants included caregivers and adolescents with type 1 diabetes (N=143, 13-18 yr) receiving diabetes treatment at a tertiary care setting. At the initial visit, adolescents and caregivers reported on daily BGM frequencies. A sub-sample provided meter downloads. Adolescents also completed a depression inventory. Three months later, adolescents provided blood sampling for A1c assessment. Multivariate general linear modeling identified that older adolescent age and more depressive symptoms were associated with reports of less frequent BGM. Two stepwise multivariate regression models examined the predictive utility of BGM indices (i.e., adolescent-reported BGM, caregiver-reported BGM, meter download) on glycemic control. Caregiver-reported BGM frequency predicted glycemic control in the absence of meter download data (pmeter download data were the most robust predictor of glycemic control (pMeter downloads have the most robust association with glycemic control when contextual variables are considered. Caregiver-reported BGM frequencies can serve as reliable substitutes in the absence of meter download, but they may not be as reliable in adolescents with depressive symptoms. © 2011 John Wiley & Sons A/S.

  9. Comparison of vildagliptin twice daily vs. sitagliptin once daily using continuous glucose monitoring (CGM): Crossover pilot study (J-VICTORIA study)

    Science.gov (United States)

    2012-01-01

    Background No previous studies have compared the DPP-4 inhibitors vildagliptin and sitagliptin in terms of blood glucose levels using continuous glucose monitoring (CGM) and cardiovascular parameters. Methods Twenty patients with type 2 diabetes mellitus were randomly allocated to groups who received vildagliptin then sitagliptin, or vice versa. Patients were hospitalized at 1 month after starting each drug, and CGM was used to determine: 1) mean (± standard deviation) 24-hour blood glucose level, 2) mean amplitude of glycemic excursions (MAGE), 3) fasting blood glucose level, 4) highest postprandial blood glucose level and time, 5) increase in blood glucose level after each meal, 6) area under the curve (AUC) for blood glucose level ≥180 mg/dL within 3 hours after each meal, and 7) area over the curve (AOC) for daily blood glucose level vildagliptin than sitagliptin (142.1 ± 35.5 vs. 153.2 ± 37.0 mg/dL; p = 0.012). In patients taking vildagliptin, MAGE was significantly lower (110.5 ± 33.5 vs. 129.4 ± 45.1 mg/dL; p = 0.040), the highest blood glucose level after supper was significantly lower (206.1 ± 40.2 vs. 223.2 ± 43.5 mg/dL; p = 0.015), the AUC (≥180 mg/dL) within 3 h was significantly lower after breakfast (484.3 vs. 897.9 mg/min/dL; p = 0.025), and urinary CPR level was significantly higher (97.0 ± 41.6 vs. 85.2 ± 39.9 μg/day; p = 0.008) than in patients taking sitagliptin. There were no significant differences in plasma HbA1c, GA, 1,5AG, IRI, CPR, BNP, or PAI-1 levels between patients taking vildagliptin and sitagliptin. Conclusions CGM showed that mean 24-h blood glucose, MAGE, highest blood glucose level after supper, and hyperglycemia after breakfast were significantly lower in patients with type 2 diabetes mellitus taking vildagliptin than those taking sitagliptin. There were no significant differences in BNP and PAI-1 levels between patients taking vildagliptin and

  10. Monitoring techniques of the western corn rootworm are the precursor to effective IPM strategies.

    Science.gov (United States)

    Lemic, Darija; Mikac, Katarina M; Kozina, Antonela; Benitez, Hugo A; McLean, Christopher M; Bažok, Renata

    2016-02-01

    The western corn rootworm (WCR) is economically the most important pest of maize in Croatia. To predict WCR adult population abundance and variability, traditional, genetic and morphometric monitoring of populations was conducted over time through each phase of the WCR invasion process in Croatia. Through traditional monitoring it was shown that WCR established their current population and reached economic densities after 14 years persisting in the study area. Regression-tree-based modelling showed that the best predictor of WCR adult abundance was the total amount of rainfall. Genetic monitoring indicated that genetic differentiation increased over time at the intrapopulation level, and morphometric monitoring indicated that wing morphotypes varied according to edaphic landscape changes. Traditional population metric surveys are important in WCR integrated pest management (IPM), as such surveys can be effectively used to predict population abundances. Novel-use monitoring techniques such as genetics and geometric morphometrics can be used to provide valuable information on variation within and among populations. The monitoring techniques presented herein provide sound data to assist in the understanding of both WCR ecology and population genetics and may provide more information than that currently available using traditional techniques (e.g. sticky traps), and as such these additional techniques should be written into IPM for WCR. © 2015 Society of Chemical Industry.

  11. 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

  12. 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

  13. Continuous Glucose Monitoring vs Conventional Therapy for Glycemic Control in Adults With Type 1 Diabetes Treated With Multiple Daily Insulin Injections: The GOLD Randomized Clinical Trial.

    Science.gov (United States)

    Lind, Marcus; Polonsky, William; Hirsch, Irl B; Heise, Tim; Bolinder, Jan; Dahlqvist, Sofia; Schwarz, Erik; Ólafsdóttir, Arndís Finna; Frid, Anders; Wedel, Hans; Ahlén, Elsa; Nyström, Thomas; Hellman, Jarl

    2017-01-24

    The majority of individuals with type 1 diabetes do not meet recommended glycemic targets. To evaluate the effects of continuous glucose monitoring in adults with type 1 diabetes treated with multiple daily insulin injections. Open-label crossover randomized clinical trial conducted in 15 diabetes outpatient clinics in Sweden between February 24, 2014, and June 1, 2016 that included 161 individuals with type 1 diabetes and hemoglobin A1c (HbA1c) of at least 7.5% (58 mmol/mol) treated with multiple daily insulin injections. Participants were randomized to receive treatment using a continuous glucose monitoring system or conventional treatment for 26 weeks, separated by a washout period of 17 weeks. Difference in HbA1c between weeks 26 and 69 for the 2 treatments. Adverse events including severe hypoglycemia were also studied. Among 161 randomized participants, mean age was 43.7 years, 45.3% were women, and mean HbA1c was 8.6% (70 mmol/mol). A total of 142 participants had follow-up data in both treatment periods. Mean HbA1c was 7.92% (63 mmol/mol) during continuous glucose monitoring use and 8.35% (68 mmol/mol) during conventional treatment (mean difference, -0.43% [95% CI, -0.57% to -0.29%] or -4.7 [-6.3 to -3.1 mmol/mol]; P < .001). Of 19 secondary end points comprising psychosocial and various glycemic measures, 6 met the hierarchical testing criteria of statistical significance, favoring continuous glucose monitoring compared with conventional treatment. Five patients in the conventional treatment group and 1 patient in the continuous glucose monitoring group had severe hypoglycemia. During washout when patients used conventional therapy, 7 patients had severe hypoglycemia. Among patients with inadequately controlled type 1 diabetes treated with multiple daily insulin injections, the use of continuous glucose monitoring compared with conventional treatment for 26 weeks resulted in lower HbA1c. Further research is needed to assess clinical outcomes and longer

  14. The integration of novel diagnostics techniques for multi-scale monitoring of large civil infrastructures

    Directory of Open Access Journals (Sweden)

    F. Soldovieri

    2008-11-01

    Full Text Available In the recent years, structural monitoring of large infrastructures (buildings, dams, bridges or more generally man-made structures has raised an increased attention due to the growing interest about safety and security issues and risk assessment through early detection. In this framework, aim of the paper is to introduce a new integrated approach which combines two sensing techniques acting on different spatial and temporal scales. The first one is a distributed optic fiber sensor based on the Brillouin scattering phenomenon, which allows a spatially and temporally continuous monitoring of the structure with a "low" spatial resolution (meter. The second technique is based on the use of Ground Penetrating Radar (GPR, which can provide detailed images of the inner status of the structure (with a spatial resolution less then tens centimetres, but does not allow a temporal continuous monitoring. The paper describes the features of these two techniques and provides experimental results concerning preliminary test cases.

  15. Effects of Acute Ingestion of Native Banana Starch on Glycemic Response Evaluated by Continuous Glucose Monitoring in Obese and Lean Subjects

    Directory of Open Access Journals (Sweden)

    Guadalupe Jiménez-Domínguez

    2015-07-01

    Full Text Available An abnormal glycemic profile, including postprandial glycemia and acute glucose spikes, precedes the onset of overt diabetes in obese subjects. Previous studies have shown the beneficial effects of chronic native banana starch (NBS supplementation. In this study, we examined the effects of acute ingestion of NBS on glycemic profiles by means of continuous glucose monitoring in obese and lean subjects. In a crossover study, obese and lean subjects consumed beverages containing either 38.3 g of NBS or 38.3 g of digestible corn starch (DCS twice daily during 4 days. On day 5, a 3-h meal tolerance test (MTT was performed to evaluate glucose and insulin responses. After 1 week of washout period, treatments were inverted. NBS supplementation reduced the 48-h glycemia AUC in lean, obese, and in the combined group of lean and obese subjects in comparison with DCS. Postprandial glucose and insulin responses at MTT were reduced after NBS in comparison with DCS in all groups. However, no changes were observed in glycemic variability (GV indexes between groups. In conclusion, acute NBS supplementation improved postprandial glucose and insulin responses in obese and lean subjects during 48 h of everyday life and at MTT. Further research to elucidate the mechanism behind these changes is required.

  16. Efficacy and safety of teneligliptin in addition to insulin therapy in type 2 diabetes mellitus patients on hemodialysis evaluated by continuous glucose monitoring.

    Science.gov (United States)

    Yajima, Takahiro; Yajima, Kumiko; Hayashi, Makoto; Takahashi, Hiroshi; Yasuda, Keigo

    2016-12-01

    Appropriate glycemic control without hypoglycemia is important in patients with type 2 diabetes on hemodialysis. Teneligliptin, a novel dipeptidyl peptidase-4 inhibitor, can be used without dose adjustment for these patients. Using continuous glucose monitoring (CGM), we evaluated the efficacy and safety of adding teneligliptin to insulin therapy. Twenty-one type 2 diabetes mellitus patients on hemodialysis treated with insulin were enrolled. After the adjustment of insulin dose, their blood glucose level was monitored by CGM. Insulin dose was reduced after teneligliptin administration. The median total daily insulin dose significantly reduced from 18 (9-24)U to 6 (0-14)U (p1). Maximum, mean, and standard deviation of blood glucose level on the hemodialysis and non-hemodialysis days did not change after teneligliptin administration. However, minimum blood glucose level was significantly elevated on the hemodialysis day after teneligliptin administration (from 3.9±1.0mmol/L to 4.4±0.9mmol/L, p=0.040). The incidence of asymptomatic hypoglycemia on the hemodialysis day detected by CGM significantly decreased from 38.1% to 19.0% (p=0.049). Teneligliptin may contribute toward reducing the total daily insulin dose and preventing hypoglycemic events on the hemodialysis day in type 2 diabetes mellitus patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Critical and subcritical damage monitoring of bonded composite repairs using innovative non-destructive techniques

    Science.gov (United States)

    Grammatikos, S. A.; Kordatos, E. Z.; Aggelis, D. G.; Matikas, T. E.; Paipetis, A. S.

    2012-04-01

    Infrared Thermography (IrT) has been shown to be capable of detecting and monitoring service induced damage of repair composite structures. Full-field imaging, along with portability are the primary benefits of the thermographic technique. On-line lock-in thermography has been reported to successfully monitor damage propagation or/and stress concentration in composite coupons, as mechanical stresses in structures induce heat concentration phenomena around flaws. During mechanical fatigue, cyclic loading plays the role of the heating source and this allows for critical and subcritical damage identification and monitoring using thermography. The Electrical Potential Change Technique (EPCT) is a new method for damage identification and monitoring during loading. The measurement of electrical potential changes at specific points of Carbon Fiber Reinforced Polymers (CFRPs) under load are reported to enable the monitoring of strain or/and damage accumulation. Along with the aforementioned techniques Finally, Acoustic Emission (AE) method is well known to provide information about the location and type of damage. Damage accumulation due to cyclic loading imposes differentiation of certain parameters of AE like duration and energy. Within the scope of this study, infrared thermography is employed along with AE and EPCT methods in order to assess the integrity of bonded repair patches on composite substrates and to monitor critical and subcritical damage induced by the mechanical loading. The combined methodologies were effective in identifying damage initiation and propagation of bonded composite repairs.

  18. Design of Cyclic Peptide Based Glucose Receptors and Their Application in Glucose Sensing.

    Science.gov (United States)

    Li, Chao; Chen, Xin; Zhang, Fuyuan; He, Xingxing; Fang, Guozhen; Liu, Jifeng; Wang, Shuo

    2017-10-03

    Glucose assay is of great scientific significance in clinical diagnostics and bioprocess monitoring, and to design a new glucose receptor is necessary for the development of more sensitive, selective, and robust glucose detection techniques. Herein, a series of cyclic peptide (CP) glucose receptors were designed to mimic the binding sites of glucose binding protein (GBP), and CPs' sequence contained amino acid sites Asp, Asn, His, Asp, and Arg, which constituted the first layer interactions of GBP. The properties of these CPs used as a glucose receptor or substitute for the GBP were studied by using a quartz crystal microbalance (QCM) technique. It was found that CPs can form a self-assembled monolayer at the Au quartz electrode surface, and the monolayer's properties were characterized by using cyclic voltammetry, electrochemical impedance spectroscopy, and atomic force microscopy. The CPs' binding affinity to saccharide (i.e., galactose, fructose, lactose, sucrose, and maltose) was investigated, and the CPs' sensitivity and selectivity toward glucose were found to be dependent upon the configuration,i.e., the amino acids sequence of the CPs. The cyclic unit with a cyclo[-CNDNHCRDNDC-] sequence gave the highest selectivity and sensitivity for glucose sensing. This work suggests that a synthetic peptide bearing a particular functional sequence could be applied for developing a new generation of glucose receptors and would find huge application in biological, life science, and clinical diagnostics fields.

  19. Development and evaluation of a technique for in vivo monitoring of 60Co in the lungs

    International Nuclear Information System (INIS)

    Mello, J.Q. de; Lucena, E.A.; Dantas, A.L.A.; Dantas, B.M.

    2015-01-01

    60 Co is a fission product of 235 U and represents a risk of internal exposure of workers in nuclear power plants, especially those involved in the maintenance of potentially contaminated parts and equipment. The control of 60 Co intake by inhalation can be performed through in vivo monitoring. This work describes the evaluation of a technique through the minimum detectable activity and the corresponding minimum detectable effective doses, based on biokinetic and dosimetric models of 60 Co in the human body. The results allow to state that the technique is suitable either for monitoring of occupational exposures or evaluation of accidental intakes. (author)

  20. Development and evaluation of a technique for in vivo monitoring of 60Co in human liver

    Science.gov (United States)

    Gomes, GH; Silva, MC; Mello, JQ; Dantas, ALA; Dantas, BM

    2018-03-01

    60Co is an ar