scholarly journals Hydrogel-based flexible materials for diabetes diagnosis, treatment, and management

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Jiang Song ◽  
Yanni Zhang ◽  
Siew Yin Chan ◽  
Zhaoyi Du ◽  
Yinjia Yan ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Diabetes Management ◽  
Wound Care ◽  
Glucose Monitoring ◽  
Diabetes Diagnosis ◽  
High Glucose Concentration ◽  
Physical Pain ◽  
Flexible Devices ◽  
Flexible Materials ◽  
Conventional Management

AbstractDiabetes is a chronic metabolic disease characterized by high glucose concentration in blood. Conventional management of diabetes requires skin pricking and subcutaneous injection, causing physical pain and physiological issues to diabetic individuals. Hydrogels possess unique advantages such as lightweight, stretchability, biocompatibility, and biodegradability, offering the opportunities to be integrated as flexible devices for diabetes management. This review highlights the development of hydrogels as flexible materials for diabetes applications in glucose monitoring, insulin delivery, wound care, and cell transplantation in recent years. Challenges and prospects in the development of hydrogel-based flexible devices for personalized management of diabetes are discussed as well.

scholarly journals Exhaled Breath Analysis for Diabetes Diagnosis and Monitoring: Relevance, Challenges and Possibilities

Biosensors ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 476
Author(s):  
Kaushiki Dixit ◽  
Somayeh Fardindoost ◽  
Adithya Ravishankara ◽  
Nishat Tasnim ◽  
Mina Hoorfar
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Breath Analysis ◽  
Blood Glucose Monitoring ◽  
Diabetes Diagnosis ◽  
Exhaled Breath ◽  
Non Invasive ◽  
Exhaled Breath Analysis ◽  
Diabetes Monitoring

With the global population prevalence of diabetes surpassing 463 million cases in 2019 and diabetes leading to millions of deaths each year, there is a critical need for feasible, rapid, and non-invasive methodologies for continuous blood glucose monitoring in contrast to the current procedures that are either invasive, complicated, or expensive. Breath analysis is a viable methodology for non-invasive diabetes management owing to its potential for multiple disease diagnoses, the nominal requirement of sample processing, and immense sample accessibility; however, the development of functional commercial sensors is challenging due to the low concentration of volatile organic compounds (VOCs) present in exhaled breath and the confounding factors influencing the exhaled breath profile. Given the complexity of the topic and the skyrocketing spread of diabetes, a multifarious review of exhaled breath analysis for diabetes monitoring is essential to track the technological progress in the field and comprehend the obstacles in developing a breath analysis-based diabetes management system. In this review, we consolidate the relevance of exhaled breath analysis through a critical assessment of current technologies and recent advancements in sensing methods to address the shortcomings associated with blood glucose monitoring. We provide a detailed assessment of the intricacies involved in the development of non-invasive diabetes monitoring devices. In addition, we spotlight the need to consider breath biomarker clusters as opposed to standalone biomarkers for the clinical applicability of exhaled breath monitoring. We present potential VOC clusters suitable for diabetes management and highlight the recent buildout of breath sensing methodologies, focusing on novel sensing materials and transduction mechanisms. Finally, we portray a multifaceted comparison of exhaled breath analysis for diabetes monitoring and highlight remaining challenges on the path to realizing breath analysis as a non-invasive healthcare approach.

scholarly journals Type 1 Diabetes Management With Technology: Patterns of Utilization and Effects on Glucose Control Using Real-World Evidence

2021 ◽  
Author(s):  
Ran Sun ◽  
Imon Banerjee ◽  
Shengtian Sang ◽  
Jennifer Joseph ◽  
Jennifer Schneider ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Language Processing ◽  
Diabetes Management ◽  
Clinical Care ◽  
Glucose Monitoring ◽  
Diabetes Diagnosis ◽  
Cohort Identification ◽  
Patterns Of Utilization ◽  
Device Use

<b>Key Points</b> <p>· About one-third of patients with type 1 diabetes were found to use continuous glucose monitoring (CGM) and/or continuous subcutaneous insulin infusion (CSII) in routine clinical care.</p> <p>· Disparities exist in CGM and CSII adoption, with device use more common in patients of higher socioeconomic status.</p> <p>· Mining clinical narratives with natural language processing techniques can be applied successfully for medical device surveillance and cohort identification for observational studies.</p> <p>· CGM use in conjunction with CSII after type 1 diabetes diagnosis is more effective than other therapy regimens and may translate to improved long-term glycemic control. </p>

scholarly journals Type 1 Diabetes Management With Technology: Patterns of Utilization and Effects on Glucose Control Using Real-World Evidence

2021 ◽  
Author(s):  
Ran Sun ◽  
Imon Banerjee ◽  
Shengtian Sang ◽  
Jennifer Joseph ◽  
Jennifer Schneider ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Language Processing ◽  
Diabetes Management ◽  
Clinical Care ◽  
Glucose Monitoring ◽  
Diabetes Diagnosis ◽  
Cohort Identification ◽  
Patterns Of Utilization ◽  
Device Use

<b>Key Points</b> <p>· About one-third of patients with type 1 diabetes were found to use continuous glucose monitoring (CGM) and/or continuous subcutaneous insulin infusion (CSII) in routine clinical care.</p> <p>· Disparities exist in CGM and CSII adoption, with device use more common in patients of higher socioeconomic status.</p> <p>· Mining clinical narratives with natural language processing techniques can be applied successfully for medical device surveillance and cohort identification for observational studies.</p> <p>· CGM use in conjunction with CSII after type 1 diabetes diagnosis is more effective than other therapy regimens and may translate to improved long-term glycemic control. </p>

Can Innovative Technologies Overcome HbA1c Disparity for African-American Youth with Type 1 Diabetes?

2021 ◽  
pp. 193229682110213
Author(s):  
Stuart Chalew ◽  
Alan M. Delamater ◽  
Sonja Washington ◽  
Jayalakshmi Bhat ◽  
Diane Franz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Racial Disparity ◽  
Diabetes Management ◽  
New Technology ◽  
African American Youth ◽  
Glucose Monitoring ◽  
Supportive Role

Achieving normal or near-normal glycemic control as reflected by HbA1c levels in patients with type 1 diabetes (T1D) is important for preventing the development and progression of chronic complications. Despite delineation and dissemination of HbA1c management targets and advances in insulin pharmacology, insulin delivery systems, and glucose monitoring, the majority of children with T1D do not achieve HbA1c goals. In particular, African Americans are more likely not to reach HbA1c goals and have persistently higher HbA1c than Non-Hispanic Whites. Availability of pumps and other technology has not eliminated the disparity in HbA1c. Multiple factors play a role in the persisting racial disparity in HbA1c outcome. The carefully designed application and deployment of new technology to help the patient/family and facilitate the supportive role of the diabetes management team may be able to overcome racial disparity in glycemic outcome and improve patient quality of life.

scholarly journals An Interactive Web Application for the Statistical Analysis of Continuous Glucose Monitoring Data in Epidemiological Studies

2021 ◽  
pp. 193229682098557
Author(s):  
Alysha M. De Livera ◽  
Jonathan E. Shaw ◽  
Neale Cohen ◽  
Anne Reutens ◽  
Agus Salim
Keyword(s):  
Continuous Glucose Monitoring ◽  
Web Application ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Epidemiological Studies ◽  
Interactive Software ◽  
Web Based ◽  
Software Applications ◽  
Visualization Of Data ◽  
User Friendly

Motivation: Continuous glucose monitoring (CGM) systems are an essential part of novel technology in diabetes management and care. CGM studies have become increasingly popular among researchers, healthcare professionals, and people with diabetes due to the large amount of useful information that can be collected using CGM systems. The analysis of the data from these studies for research purposes, however, remains a challenge due to the characteristics and large volume of the data. Results: Currently, there are no publicly available interactive software applications that can perform statistical analyses and visualization of data from CGM studies. With the rapidly increasing popularity of CGM studies, such an application is becoming necessary for anyone who works with these large CGM datasets, in particular for those with little background in programming or statistics. CGMStatsAnalyser is a publicly available, user-friendly, web-based application, which can be used to interactively visualize, summarize, and statistically analyze voluminous and complex CGM datasets together with the subject characteristics with ease.

scholarly journals Quantifying the Risk of Methicillin-Resistant Staphylococcus aureus (MRSA) Transmission From Patient to Healthcare Personnel in the Critical Care Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s364-s364
Author(s):  
Timileyin Adediran ◽  
Anthony Harris ◽  
J. Kristie Johnson ◽  
Mary-Claire Roghmann ◽  
Stephanie Hitchcok ◽  
...  
Keyword(s):  
Patient Care ◽  
Wound Care ◽  
Medical Center ◽  
Glucose Monitoring ◽  
Routine Care ◽  
Healthcare Personnel ◽  
Medication Delivery ◽  
Care Activity ◽  
The Mean ◽  
Specific Care

Background: Healthcare personnel (HCP) acquire MRSA on their gown and gloves during routine care activities for patients who are colonized or infected with MRSA at a rate of ∼15%. Certain care activities (eg, physical exam, care of endotracheal tube, wound care and bathing/hygiene) have been associated with a higher frequency of transmission from the patient to HCP gown and gloves than other activities (ie, administration of oral medicines, glucose monitoring, and manipulation of IV tubing/medication delivery). However, quantification of MRSA contamination and risk to subsequent patients is poorly defined. Objective: We sought to determine the mean MRSA colony-forming units (CFU) found on the gloves and gowns of HCP who acquire MRSA after various care activities involving patients with MRSA. Methods: We conducted a prospective cohort study at the University of Maryland Medical Center from December 2018 to October 2019. We identified patients colonized or infected with MRSA based on culture data from the prior 7 days. HCP performing prespecified care activities on eligible patients were observed. To isolate the risk of each care activity, HCP donned new gloves and gown prior to a specific care activity. Once that care activity was performed, HCP gloves and gown were swabbed prior to the any further care activities. HCP gloves were cultured with an E-swab by swabbing each digit up and down 3 times followed by 2 circles on the palm of their hands. HCP gowns were sampled by swabbing a 15 × 30-cm area along the beltline of the gown and along each inner forearm twice. E-swab liquid was then serially diluted and plated in triplicate on CHROMagar MRSA II (BD, Sparks, MD) to obtain CFU. We calculated the median CFUs and the interquartile range (IQR) for each specific care activity stratified by gown and gloves. Results: In total, 604 HCP–patient care interactions were observed. Table 1 displays the mean MRSA CFUs stratified by gown and gloves for each patient care activity of interest. Conclusions: The quantity of MRSA found on gowns and gloves varies depending on patient care activities. Recognition of differential transmission rates between various activities may allow different approaches to infection prevention, such as the use of personal protective equipment in high- versus low-risk activities and/or the use of more aggressive interventions for high-risk activities.Funding: NoneDisclosures: None

scholarly journals The promise of stem cell-derived islet replacement therapy

Diabetologia ◽  
2021 ◽  
Author(s):  
Douglas Melton
Keyword(s):  
Endocrine Cells ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Endocrine Function ◽  
Blood Glucose Monitoring ◽  
Directed Differentiation ◽  
Insulin Independence ◽  
Insulin Dependent

AbstractPresent-day treatments for people that are insulin dependent require multiple insulin injections, sometimes with an insulin pump, coupled with regular blood glucose monitoring. The availability of modified insulins, each with peaks of activity at varying times, has improved diabetes management. On the other hand, there have been impressive results leading to insulin independence by transplantation of cadaveric islets coupled with immune suppression. This review focuses on the possibility of treating diabetes with cellular transplants, specifically with the use of pluripotent stem cells, to produce a virtually unlimited and uniform supply of human islet-like clusters by directed differentiation. Prospects for improving the in vitro differentiation of human endocrine cells for the study of endocrine function and their possible clinical uses are also discussed. Graphical abstract

Combining CGM and an Online Peer Support Community for Hispanic Adults with T2D: A Feasibility Study

2021 ◽  
pp. 193229682110322
Author(s):  
Michelle L. Litchman ◽  
Ashley Ng ◽  
Ana Sanchez-Birkhead ◽  
Nancy A. Allen ◽  
Bruno Rodriguez-Gonzales ◽  
...  
Keyword(s):  
Peer Support ◽  
Feasibility Study ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Qualitative Interviews ◽  
Glucose Monitoring ◽  
Participant Satisfaction ◽  
Hispanic Community ◽  
Clinical Measures ◽  
Study Participants

Background: Previous research has identified that people with type 2 diabetes (T2D) within the Hispanic community would benefit from an online peer support community (OPSC) and continuous glucose monitoring (CGM) data to facilitate diabetes self-management. Methods: A mixed-methods feasibility study enrolled Hispanic, Spanish-speaking adults with T2D, not on insulin. Participants were provided with CGM and access to an OPSC for 12 weeks. Feasibility was assessed by number of eligible participants who enrolled, attrition, quantity of CGM data, validated clinical measures of self-efficacy, quality of life and adverse events. Engagement in the OPSC was measured using objective metrics on the online platform. Qualitative interviews were conducted upon conclusion of the intervention to assess feasibility, acceptability, participant satisfaction, and key recommendations for improvement. Results: Of 46 participants screened, 39 were eligible and 26 completed the study. Participants significantly improved self-efficacy scores. Posts in the OPSC related to goal setting had the highest engagement followed by mid-week and end of week check-in posts respectively. Participant interviews described challenges accessing the OPSC platform as a barrier to engagement. Despite this, all participants were satisfied with the intervention. Key recommendations for improvement included providing greater variety of and individualized education and the use of a peer support platform that is easily accessible. Conclusions: The CGM + OPSC intervention tailored to the Hispanic community with T2D was feasible, acceptable and satisfactory and improved participant self-efficacy for diabetes management which may lead to improved clinical outcomes.

Indole as a new tentative marker in exhaled breath for non-invasive blood glucose monitoring of diabetic subjects

2021 ◽  
Author(s):  
Herbert Fink ◽  
Tim Maihöfer ◽  
Jeffrey Bender ◽  
Jochen Schulat
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Glucose Measurement ◽  
Diabetic Patients ◽  
Exhaled Breath ◽  
Invasive Approach ◽  
Test Strips ◽  
Non Invasive

Abstract Blood glucose monitoring (BGM) is the most important part of diabetes management. In classical BGM, glucose measurement by test strips involves invasive finger pricking. We present results of a clinical study that focused on a non-invasive approach based on volatile organic compounds (VOCs) in exhaled breath. Main objective was the discovery of markers for prediction of blood glucose levels (BGL) in diabetic patients. Exhaled breath was measured repeatedly in 60 diabetic patients (30 type 1, 30 type 2) in fasting state and after a standardized meal. Proton Transfer Reaction Time of Flight Mass Spectrometry (PTR-ToF-MS) was used to sample breath every 15 minutes for a total of six hours. BGLs were tested in parallel via BGM test strips. VOC signals were plotted against glucose trends for each subject to identify correlations. Exhaled indole (a bacterial metabolite of tryptophan) showed significant mean correlation to BGL (with negative trend) and significant individual correlation in 36 patients. The type of diabetes did not affect this result. Additional experiments of one healthy male subject by ingestion of lactulose and 13C-labeled glucose (n=3) revealed that exhaled indole does not directly originate from food digestion by intestinal microbiota. As indole has been linked to human glucose metabolism, it might be a tentative marker in breath for non-invasive BGM. Clinical studies with greater diversity are required for confirmation of such results and further investigation of metabolic pathways.

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