scholarly journals Effectiveness and Practicality of eKTANG as a Digital Treat-ment for Diabetes and Relevant Influence Factors

2022 ◽  
Author(s):  
Xiaohua Lu ◽  
Dalong Guo ◽  
Lie Feng ◽  
Yan Zhou ◽  
Chuangbiao Zhang ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Health Management ◽  
Influence Factors ◽  
Glucose Monitoring ◽  
Standard Group ◽  
Course Of Disease ◽  
Treat Ment ◽  
Number Of Patients ◽  
Diet Control

Background: This work explored the effect of eKTANG, a new healthcare mode for diabetes patients, on diabetes management. Methods: Allowing general utilization of medical service and health management based on Internet, eKTANG obtained the precise data like blood glucose and blood pressure examined by an intelligent glucometer, from which doctors and the nursing team will promptly analyze the data and return feedback to the patients. In our study, overall 204 patients receiving eKTANG management over 3 months in First Affiliated Hospital of Jinan University from May 2019 to Aug 2020 were enrolled as the research objects, with data collected from patient records. Results: Through the biochemical test on relevant indexes of blood glucose, it was observed that FBG, PBG, HbA1c, TG, TC, LDL levels after management were lower than before whereas HDL expression after were lower than before. Contrasted with substandard group, standard group performed younger age, lower proportion of the married, decreased proportion of microvascular and macrovascular complications, longer course of disease, more frequent glucose monitoring, declined time of hyperglycemia and time of alarms, elevated time of euglycemia, increased proportion of diet control, more amount of exercise and higher compliance, as the number of patients choosing oral medicine in standard group was more than substandard group. The course of disease and time of hyperglycemia were risk factors of HbA1c standard reaching whereas frequency of glucose monitoring (≥1 time/week) and time of euglycemia were protective factors. Conclusion: eKTANG effectively improved diabetes management.

"Taming the Monster aka Uncontrolled Diabetes: A Viewpoint" (Preprint)

2020 ◽  
Author(s):  
Swati Anand ◽  
Amardeep Kalsi ◽  
Jonathan Figueroa ◽  
Parag Mehta
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Positive Impact ◽  
The United States ◽  
Phone Call ◽  
Diabetic Patients ◽  
Dietary Compliance ◽  
Glucose Levels ◽  
Uncontrolled Diabetes ◽  
Number Of Patients

BACKGROUND HbA1c between 6% and 6.9% is associated with the lowest incidence of all‐cause and CVD mortality, with a stepwise increase in all‐cause and cardiovascular mortality in those with an HbA1c >7%. • There are 30 million individuals in the United States (9.4% of the population) currently living with Diabetes Mellitus. OBJECTIVE Improving HbA1C levels in patients with uncontrolled Diabetes with a focused and collaborative effort. METHODS Our baseline data for Diabetic patients attending the outpatient department from July 2018 to July 2019 in a University-affiliated hospital showed a total of 217 patients for one physician. • Of 217 patients, 17 had HbA1C 9 and above. We contacted these patients and discussed the need for tight control of their blood glucose levels. We intended to ensure them that we care and encourage them to participate in our efforts to improve their outcome. • We referred 13 patients that agreed to participate to the Diabetic educator who would schedule an appointment with the patients, discuss their diet, exercise, how to take medications, self-monitoring, and psychosocial factors. • If needed, she would refer them to the Nutritionist based on patients’ dietary compliance. • The patients were followed up in the next two weeks via telemedicine or a phone call by the PCP to confirm and reinforce the education provided by the diabetes educator. RESULTS Number of patients that showed an improvement in HbA1C values: 11 Cumulative decrease in HbA1C values for 13 patients: 25.3 The average reduction in HbA1C: 1.94 CONCLUSIONS Our initiative to exclusively target the blood glucose level with our multidisciplinary approach has made a positive impact, which is reflected in the outcome. • It leads to an improvement in patient compliance and facilitates diabetes management to reduce the risk for complications CLINICALTRIAL NA

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.

Modern technologies in diabetes management - continuous glucose monitoring and insulin pump therapy

2021 ◽  
Vol 87 (1) ◽  
pp. 50-55
Author(s):  
E.Yu. Pyankova ◽  
◽  
L.A. Anshakova ◽  
I.A. Pyankov ◽  
S.V. Yegorova ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
The Individual ◽  
Glucose Lowering Therapy

The problems of complications of diabetes mellitus cannot be solved without constant monitoring of blood glucose levels. The evolution of additional technologies for the determination of glucose in the blood of the last decades makes it possible to more accurately predict the risks of complications, both in the individual and in the patient population as a whole. The article provides an overview of the methods used in modern diabetology, facilitating control over the variability of blood glucose levels and helping in a more accurate selection of glucose-lowering therapy. All presented methods are currently working in real clinical practice in the Khabarovsk Krai

Evaluation of a Continuous Blood Glucose Monitor: A Novel and Non-Invasive Wearable Using Bioimpedance Technology

2021 ◽  
pp. 193229682110541
Author(s):  
Farid Sanai ◽  
Arshman S. Sahid ◽  
Jacqueline Huvanandana ◽  
Sandra Spoa ◽  
Lachlan H. Boyle ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Blood Glucose ◽  
Real World ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Relative Difference ◽  
Self Monitoring ◽  
Non Invasive ◽  
Adult Participants ◽  
Blood Glucose Monitor

Background: Frequent blood glucose level (BGL) monitoring is essential for effective diabetes management. Poor compliance is common due to the painful finger pricking or subcutaneous lancet implantation required from existing technologies. There are currently no commercially available non-invasive devices that can effectively measure BGL. In this real-world study, a prototype non-invasive continuous glucose monitoring system (NI-CGM) developed as a wearable ring was used to collect bioimpedance data. The aim was to develop a mathematical model that could use these bioimpedance data to estimate BGL in real time. Methods: The prototype NI-CGM was worn by 14 adult participants with type 2 diabetes for 14 days in an observational clinical study. Bioimpedance data were collected alongside paired BGL measurements taken with a Food and Drug Administration (FDA)-approved self-monitoring blood glucose (SMBG) meter and an FDA-approved CGM. The SMBG meter data were used to improve CGM accuracy, and CGM data to develop the mathematical model. Results: A gradient boosted model was developed using a randomized 80-20 training-test split of data. The estimated BGL from the model had a Mean Absolute Relative Difference (MARD) of 17.9%, with the Parkes error grid (PEG) analysis showing 99% of values in clinically acceptable zones A and B. Conclusions: This study demonstrated the reliability of the prototype NI-CGM at collecting bioimpedance data in a real-world scenario. These data were used to train a model that could successfully estimate BGL with a promising MARD and clinically relevant PEG result. These results will enable continued development of the prototype NI-CGM as a wearable ring.

scholarly journals Discrepancies Between Blood Glucose and Interstitial Glucose—Technological Artifacts or Physiology: Implications for Selection of the Appropriate Therapeutic Target

2017 ◽  
Vol 11 (4) ◽  
pp. 766-772 ◽  
Author(s):  
Thorsten Siegmund ◽  
Lutz Heinemann ◽  
Ralf Kolassa ◽  
Andreas Thomas
Keyword(s):  
Blood Glucose ◽  
Therapeutic Target ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Blood Glucose Measurement ◽  
Glucose Measurement ◽  
Glucose Levels ◽  
Therapeutic Decisions ◽  
The Impact ◽  
Selection Of

Background: For decades, the major source of information used to make therapeutic decisions by patients with diabetes has been glucose measurements using capillary blood samples. Knowledge gained from clinical studies, for example, on the impact of metabolic control on diabetes-related complications, is based on such measurements. Different to traditional blood glucose measurement systems, systems for continuous glucose monitoring (CGM) measure glucose in interstitial fluid (ISF). The assumption is that glucose levels in blood and ISF are practically the same and that the information provided can be used interchangeably. Thus, therapeutic decisions, that is, the selection of insulin doses, are based on CGM system results interpreted as though they were blood glucose values. Methods: We performed a more detailed analysis and interpretation of glucose profiles obtained with CGM in situations with high glucose dynamics to evaluate this potentially misleading assumption. Results: Considering physical activity, hypoglycemic episodes, and meal-related differences between glucose levels in blood and ISF uncover clinically relevant differences that can make it risky from a therapeutic point of view to use blood glucose for therapeutic decisions. Conclusions: Further systematic and structured evaluation as to whether the use of ISF glucose is more safe and efficient when it comes to acute therapeutic decisions is necessary. These data might also have a higher prognostic relevance when it comes to long-term metabolic consequences of diabetes. In the long run, it may be reasonable to abandon blood glucose measurements as the basis for diabetes management and switch to using ISF glucose as the appropriate therapeutic target.

Blood Glucose Monitoring In Pediatric Patients—Looking Toward Better Diabetes Management and Perspectives for the Future

2010 ◽  
Vol 8 (1) ◽  
pp. 22
Author(s):  
William L Clarke ◽  
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Artificial Pancreas ◽  
Glucose Monitoring ◽  
Glycated Haemoglobin ◽  
Blood Glucose Monitoring ◽  
Nocturnal Hypoglycaemia ◽  
Intensive Glucose Control ◽  
Glycaemic Variability ◽  
Analytical Accuracy

Self-blood glucose monitoring (SBGM) is an important component of day-to-day diabetes management for children and their families. Despite some recent concerns in terms of its analytical accuracy, it has been used successfully to implement intensive glucose control in the Diabetes control and complications trial (DCCT), reduce glycated haemoglobin (HbA1c) levels, prevent acute complications, and make it possible for children to attend school and participate in sports activities safely. While still in its infancy, continuous glucose monitoring (CGM) has been shown to be useful in reducing the occurrence of nocturnal hypoglycaemia, lowering HbA1c levels and reducing glycaemic variability. Its analytical accuracy has prevented its approval as an alternative to SBGM for insulin decision-making. However, it has made possible the development and testing of closed-loop ‘artificial pancreas’ systems for controlling glucose levels in adults and adolescents.

Can Blood Glucose Monitoring be Simplified/Modified in Order to Achieve Better Diabetes Management—Perspectives for the Future

2010 ◽  
Vol 06 (01) ◽  
pp. 48
Author(s):  
Robert M Cuddihy ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Diabetes Management ◽  
Healthcare Providers ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Clear Understanding ◽  
Major Advance ◽  
Oral Agents

Self-monitoring of blood glucose (SMBG) with reflectance meters was heralded as a major advance in the management of diabetes and has been available to individuals with diabetes for home use since the late 1970s. This tool was put to use in the landmark Diabetes Control and Complications Trial (DCCT), which revolutionized care for individuals with type 1 diabetes, enabling these individuals to intensify their glucose control. SMBG has similar benefit in individuals with type 2 diabetes requiring insulin therapy. Its use in other individuals with type 2 diabetes treated with oral agents or non-insulin therapies is less clear. While SMBG is a potentially powerful tool to aid in the daily management of diabetes, to be used effectively, SMBG must be optimized to ensure the information derived from it can be acted on to modify physical activity, dietary intake, or medications to improve glycemic control. Recently, studies looking at this population have called into question the utility of SMBG in the management of individuals with type 2 diabetes treated with non-insulin therapies. However, these studies are lacking in the specifics of how such information was used to modify therapies. In addition to this, the lack of a universally accepted output for SMBG data significantly impedes its uptake and appropriate use by healthcare providers and patients. To maximize the effectiveness of SMBG, both patients and providers need to have a clear understanding of when and how to use SMBG data and, most importantly, act upon the data to effect a change in their diabetes management.

scholarly journals Evaluation of information retention and adherence to treatment in patients with gestational diabetes mellitus after multidisciplinary group

2016 ◽  
Vol 62 (3) ◽  
pp. 212-217 ◽  
Author(s):  
Ana Maria da Silva Sousa ◽  
Daine Fiuza ◽  
Fernanda Cristina Ferreira Mikami ◽  
Karen Cristine Abrão ◽  
Rossana Pulcineli Vieira Francisco ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Contact Method ◽  
Information Retention ◽  
Multidisciplinary Group

SUMMARY Objective: To evaluate the retention of information after participation in multidisciplinary group in patients with gestational diabetes mellitus (GDM) through a phone contact. Method: 122 pregnant women diagnosed with gestational diabetes were included. After diagnosis of gestational diabetes, the patients were referred to the multidisciplinary group where they received medical, nutrition and nursing guidelines related to the disease. After three days these patients received one telephone call from a nurse, who made the same questions regarding the information received. In the statistical analysis, results were presented as absolute and relative frequencies. Results: Most patients 119/122 patients (97.5%) were managing to do self glucose monitoring. Twenty-one patients (17.2%) reported having difficulty performing the blood glucose, especially finger pricking. When questioning whether the woman was following the proposed diet, 24/122 (19.7%) patients said they did not; the meal frequency was not reached by 23/122 (18.9%) of the women, and forty-seven (38.5%) of the women reported having ingested sugar in the days following the guidance in multidisciplinary group. Conclusion: Regarding the proposed treatment, there was good adherence of patients, especially in relation to blood glucose monitoring. As for nutritional control, we observed greater difficulty in following the guidelines demonstrating the need for long-term monitoring, as well as further clarification to the patients about the importance of nutrition in diabetes management.

scholarly journals Retrospective, observational study to see the effect of evogliptin on continuous glucose monitoring (CGM) in T2DM Indian patients: A real-world experience

2022 ◽  
Vol 8 (4) ◽  
pp. 267-269
Author(s):  
Abhijit Trailokya ◽  
Suhas Erande ◽  
Amol Aiwale
Keyword(s):  
Blood Glucose ◽  
Treatment Regimen ◽  
Real World ◽  
Glucose Monitoring ◽  
Small Sample ◽  
Target Range ◽  
Percentage Time ◽  
Number Of Patients ◽  
Mean Blood Glucose ◽  
Time In Target Range

This study aimed to assess effectiveness of Evogliptin 5 mg through continues glucose monitoring (CGM) in patients with T2DM in retrospective observational real world settings. Overall 6 patients who received Evogliptin as routine clinical practice in management of T2DM were analyzed retrospectively from single center. Data collected from past medical records. FreeStyle Librepro 1.0.6 was used for CGM. CGM was done 15 days prior to adding Evogliptin and repeated immediately after that for next 15 days. Mean BG level, Percentage time in target range (80-140mg/dl), Percentage time above target and Percentage time below target were assessed prior and after adding Evogliptin in existing treatment regimen. Significant reduction in Mean blood glucose level seen after adding Evogliptin in existing treatment regimen from 215 mg/dl to 138 mg/dl (-77 mg/dl P=0.006). Significant improvement seen in Percentage time in target range (80-140mg/dl) from 17% to 44% (27% P value 0.007) and in Percentage time above target from 81% to 43% (- 38%, P valve 0.003). 13.5 % of the patients seen below target. Evogliptin was found to be effective when added to the patients who were uncontrolled on other oral anti-diabetic medications. It effectively showed improvement in continues glucose monitoring (CGM) parameters like Mean blood glucose, more number of patients were in Time in Target range i.e (80-140mg/dl) after adding Evogliptin to existing anti-diabetic medications & well tolerated. Small sample size and retrospective study

scholarly journals Self-monitoring of blood glucose as a basis for diabetes management

2013 ◽  
Vol 4 (1) ◽  
pp. 47-54
Author(s):  
A. Yu Mayorov ◽  
O. G Melnikova ◽  
Yu. I Filippov
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
International Organization ◽  
Diabetes Treatment ◽  
Self Monitoring ◽  
Antidiabetic Therapy ◽  
New Methods ◽  
Before And After ◽  
External Conditions

The article represents the review of issues of self-monitoring of blood glucose (SMBG) in diabetes treatment. The therapeutic purposes are considered when carrying out SMBG before and after the meals, accepted in Russia, providing an individualization depending on age, existence of severe complications and the risk of hypoglycemia. SMBG frequency is presented at various options of the antidiabetic therapy. The value of carrying out SMBG for the patient and the doctor is discussed. The principles of the work photometric and electrochemical glucometers are given. Issues of accuracy of blood glucose measuring accepted by the International organization for standardization for the systems of SMBG are presented. The reasons of errors to the system evaluation of blood glucose are connected with incorrect hand washing, improper coding of test strips, external conditions (altitude, temperature, humidity), hematocrit, acidosis, hyperlipidemia, concentration of oxygen in blood, exogenous interfering substances (some medicines). The structure and rules of maintaining the diary as the main way of the storage of results of SMBG are presented. Data of the international and Russian studies on an assessment of efficiency of SMBG are shown. The SMBG new methods are discussed in the section on continuous glucose monitoring.

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