Comparison of venous, capillary and interstitial blood glucose data measured during hyperbaric oxygen treatment from patients with diabetes mellitus

2021 ◽  
Vol 51 (3) ◽  
pp. 240-247
Author(s):  
Carol Baines ◽  
◽  
Don Vicendese ◽  
David Cooper ◽  
William McGuiness ◽  
...  

Introduction: Patients undergoing hyperbaric oxygen treatments (HBOT) have been shown to experience a reduction in blood glucose (BG) levels during a treatment. This necessitates frequent assessment of BG levels. Continuous glucose monitoring (CGM) may represent an alternative to the current finger prick monitoring method in-chamber, however, continuous sensor glucose (SG) data has not been validated in situ. The aim was to determine the validity of continuous SG and intermittent BG monitoring with serum BG levels in diabetic patients during HBOT. Methods: Measurements were obtained (finger prick [capillary sample], CGM [interstitial fluid], and serum [venous sample]) at baseline, and at 30, 60, 90 and 120 minutes during the hyperbaric treatment. Data were analysed by calculating intraclass correlation coefficients (ICC) and using mixed effects linear regression. Results: The ICC results (n = 10 patients) between the three methods indicated very high and statistically significant absolute agreement at baseline (pre-dive) (ICC = 0.90, 95% CI 0.74-0.97), at 30 minutes (ICC = 0.85, 95% CI 0.61−0.96), 60 minutes (ICC = 0.86, 95% CI 0.58−0.96), 90 minutes (ICC = 0.87, 96% CI 0.63−0.96) and 120 minutes (ICC = 0.90, 95% CI 0.70-0.97). Capillary glucose and CGM SG readings were each within 1 mmol·L-1 on average of the serum glucose reading, with multi-level linear regression finding the average difference between the CGM SG and capillary glucose methods of BG sampling was not statistically significant (P = 0.81). Conclusions: The CGM SG data were comparable with glucose readings from capillary monitoring. Both CGM and capillary data were consistent with serum values.

Author(s):  
Herbert Fink ◽  
Tim Maihöfer ◽  
Jeffrey Bender ◽  
Jochen Schulat

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.


2020 ◽  
Author(s):  
Tayebe Yazdanyar ◽  
Mehrnoush Sohrab ◽  
Atena Ramezani ◽  
Zahra Kashi ◽  
Parastoo Karimi Ali Abadi ◽  
...  

Abstract Background: Fasting has certain effects on metabolic and anthropometric parameters in diabetic patients. It is, therefore, necessary for patients to receive proper education related to their physical activities, eating habits, blood glucose monitoring, and medications. The aim of this study was to investigate the effects of Ramadan fasting on metabolic and anthropometric indices in type ΙΙ diabetic patients.Methods: This prospective observational study was performed during Ramadan 2018. The study population consisted of diabetic patients who desired to fast and received information on physical activity, eating habits, blood glucose monitoring, and taking their medications before Ramadan. Fasting blood sugar (FBS), blood sugar 2-hour postprandial (BS2hpp), glycosylated hemoglobin (HbA1C), and the lipids profile were assessed before and after Ramadan month. FBS and BS2hpp were also evaluated on the fifteenth day of Ramadan. The significance level for data analysis was considered p<0.05.Results: Out of 40 diabetic cases who completed the study, 6 (15%) were male and 34 (75%) were female. The mean age of participants was 55.2 ± 9.3 years. The anthropometric variables, including weight, BMI, waist, and blood pressure, decreased significantly after Ramadan fasting (p<0.05). FBS decreased significantly (125.1 ± 27.4 vs 105.2 ± 21.4, p<0.0001) and serum triglyceride increased significantly (127.5 ± 45.5 vs 166.5±53.5 mg/dl, p<0.001) after fasting compared to pre-Ramadan measurement. Other variables remained unchanged.Conclusion: The results of this study indicate that type II diabetic patients who have controlled blood sugar and received information based on clinical guidelines about their lifestyle and medications can fast safely during the holy month of Ramadan.


Author(s):  
Khaled Eskaf ◽  
Tim Ritchings ◽  
Osama Bedawy

Diabetes mellitus is one of the most common chronic diseases. The number of cases of diabetes in the world is likely to increase more than two fold in the next 30 years: from 115 million in 2000 to 284 million in 2030. This chapter is concerned with helping diabetic patients to manage themselves by developing a computer system that predicts their Blood Glucose Level (BGL) after 30 minutes on the basis of their current levels, so that they can administer insulin. This will enable the diabetic patient to continue living a normal daily life, as much as is possible. The prediction of BGLs based on the current levels BGLs become feasible through the advent of Continuous Glucose Monitoring (CGM) systems, which are able to sample patients' BGLs, typically 5 minutes, and computer systems that can process and analyse these samples. The approach taken in this chapter uses machine-learning techniques, specifically Genetic Algorithms (GA), to learn BGL patterns over an hour and the resulting value 30 minutes later, without questioning the patients about their food intake and activities. The GAs were invested using the raw BGLs as input and metadata derived from a Diabetic Dynamic Model of BGLs supplemented by the changes in patients' BGLs over the previous hour. The results obtained in a preliminary study including 4 virtual patients taken from the AIDA diabetes simulation software and 3 volunteers using the DexCom SEVEN system, show that the metadata approach gives more accurate predictions. Online learning, whereby new BGL patterns were incorporated into the prediction system as they were encountered, improved the results further.


1989 ◽  
Vol 15 (5) ◽  
pp. 435-439 ◽  
Author(s):  
Johnm. Amatruda ◽  
Barbara B. Vallone ◽  
Todd Schuster ◽  
Roberta. Mooney

Precision and accuracy of capillary blood glucose measure ments performed by general staff nurses were assessed before and after a modest reeducation pro gram both with and without the use of reflectance meters. A total of 380 capillary glucose determinations were performed by nurses and the hospital laboratory on the same samples. Prior to reeducation, nurses using meters were more accurate than those reading visually, but no difference was found in precision. Reeducation improved precision equally in both groups while improving accuracy only in the group using meters. While glucose readings with the use of reflectance meters were statistically more accurate than those read visually, the percentage of readings within 10 % and 20 % of the laboratory readings was the same. Thus, the increased accuracy observed with meters may have little practical significance, suggesting that their use might better be based on other consider ations, such as user confidence, convenience, cost, and quality control. Periodic education is, however, an essential component of any quality assurance program.


Author(s):  
C P Williams ◽  
G K Davies ◽  
D F Child

Improvement in the control of diabetic patients is aided by a knowledge of blood glucose levels during a ‘normal’ (non-hospitalised) day. We have devised a 5 μl capillary tube collection system as a ‘kit’ for home use by diabetics. Blood collected into 5 μl capillary tubes is washed into a protein precipitant by the patient. The completed kit is posted to the laboratory for analysis. The technique has achieved a high degree of patient acceptability. Subsequent analysis involves the addition of a single reagent. Reagents, patient samples, and standards are stable, and the precision of the technique compares favourably with our routine glucose procedure.


Sensors ◽  
2019 ◽  
Vol 19 (5) ◽  
pp. 1151 ◽  
Author(s):  
Ruochong Zhang ◽  
Siyu Liu ◽  
Haoran Jin ◽  
Yunqi Luo ◽  
Zesheng Zheng ◽  
...  

Diabetic patients need long-term and frequent glucose monitoring to assist in insulin intake. The current finger-prick devices are painful and costly, which places noninvasive glucose sensors in high demand. In this review paper, we list several advanced electromagnetic (EM)-wave-based technologies for noninvasive glucose measurement, including infrared (IR) spectroscopy, photoacoustic (PA) spectroscopy, Raman spectroscopy, fluorescence, optical coherence tomography (OCT), Terahertz (THz) spectroscopy, and microwave sensing. The development of each method is discussed regarding the fundamental principle, system setup, and experimental results. Despite the promising achievements that have been previously reported, no established product has obtained FDA approval or survived a marketing test. The limitations of, and prospects for, these techniques are presented at the end of this review.


2017 ◽  
Vol 33 (S1) ◽  
pp. 235-236
Author(s):  
Alessandro Curto ◽  
Marika Torbol ◽  
Anna Cavazzana ◽  
Margherita Andretta ◽  
Giovanna Scroccaro

INTRODUCTION:A novel, sensor-based, factory-calibrated Flash Monitoring System (FMS) has recently proved to be an effective alternative to conventional self-monitoring of blood glucose (SMBG) in patients affected by type 1 and type 2 diabetes. The 14-days adhesive sensor, that continuously measures glucose levels in the interstitial fluid, can transfer glucose levels data to a handheld reader or a smartphone equipped with a specific medical app. The uptake of the new technology has been limited so far, because of its high costs. A cost analysis has been conducted to identify the optimal target population of introducing FSM in Veneto.METHODS:The model was designed with a 1-year time horizon for patients with diabetes using intensive insulin in Veneto region. The costs of the new technology was estimated using inputs from the two main randomized controlled trials (the IMPACT study and the REPLACE study) published in the international literature, Regional evidence-based guidelines and administrative database. Resource utilization included strips, lancets, needles, sensors, distribution and patients training. Regional unit costs were adopted.RESULTS:FSM has not shown so far relevant and statically significant benefits in terms of severe adverse events’ reduction. Estimated yearly costs for a FSM user included glucose monitoring, technology training and distribution costs, for a total of EUR1277 per patient. The new technology has been shown to be affordable in diabetic patients with i) 4years<age<18years, ii) continuous subcutaneous insulin infusion and iii) ≥5 blood glucose monitoring per day.CONCLUSIONS:The Veneto Region should carefully consider prescribing extension to other diabetic patients categories, since the high cost of the new technology. A strict prescribing monitoring is strongly recommended with the aim of ensuring appropriateness and avoiding overspending.


Author(s):  
Kanimozhi R ◽  
Saravanakumar S

Diabetes Mellitus is a serious and chronic health disease. It occurs in all age group of people, especially in adults and aged persons. It is important to measure blood glucose level frequently for the diabetes affected persons which in need to determine the appropriate insulin dosage. Along with this, the continuous glucose monitoring is vital to know whether the glucose level is in normal range. The conventional method used to measure the glucose level in blood is invasive which is infectious and a painful process. Nowadays, the non-invasive blood glucose monitoring methods are widely used. In this work, the blood glucose level is measured non-invasively using IR sensor. Besides that, the indication of insulin dosage to be taken is done by determining blood glucose concentration (non- invasively) and comparing it with Body Mass Index (BMI) of the patient. The implementation is based on the variations in the intensity of the IR LED, BMI and blood density. Themethod ismore reliable than the invasive techniques.


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