Development of robust and standardized cantilever sensors based on biotin/NeutrAvidin coupling for antibody detection

A cantilever-based protein biosensor has been developed providing a customizable multilayer platform for the detection of antibodies. It consists of a biotin-terminated PEG layer pre-functionalized on the gold-coated cantilever surface, onto which NeutrAvidin is adsorbed through biotin/NeutrAvidin specific binding. NeutrAvidin is used as a bridge layer between the biotin-coated surface and the biotinylated biomolecules, such as biotinylated bovine serum albumin (biotinylated BSA), forming a multilayer sensor for direct antibody capture. The cantilever biosensor has been successfully applied to the detection of mouse anti-BSA (m-IgG) and sheep anti-BSA(s-IgG) antibodies. As expected, the average differential surface stress signals of about 5.7 ± 0.8 × 10⁻³ N/m are very similar for BSA/m-IgG and BSA/s-IgG binding, i.e., they are independent of the origin of the antibody. A statistic evaluation of 112 response curves confirms that the multilayer protein cantilever biosensor shows high reproducibility. As a control test, a biotinylated maltose binding protein was used for detecting specificity of IgG, the result shows a signal of bBSA layer in response to antibody is 5.8 × 10⁻³ N/m compared to bMBP. The pre-functionalized biotin/PEG cantilever surface is found to show a long shelf-life of at least 40 days and retains its responsivity of above 70% of the signal when stored in PBS buffer at 4 °C. The protein cantilever biosensor represents a rapid, label-free, sensitive and reliable detection technique for a real-time protein assay.

Biosensor based on multi-walled carbon nanotubes paste electrode modified with laccase for pirimicarb pesticide quantification

This study focused on the development of a sensitive enzymatic biosensor for the determination of pirimicarb pesticide based on the immobilization of laccase on composite carbon paste electrodes. Multi-walled carbon nanotubes (MWCNTs) paste electrode modified by dispersion of laccase (3%, w/w) within the optimum composite matrix (60:40%, w/w, MWCNTs and paraffin binder) showed the best performance, with excellent electron transfer kinetic and catalytic effects related to the redox process of the substrate 4-aminophenol. No metal or anti-interference membrane was added. Based on the inhibition of laccase activity, pirimicarb can be determined in the range 9.90 × 10(-7) to 1.15 × 10(-5) mol L(-1) using 4-aminophenol as substrate at the optimum pH of 5.0, with acceptable repeatability and reproducibility (relative standard deviations lower than 5%). The limit of detection obtained was 1.8 × 10(-7) mol L(-1) (0.04 mg kg(-1) on a fresh weight vegetable basis). The high activity and catalytic properties of the laccase-based biosensor are retained during ca. one month. The optimized electroanalytical protocol coupled to the QuEChERS methodology were applied to tomato and lettuce samples spiked at three levels; recoveries ranging from 91.0 ± 0.1% to 101.0 ± 0.3% were attained. No significant effects in the pirimicarb electroanalysis were observed by the presence of pro-vitamin A, vitamins B1 and C, and glucose in the vegetable extracts. The proposed biosensor-based pesticide residue methodology fulfills all requisites to be used in implementation of food safety programs.

Nanomaterial based self-referencing microbiosensors for cell and tissue physiology research

Physiological studies require sensitive tools to directly quantify transport kinetics in the cell/tissue spatial domain under physiological conditions. Although biosensors are capable of measuring concentration, their applications in physiological studies are limited due to the relatively low sensitivity, excessive drift/noise, and inability to quantify analyte transport. Nanomaterials significantly improve the electrochemical transduction of microelectrodes, and make the construction of highly sensitive microbiosensors possible. Furthermore, a novel biosensor modality, self-referencing (SR), enables direct measurement of real-time flux and drift/noise subtraction. SR microbiosensors based on nanomaterials have been used to measure the real-time analyte transport in several cell/tissue studies coupled with various stimulators/inhibitors. These studies include: glucose uptake in pancreatic β cells, cancer cells, muscle tissues, intestinal tissues and P. Aeruginosa biofilms; glutamate flux near neuronal cells; and endogenous indole-3-acetic acid flux near the surface of Zea mays roots. Results from the SR studies provide important insights into cancer, diabetes, nutrition, neurophysiology, environmental and plant physiology studies under dynamic physiological conditions, demonstrating that the SR microbiosensors are an extremely valuable tool for physiology research.

In tube integrated electronic nose system on a flexible polymer substrate

The fabrication of electronic devices, such as gas sensors on flexible polymer substrates, enables the use of electronics in applications where conventional devices on stiff substrates could not be used. We demonstrate the development of a new intra-tube electronic-nose (e-nose) gas sensor device with multiple sensors fabricated and integrated on a flexible substrate. For this purpose, we developed a new method of fabricating a sensor array of four gas sensors on a flexible polymer substrate. The method allowed the use of lithography techniques to pattern different polymers with a broad range of solubility parameters. Conductive polymer composites were used as a gas sensitive layer due to the high stretchability of the material. Each of the 30 e-nose devices on one substrate was designed to fit on a polymer strip with a width of 2 mm. A single e-nose strip was successfully integrated into the inlet tube of a gas-measurement apparatus with an inner-tube diameter of 3 mm. Using the e-nose, we were able to differentiate between four different volatile solvent vapors. The tube-integrated e-nose outperformed a chamber-integrated e-nose of the same type in terms of response time and flow-rate influences. The sensor array inside the tube showed a faster response time and detected short pulses of analyte exposure compared to the same sensor array outside of the tube. We measured gas flow rates from 1,000 to 30 sccm without significant changes in sensor performance using this intra-tube e-nose prototype. The tube could be bent to radii < 15 mm with a sensor performance similar to an unbent sensor.

Determinants of the accuracy of continuous glucose monitoring in non-critically ill patients with heart failure or severe hyperglycemia

BACKGROUND

The accuracy of continuous glucose monitoring (CGM) in non-critically ill hospitalized patients with heart failure or severe hyperglycemia (SH) is unknown.

METHODS

Hospitalized patients with congestive heart failure (CHF) exacerbation (receiving IV or subcutaneous insulin) or SH requiring insulin infusion were compared to outpatients referred for retrospective CGM.

RESULTS

Forty-three patients with CHF, 15 patients with SH, and 88 outpatients yielded 470, 164, and 2150 meter-sensor pairs, respectively. Admission glucose differed (188 versus 509 mg/dl in CHF and SH, p < .001) but not the first sensor glucose (p = .35). In continuous glucose error grid analysis, 67-78% of pairs during hypoglycemia were in zones A+B (p = .63), compared with 98-100% in euglycemia (p < .001) and 98%, 92%, and 99% (p = .001) during hyperglycemia for the CHF, SH, and outpatient groups, respectively. Mean absolute relative difference (MARD) was lower in the CHF versus the SH group in glucose strata above 100 mg/dl, but there was no difference between the CHF and outpatient groups. Linear regression models showed that CHF versus outpatient, SH versus CHF, and coefficient of variation were significant predictors of higher MARD. Among subjects with CHF, MARD was not associated with brain natriuretic peptide or change in plasma volume, but it was significantly higher in subjects randomized to IV insulin (p = .04).

CONCLUSIONS

The results suggest that SH and glycemic variability are more important determinants of CGM accuracy than known CHF status alone in hospitalized patients.

A human pilot study of the fluorescence affinity sensor for continuous glucose monitoring in diabetes

OBJECTIVE

We report results of a pilot clinical study of a subcutaneous fluorescence affinity sensor (FAS) for continuous glucose monitoring conducted in people with type 1 and type 2 diabetes. The device was assessed based on performance, safety, and comfort level under acute conditions (4 h).

RESEARCH DESIGN AND METHODS

A second-generation FAS (BioTex Inc., Houston, TX) was subcutaneously implanted in the abdomens of 12 people with diabetes, and its acute performance to excursions in blood glucose was monitored over 4 h. After 30-60 min the subjects, who all had fasting blood glucose levels of less than 200 mg/dl, received a glucose bolus of 75 g/liter dextrose by oral administration. Capillary blood glucose samples were obtained from the finger tip. The FAS data were retrospectively evaluated by linear least squares regression analysis and by the Clarke error grid method. Comfort levels during insertion, operation, and sensor removal were scored by the subjects using an analog pain scale.

RESULTS

After retrospective calibration of 17 sensors implanted in 12 subjects, error grid analysis showed 97% of the paired values in zones A and B and 1.5% in zones C and D, respectively. The mean absolute relative error between sensor signal and capillary blood glucose was 13% [±15% standard deviation (SD), 100-350 mg/dl] with an average correlation coefficient of 0.84 (±0.24 SD). The actual average "warm-up" time for the FAS readings, at which highest correlation with glucose readings was determined, was 65 (±32 SD) min. Mean time lag was 4 (±5 SD) min during the initial operational hours. Pain levels during insertion and operation were modest.

CONCLUSIONS

The in vivo performance of the FAS demonstrates feasibility of the fluorescence affinity technology to determine blood glucose excursions accurately and safely under acute dynamic conditions in humans with type 1 and type 2 diabetes. Specific engineering challenges to sensor and instrumentation robustness remain. Further studies will be required to validate its promising performance over longer implantation duration (5-7 days) in people with diabetes.

Sap flow sensors: construction, quality control and comparison

This work provides a design for two types of sensors, based on the thermal dissipation and heat ratio methods of sap flow calculation, for moderate to large scale deployments for the purpose of monitoring tree transpiration. These designs include a procedure for making these sensors, a quality control method for the final products, and a complete list of components with vendors and pricing information. Both sensor designs were field tested alongside a commercial sap flow sensor to assess their performance and show the importance for quality controlling the sensor outputs. Results show that for roughly 2% of the cost of commercial sensors, self-made sap flow sensors can provide acceptable estimates of the sap flow measurements compared to the commercial sensors.

Blood glucose measurements in critically ill patients

Studies on tight glycemic control by intensive insulin therapy abruptly changed the climate of limited interest in the problem of hyperglycemia in critically ill patients and reopened the discussion on accuracy and reliability of glucose sensor devices. This article describes important components of blood glucose measurements and their interferences with the focus on the intensive care unit setting. Typical methodologies, organized from analytical accuracy to clinical accuracy, to assess imprecision and bias of a glucose sensor are also discussed. Finally, a list of recommendations and requirements to be considered when evaluating (time-discrete) glucose sensor devices is given.

Determination of the sodium 2-mercaptoethanesulfonate based on surface-enhanced Raman scattering

Based on the surface-enhanced Raman scattering (SERS) sodium 2-mercaptoethanesulfonate (mesna) was determined using unmodified gold colloid as the probe. The Raman scattering intensity was obviously enhanced in the presence of sodium chloride. The influence of experimental parameters, such as incubation time, sodium chloride concentration and pH value on SERS performance was examined. Under the optimum conditions, the SERS intensity is proportional to the concentration of mesna in the range of 9.0×10(-8) to 9.0×10(-7) mol/L and detection limit (S/N=3) is 1.16×10(-8) mol/L. The corresponding correlation coefficient of the linear equation is 0.996, which indicates that there is a good linear relationship between SERS intensity and mesna concentration. The experimental results indicate that the proposed method is a viable method for determination of mesna. The real samples were analyzed and the results obtained were satisfactory.

Optimization of the structure-switching aptamer-based fluorescence polarization assay for the sensitive tyrosinamide sensing

In this paper, a structure-switching aptamer assay based on a fluorescence polarization (FP) signal transduction approach and dedicated to the L-tyrosinamide sensing was described and optimized. A fluorescently labelled complementary strand (CS) of the aptamer central region was used as a probe. The effects of critical parameters such as buffer composition and pH, temperature, aptamer:CS stoichiometry, nature of the dye (Fluorescein (F) or Texas Red (TR)) and length of the CS (15-, 12-, 9- and 6-mer) on the assay analytical performances were evaluated. Under optimized experimental conditions (10 mM Tris-HCl, 5 mM MgCl(2) and 25 mM NaCl, pH 7.5 temperature of 22°C and stoichiometry 1:1), the results showed that, for a 12-mer CS, the F dye moderately increased the method sensitivity in comparison to the TR label. The F labelled 9-mer CS, however, did not allow the hybrid formation with the functional nucleic acid, thus emphasizing the importance of the nature of the fluorophore. In contrast, the same 9-mer CS labelled with the TR dye was able to effectively associate with the aptamer and was easily displaced upon target binding as demonstrated by a significant improvement of the sensitivity and a detection limit of 250 nM, comparable to those reported with direct aptasensing methods. The present study demonstrates that not only the CS length but also the nature of the dye played a preponderant role in the performance of the structure-switching aptamer assay, highlighting the importance of interdependently controlling these two factors for an optimal FP-based sensing platform.

Evaluation of a novel continuous glucose measurement device in patients with diabetes mellitus across the glycemic range

BACKGROUND

This glucose clamp study assessed the performance of an electrochemical continuous glucose monitoring (CGM) system for monitoring levels of interstitial glucose. This novel system does not require use of a trocar or needle for sensor insertion.

METHOD

Continuous glucose monitoring sensors were inserted subcutaneously into the abdominal tissue of 14 adults with type 1 or type 2 diabetes. Subjects underwent an automated glucose clamp procedure with four consecutive post-steady-state glucose plateau periods (40 min each): (a) hypoglycemic (50 mg/dl), (b) hyperglycemic (250 mg/dl), (c) second hypoglycemic (50 mg/dl), and (d) euglycemic (90 mg/dl). Plasma glucose results obtained with YSI glucose analyzers were used for sensor calibration. Accuracy was assessed retrospectively for plateau periods and transition states, when glucose levels were changing rapidly (approximately 2 mg/dl/min).

RESULTS

Mean absolute percent difference (APD) was lowest during hypoglycemic plateaus (11.68%, 14.15%) and the euglycemic-to-hypoglycemic transition (14.21%). Mean APD during the hyperglycemic plateau was 17.11%; mean APDs were 18.12% and 19.25% during the hypoglycemic-to-hyperglycemic and hyperglycemic-to-hypoglycemic transitions, respectively. Parkes (consensus) error grid analysis (EGA) and rate EGA of the plateaus and transition periods, respectively, yielded 86.8% and 68.6% accurate results (zone A) and 12.1% and 20.0% benign errors (zone B). Continuous EGA yielded 88.5%, 75.4%, and 79.3% accurate results and 8.3%, 14.3%, and 2.4% benign errors for the euglycemic, hyperglycemic, and hypoglycemic transition periods, respectively. Adverse events were mild and unlikely to be device related.

CONCLUSION

This novel CGM system was safe and accurate across the clinically relevant glucose range.

Use of a continuous glucose sensor in an extracorporeal life support circuit

BACKGROUND

Standard care for infants on extracorporeal life support (ECLS) relies on intermittent measurement of blood glucose (BG); however, this can lead to significant changes in BG that go unrecognized for several hours. The present study was designed to assess performance and clinical applicability of a subcutaneous glucose sensor technology modified for use as a blood-contacting sensor within the ECLS circuit.

METHODS

Twelve children, aged 3 years or less, requiring ECLS support were studied. Three continuous glucose sensors (Medtronic MiniMed) were inserted into hubs placed in line with the ECLS circuit. Blood glucose was assessed with a laboratory analyzer (BG(LAB); Bayer Rapidlab 860) approximately every 5 h (mean 4.9 ± 3.3 h) with more frequent samples obtained with a bedside monitor (HemoCue) as needed. Sensor current (I(SIG)) was transmitted to a laptop computer and retrospectively calibrated using BGLAB. Sensor performance was assessed by mean absolute relative difference (MARD), linear regression slope and intercept, and correlation, all with BGLAB as reference.

RESULTS

The BGLAB averaged 107.6 ± 36.4 mg/dl (mean ± standard deviation) ranging from 58 to 366 mg/dl. The MARD was 11.4%, with linear regression slope (0.86 ± 0.030) and intercept (9.0 ± 3.2 mg/dl) different from 1 and 0, respectively (p < .05), and correlation (r² = 0.76; p < .001). The system was not associated with any adverse events, and placement and removal into the hubs was easily accomplished. Instances in which more frequent BG values were obtained using a bedside HemoCue (BGHEMO) monitor showed the sensor to respond rapidly to changes.

CONCLUSIONS

We conclude that continuous sensors can be adapted for use in an ECLS circuit with accuracy similar to or better than that achieved with the subcutaneous site. Continuous glucose monitoring in this population can rapidly detect changes in BG that would not otherwise be observed. Further studies will be needed to assess the benefit of continuous glucose monitoring in this population.

Analysis of GlucoMen®Day: a novel microdialysis-based continuous glucose monitor

In this issue of Journal of Diabetes Science and Technology, Valgimigli and colleagues present promising data on the clinical accuracy of the new microdialysis-based continuous glucose monitoring device GlucoMen®Day. In this analysis, two issues are addressed: first, the established way data analyses may obscure interindividual variability in terms of a glucose monitoring system's accuracy; and second, to fully appreciate the future merits of the new system, data on accuracy, while a clearly necessary prerequisite, are not sufficient and need to be augmented by patient-reported outcome data as highlighted by recent U.S. Food and Drug Administration guidelines.

Evaluating the clinical accuracy of GlucoMen®Day: a novel microdialysis-based continuous glucose monitor

BACKGROUND

The objective of this work was to determine the clinical accuracy of GlucoMen®Day, a new microdialysis-based continuous glucose monitoring system (CGMS) from A. Menarini Diagnostics (Florence, Italy). Accuracy evaluation was performed using continuous glucose-error grid analysis (CG-EGA), as recommended by the Performance Metrics for Continuous Interstitial Glucose Monitoring; Approved Guideline (POCT05-A).

METHODS

Two independent clinical trials were carried out on patients with types 1 and 2 diabetes mellitus, the glycemic levels of whom were monitored in an in-home setting for 100-hour periods. A new multiparametric algorithm was developed and used to compensate in real-time the GlucoMen®Day signal. The time lag between continuous glucose monitoring (CGM) and reference data was first estimated using the Poincaré plot method. The entire set of CGM/reference data pairs was then evaluated following the CG-EGA criteria, which allowed an estimation of the combined point and rate accuracy stratified by glycemic ranges.

RESULTS

With an estimated time lag of 11 minutes, the linear regression analysis of the CGM/reference glucose values yielded r = 0.92. The mean absolute error (MAE) was 11.4 mg/dl. The calculated mean absolute rate deviation (MARD) was 0.63 mg/dl/min. The data points falling within the A+B zones of CG-EGA were 100% in hypoglycemia, 95.7% in euglycemia, and 95.2% in hyperglycemia.

CONCLUSIONS

The GlucoMen®Day system provided reliable, real-time measurement of subcutaneous glucose levels in patients with diabetes for up to 100 hours. The device showed the ability to follow rapid glycemic excursions and detect severe hypoglycemic events accurately. Its accuracy parameters fitted the criteria of the state-of-the-art consensus guideline for CGMS, with highly consistent results from two independent studies.

Development of an ion sensitive field effect transistor based urea biosensor with solid state reference systems

Ion sensitive field-effect transistor (ISFET) based urease biosensors with solid state reference systems for single-ended and two-ended differential readout electronics were investigated. The sensing membranes of the biosensors were fabricated with urease immobilized in a conducting polymer-based matrix. The responses of 12.9∼198.1 mV for the urea concentrations of 8∼240 mg/dL reveal that the activity of the enzyme was not significantly decreased. Biosensors combined with solid state reference systems were fabricated, and the evaluation results demonstrated the feasibility of miniaturization. For the differential system, the optimal transconductance match for biosensor and reference field-effect transistors (REFET) pair was determined through the modification of the membranes of the REFETs and enzyme field-effect transistors (EnFETs). The results show that the transconductance curve of polymer based REFET can match with that of the EnFET by adjusting the photoresist/Nafion™ ratio. The match of the transconductance curves for the differential pairs provides a wide dynamic operating measurement range. Accordingly, the miniaturized quasi-reference electrode (QRE)/REFET/EnFET combination with differential arrangement achieved similar urea response curves as those measured by a conventional large sized discrete sensor.

Long-term calibration considerations during subcutaneous microdialysis sampling in mobile rats

The level at which implanted sensors and sampling devices maintain their calibration is an important research area. In this work, microdialysis probes with identical geometry and different membranes, polycarbonate/polyether (PC) or polyethersulfone (PES), were used with internal standards (Vitamin B(12) (MW 1355), antipyrine (MW 188) and 2-deoxyglucose (2-DG, MW 164)) and endogenous glucose to investigate changes in their long-term calibration after implantation into the subcutaneous space of Sprague-Dawley rats. Histological analysis confirmed an inflammatory response to the microdialysis probes and the presence of a collagen capsule. The membrane extraction efficiency (percentage delivered to the tissue space) for antipyrine and 2-DG was not altered throughout the implant lifetime for either PC- or PES membranes. Yet, Vitamin B(12) extraction efficiency and collected glucose concentrations decreased during the implant lifetime. Antipyrine was administered i.v. and its concentrations obtained in both PC- and PES-membrane probes were significantly reduced between the implant day and seven (PC) or 10 (PES) days post-implantation suggesting that solute supply is critical for in vivo extraction efficiency. For the low molecular weight solutes such as antipyrine and glucose, localized delivery is not affected by the foreign body reaction, but recovery is significantly reduced. For Vitamin B(12), a larger solute, the fibrotic capsule formed around the probe significantly restricts diffusion from the implanted microdialysis probes.

Assessment of different techniques for subcutaneous glucose monitoring in Type 1 diabetic patients during 'real-life' glucose excursions

AIMS

To compare the accuracy of two marketed subcutaneous glucose monitoring devices (Guardian RT, GRT; GlucoDay S, GDS) and standard microdialysis (CMA60; MD) in Type 1 diabetic patients.

METHODS

Seven male Type diabetic patients were investigated over a period of 26 h simulating real-life meal glucose excursions. Catheters of the three systems were inserted into subcutaneous adipose tissue of the abdominal region. For MD, interstitial fluid was sampled at 30- to 60-min intervals for offline glucose determination. Reference samples were taken at 15- to 60-min intervals. All three systems were prospectively calibrated to reference. Median differences, median absolute relative differences (MARD), median absolute differences (MAD), Bland-Altman plot and Clark Error Grid were used to determine accuracy.

RESULTS

Bland-Altman analysis indicated a mean glucose difference (2 standard deviations) between reference and interstitial glucose of -10.5 (41.8) % for GRT, 20.2 (55.9) % for GDS and 6.5 (35.2) % for MD, respectively. Overall MAD (interquartile range) was 1.07 (0.39; 2.04) mmol/l for GRT, 1.59 (0.54; 3.08) mmol/l for GDS and 0.76 (0.26; 1.58) mmol/l for MD. Overall MARD was 15.0 (5.6; 23.4) % (GRT), 19.7 (6.1; 37.6) % (GDS) and 8.7 (4.1; 18.3) % (MD), respectively. Total sensor failure occurred in two subjects using GRT and one subject using GDS.

CONCLUSIONS

The three investigated technologies had comparable performance. Whereas GRT underestimated actual blood glucose, GDS and MD overestimated blood glucose. Considerable deviations during daily life meal glucose excursions from reference glucose were observed for all three investigated technologies. Present technologies may require further improvement until individual data can lead to direct and automated generation of therapeutic advice in diabetes management.

Amperometric glucose sensors: sources of error and potential benefit of redundancy

Amperometric glucose sensors have advanced the care of patients with diabetes and are being studied to control insulin delivery in the research setting. However, at times, currently available sensors demonstrate suboptimal accuracy, which can result from calibration error, sensor drift, or lag. Inaccuracy can be particularly problematic in a closed-loop glycemic control system. In such a system, the use of two sensors allows selection of the more accurate sensor as the input to the controller. In our studies in subjects with type 1 diabetes, the accuracy of the better of two sensors significantly exceeded the accuracy of a single, randomly selected sensor. If an array with three or more sensors were available, it would likely allow even better accuracy with the use of voting.

Individuals achieve more accurate results with meters that are codeless and employ dynamic electrochemistry

BACKGROUND

Studies have shown that controlling blood glucose can reduce the onset and progression of the long-term microvascular and neuropathic complications associated with the chronic course of diabetes mellitus. Improved glycemic control can be achieved by frequent testing combined with changes in medication, exercise, and diet. Technological advancements have enabled improvements in analytical accuracy of meters, and this paper explores two such parameters to which that accuracy can be attributed.

METHODS

Four blood glucose monitoring systems (with or without dynamic electrochemistry algorithms, codeless or requiring coding prior to testing) were evaluated and compared with respect to their accuracy.

RESULTS

Altogether, 108 blood glucose values were obtained for each system from 54 study participants and compared with the reference values. The analysis depicted in the International Organization for Standardization table format indicates that the devices with dynamic electrochemistry and the codeless feature had the highest proportion of acceptable results overall (System A, 101/103). Results were significant when compared at the 10% bias level with meters that were codeless and utilized static electrochemistry (p = .017) or systems that had static electrochemistry but needed coding (p = .008).

CONCLUSIONS

Analytical performance of these blood glucose meters differed significantly depending on their technologic features. Meters that utilized dynamic electrochemistry and did not require coding were more accurate than meters that used static electrochemistry or required coding.

Sensor calibration models for a non-invasive blood glucose measurement sensor

A calibration model was developed for a noninvasive blood glucose sensor, to determine how the blood glucose data measured by this sensor is related to blood glucose data measured with laboratory capillary finger sticks and to corrupting noise. The variability of calibration models for different patients was analyzed as well as the dynamics of the non-invasive blood glucose sensor according to reference blood glucose measurements and corrupting noise.

Modeling the error of continuous glucose monitoring sensor data: critical aspects discussed through simulation studies

BACKGROUND

Knowing the statistical properties of continuous glucose monitoring (CGM) sensor errors can be important in several practical applications, e.g., in both open- and closed-loop control algorithms. Unfortunately, modeling the accuracy of CGM sensors is very difficult for both experimental and methodological reasons. It has been suggested that the time series of CGM sensor errors can be described as realization of the output of an autoregressive (AR) model of first order driven by a white noise process. The AR model was identified exploiting several reference blood glucose (BG) samples (collected frequently in parallel to the CGM signal), a procedure to recalibrate CGM data, and a linear time-invariant model of blood-to-interstitium glucose (BG-to-IG) kinetics. By resorting to simulation, this work shows that some assumptions made in the Breton and Kovatchev modeling approach may significantly affect the estimated sensor error and its statistical properties.

METHOD

Three simulation studies were performed. The first simulation was devoted to assessing the influence of CGM data recalibration, whereas the second and third simulations examined the role of the BG-to-IG kinetic model. Analysis was performed by comparing the "original" (synthetically generated) time series of sensor errors vs its "reconstructed" version in both time and frequency domains.

RESULTS

Even small errors either in CGM data recalibration or in the description of BG-to-IG dynamics can severely affect the possibility of correctly reconstructing the statistical properties of sensor error. In particular, even if CGM sensor error is a white noise process, a spurious correlation among its samples originates from suboptimal recalibration or from imperfect knowledge of the BG-to-IG kinetics.

CONCLUSIONS

Modeling the statistical properties of CGM sensor errors from data collected in vivo is difficult because it requires perfect calibration and perfect knowledge of BG-to-IG dynamics. Results suggest that correct characterization of CGM sensor error is still an open issue and requires further development upon the pioneering contribution of Breton and Kovatchev.

Accuracy of a new real-time continuous glucose monitoring algorithm

BACKGROUND

Through minimally invasive sensor-based continuous glucose monitoring (CGM), individuals can manage their blood glucose (BG) levels more aggressively, thereby improving their hemoglobin A1c level, while reducing the risk of hypoglycemia. Tighter glycemic control through CGM, however, requires an accurate glucose sensor and calibration algorithm with increased performance at lower BG levels.

METHODS

Sensor and BG measurements for 72 adult and adolescent subjects were obtained during the course of a 26-week multicenter study evaluating the efficacy of the Paradigm REAL-Time (PRT) sensor-augmented pump system (Medtronic Diabetes, Northridge, CA) in an outpatient setting. Subjects in the study arm performed at least four daily finger stick measurements. A retrospective analysis of the data set was performed to evaluate a new calibration algorithm utilized in the Paradigm Veo insulin pump (Medtronic Diabetes) and to compare these results to performance metrics calculated for the PRT.

RESULTS

A total of N = 7193 PRT sensor downloads for 3 days of use, as well as 90,472 temporally and nonuniformly paired data points (sensor and meter values), were evaluated, with 5841 hypoglycemic and 15,851 hyperglycemic events detected through finger stick measurements. The Veo calibration algorithm decreased the overall mean absolute relative difference by greater than 0.25 to 15.89%, with hypoglycemia sensitivity increased from 54.9% in the PRT to 82.3% in the Veo (90.5% with predictive alerts); however, hyperglycemia sensitivity was decreased only marginally from 86% in the PRT to 81.7% in the Veo.

CONCLUSIONS

The Veo calibration algorithm, with sensor error reduced significantly in the 40- to 120-mg/dl range, improves hypoglycemia detection, while retaining accuracy at high glucose levels.

A calibration method for nanowire biosensors to suppress device-to-device variation

Nanowire/nanotube biosensors have stimulated significant interest; however, the inevitable device-to-device variation in the biosensor performance remains a great challenge. We have developed an analytical method to calibrate nanowire biosensor responses that can suppress the device-to-device variation in sensing response significantly. The method is based on our discovery of a strong correlation between the biosensor gate dependence (dI(ds)/dV(g)) and the absolute response (absolute change in current, DeltaI). In(2)O(3) nanowire-based biosensors for streptavidin detection were used as the model system. Studying the liquid gate effect and ionic concentration dependence of strepavidin sensing indicates that electrostatic interaction is the dominant mechanism for sensing response. Based on this sensing mechanism and transistor physics, a linear correlation between the absolute sensor response (DeltaI) and the gate dependence (dI(ds)/dV(g)) is predicted and confirmed experimentally. Using this correlation, a calibration method was developed where the absolute response is divided by dI(ds)/dV(g) for each device, and the calibrated responses from different devices behaved almost identically. Compared to the common normalization method (normalization of the conductance/resistance/current by the initial value), this calibration method was proven advantageous using a conventional transistor model. The method presented here substantially suppresses device-to-device variation, allowing the use of nanosensors in large arrays.

Miniaturization of EISCAP sensor for triglyceride detection

In this paper we discuss the fabrication and characterization of miniaturized triglyceride biosensors on crystalline silicon and porous silicon (PS) substrates. The sensors are miniaturized Electrolyte Insulator Semiconductor Capacitors (mini-EISCAPs), which primarily sense the pH variation of the electrolyte used. The lipase enzyme, which catalyses the hydrolysis of triglycerides, was immobilized on the sensor surface. Triglyceride solutions introduced into the enzyme immobilized sensor produced butyric acid which causes the change in pH of the electrolyte. Miniaturized EISCAP sensors were fabricated using bulk micromachining technique and have silicon nitride as the pH sensitive dielectric layer. The sensors are cubical pits of dimensions 1,500 microm x 1,500 microm x 100 microm which can hold an electrolyte volume of 0.1 microl. The pH changes in the solution can be sensed through the EISCAP sensors by monitoring the flatband voltage shift in the Capacitance-Voltage (C-V) characteristics taken during the course of the reaction. The reaction rate is found to be quite high in the miniature cells when compared to the sensors of bigger dimensions.