101
|
Klonoff DC, Parkes JL, Kovatchev BP, Kerr D, Bevier WC, Brazg RL, Christiansen M, Bailey TS, Nichols JH, Kohn MA. Investigation of the Accuracy of 18 Marketed Blood Glucose Monitors. Diabetes Care 2018; 41:1681-1688. [PMID: 29898901 DOI: 10.2337/dc17-1960] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 05/03/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Cleared blood glucose monitors (BGMs) for personal use may not always deliver levels of accuracy currently specified by international and U.S. regulatory bodies. This study's objective was to assess the accuracy of 18 such systems cleared by the U.S. Food and Drug Administration representing approximately 90% of commercially available systems used from 2013 to 2015. RESEARCH DESIGN AND METHODS A total of 1,035 subjects were recruited to have a capillary blood glucose (BG) level measured on six different systems and a reference capillary sample prepared for plasma testing at a reference laboratory. Products were obtained from consumer outlets and tested in three triple-blinded studies. Each of the three participating clinical sites tested a different set of six systems for each of the three studies in a round-robin. In each study, on average, a BGM was tested on 115 subjects. A compliant BG result was defined as within 15% of a reference plasma value (for BG ≥100 mg/dL [5.55 mmol/L]) or within 15 mg/dL (0.83 mmol/L) (for BG <100 mg/dL [5.55 mmol/L]). The proportion of compliant readings in each study was compared against a predetermined accuracy standard similar to, but more lenient than, current regulatory standards. Other metrics of accuracy included the overall compliance proportion; the proportion of extreme outlier readings differing from the reference value by >20%; modified Bland-Altman analysis including average bias, coefficient of variation, and 95% limits of agreement; and proportion of readings with no clinical risk as determined by the Surveillance Error Grid. RESULTS The different accuracy metrics produced almost identical BGM rankings. Six of the 18 systems met the predetermined accuracy standard in all three studies, 5 systems met it in two studies, and 3 met it in one study. Four BGMs did not meet the accuracy standard in any of the three studies. CONCLUSIONS Cleared BGMs do not always meet the level of analytical accuracy currently required for regulatory clearance. This information could assist patients, professionals, and payers in choosing products and regulators in evaluating postclearance performance.
Collapse
Affiliation(s)
- David C Klonoff
- Mills-Peninsula Medical Center, Diabetes Research Institute, San Mateo, CA
| | | | - Boris P Kovatchev
- Center for Diabetes Technology, University of Virginia, Charlottesville, VA
| | - David Kerr
- William Sansum Diabetes Center, Santa Barbara, CA
| | | | | | | | | | | | - Michael A Kohn
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| |
Collapse
|
102
|
Zhang J, Lu Y. Biocomputing for Portable, Resettable, and Quantitative Point-of-Care Diagnostics: Making the Glucose Meter a Logic-Gate Responsive Device for Measuring Many Clinically Relevant Targets. Angew Chem Int Ed Engl 2018; 57:9702-9706. [PMID: 29893502 PMCID: PMC6261302 DOI: 10.1002/anie.201804292] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/30/2018] [Indexed: 12/19/2022]
Abstract
It is recognized that biocomputing can provide intelligent solutions to complex biosensing projects. However, it remains challenging to transform biomolecular logic gates into convenient, portable, resettable and quantitative sensing systems for point-of-care (POC) diagnostics in a low-resource setting. To overcome these limitations, the first design of biocomputing on personal glucose meters (PGMs) is reported, which utilizes glucose and the reduced form of nicotinamide adenine dinucleotide as signal outputs, DNAzymes and protein enzymes as building blocks, and demonstrates a general platform for installing logic-gate responses (YES, NOT, INHIBIT, NOR, NAND, and OR) to a variety of biological species, such as cations (Na+ ), anions (citrate), organic metabolites (adenosine diphosphate and adenosine triphosphate) and enzymes (pyruvate kinase, alkaline phosphatase, and alcohol dehydrogenases). A concatenated logical gate platform that is resettable is also demonstrated. The system is highly modular and can be generally applied to POC diagnostics of many diseases, such as hyponatremia, hypernatremia, and hemolytic anemia. In addition to broadening the clinical applications of the PGM, the method reported opens a new avenue in biomolecular logic gates for the development of intelligent POC devices for on-site applications.
Collapse
Affiliation(s)
- Jingjing Zhang
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana IL 61801 (USA),
| | - Yi Lu
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana IL 61801 (USA),
| |
Collapse
|
103
|
Giordanengo A, Øzturk P, Hansen AH, Årsand E, Grøttland A, Hartvigsen G. Design and Development of a Context-Aware Knowledge-Based Module for Identifying Relevant Information and Information Gaps in Patients With Type 1 Diabetes Self-Collected Health Data. JMIR Diabetes 2018; 3:e10431. [PMID: 30291097 PMCID: PMC6238884 DOI: 10.2196/10431] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 11/30/2022] Open
Abstract
Background Patients with diabetes use an increasing number of self-management tools in their daily life. However, health institutions rarely use the data generated by these services mainly due to (1) the lack of data reliability, and (2) medical workers spending too much time extracting relevant information from the vast amount of data produced. This work is part of the FullFlow project, which focuses on self-collected health data sharing directly between patients’ tools and EHRs. Objective The main objective is to design and implement a prototype for extracting relevant information and documenting information gaps from self-collected health data by patients with type 1 diabetes using a context-aware approach. The module should permit (1) clinicians to assess the reliability of the data and to identify issues to discuss with their patients, and (2) patients to understand the implication their lifestyle has on their disease. Methods The identification of context and the design of the system relied on (1) 2 workshops in which the main author participated, 1 patient with type 1 diabetes, and 1 clinician, and (2) a co-design session involving 5 patients with type 1 diabetes and 4 clinicians including 2 endocrinologists and 2 diabetes nurses. The software implementation followed a hybrid agile and waterfall approach. The testing relied on load, and black and white box methods. Results We created a context-aware knowledge-based module able to (1) detect potential errors, and information gaps from the self-collected health data, (2) pinpoint relevant data and potential causes of noticeable medical events, and (3) recommend actions to follow to improve the reliability of the data issues and medical issues to be discussed with clinicians. The module uses a reasoning engine following a hypothesize-and-test strategy built on a knowledge base and using contextual information. The knowledge base contains hypotheses, rules, and plans we defined with the input of medical experts. We identified a large set of contextual information: emotional state (eg, preferences, mood) of patients and medical workers, their relationship, their metadata (eg, age, medical specialty), the time and location of usage of the system, patient-collected data (eg, blood glucose, basal-bolus insulin), patients’ goals and medical standards (eg, insulin sensitivity factor, in range values). Demonstrating the usage of the system revealed that (1) participants perceived the system as useful and relevant for consultation, and (2) the system uses less than 30 milliseconds to treat new cases. Conclusions Using a knowledge-based system to identify anomalies concerning the reliability of patients’ self-collected health data to provide information on potential information gaps and to propose relevant medical subjects to discuss or actions to follow could ease the introduction of self-collected health data into consultation. Combining this reasoning engine and the system of the FullFlow project could improve the diagnostic process in health care.
Collapse
Affiliation(s)
- Alain Giordanengo
- Department of Computer Science, The University of Tromsø - The Arctic University of Norway, Tromsø, Norway.,Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Pinar Øzturk
- Department of Computer Science, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Helen Hansen
- Centre for Quality Improvement and Development, University Hospital of North Norway, Tromsø, Norway.,Department of Community Medicine, The University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Eirik Årsand
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, The University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Astrid Grøttland
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Gunnar Hartvigsen
- Department of Computer Science, The University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
104
|
Zhang J, Lu Y. Biocomputing for Portable, Resettable, and Quantitative Point-of-Care Diagnostics: Making the Glucose Meter a Logic-Gate Responsive Device for Measuring Many Clinically Relevant Targets. Angew Chem Int Ed Engl 2018. [DOI: 10.1002/ange.201804292] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Jingjing Zhang
- Department of Chemistry, Beckman Institute for Advanced Science and Technology; University of Illinois at Urbana-Champaign; Urbana IL 61801 USA
| | - Yi Lu
- Department of Chemistry, Beckman Institute for Advanced Science and Technology; University of Illinois at Urbana-Champaign; Urbana IL 61801 USA
| |
Collapse
|
105
|
Coors SM, Cousin JJ, Hagan JL, Kaiser JR. Prophylactic Dextrose Gel Does Not Prevent Neonatal Hypoglycemia: A Quasi-Experimental Pilot Study. J Pediatr 2018; 198:156-161. [PMID: 29605395 DOI: 10.1016/j.jpeds.2018.02.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/30/2018] [Accepted: 02/09/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To test the hypothesis that prophylactic dextrose gel administered to newborn infants at risk for hypoglycemia will increase the initial blood glucose concentration after the first feeding and decrease neonatal intensive care unit (NICU) admissions for treatment of asymptomatic neonatal hypoglycemia compared with feedings alone. STUDY DESIGN This quasi-experimental study allocated asymptomatic at-risk newborn infants (late preterm, birth weight <2500 or >4000 g, and infants of mothers with diabetes) to receive prophylactic dextrose gel (Insta-Glucose; Valeant Pharmaceuticals North America LLC, Bridgewater, New Jersey); other at-risk infants formed the control group. After the initial feeding, the prophylactic group received dextrose gel (0.5 mL/kg) rubbed into the buccal mucosa. The blood glucose concentration was checked 30 minutes later. Initial glucose concentrations and rate of NICU admissions were compared between the prophylactic group and controls using bivariate analyses. A multivariable linear regression compared first glucose concentrations between groups, adjusting for at-risk categories and age at first glucose concentration. RESULTS There were 236 subjects (72 prophylactic, 164 controls). The first glucose concentration was not different between the prophylactic and control groups in bivariate analysis (52.1 ± 17.1 vs 50.5 ± 15.3 mg/dL, P = .69) and after adjusting for covariates (P = .18). Rates of NICU admission for treatment of transient neonatal hypoglycemia were 9.7% and 14.6%, respectively (P = .40). CONCLUSIONS Prophylactic dextrose gel did not reduce transient neonatal hypoglycemia or NICU admissions for hypoglycemia. The carbohydrate concentration of Insta-Glucose (77%) may have caused a hyperinsulinemic response, or alternatively, exogenous enteral dextrose influences glucose homeostasis minimally during the first few hours when counter-regulatory mechanisms are especially active. TRIAL REGISTRATION ClinicalTrials.gov: NCT02523222.
Collapse
Affiliation(s)
- Sarah M Coors
- Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Houston, TX.
| | - Joshua J Cousin
- Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Houston, TX
| | - Joseph L Hagan
- Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Houston, TX
| | - Jeffrey R Kaiser
- Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Houston, TX; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX
| |
Collapse
|
106
|
Fast and simple glucose assay based on filter paper as enzymes carrier using phone camera detection. CHEMICAL PAPERS 2018. [DOI: 10.1007/s11696-018-0527-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
107
|
El-Maiss J, Cuccarese M, Maerten C, Lupattelli P, Chiummiento L, Funicello M, Schaaf P, Jierry L, Boulmedais F. Mussel-Inspired Electro-Cross-Linking of Enzymes for the Development of Biosensors. ACS APPLIED MATERIALS & INTERFACES 2018; 10:18574-18584. [PMID: 29799715 DOI: 10.1021/acsami.8b04764] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In medical diagnosis and environmental monitoring, enzymatic biosensors are widely applied because of their high sensitivity, potential selectivity, and their possibility of miniaturization/automation. Enzyme immobilization is a critical process in the development of this type of biosensors with the necessity to avoid the denaturation of the enzymes and ensuring their accessibility toward the analyte. Electrodeposition of macromolecules is increasingly considered to be the most suitable method for the design of biosensors. Being simple and attractive, it finely controls the immobilization of enzymes on electrode surfaces, usually by entrapment or adsorption, using an electrical stimulus. Performed manually, enzyme immobilization by cross-linking prevents enzyme leaching and was never done using an electrochemical stimulus. In this work, we present a mussel-inspired electro-cross-linking process using glucose oxidase (GOX) and a homobifunctionalized catechol ethylene oxide spacer as a cross-linker in the presence of ferrocene methanol (FC) acting as a mediator of the buildup. Performed in one pot, the process takes place in three steps: (i) electro-oxidation of FC, by the application of cyclic voltammetry, creating a gradient of ferrocenium (FC+); (ii) oxidation of bis-catechol into a bis-quinone molecule by reaction with the electrogenerated FC+; and (iii) a chemical reaction of bis-quinone with free amino moieties of GOX through Michael addition and a Schiff's base condensation reaction. Employed for the design of a second-generation glucose biosensor using ferrocene methanol (FC) as a mediator, this new enzyme immobilization process presents several advantages. The cross-linked enzymatic film (i) is obtained in a one-pot process with nonmodified GOX, (ii) is strongly linked to the metallic electrode surface thanks to catechol moieties, and (iii) presents no leakage issues. The developed GOX/bis-catechol film shows a good response to glucose with a quite wide linear range from 1.0 to 12.5 mM as well as a good sensitivity (0.66 μA/mM cm2) and a high selectivity to glucose. These films would distinguish between healthy (3.8 and 6.5 mM) and hyperglycemic subjects (>7 mM). Finally, we show that this electro-cross-linking process allows the development of miniaturized biosensors through the functionalization of a single electrode out of a microelectrode array. Elegant and versatile, this electro-cross-linking process can also be used for the development of enzymatic biofuel cells.
Collapse
Affiliation(s)
- Janwa El-Maiss
- Université de Strasbourg, CNRS, Institut Charles Sadron UPR 22 , 67034 Strasbourg , France
| | - Marco Cuccarese
- Université de Strasbourg, CNRS, Institut Charles Sadron UPR 22 , 67034 Strasbourg , France
- Dipartimento di Scienze , Università degli Studi della Basilicata , 85100 Potenza , Italy
| | - Clément Maerten
- Université de Strasbourg, CNRS, Institut Charles Sadron UPR 22 , 67034 Strasbourg , France
| | - Paolo Lupattelli
- Université de Strasbourg, CNRS, Institut Charles Sadron UPR 22 , 67034 Strasbourg , France
- Dipartimento di Scienze , Università degli Studi della Basilicata , 85100 Potenza , Italy
| | - Lucia Chiummiento
- Dipartimento di Scienze , Università degli Studi della Basilicata , 85100 Potenza , Italy
| | - Maria Funicello
- Dipartimento di Scienze , Università degli Studi della Basilicata , 85100 Potenza , Italy
| | - Pierre Schaaf
- Université de Strasbourg, CNRS, Institut Charles Sadron UPR 22 , 67034 Strasbourg , France
- Ecole de Chimie, Polymères et Matériaux , Université de Strasbourg , 67087 Strasbourg , France
- University of Strasbourg Institute of Advanced Study , 67083 Strasbourg , France
- Biomatériaux et Bioingénierie , Institut National de la Santé et de la Recherche Médicale, UMR-S 1121 , 67087 Strasbourg , France
- Faculté de Chirurgie Dentaire, Fédération de Médecine Translationnelle de Strasbourg (FMTS), and Fédération des Matériaux et Nanoscience d'Alsace (FMNA) , Université de Strasbourg , 67000 Strasbourg , France
- International Center for Frontier Research in Chemistry , 67083 Strasbourg , France
| | - Loïc Jierry
- Université de Strasbourg, CNRS, Institut Charles Sadron UPR 22 , 67034 Strasbourg , France
- Ecole de Chimie, Polymères et Matériaux , Université de Strasbourg , 67087 Strasbourg , France
| | - Fouzia Boulmedais
- Université de Strasbourg, CNRS, Institut Charles Sadron UPR 22 , 67034 Strasbourg , France
- University of Strasbourg Institute of Advanced Study , 67083 Strasbourg , France
| |
Collapse
|
108
|
van Enter BJ, von Hauff E. Challenges and perspectives in continuous glucose monitoring. Chem Commun (Camb) 2018; 54:5032-5045. [PMID: 29687110 DOI: 10.1039/c8cc01678j] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
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.
Collapse
Affiliation(s)
- Benjamin Jasha van Enter
- Physics of Energy Department of Physics and Astronomy, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.
| | | |
Collapse
|
109
|
Khatun A, Waters DL, Liu L. Optimization of an In Vitro Starch Digestibility Assay for Rice. STARCH-STARKE 2018. [DOI: 10.1002/star.201700340] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Amina Khatun
- Southern Cross Plant Science; Southern Cross University; Lismore NSW 2480 Australia
| | - Daniel L.E. Waters
- Southern Cross Plant Science; Southern Cross University; Lismore NSW 2480 Australia
- ARCITTC for Functional Grains; Charles Sturt University; Wagga Wagga NSW 2650 Australia
| | - Lei Liu
- Southern Cross Plant Science; Southern Cross University; Lismore NSW 2480 Australia
| |
Collapse
|
110
|
Hoekstra R, Blondeau P, Andrade FJ. Distributed electrochemical sensors: recent advances and barriers to market adoption. Anal Bioanal Chem 2018; 410:4077-4089. [PMID: 29806065 DOI: 10.1007/s00216-018-1104-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/16/2018] [Accepted: 04/23/2018] [Indexed: 02/07/2023]
Abstract
Despite predictions of their widespread application in healthcare and environmental monitoring, electrochemical sensors are yet to be distributed at scale, instead remaining largely confined to R&D labs. This contrasts sharply with the situation for physical sensors, which are now ubiquitous and seamlessly embedded in the mature ecosystem provided by electronics and connectivity protocols. Although chemical sensors could be integrated into the same ecosystem, there are fundamental issues with these sensors in the three key areas of analytical performance, usability, and affordability. Nevertheless, advances are being made in each of these fields, leading to hope that the deployment of automated and user-friendly low-cost electrochemical sensors is on the horizon. Here, we present a brief survey of key challenges and advances in the development of distributed electrochemical sensors for liquid samples, geared towards applications in healthcare and wellbeing, environmental monitoring, and homeland security. As will be seen, in many cases the analytical performance of the sensor is acceptable; it is usability that is the major barrier to commercial viability at this moment. Were this to be overcome, the issue of affordability could be addressed. Graphical Abstract ᅟ.
Collapse
Affiliation(s)
- Rafael Hoekstra
- Department of Analytical Chemistry and Organic Chemistry, Universitat Rovira i Virgili, Campus Sescelades, c/. Marcel·lí Domingo, 1, 43007, Tarragona, Spain
| | - Pascal Blondeau
- Department of Analytical Chemistry and Organic Chemistry, Universitat Rovira i Virgili, Campus Sescelades, c/. Marcel·lí Domingo, 1, 43007, Tarragona, Spain
| | - Francisco J Andrade
- Department of Analytical Chemistry and Organic Chemistry, Universitat Rovira i Virgili, Campus Sescelades, c/. Marcel·lí Domingo, 1, 43007, Tarragona, Spain.
| |
Collapse
|
111
|
Li FF, Xie Y, Shi BY, Niu M, Guo H, Cao Y, Liu BL, Yan RN, Su XF, Wu JD, Zhang DF, Chen LM, Ma JH. The real world of blood glucose point-of-care testing (POCT) system running in China teaching hospital. Expert Rev Med Devices 2018; 15:445-451. [PMID: 29737214 DOI: 10.1080/17434440.2018.1473031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The blood glucose point-of-care testing (POCT) system is important in the decision-making process involving patients suspected of having hypoglycemia. To investigate the real world of the POCT system being used in teaching hospitals in China. METHODS The survey was conducted by Hisend Research Group from May 2015 to July 2015 in four teaching hospitals in China. The survey questions were referred to the ISO 15197:2013 standard requirements for the use of the POCT system in a hospital setting. RESULTS A total of 170 subjects were included from 4 hospitals, which included nursing staff, nurse unit managers, employees from the department of medical instruments, and staff members employed by the clinical laboratories in the Tianjin Metabolism Hospital, Nanjing First Hospital, First Affiliated Hospital of Dalian Medical University, and the First hospital affiliated with the Xi'an Transportation University. The average score for the four hospitals surveyed in this study was 66.6, which varied from 46.1 to 79.7. The main factors influencing the scores were the multiple choices of blood-glucose meters, and the quality control assessment. CONCLUSION Our data indicates that the real world use of the POCT system in hospital settings in China needs more closer adherence to a quality management framework.
Collapse
Affiliation(s)
- Feng-Fei Li
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Yun Xie
- b 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, Key Laboratory of Hormone and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology , Tianjin Medical University , Tianjin , China
| | - Bing-Yin Shi
- c Department of Endocrinology , First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , Shaanxi , China
| | - Min Niu
- d Department of Endocrinology , First Affiliated Hospital of Dalian Medical University , Dalian , China
| | - Hui Guo
- c Department of Endocrinology , First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , Shaanxi , China
| | - Yan Cao
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Bing-Li Liu
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Reng-Na Yan
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Xiao-Fei Su
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Jin-Dan Wu
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Dan-Feng Zhang
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Li-Ming Chen
- b 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, Key Laboratory of Hormone and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology , Tianjin Medical University , Tianjin , China
| | - Jian-Hua Ma
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| |
Collapse
|
112
|
Clarke SF, Foster JR. A history of blood glucose meters and their role in self-monitoring of diabetes mellitus. Br J Biomed Sci 2018. [DOI: 10.1080/09674845.2012.12002443] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- S. F. Clarke
- History Committee, Institute of Biomedical Science, 12 Coldbath Square, London EC1R 5HL
| | - J. R. Foster
- History Committee, Institute of Biomedical Science, 12 Coldbath Square, London EC1R 5HL
| |
Collapse
|
113
|
Olarte O, Barbé K. Fractional models in electrical impedance spectroscopy data for glucose detection. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2017.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
114
|
A Novel Approach to Assess Performance of Glucometer. POINT OF CARE 2017. [DOI: 10.1097/poc.0000000000000150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
115
|
Bajgrowicz-Cieslak M, Alqurashi Y, Elshereif MI, Yetisen AK, Hassan MU, Butt H. Optical glucose sensors based on hexagonally-packed 2.5-dimensional photonic concavities imprinted in phenylboronic acid functionalized hydrogel films. RSC Adv 2017; 7:53916-53924. [PMID: 29308195 PMCID: PMC5708336 DOI: 10.1039/c7ra11184c] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 11/16/2017] [Indexed: 11/21/2022] Open
Abstract
Continuous glucose monitoring aims to achieve accurate control of blood glucose concentration to prevent hypo/hyperglycaemia in diabetic patients. Hydrogel-based systems have emerged as a reusable sensing platform to quantify biomarkers in high-risk patients at clinical and point-of-care settings. The capability to integrate hydrogel-based systems with optical transducers will provide quantitative and colorimetric measurements via spectrophotometric analyses of biomarkers. Here, we created an imprinting method to rapidly produce 2.5D photonic concavities in phenylboronic acid functionalized hydrogel films. Our method exploited diffraction properties of hexagonally-packed 2.5D photonic microscale concavities having a lattice spacing of 3.3 μm. Illumination of the 2.5D hexagonally-packed structure with a monochromatic light source in transmission mode allowed reversible and quantitative measurements of variation in the glucose concentration based on first order lattice interspace tracking. Reversible covalent phenylboronic acid coupling with cis-diols of glucose molecules expanded the hydrogel matrix by ∼2% and 34% in the presence of glucose concentrations of 1 mM and 200 mM, respectively. A Donnan osmotic pressure induced volumetric expansion of the hydrogel matrix due to increasing glucose concentrations (1-200 mM), resulted in a nanoscale modulation of the lattice interspace, and shifted the diffraction angle (∼45° to 36°) as well as the interspacing between the 1st order diffraction spots (∼8 to 3 mm). The sensor exhibited a maximum lattice spacing diffraction shift within a response time of 15 min in a reversible manner. The developed 2.5D photonic sensors may have application in medical point-of-care diagnostics, implantable chips, and wearable continuous glucose monitoring devices.
Collapse
Affiliation(s)
| | - Yousef Alqurashi
- School of Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. ; Tel: +44 (0)121 4158623
| | - Mohamed Ismail Elshereif
- School of Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. ; Tel: +44 (0)121 4158623
| | - Ali K Yetisen
- School of Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. ; Tel: +44 (0)121 4158623
- Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, 65 Landsdowne Street, Cambridge, MA 02139, USA
| | - Muhammad Umair Hassan
- School of Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. ; Tel: +44 (0)121 4158623
- Centre for Micro and Nano Devices, COMSATS Institute of Information Technology, Park Road, Islamabad, 44000, Pakistan
| | - Haider Butt
- School of Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. ; Tel: +44 (0)121 4158623
| |
Collapse
|
116
|
Márquez A, Jiménez-Jorquera C, Domínguez C, Muñoz-Berbel X. Electrodepositable alginate membranes for enzymatic sensors: An amperometric glucose biosensor for whole blood analysis. Biosens Bioelectron 2017; 97:136-142. [DOI: 10.1016/j.bios.2017.05.051] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/10/2017] [Accepted: 05/29/2017] [Indexed: 10/19/2022]
|
117
|
Smolkin T, Ulanovsky I, Carasso P, Makhoul IR. Standards of admission capillary blood glucose levels in cesarean born neonates. World J Pediatr 2017; 13:433-438. [PMID: 28194693 DOI: 10.1007/s12519-017-0016-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 06/17/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neonatal hypoglycemia (NH) and cutoffs remain undefined. Our center screens all cesarean-delivered (CD) neonates for NH. We sought to define standards of admission capillary blood glucose levels (ACBGLs) in CD neonates who were at the lowest risk for hypoglycemia. METHODS Of 4947 neonates, 519 met all 14 inclusion criteria. These highly-selected neonates were apparently the healthiest, least-stressed, earliest to be admitted to nursery and at lowest-risk for hypoglycemia. For each CD, cord blood gases and glucose were determined and each infant was screened for blood glucose at nursery admission. RESULTS Sampling age was 41.6±15.3 minutes, a mean ACBGL of 52.3±10.7 mg/dL, and percentiles as follows: 1st percentile, 29.2; 3rd, 33.6; 5th, 35.0; 10th, 39.0; 25th, 46.0; 50th, 51.0; 75th, 58.0; 90th, 67.0; 95th, 71.0; 97th, 73.0, and 99th, 84.4. ACBGL rose significantly with increasing gestational age (P=0.004), increasing cord blood glucose (P<0.001), decreasing cord blood pH (P<0.001) and decreasing sampling age (P=0.027). CONCLUSIONS Setting uniform ACBGL cutoffs for NH definition is unachievable due to the enormous heterogeneity among newborns. Hence, we provide group-based ACBGL standards in CD neonates. We propose setting ACBGL cutoffs for use in CD neonates: 1) hypoglycemia: ACBGL <5th percentile (<35 mg/dL); and 2) interventional hypoglycemia: ACBGL <1st percentile (<30 mg/dL).
Collapse
Affiliation(s)
- Tatiana Smolkin
- Department of Neonatology, Ruth Rappaport Children's Hospital, Haifa Israel, Rambam Health Care Campus, Bat-Galim, Haifa, 31096, Israel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Irena Ulanovsky
- Department of Neonatology, Ruth Rappaport Children's Hospital, Haifa Israel, Rambam Health Care Campus, Bat-Galim, Haifa, 31096, Israel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Pnina Carasso
- Department of Neonatology, Ruth Rappaport Children's Hospital, Haifa Israel, Rambam Health Care Campus, Bat-Galim, Haifa, 31096, Israel
| | - Imad R Makhoul
- Department of Neonatology, Ruth Rappaport Children's Hospital, Haifa Israel, Rambam Health Care Campus, Bat-Galim, Haifa, 31096, Israel.
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| |
Collapse
|
118
|
Rojekar MV, Kumawat V, Panot J, Khedkar S, Adhe-Rojekar A. Assessment of analytical performance of glucose meter in pediatric age group at tertiary care referral hospital. J Diabetes Metab Disord 2017; 16:38. [PMID: 28924562 PMCID: PMC5598041 DOI: 10.1186/s40200-017-0318-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 08/28/2017] [Indexed: 11/10/2022]
Abstract
Background Glucometers are the excellent tools for self-monitoring of blood glucose (SMBG). They are important especially in the circumstances where continuous monitoring is mandatory and at decision making levels. Tight glycemic control protocols are important for preventing the ill effects of fluctuating glucose levels. This increases the use of glucometers in various healthcare settings. As technology advances, glucometers are getting better in terms of quality of results. But still some lacunae are there. Methods Present study was conducted in the tertiary care referral hospital. One hundred twenty five patients were recruited from pediatric wards. Bland-Altman plot, Parke error grid and Surveillance error grid analysis were used for comparing results of glucose meter with that of standard laboratory method. Results It is found that there is significant difference between the results by two methods. Though minimal but glucose meter results deviate from the results of standard lab method. This will affect the overall patient care especially in emergency conditions. Conclusions This study is the first of its kind as no similar studies have been reported in the pediatric population. For effective use of glucose meter it should give as accurate as possible estimate of actual glucose levels. Results should not only be accurate but also precise without which critical errors may be possible. We recommend that for any glucose meter there should be regular maintenance as well as calibration is to be done. So that agreement with reference laboratory method is maintained and effective medical decisions are made.
Collapse
|
119
|
|
120
|
Tang R, Yang H, Choi JR, Gong Y, You M, Wen T, Li A, Li X, Xu B, Zhang S, Mei Q, Xu F. Capillary blood for point-of-care testing. Crit Rev Clin Lab Sci 2017; 54:294-308. [PMID: 28763247 DOI: 10.1080/10408363.2017.1343796] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Clinically, blood sample analysis has been widely used for health monitoring. In hospitals, arterial and venous blood are utilized to detect various disease biomarkers. However, collection methods are invasive, painful, may result in injury and contamination, and skilled workers are required, making these methods unsuitable for use in a resource-limited setting. In contrast, capillary blood is easily collected by a minimally invasive procedure and has excellent potential for use in point-of-care (POC) health monitoring. In this review, we first discuss the differences among arterial blood, venous blood, and capillary blood in terms of the puncture sites, components, sample volume, collection methods, and application areas. Additionally, we review the most recent advances in capillary blood-based commercial products and microfluidic instruments for various applications. We also compare the accuracy of microfluidic-based testing with that of laboratory-based testing for capillary blood-based disease diagnosis at the POC. Finally, we discuss the challenges and future perspectives for developing capillary blood-based POC instruments.
Collapse
Affiliation(s)
- Ruihua Tang
- a School of Life Sciences , Northwestern Polytechnical University , Xi'an , P.R. China.,b Key Laboratory for Space Bioscience and Biotechnology , Northwestern Polytechnical University , Xi'an , P.R. China.,c Bioinspired Engineering and Biomechanics Center (BEBC) , Xi'an Jiaotong University , Xi'an , P.R. China.,d College of Bioresources Chemical and Materials Engineering , Shaanxi University of Science and Technology , Xi'an , China
| | - Hui Yang
- a School of Life Sciences , Northwestern Polytechnical University , Xi'an , P.R. China.,b Key Laboratory for Space Bioscience and Biotechnology , Northwestern Polytechnical University , Xi'an , P.R. China
| | - Jane Ru Choi
- c Bioinspired Engineering and Biomechanics Center (BEBC) , Xi'an Jiaotong University , Xi'an , P.R. China
| | - Yan Gong
- c Bioinspired Engineering and Biomechanics Center (BEBC) , Xi'an Jiaotong University , Xi'an , P.R. China.,e The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology , Xi'an Jiaotong University , Xi'an , P.R. China.,f Xi'an Diandi Biotech Company , Xi'an , P.R. China
| | - MinLi You
- c Bioinspired Engineering and Biomechanics Center (BEBC) , Xi'an Jiaotong University , Xi'an , P.R. China.,e The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology , Xi'an Jiaotong University , Xi'an , P.R. China
| | - Ting Wen
- f Xi'an Diandi Biotech Company , Xi'an , P.R. China
| | - Ang Li
- g Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology , Xi'an Jiaotong University , Xi'an , P.R. China
| | - XiuJun Li
- h Department of Chemistry , University of Texas at El Paso , El Paso , TX , USA
| | - Bo Xu
- i School of Finance and Economics , Xi'an Jiaotong University , Xi'an , P.R. China
| | - Sufeng Zhang
- d College of Bioresources Chemical and Materials Engineering , Shaanxi University of Science and Technology , Xi'an , China
| | - Qibing Mei
- a School of Life Sciences , Northwestern Polytechnical University , Xi'an , P.R. China.,b Key Laboratory for Space Bioscience and Biotechnology , Northwestern Polytechnical University , Xi'an , P.R. China
| | - Feng Xu
- c Bioinspired Engineering and Biomechanics Center (BEBC) , Xi'an Jiaotong University , Xi'an , P.R. China.,e The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology , Xi'an Jiaotong University , Xi'an , P.R. China
| |
Collapse
|
121
|
Lopes JH, Colson FX, Barralet JE, Merle G. Electrically wired enzyme/TiO2 composite for glucose detection. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 76:991-996. [DOI: 10.1016/j.msec.2017.03.113] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 01/17/2017] [Accepted: 03/15/2017] [Indexed: 11/27/2022]
|
122
|
Riddell MC, Gallen IW, Smart CE, Taplin CE, Adolfsson P, Lumb AN, Kowalski A, Rabasa-Lhoret R, McCrimmon RJ, Hume C, Annan F, Fournier PA, Graham C, Bode B, Galassetti P, Jones TW, Millán IS, Heise T, Peters AL, Petz A, Laffel LM. Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol 2017; 5:377-390. [PMID: 28126459 DOI: 10.1016/s2213-8587(17)30014-1] [Citation(s) in RCA: 488] [Impact Index Per Article: 69.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 11/20/2016] [Accepted: 11/21/2016] [Indexed: 12/28/2022]
Abstract
Type 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of different forms of physical activity is particularly difficult for both the individual with type 1 diabetes and the health-care provider. People with type 1 diabetes tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass nor achieving the minimum amount of moderate to vigorous aerobic activity per week. Regular exercise can improve health and wellbeing, and can help individuals to achieve their target lipid profile, body composition, and fitness and glycaemic goals. However, several additional barriers to exercise can exist for a person with diabetes, including fear of hypoglycaemia, loss of glycaemic control, and inadequate knowledge around exercise management. This Review provides an up-to-date consensus on exercise management for individuals with type 1 diabetes who exercise regularly, including glucose targets for safe and effective exercise, and nutritional and insulin dose adjustments to protect against exercise-related glucose excursions.
Collapse
Affiliation(s)
- Michael C Riddell
- Muscle Health Research Centre, York University, Toronto, ON, Canada.
| | - Ian W Gallen
- Royal Berkshire NHS Foundation Trust Centre for Diabetes and Endocrinology, Royal Berkshire Hospital, Reading, UK
| | - Carmel E Smart
- Hunter Medical Research Institute, School of Health Sciences, University of Newcastle, Rankin Park, NSW, Australia
| | - Craig E Taplin
- Division of Endocrinology and Diabetes, Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, WA, USA
| | - Peter Adolfsson
- Department of Pediatrics, The Hospital of Halland, Kungsbacka, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alistair N Lumb
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK
| | - Aaron Kowalski
- Juvenile Diabetes Research Foundation, New York, NY, USA
| | - Remi Rabasa-Lhoret
- Department of Nutrition and Institut de Recherches Cliniques de Montréal, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Rory J McCrimmon
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK
| | | | - Francesca Annan
- Children and Young People's Diabetes Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - Paul A Fournier
- School of Sport Science, Exercise, and Health, Perth, WA, Australia
| | | | - Bruce Bode
- Atlanta Diabetes Associates, Atlanta, GA, USA
| | - Pietro Galassetti
- Department of Pediatrics, University of California Irvine, Irvine, CA, USA; AstraZeneca, Gaithersburg, MD, USA
| | - Timothy W Jones
- The University of Western Australia, Perth, WA, Australia; Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, WA, Australia; Telethon Kids Institute, Perth, WA, Australia
| | - Iñigo San Millán
- Department of Physical Medicine and Rehabilitation, University of Colorado, School of Medicine, Aurora, CO, USA
| | | | - Anne L Peters
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Lori M Laffel
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA; Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, MA, USA
| |
Collapse
|
123
|
Ekhlaspour L, Mondesir D, Lautsch N, Balliro C, Hillard M, Magyar K, Radocchia LG, Esmaeili A, Sinha M, Russell SJ. Comparative Accuracy of 17 Point-of-Care Glucose Meters. J Diabetes Sci Technol 2017; 11:558-566. [PMID: 27697848 PMCID: PMC5505415 DOI: 10.1177/1932296816672237] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The accuracy of point-of-care blood glucose (BG) meters is important for the detection of dysglycemia, calculation of insulin doses, and the calibration of continuous glucose monitors. The objective of this study was to compare the accuracy of commercially available glucose meters in a challenging laboratory study using samples with a wide range of reference BG and hemoglobin values. METHODS Fresh, discarded blood samples from a hospital STAT laboratory were either used without modification, spiked with a glucose solution, or incubated at 37°C to produce 347 samples with an even distribution across reference BG levels from 20 to 440 mg/dl and hemoglobin values from 9 to 16 g/dl. We measured the BG of each sample with 17 different commercially available glucose meters and the reference method (YSI 2300) at the same time. We determined the mean absolute relative difference (MARD) for each glucose meter, overall and stratified by reference BG and by hemoglobin level. RESULTS The accuracy of different meters widely, exhibiting a range of MARDs from 5.6% to 20.8%. Accuracy was lower in the hypoglycemic range, but was not consistently lower in samples with anemic blood hemoglobin levels. CONCLUSIONS The accuracy of commercially available glucose meters varies widely. Although the sample mix in this study was much more challenging than those that would be collected under most use conditions, some meters were robust to these challenges and exhibited high accuracy in this setting. These data on relative accuracy and robustness to challenging samples may be useful in informing the choice of a glucose meter.
Collapse
Affiliation(s)
- Laya Ekhlaspour
- Massachusetts General Hospital Diabetes Research Center, Boston, MA, USA
| | - Debbie Mondesir
- Massachusetts General Hospital Diabetes Research Center, Boston, MA, USA
| | - Norman Lautsch
- Massachusetts General Hospital Diabetes Research Center, Boston, MA, USA
| | - Courtney Balliro
- Massachusetts General Hospital Diabetes Research Center, Boston, MA, USA
| | - Mallory Hillard
- Massachusetts General Hospital Diabetes Research Center, Boston, MA, USA
| | - Kendra Magyar
- Massachusetts General Hospital Diabetes Research Center, Boston, MA, USA
| | | | - Aryan Esmaeili
- Massachusetts General Hospital Diabetes Research Center, Boston, MA, USA
| | - Manasi Sinha
- Massachusetts General Hospital Diabetes Research Center, Boston, MA, USA
| | - Steven J. Russell
- Massachusetts General Hospital Diabetes Research Center, Boston, MA, USA
| |
Collapse
|
124
|
Chen Q, Fu Y, Zhang W, Ye S, Zhang H, Xie F, Gong L, Wei Z, Jin H, Chen J. Highly sensitive detection of glucose: A quantitative approach employing nanorods assembled plasmonic substrate. Talanta 2017; 165:516-521. [DOI: 10.1016/j.talanta.2016.12.076] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/23/2016] [Accepted: 12/26/2016] [Indexed: 01/28/2023]
|
125
|
Capillary Blood Glucose Meters in the Home, Clinic, and Hospital. POINT OF CARE 2017. [DOI: 10.1097/poc.0000000000000119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
126
|
Bennett KA, Turner LM, Millward S, Moss SEW, Hall AJ. Obtaining accurate glucose measurements from wild animals under field conditions: comparing a hand held glucometer with a standard laboratory technique in grey seals. CONSERVATION PHYSIOLOGY 2017; 5:cox013. [PMID: 28413683 PMCID: PMC5386009 DOI: 10.1093/conphys/cox013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/18/2017] [Accepted: 01/30/2017] [Indexed: 05/30/2023]
Abstract
Glucose is an important metabolic fuel and circulating levels are tightly regulated in most mammals, but can drop when body fuel reserves become critically low. Glucose is mobilized rapidly from liver and muscle during stress in response to increased circulating cortisol. Blood glucose levels can thus be of value in conservation as an indicator of nutritional status and may be a useful, rapid assessment marker for acute or chronic stress. However, seals show unusual glucose regulation: circulating levels are high and insulin sensitivity is limited. Accurate blood glucose measurement is therefore vital to enable meaningful health and physiological assessments in captive, wild or rehabilitated seals and to explore its utility as a marker of conservation relevance in these animals. Point-of-care devices are simple, portable, relatively cheap and use less blood compared with traditional sampling approaches, making them useful in conservation-related monitoring. We investigated the accuracy of a hand-held glucometer for 'instant' field measurement of blood glucose, compared with blood drawing followed by laboratory testing, in wild grey seals (Halichoerus grypus), a species used as an indicator for Good Environmental Status in European waters. The glucometer showed high precision, but low accuracy, relative to laboratory measurements, and was least accurate at extreme values. It did not provide a reliable alternative to plasma analysis. Poor correlation between methods may be due to suboptimal field conditions, greater and more variable haematocrit, faster erythrocyte settling rate and/or lipaemia in seals. Glucometers must therefore be rigorously tested before use in new species and demographic groups. Sampling, processing and glucose determination methods have major implications for conclusions regarding glucose regulation, and health assessment in seals generally, which is important in species of conservation concern and in development of circulating glucose as a marker of stress or nutritional state for use in management and monitoring.
Collapse
Affiliation(s)
- Kimberley A. Bennett
- Division of Science, School of Science, Engineering and Technology, Abertay University, DundeeDD1 1HG, UK
- Marine Biology and Ecology Research Centre, Plymouth University, Drake Circus, PlymouthPL4 8AA, UK
| | - Lucy M. Turner
- Marine Biology and Ecology Research Centre, Plymouth University, Drake Circus, PlymouthPL4 8AA, UK
| | - Sebastian Millward
- Marine Biology and Ecology Research Centre, Plymouth University, Drake Circus, PlymouthPL4 8AA, UK
| | - Simon E. W. Moss
- NERC Sea Mammal Research Unit, Scottish Oceans Institute, University of St Andrews, St Andrews, FifeKY16 8LB, UK
| | - Ailsa J. Hall
- NERC Sea Mammal Research Unit, Scottish Oceans Institute, University of St Andrews, St Andrews, FifeKY16 8LB, UK
| |
Collapse
|
127
|
Malkani S, Kotwal A. Frequency and Predictors of Self-Reported Hypoglycemia in Insulin-Treated Diabetes. J Diabetes Res 2017; 2017:7425925. [PMID: 28913365 PMCID: PMC5585629 DOI: 10.1155/2017/7425925] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/06/2017] [Indexed: 01/16/2023] Open
Abstract
AIMS Hypoglycemia is a limiting factor for achieving stringent glycemic control in diabetes. This study analyzes the frequency and predictors of hypoglycemia in insulin-treated diabetes in an ambulatory setting. METHODS A retrospective chart review was performed to study self-monitored blood glucose (SMBG) data for 3 months prior to a patient's HbA1c test. RESULTS Hypoglycemia occurred more frequently in type 1 than in type 2 diabetes; however, 19% of type 2 diabetes patients did experience at least one episode of severe hypoglycemia. For type 1 diabetes, hypoglycemia had a positive association with glycemic variability and duration of diabetes and a negative association with HbA1c and lowest blood glucose (BG). For type 2 diabetes, a positive association was noted with glycemic variability and a negative association with age and lowest BG. CONCLUSIONS Delineating factors predisposing to hypoglycemia in type 2 diabetes is difficult. Lower HbA1c is a potential predictor of hypoglycemia in type 1 but not in type 2 diabetes. Longer duration of diabetes for type 1 and younger age for type 2 are associated with more hypoglycemia. Glycemic variability portends increased risk for hypoglycemia and should be a focus of further research.
Collapse
Affiliation(s)
- Samir Malkani
- Division of Diabetes, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Anupam Kotwal
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 First Street SW, Mayo 18, Rochester, MN 55905, USA
- *Anupam Kotwal:
| |
Collapse
|
128
|
Zhang R, Gao F, Feng X, Liu S, Kishor R, Luo Y, Zheng Y. Noninvasive photoacoustic measurement of glucose by data fusion. Analyst 2017; 142:2892-2896. [DOI: 10.1039/c7an00743d] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A novel method of noninvasive photoacoustic glucose measurement utilizing the amplitude and phase difference information.
Collapse
Affiliation(s)
- Ruochong Zhang
- School of Electrical and Electronic Engineering
- Nanyang Technological University
- 639798 Singapore
| | - Fei Gao
- School of Electrical and Electronic Engineering
- Nanyang Technological University
- 639798 Singapore
- School of Information Science and Technology
- ShanghaiTech University
| | - Xiaohua Feng
- School of Electrical and Electronic Engineering
- Nanyang Technological University
- 639798 Singapore
| | - Siyu Liu
- School of Electrical and Electronic Engineering
- Nanyang Technological University
- 639798 Singapore
| | - Rahul Kishor
- School of Electrical and Electronic Engineering
- Nanyang Technological University
- 639798 Singapore
| | - Yunqi Luo
- School of Electrical and Electronic Engineering
- Nanyang Technological University
- 639798 Singapore
| | - Yuanjin Zheng
- School of Electrical and Electronic Engineering
- Nanyang Technological University
- 639798 Singapore
| |
Collapse
|
129
|
Chawla M, Randhawa JK, Siril PF. Calcination temperature as a probe to tune the non-enzymatic glucose sensing activity of Cu–Ni bimetallic nanocomposites. NEW J CHEM 2017. [DOI: 10.1039/c6nj03920k] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A seven-fold increase in the glucose sensing activity of CuO–NiO bimetallic nanocomposites was induced via calcination.
Collapse
Affiliation(s)
- Mohit Chawla
- Advanced Materials Research Centre
- School of Basic Sciences
- Indian Institute of Technology Mandi
- Mandi
- India
| | | | - Prem Felix Siril
- Advanced Materials Research Centre
- School of Basic Sciences
- Indian Institute of Technology Mandi
- Mandi
- India
| |
Collapse
|
130
|
Martinkova P, Pohanka M. Colorimetric sensor based on bubble wrap and camera phone for glucose determination. J Appl Biomed 2016. [DOI: 10.1016/j.jab.2016.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
131
|
Inzucchi SE, Viscoli CM, Young LH, Furie KL, Gorman M, Lovejoy AM, Dagogo-Jack S, Ismail-Beigi F, Korytkowski MT, Pratley RE, Schwartz GG, Kernan WN. Pioglitazone Prevents Diabetes in Patients With Insulin Resistance and Cerebrovascular Disease. Diabetes Care 2016; 39:1684-92. [PMID: 27465265 PMCID: PMC5033078 DOI: 10.2337/dc16-0798] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/04/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The Insulin Resistance Intervention after Stroke (IRIS) trial recently found that pioglitazone reduced risk for stroke and myocardial infarction in patients with insulin resistance but without diabetes who had had a recent ischemic stroke or transient ischemic attack (TIA). This report provides detailed results on the metabolic effects of pioglitazone and the trial's prespecified secondary aim of diabetes prevention. RESEARCH DESIGN AND METHODS A total of 3,876 patients with recent ischemic stroke or TIA, no history of diabetes, fasting plasma glucose (FPG) <126 mg/dL, and insulin resistance by homeostasis model assessment of insulin resistance (HOMA-IR) score >3.0 were randomly assigned to pioglitazone or placebo. Surveillance for diabetes onset during the trial was accomplished by periodic interviews and annual FPG testing. RESULTS At baseline, the mean FPG, HbA1c, insulin, and HOMA-IR were 98.2 mg/dL (5.46 mmol/L), 5.8% (40 mmol/mol), 22.4 μIU/mL, and 5.4, respectively. After 1 year, mean HOMA-IR and FPG decreased to 4.1 and 95.1 mg/dL (5.28 mmol/L) in the pioglitazone group and rose to 5.7 and 99.7 mg/dL (5.54 mmol/L), in the placebo group (all P < 0.0001). Over a median follow-up of 4.8 years, diabetes developed in 73 (3.8%) participants assigned to pioglitazone compared with 149 (7.7%) assigned to placebo (hazard ratio [HR] 0.48 [95% CI 0.33-0.69]; P < 0.0001). This effect was predominately driven by those with initial impaired fasting glucose (FPG >100 mg/dL [5.6 mmol/L]; HR 0.41 [95% CI 0.30-0.57]) or elevated HbA1c (>5.7% [39 mmol/mol]; HR 0.46 [0.34-0.62]). CONCLUSIONS Among patients with insulin resistance but without diabetes who had had a recent ischemic stroke or TIA, pioglitazone decreased the risk of diabetes while also reducing the risk of subsequent ischemic events. Pioglitazone is the first medication shown to prevent both progression to diabetes and major cardiovascular events as prespecified outcomes in a single trial.
Collapse
Affiliation(s)
| | | | | | - Karen L Furie
- Alpert Medical School of Brown University, Providence, RI
| | | | | | | | | | | | | | - Gregory G Schwartz
- VA Medical Center and University of Colorado School of Medicine, Denver, CO
| | | | | |
Collapse
|
132
|
Datta D, Grahamslaw J, Gray AJ, Graham C. Capillary and Venous Lactate Agreement: a pilot prospective observational study. Emerg Med J 2016; 34:195-197. [DOI: 10.1136/emermed-2016-206109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/25/2016] [Accepted: 09/02/2016] [Indexed: 11/04/2022]
|
133
|
Erbach M, Freckmann G, Hinzmann R, Kulzer B, Ziegler R, Heinemann L, Schnell O. Interferences and Limitations in Blood Glucose Self-Testing: An Overview of the Current Knowledge. J Diabetes Sci Technol 2016; 10:1161-8. [PMID: 27044519 PMCID: PMC5032951 DOI: 10.1177/1932296816641433] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In general, patients with diabetes performing self-monitoring of blood glucose (SMBG) can strongly rely on the accuracy of measurement results. However, various factors such as application errors, extreme environmental conditions, extreme hematocrit values, or medication interferences may potentially falsify blood glucose readings. Incorrect blood glucose readings may lead to treatment errors, for example, incorrect insulin dosing. Therefore, the diabetes team as well as the patients should be well informed about limitations in blood glucose testing. The aim of this publication is to review the current knowledge on limitations and interferences in blood glucose testing with the perspective of their clinical relevance.
Collapse
Affiliation(s)
| | - Guido Freckmann
- Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH, Ulm, Germany
| | | | - Bernhard Kulzer
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - Ralph Ziegler
- Diabetes Clinic for Children and Adolescents, Muenster, Germany
| | | | - Oliver Schnell
- Forschergruppe Diabetes e.V., Munich-Neuherberg, Germany
| |
Collapse
|
134
|
Daly N, Carroll C, Flynn I, Harley R, Maguire PJ, Turner MJ. Evaluation of point-of-care maternal glucose measurements for the diagnosis of gestational diabetes mellitus. BJOG 2016; 124:1746-1752. [DOI: 10.1111/1471-0528.14255] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 11/28/2022]
Affiliation(s)
- N Daly
- UCD Centre for Human Reproduction; Coombe Women and Infants University Hospital; Dublin Ireland
| | - C Carroll
- UCD Centre for Human Reproduction; Coombe Women and Infants University Hospital; Dublin Ireland
| | - I Flynn
- UCD Centre for Human Reproduction; Coombe Women and Infants University Hospital; Dublin Ireland
| | - R Harley
- UCD Centre for Human Reproduction; Coombe Women and Infants University Hospital; Dublin Ireland
| | - PJ Maguire
- UCD Centre for Human Reproduction; Coombe Women and Infants University Hospital; Dublin Ireland
| | - MJ Turner
- UCD Centre for Human Reproduction; Coombe Women and Infants University Hospital; Dublin Ireland
| |
Collapse
|
135
|
Koenig A, Verlander LL. Usefulness of whole blood, plasma, peritoneal fluid, and peritoneal fluid supernatant glucose concentrations obtained by a veterinary point-of-care glucometer to identify septic peritonitis in dogs with peritoneal effusion. J Am Vet Med Assoc 2016; 247:1027-32. [PMID: 26480011 DOI: 10.2460/javma.247.9.1027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the usefulness of a veterinary point-of-care glucometer for identification of septic peritonitis in dogs with peritoneal effusion (PE). DESIGN Prospective clinical evaluation. ANIMALS 39 dogs with PE. PROCEDURES Blood and peritoneal fluid convenience samples were collected concurrently in all dogs at the time of initial evaluation. A veterinary point-of-care glucometer was used to measure glucose concentration in heparinized whole blood, plasma, peritoneal fluid, and peritoneal fluid supernatant samples. Seventeen dogs had confirmed septic peritonitis, and 22 dogs had nonseptic PE. Sensitivity, specificity, positive and negative predictive values, and accuracy of identification of dogs with septic peritonitis were calculated for glucose concentration differences for whole blood versus peritoneal fluid (WB-PF), plasma versus peritoneal fluid (P-PF), and plasma versus peritoneal fluid supernatant (P-PFS). RESULTS With a cutoff of > 20 mg/dL, the glucose concentration difference for WB-PF was an insensitive indicator of septic peritonitis (sensitivity, 41.2%; specificity, 100%). In comparison, the glucose concentration differences for P-PF and P-PFS had a higher sensitivity for septic peritonitis (88.2% and 82.4%, respectively) but a lower specificity (80% and 77.8%, respectively). With a glucose concentration difference cutoff of ≥ 38 mg/dL, specificity, positive predictive value, and accuracy of P-PF and P-PFS improved. CONCLUSIONS AND CLINICAL RELEVANCE Determination of the glucose concentration difference for WB-PF with the veterinary point-of-care glucometer was not useful in identifying all dogs with septic peritonitis. A glucose concentration difference of ≥ 38 mg/dL for P-PF or P-PFS, however, supported an accurate diagnosis of septic peritonitis in dogs with PE.
Collapse
|
136
|
Abstract
This article provides an overview of the current use of point-of-care testing (POCT) and its utility for patients’ self-management of chronic disease states. Pharmacists utilize POCT to provide rapid laboratory diagnostic results as a monitoring tool in the management of their patients and in order to improve medication outcomes. Considerations for the transition to use of POCT in the home to further improve disease management and improve health care cost-effectiveness are discussed. Devices available for home use include those suitable for management of diabetes mellitus, hypertension, congestive heart failure, and anticoagulation. Many of these devices include software capabilities enabling patients to share important health information with health care providers using a computer. Limitations and challenges surrounding implementation of home POCT for patients include reliability of instrumentation, ability to coordinate data collection, necessary training requirements, and cost-effectiveness. Looking forward, the successful integration of POCT into the homes of patients is contingent on a concerted effort made by all members of the health care team.
Collapse
Affiliation(s)
- Joseph A. Goble
- University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Patrick T. Rocafort
- Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD, USA
| |
Collapse
|
137
|
Bragg F, Li L, Yang L, Guo Y, Chen Y, Bian Z, Chen J, Collins R, Peto R, Wang C, Dong C, Pan R, Zhou J, Xu X, Chen Z. Risks and Population Burden of Cardiovascular Diseases Associated with Diabetes in China: A Prospective Study of 0.5 Million Adults. PLoS Med 2016; 13:e1002026. [PMID: 27379518 PMCID: PMC4933372 DOI: 10.1371/journal.pmed.1002026] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 04/15/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In China, diabetes prevalence is rising rapidly, but little is known about the associated risks and population burden of cardiovascular diseases. We assess associations of diabetes with major cardiovascular diseases and the relevance of diabetes duration and other modifiable risk factors to these associations. METHODS AND FINDINGS A nationwide prospective study recruited 512,891 men and women aged 30-79 y between 25 June 2004 and 15 July 2008 from ten diverse localities across China. During ~7 y of follow-up, 7,353 cardiovascular deaths and 25,451 non-fatal major cardiovascular events were recorded among 488,760 participants without prior cardiovascular disease at baseline. Cox regression yielded adjusted hazard ratios (HRs) comparing disease risks in individuals with diabetes to those without. Overall, 5.4% (n = 26,335) of participants had self-reported (2.7%) or screen-detected (2.7%) diabetes. Individuals with self-reported diabetes had an adjusted HR of 2.07 (95% CI 1.90-2.26) for cardiovascular mortality. There were significant excess risks of major coronary event (2.44, 95% CI 2.18-2.73), ischaemic stroke (1.68, 95% CI 1.60-1.77), and intracerebral haemorrhage (1.24, 95% CI 1.07-1.44). Screen-detected diabetes was also associated with significant, though more modest, excess cardiovascular risks, with corresponding HRs of 1.66 (95% CI 1.51-1.83), 1.62 (95% CI 1.40-1.86), 1.48 (95% CI 1.40-1.57), and 1.17 (95% CI 1.01-1.36), respectively. Misclassification of screen-detected diabetes may have caused these risk estimates to be underestimated, whilst lack of data on lipids may have resulted in residual confounding of diabetes-associated cardiovascular disease risks. Among individuals with diabetes, cardiovascular risk increased progressively with duration of diabetes and number of other presenting modifiable cardiovascular risk factors. Assuming a causal association, diabetes now accounts for ~0.5 million (489,676, 95% CI 335,777-681,202) cardiovascular deaths annually in China. CONCLUSIONS Among Chinese adults, diabetes is associated with significantly increased risks of major cardiovascular diseases. The increasing prevalence and younger age of onset of diabetes foreshadow greater diabetes-attributable disease burden in China.
Collapse
Affiliation(s)
- Fiona Bragg
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Chinese Academy of Medical Sciences, Beijing, China
- * E-mail: (LL); (ZC)
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Rory Collins
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Richard Peto
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Chunmei Wang
- Tongxiang Centre for Disease Control and Prevention, Zhejiang, China
| | - Caixia Dong
- Gansu Centre for Disease Control and Prevention, Gansu, China
| | - Rong Pan
- Liuzhou Centre for Disease Control and Prevention, Liuzhou, China
| | - Jinyi Zhou
- Jiangsu Centre for Disease Control and Prevention, Jiangsu, China
| | - Xin Xu
- Liuyang Centre for Disease Control and Prevention, Hunan, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- * E-mail: (LL); (ZC)
| | | |
Collapse
|
138
|
Ottiger C, Gygli N, Huber AR, Fernandez-Tresguerres B, Pardo S, Petruschke T. Performance of a Blood Glucose Monitoring System in a Point-of-Care Setting. J Diabetes Sci Technol 2016; 10:939-46. [PMID: 26989068 PMCID: PMC4928233 DOI: 10.1177/1932296816638854] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study assesses and demonstrates that CONTOUR® XT-BGMS (CXT-BGMS) complies with the requirements of the German (RiliBÄK) and Swiss (QUALAB) quality control guidelines for point-of-care testing (POCT) and fulfills the ISO15197:2013 accuracy limits criteria under the routine conditions of a hospital point-of care setting. This single-center study was conducted in Switzerland using 105 venous blood samples from hospitalized patients. Each sample was tested in comparison to the hexokinase reference method. Compliance with POCT guidelines was assessed by daily BGMS measurements using control solutions. Accuracy of CXT-BGMS according to ISO limits was 98.41%. All control measurements were within the limits defined by RiliBÄK (within ± 11% of target values and root mean square error [RMSE] within RMSE limits), and QUALAB (within ± 10% of target values).
Collapse
|
139
|
Chong SK, Reineke EL. Point-of-Care Glucose and Ketone Monitoring. Top Companion Anim Med 2016; 31:18-26. [PMID: 27451045 DOI: 10.1053/j.tcam.2016.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/19/2016] [Indexed: 11/11/2022]
Abstract
Early and rapid identification of hypo- and hyperglycemia as well as ketosis is essential for the practicing veterinarian as these conditions can be life threatening and require emergent treatment. Point-of-care testing for both glucose and ketone is available for clinical use and it is important for the veterinarian to understand the limitations and potential sources of error with these tests. This article discusses the devices used to monitor blood glucose including portable blood glucose meters, point-of-care blood gas analyzers and continuous glucose monitoring systems. Ketone monitoring options discussed include the nitroprusside reagent test strips and the 3-β-hydroxybutyrate ketone meter.
Collapse
Affiliation(s)
- Siew Kim Chong
- Emergency and Critical Care, Matthew J Ryan Hospital, University of Pennsylvania, Philadelphia, PA, USA.
| | - Erica L Reineke
- Emergency and Critical Care, Matthew J Ryan Hospital, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
140
|
Abstract
Maintaining blood glucose concentration within an acceptable range is a goal for patients with diabetes mellitus. Point-of-care glucose meters initially designed for home self-monitoring in patients with diabetes have been widely used in the hospital settings because of ease of use and quick reporting of blood glucose information. They are not only utilized for the general inpatient population but also for critically ill patients. Many factors affect the accuracy of point-of-care glucose testing, particularly in critical care settings. Inaccurate blood glucose information can result in unsafe insulin delivery which causes poor glucose control and can be fatal. Healthcare professionals should be aware of the limitations of point-of-care glucose testing. This chapter will first introduce glucose regulation in diabetes mellitus, hyperglycemia/hypoglycemia in the intensive care unit, importance of glucose control in critical care patients, and pathophysiological variables of critically ill patients that affect the accuracy of point-of-care glucose testing. Then, we will discuss currently available point-of-care glucose meters and preanalytical, analytical, and postanalytical sources of variation and error in point-of-care glucose testing.
Collapse
Affiliation(s)
- S N Narla
- Medical University of South Carolina, Charleston, SC, United States
| | - M Jones
- Medical University of South Carolina, Charleston, SC, United States
| | - K L Hermayer
- Medical University of South Carolina, Charleston, SC, United States
| | - Y Zhu
- Medical University of South Carolina, Charleston, SC, United States.
| |
Collapse
|
141
|
Naugler C, Zhang Z, Redman L. WITHDRAWN: Performance of Community Blood Glucose Meters in Calgary, Alberta: An Analysis of Quality Assurance Data. Can J Diabetes 2016; 40 Suppl 1:21-3. [DOI: 10.1016/j.jcjd.2016.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 04/16/2014] [Accepted: 04/20/2014] [Indexed: 11/29/2022]
|
142
|
Photonic hydrogel sensors. Biotechnol Adv 2016; 34:250-71. [DOI: 10.1016/j.biotechadv.2015.10.005] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 10/11/2015] [Accepted: 10/16/2015] [Indexed: 12/22/2022]
|
143
|
Lan T, Zhang J, Lu Y. Transforming the blood glucose meter into a general healthcare meter for in vitro diagnostics in mobile health. Biotechnol Adv 2016; 34:331-41. [PMID: 26946282 PMCID: PMC4833671 DOI: 10.1016/j.biotechadv.2016.03.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 02/20/2016] [Accepted: 03/01/2016] [Indexed: 01/08/2023]
Abstract
Recent advances in mobile network and smartphones have provided an enormous opportunity for transforming in vitro diagnostics (IVD) from central labs to home or other points of care (POC). A major challenge to achieving the goal is a long time and high costs associated with developing POC IVD devices in mobile Health (mHealth). Instead of developing a new POC device for every new IVD target, we and others are taking advantage of decades of research, development, engineering and continuous improvement of the blood glucose meter (BGM), including those already integrated with smartphones, and transforming the BGM into a general healthcare meter for POC IVDs of a wide range of biomarkers, therapeutic drugs and other analytical targets. In this review, we summarize methods to transduce and amplify selective binding of targets by antibodies, DNA/RNA aptamers, DNAzyme/ribozymes and protein enzymes into signals such as glucose or NADH that can be measured by commercially available BGM, making it possible to adapt many clinical assays performed in central labs, such as immunoassays, aptamer/DNAzyme assays, molecular diagnostic assays, and enzymatic activity assays onto BGM platform for quantification of non-glucose targets for a wide variety of IVDs in mHealth.
Collapse
Affiliation(s)
- Tian Lan
- GlucoSentient, Inc., 60 Hazelwood Drive, Champaign, IL 61820, USA.
| | - Jingjing Zhang
- Department of Chemistry, University of Illinois at Urbana-Champaign, 601 S. Mathews Ave., Urbana, IL 61801, USA
| | - Yi Lu
- Department of Chemistry, University of Illinois at Urbana-Champaign, 601 S. Mathews Ave., Urbana, IL 61801, USA.
| |
Collapse
|
144
|
Omar M, Reichling M, Liodakis E, Ettinger M, Guenther D, Decker S, Krettek C, Suero EM, Mommsen P. Rapid exclusion of bacterial arthritis using a glucometer. Clin Rheumatol 2016; 36:591-598. [PMID: 27071629 DOI: 10.1007/s10067-016-3255-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 03/30/2016] [Accepted: 04/01/2016] [Indexed: 11/26/2022]
Abstract
Bacterial arthritis is a medical emergency. However, prompt diagnosis and differentiation from non-infectious diseases are challenging. As bacterial metabolism leads to glucose reduction, measurement of synovial fluid glucose seems to be a promising diagnostic approach. The purpose of this study was to determine whether synovial fluid glucose levels could be accurately measured by using a glucometer and to evaluate its diagnostic accuracy in diagnosing bacterial arthritis compared to currently available markers. In a prospective diagnostic study, 102 consecutive patients with atraumatic joint effusion were included. Synovial fluid glucose concentrations were determined using both glucometer and automated analyzer respectively. Synovial fluid culture, crystal analysis, and synovial cell analysis were performed. Blood samples were taken for blood cultures, analyses of serum infection markers, and serum glucose. There was a high correlation between synovial fluid glucose measured by the glucometer and the automated analyzer (r 2 = 0.92). According to the receiver operating characteristic curve, a threshold of 1.4 mmol/l had a sensitivity of 100 % (95 % CI 78.2-100 %), a specificity of 92.0 % (95 % CI 84.1-96.7 %), a positive predictive value of 68.2 % (95 % CI 45.1-86.1 %), and a negative predictive value of 100 % (95 % CI 95.5-100 %). These results suggest that synovial fluid glucose concentrations could be reliably measured using a glucometer. Due to its simplicity, this test has the potential to be an adjunct in the diagnostic cascade of bacterial arthritis.
Collapse
Affiliation(s)
- Mohamed Omar
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Moritz Reichling
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Emmanouil Liodakis
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Max Ettinger
- Orthopedic Surgery Department, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany
| | - Daniel Guenther
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Sebastian Decker
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Christian Krettek
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Eduardo M Suero
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Philipp Mommsen
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| |
Collapse
|
145
|
Lindholm C, Altimiras J. Point-of-care devices for physiological measurements in field conditions. A smorgasbord of instruments and validation procedures. Comp Biochem Physiol A Mol Integr Physiol 2016; 202:99-111. [PMID: 27083239 DOI: 10.1016/j.cbpa.2016.04.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/30/2016] [Accepted: 04/09/2016] [Indexed: 01/05/2023]
Abstract
Point-of-care (POC) devices provide quick diagnostic results that increase the efficiency of patient care. Many POC devices are currently available to measure metabolites, blood gases, hormones, disease biomarkers or pathogens in samples as diverse as blood, urine, feces or exhaled breath. This diversity is potentially very useful for the comparative physiologist in field studies if proper validation studies are carried out to justify the accuracy of the devices in non-human species under different conditions. Our review presents an account of physiological parameters that can be monitored with POC devices and surveys the literature for suitable quantitative and statistical procedures for comparing POC measurements with reference "gold standard" procedures. We provide a set of quantitative tools and report on different correlation coefficients (Lin's Concordance Correlation Coefficient or the more widespread Pearson correlation coefficient), describe the graphical assessment of variation using Bland-Altman plots and discuss the difference between Model I and Model II regression procedures. We also report on three validation datasets for lactate, glucose and hemoglobin measurements in birds using the newly proposed procedures. We conclude the review with a haphazard account of future developments in the field, emphasizing the interest in lab-on-a-chip devices to carry out more complex experimental measurements than the ones currently available in POC devices.
Collapse
Affiliation(s)
- Caroline Lindholm
- Avian Behavioral Genomics and Physiology group, Division of Biology, Department of Physics, Chemistry and Biology (IFM), Linköping Univ., SE-58183 Linköping, Sweden
| | - Jordi Altimiras
- Avian Behavioral Genomics and Physiology group, Division of Biology, Department of Physics, Chemistry and Biology (IFM), Linköping Univ., SE-58183 Linköping, Sweden.
| |
Collapse
|
146
|
|
147
|
Wiencek J, Nichols J. Issues in the practical implementation of POCT: overcoming challenges. Expert Rev Mol Diagn 2016; 16:415-22. [PMID: 26783053 DOI: 10.1586/14737159.2016.1141678] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There are many challenges in implementing a successful point-of-care testing (POCT) program. When compared to traditional testing, POCT results are faster and allow for rapid patient treatment. Unfortunately, the excitement of this technology is often lost due to an assortment of practical obstacles. Implementation of POCT requires consideration of the regulatory complexity and amount of documentation to be compliant. As more tests move to the site of patient care, the number of operators that need to be trained and assessed will grow. An effective POCT program rests solely on the foundation of education and training of each operator, but assuring regular competency updates for a large number of staff can be a management issue. Discussed in this article are several of the key obstacles to implementing a POCT program including laboratory quality regulations, compliance documentation and operational management challenges.
Collapse
Affiliation(s)
- Joesph Wiencek
- a Department of Pathology, Microbiology and Immunology , Vanderbilt University School of Medicine , Nashville , TN , USA
| | - James Nichols
- a Department of Pathology, Microbiology and Immunology , Vanderbilt University School of Medicine , Nashville , TN , USA
| |
Collapse
|
148
|
Bhavadharini B, Mahalakshmi MM, Maheswari K, Kalaiyarasi G, Anjana RM, Deepa M, Ranjani H, Priya M, Uma R, Usha S, Pastakia SD, Malanda B, Belton A, Unnikrishnan R, Kayal A, Mohan V. Use of capillary blood glucose for screening for gestational diabetes mellitus in resource-constrained settings. Acta Diabetol 2016; 53:91-7. [PMID: 25916215 PMCID: PMC4749644 DOI: 10.1007/s00592-015-0761-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/12/2015] [Indexed: 12/17/2022]
Abstract
AIMS The aim of the study was to evaluate usefulness of capillary blood glucose (CBG) for diagnosis of gestational diabetes mellitus (GDM) in resource-constrained settings where venous plasma glucose (VPG) estimations may be impossible. METHODS Consecutive pregnant women (n = 1031) attending antenatal clinics in southern India underwent 75-g oral glucose tolerance test (OGTT). Fasting, 1- and 2-h VPG (AU2700 Beckman, Fullerton, CA) and CBG (One Touch Ultra-II, LifeScan) were simultaneously measured. Sensitivity and specificity were estimated for different CBG cut points using the International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria for the diagnosis of GDM as gold standard. Bland-Altman plots were drawn to look at the agreement between CBG and VPG. Correlation and regression equation analysis were also derived for CBG values. RESULTS Pearson's correlation between VPG and CBG for fasting was r = 0.433 [intraclass correlation coefficient (ICC) = 0.596, p < 0.001], for 1H, it was r = 0.653 (ICC = 0.776, p < 0.001), and for 2H, r = 0.784 (ICC = 0.834, p < 0.001). Comparing a single CBG 2-h cut point of 140 mg/dl (7.8 mmol/l) with the IADPSG criteria, the sensitivity and specificity were 62.3 and 80.7 %, respectively. If CBG cut points of 120 mg/dl (6.6 mmol/l) or 110 mg/dl (6.1 mmol/l) were used, the sensitivity improves to 78.3 and 92.5 %, respectively. CONCLUSIONS In settings where VPG estimations are not possible, CBG can be used as an initial screening test for GDM, using lower 2H CBG cut points to maximize the sensitivity. Those who screen positive can be referred to higher centers for definitive testing, using VPG.
Collapse
Affiliation(s)
- Balaji Bhavadharini
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Manni Mohanraj Mahalakshmi
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Kumar Maheswari
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Gunasekaran Kalaiyarasi
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Mohan Deepa
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Harish Ranjani
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Miranda Priya
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Ram Uma
- Seethapathy Clinic and Hospital, Chennai, India
| | - Sriram Usha
- Associates in Clinical Endocrinology Education and Research (ACEER), Chennai, India
| | | | - Belma Malanda
- International Diabetes Federation, Brussels, Belgium
| | - Anne Belton
- International Diabetes Federation, Brussels, Belgium
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | | | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India.
| |
Collapse
|
149
|
Gerber KL, Freeman KP. ASVCP guidelines: quality assurance for portable blood glucose meter (glucometer) use in veterinary medicine. Vet Clin Pathol 2016; 45:10-27. [DOI: 10.1111/vcp.12310] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Karen L. Gerber
- College of Public Health, Medical and Veterinary Sciences; James Cook University; Townsville Qld Australia
| | | |
Collapse
|
150
|
Vellayappan MV, Venugopal JR, Ramakrishna S, Ray S, Ismail AF, Mandal M, Manikandan A, Seal S, Jaganathan SK. Electrospinning applications from diagnosis to treatment of diabetes. RSC Adv 2016. [DOI: 10.1039/c6ra15252j] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Modern applications of electrospinning.
Collapse
Affiliation(s)
- M. V. Vellayappan
- Faculty of Biosciences and Medical Engineering
- Universiti Teknologi Malaysia
- Johor Bahru
- Malaysia
| | - J. R. Venugopal
- Center for Nanofibers & Nanotechnology Initiative
- Department of Mechanical Engineering
- National University of Singapore
- Singapore
| | - S. Ramakrishna
- Center for Nanofibers & Nanotechnology Initiative
- Department of Mechanical Engineering
- National University of Singapore
- Singapore
| | - S. Ray
- MBIE NZ Product Accelerator and Biocide Toolbox Programmes
- School of Chemical Sciences
- The University of Auckland
- Auckland 1142
- New Zealand
| | - A. F. Ismail
- Advanced Membrane Technology Research Centre (AMTEC)
- Universiti Teknologi Malaysia
- Johor Bahru 81310
- Malaysia
| | - M. Mandal
- School of Medical Science and Technology
- Indian Institute of Technology Kharagpur
- West Bengal 721302
- India
| | - A. Manikandan
- Department of Chemistry
- Bharath University
- Chennai
- India
| | - S. Seal
- NanoScience Technology Center
- University of Central Florida Engineering
- Orlando
- USA
| | - S. K. Jaganathan
- Department for Management of Science and Technology Development
- Ton Duc Thang University
- Ho Chi Minh City
- Vietnam
- Faculty of Applied Sciences
| |
Collapse
|