Usability Evaluation of a Blood Glucose Monitoring System With a Spill-Resistant Vial, Easier Strip Handling, and Connectivity to a Mobile App: Improvement of Patient Convenience and Satisfaction

BACKGROUND

Proper management of diabetes mellitus requires regular self-monitoring of blood glucose (SMBG). This research evaluated the usability of the Accu-Chek® Guide Meter that includes a spill-resistant vial, easier strip handling, and wireless connectivity to a mobile app.

METHODS

A total of 197 participants were allowed to experience typical blood glucose testing tasks on the Accu-Chek Guide Meter, review data such as last result, patterns, and target percentage on the meter and on the mobile app, and then evaluate their experience through a human factors usability survey. Participants used a 6-point agree/disagree scale to rate 34 market statement questions.

RESULTS

The results of a Pearson chi-square proportions test for each of the 34 market statement questions showed a significant difference (P < .0001) between the disagree responses (1-3) and agree responses (4-6). An overwhelming majority of participants found all aspects of the system, including the test strips, strip vial, and data analysis on the meter and the mobile app, to be a good fit for their lifestyle and to provide a better testing experience.

CONCLUSIONS

This study found superior usability of the new meter system over the participants' current meters in both the United States and France.

Empowering Patients and Caregivers to Manage Healthcare Via Streamlined Presentation of Web Objects Selected by Modeling Learning Benefits Obtained by Similar Peers

In this article, we introduce a framework for selecting web objects (texts, videos, simulations) from a large online repository to present to patients and caregivers, in order to assist in their healthcare. Motivated by the paradigm of peer-based intelligent tutoring, we model the learning gains achieved by users when exposed to specific web objects in order to recommend those objects most likely to deliver benefit to new users. We are able to show that this streamlined presentation leads to effective knowledge gains, both through a process of simulated learning and through a user study, for the specific application of caring for children with autism. The value of our framework for peer-driven content selection of health information is emphasized through two additional roles for peers: attaching commentary to web objects and proposing subdivided objects for presentation, both of which are demonstrated to deliver effective learning gains, in simulations. In all, we are offering an opportunity for patients to navigate the deep waters of excessive online information towards effective management of healthcare, through content selection influenced by previous peer experiences.

COMPARAÇÃO ENTRE OS MÉTODOS LABORATORIAL E PORTÁTIL NA ANÁLISE DA GLICEMIA EM FELINOS COM AMOSTRAS DE SANGUE VENOSO CENTRAL E CAPILAR

Objetivou-se comparar a eficácia do método portátil de mensuração glicêmica com o método laboratorial de referência, utilizando-se amostras de sangue venoso central e de sangue capilar de 20 felinos. Considerou-se como valor padrão de referência o obtido pelo método laboratorial a partir de amostra de sangue venoso central. Outros dois valores foram obtidos por glicosímetro portátil, sendo utilizada amostra do mesmo sangue venoso central e outra amostra a partir de sangue capilar. Para os 20 felinos, os resultados glicêmicos verificados pelo método laboratorial tiveram média de 80mg/dL; e os resultados constatados pelo glicosímetro, média de 84,1mg/dL com sangue venoso central e 73,1mg/dL com sangue capilar. As médias glicêmicas obtidas pelo glicosímetro com ambas as amostras de sangue em relação à alcançada pelo método laboratorial resultaram em variações inferiores à máxima instituída (20%) por órgãos reguladores de glicosímetros e por entidade de padronização, bem como a variação entre as médias glicêmicas obtidas pelo aparelho com as distintas amostras de sangue. Na análise comparativa houve diferença significativa entre os métodos (p<0,05). Concluiu-se que o glicosímetro portátil é eficaz para mensuração da glicemia em felinos, tanto a partir de amostras de sangue venoso central como de sangue capilar.

Self-monitoring of blood glucose during pregnancy: indications and limitations

Self-monitoring of blood glucose (SMBG) is an important tool to treat diabetes during pregnancy. However, proper implementation of SMBG in pregnant women requires understanding of its applications and limitations. This article reviews issues related to the implementation, efficacy, and accuracy of SMBG and discusses factors that can confound results of SMBG during pregnancy.

Eliminating the blood: ongoing outbreaks of hepatitis B virus infection and the need for innovative glucose monitoring technologies

BACKGROUND

As part of routine diabetes care, capillary blood is typically sampled using a finger-stick device and then tested using a handheld blood glucose meter. In settings where multiple persons require assistance with blood glucose monitoring, opportunities for bloodborne pathogen transmission may exist.

METHODS

Reports of hepatitis B virus (HBV) infection outbreaks in the United States that have been attributed to blood glucose monitoring practices were reviewed and summarized.

RESULTS

Since 1990, state and local health departments investigated 18 HBV infection outbreaks, 15 (83%) in the past 10 years, that were associated with the improper use of blood glucose monitoring equipment. At least 147 persons acquired HBV infection during these outbreaks, 6 (4.1%) of whom died from complications of acute HBV infection. Outbreaks appear to have become more frequent in the past decade, primarily affecting long-term care residents with diabetes. Each outbreak was attributed to glucose monitoring practices that exposed HBV-susceptible persons to blood-contaminated equipment that was previously used on HBV-infected persons. The predominant unsafe practices were the use of spring-loaded finger-stick devices on multiple persons and the sharing of blood glucose testing meters without cleaning and disinfection between uses.

CONCLUSION

Hepatitis B virus infection outbreaks associated with blood glucose monitoring have occurred with increasing regularity in the Unites States and may represent a growing but under-recognized problem. Advances in technology, such as the development of blood glucose testing meters that can withstand frequent disinfection and noninvasive glucose monitoring methods, will likely prove useful in improving patient safety.

Recent progress in analytical instrumentation for glycemic control in diabetic and critically ill patients

Implementing strict glycemic control can reduce the risk of serious complications in both diabetic and critically ill patients. For this reason, many different analytical, mainly electrochemical and optical sensor approaches for glucose measurements have been developed. Self-monitoring of blood glucose (SMBG) has been recognised as being an indispensable tool for intensive diabetes therapy. Recent progress in analytical instrumentation, allowing submicroliter samples of blood, alternative site testing, reduced test time, autocalibration, and improved precision, is comprehensively described in this review. Continuous blood glucose monitoring techniques and insulin infusion strategies, developmental steps towards the realization of the dream of an artificial pancreas under closed loop control, are presented. Progress in glucose sensing and glycemic control for both patient groups is discussed by assessing recent published literature (up to 2006). The state-of-the-art and trends in analytical techniques (either episodic, intermittent or continuous, minimal-invasive, or noninvasive) detailed in this review will provide researchers, health professionals and the diabetic community with a comprehensive overview of the potential of next-generation instrumentation suited to either short- and long-term implantation or ex vivo measurement in combination with appropriate body interfaces such as microdialysis catheters.

Screening for type 2 diabetes mellitus using gingival crevicular blood

This study was conducted to assess the usefulness of the gingival crevicular blood for estimating the glucose level during routine periodontal examination using Xitux Diagnostics Smart-X self-monitoring blood glucose device among Jordanian patients attending dental teaching clinics. A total of 34 type 2 diabetic patients (18 males and 16 females) and 26 non-diabetic patients (14 males and 12 females) participated in this study. Glucose level was measured in a sample of gingival crevicular blood and in another sample obtained by finger puncture using a self-monitoring device. Glucose measurements from gingival crevicular blood samples, ranged from 57 to 250 mg dl-1 with a mean of 125.4+/-60.7 mg dl-1 (+/-SD) and glucose measurements obtained by finger puncture, ranged from 62 to 263 mg dl-1 with a mean of 131.9+/-61.1 mg dl-1. Pearson's correlation coefficient was performed to assess the correlation between the glucose measurements in these two samples. Pearson's correlation coefficient showed an almost perfect positive correlation between the gingival readings and finger-puncture readings (r=0.997, P<0.0001). In conclusion, gingival crevicular blood can provide an acceptable source for measuring blood glucose level. However, the technique to obtain an acceptable blood sample from gingival crevices is not always feasible which would limit its application as a clinical practice. Additional studies that refine this technique and use larger sample size are recommended.

Barriers to Glucose Control in the Intensive Care Unit

Despite published evidence supporting glycemic control in critically ill patients, achieving euglycemia remains a problem in the intensive care units (ICUs) of many institutions. Clinicians seeking to implement the findings of published evidence in their practice face many potential barriers that make euglycemia difficult to achieve in patients in the ICU. Developing a comprehensive understanding of the many barriers to ICU glucose control can aide clinicians in attempting to change practice and improve patient outcomes. Barriers to ICU glucose control include the role of different health professionals in glucose management, communication among health care professionals, guidelines, protocols, ICU culture, fear of hypoglycemia, glucose monitoring, education, systems analysis, health care resources, nutritional needs, and drug utilization. By ensuring compliance, changing ICU culture, developing guidelines and protocols, and incorporating a multidisciplinary approach, clinicians can achieve glycemic control in the critically ill population and improve patient outcomes.