Approaches for improving glucose monitor measurements for self-monitoring of blood glucose: from measurement harmonization to external quality assessment programs

Accelerometer-based physical activity: total volume per day and standardized measures

The use of accelerometers in physical activity (PA) research has increased exponentially over the past 20 yr. The first commercially available accelerometer for assessing PA, the Caltrac, was worn on the waist and estimated PA energy expenditure in kilocalories. Around 1995, the emphasis shifted to measuring minutes of moderate-to-vigorous PA (MVPA), especially for bouts of 10 min or longer. Recent studies, however, show that light-intensity PA and intermittent (nonbout) MVPA also have important health benefits. The total volume of PA performed is an important variable because it takes the frequency, intensity, and duration of activity bouts and condenses them down into a single metric. The total volume of PA is appropriate for many research applications and can enhance comparisons between studies. In the future, machine learning algorithms will provide improved accuracy for activity type recognition and estimation of PA energy expenditure. However, in the current landscape of objectively measured PA, total activity counts per day (TAC/d) is a proxy for the total volume of PA. TAC/d percentiles for age- and gender-specific groups have been developed from the National Health and Nutrition Examination Survey ActiGraph data (2003-2006), providing a novel way to assess PA. The use of TAC/d or standardized units of acceleration could harmonize PA across studies. TAC/d should be viewed as an additional metric, not intended to replace other metrics (e.g., sedentary time, light-intensity PA, moderate PA, and vigorous PA) that may also be related to health. As future refinements to wearable monitors occur, researchers should continue to consider metrics that reflect the total volume of PA in addition to existing PA metrics.

Glucose biosensors: an overview of use in clinical practice

Blood glucose monitoring has been established as a valuable tool in the management of diabetes. Since maintaining normal blood glucose levels is recommended, a series of suitable glucose biosensors have been developed. During the last 50 years, glucose biosensor technology including point-of-care devices, continuous glucose monitoring systems and noninvasive glucose monitoring systems has been significantly improved. However, there continues to be several challenges related to the achievement of accurate and reliable glucose monitoring. Further technical improvements in glucose biosensors, standardization of the analytical goals for their performance, and continuously assessing and training lay users are required. This article reviews the brief history, basic principles, analytical performance, and the present status of glucose biosensors in the clinical practice.