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Fakheran O, Bencze B, Mischak I, Vegh D, Payer M. The reliability of using gingival crevicular blood to measure blood glucose and hba1c levels in the dental setting: a systematic review and meta-analysis. Clin Oral Investig 2024; 28:299. [PMID: 38702475 PMCID: PMC11068679 DOI: 10.1007/s00784-024-05685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/24/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE There are 500 million patients living with diabetes mellitus worldwide and 50% of them remain undiagnosed. Routine periodontal probing provides gingival crevicular blood in patients with gingivitis. Gingival blood may be useful for diabetes screening without the need for any expensive, painful or time-consuming method by using convenient glucometers. Therefore, the objective of this systematic review and meta-analysis is to answer the question to "is there a difference in glucose or HbA1c levels (O) in patients with positive gingival bleeding (P) measured on gingival crevicular blood (GCB) (I) compared to finger prick capillary blood (CB) (C). MATERIALS AND METHODS The authors performed an electronic search of six databases using identical MeSH phrases. Only human clinical studies without limitations on the year of publication were considered. Data extraction was done by using standardized data collection sheets. Risk of bias assessment were conducted using QUADAS-2 and QUADAS-C. Meta-analyses were carried out with the random effects model to aggregate the correlation coefficients and the difference between the means between gingival and capillary blood reading, using 95% confidence intervals. RESULTS The database and manual search yielded 268 articles, from which the selection procedure provided 36 articles for full-text screening, and the final pool of eligible articles composed of 23 studies with 1680 patients. Meta-analysis results on glycemic levels showed differences between the GCB and CB procedures in patients with and without diabetes with values of -6.80 [-17.35; 3.76] and - 4.36 [-9.89; 1.18], respectively. Statistically significant correlations were found (p = 0.001) between GCB and CB measurements in patients with (0.97 [0.927; 0.987]) and without diabetes (0.927 [0.873; 0.958]). CONCLUSION Gingival blood could prove to be useful to identify patients with undiagnosed diabetes when the necessary amount of uncontaminated blood is present. However, this technique is limited by the possibility of contamination, prandial status and inaccuracies, so it is unsuited to address the patient's glycemic control accurately.
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Affiliation(s)
- Omid Fakheran
- Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, Billrothgasse 4, Graz, 8010, Austria
| | - Bulcsu Bencze
- Department of Prosthodontics, Semmelweis University, Szentkiralyi utca 47, Budapest, 1088, Hungary
| | - Irene Mischak
- Department of Prosthodontics, Semmelweis University, Szentkiralyi utca 47, Budapest, 1088, Hungary
| | - Daniel Vegh
- Department of Prosthodontics, Semmelweis University, Szentkiralyi utca 47, Budapest, 1088, Hungary.
| | - Michael Payer
- Division of Oral Surgery and Orthodontics, Department of Dentistry and Oral Health, Medical University of Graz, Billrothgasse 4, Graz, 8010, Austria
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Mittal R, Koutras N, Maya J, Lemos JRN, Hirani K. Blood glucose monitoring devices for type 1 diabetes: a journey from the food and drug administration approval to market availability. Front Endocrinol (Lausanne) 2024; 15:1352302. [PMID: 38559693 PMCID: PMC10978642 DOI: 10.3389/fendo.2024.1352302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/22/2024] [Indexed: 04/04/2024] Open
Abstract
Blood glucose monitoring constitutes a pivotal element in the clinical management of Type 1 diabetes (T1D), a globally escalating metabolic disorder. Continuous glucose monitoring (CGM) devices have demonstrated efficacy in optimizing glycemic control, mitigating adverse health outcomes, and augmenting the overall quality of life for individuals afflicted with T1D. Recent progress in the field encompasses the refinement of electrochemical sensors, which enhances the effectiveness of blood glucose monitoring. This progress empowers patients to assume greater control over their health, alleviating the burdens associated with their condition, and contributing to the overall alleviation of the healthcare system. The introduction of novel medical devices, whether derived from existing prototypes or originating as innovative creations, necessitates adherence to a rigorous approval process regulated by the Food and Drug Administration (FDA). Diverse device classifications, stratified by their associated risks, dictate distinct approval pathways, each characterized by varying timelines. This review underscores recent advancements in blood glucose monitoring devices primarily based on electrochemical sensors and elucidates their regulatory journey towards FDA approval. The advent of innovative, non-invasive blood glucose monitoring devices holds promise for maintaining stringent glycemic control, thereby preventing T1D-associated comorbidities, and extending the life expectancy of affected individuals.
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Affiliation(s)
- Rahul Mittal
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Nicole Koutras
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
| | - Jonathan Maya
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
| | - Joana R. N. Lemos
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Khemraj Hirani
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL, United States
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Kumari R, Anand PK, Shin J. Improving the Accuracy of Continuous Blood Glucose Measurement Using Personalized Calibration and Machine Learning. Diagnostics (Basel) 2023; 13:2514. [PMID: 37568877 PMCID: PMC10416969 DOI: 10.3390/diagnostics13152514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Despite tremendous developments in continuous blood glucose measurement (CBGM) sensors, they are still not accurate for all patients with diabetes. As glucose concentration in the blood is <1% of the total blood volume, it is challenging to accurately measure glucose levels in the interstitial fluid using CBGM sensors due to within-patient and between-patient variations. To address this issue, we developed a novel data-driven approach to accurately predict CBGM values using personalized calibration and machine learning. First, we scientifically divided measured blood glucose into smaller groups, namely, hypoglycemia (<80 mg/dL), nondiabetic (81-115 mg/dL), prediabetes (116-150 mg/dL), diabetes (151-181 mg/dL), severe diabetes (181-250 mg/dL), and critical diabetes (>250 mg/dL). Second, we separately trained each group using different machine learning models based on patients' personalized parameters, such as physical activity, posture, heart rate, breath rate, skin temperature, and food intake. Lastly, we used multilayer perceptron (MLP) for the D1NAMO dataset (training to test ratio: 70:30) and grid search for hyperparameter optimization to predict accurate blood glucose concentrations. We successfully applied our proposed approach in nine patients with type 1 diabetes and observed that the mean absolute relative difference (MARD) decreased from 17.8% to 8.3%.
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Affiliation(s)
- Ranjita Kumari
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Gyeonggi, Suwon 16419, Republic of Korea;
| | - Pradeep Kumar Anand
- Clinical Research Group, Samsung Healthcare, Gangdong-gu, Seoul 05340, Republic of Korea;
| | - Jitae Shin
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Gyeonggi, Suwon 16419, Republic of Korea;
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Soliman SS, Mahmoud AM, Elghobashy MR, Zaazaa HE, Sedik GA. Point-of-care electrochemical sensor for selective determination of date rape drug "ketamine" based on core-shell molecularly imprinted polymer. Talanta 2023; 254:124151. [PMID: 36463800 DOI: 10.1016/j.talanta.2022.124151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/12/2022] [Accepted: 11/27/2022] [Indexed: 11/30/2022]
Abstract
Misuse of illicit drugs is a serious problem that became the primary concern for many authorities worldwide. Point-of-care (POC) diagnostic tools can provide accurate and fast screening information that helps to detect illicit drugs in a short time. A portable, disposable and reproducible core-shell molecularly imprinted polymer (MIP) screen-printed sensor was synthesized as a POC analyzer for the assay of the date rape drug "ketamine hydrochloride" in different matrices. Firstly, the screen-printed electrode substrate was modified electrochemically with polyaniline (PANI) as an ion-to-electron transducer interlayer to improve the potential signal stability. Secondly, core-shell MIP was prepared, the core consisting of silica nanoparticles prepared by Stober's method, while the MIP shell was synthesized onto silica nanoparticles surface by copolymerizing methacrylic acid functional monomer and the crossing agent; ethylene glycol dimethacrylate in the presence of ketamine as a template molecule. Finally, the core-shell MIP was incorporated into the PVC membrane as an ionophore and drop-casted over PANI modified screen-printed carbon electrode. The imprinting process and the morphology of MIP were examined using scanning electron microscopy, Fourier-transform infrared and X-ray photoelectron spectroscopic methods. The sensor exhibited a short response time within 3-5 s in a pH range (2.0-5.0). The potential profile indicated a linear relationship in a dynamic concentration range of 1.0 × 10-6 M to 1.0 × 10-2 M with a slope of 54.7 mV/decade. The sensor was employed to determine ketamine in biological matrices and beverages.
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Affiliation(s)
- Shymaa S Soliman
- Analytical Chemistry Department, Faculty of Pharmacy, October 6 University, October 6 City, Giza, 12858, Egypt
| | - Amr M Mahmoud
- Analytical Chemistry Department, Faculty of Pharmacy, Cairo University, El-Kasr-El Aini Street, Cairo, 11562, Egypt
| | - Mohamed R Elghobashy
- Analytical Chemistry Department, Faculty of Pharmacy, October 6 University, October 6 City, Giza, 12858, Egypt; Analytical Chemistry Department, Faculty of Pharmacy, Cairo University, El-Kasr-El Aini Street, Cairo, 11562, Egypt
| | - Hala E Zaazaa
- Analytical Chemistry Department, Faculty of Pharmacy, Cairo University, El-Kasr-El Aini Street, Cairo, 11562, Egypt
| | - Ghada A Sedik
- Analytical Chemistry Department, Faculty of Pharmacy, Cairo University, El-Kasr-El Aini Street, Cairo, 11562, Egypt.
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Mondal H, Mondal S. Analyse Accuracy of Glucose Monitors without any Dedicated Software Package. Indian J Endocrinol Metab 2022; 26:284-288. [PMID: 36248042 PMCID: PMC9555376 DOI: 10.4103/ijem.ijem_500_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 04/09/2022] [Accepted: 04/22/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Himel Mondal
- Department of Physiology, Saheed Laxman Nayak Medical College and Hospital, Koraput, Odisha, India
| | - Shaikat Mondal
- Department of Physiology, Raiganj Government Medical College and Hospital, West Bengal, India
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Affiliation(s)
- Laurence B Katz
- LifeScan Global Corp., Malvern, PA, USA
- Laurence B Katz, PhD, LifeScan Inc., 20 Valley
Stream Parkway, PA 19355 USA.
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Clinical Applications of Visual Plasmonic Colorimetric Sensing. SENSORS 2020; 20:s20216214. [PMID: 33143365 PMCID: PMC7663786 DOI: 10.3390/s20216214] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 02/06/2023]
Abstract
Colorimetric analysis has become of great importance in recent years to improve the operationalization of plasmonic-based biosensors. The unique properties of nanomaterials have enabled the development of a variety of plasmonics applications on the basis of the colorimetric sensing provided by metal nanoparticles. In particular, the extinction of localized surface plasmon resonance (LSPR) in the visible range has permitted the exploitation of LSPR colorimetric-based biosensors as powerful tools for clinical diagnostics and drug monitoring. This review summarizes recent progress in the biochemical monitoring of clinical biomarkers by ultrasensitive plasmonic colorimetric strategies according to the distance- or the morphology/size-dependent sensing modes. The potential of colorimetric nanosensors as point of care devices from the perspective of naked-eye detection is comprehensively discussed for a broad range of analytes including pharmaceuticals, proteins, carbohydrates, nucleic acids, bacteria, and viruses such as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The practical suitability of plasmonic-based colorimetric assays for the rapid visual readout in biological samples, considering current challenges and future perspectives, is also reviewed.
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Rafat N, Satoh P, Calabrese Barton S, Worden RM. Integrated Experimental and Theoretical Studies on an Electrochemical Immunosensor. BIOSENSORS 2020; 10:bios10100144. [PMID: 33080847 PMCID: PMC7603011 DOI: 10.3390/bios10100144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/11/2020] [Accepted: 10/12/2020] [Indexed: 05/31/2023]
Abstract
Electrochemical immunosensors (EIs) integrate biorecognition molecules (e.g., antibodies) with redox enzymes (e.g., horseradish peroxidase) to combine the advantages of immunoassays (high sensitivity and selectivity) with those of electrochemical biosensors (quantitative electrical signal). However, the complex network of mass-transfer, catalysis, and electrochemical reaction steps that produce the electrical signal makes the design and optimization of EI systems challenging. This paper presents an integrated experimental and modeling framework to address this challenge. The framework includes (1) a mechanistic mathematical model that describes the rate of key mass-transfer and reaction steps; (2) a statistical-design-of-experiments study to optimize operating conditions and validate the mechanistic model; and (3) a novel dimensional analysis to assess the degree to which individual mass-transfer and reaction steps limit the EI's signal amplitude and sensitivity. The validated mechanistic model was able to predict the effect of four independent variables (working electrode overpotential, pH, and concentrations of catechol and hydrogen peroxide) on the EI's signal magnitude. The model was then used to calculate dimensionless groups, including Damkohler numbers, novel current-control coefficients, and sensitivity-control coefficients that indicated the extent to which the individual mass-transfer or reaction steps limited the EI's signal amplitude and sensitivity.
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Affiliation(s)
- Neda Rafat
- Department of Chemical Engineering and Materials Science, Michigan State University, 428 S. Shaw Lane, East Lansing, MI 48824, USA; (N.R.); (P.S.); (S.C.B.)
- The Institute for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Dr, East Lansing, MI 48824, USA
| | - Paul Satoh
- Department of Chemical Engineering and Materials Science, Michigan State University, 428 S. Shaw Lane, East Lansing, MI 48824, USA; (N.R.); (P.S.); (S.C.B.)
| | - Scott Calabrese Barton
- Department of Chemical Engineering and Materials Science, Michigan State University, 428 S. Shaw Lane, East Lansing, MI 48824, USA; (N.R.); (P.S.); (S.C.B.)
| | - Robert Mark Worden
- Department of Chemical Engineering and Materials Science, Michigan State University, 428 S. Shaw Lane, East Lansing, MI 48824, USA; (N.R.); (P.S.); (S.C.B.)
- The Institute for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Dr, East Lansing, MI 48824, USA
- Department of Biomedical Engineering, Michigan State University, 775 Woodlot Dr, East Lansing, MI 48824, USA
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