Continuous Glucose Monitoring

In this paper, we present preliminary results showing the response of glucose-sensitive hydrogels, confined in micro-pressure sensors, to the changes in environmental glucose concentration. The glucose concentrations were incrementally varied between 20 and 0mM in 0.15M PBS solution at 7.4 pH and bovine serum at 7.4 pH at room temperature and response of the sensor was recorded. The micro sensors demonstrate a response time of 10 minutes in both PBS and serum. Tissue response after 55 days of subcutaneous implantation of a EtO sterilized sensor in mice is presented. The preliminary analysis of the surrounding tissue shows inflammation which is believed not to interfere with the sensor performance.

Aims: We evaluated the impact of cystic fibrosis-related diabetes (CFRD) on lung disease and nutritional status.Study Design: The retrospective cohort study evaluated the subjects' medical records from 2004 to 2019. All participants older than 10 years diagnosed by a 30-minutely sampled OGTT formed OGTT-CFRD subgroup. The participants diagnosed with continuous glucose monitoring (CGM) (at least two peaks above 11.1 mmol/l and more than 10% of recorded time above 7.8 mmol/l) formed a CFRD-CGM subgroup. The participants without CFRD formed a non-CFRD group. The longitudinal follow-up was made 2 years before and 3 years after insulin therapy initiation.Results: Of 144 participants included, aged 10–55 years (44% males), 28 (19.4%) had CFRD. The HbA1c was significantly lower in the CGM-CFRD in comparison to the OGTT-CFRD subgroup (5.9 ± 0.62 and 7.3 ± 1.7% respectfully; p = 0.04). Subjects with CFRD were malnourished in comparison to non-CFRD, with significant improvements with insu...

A non-invasive blood glucose monitoring system with six laser diodes is used to obtain a total of 290 NIR spectra from the Oral Glucose Tolerance Test (OGTT) experiment with the participation of a healthy volunteer over 4 days. Each laser diode operates at the discrete wavelengths between 1500nm and 1800nm with the power of 6mW each. A comparative analysis using the Partial Least Squares (PLS) model and the Neural Network (NN) model is studied. The study shows that the NN model performs better than the PLS model due to the presence of nonlinearity in the collected data. The presence of the nonlinearity is tested by using the Durbin-Watson test. ©2009 IEEE.

http://ieeexplore.ieee.org/xpls/abs_all.jsp?arnumber=5384079

Essential properties of biosensors for continuous monitoring in blood
and tissue are selectivity, sensitivity and biocompatibility. A variety of membranes
have been explored to achieve these properties. A good understanding of the diffusion
properties of analytes and interferent species through these membranes is
important for improvement of design and the understanding of response change in
complex biological matrix. A simple analytical expression for the accurate determination
of diffusion coeffi cient of analytes through biofi lms and cylindrical granules
is described and its application for biosensing presented. A general, needle-based,
amperometric platform for the continuous monitoring of oxygen, glucose and lactate
is also described, most notably a recess tip format, and some considerations on
biosensor design and application are discussed.

This work compares several well-known models and simulators which may be used as a means to analyze glucose level controllers for Insulin Dependent Diabetes Mellitus (IDDM) patients. The objective is to compare them in terms of their use in practical situations which should include important issues: model uncertainty, time variations, nonlinearities, glucose and insulin measurement noise, delays between subcutaneous and plasma levels, pump saturation, and real-time controller implementation. The prospective use as a means of controller design is also taken into consideration.

From the very beginning of the civilization, human adopted new technologies to make simple their life, it leads them to the urbanization & industrialization. The result of that is the increasement of pollution in the air. After twentieth century, transportation sector became the major contributor to this pollution. This sector produces harmful gases like CO, HC, NOx etc. This has the harmful effects on the human being, more precisely asthma, eye iteration, lung disorder & consequences of fertility etc. To control the effect of that gases continuous monitoring of that gases is one of the way. Our system can be used to do this process properly. The application of IOT make this system more advance in order to control the car emission. It consist of MQ2, MQ7, MQ135 sensors. The system will implemente nearer to the tailpipe of the vehicle to monitor the emission, the result would be sent to the server as well as in the android application from which the concerned authority can check the result, will help to take the necessary step.

The uptake and utilization of glucose and glutamine by cancer cells is markedly higher than by
most non-transformed, normal epithelial and mesenchymal cells. This metabolic shift enables the
production of ATP and anabolic precursors necessary for the synthesis of proteins, lipids and nucleotides
required for survival, proliferation and invasiveness. The observations that certain oncogenic proteins
(Ras, c-Myc and HIF-1α) and tumor suppressors (P53, PTEN, Rb and VHL) regulate the expression and
activity of several metabolic enzymes has supported their potential as molecular targets for the
development of anti-neoplastic agents. Indeed, recent pre-clinical studies have shown that several
established and novel inhibitors of metabolic enzymes exhibit reasonable therapeutic indices when tested
in xenograft models of tumorigenesis. In this review, we will discuss the rationale of targeting metabolic
enzymes for the treatment of cancer and then will describe published pre-clinical and clinical data for
several inhibitors of metabolism in cancer.

Diabet. Med. 27, 1060–1065 (2010)Diabet. Med. 27, 1060–1065 (2010)AbstractAims  To identify psychosocial factors associated with the use of continuous glucose monitoring by adults with Type 1 diabetes.Methods  Twenty adult patients (aged 45 ± 15 years, diabetes duration 25 ± 19 years, 50% female) followed at our site in the multi-centre Juvenile Diabetes Research Foundation continuous glucose monitoring trial were divided into three groups: Glycated haemoglobin (HbA1c) Responders who demonstrated an improvement in glycaemic control with continuous glucose monitoring (baseline HbA1c≥ 7.0%, HbA1c reduction greater than or equal to 0.5%), Hypoglycaemia Responders (baseline HbA1c < 7.0%) who demonstrated decreased time < 3.9 mmol/l while remaining within target HbA1c, and HbA1c Non-Responders (baseline HbA1c≥ 7.0%, HbA1c reduction less than 0.5%). Subjects participated in semi-structured interviews focusing on their psychosocial experiences with continuous glucose monitoring.Results  Three major themes were identified that differentiated Responders (including both the HbA1c and Hypoglycaemia groups) from Non-Responders: (i) coping with frustrations—Responders used self-controlled rather than emotions-based coping when faced with continuous glucose monitoring frustrations; (ii) use of information—Responders used retrospective pattern analysis, not just minute-by-minute data analysis, in glycaemic management; (iii) ‘significant other’/spousal involvement—Responders endorsed interest, encouragement and participation by their loved ones. Both Responders and Non-Responders expressed body image concerns when wearing continuous glucose monitoring devices.Conclusions  This qualitative study points to the importance of coping skills, retrospective review of data, and ‘significant other’ involvement in the effective use of continuous glucose monitoring. These findings will inform clinical initiatives to improve patient selection and training in the use of this new technology and have served as the basis for development of quantitative surveys to be used in clinical practice.Aims  To identify psychosocial factors associated with the use of continuous glucose monitoring by adults with Type 1 diabetes.Methods  Twenty adult patients (aged 45 ± 15 years, diabetes duration 25 ± 19 years, 50% female) followed at our site in the multi-centre Juvenile Diabetes Research Foundation continuous glucose monitoring trial were divided into three groups: Glycated haemoglobin (HbA1c) Responders who demonstrated an improvement in glycaemic control with continuous glucose monitoring (baseline HbA1c≥ 7.0%, HbA1c reduction greater than or equal to 0.5%), Hypoglycaemia Responders (baseline HbA1c < 7.0%) who demonstrated decreased time < 3.9 mmol/l while remaining within target HbA1c, and HbA1c Non-Responders (baseline HbA1c≥ 7.0%, HbA1c reduction less than 0.5%). Subjects participated in semi-structured interviews focusing on their psychosocial experiences with continuous glucose monitoring.Results  Three major themes were identified that differentiated Responders (including both the HbA1c and Hypoglycaemia groups) from Non-Responders: (i) coping with frustrations—Responders used self-controlled rather than emotions-based coping when faced with continuous glucose monitoring frustrations; (ii) use of information—Responders used retrospective pattern analysis, not just minute-by-minute data analysis, in glycaemic management; (iii) ‘significant other’/spousal involvement—Responders endorsed interest, encouragement and participation by their loved ones. Both Responders and Non-Responders expressed body image concerns when wearing continuous glucose monitoring devices.Conclusions  This qualitative study points to the importance of coping skills, retrospective review of data, and ‘significant other’ involvement in the effective use of continuous glucose monitoring. These findings will inform clinical initiatives to improve patient selection and training in the use of this new technology and have served as the basis for development of quantitative surveys to be used in clinical practice.

Objective: Spinal misalignment increases spinal cord tension and is linked to various health conditions. There has never been a study on the impact of spinal alignment on blood glucose metabolism. This prospective case with long-term follow-up explores spinal alignment and its impact on type 1 diabetes mellitus.
Case and methods: A 26-year-old male presented with chronic mid-back pain for 9 years and type 1 diabetes mellitus. Radiography and MRI revealed hypokyphosis of the thoracic spine with spinal misalignment from thoracic vertebrae 6 through 9 consistent with vertebral subluxation. Glycosylated hemoglobin and blood-glucose averages were obtained by continuous glucose monitoring. Back pain, paraspinal muscle tension, and quality of life were also measured. The patient received Chiropractic BioPhysics® care including Mirror Image® corrective spinal exercises, adjustments, and traction.
Results: After 36 visits, the patient reported improvement in his mid-back pain and quality of life. Thoracic x-rays showed correction of thoracic hypokyphosis. Surface EMG measuring paraspinal muscle tension improved and continuous glucose monitoring showed dramatic drop in blood glucose immediately following the onset of each visit and improvement in blood glucose averages, percentage of time of blood glucose in a healthy target range, and glycosylated hemoglobin. The patient reported he reduced his basal insulin by approximately half during chiropractic care.
Conclusions: This case suggests that correction of thoracic hypokyphosis using Chiropractic BioPhysics® care protocols may result in improved glycosylated hemoglobin and blood glucose metabolism for a person with type 1 diabetes mellitus, as well as back pain, paraspinal muscle tension, and quality of life.

Objectives:To systematically review whether the mode of intensive insulin therapy (continuous subcutaneous insulin infusion [CSII] vs. multiple daily injections [MDI]) and/or the mode of blood glucose monitoring (real time-continuous glucose monitoring [rt-CGM] vs. self-monitoring of blood glucose [SMBG]) results in better glycemic control, less hypoglycemia, improved quality of life, and improved clinical outcomes in individuals with type 1 diabetes, type 2 diabetes, and pre-existing diabetes in pregnancy.

Objectives: To systematically review whether the mode of intensive insulin therapy (continuous subcutaneous insulin infusion [CSII] vs. multiple daily injections [MDI]) and/or the mode of blood glucose monitoring (real time-continuous glucose monitoring [rt-CGM] vs. self-monitoring of blood glucose [SMBG]) results in better glycemic control, less hypoglycemia, improved quality of life, and improved clinical outcomes in individuals with type 1 diabetes, type 2 diabetes, and pre-existing diabetes in pregnancy.

We demonstrate that microporous PVDF membranes sandwiched between multiple layers of nanoma-terials can be used for continuous monitoring of glucose level in vivo. This is achieved by coating needle electrodes with Polyaniline nanofiber, Platinum nanoparticles, glucose oxidase enzyme and porous layers, successfully fabricated with layer-by-layer deposition. Nanoparticles incorporated into conductive Polyaniline nanofibers resulted in high surface to volume ratio and electrocatalytic activity for glucose enzyme. A composite coating membrane of porous PVDF and nano-sphere Nafion limited the glucose transportation and increased the lifetime of in vivo measurements. The glucose biosensor exhibited a sub-microamperometric output current, fast response time of less than 30 s and a sensitivity of 0.23 μA/ mM. The linear sensing range in terms of glucose concentration was from 0 to 20 mM. Implantable experiments using mice models showed excellent response to the variation of blood glucose concentration while maintaining biocompatibility with the surrounding tissues. The sensitivity was shown to remain within 10% close to initial sensitivity within the 7 days of continuous monitoring, and maintain at 70% of the initial sensitivity within 21 days.

The pervasive availability of smartphones and their connected external sensors or wearable devices can provide a new public health data collection capability. Current research and commercial efforts have concentrated on sensor-based collection of health data for personal fitness and healthcare feedback purposes. However, to date there has not been a detailed investigation of how such smartphones and sensors can be utilized for public health data collection purposes. Public health data have the characteristic of being capturable while still not infringing upon privacy, as the full detailed data of individuals are not needed but rather only anonymized, aggregate, de-identified, and nonunique data for an individual. For example, rather than details of physical activity including specific route, just total caloric burn over a week or month could be submitted, thereby strongly assisting non-reidentification. In this paper we introduce, prototype, and evaluate a new type of public health information system to provide aggregate population health data capture and public health intervention capabilities via utilizing smartphone and sensor capabilities, while fully maintaining the anonymity and privacy of each individual. We consider in particular the key aspects of privacy, anonymity, and intervention capabilities of these emerging systems and provide a detailed evaluation of anonymity preservation characteristics.

Biomass is one of the major natural resources and biomass has always been a major source of energy for mankind and it is presently estimated to contribute of the order 10-14% of the world energy supply. The more efficient use of biomass is demanded to solve the global crisis such as depletion of fossil fuel and global warming. Woody biomass, including agriculture residues, wood chips, municipal solid wastes, paper wastes, etc., has already been transferred to bio-ethanol and bio-diesel in some cases and used as energy related products, although many issues such as efficiency and productivity still exist to be overcome. Xylose is one of the major fermentable sugars present in woody biomass, the second most abundant carbohydrate polymer in nature to glucose. The efficient fermentation of glucose as well as xylose are required to develop economically viable processes for producing biofuels such as ethanol from woody biomass. Saccharomyces cerevisieae is the favored ethanol-producing microorganism, but it can not metabolize xylose which is an unfermentable sugar of the pentose category. Xylose consuming yeasts such as Pichia stipitis can metabolize xylose through expression of xylose reductase (XR) and xylitol dehydrogenase (XDH). However, Pichia stipitis is susceptible to ethanol and obliges stumpy and carefully controlled oxygenation, these disadvantages avert its usage for industrial ethanol production. Saccharomyces strains producing XR and XDH from Pichia stipitis has the ability to produce ethanol from xylose. During this course, the problems are limited production of ethanol and high xylitol excretion. The making of thermostable XDH carried out in this study is expected to resolve these problems. The significant enhancement was found in Y-C4 strain that contained thermostable enzyme XDH, 51% decrease of unfavorable xylitol excretion with 19% increased ethanol production, when compared with the reference strain expressing the wild-type XDH. © 2008 Springer-Verlag.

http://link.springer.com/chapter/10.1007/978-3-540-69139-6_78

Diabetic individuals need to tightly control their blood glucose concentration. Several methods have been developed for this purpose, such as the finger-prick or continuous glucose monitoring systems (CGMs). However, these methods present the disadvantage of being invasive. Moreover, CGMs have limited accuracy, notably to detect hypoglycemia. It is also known that physical exercise, and even daily activity, disrupt glucose dynamics and can generate problems with blood glucose regulation during and after exercise. In order to deal with these challenges, devices for monitoring patients&#39; physical activity are currently under development. This review focuses on non-invasive sensors using physiological parameters related to physical exercise that were used to improve glucose monitoring in type 1 diabetes (T1DM) patients. These devices are promising for diabetes management. Indeed they permit to estimate glucose concentration either based solely on physical activity parameters or in c...

To assess the relevance of unrecognized hyperglycemia among high-risk subjects for developing diabetes a cross-sectional study was carried out. Subjects aged 40-75 years with (high-risk group) and without (control group) history of impaired glucose metabolism underwent a 2h-oral glucose tolerance test (OGTT). All individuals with diabetes diagnostic criteria and all controls with glucose abnormalities at OGTT were excluded. An individualized 48-h continuous glucose monitoring (CGM) calibrated by fasting plasma glucose was performed. The microdialysis-based biosensor recordings were computerized in order to identify continuous glucose profiles. Of the 121 monitored subjects, 104 were finally analyzed (56.7% female, 57.8 years, BMI=29.2, A1C=4.9%, HOMA index=2.5). Glucose profiles corresponded to 31 controls (29.8%), 32 high-risk individuals with normal OGTT (30.8%) and 41 (39.4%) with hyperglycemia at OGTT. The recordings defined as hyperglycemia (fasting &amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=6.1 mmol/l, non-fasting &amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=7.8 mmol/l) appeared during an average of 1.4h, 4.9h and 7.6h (3.9%, 13.9% and 19% of the CGM time), respectively. The highest percentage of impaired CGM registers corresponded to the fasting period. Nevertheless, the longest duration corresponded to the non-fasting period. The CGM evidenced a relevant degree of casual undetected hyperglycaemia among high-risk individuals.

Automated closed-loop insulin delivery, also referred to as the &#39;artificial pancreas&#39;, has been an important but elusive goal of diabetes treatment for many decades. Research milestones include the conception of continuous glucose monitoring in the early 1960s, followed by the production of the first commercial hospital-based artificial pancreas in the late 1970s that combined intravenous glucose sensing and insulin delivery. In the past 10 years, research into the artificial pancreas has gained substantial momentum and focused on the subcutaneous route for glucose measurement and insulin delivery, which reflects technological advances in interstitial glucose monitoring and the increasing use of the continuous subcutaneous insulin infusion. This Review discusses the design of an artificial pancreas, its components and clinical results, as well as the advantages and disadvantages of different types of automated closed-loop systems and potential future advances. The introducti...

This paper presents a novel framework on a remotely
powered implantable glucose monitoring system. The RF signal
interaction with the biological tissue under investigation has been
characterized. The implantable unit is remotely powered by an
external unit through inductive coupling. The novelty of this
work resides in the design of two efficient class E Power
Amplifiers (PAs) with power efficiency of 76% and 73% for the
external power unit and the implantable unit respectively. The
implantable wireless transmitter utilizes low power
communication protocol, Bluetooth low energy, to transmit the
measured glucose data to patient’s mobile phone or PDA.

Deep eutectic solvents (DESs) are considered nowadays as green ionic liquid (IL) analogues. Despite their relatively short period of introduction as a special class of ILs, they have been under an increasing emphasis by the scientific community due to their favorable properties. In the present study, a glucose based DES of choline chloride (2-hydroxyethyl-trimethylammonium chloride) with the monosaccharide sugar d-glucose anhydrous was synthesized at different molar ratios. The physical properties of density, viscosity, surface tension, refractive index, and pH were measured and analyzed as function of temperature in the practical temperature range of 298.15-358.15 K. The analysis of these physical properties revealed that these novel DESs have the potential to be utilized for several possible industrial applications involving processing and separation of food constituents, pharmaceutical applications, as well as mediums for chemical reactions. © 2012 Elsevier B.V.

http://ac.els-cdn.com/S0167732212004382/1-s2.0-S0167732212004382-main.pdf?_tid=b5a468c2-0ca1-11e4-b32b-00000aacb35d&acdnat=1405485120_3986b537c7d953e133b7117c8d72dee4 
http://www.sciencedirect.com/science/article/pii/S0167732212004382

Glucose substrates are successfully harnessed to generate electricity in a membraneless biofuel cell with a mesh network of carbon nanotubes pyroquinoline quinone glucose dehydrogenase-modified anode and a laccase-modified cathode. Using glucose as a substrate, this glucose-oxygen biofuel cell is able to produce a steady current density of 337.5 µA/cm² and an open circuit voltage of 524 mV in 360 mg/dL glucose solution. Interestingly, the fuel cell in combination with a capacitor as the transducer element can also be utilized as a glucose monitor while generating electricity simultaneously to power small electronic devices, such as light emitting diode (LED). Moreover, the self-powered glucose monitor exhibited a linear dynamic range of 9 mg/dL to 630 mg/dL glucose. These results and device demonstrations suggest that further research into self-powered glucose monitors can provide major benefit in developing a novel autonomous implantable glucose monitor platform to greatly improve the quality of life for individuals living with diabetes.

User acceptability of new health technologies is important in determining their widespread use and adoption. The aim of this current study was twofold: first, to investigate the acceptability of two continuous glucose monitoring devices for people with diabetes; and second, to develop a valid questionnaire measure to assess the acceptability of continuous glucose monitoring devices. Semi-structured interviews were conducted with six people with diabetes who had previously used the GlucoWatchBiographer (Animas Corp., West Chester, PA) or the CGMS continuous glucose monitoring system (Medtronic MiniMed, Northridge, CA) in order to increase understanding of the issues relating to acceptability of, and satisfaction with, the devices. Interview transcripts were analyzed qualitatively using framework analysis. These analyses, together with consultation with researchers and health professionals in the field, provided the foundation for development of a questionnaire measure that was pilote...