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Journal of the American College of... Oct 2018The primary objective of this study was to analyze the most up-to-date evidence regarding whether and how blood sugar regulation influences cardiovascular health... (Review)
Review
The primary objective of this study was to analyze the most up-to-date evidence regarding whether and how blood sugar regulation influences cardiovascular health promotion and disease prevention by carrying out an umbrella review. Three separate, systematic literature searches identified 2,343 papers in total. Overall, 44 studies were included for data extraction and analysis. The included systematic reviews and meta-analyses published between January 1, 2016, and December 31, 2017, were of good to very good quality (median Overview Quality Assessment Questionnaire score = 17). Identified evidence suggests that cardiovascular disease (CVD) prevention services should consider regulation of blood glucose as a key target for intervention. Furthermore, the recommendations for effective intervention and service development/training described here for prevention of CVD should be adopted into evidence-based practice guidelines. Multidisciplinary teams should be formed to deliver multicomponent interventions in community-based settings. There may be substantial opportunities for integrating CVD and diabetes prevention services.
Topics: Blood Glucose; Cardiovascular Diseases; Health Promotion; Humans; Meta-Analysis as Topic; Primary Prevention; Systematic Reviews as Topic
PubMed: 30286928
DOI: 10.1016/j.jacc.2018.07.081 -
PloS One 2021Glycemic control is essential to manage metabolic diseases such as diabetes. Frequent measurements of systemic glucose levels with prompt managements can prevent organ... (Observational Study)
Observational Study
Glycemic control is essential to manage metabolic diseases such as diabetes. Frequent measurements of systemic glucose levels with prompt managements can prevent organ damages. The eye is a glucose highly demanding organ in our body, and the anterior chamber (AC) in the eye has been suggested for a noninvasive blood glucose monitoring site. However, calculating blood glucose levels from measuring glucose levels in AC has been difficult and unclear. In this study, we aimed to examine glucose levels from AC and find a correlation with blood glucose levels. A total of 30 patients with cataracts (men and women, study 1; 7 and 3, study 2; 9 and 11) who visited Keio University Hospital from 2015 to 2018 and agreed to participate in this study were recruited. Glucose levels from AC and the blood were examined by a UV-hexokinase or H2O2-electrode method before/during the cataract surgery. These values were analyzed with regression analyses depending on the groups (blood glucose-ascending and descending groups). In the blood glucose-descending group, glucose levels from AC were strongly correlated with blood glucose levels (a high R2 value, 0.8636). However, the relatively moderate correlation was seen in the blood glucose-ascending group (a low R2 value, 0.5228). Taken together, we showed different correlation ratios on glucose levels between AC and the blood, based on blood glucose dynamics. Stacking data regarding this issue would enable establishing noninvasive blood glucose monitoring from measuring glucose levels in AC more correctly, which will be helpful for proper and prompt managements for glucose-mediated complications.
Topics: Aged; Aged, 80 and over; Anterior Chamber; Blood Glucose; Blood Glucose Self-Monitoring; Cataract Extraction; Diabetes Mellitus; Female; Glucose; Humans; Hypoglycemic Agents; Male; Middle Aged; Prospective Studies
PubMed: 34469502
DOI: 10.1371/journal.pone.0256986 -
European Review For Medical and... Sep 2022Traditional blood glucose testing methods have several disadvantages, such as high pain and poor acquisition continuity. In response to these shortcomings, we propose a...
OBJECTIVE
Traditional blood glucose testing methods have several disadvantages, such as high pain and poor acquisition continuity. In response to these shortcomings, we propose a multi-parameter fusion non-invasive blood glucose detection method that combines machine learning and photoplethysmography (PPG) signal feature parameter analysis.
MATERIALS AND METHODS
This method uses the signal validity check process based on the correlation operation to test and calculate PPG data. It, then, respectively applies the bootstrap aggregation algorithm and the random forests algorithm to establish two non-invasive blood glucose detection models that comprehensively predict blood glucose data.
RESULTS
Experimental comparative analysis showed that the accuracy of the detection model based on the random forests algorithm is superior. The correlation coefficient of the obtained blood glucose prediction set is 0.972, the mean square error is 0.257, and the relative error is less than ± 20%.
CONCLUSIONS
Relative error in blood glucose prediction meets the national standards in China. Meanwhile, the results of the Clarke Error Grid Analysis indicate that the non-invasive blood glucose testing method proposed in this study meets clinical accuracy requirements.
Topics: Algorithms; Blood Glucose; China; Machine Learning; Photoplethysmography
PubMed: 36111903
DOI: 10.26355/eurrev_202209_29618 -
Annual International Conference of the... Jul 2019Diabetes is a chronic disease characterized by abnormal blood glucose levels which has short and long term complications. Management of diabetes relies on a regular...
Diabetes is a chronic disease characterized by abnormal blood glucose levels which has short and long term complications. Management of diabetes relies on a regular control of blood glucose levels, commonly measured with invasive sensors, which are painful and cause patient discomfort. Scientific community is trying to develop noninvasive monitoring sensors to measure blood glucose continuously. Whereas previous work are focused on single methods and techniques, we present hereby a feasibility study of a non-invasive sensor integrating three different types of techniques: electromagnetic, acoustic speed and near infra-red spectroscopy. Our prototype is subject to different sources of bias, however, the cross-compensation of these three techniques can minimize the low performance of single-technique approaches. The results are promising and show the potential of using combined techniques for non-invasive blood glucose measurement.
Topics: Biosensing Techniques; Blood Glucose; Blood Glucose Self-Monitoring; Diabetes Mellitus; Feasibility Studies; Humans; Insulin Infusion Systems; Spectroscopy, Near-Infrared
PubMed: 31946104
DOI: 10.1109/EMBC.2019.8857261 -
Journal of Veterinary Internal Medicine May 2018Little information is available about posthypoglycemic hyperglycemia (PHH) in diabetic cats, and a causal link between hypoglycemia and subsequent hyperglycemia is not...
BACKGROUND
Little information is available about posthypoglycemic hyperglycemia (PHH) in diabetic cats, and a causal link between hypoglycemia and subsequent hyperglycemia is not clear. Fluctuations in blood glucose concentrations might only represent high glycemic variability.
HYPOTHESIS
Insulin induces PHH in healthy cats, and PHH is associated with poorly regulated diabetes and increased glycemic variability in diabetic cats.
ANIMALS
Six healthy cats, 133 diabetic cats.
METHODS
Insulin (protamine-zinc and degludec; 0.1-0.3 IU/kg) administered to healthy cats. Blood glucose curves were generated with portable glucose meter to determine the percentage of curves with PHH. Data from insulin-treated diabetic cats with blood glucose curves showing hypoglycemia included data of cats with and without PHH. Post-hypoglycemic hyperglycemia was defined as blood glucose concentrations <4 mmol/L followed by blood glucose concentrations >15 mmol/L within 12 hours. Glycemic variability was calculated as the standard deviation of the blood glucose concentrations.
RESULTS
In healthy cats, all insulin doses caused hypoglycemia but PHH was not observed; glycemic variability did not differ between insulin preparations. Among diabetic cats with hypoglycemia, 33 (25%) had PHH. Compared with cats without PHH, their daily insulin dose was higher (1.09 ± 0.55 versus 0.65 ± 0.56 IU/kg; P < .001), serum fructosamine concentration was higher (565 ± 113 versus 430 ± 112 µmol/L; P < .001), remission was less frequent (10% versus 56%; P < .001), and glycemic variability was larger (8.1 ± 2.4 mmol/L versus 2.9 ± 2.2 mmol/L; P < .001).
CONCLUSIONS AND CLINICAL IMPORTANCE
Insulin-induced hypoglycemia did not cause PHH in healthy cats but it occurred in 25% of diabetic cats with hypoglycemia, particularly when diabetes was poorly controlled. Glycemic variability was increased in cats with PHH.
Topics: Animals; Blood Glucose; Case-Control Studies; Cat Diseases; Cats; Diabetes Mellitus; Female; Hypoglycemia; Insulin; Male
PubMed: 29603806
DOI: 10.1111/jvim.15134 -
Current Opinion in Anaesthesiology Jun 2019The implications for perioperative management of new oral antihyperglycemic medications and new insulin treatment technologies are reviewed. (Review)
Review
PURPOSE OF REVIEW
The implications for perioperative management of new oral antihyperglycemic medications and new insulin treatment technologies are reviewed.
RECENT FINDINGS
The preoperative period represents an opportunity to optimize glycemic control and potentially to reduce adverse outcomes. There is now general consensus that the optimal blood glucose target for hospitalized patients is approximately 106-180 mg/dl (6-10 mmol/l). Recommendations for the management of antihyperglycemic medications vary among national guidelines. It may not be necessary to cease all antihyperglycemic agents prior to surgery. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are associated with higher rates of ketoacidosis especially in acutely unwell and postsurgical patients. The clinical practice implications of new insulin formulations, and new systems for insulin delivery, are not clear. The optimal perioperative management of these will vary depending on local institutional factors such as staff skills and existing clinical practices. Improved hospital care delivery standards, quality assurance, process improvements, consistency in clinical practice, and coordinated multidisciplinary teamwork should be a major focus for improving outcomes of perioperative patients with diabetes.
SUMMARY
Sulfonylureas and SGLT2i should be ceased before moderate or major surgery. Other oral antihyperglycemic therapies may be continued or ceased. Complex patients and/or new therapies require specialized multidisciplinary management.
Topics: Administration, Oral; Blood Glucose; Diabetes Mellitus; Humans; Hypoglycemic Agents; Insulin; Patient Care Planning; Patient Care Team; Perioperative Care; Postoperative Complications; Practice Guidelines as Topic; Surgical Procedures, Operative
PubMed: 30958402
DOI: 10.1097/ACO.0000000000000735 -
Journal of Diabetes Science and... Sep 2019In this commentary, we briefly review the currently recommended approaches to interpretation and management of continuous glucose monitor (CGM) rate of change (ROC)... (Review)
Review
In this commentary, we briefly review the currently recommended approaches to interpretation and management of continuous glucose monitor (CGM) rate of change (ROC) trend arrows and discuss the inherent difficulty in incorporating practical recommendations for their application into routine clinical care. We have limited our review and discussion to the currently available Dexcom G5 and G6 CGM systems and Abbott's Freestyle Libre flash glucose monitor (FGM) system, as they are the most widely used and currently approved for nonadjunctive use in the United States.
Topics: Blood Glucose; Blood Glucose Self-Monitoring; Clinical Decision-Making; Humans
PubMed: 30636438
DOI: 10.1177/1932296818823538 -
Journal of Diabetes Science and... Nov 2014Glycemic control in hospitalized patients with diabetes requires accurate near-patient glucose monitoring systems. In the past decade, point-of-care blood glucose... (Review)
Review
Glycemic control in hospitalized patients with diabetes requires accurate near-patient glucose monitoring systems. In the past decade, point-of-care blood glucose monitoring devices have become the mainstay of near-patient glucose monitoring in hospitals across the world. In this article, we focus on its history, accuracy, clinical use, and cost-effectiveness. Point-of-care devices have evolved from 1.2 kg instruments with no informatics to handheld lightweight portable devices with advanced connectivity features. Their accuracy however remains a subject of debate, and new standards for their approval have now been issued by both the International Organization for Standardization and the Clinical and Laboratory Standards Institute. While their cost-effectiveness remains to be proved, their clinical value for managing inpatients with diabetes remains unchallenged. This evidence-based review provides an overall view of its use in the hospital setting.
Topics: Blood Glucose; Cost-Benefit Analysis; Evidence-Based Medicine; Hospitals; Humans; Inpatients; Point-of-Care Systems
PubMed: 25355711
DOI: 10.1177/1932296814538940 -
BMC Research Notes Dec 2022To compare the accuracy of point-of-care capillary and venous/arterial samples to laboratory testing of venous/arterial samples in critically sick shocked and...
OBJECTIVES
To compare the accuracy of point-of-care capillary and venous/arterial samples to laboratory testing of venous/arterial samples in critically sick shocked and non-shocked patients. This is a prospective case-control study including capillary, venous, and arterial blood samples from 268 critically ill patients. The King Fahd Military Medical Complex in Dhahran, Saudi Arabia, was the site of this investigation.
RESULTS
We were able to obtain data on 268 patients for this investigation. POCT and lab findings of venous and central blood did not differ significantly (P = 0.389 and 0.208), while POCT indicated somewhat higher results with venous glucose concentrations of 10.18 and 10.05 (POCT and lab tests respectively) and 9.18 and 9.54 (POCT and lab tests respectively). In addition, the mean differences between POC and laboratory analyses of venous, arterial, and central glucose were 0.13, - 1.75, and - 0.36 mmol/L for venous, arterial, and central glucose, respectively. Except for arterial blood glucose, we did not observe a significant difference between POCT and routine laboratory analysis of glucose concentrations in critically ill patients. Compared to laboratory blood analysis, the use of POCT is marginally accurate, with no difference between shocked and non-shocked patients.
Topics: Humans; Point-of-Care Systems; Blood Glucose; Critical Illness; Case-Control Studies; Veins; Shock
PubMed: 36528779
DOI: 10.1186/s13104-022-06256-0 -
Clinical Chemistry May 2009
Topics: Blood Glucose; Diabetes Mellitus; Humans; Reproducibility of Results; Specimen Handling
PubMed: 19282352
DOI: 10.1373/clinchem.2009.126037