Basement Membrane-Based Glucose Sensor Coatings Enhance Continuous Glucose Monitoring in Vivo
Klueh, Ulrike; Qiao, Yi; Czajkowski, Caroline; Ludzinska, Izabela; Antar, Omar; Kreutzer, Donald L.
2015-01-01
Background: Implantable glucose sensors demonstrate a rapid decline in function that is likely due to biofouling of the sensor. Previous efforts directed at overcoming this issue has generally focused on the use of synthetic polymer coatings, with little apparent effect in vivo, clearly a novel approach is required. We believe that the key to extending sensor life span in vivo is the development of biocompatible basement membrane (BM) based bio-hydrogels as coatings for glucose sensors. Method: BM based bio-hydrogel sensor coatings were developed using purified BM preparations (ie, Cultrex from Trevigen Inc). Modified Abbott sensors were coated with Cultrex BM extracts. Sensor performance was evaluated for the impact of these coatings in vitro and in vivo in a continuous glucose monitoring (CGM) mouse model. In vivo sensor function was assessed over a 28-day time period expressed as mean absolute relative difference (MARD) values. Tissue reactivity of both Cultrex coated and uncoated glucose sensors was evaluated at 7, 14, 21 and 28 days post–sensor implantation with standard histological techniques. Results: The data demonstrate that Cultrex-based sensor coatings had no effect on glucose sensor function in vitro. In vivo glucose sensor performance was enhanced following BM coating as determined by MARD analysis, particularly in weeks 2 and 3. In vivo studies also demonstrated that Cultrex coatings significantly decreased sensor-induced tissue reactions at the sensor implantation sites. Conclusion: Basement-membrane-based sensor coatings enhance glucose sensor function in vivo, by minimizing or preventing sensor-induced tissues reactions. PMID:26306494
Basement Membrane-Based Glucose Sensor Coatings Enhance Continuous Glucose Monitoring in Vivo.
Klueh, Ulrike; Qiao, Yi; Czajkowski, Caroline; Ludzinska, Izabela; Antar, Omar; Kreutzer, Donald L
2015-08-25
Implantable glucose sensors demonstrate a rapid decline in function that is likely due to biofouling of the sensor. Previous efforts directed at overcoming this issue has generally focused on the use of synthetic polymer coatings, with little apparent effect in vivo, clearly a novel approach is required. We believe that the key to extending sensor life span in vivo is the development of biocompatible basement membrane (BM) based bio-hydrogels as coatings for glucose sensors. BM based bio-hydrogel sensor coatings were developed using purified BM preparations (ie, Cultrex from Trevigen Inc). Modified Abbott sensors were coated with Cultrex BM extracts. Sensor performance was evaluated for the impact of these coatings in vitro and in vivo in a continuous glucose monitoring (CGM) mouse model. In vivo sensor function was assessed over a 28-day time period expressed as mean absolute relative difference (MARD) values. Tissue reactivity of both Cultrex coated and uncoated glucose sensors was evaluated at 7, 14, 21 and 28 days post-sensor implantation with standard histological techniques. The data demonstrate that Cultrex-based sensor coatings had no effect on glucose sensor function in vitro. In vivo glucose sensor performance was enhanced following BM coating as determined by MARD analysis, particularly in weeks 2 and 3. In vivo studies also demonstrated that Cultrex coatings significantly decreased sensor-induced tissue reactions at the sensor implantation sites. Basement-membrane-based sensor coatings enhance glucose sensor function in vivo, by minimizing or preventing sensor-induced tissues reactions. © 2015 Diabetes Technology Society.
Factory-Calibrated Continuous Glucose Sensors: The Science Behind the Technology.
Hoss, Udo; Budiman, Erwin Satrya
2017-05-01
The use of commercially available continuous glucose monitors for diabetes management requires sensor calibrations, which until recently are exclusively performed by the patient. A new development is the implementation of factory calibration for subcutaneous glucose sensors, which eliminates the need for user calibrations and the associated blood glucose tests. Factory calibration means that the calibration process is part of the sensor manufacturing process and performed under controlled laboratory conditions. The ability to move from a user calibration to factory calibration is based on several technical requirements related to sensor stability and the robustness of the sensor manufacturing process. The main advantages of factory calibration over the conventional user calibration are: (a) more convenience for the user, since no more fingersticks are required for calibration and (b) elimination of use errors related to the execution of the calibration process, which can lead to sensor inaccuracies. The FreeStyle Libre ™ and FreeStyle Libre Pro ™ flash continuous glucose monitoring systems are the first commercially available sensor systems using factory-calibrated sensors. For these sensor systems, no user calibrations are required throughout the sensor wear duration.
Factory-Calibrated Continuous Glucose Sensors: The Science Behind the Technology
Budiman, Erwin Satrya
2017-01-01
Abstract The use of commercially available continuous glucose monitors for diabetes management requires sensor calibrations, which until recently are exclusively performed by the patient. A new development is the implementation of factory calibration for subcutaneous glucose sensors, which eliminates the need for user calibrations and the associated blood glucose tests. Factory calibration means that the calibration process is part of the sensor manufacturing process and performed under controlled laboratory conditions. The ability to move from a user calibration to factory calibration is based on several technical requirements related to sensor stability and the robustness of the sensor manufacturing process. The main advantages of factory calibration over the conventional user calibration are: (a) more convenience for the user, since no more fingersticks are required for calibration and (b) elimination of use errors related to the execution of the calibration process, which can lead to sensor inaccuracies. The FreeStyle Libre™ and FreeStyle Libre Pro™ flash continuous glucose monitoring systems are the first commercially available sensor systems using factory-calibrated sensors. For these sensor systems, no user calibrations are required throughout the sensor wear duration. PMID:28541139
An Implantable RFID Sensor Tag toward Continuous Glucose Monitoring.
Xiao, Zhibin; Tan, Xi; Chen, Xianliang; Chen, Sizheng; Zhang, Zijian; Zhang, Hualei; Wang, Junyu; Huang, Yue; Zhang, Peng; Zheng, Lirong; Min, Hao
2015-05-01
This paper presents a wirelessly powered implantable electrochemical sensor tag for continuous blood glucose monitoring. The system is remotely powered by a 13.56-MHz inductive link and utilizes an ISO 15693 radio frequency identification (RFID) standard for communication. This paper provides reliable and accurate measurement for changing glucose level. The sensor tag employs a long-term glucose sensor, a winding ferrite antenna, an RFID front-end, a potentiostat, a 10-bit sigma-delta analog to digital converter, an on-chip temperature sensor, and a digital baseband for protocol processing and control. A high-frequency external reader is used to power, command, and configure the sensor tag. The only off-chip support circuitry required is a tuned antenna and a glucose microsensor. The integrated chip fabricated in SMIC 0.13-μm CMOS process occupies an area of 1.2 mm ×2 mm and consumes 50 μW. The power sensitivity of the whole system is -4 dBm. The sensor tag achieves a measured glucose range of 0-30 mM with a sensitivity of 0.75 nA/mM.
Consistency of Continuous Ambulatory Interstitial Glucose Monitoring Sensors.
Wu, Pei T; Segovia, David E; Lee, Cathy C; Nguyen, Kim-Lien
2018-05-16
The abdominal region is the most common location for continuous glucose monitor (CGM) sensor insertion. However, a paucity of post-marketing data is available to demonstrate intra-individual consistency of CGM readings at different abdominal insertion sites. Healthy adults (fasting glucose (FG) < 5.5 mmol/L; BMI < 30 kg/m²) were recruited and a CGM sensor was placed on each side of the abdomen. Postprandial and continuous 48-h interstitial glucose levels were analyzed. There was no significant difference in the 3-h postprandial glucose (PPG) level derived from the left versus right CGM, which remained non-significant after adjusting for waist circumference or FG. Among the glucose levels recorded over 48-h, values on the left site were greater in 3.6% of the data points ( p < 0.05). After adjusting for waist circumference, only 0.5% of the glucose values remained significantly greater on the left ( p < 0.05). When adjusted for FG, similar results were observed. For both PPG and 48-h readings, the mean absolute relative difference was not significant between the two abdominal sites. CGM-derived glucose measures were highly consistent between the left and right abdomen during both the postprandial and post-absorptive periods.
Hoss, Udo; Jeddi, Iman; Schulz, Mark; Budiman, Erwin; Bhogal, Claire; McGarraugh, Geoffrey
2010-08-01
Commercial continuous subcutaneous glucose monitors require in vivo calibration using capillary blood glucose tests. Feasibility of factory calibration, i.e., sensor batch characterization in vitro with no further need for in vivo calibration, requires a predictable and stable in vivo sensor sensitivity and limited inter- and intra-subject variation of the ratio of interstitial to blood glucose concentration. Twelve volunteers wore two FreeStyle Navigator (Abbott Diabetes Care, Alameda, CA) continuous glucose monitoring systems for 5 days in parallel for two consecutive sensor wears (four sensors per subject, 48 sensors total). Sensors from a prototype sensor lot with a low variability in glucose sensitivity were used for the study. Median sensor sensitivity values based on capillary blood glucose were calculated per sensor and compared for inter- and intra-subject variation. Mean absolute relative difference (MARD) calculation and error grid analysis were performed using a single calibration factor for all sensors to simulate factory calibration and compared to standard fingerstick calibration. Sensor sensitivity variation in vitro was 4.6%, which increased to 8.3% in vivo (P < 0.0001). Analysis of variance revealed no significant inter-subject differences in sensor sensitivity (P = 0.134). Applying a single universal calibration factor retrospectively to all sensors resulted in a MARD of 10.4% and 88.1% of values in Clarke Error Grid Zone A, compared to a MARD of 10.9% and 86% of values in Error Grid Zone A for fingerstick calibration. Factory calibration of sensors for continuous subcutaneous glucose monitoring is feasible with similar accuracy to standard fingerstick calibration. Additional data are required to confirm this result in subjects with diabetes.
Yum, Kyungsuk; McNicholas, Thomas P.; Mu, Bin; Strano, Michael S.
2013-01-01
This article reviews research efforts on developing single-walled carbon nanotube (SWNT)-based near-infrared (NIR) optical glucose sensors toward long-term in vivo continuous glucose monitoring (CGM). We first discuss the unique optical properties of SWNTs and compare SWNTs with traditional organic and nanoparticle fluorophores regarding in vivo glucose-sensing applications. We then present our development of SWNT-based glucose sensors that use glucose-binding proteins and boronic acids as a high-affinity molecular receptor for glucose and transduce binding events on the receptors to modulate SWNT fluorescence. Finally, we discuss opportunities and challenges in translating the emerging technology of SWNT-based NIR optical glucose sensors into in vivo CGM for practical clinical use. PMID:23439162
Klueh, Ulrike; Ludzinska, Izabela; Czajkowski, Caroline; Qiao, Yi; Kreutzer, Donald L
2018-01-01
Overcoming sensor-induced tissue reactions is an essential element of achieving successful continuous glucose monitoring (CGM) in the management of diabetes, particularly when used in closed loop technology. Recently, we demonstrated that basement membrane (BM)-based glucose sensor coatings significantly reduced tissue reactions at sites of device implantation. However, the biocompatible BM-based biohydrogel sensor coating rapidly degraded over a less than a 3-week period, which effectively eliminated the protective sensor coating. In an effort to increase the stability and effectiveness of the BM coating, we evaluated the impact of crosslinking BM utilizing glutaraldehyde as a crosslinking agent, designated as X-Cultrex. Sensor performance (nonrecalibrated) was evaluated for the impact of these X-Cultrex coatings in vitro and in vivo. Sensor performance was assessed over a 28-day time period in a murine CGM model and expressed as mean absolute relative difference (MARD) values. Tissue reactivity of Cultrex-coated, X-Cultrex-coated, and uncoated glucose sensors was evaluated over a 28-day time period in vivo using standard histological techniques. These studies demonstrated that X-Cultrex-based sensor coatings had no effect on glucose sensor function in vitro. In vivo, glucose sensor performance was significantly enhanced following X-Cultrex coating throughout the 28-day study. Histological evaluations of X-Cultrex-treated sensors demonstrated significantly less tissue reactivity when compared to uncoated sensors. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 7-16, 2018. © 2017 Wiley Periodicals, Inc.
Use of a continuous glucose sensor in an extracorporeal life support circuit.
Steil, Garry M; Alexander, Jamin; Papas, Alexandra; Monica, Langer; Modi, Biren P; Piper, Hannah; Jaksic, Tom; Gottlieb, Rebecca; Agus, Michael S D
2011-01-01
Standard care for infants on extracorporeal life support (ECLS) relies on intermittent measurement of blood glucose (BG); however, this can lead to significant changes in BG that go unrecognized for several hours. The present study was designed to assess performance and clinical applicability of a subcutaneous glucose sensor technology modified for use as a blood-contacting sensor within the ECLS circuit. Twelve children, aged 3 years or less, requiring ECLS support were studied. Three continuous glucose sensors (Medtronic MiniMed) were inserted into hubs placed in line with the ECLS circuit. Blood glucose was assessed with a laboratory analyzer (BG(LAB); Bayer Rapidlab 860) approximately every 5 h (mean 4.9 ± 3.3 h) with more frequent samples obtained with a bedside monitor (HemoCue) as needed. Sensor current (I(SIG)) was transmitted to a laptop computer and retrospectively calibrated using BGLAB. Sensor performance was assessed by mean absolute relative difference (MARD), linear regression slope and intercept, and correlation, all with BGLAB as reference. The BGLAB averaged 107.6 ± 36.4 mg/dl (mean ± standard deviation) ranging from 58 to 366 mg/dl. The MARD was 11.4%, with linear regression slope (0.86 ± 0.030) and intercept (9.0 ± 3.2 mg/dl) different from 1 and 0, respectively (p < .05), and correlation (r² = 0.76; p < .001). The system was not associated with any adverse events, and placement and removal into the hubs was easily accomplished. Instances in which more frequent BG values were obtained using a bedside HemoCue (BGHEMO) monitor showed the sensor to respond rapidly to changes. We conclude that continuous sensors can be adapted for use in an ECLS circuit with accuracy similar to or better than that achieved with the subcutaneous site. Continuous glucose monitoring in this population can rapidly detect changes in BG that would not otherwise be observed. Further studies will be needed to assess the benefit of continuous glucose monitoring in this
Romey, Matthew; Jovanovič, Lois; Bevier, Wendy; Markova, Kateryna; Strasma, Paul; Zisser, Howard
2012-11-01
Stress hyperglycemia in the critically ill is associated with increased morbidity and mortality. Continuous glucose monitoring offers a solution to the difficulties of dosing intravenous insulin properly to maintain glycemic control. The purpose of this study was to evaluate an intravascular continuous glucose monitoring (IV-CGM) system with a sensing element based on the concept of quenched fluorescence. A second-generation intravascular continuous glucose sensor was evaluated in 13 volunteer subjects with type 1 diabetes mellitus. There were 21 study sessions of up to 24 h in duration. Sensors were inserted into peripheral veins of the upper extremity, up to two sensors per subject per study session. Sensor output was compared with temporally correlated reference measurements obtained from venous samples on a laboratory glucose analyzer. Data were obtained from 23 sensors in 13 study sessions with 942 paired reference values. Fourteen out of 23 sensors (60.9%) had a mean absolute relative difference ≤ 10%. Eighty-nine percent of paired points were in the clinically accurate A zone of the Clarke error grid and met ISO 15197 performance criteria. Adequate venous blood flow was identified as a necessary condition for accuracy when local sensor readings are compared with venous blood glucose. The IV-CGM system was capable of achieving a high level of glucose measurement accuracy. However, superficial peripheral veins may not provide adequate blood flow for reliable indwelling blood glucose monitoring. © 2012 Diabetes Technology Society.
Romey, Matthew; Jovanovič, Lois; Bevier, Wendy; Markova, Kateryna; Strasma, Paul; Zisser, Howard
2012-01-01
Background Stress hyperglycemia in the critically ill is associated with increased morbidity and mortality. Continuous glucose monitoring offers a solution to the difficulties of dosing intravenous insulin properly to maintain glycemic control. The purpose of this study was to evaluate an intravascular continuous glucose monitoring (IV-CGM) system with a sensing element based on the concept of quenched fluorescence. Method A second-generation intravascular continuous glucose sensor was evaluated in 13 volunteer subjects with type 1 diabetes mellitus. There were 21 study sessions of up to 24 h in duration. Sensors were inserted into peripheral veins of the upper extremity, up to two sensors per subject per study session. Sensor output was compared with temporally correlated reference measurements obtained from venous samples on a laboratory glucose analyzer. Results Data were obtained from 23 sensors in 13 study sessions with 942 paired reference values. Fourteen out of 23 sensors (60.9%) had a mean absolute relative difference ≤ 10%. Eighty-nine percent of paired points were in the clinically accurate A zone of the Clarke error grid and met ISO 15197 performance criteria. Adequate venous blood flow was identified as a necessary condition for accuracy when local sensor readings are compared with venous blood glucose. Conclusions The IV-CGM system was capable of achieving a high level of glucose measurement accuracy. However, superficial peripheral veins may not provide adequate blood flow for reliable indwelling blood glucose monitoring. PMID:23294770
A minimally invasive chip based near infrared sensor for continuous glucose monitoring
NASA Astrophysics Data System (ADS)
Ben Mohammadi, L.; Sigloch, S.; Frese, I.; Stein, V.; Welzel, K.; Schmitz, F.; Klotzbücher, T.
2012-06-01
Assessment of glycaemia in diabetes is crucially important for prevention of both, acute and long term complications. Continuous glucose monitoring (CGM) is certainly the most appropriate way for optimizing the glycaemic control, since it prevents or delays the progression of complications associated with hypo- or hyperglycaemic events, reducing morbidity, mortality, and overall costs in health care systems. In this paper we describe the concept and first in vitro results of a minimally invasive, chip-based NIR-Sensor for continuous glucose monitoring. The sensor concept is based on difference infrared absorption spectroscopy, which was evaluated within laboratory measurements of D+-Glucose dissolved in water. The laboratory measurements revealed a linear relationship between glucose concentration and the integrated difference spectroscopy signal with a coefficient of determination of 99.6% in the concentration range of 0- 500 mg/dL. Suitable wavelength bands were identified in which the correlation is preserved and commercial light sources are available for realisation of a spectrometer-less, integrated NIR-sensor. In the designed sensor the component area (non-disposable) is separated from the detection area (disposable, low-cost). The disposable part of the sensor is fluidically connected to a micro-dialyses needle, accessing glucose subcutaneously via the ISF (interstitial fluid) or intravascularly. The non-disposable part contains all the optical elements, like LED's and photo-detectors. The in- and out-coupling of the optical signal is achieved across the plane of the chip by using total internal reflection on mirrors integrated into the fluidic chip. The glucose is continuously measured by considering the difference signals of light at the corresponding wavelengths, as a function of time or in defined intervals if the light sources are modulated. The in-vitro measurements show an absolute error of about 5 mg/dL with a relative error of 5% for glucose
Dehennis, Andrew; Mortellaro, Mark A; Ioacara, Sorin
2015-07-29
Continuous glucose monitoring (CGM), which enables real-time glucose display and trend information as well as real-time alarms, can improve glycemic control and quality of life in patients with diabetes mellitus. Previous reports have described strategies to extend the useable lifetime of a single sensor from 1-2 weeks to 28 days. The present multisite study describes the characterization of a sensing platform achieving 90 days of continuous use for a single, fully implanted sensor. The Senseonics CGM system is composed of a long-term implantable glucose sensor and a wearable smart transmitter. Study subjects underwent subcutaneous implantation of sensors in the upper arm. Eight-hour clinic sessions were performed every 14 days, during which sensor glucose values were compared against venous blood lab reference measurements collected every 15 minutes using mean absolute relative differences (MARDs). All subjects (mean ± standard deviation age: 43.5 ± 11.0 years; with 10 sensors inserted in men and 14 in women) had type 1 diabetes mellitus. Most (22 of 24) sensors reported glucose values for the entire 90 days. The MARD value was 11.4 ± 2.7% (range, 8.1-19.5%) for reference glucose values between 40-400 mg/dl. There was no significant difference in MARD throughout the 90-day study (P = .31). No serious adverse events were noted. The Senseonics CGM, composed of an implantable sensor, external smart transmitter, and smartphone app, is the first system that uses a single sensor for continuous display of accurate glucose values for 3 months. © 2015 Diabetes Technology Society.
Clarke, William L; Anderson, Stacey; Farhy, Leon; Breton, Marc; Gonder-Frederick, Linda; Cox, Daniel; Kovatchev, Boris
2005-10-01
To compare the clinical accuracy of two different continuous glucose sensors (CGS) during euglycemia and hypoglycemia using continuous glucose-error grid analysis (CG-EGA). FreeStyle Navigator (Abbott Laboratories, Alameda, CA) and MiniMed CGMS (Medtronic, Northridge, CA) CGSs were applied to the abdomens of 16 type 1 diabetic subjects (age 42 +/- 3 years) 12 h before the initiation of the study. Each system was calibrated according to the manufacturer's recommendations. Each subject underwent a hyperinsulinemic-euglycemic clamp (blood glucose goal 110 mg/dl) for 70-210 min followed by a 1-mg.dl(-1).min(-1) controlled reduction in blood glucose toward a nadir of 40 mg/dl. Arterialized blood glucose was determined every 5 min using a Beckman Glucose Analyzer (Fullerton, CA). CGS glucose recordings were matched to the reference blood glucose with 30-s precision, and rates of glucose change were calculated for 5-min intervals. CG-EGA was used to quantify the clinical accuracy of both systems by estimating combined point and rate accuracy of each system in the euglycemic (70-180 mg/dl) and hypoglycemic (<70 mg/dl) ranges. A total of 1,104 data pairs were recorded in the euglycemic range and 250 data pairs in the hypoglycemic range. Overall correlation between CGS and reference glucose was similar for both systems (Navigator, r = 0.84; CGMS, r = 0.79, NS). During euglycemia, both CGS systems had similar clinical accuracy (Navigator zones A + B, 88.8%; CGMS zones A + B, 89.3%, NS). However, during hypoglycemia, the Navigator was significantly more clinically accurate than the CGMS (zones A + B = 82.4 vs. 61.6%, Navigator and CGMS, respectively, P < 0.0005). CG-EGA is a helpful tool for evaluating and comparing the clinical accuracy of CGS systems in different blood glucose ranges. CG-EGA provides accuracy details beyond other methods of evaluation, including correlational analysis and the original EGA.
van Beers, Cornelis A. J.; DeVries, J. Hans
2016-01-01
The necessity of strict glycemic control is unquestionable. However, hypoglycemia remains a major limiting factor in achieving satisfactory glucose control, and evidence is mounting to show that hypoglycemia is not benign. Over the past decade, evidence has consistently shown that real-time continuous glucose monitoring improves glycemic control in terms of lowering glycated hemoglobin levels. However, real-time continuous glucose monitoring has not met the expectations of the diabetes community with regard to hypoglycemia prevention. The earlier trials did not demonstrate any effect on either mild or severe hypoglycemia and the effect of real-time continuous glucose monitoring on nocturnal hypoglycemia was often not reported. However, trials specifically designed to reduce hypoglycemia in patients with a high hypoglycemia risk have demonstrated a reduction in hypoglycemia, suggesting that real-time continuous glucose monitoring can prevent hypoglycemia when it is specifically used for that purpose. Moreover, the newest generation of diabetes technology currently available commercially, namely sensor-augmented pump therapy with a (predictive) low glucose suspend feature, has provided more convincing evidence for hypoglycemia prevention. This article provides an overview of the hypoglycemia outcomes of randomized controlled trials that investigate the effect of real-time continuous glucose monitoring alone or sensor-augmented pump therapy with a (predictive) low glucose suspend feature. Furthermore, several possible explanations are provided why trials have not shown a reduction in severe hypoglycemia. In addition, existing evidence is presented of real-time continuous glucose monitoring in patients with impaired awareness of hypoglycemia who have the highest risk of severe hypoglycemia. PMID:27257169
Sharifi, Amin; Varsavsky, Andrea; Ulloa, Johanna; Horsburgh, Jodie C; McAuley, Sybil A; Krishnamurthy, Balasubramanian; Jenkins, Alicia J; Colman, Peter G; Ward, Glenn M; MacIsaac, Richard J; Shah, Rajiv; O'Neal, David N
2016-05-01
Current electrochemical glucose sensors use a single electrode. Multiple electrodes (redundancy) may enhance sensor performance. We evaluated an electrochemical redundant sensor (ERS) incorporating two working electrodes (WE1 and WE2) onto a single subcutaneous insertion platform with a processing algorithm providing a single real-time continuous glucose measure. Twenty-three adults with type 1 diabetes each wore two ERSs concurrently for 168 hours. Post-insertion a frequent sampling test (FST) was performed with ERS benchmarked against a glucose meter (Bayer Contour Link). Day 4 and 7 FSTs were performed with a standard meal and venous blood collected for reference glucose measurements (YSI and meter). Between visits, ERS was worn with capillary blood glucose testing ≥8 times/day. Sensor glucose data were processed prospectively. Mean absolute relative deviation (MARD) for ERS day 1-7 (3,297 paired points with glucose meter) was (mean [SD]) 10.1 [11.5]% versus 11.4 [11.9]% for WE1 and 12.0 [11.9]% for WE2; P < .0001. ERS Clarke A and A+B were 90.2% and 99.8%, respectively. ERS day 4 plus day 7 MARD (1,237 pairs with YSI) was 9.4 [9.5]% versus 9.6 [9.7]% for WE1 and 9.9 [9.7]% for WE2; P = ns. ERS day 1-7 precision absolute relative deviation (PARD) was 9.9 [3.6]% versus 11.5 [6.2]% for WE1 and 10.1 [4.4]% for WE2; P = ns. ERS sensor display time was 97.8 [6.0]% versus 91.0 [22.3]% for WE1 and 94.1 [14.3]% for WE2; P < .05. Electrochemical redundancy enhances glucose sensor accuracy and display time compared with each individual sensing element alone. ERS performance compares favorably with 'best-in-class' of non-redundant sensors. © 2015 Diabetes Technology Society.
Continuous glucose monitoring on the ICU using a subcutaneous sensor.
Punke, M A; Decker, C; Wodack, K; Reuter, D A; Kluge, S
2015-06-01
Hypoglycemia is a frequent and feared complication of insulin therapy on the intensive care unit (ICU). Sedated patients in particular are at risk for hypoglycemia due to the absence of clinical symptoms. Furthermore, recent studies point to a correlation between the variability of blood glucose and mortality. Therefore, continuous glucose monitoring has the potential to influence outcome due to a better control of blood glucose in critically ill patients. We evaluated the efficacy, accuracy and safety of a new commercially available subcutaneous continuous glucose monitoring system (sCGM; Sentrino®, Medtronic) in a pilot study in critically ill adult patients. sCGM data were recorded for up to 72 h and values were compared with blood glucose values measured by cassette-based blood gas analyzer (BGA). A total of 14 patients (eight male, six female), with a mean age of 62.1 ± 9.8 years, referred to the ICU after major abdominal surgery were studied. The average simplified acute physiology score (SAPS II) was 35 ± 9. Three patients had known type II diabetes. The average runtime of sensors was 44.1 ± 22.1 h. In comparison to BGA, measurement of blood glucose by sCGM revealed an accuracy of 1.5 mg/dl, and a precision of +34.2 mg/dl to -31.2 mg/dl. Linn's concordance correlation coefficient yielded 0.74 with a 95% confidence interval of 0.68-0.78. No hypoglycemic events, defined as a blood glucose level below 70 mg/dl, occurred during treatment. sCGM monitoring via a subcutaneous sensor demonstrated high accuracy and considerable variability compared to blood gas samples, even in critically ill patients.
Accuracy of a Fourth-Generation Subcutaneous Continuous Glucose Sensor.
Christiansen, Mark P; Garg, Satish K; Brazg, Ronald; Bode, Bruce W; Bailey, Timothy S; Slover, Robert H; Sullivan, Ashley; Huang, Suiying; Shin, John; Lee, Scott W; Kaufman, Francine R
2017-08-01
This study evaluated the accuracy and performance of a fourth-generation subcutaneous glucose sensor (Guardian ™ Sensor 3) in the abdomen and arm. Eighty-eight subjects (14-75 years of age, mean ± standard deviation [SD] of 42.0 ± 19.1 years) with type 1 or type 2 diabetes participated in the study. Subjects wore two sensors in the abdomen that were paired with either a MiniMed ™ 640G insulin pump, or an iPhone ® or iPod ® touch ® running a glucose monitoring mobile application (Guardian Connect system) and a third sensor in the arm, which was connected to a glucose sensor recorder (GSR). Subjects were also asked to undergo in-clinic visits of 12-14 h on study days 1, 3, and 7 for frequent blood glucose sample testing using a Yellow Springs Instrument (YSI) reference. The overall mean absolute relative difference (MARD ± SD) between abdomen sensor glucose (SG) and YSI reference values was 9.6% ± 9.0% and 9.4% ± 9.8% for the MiniMed 640G insulin pump and Guardian Connect system, respectively; and 8.7% ± 8.0% between arm SG and YSI reference values. The percentage of SG values within 20% agreement of the YSI reference value (for YSI >80 mg/dL) was 90.7% with the MiniMed 640G insulin pump, 91.8% with the Guardian Connect system, and 93.1% for GSR-connected arm sensors. Mean functional sensor life, when calibrating 3-4 times/day, was 145.9 ± 39.3 h for sensors paired with the MiniMed 640G insulin pump, 146.1 ± 41.6 h for sensors paired with the Guardian Connect system, and 147.6 ± 40.4 h for sensors connected to the GSR. Responses to survey questions regarding sensor comfort and ease of use were favorable. The Guardian Sensor 3 glucose sensor, whether located in abdomen or the arm, provided accurate glucose readings when compared with the YSI reference and demonstrated functional life commensurate with the intended 7-day use. ClinicalTrials.gov : NCT02246582.
Accuracy of a Fourth-Generation Subcutaneous Continuous Glucose Sensor
Garg, Satish K.; Brazg, Ronald; Bode, Bruce W.; Bailey, Timothy S.; Slover, Robert H.; Sullivan, Ashley; Huang, Suiying; Shin, John; Lee, Scott W.; Kaufman, Francine R.
2017-01-01
Abstract Background: This study evaluated the accuracy and performance of a fourth-generation subcutaneous glucose sensor (Guardian™ Sensor 3) in the abdomen and arm. Methods: Eighty-eight subjects (14–75 years of age, mean ± standard deviation [SD] of 42.0 ± 19.1 years) with type 1 or type 2 diabetes participated in the study. Subjects wore two sensors in the abdomen that were paired with either a MiniMed™ 640G insulin pump, or an iPhone® or iPod® touch® running a glucose monitoring mobile application (Guardian Connect system) and a third sensor in the arm, which was connected to a glucose sensor recorder (GSR). Subjects were also asked to undergo in-clinic visits of 12–14 h on study days 1, 3, and 7 for frequent blood glucose sample testing using a Yellow Springs Instrument (YSI) reference. Results: The overall mean absolute relative difference (MARD ± SD) between abdomen sensor glucose (SG) and YSI reference values was 9.6% ± 9.0% and 9.4% ± 9.8% for the MiniMed 640G insulin pump and Guardian Connect system, respectively; and 8.7% ± 8.0% between arm SG and YSI reference values. The percentage of SG values within 20% agreement of the YSI reference value (for YSI >80 mg/dL) was 90.7% with the MiniMed 640G insulin pump, 91.8% with the Guardian Connect system, and 93.1% for GSR-connected arm sensors. Mean functional sensor life, when calibrating 3–4 times/day, was 145.9 ± 39.3 h for sensors paired with the MiniMed 640G insulin pump, 146.1 ± 41.6 h for sensors paired with the Guardian Connect system, and 147.6 ± 40.4 h for sensors connected to the GSR. Responses to survey questions regarding sensor comfort and ease of use were favorable. Conclusions: The Guardian Sensor 3 glucose sensor, whether located in abdomen or the arm, provided accurate glucose readings when compared with the YSI reference and demonstrated functional life commensurate with the intended 7-day use. ClinicalTrials.gov: NCT
Validation of the continuous glucose monitoring sensor in preterm infants.
Beardsall, K; Vanhaesebrouck, S; Ogilvy-Stuart, A L; Vanhole, C; VanWeissenbruch, M; Midgley, P; Thio, M; Cornette, L; Ossuetta, I; Palmer, C R; Iglesias, I; de Jong, M; Gill, B; de Zegher, F; Dunger, D B
2013-03-01
Recent studies have highlighted the need for improved methods of monitoring glucose control in intensive care to reduce hyperglycaemia, without increasing the risk of hypoglycaemia. Continuous glucose monitoring is increasingly used in children with diabetes, but there are little data regarding its use in the preterm infant, particularly at extremes of glucose levels and over prolonged periods. This study aimed to assess the accuracy of the continuous glucose monitoring sensor (CGMS) across the glucose profile, and to determine whether there was any deterioration over a 7 day period. Prospectively collected CGMS data from the NIRTURE Trial was compared with the data obtained simultaneously using point of care glucose monitors. An international multicentre randomised controlled trial. One hundred and eighty-eight very low birth weight control infants. Optimal accuracy, performance goals (American Diabetes Association consensus), Bland Altman, Error Grid analyses and accuracy. The mean (SD) duration of CGMS recordings was 156.18 (29) h (6.5 days), with a total of 5207 paired glucose levels. CGMS data correlated well with point of care devices (r=0.94), with minimal bias. It met the Clarke Error Grid and Consensus Grid criteria for clinical significance. Accuracy of single readings to detect set thresholds of hypoglycaemia, or hyperglycaemia was poor. There was no deterioration over time from insertion. CGMS can provide information on trends in glucose control, and guidance on the need for blood glucose assessment. This highlights the potential use of CGMS in optimising glucose control in preterm infants.
In vivo continuous glucose monitoring using a chip based near infrared sensor
NASA Astrophysics Data System (ADS)
Ben Mohammadi, L.; Sigloch, S.; Frese, I.; Welzel, K.; Göddel, M.; Klotzbücher, T.
2014-05-01
Diabetes is a serious health condition considered to be one of the major healthcare epidemics of modern era. An effective treatment of this disease can be only achieved by reliable continuous information on blood glucose levels. In this work we present a minimally invasive, chip-based near infrared (NIR) sensor, combined with microdialysis, for continuous glucose monitoring (CGM). The sensor principle is based on difference absorption spectroscopy in the 1st overtone band of the near infrared spectrum. The device features a multi-emitter LED and InGaAs-Photodiodes, which are located on a single electronic board (non-disposable part), connected to a personal computer via Bluetooth. The disposable part consists of a chip containing the fluidic connections for microdialysis, two fluidic channels acting as optical transmission cells and total internally reflecting mirrors for in- and out-coupling of the LED light to the chip and to the detectors. The sensor is combined with an intraveneous microdialysis to separate the glucose from the cells and proteins in the blood and operates without any chemical consumption. In vitro measurements showed a linear relationship between glucose concentration and the integrated difference signal with a coefficient of determination of 99 % in the relevant physiological concentration range from 0 to 400 mg/dl. In vivo measurements on 10 patients showed that the NIR-CGM sensor data reflects the blood reference values adequately, if a proper calibration and signal drift compensation is applied. The MARE (mean absolute relative error) value taken over all patient data is 13.8 %. The best achieved MARE value is at 4.8 %, whereas the worst is 25.8 %, with a standard deviation of 5.5 %.
Klueh, Ulrike; Antar, Omar; Qiao, Yi; Kreutzer, Donald L.
2014-01-01
The concept of increased blood vessel (BV) density proximal to glucose sensors implanted in the interstitial tissue increases the accuracy and lifespan of sensors is accepted, despite limited existing experimental data. Interestingly, there is no previous data or even conjecture in the literature on the role of lymphatic vessels (LV) alone, or in combination with BV, in enhancing continuous glucose monitoring (CGM) in vivo. To investigate the impact of inducing vascular networks (BV and LV) at sites of glucose sensor implantation, we utilized adenovirus based local gene therapy of vascular endothelial cell growth factor-A (VEGF-A) to induce vessels at sensor implantation sites. The results of these studies demonstrated that 1) VEGF-A based local gene therapy increases vascular networks (blood vessels and lymphatic vessels) at sites of glucose sensor implantation; and 2) this local increase of vascular networks enhances glucose sensor function in vivo from 7 days to greater than 28 days post sensor implantation. This data provides “proof of concept” for the effective usage of local angiogenic factor (AF) gene therapy in mammalian models in an effort to extend CGM in vivo. It also supports the practice of a variety of viral and non-viral vectors as well as gene products (e.g. anti-inflammatory and anti-fibrosis genes) to engineer “implant friendly tissues” for the usage with implantable glucose sensors as well as other implantable devices. PMID:24243850
Sparacino, Giovanni; Zanon, Mattia; Facchinetti, Andrea; Zecchin, Chiara; Maran, Alberto; Cobelli, Claudio
2012-01-01
Monitoring glucose concentration in the blood is essential in the therapy of diabetes, a pathology which affects about 350 million people around the World (three million in Italy), causes more than four million deaths per year and consumes a significant portion of the budget of national health systems (10% in Italy). In the last 15 years, several sensors with different degree of invasiveness have been proposed to monitor glycemia in a quasi-continuous way (up to 1 sample/min rate) for relatively long intervals (up to 7 consecutive days). These continuous glucose monitoring (CGM) sensors have opened new scenarios to assess, off-line, the effectiveness of individual patient therapeutic plans from the retrospective analysis of glucose time-series, but have also stimulated the development of innovative on-line applications, such as hypo/hyper-glycemia alert systems and artificial pancreas closed-loop control algorithms. In this review, we illustrate some significant Italian contributions, both from industry and academia, to the growth of the CGM sensors research area. In particular, technological, algorithmic and clinical developments performed in Italy will be discussed and put in relation with the advances obtained in the field in the wider international research community. PMID:23202020
Sparacino, Giovanni; Zanon, Mattia; Facchinetti, Andrea; Zecchin, Chiara; Maran, Alberto; Cobelli, Claudio
2012-10-12
Monitoring glucose concentration in the blood is essential in the therapy of diabetes, a pathology which affects about 350 million people around the World (three million in Italy), causes more than four million deaths per year and consumes a significant portion of the budget of national health systems (10% in Italy). In the last 15 years, several sensors with different degree of invasiveness have been proposed to monitor glycemia in a quasi-continuous way (up to 1 sample/min rate) for relatively long intervals (up to 7 consecutive days). These continuous glucose monitoring (CGM) sensors have opened new scenarios to assess, off-line, the effectiveness of individual patient therapeutic plans from the retrospective analysis of glucose time-series, but have also stimulated the development of innovative on-line applications, such as hypo/hyper-glycemia alert systems and artificial pancreas closed-loop control algorithms. In this review, we illustrate some significant Italian contributions, both from industry and academia, to the growth of the CGM sensors research area. In particular, technological, algorithmic and clinical developments performed in Italy will be discussed and put in relation with the advances obtained in the field in the wider international research community.
Seo, Dongmin; Paek, Sung-Ho; Oh, Sangwoo; Seo, Sungkyu; Paek, Se-Hwan
2016-01-01
The incidence of diabetes is continually increasing, and by 2030, it is expected to have increased by 69% and 20% in underdeveloped and developed countries, respectively. Therefore, glucose sensors are likely to remain in high demand in medical device markets. For the current study, we developed a needle-type bio-layer interference (BLI) sensor that can continuously monitor glucose levels. Using dialysis procedures, we were able to obtain hypoglycemic samples from commercial human serum. These dialysis-derived samples, alongside samples of normal human serum were used to evaluate the utility of the sensor for the detection of the clinical interest range of glucose concentrations (70–200 mg/dL), revealing high system performance for a wide glycemic state range (45–500 mg/dL). Reversibility and reproducibility were also tested over a range of time spans. Combined with existing BLI system technology, this sensor holds great promise for use as a wearable online continuous glucose monitoring system for patients in a hospital setting. PMID:27669267
Seo, Dongmin; Paek, Sung-Ho; Oh, Sangwoo; Seo, Sungkyu; Paek, Se-Hwan
2016-09-24
The incidence of diabetes is continually increasing, and by 2030, it is expected to have increased by 69% and 20% in underdeveloped and developed countries, respectively. Therefore, glucose sensors are likely to remain in high demand in medical device markets. For the current study, we developed a needle-type bio-layer interference (BLI) sensor that can continuously monitor glucose levels. Using dialysis procedures, we were able to obtain hypoglycemic samples from commercial human serum. These dialysis-derived samples, alongside samples of normal human serum were used to evaluate the utility of the sensor for the detection of the clinical interest range of glucose concentrations (70-200 mg/dL), revealing high system performance for a wide glycemic state range (45-500 mg/dL). Reversibility and reproducibility were also tested over a range of time spans. Combined with existing BLI system technology, this sensor holds great promise for use as a wearable online continuous glucose monitoring system for patients in a hospital setting.
Use of an Intravascular Fluorescent Continuous Glucose Sensor in ICU Patients.
Strasma, Paul J; Finfer, Simon; Flower, Oliver; Hipszer, Brian; Kosiborod, Mikhail; Macken, Lewis; Sechterberger, Marjolein; van der Voort, Peter H J; DeVries, J Hans; Joseph, Jeffrey I
2015-07-01
Hyperglycemia and hypoglycemia are associated with adverse clinical outcomes in intensive care patients. In product development studies at 4 ICUs, the safety and performance of an intravascular continuous glucose monitoring (IV-CGM) system was evaluated in 70 postsurgical patients. The GluCath System (GluMetrics, Inc) used a quenched chemical fluorescence mechanism to optically measure blood glucose when deployed via a radial artery catheter or directly into a peripheral vein. Periodic ultrasound assessed blood flow and thrombus formation. Patient glucose levels were managed according to the standard of care and existing protocols at each site. Reference blood samples were acquired hourly and compared against prospectively calibrated sensor results. In all, 63 arterial sensors and 9 venous sensors were deployed in 70 patients. Arterial sensors did not interfere with invasive blood pressure monitoring, sampling or other aspects of patient care. A majority of venous sensors (66%) exhibited thrombus on ultrasound. In all, 89.4% (1383/1547) of arterial and 72.2% (182/252) of venous measurements met ISO15197:2003 criteria (within 20%), and 72.7% (1124/1547) of arterial and 56.3% (142/252) of venous measurements met CLSI POCT 12-A3 criteria (within 12.5%). The aggregate mean absolute relative difference (MARD) between the sensors and the reference was 9.6% for arterial and 14.2% for venous sensors. The GluCath System exhibited acceptable accuracy when deployed in a radial artery for up to 48 hours in ICU patients after elective cardiac surgery. Accuracy of venous deployment was substantially lower with significant rates of intravascular thrombus observed using ultrasound. © 2015 Diabetes Technology Society.
Signal, Matthew; Thomas, Felicity; Shaw, Geoffrey M.; Chase, J. Geoffrey
2013-01-01
Background Critically ill patients often experience high levels of insulin resistance and stress-induced hyperglycemia, which may negatively impact outcomes. However, evidence surrounding the causes of negative outcomes remains inconclusive. Continuous glucose monitoring (CGM) devices allow researchers to investigate glucose complexity, using detrended fluctuation analysis (DFA), to determine whether it is associated with negative outcomes. The aim of this study was to investigate the effects of CGM device type/calibration and CGM sensor location on results from DFA. Methods This study uses CGM data from critically ill patients who were each monitored concurrently using Medtronic iPro2s on the thigh and abdomen and a Medtronic Guardian REAL-Time on the abdomen. This allowed interdevice/calibration type and intersensor site variation to be assessed. Detrended fluctuation analysis is a technique that has previously been used to determine the complexity of CGM data in critically ill patients. Two variants of DFA, monofractal and multifractal, were used to assess the complexity of sensor glucose data as well as the precalibration raw sensor current. Monofractal DFA produces a scaling exponent (H), where H is inversely related to complexity. The results of multifractal DFA are presented graphically by the multifractal spectrum. Results From the 10 patients recruited, 26 CGM devices produced data suitable for analysis. The values of H from abdominal iPro2 data were 0.10 (0.03–0.20) higher than those from Guardian REAL-Time data, indicating consistently lower complexities in iPro2 data. However, repeating the analysis on the raw sensor current showed little or no difference in complexity. Sensor site had little effect on the scaling exponents in this data set. Finally, multifractal DFA revealed no significant associations between the multifractal spectrums and CGM device type/calibration or sensor location. Conclusions Monofractal DFA results are dependent on the device
Cell based metabolic barriers to glucose diffusion: macrophages and continuous glucose monitoring.
Klueh, Ulrike; Frailey, Jackman T; Qiao, Yi; Antar, Omar; Kreutzer, Donald L
2014-03-01
It is assumed that MQ are central to glucose sensor bio-fouling and therefore have a major negative impact on continuous glucose monitoring (CGM) performance in vivo. However to our knowledge there is no data in the literature to directly support or refute this assumption. Since glucose and oxygen (O2) are key to glucose sensor function in vivo, understanding and controlling glucose and O2 metabolic activity of MQ is likely key to successful glucose sensor performance. We hypothesized that the accumulation of MQ at the glucose sensor-tissue interface will act as "Cell Based Metabolic Barriers" (CBMB) to glucose diffusing from the interstitial tissue compartment to the implanted glucose sensor and as such creating an artificially low sensor output, thereby compromising sensor function and CGM. Our studies demonstrated that 1) direct injections of MQ at in vivo sensor implantation sites dramatically decreased sensor output (measured in nA), 2) addition of MQ to glucose sensors in vitro resulted in a rapid and dramatic fall in sensor output and 3) lymphocytes did not affect sensor function in vitro or in vivo. These data support our hypothesis that MQ can act as metabolic barriers to glucose and O2 diffusion in vivo and in vitro. Copyright © 2014 Elsevier Ltd. All rights reserved.
Cell Based Metabolic Barriers to Glucose Diffusion: Macrophages and Continuous Glucose Monitoring
Klueh, Ulrike; Frailey, Jackman; Qiao, Yi; Antar, Omar; Kreutzer, Donald L.
2014-01-01
It is assumed that MQ are central to glucose sensor bio-fouling and therefore have a major negative impact on continuous glucose monitoring (CGM) performance in vivo. However to our knowledge there is no data in the literature to directly support or refute this assumption. Since glucose and oxygen (O2) are key to glucose sensor function in vivo, understanding and controlling glucose and O2 metabolic activity of MQ is likely key to successful glucose sensor performance. We hypothesized that the accumulation of MQ at the glucose sensor-tissue interface will act as “Cell Based Metabolic Barriers” (CBMB) to glucose diffusing from the interstitial tissue compartment to the implanted glucose sensor and as such creating an artificially low sensor output, thereby compromising sensor function and CGM. Our studies demonstrated that 1) direct injections of MQ at in vivo sensor implantation sites dramatically decreased sensor output (measured in nA), 2) addition of MQ to glucose sensors in vitro resulted in a rapid and dramatic fall in sensor output and 3) lymphocytes did not affect sensor function in vitro or in vivo. These data support our hypothesis that MQ can act as metabolic barriers to glucose and O2 diffusion in vivo and in vitro. PMID:24461328
Toward an injectable continuous osmotic glucose sensor.
Johannessen, Erik; Krushinitskaya, Olga; Sokolov, Andrey; Philipp, Häfliger; Hoogerwerf, Arno; Hinderling, Christian; Kautio, Kari; Lenkkeri, Jaakko; Strömmer, Esko; Kondratyev, Vasily; Tønnessen, Tor Inge; Mollnes, Tom Eirik; Jakobsen, Henrik; Zimmer, Even; Akselsen, Bengt
2010-07-01
The growing pandemic of diabetes mellitus places a stringent social and economic burden on the society. A tight glycemic control circumvents the detrimental effects, but the prerogative is the development of new more effective tools capable of longterm tracking of blood glucose (BG) in vivo. Such discontinuous sensor technologies will benefit from an unprecedented marked potential as well as reducing the current life expectancy gap of eight years as part of a therapeutic regime. A sensor technology based on osmotic pressure incorporates a reversible competitive affinity assay performing glucose-specific recognition. An absolute change in particles generates a pressure that is proportional to the glucose concentration. An integrated pressure transducer and components developed from the silicon micro- and nanofabrication industry translate this pressure into BG data. An in vitro model based on a 3.6 x 8.7 mm large pill-shaped implant is equipped with a nanoporous membrane holding 4-6 nm large pores. The affinity assay offers a dynamic range of 36-720 mg/dl with a resolution of +/-16 mg/dl. An integrated 1 x 1 mm(2) large control chip samples the sensor signals for data processing and transmission back to the reader at a total power consumption of 76 microW. Current studies have demonstrated the design, layout, and performance of a prototype osmotic sensor in vitro using an affinity assay solution for up to four weeks. The small physical size conforms to an injectable device, forming the basis of a conceptual monitor that offers a tight glycemic control of BG. 2010 Diabetes Technology Society.
Real-time improvement of continuous glucose monitoring accuracy: the smart sensor concept.
Facchinetti, Andrea; Sparacino, Giovanni; Guerra, Stefania; Luijf, Yoeri M; DeVries, J Hans; Mader, Julia K; Ellmerer, Martin; Benesch, Carsten; Heinemann, Lutz; Bruttomesso, Daniela; Avogaro, Angelo; Cobelli, Claudio
2013-04-01
Reliability of continuous glucose monitoring (CGM) sensors is key in several applications. In this work we demonstrate that real-time algorithms can render CGM sensors smarter by reducing their uncertainty and inaccuracy and improving their ability to alert for hypo- and hyperglycemic events. The smart CGM (sCGM) sensor concept consists of a commercial CGM sensor whose output enters three software modules, able to work in real time, for denoising, enhancement, and prediction. These three software modules were recently presented in the CGM literature, and here we apply them to the Dexcom SEVEN Plus continuous glucose monitor. We assessed the performance of the sCGM on data collected in two trials, each containing 12 patients with type 1 diabetes. The denoising module improves the smoothness of the CGM time series by an average of ∼57%, the enhancement module reduces the mean absolute relative difference from 15.1 to 10.3%, increases by 12.6% the pairs of values falling in the A-zone of the Clarke error grid, and finally, the prediction module forecasts hypo- and hyperglycemic events an average of 14 min ahead of time. We have introduced and implemented the sCGM sensor concept. Analysis of data from 24 patients demonstrates that incorporation of suitable real-time signal processing algorithms for denoising, enhancement, and prediction can significantly improve the performance of CGM applications. This can be of great clinical impact for hypo- and hyperglycemic alert generation as well in artificial pancreas devices.
Continuous glucose monitoring--a study of the Enlite sensor during hypo- and hyperbaric conditions.
Adolfsson, Peter; Örnhagen, Hans; Eriksson, Bengt M; Cooper, Ken; Jendle, Johan
2012-06-01
The performance and accuracy of the Enlite(™) (Medtronic, Inc., Northridge, CA) sensor may be affected by microbubble formation at the electrode surface during hypo- and hyperbaric conditions. The effects of acute pressure changes and of prewetting of sensors were investigated. On Day 1, 24 sensors were inserted on the right side of the abdomen and back in one healthy individual; 12 were prewetted with saline solution, and 12 were inserted dry. On Day 2, this procedure was repeated on the left side. All sensors were attached to an iPro continuous glucose monitoring (CGM) recorder. Hypobaric and hyperbaric tests were conducted in a pressure chamber, with each test lasting 105 min. Plasma glucose values were obtained at 5-min intervals with a HemoCue(®) (Ängelholm, Sweden) model 201 glucose analyzer for comparison with sensor glucose values. Ninety percent of the CGM systems operated during the tests. The mean absolute relative difference was lower during hyperbaric than hypobaric conditions (6.7% vs. 14.9%, P<0.001). Sensor sensitivity was slightly decreased (P<0.05) during hypobaric but not during hyperbaric conditions. Clarke Error Grid Analysis showed that 100% of the values were found in the A+B region. No differences were found between prewetted and dry sensors. The Enlite sensor performed adequately during acute pressure changes and was more accurate during hyperbaric than hypobaric conditions. Prewetting the sensors did not improve accuracy. Further studies on type 1 diabetes subjects are needed under various pressure conditions.
Assessing sensor accuracy for non-adjunct use of continuous glucose monitoring.
Kovatchev, Boris P; Patek, Stephen D; Ortiz, Edward Andrew; Breton, Marc D
2015-03-01
The level of continuous glucose monitoring (CGM) accuracy needed for insulin dosing using sensor values (i.e., the level of accuracy permitting non-adjunct CGM use) is a topic of ongoing debate. Assessment of this level in clinical experiments is virtually impossible because the magnitude of CGM errors cannot be manipulated and related prospectively to clinical outcomes. A combination of archival data (parallel CGM, insulin pump, self-monitoring of blood glucose [SMBG] records, and meals for 56 pump users with type 1 diabetes) and in silico experiments was used to "replay" real-life treatment scenarios and relate sensor error to glycemic outcomes. Nominal blood glucose (BG) traces were extracted using a mathematical model, yielding 2,082 BG segments each initiated by insulin bolus and confirmed by SMBG. These segments were replayed at seven sensor accuracy levels (mean absolute relative differences [MARDs] of 3-22%) testing six scenarios: insulin dosing using sensor values, threshold, and predictive alarms, each without or with considering CGM trend arrows. In all six scenarios, the occurrence of hypoglycemia (frequency of BG levels ≤50 mg/dL and BG levels ≤39 mg/dL) increased with sensor error, displaying an abrupt slope change at MARD =10%. Similarly, hyperglycemia (frequency of BG levels ≥250 mg/dL and BG levels ≥400 mg/dL) increased and displayed an abrupt slope change at MARD=10%. When added to insulin dosing decisions, information from CGM trend arrows, threshold, and predictive alarms resulted in improvement in average glycemia by 1.86, 8.17, and 8.88 mg/dL, respectively. Using CGM for insulin dosing decisions is feasible below a certain level of sensor error, estimated in silico at MARD=10%. In our experiments, further accuracy improvement did not contribute substantively to better glycemic outcomes.
Ribet, Federico; Stemme, Göran; Roxhed, Niclas
2017-04-15
An ultra-miniaturized electrochemical biosensor for continuous glucose monitoring (CGM) is presented. The aim of this work is to demonstrate the possibility of an overall reduction in sensor size to allow minimally invasive glucose monitoring in the interstitial fluid in the dermal region, in contrast to larger state-of-the-art systems, which are necessarily placed in the subcutaneous layer. Moreover, the reduction in size might be a key factor to improve the stability and reliability of transdermal sensors, due to the reduction of the detrimental foreign body reaction and of consequent potential failures. These advantages are combined with lower invasiveness and discomfort for patients. The realized device consists of a microfabricated three-electrode enzymatic sensor with a total surface area of the sensing portion of less than 0.04mm 2 , making it the smallest fully integrated planar amperometric glucose sensor area reported to date. The working electrode and counter electrode consist of platinum and are functionalized by drop casting of three polymeric membranes. The on-chip iridium oxide (IrOx) pseudo-reference electrode provides the required stability for measurements under physiological conditions. The device is able to dynamically and linearly measure glucose concentrations in-vitro over the relevant physiological range, while showing sufficient selectivity to known interfering species present in the interstitial fluid, with resolution and sensitivity (1.51nA/mM) comparable to that of state-of-art commercial CGM systems. This work can therefore enable less invasive and improved CGM in patients affected by diabetes. Copyright © 2016 Elsevier B.V. All rights reserved.
Simulation of an enzyme-based glucose sensor
NASA Astrophysics Data System (ADS)
Sha, Xianzheng; Jablecki, Michael; Gough, David A.
2001-09-01
An important biosensor application is the continuous monitoring blood or tissue fluid glucose concentration in people with diabetes. Our research focuses on the development of a glucose sensor based on potentiostatic oxygen electrodes and immobilized glucose oxidase for long- term application as an implant in tissues. As the sensor signal depends on many design variables, a trial-and-error approach to sensor optimization can be time-consuming. Here, the properties of an implantable glucose sensor are optimized by a systematic computational simulation approach.
Zhou, Jian; Lv, Xiaofeng; Mu, Yiming; Wang, Xianling; Li, Jing; Zhang, Xingguang; Wu, Jinxiao; Bao, Yuqian; Jia, Weiping
2012-08-01
The purpose of this multicenter study was to investigate the accuracy of a real-time continuous glucose monitoring sensor in Chinese diabetes patients. In total, 48 patients with type 1 or 2 diabetes from three centers in China were included in the study. The MiniMed Paradigm(®) 722 insulin pump (Medtronic, Northridge, CA) was used to monitor the real-time continuous changes of blood glucose levels for three successive days. Venous blood of the subjects was randomly collected every 15 min for seven consecutive hours on the day when the subjects were wearing the sensor. Reference values were provided by the YSI(®) 2300 STAT PLUS™ glucose and lactate analyzer (YSI Life Sciences, Yellow Springs, OH). In total, 1,317 paired YSI-sensor values were collected from the 48 patients. Of the sensor readings, 88.3% (95% confidence interval, 0.84-0.92) were within±20% of the YSI values, and 95.7% were within±30% of the YSI values. Clarke and consensus error grid analyses showed that the ratios of the YSI-sensor values in Zone A to the values in Zone B were 99.1% and 99.9%, respectively. Continuous error grid analysis showed that the ratios of the YSI-sensor values in the region of accurate reading, benign errors, and erroneous reading were 96.4%, 1.8%, and 1.8%, respectively. The mean absolute relative difference (ARD) for all subjects was 10.4%, and the median ARD was 7.8%. Bland-Altman analysis detected a mean blood glucose level of 3.84 mg/dL. Trend analysis revealed that 86.1% of the difference of the rates of change between the YSI values and the sensor readings occurred within the range of 1 mg/dL/min. The Paradigm insulin pump has high accuracy in both monitoring the real-time continuous changes and predicting the trend of changes in blood glucose level. However, actual clinical manifestations should be taken into account for diagnosis of hypoglycemia.
Continuous Glucose Monitoring: Impact on Hypoglycemia.
van Beers, Cornelis A J; DeVries, J Hans
2016-11-01
The necessity of strict glycemic control is unquestionable. However, hypoglycemia remains a major limiting factor in achieving satisfactory glucose control, and evidence is mounting to show that hypoglycemia is not benign. Over the past decade, evidence has consistently shown that real-time continuous glucose monitoring improves glycemic control in terms of lowering glycated hemoglobin levels. However, real-time continuous glucose monitoring has not met the expectations of the diabetes community with regard to hypoglycemia prevention. The earlier trials did not demonstrate any effect on either mild or severe hypoglycemia and the effect of real-time continuous glucose monitoring on nocturnal hypoglycemia was often not reported. However, trials specifically designed to reduce hypoglycemia in patients with a high hypoglycemia risk have demonstrated a reduction in hypoglycemia, suggesting that real-time continuous glucose monitoring can prevent hypoglycemia when it is specifically used for that purpose. Moreover, the newest generation of diabetes technology currently available commercially, namely sensor-augmented pump therapy with a (predictive) low glucose suspend feature, has provided more convincing evidence for hypoglycemia prevention. This article provides an overview of the hypoglycemia outcomes of randomized controlled trials that investigate the effect of real-time continuous glucose monitoring alone or sensor-augmented pump therapy with a (predictive) low glucose suspend feature. Furthermore, several possible explanations are provided why trials have not shown a reduction in severe hypoglycemia. In addition, existing evidence is presented of real-time continuous glucose monitoring in patients with impaired awareness of hypoglycemia who have the highest risk of severe hypoglycemia. © 2016 Diabetes Technology Society.
Assessing Sensor Accuracy for Non-Adjunct Use of Continuous Glucose Monitoring
Patek, Stephen D.; Ortiz, Edward Andrew; Breton, Marc D.
2015-01-01
Abstract Background: The level of continuous glucose monitoring (CGM) accuracy needed for insulin dosing using sensor values (i.e., the level of accuracy permitting non-adjunct CGM use) is a topic of ongoing debate. Assessment of this level in clinical experiments is virtually impossible because the magnitude of CGM errors cannot be manipulated and related prospectively to clinical outcomes. Materials and Methods: A combination of archival data (parallel CGM, insulin pump, self-monitoring of blood glucose [SMBG] records, and meals for 56 pump users with type 1 diabetes) and in silico experiments was used to “replay” real-life treatment scenarios and relate sensor error to glycemic outcomes. Nominal blood glucose (BG) traces were extracted using a mathematical model, yielding 2,082 BG segments each initiated by insulin bolus and confirmed by SMBG. These segments were replayed at seven sensor accuracy levels (mean absolute relative differences [MARDs] of 3–22%) testing six scenarios: insulin dosing using sensor values, threshold, and predictive alarms, each without or with considering CGM trend arrows. Results: In all six scenarios, the occurrence of hypoglycemia (frequency of BG levels ≤50 mg/dL and BG levels ≤39 mg/dL) increased with sensor error, displaying an abrupt slope change at MARD =10%. Similarly, hyperglycemia (frequency of BG levels ≥250 mg/dL and BG levels ≥400 mg/dL) increased and displayed an abrupt slope change at MARD=10%. When added to insulin dosing decisions, information from CGM trend arrows, threshold, and predictive alarms resulted in improvement in average glycemia by 1.86, 8.17, and 8.88 mg/dL, respectively. Conclusions: Using CGM for insulin dosing decisions is feasible below a certain level of sensor error, estimated in silico at MARD=10%. In our experiments, further accuracy improvement did not contribute substantively to better glycemic outcomes. PMID:25436913
Improved blood glucose estimation through multi-sensor fusion.
Xiong, Feiyu; Hipszer, Brian R; Joseph, Jeffrey; Kam, Moshe
2011-01-01
Continuous glucose monitoring systems are an integral component of diabetes management. Efforts to improve the accuracy and robustness of these systems are at the forefront of diabetes research. Towards this goal, a multi-sensor approach was evaluated in hospitalized patients. In this paper, we report on a multi-sensor fusion algorithm to combine glucose sensor measurements in a retrospective fashion. The results demonstrate the algorithm's ability to improve the accuracy and robustness of the blood glucose estimation with current glucose sensor technology.
Continuous glucose monitoring: quality of hypoglycaemia detection.
Zijlstra, E; Heise, T; Nosek, L; Heinemann, L; Heckermann, S
2013-02-01
To evaluate the accuracy of a (widely used) continuous glucose monitoring (CGM)-system and its ability to detect hypoglycaemic events. A total of 18 patients with type 1 diabetes mellitus used continuous glucose monitoring (Guardian REAL-Time CGMS) during two 9-day in-house periods. A hypoglycaemic threshold alarm alerted patients to sensor readings <70 mg/dl. Continuous glucose monitoring sensor readings were compared to laboratory reference measurements taken every 4 h and in case of a hypoglycaemic alarm. A total of 2317 paired data points were evaluated. Overall, the mean absolute relative difference (MARD) was 16.7%. The percentage of data points in the clinically accurate or acceptable Clarke Error Grid zones A + B was 94.6%. In the hypoglycaemic range, accuracy worsened (MARD 38.8%) leading to a failure to detect more than half of the true hypoglycaemic events (sensitivity 37.5%). Furthermore, more than half of the alarms that warn patients for hypoglycaemia were false (false alert rate 53.3%). Above the low alert threshold, the sensor confirmed 2077 of 2182 reference values (specificity 95.2%). Patients using continuous glucose monitoring should be aware of its limitation to accurately detect hypoglycaemia. © 2012 Blackwell Publishing Ltd.
Dutt-Ballerstadt, Ralph; Evans, Colton; Pillai, Arun P; Orzeck, Eric; Drabek, Rafal; Gowda, Ashok; McNichols, Roger
2012-03-01
We report results of a pilot clinical study of a subcutaneous fluorescence affinity sensor (FAS) for continuous glucose monitoring conducted in people with type 1 and type 2 diabetes. The device was assessed based on performance, safety, and comfort level under acute conditions (4 h). A second-generation FAS (BioTex Inc., Houston, TX) was subcutaneously implanted in the abdomens of 12 people with diabetes, and its acute performance to excursions in blood glucose was monitored over 4 h. After 30-60 min the subjects, who all had fasting blood glucose levels of less than 200 mg/dl, received a glucose bolus of 75 g/liter dextrose by oral administration. Capillary blood glucose samples were obtained from the finger tip. The FAS data were retrospectively evaluated by linear least squares regression analysis and by the Clarke error grid method. Comfort levels during insertion, operation, and sensor removal were scored by the subjects using an analog pain scale. After retrospective calibration of 17 sensors implanted in 12 subjects, error grid analysis showed 97% of the paired values in zones A and B and 1.5% in zones C and D, respectively. The mean absolute relative error between sensor signal and capillary blood glucose was 13% [±15% standard deviation (SD), 100-350 mg/dl] with an average correlation coefficient of 0.84 (±0.24 SD). The actual average "warm-up" time for the FAS readings, at which highest correlation with glucose readings was determined, was 65 (±32 SD) min. Mean time lag was 4 (±5 SD) min during the initial operational hours. Pain levels during insertion and operation were modest. The in vivo performance of the FAS demonstrates feasibility of the fluorescence affinity technology to determine blood glucose excursions accurately and safely under acute dynamic conditions in humans with type 1 and type 2 diabetes. Specific engineering challenges to sensor and instrumentation robustness remain. Further studies will be required to validate its promising
Hydrogel-based electrochemical sensor for non-invasive and continuous glucose monitoring
NASA Astrophysics Data System (ADS)
Park, Habeen; Lee, Ji-Young; Kim, Dong-Chul; Koh, Younggook; Cha, Junhoe
2017-07-01
Monitoring blood glucose level of diabetic patients is crucial in diabetes care from life threating complications. Selfmonitoring blood glucose (SMBG) that involves finger prick to draw blood samples into the measurement system is a widely-used method of routine measurement of blood glucose levels to date. SMBG includes, however, unavoidable pain problems resulting from the repetitive measurements. We hereby present a hydrogel-based electrochemical (H-EC) sensor to monitor the glucose level, non-invasively. Glucose oxidase (GOx) was immobilized in the disc-type hydroxyethyl methacrylate (HEMA) based hydrogel and kept intact in the hydrogel. Fast electron transfer mediated by Prussian blue (PB, hexacyanoferrate) generated efficient signal amplifications to facilitate the detection of the extracted glucose from the interstitial fluid. The linear response and the selectivity against glucose of the H-EC sensor were validated by chronoamperometry. For the practical use, the outcomes from the correlation of the extracted glucose concentration and the blood glucose value by on-body extraction, as well as the validation of the hydrogel-based electrochemical (H-EC) device, were applied to the on-body glucose monitoring.
Wearable Contact Lens Biosensors for Continuous Glucose Monitoring Using Smartphones.
Elsherif, Mohamed; Hassan, Mohammed Umair; Yetisen, Ali K; Butt, Haider
2018-05-17
Low-cost, robust, and reusable continuous glucose monitoring systems that can provide quantitative measurements at point-of-care settings is an unmet medical need. Optical glucose sensors require complex and time-consuming fabrication processes, and their readouts are not practical for quantitative analyses. Here, a wearable contact lens optical sensor was created for the continuous quantification of glucose at physiological conditions, simplifying the fabrication process and facilitating smartphone readouts. A photonic microstructure having a periodicity of 1.6 μm was printed on a glucose-selective hydrogel film functionalized with phenylboronic acid. Upon binding with glucose, the microstructure volume swelled, which modulated the periodicity constant. The resulting change in the Bragg diffraction modulated the space between zero- and first-order spots. A correlation was established between the periodicity constant and glucose concentration within 0-50 mM. The sensitivity of the sensor was 12 nm mM -1 , and the saturation response time was less than 30 min. The sensor was integrated with commercial contact lenses and utilized for continuous glucose monitoring using smartphone camera readouts. The reflected power of the first-order diffraction was measured via a smartphone application and correlated to the glucose concentrations. A short response time of 3 s and a saturation time of 4 min was achieved in the continuous monitoring mode. Glucose-sensitive photonic microstructures may have applications in point-of-care continuous monitoring devices and diagnostics at home settings.
CMOS image sensor-based implantable glucose sensor using glucose-responsive fluorescent hydrogel.
Tokuda, Takashi; Takahashi, Masayuki; Uejima, Kazuhiro; Masuda, Keita; Kawamura, Toshikazu; Ohta, Yasumi; Motoyama, Mayumi; Noda, Toshihiko; Sasagawa, Kiyotaka; Okitsu, Teru; Takeuchi, Shoji; Ohta, Jun
2014-11-01
A CMOS image sensor-based implantable glucose sensor based on an optical-sensing scheme is proposed and experimentally verified. A glucose-responsive fluorescent hydrogel is used as the mediator in the measurement scheme. The wired implantable glucose sensor was realized by integrating a CMOS image sensor, hydrogel, UV light emitting diodes, and an optical filter on a flexible polyimide substrate. Feasibility of the glucose sensor was verified by both in vitro and in vivo experiments.
Siegelaar, Sarah E; Barwari, Temo; Hermanides, Jeroen; van der Voort, Peter H J; Hoekstra, Joost B L; DeVries, J Hans
2013-11-01
Continuous glucose monitoring could be helpful for glucose regulation in critically ill patients; however, its accuracy is uncertain and might be influenced by microcirculation. We investigated the microcirculation and its relation to the accuracy of 2 continuous glucose monitoring devices in patients after cardiac surgery. The present prospective, observational study included 60 patients admitted for cardiac surgery. Two continuous glucose monitoring devices (Guardian Real-Time and FreeStyle Navigator) were placed before surgery. The relative absolute deviation between continuous glucose monitoring and the arterial reference glucose was calculated to assess the accuracy. Microcirculation was measured using the microvascular flow index, perfused vessel density, and proportion of perfused vessels using sublingual sidestream dark-field imaging, and tissue oxygenation using near-infrared spectroscopy. The associations were assessed using a linear mixed-effects model for repeated measures. The median relative absolute deviation of the Navigator was 11% (interquartile range, 8%-16%) and of the Guardian was 14% (interquartile range, 11%-18%; P = .05). Tissue oxygenation significantly increased during the intensive care unit admission (maximum 91.2% [3.9] after 6 hours) and decreased thereafter, stabilizing after 20 hours. A decrease in perfused vessel density accompanied the increase in tissue oxygenation. Microcirculatory variables were not associated with sensor accuracy. A lower peripheral temperature (Navigator, b = -0.008, P = .003; Guardian, b = -0.006, P = .048), and for the Navigator, also a higher Acute Physiology and Chronic Health Evaluation IV predicted mortality (b = 0.017, P < .001) and age (b = 0.002, P = .037) were associated with decreased sensor accuracy. The results of the present study have shown acceptable accuracy for both sensors in patients after cardiac surgery. The microcirculation was impaired to a limited extent compared
CMOS image sensor-based implantable glucose sensor using glucose-responsive fluorescent hydrogel
Tokuda, Takashi; Takahashi, Masayuki; Uejima, Kazuhiro; Masuda, Keita; Kawamura, Toshikazu; Ohta, Yasumi; Motoyama, Mayumi; Noda, Toshihiko; Sasagawa, Kiyotaka; Okitsu, Teru; Takeuchi, Shoji; Ohta, Jun
2014-01-01
A CMOS image sensor-based implantable glucose sensor based on an optical-sensing scheme is proposed and experimentally verified. A glucose-responsive fluorescent hydrogel is used as the mediator in the measurement scheme. The wired implantable glucose sensor was realized by integrating a CMOS image sensor, hydrogel, UV light emitting diodes, and an optical filter on a flexible polyimide substrate. Feasibility of the glucose sensor was verified by both in vitro and in vivo experiments. PMID:25426316
Christiansen, Mark P; Klaff, Leslie J; Brazg, Ronald; Chang, Anna R; Levy, Carol J; Lam, David; Denham, Douglas S; Atiee, George; Bode, Bruce W; Walters, Steven J; Kelley, Lynne; Bailey, Timothy S
2018-03-01
Persistent use of real-time continuous glucose monitoring (CGM) improves diabetes control in individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D). PRECISE II was a nonrandomized, blinded, prospective, single-arm, multicenter study that evaluated the accuracy and safety of the implantable Eversense CGM system among adult participants with T1D and T2D (NCT02647905). The primary endpoint was the mean absolute relative difference (MARD) between paired Eversense and Yellow Springs Instrument (YSI) reference measurements through 90 days postinsertion for reference glucose values from 40 to 400 mg/dL. Additional endpoints included Clarke Error Grid analysis and sensor longevity. The primary safety endpoint was the incidence of device-related or sensor insertion/removal procedure-related serious adverse events (SAEs) through 90 days postinsertion. Ninety participants received the CGM system. The overall MARD value against reference glucose values was 8.8% (95% confidence interval: 8.1%-9.3%), which was significantly lower than the prespecified 20% performance goal for accuracy (P < 0.0001). Ninety-three percent of CGM values were within 20/20% of reference values over the total glucose range of 40-400 mg/dL. Clarke Error Grid analysis showed 99.3% of samples in the clinically acceptable error zones A (92.8%) and B (6.5%). Ninety-one percent of sensors were functional through day 90. One related SAE (1.1%) occurred during the study for removal of a sensor. The PRECISE II trial demonstrated that the Eversense CGM system provided accurate glucose readings through the intended 90-day sensor life with a favorable safety profile.
Moatti-Sirat, D; Capron, F; Poitout, V; Reach, G; Bindra, D S; Zhang, Y; Wilson, G S; Thévenot, D R
1992-03-01
A miniaturized amperometric, enzymatic, glucose sensor (outer diameter 0.45 mm) was evaluated after implantation in the subcutaneous tissue of normal rats. A simple experimental procedure was designed for the long-term assessment of the sensor's function which was performed by recording the current during an intraperitoneal glucose load. The sensor was calibrated by accounting for the increase in the current during the concomitant increase in plasma glucose concentration, determined in blood sampled at the tail vein. This made it possible to estimate the glucose concentration in subcutaneous tissue. During the glucose load, the change in subcutaneous glucose concentration followed that in blood with a lag time consistently shorter than 5 min. The estimations of subcutaneous glucose concentration during these tests were compared to the concomitant plasma glucose concentrations by using a grid analysis. Three days after implantation (n = 6 experiments), 79 estimations were considered accurate, except for five which were in the acceptable zone. Ten days after implantation (n = 5 experiments), 101 estimations were accurate, except for one value, which was still acceptable. The sensitivity was around 0.5 nA.mmol-1.l-1 on day 3 and day 10. A longitudinal study on seven sensors tested on different days demonstrated a relative stability of the sensor's sensitivity. Finally, histological examination of the zone around the implantation site revealed a fibrotic reaction containing neocapillaries, which could explain the fast response of the sensor to glucose observed in vivo, even on day 10. We conclude that this miniaturized glucose sensor, whose size makes it easily implanted, works for at least ten days after implantation into rat subcutaneous tissue.
Noninvasive Continuous Monitoring of Tear Glucose Using Glucose-Sensing Contact Lenses.
Ascaso, Francisco J; Huerva, Valentín
2016-04-01
: The incidence of diabetes mellitus is dramatically increasing in the developed countries. Tight control of blood glucose concentration is crucial to diabetic patients to prevent microvascular complications. Self-monitoring of blood glucose is widely used for controlling blood glucose levels and usually performed by an invasive test using a portable glucometer. Many technologies have been developed over the past decades with the purpose of obtaining a continuous physiological glycemic monitoring. A contact lens is the ideal vehicle for continuous tear glucose monitoring of glucose concentration in tear film. There are several research groups that are working in the development of contact lenses with embedded biosensors for continuously and noninvasively monitoring tear glucose levels. Although numerous aspects must be improved, contact lens technology is one step closer to helping diabetic subjects better manage their condition, and these contact lenses will be able to measure the level of glucose in the wearer's tears and communicate the information to a mobile phone or computer. This article reviews studies on ocular glucose and its monitoring methods as well as the attempts to continuously monitor the concentration of tear glucose by using contact lens-based sensors.
Zhou, Tony; Dickson, Jennifer L; Geoffrey Chase, J
2018-01-01
Continuous glucose monitoring (CGM) devices have been effective in managing diabetes and offer potential benefits for use in the intensive care unit (ICU). Use of CGM devices in the ICU has been limited, primarily due to the higher point accuracy errors over currently used traditional intermittent blood glucose (BG) measures. General models of CGM errors, including drift and random errors, are lacking, but would enable better design of protocols to utilize these devices. This article presents an autoregressive (AR) based modeling method that separately characterizes the drift and random noise of the GlySure CGM sensor (GlySure Limited, Oxfordshire, UK). Clinical sensor data (n = 33) and reference measurements were used to generate 2 AR models to describe sensor drift and noise. These models were used to generate 100 Monte Carlo simulations based on reference blood glucose measurements. These were then compared to the original CGM clinical data using mean absolute relative difference (MARD) and a Trend Compass. The point accuracy MARD was very similar between simulated and clinical data (9.6% vs 9.9%). A Trend Compass was used to assess trend accuracy, and found simulated and clinical sensor profiles were similar (simulated trend index 11.4° vs clinical trend index 10.9°). The model and method accurately represents cohort sensor behavior over patients, providing a general modeling approach to any such sensor by separately characterizing each type of error that can arise in the data. Overall, it enables better protocol design based on accurate expected CGM sensor behavior, as well as enabling the analysis of what level of each type of sensor error would be necessary to obtain desired glycemic control safety and performance with a given protocol.
Optical biosensor optimized for continuous in-line glucose monitoring in animal cell culture.
Tric, Mircea; Lederle, Mario; Neuner, Lisa; Dolgowjasow, Igor; Wiedemann, Philipp; Wölfl, Stefan; Werner, Tobias
2017-09-01
Biosensors for continuous glucose monitoring in bioreactors could provide a valuable tool for optimizing culture conditions in biotechnological applications. We have developed an optical biosensor for long-term continuous glucose monitoring and demonstrated a tight glucose level control during cell culture in disposable bioreactors. The in-line sensor is based on a commercially available oxygen sensor that is coated with cross-linked glucose oxidase (GOD). The dynamic range of the sensor was tuned by a hydrophilic perforated diffusion membrane with an optimized permeability for glucose and oxygen. The biosensor was thoroughly characterized by experimental data and numerical simulations, which enabled insights into the internal concentration profile of the deactivating by-product hydrogen peroxide. The simulations were carried out with a one-dimensional biosensor model and revealed that, in addition to the internal hydrogen peroxide concentration, the turnover rate of the enzyme GOD plays a crucial role for biosensor stability. In the light of this finding, the glucose sensor was optimized to reach a long functional stability (>52 days) under continuous glucose monitoring conditions with a dynamic range of 0-20 mM and a response time of t 90 ≤ 10 min. In addition, we demonstrated that the sensor was sterilizable with beta and UV irradiation and only subjected to minor cross sensitivity to oxygen, when an oxygen reference sensor was applied. Graphical abstract Measuring setup of a glucose biosensor in a shake flask for continuous glucose monitoring in mammalian cell culture.
Müller, Achim Josef; Knuth, Monika; Nikolaus, Katharina Sibylle; Krivánek, Roland; Küster, Frank; Hasslacher, Christoph
2013-01-01
This article describes a new fiber-coupled, percutaneous fluorescent continuous glucose monitoring (CGM) system that has shown 14 days of functionality in a human clinical trial. The new optical CGM system (FiberSense) consists of a transdermal polymer optical fiber containing a biochemical glucose sensor and a small fluorescence photometer optically coupled to the fiber. The glucose-sensitive optical fiber was implanted in abdominal and upper-arm subcutaneous tissue of six diabetes patients and remained there for up to 14 days. The performance of the system was monitored during six visits to the study center during the trial. Blood glucose changes were induced by oral carbohydrate intake and insulin injections, and capillary blood glucose samples were obtained from the finger tip. The data were analyzed using linear regression and the consensus error grid analysis. The FiberSense worn at the upper arm exhibited excellent results during 14 wearing days, with an overall mean absolute relative difference (MARD) of 8.3% and 94.6% of the data in zone A of the consensus error grid. At the abdominal application site, FiberSense resulted in a MARD of 11.4 %, with 93.8% of the data in zone A. The FiberSense CGM system provided consistent, reliable measurements of subcutaneous glucose levels in human clinical trial patients with diabetes for up to 14 days. © 2013 Diabetes Technology Society.
Measurement of Glucose in Blood with a Phenylboronic Acid Optical Sensor
Worsley, Graham J.; Tourniaire, Guilhem A.; Medlock, Kathryn E. S.; Sartain, Felicity K.; Harmer, Hazel E.; Thatcher, Michael; Horgan, Adrian M.; Pritchard, John
2008-01-01
Background Current methods of glucose monitoring rely predominantly on enzymes such as glucose oxidase for detection. Phenylboronic acid receptors have been proposed as alternative glucose binders. A unique property of these molecules is their ability to bind glucose in a fully reversible covalent manner that facilitates direct continuous measurements. We examined (1) the ability of a phenylboronic-based sensor to measure glucose in blood and blood plasma and (2) the effect on measurement accuracy of a range of potential interferents. We also showed that the sensor is able to track glucose fluctuations occurring at rates mimicking those experienced in vivo. Method In vitro static measurements of glucose in blood and blood plasma were conducted using holographic sensors containing acrylamide, N,N′-methylenebisacrylamide, 3-acrylamidophenylboronic acid, and (3-acrylamidopropyl) trimethylammonium chloride. The same sensors were also used for in vitro measurements performed under flow conditions. Results The opacity of the liquid had no affect on the ability of the optical sensor to measure glucose in blood or blood plasma. The presence of common antibiotics, diabetic drugs, pain killers, and endogenous substances did not affect the measurement accuracy, as shown by error grid analysis. Ex vivo flow experiments showed that the sensor is able to track changes accurately in concentration occurring in real time without lag or evidence of hysteresis. Conclusions The ability of phenylboronic acid sensors to measure glucose in whole blood was demonstrated for the first time. Holographic sensors are ideally suited to continuous blood glucose measurements, being physically and chemically robust and potentially calibration free. PMID:19885345
Development of a nanowire based titanium needle probe sensor for glucose monitoring
NASA Astrophysics Data System (ADS)
Deshpande, Devesh C.
The need for continuous monitoring of various physiological functions such as blood glucose levels, neural functions and cholesterol levels has fostered the research and development of various schemes of biosensors to sense and help control the respective function. The needs of patients for sensors with minimal discomfort, longer life and better performance have necessitated the development towards smaller and more efficient sensors. In addition, the need for higher functionality from smaller sensors has led to the development of sensors with multiple electrodes, each electrode capable of sensing a different body function. Such multi-electrode sensors need to be fabricated using micro-fabrication processes in order to achieve precise control over the size, shape and placement of the electrodes. Multielectrode sensors fabricated using silicon and polymers have been demonstrated. One physiological function that attracts widespread interest is continuous glucose monitoring in our blood, since Diabetes affects millions of people all over the world. Significant deviations of blood glucose levels from the normal levels of 4-8 mM can cause fainting, coma and damage to the eyes, kidneys, nerves and blood vessels. For chronic patients, continuous monitoring of glucose levels is essential for accurate and timely treatment. A few continuous monitoring sensors are available in the market, but they have problems and cannot replace the strip type one-time glucose monitoring systems as yet. To address this need, large scale research efforts have been targeted towards continuous monitoring. The demand for higher accuracy and sensitivity has motivated researchers to evaluate the use of nanostructures in sensing. The large surface area-to-volume ratio of such structures could enable further miniaturization and push the detection limits, potentially enabling even single molecule detection. This research involved the development of a biocompatible titanium needle probe sensor for
Metabolic Biofouling of Glucose Sensors in Vivo: Role of Tissue Microhemorrhages
Klueh, Ulrike; Liu, Zenghe; Feldman, Ben; Henning, Timothy P; Cho, Brian; Ouyang, Tianmei; Kreutzer, Don
2011-01-01
Objective: Based on our in vitro study that demonstrated the adverse effects of blood clots on glucose sensor function, we hypothesized that in vivo local tissue hemorrhages, induced as a consequence of sensor implantation or sensor movement post-implantation, are responsible for unreliable readings or an unexplained loss of functionality shortly after implantation. Research Design and Methods: To investigate this issue, we utilized real-time continuous monitoring of blood glucose levels in a mouse model. Direct injection of blood at the tissue site of sensor implantation was utilized to mimic sensor-induced local tissue hemorrhages. Results: It was found that blood injections, proximal to the sensor, consistently caused lowered sensor glucose readings, designated temporary signal reduction, in vivo in our mouse model, while injections of plasma or saline did not have this effect. Conclusion: These results support our hypothesis that tissue hemorrhage and resulting blood clots near the sensor can result in lowered local blood glucose concentrations due to metabolism of glucose by the clot. The lowered local blood glucose concentration led to low glucose readings from the still functioning sensor that did not reflect the systemic glucose level. PMID:21722574
Evaluation of a minimally invasive glucose biosensor for continuous tissue monitoring.
Sharma, Sanjiv; Huang, Zhenyi; Rogers, Michelle; Boutelle, Martyn; Cass, Anthony E G
2016-11-01
We describe here a minimally invasive glucose biosensor based on a microneedle array electrode fabricated from an epoxy-based negative photoresist (SU8 50) and designed for continuous measurement in the dermal compartment with minimal pain. These minimally invasive, continuous monitoring sensor devices (MICoMS) were produced by casting the structures in SU8 50, crosslinking and then metallising them with platinum or silver to obtain the working and reference electrodes, respectively. The metallised microneedle array electrodes were subsequently functionalised by entrapping glucose oxidase in electropolymerised polyphenol (PP) film. Sensor performance in vitro showed that glucose concentrations down to 0.5 mM could be measured with a response times (T 90 ) of 15 s. The effect of sterilisation by Co60 irradiation was evaluated. In preparation for further clinical studies, these sensors were tested in vivo in a healthy volunteer for a period of 3-6 h. The sensor currents were compared against point measurements obtained with a commercial capillary blood glucometer. The epoxy MICoMS devices showed currents values that could be correlated with these. Graphical Abstract Microneedle arrays for continuous glucose monitoring in dermal interstitial fluid.
Evaluation of MOSFET-type glucose sensor using platinum electrode with glucose oxidase
NASA Astrophysics Data System (ADS)
Ooe, Katsutoshi; Hamamoto, Yasutaro; Hirano, Yoshiaki
2005-02-01
As the population ages, health management will be one of the important issues. The development of a safe medical machine based on MEMS technologies for the human body will be the primary research project in the future. We have developed the glucose sensor, as one of the medical based devices, for use in the Health Monitoring System (HMS). HMS is the device that continuously monitors human health conditions. For example, blood is the monitoring target of HMS. The glucose sensor specifically detects the glucose levels of the blood and monitors the glucose concentration as the blood sugar level. This glucose sensor has a "separated Au electrode", which immobilizes GOx. In our previous work, GOx was immobilized onto Au electrode by the SAMs (Self-Assembled Monolayer) method, and the sensor, using this working electrode, detected the glucose concentration of an aqueous glucose solution. In this report, we used a Pt electrode, which immobilized GOx, as a working electrode. Au electrode, which was used previously, was dissolved by the application of current in the presence of chloride ions. Based on the above-mentioned fact, a new working electrode, which immobilized GOx, was produced using Pt, which did not possess such characteristics. These Pt working electrodes were produced using the covalent binding method and the cross-link method, and both the electrodes displayed a good sensing property. In addition, the electrode using glutaraldehyde (GA) and bovine serum albumin (BSA) as crosslinking agents was produced, and it displayed better characteristics as compared with those displayed by the electrode that used only GA. Based on the above-mentioned techniques, the improvement in performance of the sensor was confirmed.
Progress toward the development of an implantable sensor for glucose.
Wilson, G S; Zhang, Y; Reach, G; Moatti-Sirat, D; Poitout, V; Thévenot, D R; Lemonnier, F; Klein, J C
1992-09-01
The development of an electrochemically based implantable sensor for glucose is described. The sensor is needle-shaped, about the size of a 28-gauge needle. It is flexible and must be implanted subcutaneously by using a 21-gauge catheter, which is then removed. When combined with a monitoring unit, this device, based on the glucose oxidase-catalyzed oxidation of glucose, reliably monitors glucose concentrations for as long as 10 days in rats. Various design considerations, including the decision to monitor the hydrogen peroxide produced in the enzymatic reaction, are discussed. Glucose constitutes the most important future target analyte for continuous monitoring, but the basic methodology developed for glucose could be applied to several other analytes such as lactate or ascorbate. The success in implementation of such a device depends on a reaction of the tissue surrounding the implant so as not to interfere with the proper functioning of the sensor. Histochemical evidence indicates that the tissue response leads to enhanced sensor performance.
Susceptibility of interstitial continuous glucose monitor performance to sleeping position.
Mensh, Brett D; Wisniewski, Natalie A; Neil, Brian M; Burnett, Daniel R
2013-07-01
Developing a round-the-clock artificial pancreas requires accurate and stable continuous glucose monitoring. The most widely used continuous glucose monitors (CGMs) are percutaneous, with the sensor residing in the interstitial space. Inaccuracies in percutaneous CGM readings during periods of lying on the devices (e.g., in various sleeping positions) have been anecdotally reported but not systematically studied. In order to assess the impact of sleep and sleep position on CGM performance, we conducted a study in human subjects in which we measured the variability of interstitial CGM data at night as a function of sleeping position. Commercially available sensors were placed for 4 days in the abdominal subcutaneous tissue in healthy, nondiabetic volunteers (four sensors per person, two per side). Nocturnal sleeping position was determined from video recordings and correlated to sensor data. We observed that, although the median of the four sensor readings was typically 70-110 mg/dl during sleep, individual sensors intermittently exhibited aberrant glucose readings (>25 mg/dl away from median) and that these aberrant readings were strongly correlated with subjects lying on the sensors. We expected and observed that most of these aberrant sleep-position-related CGM readings were sudden decreases in reported glucose values, presumably due to local blood-flow decreases caused by tissue compression. Curiously, in rare cases, the aberrant CGM readings were elevated values. These findings highlight limitations in our understanding of interstitial fluid physiology in the subcutaneous space and have significant implications for the utilization of sensors in the construction of an artificial pancreas. © 2013 Diabetes Technology Society.
Rigla, Mercedes; Pons, Belén; Rebasa, Pere; Luna, Alexis; Pozo, Francisco Javier; Caixàs, Assumpta; Villaplana, Maria; Subías, David; Bella, Maria Rosa; Combalia, Neus
2018-04-01
Subcutaneous (s.c.) glucose sensors have become a key component in type 1 diabetes management. However, their usability is limited by the impact of foreign body response (FBR) on their duration, reliability, and accuracy. Our study gives the first description of human acute and subacute s.c. response to glucose sensors, showing the changes observed in the sensor surface, the inflammatory cells involved in the FBR and their relationship with sensor performance. Twelve obese patients (seven type 2 diabetes) underwent two abdominal biopsies comprising the surrounding area where they had worn two glucose sensors: the first one inserted 7 days before and the second one 24 h before biopsy procedure. Samples were processed and studied to describe tissue changes by two independent pathologists (blind regarding sensor duration). Macrophages quantification was studied by immunohistochemistry methods in the area surrounding the sensor (CD68, CD163). Sensor surface changes were studied by scanning electron microscopy. Seven-day continuous glucose monitoring records were considered inaccurate when mean absolute relative difference was higher than 10%. Pathologists were able to correctly classify all the biopsies regarding sensor duration. Acute response (24 h) was characterized by the presence of neutrophils while macrophages were the main cell involved in subacute inflammation. The number of macrophages around the insertion hole was higher for less accurate sensors compared with those performing more accurately (32.6 ± 14 vs. 10.6 ± 1 cells/0.01 mm 2 ; P < 0.05). The accumulation of macrophages at the sensor-tissue interface is related with decrease in accuracy of the glucose measure.
Ito, N; Saito, A; Kayashima, S; Kimura, J; Kuriyama, T; Nagata, N; Arai, T; Kikuchi, M
1995-01-01
A transcutaneous blood glucose monitoring system consists of an ion-sensitive field-effect transistor (ISFET) glucose sensor unit and a suction effusion fluid (SEF) collecting unit. The SEF is directly collected by a weak suction (400 mmHg absolute pressure) through the skin from which the corneum layer of the epidermis has been previously removed. An ISFET glucose sensor unit is able to measure glucose concentrations in a microliter order sampling volume. The system was applied to three diabetic patients during a 75 g oral glucose tolerance test for monitoring blood glucose levels. During the experiments, glucose changes in the SEF followed actual blood glucose levels with 10 min delays. Results suggest the feasibility of utilizing quasi-continuous, transcutaneous blood glucose monitoring for individual patients with various diabetic histories or diabetic complications.
Cheyne, E H; Cavan, D A; Kerr, D
2002-01-01
It has been suggested that the continuous glucose monitoring system may be a useful tool for detecting unrecognised hypoglycaemia, especially at times when finger prick testing is difficult or impossible (e.g., at night). Studies suggest that subcutaneous glucose levels closely mimic blood glucose levels with a lag time of only a few minutes. However, no studies have been published to show how well the sensor performs during sustained or in recovery from hypoglycaemia. This study involved using a hyperinsulinaemic glucose clamp (60 mU/m2) in nine healthy volunteers. Each subject had two sensors inserted the day before the study. Blood glucose levels were maintained at euglycaemia for the first 60 min, then decreased to 45 mg/dL (2.5 mmol/L) for 60 min, and finally restored to euglycaemia. Blood glucose measurements were compared with interstitial values recorded by the sensor. Sensor profiles showed acceptable agreement with blood glucose levels at each of the three plateaus with a correlation coefficient of 0.79, slope of 0.85, and mean absolute error of 7%. The sensor drop closely matched the drop in blood glucose, but the recovery from hypoglycaemia was delayed by an average of 26 min. Continuous glucose sensing provides a useful means of detecting unrecognised hypoglycaemia in type 1 diabetes, although the duration of hypoglycaemia may be overestimated.
Fabrication of nitric oxide-releasing polyurethane glucose sensor membranes
Koh, Ahyeon; Riccio, Daniel A.; Sun, Bin; Carpenter, Alexis W.; Nichols, Scott P.; Schoenfisch, Mark H.
2011-01-01
Despite clear evidence that polymeric nitric oxide (NO) release coatings reduce the foreign body response (FBR) and may thus improve the analytical performance of in vivo continuous glucose monitoring devices when used as sensor membranes, the compatibility of the NO release chemistry with that required for enzymatic glucose sensing remains unclear. Herein, we describe the fabrication and characterization of NO-releasing polyurethane sensor membranes using NO donor-modified silica vehicles embedded within the polymer. In addition to demonstrating tunable NO release as a function of the NO donor silica scaffold and polymer compositions and concentrations, we describe the impact of the NO release vehicle and its release kinetics on glucose sensor performance. PMID:21795038
Enzymatic glucose sensor compensation for variations in ambient oxygen concentration
NASA Astrophysics Data System (ADS)
Collier, Bradley B.; McShane, Michael J.
2013-02-01
Due to the increasing prevalence of diabetes, research toward painless glucose sensing continues. Oxygen sensitive phosphors with glucose oxidase (GOx) can be used to determine glucose levels indirectly by monitoring oxygen consumption. This is an attractive combination because of its speed and specificity. Packaging these molecules together in "smart materials" for implantation will enable non-invasive glucose monitoring. As glucose levels increase, oxygen levels decrease; consequently, the luminescence intensity and lifetime of the phosphor increase. Although the response of the sensor is dependent on glucose concentration, the ambient oxygen concentration also plays a key role. This could lead to inaccurate glucose readings and increase the risk of hyper- or hypoglycemia. To mitigate this risk, the dependence of hydrogel glucose sensor response on oxygen levels was investigated and compensation methods explored. Sensors were calibrated at different oxygen concentrations using a single generic logistic equation, such that trends in oxygen-dependence were determined as varying parameters in the equation. Each parameter was found to be a function of oxygen concentration, such that the correct glucose calibration equation can be calculated if the oxygen level is known. Accuracy of compensation will be determined by developing an overall calibration, using both glucose and oxygen sensors in parallel, correcting for oxygen fluctuations in real time by intentionally varying oxygen, and calculating the error in actual and predicted glucose levels. While this method was developed for compensation of enzymatic glucose sensors, in principle it can also be implemented with other kinds of sensors utilizing oxidases.
Zanderigo, Francesca; Sparacino, Giovanni; Kovatchev, Boris; Cobelli, Claudio
2007-09-01
The aim of this article was to use continuous glucose error-grid analysis (CG-EGA) to assess the accuracy of two time-series modeling methodologies recently developed to predict glucose levels ahead of time using continuous glucose monitoring (CGM) data. We considered subcutaneous time series of glucose concentration monitored every 3 minutes for 48 hours by the minimally invasive CGM sensor Glucoday® (Menarini Diagnostics, Florence, Italy) in 28 type 1 diabetic volunteers. Two prediction algorithms, based on first-order polynomial and autoregressive (AR) models, respectively, were considered with prediction horizons of 30 and 45 minutes and forgetting factors (ff) of 0.2, 0.5, and 0.8. CG-EGA was used on the predicted profiles to assess their point and dynamic accuracies using original CGM profiles as reference. Continuous glucose error-grid analysis showed that the accuracy of both prediction algorithms is overall very good and that their performance is similar from a clinical point of view. However, the AR model seems preferable for hypoglycemia prevention. CG-EGA also suggests that, irrespective of the time-series model, the use of ff = 0.8 yields the highest accurate readings in all glucose ranges. For the first time, CG-EGA is proposed as a tool to assess clinically relevant performance of a prediction method separately at hypoglycemia, euglycemia, and hyperglycemia. In particular, we have shown that CG-EGA can be helpful in comparing different prediction algorithms, as well as in optimizing their parameters.
Continuous Glucose Monitoring For Patients with Diabetes
2011-01-01
Executive Summary Objective To determine the effectiveness and cost-effectiveness of continuous glucose monitoring combined with self-monitoring of blood glucose compared with self-monitoring of blood glucose alone in the management of diabetes. Clinical Need: Condition and Target Population Diabetes is a chronic metabolic disorder that interferes with the body’s ability to produce or effectively use insulin. In 2005, an estimated 816,000 Ontarians had diabetes representing 8.8% of the province’s population. Type 1 or juvenile onset diabetes is a life-long disorder that commonly manifests in children and adolescents. It represents about 10% of the total diabetes population and involves immune-mediated destruction of insulin producing cells in the pancreas. The loss of these cells necessitates insulin therapy. Type 2 or “adult-onset” diabetes represents about 90% of the total diabetes population and is marked by a resistance to insulin or insufficient insulin secretion. The risk of developing type 2 diabetes increases with age, obesity and lack of physical activity. Approximately 30% of patients with type 2 diabetes eventually require insulin therapy. Technology Continuous glucose monitors (CGM) measure glucose levels in the interstitial fluid surrounding skin cells. These measurements supplement conventional self monitoring of blood glucose (SMBG) by monitoring the glucose fluctuations continuously over a stipulated period of time, thereby identifying fluctuations that would not be identified with SMBG alone. To use a CGM, a sensor is inserted under the skin to measure glucose in the interstitial fluid. The sensor is wired to a transmitter. The device requires calibration using a capillary blood glucose measurement. Each sensor continuously measures glucose every 5-10 seconds averaging these values every 5 minutes and storing this data in the monitors memory. Depending on the device used, the algorithm in the device can measure glucose over a 3 or 6 day
A label-free fiber-optic Turbidity Affinity Sensor (TAS) for continuous glucose monitoring.
Dutt-Ballerstadt, Ralph; Evans, Colton; Pillai, Arun P; Gowda, Ashok
2014-11-15
In this paper, we describe the concept of a novel implantable fiber-optic Turbidity Affinity Sensor (TAS) and report on the findings of its in-vitro performance for continuous glucose monitoring. The sensing mechanism of the TAS is based on glucose-specific changes in light scattering (turbidity) of a hydrogel suspension consisting of small particles made of crosslinked dextran (Sephadex G100), and a glucose- and mannose-specific binding protein - Concanavalin A (ConA). The binding of ConA to Sephadex particles results in a significant turbidity increase that is much greater than the turbidity contribution by the individual components. The turbidity of the TAS was measured by determining the intensity of light passing through the suspension enclosed within a small semi-permeable hollow fiber (OD: 220 μm, membrane thickness: 20 μm, molecular weight cut-off: 10 kDa) using fiber optics. The intensity of measured light of the TAS was proportional to the glucose concentration over the concentration range from 50mg/dL to 400mg/dL in PBS and whole blood at 37°C (R>0.96). The response time was approximately 4 min. The stability of the glucose response of the TAS decreased only slightly (by 20%) over an 8-day study period at 37°C. In conclusion, this study demonstrated proof-of-concept of the TAS for interstitial glucose monitoring. Due to the large signal amplitude of the turbidity change, and the lack of need for wavelength-specific emission and excitation filters, a very small, robust and compact TAS device with an extremely short optical pathlength could be feasibly designed and implemented for in-vivo glucose monitoring in people with diabetes. Copyright © 2014 Elsevier B.V. All rights reserved.
Implantable fluorescence-based glucose sensor development
NASA Astrophysics Data System (ADS)
Ibey, Bennett L.; Yadavalli, Vamsi K.; Thomas, Hope R.; Rounds, Rebecca M.; Pishko, Michael V.; Cote, Gerard L.
2005-03-01
An implantable sensor is being created that allows measurement of blood glucose through fluorescent detection of an embedded chemical assay. The sensor is based on the competitive binding reaction between the protein Concanavalin A and various saccharide molecules, specifically a glycodendrimer and glucose. Previous studies have shown the ability of an embedded chemical assay using Con A and dextran with shorter wavelength dyes to both sense changes in glucose and generate sufficient fluorescent emission to pass through the dermal tissue. However, due to the chemical constituents of the assay, multivalent binding was evident resulting in poor spectral change due to glucose within the biological range. Use of a glycodendrimer and longer wavelength dyes has improved the sensor"s spectral change due to glucose and the overall signal to noise ratio of the sensor. In this work, a description of this sensor and the results obtained from it will be presented showing a large dynamic range of fluorescence with glucose.
Continuous non-invasive blood glucose monitoring by spectral image differencing method
NASA Astrophysics Data System (ADS)
Huang, Hao; Liao, Ningfang; Cheng, Haobo; Liang, Jing
2018-01-01
Currently, the use of implantable enzyme electrode sensor is the main method for continuous blood glucose monitoring. But the effect of electrochemical reactions and the significant drift caused by bioelectricity in body will reduce the accuracy of the glucose measurements. So the enzyme-based glucose sensors need to be calibrated several times each day by the finger-prick blood corrections. This increases the patient's pain. In this paper, we proposed a method for continuous Non-invasive blood glucose monitoring by spectral image differencing method in the near infrared band. The method uses a high-precision CCD detector to switch the filter in a very short period of time, obtains the spectral images. And then by using the morphological method to obtain the spectral image differences, the dynamic change of blood sugar is reflected in the image difference data. Through the experiment proved that this method can be used to monitor blood glucose dynamically to a certain extent.
Nonenzymatic Wearable Sensor for Electrochemical Analysis of Perspiration Glucose.
Zhu, Xiaofei; Ju, Yinhui; Chen, Jian; Liu, Deye; Liu, Hong
2018-05-25
We report a nonenzymatic wearable sensor for electrochemical analysis of perspiration glucose. Multipotential steps are applied on a Au electrode, including a high negative pretreatment potential step for proton reduction which produces a localized alkaline condition, a moderate potential step for electrocatalytic oxidation of glucose under the alkaline condition, and a positive potential step to clean and reactivate the electrode surface for the next detection. Fluorocarbon-based materials were coated on the Au electrode for improving the selectivity and robustness of the sensor. A fully integrated wristband is developed for continuous real-time monitoring of perspiration glucose during physical activities, and uploading the test result to a smartphone app via Bluetooth.
Rossetti, Paolo; Bondia, Jorge; Vehí, Josep; Fanelli, Carmine G.
2010-01-01
Evaluation of metabolic control of diabetic people has been classically performed measuring glucose concentrations in blood samples. Due to the potential improvement it offers in diabetes care, continuous glucose monitoring (CGM) in the subcutaneous tissue is gaining popularity among both patients and physicians. However, devices for CGM measure glucose concentration in compartments other than blood, usually the interstitial space. This means that CGM need calibration against blood glucose values, and the accuracy of the estimation of blood glucose will also depend on the calibration algorithm. The complexity of the relationship between glucose dynamics in blood and the interstitial space, contrasts with the simplistic approach of calibration algorithms currently implemented in commercial CGM devices, translating in suboptimal accuracy. The present review will analyze the issue of calibration algorithms for CGM, focusing exclusively on the commercially available glucose sensors. PMID:22163505
Leelarathna, Lalantha; English, Shane W; Thabit, Hood; Caldwell, Karen; Allen, Janet M; Kumareswaran, Kavita; Wilinska, Malgorzata E; Nodale, Marianna; Haidar, Ahmad; Evans, Mark L; Burnstein, Rowan; Hovorka, Roman
2014-02-01
Accurate real-time continuous glucose measurements may improve glucose control in the critical care unit. We evaluated the accuracy of the FreeStyle(®) Navigator(®) (Abbott Diabetes Care, Alameda, CA) subcutaneous continuous glucose monitoring (CGM) device in critically ill adults using two methods of calibration. In a randomized trial, paired CGM and reference glucose (hourly arterial blood glucose [ABG]) were collected over a 48-h period from 24 adults with critical illness (mean±SD age, 60±14 years; mean±SD body mass index, 29.6±9.3 kg/m(2); mean±SD Acute Physiology and Chronic Health Evaluation score, 12±4 [range, 6-19]) and hyperglycemia. In 12 subjects, the CGM device was calibrated at variable intervals of 1-6 h using ABG. In the other 12 subjects, the sensor was calibrated according to the manufacturer's instructions (1, 2, 10, and 24 h) using arterial blood and the built-in point-of-care glucometer. In total, 1,060 CGM-ABG pairs were analyzed over the glucose range from 4.3 to 18.8 mmol/L. Using enhanced calibration median (interquartile range) every 169 (122-213) min, the absolute relative deviation was lower (7.0% [3.5, 13.0] vs. 12.8% [6.3, 21.8], P<0.001), and the percentage of points in the Clarke error grid Zone A was higher (87.8% vs. 70.2%). Accuracy of the Navigator CGM device during critical illness was comparable to that observed in non-critical care settings. Further significant improvements in accuracy may be obtained by frequent calibrations with ABG measurements.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lane, Stephen M.; Mastrototaro, John J.
Diabetes is a chronic disease that affects 14 million people in the U.S. and more than 110 million people worldwide. Each year in this country 27,000 diabetic patients become blind, 15,000 have kidney failure, and over 54,000 have peripheral limb amputations. In 1992, total healthcare costs in the U.S. for diabetes were more than $105 billion, approximately 15% of our healthcare budget. Conventional therapy for the most severe form of diabetes, insulin-dependent diabetes mellitus (IDDM) or Type I diabetes, is to administer one or two injections per day of various forms of insulin while monitoring blood glucose levels twice ormore » three times daily with commercial glucometers that require blood samples. Near normal blood sugar levels (glycemic control) is difficult to achieve with conventional therapy. In the fall of 1993, the results of the 10-year $165 million Diabetes Control and Complications Trial (DCCT) were published which showed that intensive insulin management would lead to dramatically fewer cases of retinopathy (which leads to blindness), nephropathy (which leads to kidney failure), and neuropathy (which can lead to limb amputations) [New England Journal of Medicine, Vo1239, No.14 977-986 (1993)]. If existing commercial insulin pumps could be combined with a continuous glucose sensor, a more physiological and fine-tuned therapy could be provided - in effect, an artificial biomechanical pancreas would be available. Existing research suggested that such a development would dramatically improve glucose control, thus greatly reducing morbidity and mortality from this disease. MiniMed Technologies in Sylmar, CA, identified a number of optically based sensor strategies as well as candidate chemical reactions that could be used to implement a minimally invasive opto-chemical glucose sensor. LLNL evaluated these sensor strategies and chemical reactions. These evaluations were the first steps leading to development of a sensor of considerable importance that
An Overview of Insulin Pumps and Glucose Sensors for the Generalist
McAdams, Brooke H.; Rizvi, Ali A.
2016-01-01
Continuous subcutaneous insulin, or the insulin pump, has gained popularity and sophistication as a near-physiologic programmable method of insulin delivery that is flexible and lifestyle-friendly. The introduction of continuous monitoring with glucose sensors provides unprecedented access to, and prediction of, a patient’s blood glucose levels. Efforts are underway to integrate the two technologies, from “sensor-augmented” and “sensor-driven” pumps to a fully-automated and independent sensing-and-delivery system. Implantable pumps and an early-phase “bionic pancreas” are also in active development. Fine-tuned “pancreas replacement” promises to be one of the many avenues that offers hope for individuals suffering from diabetes. Although endocrinologists and diabetes specialists will continue to maintain expertise in this field, it behooves the primary care physician to have a working knowledge of insulin pumps and sensors to ensure optimal clinical care and decision-making for their patients. PMID:26742082
Patel, Jasbir N; Gray, Bonnie L; Kaminska, Bozena; Gates, Byron D
2011-09-01
Continuous glucose monitoring for patients with diabetes is of paramount importance to avoid severe health conditions resulting from hypoglycemia or hyperglycemia. Most available methods require an invasive setup and a health care professional. Handheld devices available on the market also require finger pricking for every measurement and do not provide continuous monitoring. Hence, continuous glucose monitoring from human tears using a glucose sensor embedded in a contact lens has been considered as a suitable option. However, the glucose concentration in human tears is very low in comparison with the blood glucose level (1/10-1/40 concentration). We propose a sensor that solves the sensitivity problem in a new way, is flexible, and is constructed onto the oxygen permeable contact lens material. To achieve such sensitivity while maintaining a small sensor footprint suitable for placement in a contact lens, we increased the active electrode area by using three-dimensional (3-D) electrode micropatterning. Fully flexible 3-D electrodes were realized utilizing ordered arrays of pillars with different shapes and heights. We successfully fabricated square and cylindrical pillars with different height (50, 100, and 200 μm) and uniform metal coverage to realize sensor electrodes. The increased surface area produces high amperometric current that increases sensor sensitivity up to 300% using 200 μm tall square pillars. The sensitivity improvement closely follows the improvement in the surface area of the electrode. The proposed flexible glucose sensors with 3-D microstructure electrodes are more sensitive to lower glucose concentrations and generate higher current signal than conventional glucose sensors. © 2011 Diabetes Technology Society.
Occurence of adverse events due to continuous glucose monitoring.
Jadviscokova, Tereza; Fajkusova, Zuzana; Pallayova, Maria; Luza, Jiri; Kuzmina, Galina
2007-12-01
Continuous glucose monitoring (CGM) using transcutaneous sensors is becoming a sophisticated method to control and regulate glucose metabolism. The transcutaneous sensor of the CGM system (CGMS Medtronic Minimed, Northridge, CA, USA) is chosen to measure glucose concentration in interstitial fluid up to three days after insertion even though its function remains stable for a longer period. The question arises, which factors really limit the period of sensor insertion without unnecessary risk. The aim of this study was to assess any adverse events occurring in the course of 9 days after the sensor insertion. In a group of 22 healthy volunteers aged 21.8+/-1.30 y (mean +/- SE) a total of 26 sensors was inserted subcutaneously in gluteal or lumbar region for 9 days. Before insertion the site was sprayed with an antiseptic (Cutasept F, Bode Chemie, Hamburg, Germany). Local adverse reactions and disturbances in general condition were examined. In the course of 184 sensor-days, there were only minor local adverse events: hypersensitivity, itching, pain, redness, burning, subcutaneous hemorrhage. Additionally, sleep disturbances, attention deficits, problems related to the CGMS monitor, to adhesive tape and/or sensor were found. None of these resulted in sensor withdrawal. In 12 volunteers (55 %) no complications were observed. The sensor function measured according to electrical signals (ISIG) failed (always on day 1-2) in 4 cases (16 %). The present FDA approved 3-day insertion period for Medtronic transcutaneous sensor does not seem to limit its use and appears to be worth a careful revision.
Leelarathna, Lalantha; English, Shane W.; Thabit, Hood; Caldwell, Karen; Allen, Janet M.; Kumareswaran, Kavita; Wilinska, Malgorzata E.; Nodale, Marianna; Haidar, Ahmad; Evans, Mark L.; Burnstein, Rowan
2014-01-01
Abstract Objective: Accurate real-time continuous glucose measurements may improve glucose control in the critical care unit. We evaluated the accuracy of the FreeStyle® Navigator® (Abbott Diabetes Care, Alameda, CA) subcutaneous continuous glucose monitoring (CGM) device in critically ill adults using two methods of calibration. Subjects and Methods: In a randomized trial, paired CGM and reference glucose (hourly arterial blood glucose [ABG]) were collected over a 48-h period from 24 adults with critical illness (mean±SD age, 60±14 years; mean±SD body mass index, 29.6±9.3 kg/m2; mean±SD Acute Physiology and Chronic Health Evaluation score, 12±4 [range, 6–19]) and hyperglycemia. In 12 subjects, the CGM device was calibrated at variable intervals of 1–6 h using ABG. In the other 12 subjects, the sensor was calibrated according to the manufacturer's instructions (1, 2, 10, and 24 h) using arterial blood and the built-in point-of-care glucometer. Results: In total, 1,060 CGM–ABG pairs were analyzed over the glucose range from 4.3 to 18.8 mmol/L. Using enhanced calibration median (interquartile range) every 169 (122–213) min, the absolute relative deviation was lower (7.0% [3.5, 13.0] vs. 12.8% [6.3, 21.8], P<0.001), and the percentage of points in the Clarke error grid Zone A was higher (87.8% vs. 70.2%). Conclusions: Accuracy of the Navigator CGM device during critical illness was comparable to that observed in non–critical care settings. Further significant improvements in accuracy may be obtained by frequent calibrations with ABG measurements. PMID:24180327
Peterson, Karolina; Zapletalova, Jana; Kudlova, Pavla; Matuskova, Veronika; Bartek, Josef; Novotny, Dalibor; Chlup, Rudolf
2009-03-01
The latest Paradigm 722 insulin pump, Medtronic MiniMed, USA, enables daily reading of 288 interstitial fluid glucose concentrations determined by a sensor inserted into subcutaneous tissue; the sensor signals are transmitted into the insulin pump, enabling the patient to see real-time glucose concentration on the display and adapt further treatment. To assess the evolution of HbA1c over the course of a 3-month period in two cohorts of persons with type 1 (n=39) or type 2 (n=3) diabetes (PWD): 1) PWD on Paradigm 722 using sensors for continuous glucose monitoring (CGM group), 2) PWD on other types of insulin pumps performing intensive self-monitoring as before (3 to 6 times/d) on glucometer Linus, Wellion, Agamatrix (control group). Compliant PWDs using insulin pump with insulin aspart for several previous months were included in the study. Seventeen were put on Paradigm 722 with CGM and 25 were included in the control group. Paired t-test and the statistical program SPSS v.15.0 were used to analyze the data. There was no significant difference in age between the two groups (P=0.996), in diabetes duration (P=0.482) or in daily insulin dose (P=0.469). In the CGM group (but not in the control group) HbA1c/IFCC dropped from 6.98+/-0.43 % to 5.98+/-0.36 % (P=0.006) within 1 month and remained reduced. The use of the Paradigm 722 insulin pump with CGM resulted in significant improvement in HbA1c which appeared within one month and remained throughout the whole 3-month study period. No significant improvement in HbA1c was seen in the control group.
Toward CMOS image sensor based glucose monitoring.
Devadhasan, Jasmine Pramila; Kim, Sanghyo
2012-09-07
Complementary metal oxide semiconductor (CMOS) image sensor is a powerful tool for biosensing applications. In this present study, CMOS image sensor has been exploited for detecting glucose levels by simple photon count variation with high sensitivity. Various concentrations of glucose (100 mg dL(-1) to 1000 mg dL(-1)) were added onto a simple poly-dimethylsiloxane (PDMS) chip and the oxidation of glucose was catalyzed with the aid of an enzymatic reaction. Oxidized glucose produces a brown color with the help of chromogen during enzymatic reaction and the color density varies with the glucose concentration. Photons pass through the PDMS chip with varying color density and hit the sensor surface. Photon count was recognized by CMOS image sensor depending on the color density with respect to the glucose concentration and it was converted into digital form. By correlating the obtained digital results with glucose concentration it is possible to measure a wide range of blood glucose levels with great linearity based on CMOS image sensor and therefore this technique will promote a convenient point-of-care diagnosis.
Electron-transfer mediator for a NAD-glucose dehydrogenase-based glucose sensor.
Kim, Dong-Min; Kim, Min-yeong; Reddy, Sanapalli S; Cho, Jaegeol; Cho, Chul-ho; Jung, Suntae; Shim, Yoon-Bo
2013-12-03
A new electron-transfer mediator, 5-[2,5-di (thiophen-2-yl)-1H-pyrrol-1-yl]-1,10-phenanthroline iron(III) chloride (FePhenTPy) oriented to the nicotinamide adenine dinucleotide-dependent-glucose dehydrogenase (NAD-GDH) system was synthesized through a Paal-Knorr condensation reaction. The structure of the mediator was confirmed by Fourier-transform infrared spectroscopy, proton and carbon nucler magnetic resonance spectroscopy, and mass spectroscopy, and its electron-transfer characteristic for a glucose sensor was investigated using voltammetry and impedance spectroscopy. A disposable amperometric glucose sensor with NAD-GDH was constructed with FePhenTPy as an electron-transfer mediator on a screen printed carbon electrode (SPCE) and its performance was evaluated, where the addition of reduces graphene oxide (RGO) to the mediator showed the enhanced sensor performance. The experimental parameters to affect the analytical performance and the stability of the proposed glucose sensor were optimized, and the sensor exhibited a dynamic range between 30 mg/dL and 600 mg/dL with the detection limit of 12.02 ± 0.6 mg/dL. In the real sample experiments, the interference effects by acetaminophen, ascorbic acid, dopamine, uric acid, caffeine, and other monosaccharides (fructose, lactose, mannose, and xylose) were completely avoided through coating the sensor surface with the Nafion film containing lead(IV) acetate. The reliability of proposed glucose sensor was evaluated by the determination of glucose in artificial blood and human whole blood samples.
Adolfsson, Peter; Örnhagen, Hans; Eriksson, Bengt M.; Gautham, Raghavendhar; Jendle, Johan
2012-01-01
Background There is a need for reliable methods of glucose measurement in different environmental conditions. The objective of this in vitro study was to evaluate the performance of the Enlite® Sensor when connected to either the iPro™ Continuous Glucose Monitor recording device or the Guardian® REAL-Time transmitting device, in hypobaric and hyperbaric conditions. Methods Sixteen sensors connected to eight iPro devices and eight Guardian REAL-Time devices were immersed in three beakers containing separate glucose concentrations: 52, 88, and 207 mg/dl (2.9, 4.9, and 11.3 mmol/liter). Two different pressure tests were conducted: a hypobaric test, corresponding to maximum 18000 ft/5500 m height, and a hyperbaric test, corresponding to maximum 100 ft/30 m depth. The linearity of the sensor signals in the different conditions was evaluated. Results The sensors worked continuously, and the sensor signals were collected without interruption at all pressures tested. When comparing the input signals for glucose (ISIGs) and the different glucose concentrations during altered pressure, linearity (R2) of 0.98 was found. During the hypobaric test, significant differences (p < .005) were seen when comparing the ISIGs during varying pressure at two of the glucose concentrations (52 and 207 mg/dl), whereas no difference was seen at the 88 mg/dl glucose concentration. During the hyperbaric test, no differences were found. Conclusions The Enlite Sensors connected to either the iPro or the Guardian REAL-Time device provided values continuously. In hyperbaric conditions, no significant differences were seen during changes in ambient pressure; however, during hypobaric conditions, the ISIG was significantly different in the low and high glucose concentrations. PMID:23294783
Adolfsson, Peter; Ornhagen, Hans; Eriksson, Bengt M; Gautham, Raghavendhar; Jendle, Johan
2012-11-01
There is a need for reliable methods of glucose measurement in different environmental conditions. The objective of this in vitro study was to evaluate the performance of the Enlite® Sensor when connected to either the iPro™ Continuous Glucose Monitor recording device or the Guardian® REAL-Time transmitting device, in hypobaric and hyperbaric conditions. Sixteen sensors connected to eight iPro devices and eight Guardian REAL-Time devices were immersed in three beakers containing separate glucose concentrations: 52, 88, and 207 mg/dl (2.9, 4.9, and 11.3 mmol/liter). Two different pressure tests were conducted: a hypobaric test, corresponding to maximum 18000 ft/5500 m height, and a hyperbaric test, corresponding to maximum 100 ft/30 m depth. The linearity of the sensor signals in the different conditions was evaluated. The sensors worked continuously, and the sensor signals were collected without interruption at all pressures tested. When comparing the input signals for glucose (ISIGs) and the different glucose concentrations during altered pressure, linearity (R(2)) of 0.98 was found. During the hypobaric test, significant differences (p < .005) were seen when comparing the ISIGs during varying pressure at two of the glucose concentrations (52 and 207 mg/dl), whereas no difference was seen at the 88 mg/dl glucose concentration. During the hyperbaric test, no differences were found. The Enlite Sensors connected to either the iPro or the Guardian REAL-Time device provided values continuously. In hyperbaric conditions, no significant differences were seen during changes in ambient pressure; however, during hypobaric conditions, the ISIG was significantly different in the low and high glucose concentrations. © 2012 Diabetes Technology Society.
Calhoun, Peter; Lum, John; Beck, Roy W; Kollman, Craig
2013-09-01
Knowledge of the accuracy of continuous glucose monitoring (CGM) devices is important for its use as a management tool for individuals with diabetes and for its use to assess outcomes in clinical studies. Using data from several inpatient studies, we compared the accuracy of two sensors, the Medtronic Enlite™ using MiniMed Paradigm(®) Veo™ calibration and the Sof-Sensor(®) glucose sensor using Guardian(®) REAL-Time CGM calibration (all from Medtronic Diabetes, Northridge, CA). Nocturnal data were analyzed from eight inpatient studies in which both CGM and reference glucose measurements were available. The analyses included 1,666 CGM-reference paired glucose values for the Enlite in 54 participants over 69 nights and 3,627 paired values for the Sof-Sensor in 66 participants over 91 nights. The Enlite sensor tended to report glucose levels lower than the reference over the entire range of glucose values, whereas the Sof-Sensor values tended to be higher than reference values in the hypoglycemic range and lower than reference values in the hyperglycemic range. The overall median sensor-reference difference was -15 mg/dL for the Enlite and -1 mg/dL for the Sof-Sensor (P<0.001). The median relative absolute difference was 15% for the Enlite versus 12% for the Sof-Sensor (P=0.06); 66% of Enlite values and 73% of Sof-Sensor values met International Organization for Standardization criteria. We found that the Enlite tended to be biased low over the entire glucose range, whereas the Sof-Sensor showed the more typical sensor pattern of being biased high in the hypoglycemic range and biased low in the hyperglycemic range.
Bode, Bruce; Gross, Kenneth; Rikalo, Nancy; Schwartz, Sherwyn; Wahl, Timothy; Page, Casey; Gross, Todd; Mastrototaro, John
2004-04-01
The purposes of this study were to demonstrate the accuracy and effectiveness of the Guardian Continuous Monitoring System (Medtronic MiniMed, Northridge, California) and to demonstrate that the application of real-time alarms to continuous monitoring alerts users to hypo and hyperglycemia and reduces excursions in people with diabetes. A total of 71 subjects with type 1 diabetes, mean hemoglobin A1c of 7.6 +/- 1.1%, age 44.0 +/- 11.4 years, and duration of diabetes 23.6 +/- 10.6 years were enrolled in this two-period, randomized, multicenter study. Subjects were randomized into either an Alert group or a Control group. The accuracy of the Guardian was evaluated by treating the study data as a single-sample correlational design. Effectiveness of the Guardian alerts was evaluated by comparing the Alert group with the Control group. The mean (median) absolute relative error between home blood glucose meter readings and sensor values was 21.3% (17.3%), and the Guardian, on average, read 12.8 mg/dL below the concurrent home blood glucose meter readings. The hypoglycemia alert was able to distinguished glucose values < or =70 mg/dL with 67% sensitivity, 90% specificity, and 47% false alerts. The hyperglycemia alert showed a similar ability to detect sensor values > or =250 mg/dL with 63% sensitivity, 97% specificity, and 19% false alerts. The Alert group demonstrated a median decrease in the duration of hypoglycemic excursions (-27.8 min) that was significantly greater than the median decrease in the duration of hypoglycemic excursions in the Control group (-4.5 min) (P = 0.03). A marginally significant increase in the frequency of hyperglycemic excursions (P = 0.07) between Period 1 and Period 2 was accompanied by a decrease of 9.6 min in the duration of hyperglycemic excursions in the Alert group. Glucose measurements differ between blood samples taken from the finger and interstitial fluid, especially when levels are changing rapidly; however, these results
Towards a continuous glucose monitoring system using tunable quantum cascade lasers
NASA Astrophysics Data System (ADS)
Haase, Katharina; Müller, Niklas; Petrich, Wolfgang
2018-02-01
We present a reagent-free approach for long-term continuous glucose monitoring (cgm) of liquid samples using midinfrared absorption spectroscopy. This method could constitute an alternative to enzymatic glucose sensors in order to manage the widespread disease of Diabetes. In order to acquire spectra of the liquid specimen, we use a spectrally tunable external-cavity (EC-) quantum cascade laser (QCL) as radiation source in combination with a fiber-based in vitro sensor setup. Hereby we achieve a glucose sensitivity in pure glucose solutions of 3 mg/dL (RMSEP). Furthermore, the spectral tunability of the EC-QCL enables us to discriminate glucose from other molecules. We exemplify this by detecting glucose among other saccharides with an accuracy of 8 mg/dL (within other monosaccharides, RMSEVC) and 14 mg/dL (within other mono- and disaccharides, RMSECV). Moreover, we demonstrate a characterization of the significance of each wavenumber for an accurate prediction of glucose among other saccharides using an evolutionary algorithm. We show, that by picking 10 distinct wavenumbers we can achieve comparable accuracies to the use of a complete spectrum.
New-generation diabetes management: glucose sensor-augmented insulin pump therapy.
Cengiz, Eda; Sherr, Jennifer L; Weinzimer, Stuart A; Tamborlane, William V
2011-07-01
Diabetes is one of the most common chronic disorders with an increasing incidence worldwide. Technologic advances in the field of diabetes have provided new tools for clinicians to manage this challenging disease. For example, the development of continuous subcutaneous insulin infusion systems have allowed for refinement in the delivery of insulin, while continuous glucose monitors provide patients and clinicians with a better understanding of the minute to minute glucose variability, leading to the titration of insulin delivery based on this variability when applicable. Merging of these devices has resulted in sensor-augmented insulin pump therapy, which became a major building block upon which the artificial pancreas (closed-loop systems) can be developed. This article summarizes the evolution of sensor-augmented insulin pump therapy until present day and its future applications in new-generation diabetes management.
Choleau, C; Klein, J C; Reach, G; Aussedat, B; Demaria-Pesce, V; Wilson, G S; Gifford, R; Ward, W K
2002-08-01
The calibration of a continuous glucose monitoring system, i.e. the transformation of the signal I(t) generated by the glucose sensor at time (t) into an estimation of glucose concentration G(t), represents a key issue. The two-point calibration procedure consists of the determination of a sensor sensitivity S and of a background current I(o) by plotting two values of the sensor signal versus the concomitant blood glucose concentrations. The estimation of G(t) is subsequently given by G(t) = (I(t)-I(o))/S. A glucose sensor was implanted in the subcutaneous tissue of nine type 1 diabetic patients during 3 (n = 2) and 7 days (n = 7). For each individual trial, S and I(o) were determined by taking into account the values of two sets of sensor output and blood glucose concentration distant by at least 1 h, the procedure being repeated for each consecutive set of values. S and I(o) were found to be negatively correlated, the value of I(o) being sometimes negative. Theoretical analysis demonstrates that this phenomenon can be explained by the effect of measurement uncertainties on the determination of capillary glucose concentration and of sensor output.
... transmit- ter sends information about glucose levels via radio waves from the sensor to a pagerlike wireless ... 703–738–4929 Email: ndep@mail.nih.gov Internet: www.ndep.nih.gov American Diabetes Association 1701 ...
Accuracy of a new real-time continuous glucose monitoring algorithm.
Keenan, D Barry; Cartaya, Raymond; Mastrototaro, John J
2010-01-01
Through minimally invasive sensor-based continuous glucose monitoring (CGM), individuals can manage their blood glucose (BG) levels more aggressively, thereby improving their hemoglobin A1c level, while reducing the risk of hypoglycemia. Tighter glycemic control through CGM, however, requires an accurate glucose sensor and calibration algorithm with increased performance at lower BG levels. Sensor and BG measurements for 72 adult and adolescent subjects were obtained during the course of a 26-week multicenter study evaluating the efficacy of the Paradigm REAL-Time (PRT) sensor-augmented pump system (Medtronic Diabetes, Northridge, CA) in an outpatient setting. Subjects in the study arm performed at least four daily finger stick measurements. A retrospective analysis of the data set was performed to evaluate a new calibration algorithm utilized in the Paradigm Veo insulin pump (Medtronic Diabetes) and to compare these results to performance metrics calculated for the PRT. A total of N = 7193 PRT sensor downloads for 3 days of use, as well as 90,472 temporally and nonuniformly paired data points (sensor and meter values), were evaluated, with 5841 hypoglycemic and 15,851 hyperglycemic events detected through finger stick measurements. The Veo calibration algorithm decreased the overall mean absolute relative difference by greater than 0.25 to 15.89%, with hypoglycemia sensitivity increased from 54.9% in the PRT to 82.3% in the Veo (90.5% with predictive alerts); however, hyperglycemia sensitivity was decreased only marginally from 86% in the PRT to 81.7% in the Veo. The Veo calibration algorithm, with sensor error reduced significantly in the 40- to 120-mg/dl range, improves hypoglycemia detection, while retaining accuracy at high glucose levels. 2010 Diabetes Technology Society.
[Design and implementation of real-time continuous glucose monitoring instrument].
Huang, Yonghong; Liu, Hongying; Tian, Senfu; Jia, Ziru; Wang, Zi; Pi, Xitian
2017-12-01
Real-time continuous glucose monitoring can help diabetics to control blood sugar levels within the normal range. However, in the process of practical monitoring, the output of real-time continuous glucose monitoring system is susceptible to glucose sensor and environment noise, which will influence the measurement accuracy of the system. Aiming at this problem, a dual-calibration algorithm for the moving-window double-layer filtering algorithm combined with real-time self-compensation calibration algorithm is proposed in this paper, which can realize the signal drift compensation for current data. And a real-time continuous glucose monitoring instrument based on this study was designed. This real-time continuous glucose monitoring instrument consisted of an adjustable excitation voltage module, a current-voltage converter module, a microprocessor and a wireless transceiver module. For portability, the size of the device was only 40 mm × 30 mm × 5 mm and its weight was only 30 g. In addition, a communication command code algorithm was designed to ensure the security and integrity of data transmission in this study. Results of experiments in vitro showed that current detection of the device worked effectively. A 5-hour monitoring of blood glucose level in vivo showed that the device could continuously monitor blood glucose in real time. The relative error of monitoring results of the designed device ranged from 2.22% to 7.17% when comparing to a portable blood meter.
[Continuous glucose monitoring with type 1 diabetes mellitus].
López-Siguero, J P; García Arias, M J; del Pino de la Fuente, A; Moreno Molina, J A
2003-03-01
Appropriate metabolic control of children with type 1 diabetes mellitus (DM) is based on frequent measurements of capillary glycemia. However, this method offers only partial information on fluctuations in glycemia during the day, while episodes of postprandial hyperglycemia and hypoglycemia, mainly nocturnal, go unnoticed. To analyze pre- and postprandial blood glucose levels, as well as the presence and duration of hypoglycemic episodes in diabetic children aged more than 8 years old with more than one year of disease duration. Seventeen patients of both sexes (mean age: 12 years old) with type 1 DM were monitored with the continuous glucose monitoring system (CGMS) during working days. Maximum values of pre- and postprandial glucose (1-3 hours after breakfast, lunch and dinner) were registered. Data were downloaded with a Com-station. The mean duration of sensor-wearing was 2.97 days. Pre- and postprandial values were high: mean preprandial values were between 144.9 and 160.5 mg % and mean postprandial values were between 230.4 and 248.8 mg %. The mean number of hypoglycemic episodes detected with the sensor was 4.9 compared with 1.8 detected with the glucometer (p < 0.05). Episodes of mainly nocturnal asymptomatic hypoglycemia were detected with a mean duration of 145 minutes during the night and 75 minutes during the day. The use of continuous subcutaneous glucose monitoring demonstrates that glycemic objectives are not achieved by conventional insulin therapy. It also shows that there are a high number of hypoglycemic episodes, most of which are asymptomatic.
Continuous glucose monitoring for patients with diabetes: an evidence-based analysis.
2011-01-01
To determine the effectiveness and cost-effectiveness of continuous glucose monitoring combined with self-monitoring of blood glucose compared with self-monitoring of blood glucose alone in the management of diabetes. CONDITION AND TARGET POPULATION Diabetes is a chronic metabolic disorder that interferes with the body's ability to produce or effectively use insulin. In 2005, an estimated 816,000 Ontarians had diabetes representing 8.8% of the province's population. Type 1 or juvenile onset diabetes is a life-long disorder that commonly manifests in children and adolescents. It represents about 10% of the total diabetes population and involves immune-mediated destruction of insulin producing cells in the pancreas. The loss of these cells necessitates insulin therapy. Type 2 or "adult-onset" diabetes represents about 90% of the total diabetes population and is marked by a resistance to insulin or insufficient insulin secretion. The risk of developing type 2 diabetes increases with age, obesity and lack of physical activity. Approximately 30% of patients with type 2 diabetes eventually require insulin therapy. Continuous glucose monitors (CGM) measure glucose levels in the interstitial fluid surrounding skin cells. These measurements supplement conventional self monitoring of blood glucose (SMBG) by monitoring the glucose fluctuations continuously over a stipulated period of time, thereby identifying fluctuations that would not be identified with SMBG alone. To use a CGM, a sensor is inserted under the skin to measure glucose in the interstitial fluid. The sensor is wired to a transmitter. The device requires calibration using a capillary blood glucose measurement. Each sensor continuously measures glucose every 5-10 seconds averaging these values every 5 minutes and storing this data in the monitors memory. Depending on the device used, the algorithm in the device can measure glucose over a 3 or 6 day period using one sensor. After the 3 or 6 day period, a new
Optical microsensor for continuous glucose measurements in interstitial fluid
NASA Astrophysics Data System (ADS)
Olesberg, Jonathon T.; Cao, Chuanshun; Yager, Jeffrey R.; Prineas, John P.; Coretsopoulos, Chris; Arnold, Mark A.; Olafsen, Linda J.; Santilli, Michael
2006-02-01
Tight control of blood glucose levels has been shown to dramatically reduce the long-term complications of diabetes. Current invasive technology for monitoring glucose levels is effective but underutilized by people with diabetes because of the pain of repeated finger-sticks, the inconvenience of handling samples of blood, and the cost of reagent strips. A continuous glucose sensor coupled with an insulin delivery system could provide closed-loop glucose control without the need for discrete sampling or user intervention. We describe an optical glucose microsensor based on absorption spectroscopy in interstitial fluid that can potentially be implanted to provide continuous glucose readings. Light from a GaInAsSb LED in the 2.2-2.4 μm wavelength range is passed through a sample of interstitial fluid and a linear variable filter before being detected by an uncooled, 32-element GaInAsSb detector array. Spectral resolution is provided by the linear variable filter, which has a 10 nm band pass and a center wavelength that varies from 2.18-2.38 μm (4600-4200 cm -1) over the length of the detector array. The sensor assembly is a monolithic design requiring no coupling optics. In the present system, the LED running with 100 mA of drive current delivers 20 nW of power to each of the detector pixels, which have a noise-equivalent-power of 3 pW/Hz 1/2. This is sufficient to provide a signal-to-noise ratio of 4500 Hz 1/2 under detector-noise limited conditions. This signal-to-noise ratio corresponds to a spectral noise level less than 10 μAU for a five minute integration, which should be sufficient for sub-millimolar glucose detection.
Micro-Electromechanical Affinity Sensor for the Monitoring of Glucose in Bioprocess Media
Theuer, Lorenz; Lehmann, Micha; Junne, Stefan; Neubauer, Peter; Birkholz, Mario
2017-01-01
An affinity-viscometry-based micro-sensor probe for continuous glucose monitoring was investigated with respect to its suitability for bioprocesses. The sensor operates with glucose and dextran competing as binding partner for concanavalin A, while the viscosity of the assay scales with glucose concentration. Changes in viscosity are determined with a micro-electromechanical system (MEMS) in the measurement cavity of the sensor probe. The study aimed to elucidate the interactions between the assay and a typical phosphate buffered bacterial cultivation medium. It turned out that contact with the medium resulted in a significant long-lasting drift of the assay’s viscosity at zero glucose concentration. Adding glucose to the medium lowers the drift by a factor of eight. The cglc values measured off-line with the glucose sensor for monitoring of a bacterial cultivation were similar to the measurements with an enzymatic assay with a difference of less than ±0.15 g·L−1. We propose that lectin agglomeration, the electro-viscous effect, and constitutional changes of concanavalin A due to exchanges of the incorporated metal ions may account for the observed viscosity increase. The study has demonstrated the potential of the MEMS sensor to determine sensitive viscosity changes within very small sample volumes, which could be of interest for various biotechnological applications. PMID:28594350
Characterizing Accuracy and Precision of Glucose Sensors and Meters
2014-01-01
There is need for a method to describe precision and accuracy of glucose measurement as a smooth continuous function of glucose level rather than as a step function for a few discrete ranges of glucose. We propose and illustrate a method to generate a “Glucose Precision Profile” showing absolute relative deviation (ARD) and /or %CV versus glucose level to better characterize measurement errors at any glucose level. We examine the relationship between glucose measured by test and comparator methods using linear regression. We examine bias by plotting deviation = (test – comparator method) versus glucose level. We compute the deviation, absolute deviation (AD), ARD, and standard deviation (SD) for each data pair. We utilize curve smoothing procedures to minimize the effects of random sampling variability to facilitate identification and display of the underlying relationships between ARD or %CV and glucose level. AD, ARD, SD, and %CV display smooth continuous relationships versus glucose level. Estimates of MARD and %CV are subject to relatively large errors in the hypoglycemic range due in part to a markedly nonlinear relationship with glucose level and in part to the limited number of observations in the hypoglycemic range. The curvilinear relationships of ARD and %CV versus glucose level are helpful when characterizing and comparing the precision and accuracy of glucose sensors and meters. PMID:25037194
New-generation diabetes management: glucose sensor-augmented insulin pump therapy
Cengiz, Eda; Sherr, Jennifer L; Weinzimer, Stuart A; Tamborlane, William V
2011-01-01
Diabetes is one of the most common chronic disorders with an increasing incidence worldwide. Technologic advances in the field of diabetes have provided new tools for clinicians to manage this challenging disease. For example, the development of continuous subcutaneous insulin infusion systems have allowed for refinement in the delivery of insulin, while continuous glucose monitors provide patients and clinicians with a better understanding of the minute to minute glucose variability, leading to the titration of insulin delivery based on this variability when applicable. Merging of these devices has resulted in sensor-augmented insulin pump therapy, which became a major building block upon which the artificial pancreas (closed-loop systems) can be developed. This article summarizes the evolution of sensor-augmented insulin pump therapy until present day and its future applications in new-generation diabetes management. PMID:21728731
Flash Glucose Monitoring: Differences Between Intermittently Scanned and Continuously Stored Data.
Pleus, Stefan; Kamecke, Ulrike; Link, Manuela; Haug, Cornelia; Freckmann, Guido
2018-03-01
The flash glucose monitoring system FreeStyle Libre (Abbott Diabetes Care Ltd., Witney, UK) measures interstitial glucose concentrations and continuously stores measurement values every 15 minutes. To obtain a current glucose reading, users have to scan the sensor with the reader. In a clinical trial, 5% of the scanned data showed relative differences of more than ±10% compared with continuously stored data points (median -0.5%). Such differences might impact results of studies using this system. It should be indicated whether scanned or continuously stored data were used for analyses. Health care professionals might have to differentiate between data reports from clinical software and the scanned data their patients are provided with. Additional information on these differences and their potential impact on therapeutic decisions would be helpful.
Vaddiraju, Santhisagar; Legassey, Allen; Qiang, Liangliang; Wang, Yan; Burgess, Diane J; Papadimitrakopoulos, Fotios
2013-03-01
Needle-implantable sensors have shown to provide reliable continuous glucose monitoring for diabetes management. In order to reduce tissue injury during sensor implantation, there is a constant need for device size reduction, which imposes challenges in terms of sensitivity and reliability, as part of decreasing signal-to-noise and increasing layer complexity. Herein, we report sensitivity enhancement via electrochemical surface rebuilding of the working electrode (WE), which creates a three-dimensional nanoporous configuration with increased surface area. The gold WE was electrochemically rebuilt to render its surface nanoporous followed by decoration with platinum nanoparticles. The efficacy of such process was studied using sensor sensitivity against hydrogen peroxide (H2O2). For glucose detection, the WE was further coated with five layers, namely, (1) polyphenol, (2) glucose oxidase, (3) polyurethane, (4) catalase, and (5) dexamethasone-releasing poly(vinyl alcohol)/poly(lactic-co-glycolic acid) composite. The amperometric response of the glucose sensor was noted in vitro and in vivo. Scanning electron microscopy revealed that electrochemical rebuilding of the WE produced a nanoporous morphology that resulted in a 20-fold enhancement in H2O2 sensitivity, while retaining >98% selectivity. This afforded a 4-5-fold increase in overall glucose response of the glucose sensor when compared with a control sensor with no surface rebuilding and fittable only within an 18 G needle. The sensor was able to reproducibly track in vivo glycemic events, despite the large background currents typically encountered during animal testing. Enhanced sensor performance in terms of sensitivity and large signal-to-noise ratio has been attained via electrochemical rebuilding of the WE. This approach also bypasses the need for conventional and nanostructured mediators currently employed to enhance sensor performance. © 2013 Diabetes Technology Society.
A Fully Implantable, NFC Enabled, Continuous Interstitial Glucose Monitor
Anabtawi, Nijad; Freeman, Sabrina; Ferzli, Rony
2017-01-01
This work presents an integrated system-on-chip (SoC) that forms the core of a long-term, fully implantable, battery assisted, passive continuous glucose monitor. It integrates an amperometric glucose sensor interface, a near field communication (NFC) wireless front-end and a fully digital switched mode power management unit for supply regulation and on board battery charging. It uses 13.56 MHz (ISM) band to harvest energy and backscatter data to an NFC reader. System was implemented in 14nm CMOS technology and validated with post layout simulations. PMID:28702512
A Fully Implantable, NFC Enabled, Continuous Interstitial Glucose Monitor.
Anabtawi, Nijad; Freeman, Sabrina; Ferzli, Rony
2016-02-01
This work presents an integrated system-on-chip (SoC) that forms the core of a long-term, fully implantable, battery assisted, passive continuous glucose monitor. It integrates an amperometric glucose sensor interface, a near field communication (NFC) wireless front-end and a fully digital switched mode power management unit for supply regulation and on board battery charging. It uses 13.56 MHz (ISM) band to harvest energy and backscatter data to an NFC reader. System was implemented in 14nm CMOS technology and validated with post layout simulations.
Lucisano, Joseph Y; Routh, Timothy L; Lin, Joe T; Gough, David A
2017-09-01
The use of a fully implanted first-generation prototype sensor/telemetry system is described for long-term monitoring of subcutaneous tissue glucose in a small cohort of people with diabetes. Sensors are based on a membrane containing immobilized glucose oxidase and catalase coupled to oxygen electrodes and a telemetry system, integrated as an implant. The devices remained implanted for up to 180 days, with signals transmitted every 2 min to external receivers. The data include signal recordings from glucose clamps and spontaneous glucose excursions, matched, respectively, to reference blood glucose and finger-stick values. The sensor signals indicate dynamic tissue glucose, for which there is no independent standard, and a model describing the relationship between blood glucose and the signal is, therefore, included. The values of all model parameters have been estimated, including the permeability of adjacent tissues to glucose, and equated to conventional mass transfer parameters. As a group, the sensor calibration varied randomly at an average rate of -2.6%/week. Statistical correlation indicated strong association between the sensor signals and reference glucose values. Continuous long-term glucose monitoring in individuals with diabetes is feasible with this system. All therapies for diabetes are based on glucose control, and therefore, require glucose monitoring. This fully implanted long-term sensor/telemetry system may facilitate a new era of management of the disease.
Lucisano, Joseph Y.; Routh, Timothy L.; Lin, Joe T.; Gough, David A.
2017-01-01
Objective The use of a fully implanted, first-generation prototype sensor/telemetry system is described for long-term monitoring of subcutaneous tissue glucose in a small cohort of people with diabetes. Methods Sensors are based on a membrane containing immobilized glucose oxidase and catalase coupled to oxygen electrodes and a telemetry system, integrated as an implant. The devices remained implanted for up to 180 days, with signals transmitted every 2 minutes to external receivers. Results The data include signal recordings from glucose clamps and spontaneous glucose excursions, matched respectively to reference blood glucose and finger-stick values. The sensor signals indicate dynamic tissue glucose, for which there is no independent standard, and a model describing the relationship between blood glucose and the signal is therefore included. The values of all model parameters have been estimated, including the permeability of adjacent tissues to glucose, and equated to conventional mass transfer parameters. As a group, the sensor calibration varied randomly at an average rate of −2.6%/week. Statistical correlation indicated strong association between the sensor signals and reference glucose values. Conclusions Continuous, long-term glucose monitoring in individuals with diabetes is feasible with this system. Significance All therapies for diabetes are based on glucose control and therefore require glucose monitoring. This fully implanted, long-term sensor/telemetry system may facilitate a new era of management of the disease. PMID:27775510
Impact of macrophage deficiency and depletion on continuous glucose monitoring in vivo
Klueh, Ulrike; Qiao, Yi; Frailey, Jackman T.; Kreutzer, Donald L.
2014-01-01
Although it is assumed that macrophages (MQ) have a major negative impact on continuous glucose monitoring (CGM), surprisingly there is no data in the literature to directly support or refute the role of MQ or related foreign body giant cells in the bio-fouling of glucose sensors in vivo. As such, we developed the hypothesis that MQ are key in controlling glucose sensor performance and CGM in vivo and MQ deficiencies or depletion would enhance CGM. To test this hypothesis we determined the presence/distribution of MQ at the sensor tissue interface over a 28-day time period using F4/80 antibody and immunohistochemical analysis. We also evaluated the impact of spontaneous MQ deficiency (op/op mice) and induced-transgenic MQ depletions (Diphtheria Toxin Receptor (DTR) mice) on sensor function and CGM utilizing our murine CGM system. The results of these studies demonstrated: 1) a time dependent increase in MQ accumulation (F4/80 positive cells) at the sensor tissue interface; and 2) MQ deficient mice and MQ depleted C57BL/6 mice demonstrated improved sensor performance (MARD) when compared to normal mice (C57BL/6). These studies directly demonstrate the importance of MQ in sensor function and CGM in vivo. PMID:24331705
Poitout, V; Moatti-Sirat, D; Reach, G
1992-01-01
The feasibility of calibrating a glucose sensor by using a wearable glucose meter for blood glucose determination and moderate variations of blood glucose concentration was assessed. Six miniaturized glucose sensors were implanted in the subcutaneous tissue of conscious dogs, and the parameters used for the in vivo calibration of the sensor (sensitivity coefficient and extrapolated current in the absence of glucose) were determined from values of blood glucose and sensor response obtained during glucose infusion. (1) Venous plasma glucose level and venous total blood glucose level were measured simultaneously on the same sample, using a Beckman analyser and a Glucometer II, respectively. The regression between plasma glucose (x) and whole blood glucose (y) was y = 1.12x-0.08 mM (n = 114 values, r = 0.96, p = 0.0001). The error grid analysis indicated that the use of a Glucometer II for blood glucose determination was appropriate in dogs. (2) The in vivo sensitivity coefficients were 0.57 +/- 0.11 nA mM-1 when determined from plasma glucose, and 0.51 +/- 0.07 nA mM-1 when determined from whole blood glucose (t = 1.53, p = 0.18, n.s.). The background currents were 0.88 +/- 0.57 nA when determined from plasma glucose, and 0.63 +/- 0.77 nA when determined from whole blood glucose (t = 0.82, p = 0.45, n.s.). (3) The regression equation of the estimation of the subcutaneous glucose level obtained from the two methods was y = 1.04x + 0.56 mM (n = 171 values, r = 0.98, p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
Function of an Implanted Tissue Glucose Sensor for More than One Year in Animals
Gough, David A.; Kumosa, Lucas S.; Routh, Timothy L.; Lin, Joe T.; Lucisano, Joseph Y.
2015-01-01
An implantable sensor capable of long-term monitoring of tissue glucose concentrations by wireless telemetry has been developed for eventual application in people with diabetes. In a recent trial, the sensor-telemetry system functioned continuously while implanted in subcutaneous tissues of two pigs for a total of 222 days and 520 days respectively, with each animal in both non-diabetic and diabetic states. The sensor detects glucose via an enzyme electrode principle that is based on differential electrochemical oxygen detection, which reduces the sensitivity of the sensor to encapsulation by the body, variations in local microvascular perfusion, limited availability of tissue oxygen, and inactivation of the enzymes. After an initial two-week stabilization period, the implanted sensors maintained stability of calibration for extended periods. The lag between blood and tissue glucose concentrations was 11.8 ± 5.7 minutes and 6.5 ± 13.3 minutes respectively, for rising and falling blood glucose challenges (mean ± SD). The lag was determined mainly by glucose mass transfer in the tissues, rather than the intrinsic response of the sensor, and showed no systematic change over implant test periods. These results represent a milestone in the translation of the sensor system to human applications. PMID:20668297
Wang, Xiaolin; Ioacara, Sorin; DeHennis, Andrew
2015-11-01
This study analyzed the overall nocturnal performance during home use of a long-term subcutaneous implantable continuous glucose monitoring (CGM) sensor. In this study, 12 subjects with type 1 diabetes mellitus (T1DM) (mean±SD age, 37±8 years; mean±SD disease duration, 11±6 years) were implanted with an investigational continuous glucose sensor in the upper arm for up to 90 days. All subjects received full access to real-time glucose display and user programmable hypo- and hyperglycemic alarms. Subjects calibrated the sensors with a self-monitoring of blood glucose (SMBG) meter and continued to rely on their regular SMBG measurements for their diabetes management. Accuracy of the sensors during the home-use study was calculated using SMBG as the reference. The nocturnal sensor attenuation (NSA) concept was tested. Sensitivity and specificity of the nocturnal hypoglycemic alarm were calculated. Mean±SD glucose sensor life span was 87±7 days. The mean±SE absolute relative difference over the range of 40-400 mg/dL for the sensors in this home-use study was 12.3±0.7% using SMBG as the reference. The hypoglycemia alarms were set to be triggered when the glucose level went below 70 mg/dL. Percentage of nights with hypoglycemic alarms triggered for at least 10 min was 13.6%. Recovery into euglycemia within 30 min from the timestamp of the immediate confirmatory SMBG testing was obtained in 74% of all episodes (n=20). The implanted continuous glucose sensor showed a hypoglycemia detection sensitivity and specificity of 77% and 96%, respectively. The NSA-associated high negative rate of change of at least -4 mg/dL/min was not encountered during night use of the system. This home-use study of a fully implantable, long-term continuous glucose sensor shows excellent performance in nocturnal hypoglycemia detection in T1DM patients. The apparent lack of NSA affecting the implanted sensor and the high specificity of the hypoglycemic alarm expedite the recovery
Chaudhary, Ayesha; Harma, Harri; Hanninen, Pekka; McShane, Michael J; Srivastava, Rohit
2011-08-01
Minimally invasive optical glucose biosensors with increased functional longevity form one of the most promising techniques for continuous glucose monitoring, because of their long-term stability, reversibility, repeatability, specificity, and high sensitivity. They are based on the principle of competitive binding and fluorescence resonance energy transfer. Moving to the near-infrared region of the spectrum has the potential to improve signal throughput for implanted sensors, but requires a change in dye chemistry that could alter response sensitivity, range, and toxicity profiles. The near-infrared dissolved-core alginate microsphere sensors were fabricated by emulsion followed by surface coating by layer-by-layer self-assembly. The particles were characterized for sensor stability, sensor response, and reversibility in deionized water and simulated interstitial fluid. The sensor response to step changes in bulk glucose concentrations was also evaluated under dynamic conditions using a microflow cell unit. Finally, in vitro cytotoxicity assays were performed with L929 mouse fibroblast cell lines to demonstrate preliminary biocompatibility of the sensors. The glucose sensitivity under controlled and dynamic conditions was observed to be 0.86%/mM glucose with an analytical response range of 0-30 mM glucose, covering both the physiological and pathophysiological range. The sensor demonstrated a repeatable, reversible, and reproducible response, with a maximum response time of 120 s. In vitro cytotoxicity assays revealed nearly 95% viability of cells, thereby suggesting that the alginate microsphere sensor system does not exhibit cytotoxicity. The incorporation of near-infrared dyes shows promise in improving sensor response because of their high sensitivity and improved tissue penetration of infrared light. The sensitivity for the sensors was approximately 1.5 times greater than that observed for visible dye sensors, and the new dye chemistry did not significantly
Glucose sensor excludes hypoglycaemia as cause of death.
Schmidt, Signe; Nørgaard, Kirsten
2012-05-01
The cause of death can be difficult to verify post-mortem in unexpected deaths in patients with Type 1 diabetes. This report describes an unexpected death in a 44-year-old man with Type 1 diabetes treated with sensor-augmented pump therapy. Continuous glucose monitoring data proved useful in determining the cause of death. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
van den Bosch, Edith E.M.; de Bont, Nik H.M.; Qiu, Jun; Gelling, Onko-Jan
2013-01-01
Background Continuous glucose monitors (CGMs) measure glucose in real time, making it possible to improve glycemic control. A promising technique involves glucose sensors implanted in subcutaneous tissue measuring glucose concentration in interstitial fluid. A major drawback of this technique is sensor bioinstability, which can lead to unpredictable drift and reproducibility. The bioinstability is partly due to sensor design but is also affected by naturally occurring subcutaneous inflammations. Applying a nonbiofouling coating to the sensor membrane could be a means to enhancing sensocompatibility. Methods This study evaluates the suitability of a polyethylene-glycol-based coating on sensors in CGMs. Methods used include cross hatch, wet paper rub, paper double rub, bending, hydrophilicity, protein adsorption, bio-compatibility, hemocompatibility, and glucose/oxygen permeability testing. Results Results demonstrate that coating homogeneity, adhesion, integrity, and scratch resistance are good. The coating repels lysozyme and bovine serum albumin, and only a low level of fibrin and blood platelet adsorption to the coating was recorded when testing in whole human blood. Cytotoxicity, irritation, sensitization, and hemolysis were assessed, and levels suggested good biocompatibility of the coating in subcutaneous tissue. Finally, it was shown that the coating can be applied to cellulose acetate membranes of different porosity without changing their permeability for glucose and oxygen. Conclusions These results suggest that the mechanical properties of the coating are sufficient for the given application, that the coating is effective in preventing protein adsorption and blood clot formation on the sensor surface, and that the coating can be applied to membranes without hindering their glucose and oxygen transport. PMID:23567005
Vallejo-Heligon, Suzana G; Brown, Nga L; Reichert, William M; Klitzman, Bruce
2016-01-01
Continuous glucose sensors offer the promise of tight glycemic control for insulin dependent diabetics; however, utilization of such systems has been hindered by issues of tissue compatibility. Here we report on the in vivo performance of implanted glucose sensors coated with Dexamethasone-loaded (Dex-loaded) porous coatings employed to mediate the tissue-sensor interface. Two animal studies were conducted to (1) characterize the tissue modifying effects of the porous Dex-loaded coatings deployed on sensor surrogate implants and (2) investigate the effects of the same coatings on the in vivo performance of Medtronic MiniMed SOF-SENSOR™ glucose sensors. The tissue response to implants was evaluated by quantifying macrophage infiltration, blood vessel formation, and collagen density around implants. Sensor function was assessed by measuring changes in sensor sensitivity and time lag, calculating the Mean Absolute Relative Difference (MARD) for each sensor treatment, and performing functional glucose challenge test at relevant time points. Implants treated with porous Dex-loaded coatings diminished inflammation and enhanced vascularization of the tissue surrounding the implants. Functional sensors with Dex-loaded porous coatings showed enhanced sensor sensitivity over a 21-day period when compared to controls. Enhanced sensor sensitivity was accompanied with an increase in sensor signal lag and MARD score. These results indicate that Dex-loaded porous coatings were able to elicit an attenuated tissue response, and that such tissue microenvironment could be conducive towards extending the performance window of glucose sensors in vivo. In the present article, a coating to extend the functionality of implantable glucose sensors in vivo was developed. Our study showed that the delivery of an anti-inflammatory agent with the presentation of micro-sized topographical cues from coatings may lead to improved long-term glucose sensor function in vivo. We believe that
Harper, Alice; Anderson, Mark R
2010-01-01
In 1962, Clark and Lyons proposed incorporating the enzyme glucose oxidase in the construction of an electrochemical sensor for glucose in blood plasma. In their application, Clark and Lyons describe an electrode in which a membrane permeable to glucose traps a small volume of solution containing the enzyme adjacent to a pH electrode, and the presence of glucose is detected by the change in the electrode potential that occurs when glucose reacts with the enzyme in this volume of solution. Although described nearly 50 years ago, this seminal development provides the general structure for constructing electrochemical glucose sensors that is still used today. Despite the maturity of the field, new developments that explore solutions to the fundamental limitations of electrochemical glucose sensors continue to emerge. Here we discuss two developments of the last 15 years; confining the enzyme and a redox mediator to a very thin molecular films at electrode surfaces by electrostatic assembly, and the use of electrodes modified by carbon nanotubes (CNTs) to leverage the electrocatalytic effect of the CNTs to reduce the oxidation overpotential of the electrode reaction or for the direct electron transport to the enzyme.
Continuous glucose determination using fiber-based tunable mid-infrared laser spectroscopy
NASA Astrophysics Data System (ADS)
Yu, Songlin; Li, Dachao; Chong, Hao; Sun, Changyue; Xu, Kexin
2014-04-01
Wavelength-tunable laser spectroscopy in combination with a small-sized fiber-optic attenuated total reflection (ATR) sensor (fiber-based evanescent field analysis, FEFA) is reported for the continuous measurement of the glucose level. We propose a method of controlling and stabilizing the wavelength and power of laser emission and present a newly developed mid-infrared wavelength-tunable laser with a broad emission spectrum band of 9.19-9.77 μm (1024-1088 cm-1). The novel small-sized flow-through fiber-optic ATR sensor with long optical sensing length was used for glucose level determination. The experimental results indicate that the noise-equivalent concentration of this laser measurement system is as low as 3.8 mg/dL, which is among the most precise glucose measurements using mid-infrared spectroscopy. The sensitivity, which is three times that of conventional Fourier transform infrared spectrometer, was acquired because of the higher laser power and higher spectral resolution. The best prediction of the glucose concentration in phosphate buffered saline solution was achieved using the five-variable partial least-squares model, yielding a root-mean-square error of prediction as small as 3.5 mg/dL. The high sensitivity, multiple tunable wavelengths and small fiber-based sensor with long optical sensing length make glucose determination possible in blood or interstitial fluid in vivo.
Ricci, Francesco; Caprio, Felice; Poscia, Alessandro; Valgimigli, Francesco; Messeri, Dimitri; Lepori, Elena; Dall'Oglio, Giorgio; Palleschi, Giuseppe; Moscone, Danila
2007-04-15
Glucose biosensors based on the use of planar screen-printed electrodes modified with an electrochemical mediator and with glucose oxidase have been optimised for their application in the continuous glucose monitoring in diabetic patients. A full study of their operative stability and temperature dependence has been accomplished, thus giving useful information for in vivo applications. The effect of dissolved oxygen concentration in the working solution was also studied in order to evaluate its effect on the linearity of the sensors. Glucose monitoring performed with serum samples was performed to evaluate the effect of matrix components on operative stability and demonstrated an efficient behaviour for 72 h of continuous monitoring. Finally, these studies led to a sensor capable of detecting glucose at concentrations as low as 0.04 mM and with a good linearity up to 2.0 mM (at 37 degrees C) with an operative stability of ca. 72 h, thus demonstrating the possible application of these sensors for continuous glucose monitoring in conjunction with a microdialysis probe. Moreover, preliminary in vivo experiments for ca. 20 h have demonstrated the feasibility of this system.
Fortin, Nicolas; Klok, Harm-Anton
2015-03-04
Tight regulation of blood glucose levels of diabetic patients requires durable and robust continuous glucose sensing schemes. This manuscript reports the fabrication of ultrathin, phenylboronic acid (PBA) functionalized polymer brushes that swell upon glucose binding and which were integrated as the sensing interface in a new polypropylene hollow fiber (PPHF)-based hydraulic flow glucose sensor prototype. The polymer brushes were prepared via surface-initiated atom transfer radical polymerization of sodium methacrylate followed by postpolymerization modification with 3-aminophenyl boronic acid. In a first series of experiments, the glucose-response of PBA-functionalized poly(methacrylic acid) (PMAA) brushes grafted from planar silicon surfaces was investigated by quartz crystal microbalance with dissipation (QCM-D) and atomic force microscopy (AFM) experiments. The QCM-D experiments revealed a more or less linear change of the frequency shift for glucose concentrations up to ∼10 mM and demonstrated that glucose binding was completely reversible for up to seven switching cycles. The AFM experiments indicated that glucose binding was accompanied by an increase in the film thickness of the PBA functionalized PMAA brushes. The PBA functionalized PMAA brushes were subsequently grafted from the surface of PPHF membranes. The hydraulic permeability of these porous fibers depends on the thickness and swelling of the PMAA brush coating. PBA functionalized brush-coated PPHFs showed a decrease in flux upon exposure to glucose, which is consistent with swelling of the brush coating. Because they avoid the use of enzymes and do not rely on an electrochemical transduction scheme, these PPHF-based hydraulic flow sensors could represent an interesting alternative class of continuous glucose sensors.
Sode, Koji; Loew, Noya; Ohnishi, Yosuke; Tsuruta, Hayato; Mori, Kazushige; Kojima, Katsuhiro; Tsugawa, Wakako; LaBelle, Jeffrey T; Klonoff, David C
2017-01-15
In this study, a novel fungus FAD dependent glucose dehydrogenase, derived from Aspergillus niger (AnGDH), was characterized. This enzyme's potential for the use as the enzyme for blood glucose monitor enzyme sensor strips was evaluated, especially by investigating the effect of the presence of xylose during glucose measurements. The substrate specificity of AnGDH towards glucose was investigated, and only xylose was found as a competing substrate. The specific catalytic efficiency for xylose compared to glucose was 1.8%. The specific activity of AnGDH for xylose at 5mM concentration compared to glucose was 3.5%. No other sugars were used as substrate by this enzyme. The superior substrate specificity of AnGDH was also demonstrated in the performance of enzyme sensor strips. The impact of spiking xylose in a sample with physiological glucose concentrations on the sensor signals was investigated, and it was found that enzyme sensor strips using AnGDH were not affected at all by 5mM (75mg/dL) xylose. This is the first report of an enzyme sensor strip using a fungus derived FADGDH, which did not show any positive bias at a therapeutic level xylose concentration on the signal for a glucose sample. This clearly indicates the superiority of AnGDH over other conventionally used fungi derived FADGDHs in the application for SMBG sensor strips. The negligible activity of AnGDH towards xylose was also explained on the basis of a 3D structural model, which was compared to the 3D structures of A. flavus derived FADGDH and of two glucose oxidases. Copyright © 2016 Elsevier B.V. All rights reserved.
Thomé-Duret, V; Reach, G; Gangnerau, M N; Lemonnier, F; Klein, J C; Zhang, Y; Hu, Y; Wilson, G S
1996-11-01
The development of a hypoglycemic alarm system using a subcutaneous glucose sensor implies that a decrease in blood glucose is rapidly followed by a decrease in the signal generated by the sensor. In a first set of experiments the linearity and the kinetics of the response of sensors implanted in the subcutaneous tissue of normal rats were investigated during a progressive increase in plasma glucose concentration: the sensitivities determined between 5 and 10 mM and between 10 and 15 mM were not significantly different, and a 5-10 min delay in the sensor's response was observed. In a second set of experiments, performed in diabetic rats, the kinetics of the decrease in subcutaneous glucose concentration following insulin administration was monitored during a decrease in plasma glucose level, from 15 to 3 mmol/L. During the 20 first min following insulin administration, the sensor monitored glucose concentration in subcutaneous tissue with no lag time. Subsequently, the decrease in the estimation of subcutaneous glucose concentration preceded that of plasma glucose. This phenomenon was not observed when the same sensors were investigated in vitro during a similar decrease in glucose concentration and may be due to a mechanism occurring in vivo, such as the effect of insulin on glucose transfer from the interstitial space to the cells surrounding the sensor. It reinforces the interest of the use of implantable glucose sensors as a part of a hypoglycemic alarm.
Morrow, Linda; Hompesch, Marcus; Tideman, Ann M; Matson, Jennifer; Dunne, Nancy; Pardo, Scott; Parkes, Joan L; Schachner, Holly C; Simmons, David A
2011-07-01
This glucose clamp study assessed the performance of an electrochemical continuous glucose monitoring (CGM) system for monitoring levels of interstitial glucose. This novel system does not require use of a trocar or needle for sensor insertion. Continuous glucose monitoring sensors were inserted subcutaneously into the abdominal tissue of 14 adults with type 1 or type 2 diabetes. Subjects underwent an automated glucose clamp procedure with four consecutive post-steady-state glucose plateau periods (40 min each): (a) hypoglycemic (50 mg/dl), (b) hyperglycemic (250 mg/dl), (c) second hypoglycemic (50 mg/dl), and (d) euglycemic (90 mg/dl). Plasma glucose results obtained with YSI glucose analyzers were used for sensor calibration. Accuracy was assessed retrospectively for plateau periods and transition states, when glucose levels were changing rapidly (approximately 2 mg/dl/min). Mean absolute percent difference (APD) was lowest during hypoglycemic plateaus (11.68%, 14.15%) and the euglycemic-to-hypoglycemic transition (14.21%). Mean APD during the hyperglycemic plateau was 17.11%; mean APDs were 18.12% and 19.25% during the hypoglycemic-to-hyperglycemic and hyperglycemic-to-hypoglycemic transitions, respectively. Parkes (consensus) error grid analysis (EGA) and rate EGA of the plateaus and transition periods, respectively, yielded 86.8% and 68.6% accurate results (zone A) and 12.1% and 20.0% benign errors (zone B). Continuous EGA yielded 88.5%, 75.4%, and 79.3% accurate results and 8.3%, 14.3%, and 2.4% benign errors for the euglycemic, hyperglycemic, and hypoglycemic transition periods, respectively. Adverse events were mild and unlikely to be device related. This novel CGM system was safe and accurate across the clinically relevant glucose range. © 2011 Diabetes Technology Society.
Morrow, Linda; Hompesch, Marcus; Tideman, Ann M; Matson, Jennifer; Dunne, Nancy; Pardo, Scott; Parkes, Joan L; Schachner, Holly C; Simmons, David A
2011-01-01
Background This glucose clamp study assessed the performance of an electrochemical continuous glucose monitoring (CGM) system for monitoring levels of interstitial glucose. This novel system does not require use of a trocar or needle for sensor insertion. Method Continuous glucose monitoring sensors were inserted subcutaneously into the abdominal tissue of 14 adults with type 1 or type 2 diabetes. Subjects underwent an automated glucose clamp procedure with four consecutive post-steady-state glucose plateau periods (40 min each): (a) hypoglycemic (50 mg/dl), (b) hyperglycemic (250 mg/dl), (c) second hypoglycemic (50 mg/dl), and (d) euglycemic (90 mg/dl). Plasma glucose results obtained with YSI glucose analyzers were used for sensor calibration. Accuracy was assessed retrospectively for plateau periods and transition states, when glucose levels were changing rapidly (approximately 2 mg/dl/min). Results Mean absolute percent difference (APD) was lowest during hypoglycemic plateaus (11.68%, 14.15%) and the euglycemic-to-hypoglycemic transition (14.21%). Mean APD during the hyperglycemic plateau was 17.11%; mean APDs were 18.12% and 19.25% during the hypoglycemic-to-hyperglycemic and hyperglycemic-to-hypoglycemic transitions, respectively. Parkes (consensus) error grid analysis (EGA) and rate EGA of the plateaus and transition periods, respectively, yielded 86.8% and 68.6% accurate results (zone A) and 12.1% and 20.0% benign errors (zone B). Continuous EGA yielded 88.5%, 75.4%, and 79.3% accurate results and 8.3%, 14.3%, and 2.4% benign errors for the euglycemic, hyperglycemic, and hypoglycemic transition periods, respectively. Adverse events were mild and unlikely to be device related. Conclusion This novel CGM system was safe and accurate across the clinically relevant glucose range. PMID:21880226
Mortellaro, Mark; DeHennis, Andrew
2014-11-15
A continuous glucose monitoring (CGM) system consisting of a wireless, subcutaneously implantable glucose sensor and a body-worn transmitter is described and clinical performance over a 28 day implant period in 12 type 1 diabetic patients is reported. The implantable sensor is constructed of a fluorescent, boronic-acid based glucose indicating polymer coated onto a miniaturized, polymer-encased optical detection system. The external transmitter wirelessly communicates with and powers the sensor and contains Bluetooth capability for interfacing with a Smartphone application. The accuracy of 19 implanted sensors were evaluated over 28 days during 6 in-clinic sessions by comparing the CGM glucose values to venous blood glucose measurements taken every 15 min. Mean absolute relative difference (MARD) for all sensors was 11.6 ± 0.7%, and Clarke error grid analysis showed that 99% of paired data points were in the combined A and B zones. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.
Enhancing the accuracy of subcutaneous glucose sensors: a real-time deconvolution-based approach.
Guerra, Stefania; Facchinetti, Andrea; Sparacino, Giovanni; Nicolao, Giuseppe De; Cobelli, Claudio
2012-06-01
Minimally invasive continuous glucose monitoring (CGM) sensors can greatly help diabetes management. Most of these sensors consist of a needle electrode, placed in the subcutaneous tissue, which measures an electrical current exploiting the glucose-oxidase principle. This current is then transformed to glucose levels after calibrating the sensor on the basis of one, or more, self-monitoring blood glucose (SMBG) samples. In this study, we design and test a real-time signal-enhancement module that, cascaded to the CGM device, improves the quality of its output by a proper postprocessing of the CGM signal. In fact, CGM sensors measure glucose in the interstitium rather than in the blood compartment. We show that this distortion can be compensated by means of a regularized deconvolution procedure relying on a linear regression model that can be updated whenever a pair of suitably sampled SMBG references is collected. Tests performed both on simulated and real data demonstrate a significant accuracy improvement of the CGM signal. Simulation studies also demonstrate the robustness of the method against departures from nominal conditions, such as temporal misplacement of the SMBG samples and uncertainty in the blood-to-interstitium glucose kinetic model. Thanks to its online capabilities, the proposed signal-enhancement algorithm can be used to improve the performance of CGM-based real-time systems such as the hypo/hyper glycemic alert generators or the artificial pancreas.
Novel glucose fiber sensor combining ThFBG with GOD
NASA Astrophysics Data System (ADS)
Li, Mengmeng; Zhou, Ciming; Fan, Dian; Ou, Yiwen
2016-10-01
We propose a novel glucose fiber optic sensor combining a thinned cladding fiber Bragg grating (ThFBG) with glucose oxidase (GOD). By immobilizing GOD on the surface of a ThFBG, the fabricated sensor can obtain a high specificity to glucose. Because of the evanescent field, the sensor is very sensitive to the ambient refractive index change arising from the catalytic reaction between glucose and GOD. A four-level fiber model was simulated and verified the precision of the sensing principle. Two methods, glutaraldehyde crosslinking method (GCM) and 3-aminopropyl triethoxysilane covalent coupling method (ATCCM), were experimentally utilized to immobilize GOD. And sensor fabricated with the method ATCCM shows a measurement range of 0-0.82 mg/mL which is better than the sensor fabricated with the method GCM with measurement range of 0-0.67 mg/mL under the same condition. By using ATCCM to immobilize GOD with different concentrations, three sensors were fabricated and used for glucose measurement by monitoring the Bragg wavelength (λb) shifts, the results indicate a good linear relationship between wavelength shift and glucose concentration within a specific range, and the measurement range increases as GOD concentration increases. The highest sensitivity of sensor reaches up to 0.0549 nm/(mg.mL-1). The proposed sensor has distinct advantages in sensing structure, cost and specificity.
Glucose oxidase probe as a surface-enhanced Raman scattering sensor for glucose.
Qi, Guohua; Wang, Yi; Zhang, Biying; Sun, Dan; Fu, Cuicui; Xu, Weiqing; Xu, Shuping
2016-10-01
Glucose oxidase (GOx) possessing a Raman-active chromophore (flavin adenine dinucleotide) is used as a signal reporter for constructing a highly specific "turn off" surface-enhanced Raman scattering (SERS) sensor for glucose. This sensing chip is made by the electrostatic assembly of GOx over silver nanoparticle (Ag NP)-functionalized SERS substrate through a positively charged polyelectrolyte linker under the pH of 6.86. To trace glucose in blood serum, owing to the reduced pH value caused by the production of gluconic acid in the GOx-catalyzed oxidation reaction, the bonding force between GOx and polyelectrolyte weakens, making GOx drop off from the sensing chip. As a result, the SERS intensity of GOx on the chip decreases along with the concentration of glucose. This glucose SERS sensor exhibits excellent selectivity based on the specific GOx/glucose catalysis reaction and high sensitivity to 1.0 μM. The linear sensing range is 2.0-14.0 mM, which also meets the requirement on the working range of the human blood glucose detection. Using GOx as a probe shows superiority over other organic probes because GOx almost has no toxicity to the biological system. This sensing mechanism can be applied for intracellular in vivo SERS monitoring of glucose in the future. Graphical abstract Glucose oxidase is used as a Raman signal reporter for constructing a highly specific glucose surface-enhanced Raman scattering (SERS) sensor.
Thirty-fifth anniversary of the optical affinity sensor for glucose: a personal retrospective.
Schultz, Jerome S
2015-01-01
Since 1962 when Clark introduced the enzyme electrode, research has been intense for a robust implantable glucose sensor. An alternative "optical affinity sensor" was introduced by Jerome Schultz in 1979. The evolution of this sensor technology into a new methodology is reviewed. The approach integrates a variety of disparate concepts: the selectivity of immunoassays-selectivity for glucose was obtained with concanavalin A, detection sensitivity was obtained with fluorescence (FITC-Dextran), and miniaturization was achieved by the use of an optical fiber readout system. Refinements of Schultz's optical affinity sensor approach over the past 35 years have led to a number of configurations that show great promise to meet the needs of a successful implantable continuous monitoring device for diabetics, some of which are currently being tested clinically. © 2014 Diabetes Technology Society.
Continuous glucose monitoring: A review of the technology and clinical use.
Klonoff, David C; Ahn, David; Drincic, Andjela
2017-11-01
Continuous glucose monitoring (CGM) is an increasingly adopted technology for insulin-requiring patients that provides insights into glycemic fluctuations. CGM can assist patients in managing their diabetes with lifestyle and medication adjustments. This article provides an overview of the technical and clinical features of CGM based on a review of articles in PubMed on CGM from 1999 through January 31, 2017. A detailed description is presented of three professional (retrospective), three personal (real-time) continuous glucose monitors, and three sensor integrated pumps (consisting of a sensor and pump that communicate with each other to determine an optimal insulin dose and adjust the delivery of insulin) that are currently available in United States. We have reviewed outpatient CGM outcomes, focusing on hemoglobin A1c (A1C), hypoglycemia, and quality of life. Issues affecting accuracy, detection of glycemic variability, strategies for optimal use, as well as cybersecurity and future directions for sensor design and use are discussed. In conclusion, CGM is an important tool for monitoring diabetes that has been shown to improve outcomes in patients with type 1 diabetes mellitus. Given currently available data and technological developments, we believe that with appropriate patient education, CGM can also be considered for other patient populations. Copyright © 2017 Elsevier B.V. All rights reserved.
A polymer-based ratiometric intracellular glucose sensor.
Zhang, Liqiang; Su, Fengyu; Buizer, Sean; Kong, Xiangxing; Lee, Fred; Day, Kevin; Tian, Yanqing; Meldrum, Deirdre R
2014-07-04
The glucose metabolism level reflects cell proliferative status. A polymeric glucose ratiometric sensor comprising poly(N-(2-hydroxypropyl)methacrylamide) (PHPMA) and poly[2-(methacryloyloxy)ethyl]trimethylammonium chloride (PMAETMA) was synthesized. Cellular internalization and glucose response of the polymer within HeLa cells were investigated.
An NFC-Enabled CMOS IC for a Wireless Fully Implantable Glucose Sensor.
DeHennis, Andrew; Getzlaff, Stefan; Grice, David; Mailand, Marko
2016-01-01
This paper presents an integrated circuit (IC) that merges integrated optical and temperature transducers, optical interface circuitry, and a near-field communication (NFC)-enabled digital, wireless readout for a fully passive implantable sensor platform to measure glucose in people with diabetes. A flip-chip mounted LED and monolithically integrated photodiodes serve as the transduction front-end to enable fluorescence readout. A wide-range programmable transimpedance amplifier adapts the sensor signals to the input of an 11-bit analog-to-digital converter digitizing the measurements. Measurement readout is enabled by means of wireless backscatter modulation to a remote NFC reader. The system is able to resolve current levels of less than 10 pA with a single fluorescent measurement energy consumption of less than 1 μJ. The wireless IC is fabricated in a 0.6-μm-CMOS process and utilizes a 13.56-MHz-based ISO15693 for passive wireless readout through a NFC interface. The IC is utilized as the core interface to a fluorescent, glucose transducer to enable a fully implantable sensor-based continuous glucose monitoring system.
Lin, Songyue; Feng, Wendou; Miao, Xiaofei; Zhang, Xiangxin; Chen, Sujing; Chen, Yuanqiang; Wang, Wei; Zhang, Yining
2018-07-01
Flexible and implantable glucose biosensors are emerging technologies for continuous monitoring of blood-glucose of diabetes. Developing a flexible conductive substrates with high active surface area is critical for advancing the technology. Here, we successfully fabricate a flexible and highly sensitive nonenzymatic glucose by using DVD-laser scribed graphene (LSG) as a flexible conductively substrate. Copper nanoparticles (Cu-NPs) are electrodeposited as the catalyst. The LSG/Cu-NPs sensor demonstrates excellent catalytic activity toward glucose oxidation and exhibits a linear glucose detection range from 1 μM to 4.54 mM with high sensitivity (1.518 mA mM -1 cm -2 ) and low limit of detection (0.35 μM). Moreover, the LSG/Cu-NPs sensor shows excellent reproducibility and long-term stability. It is also highly selective toward glucose oxidation under the presence of various interfering species. Excellent flexing stability is also demonstrated by the LSG/Cu-NPs sensor, which is capable of maintaining 83.9% of its initial current after being bent against a 4-mm diameter rod for 180 times. The LSG/Cu-NPs sensor shows great potential for practical application as a nonenzymatic glucose biosensor. Meanwhile, the LSG conductive substrate provides a platform for the developing next-generation flexible and potentially implantable bioelectronics and biosensors. Copyright © 2018 Elsevier B.V. All rights reserved.
Ward, W K; Engle, J M; Branigan, D; El Youssef, J; Massoud, R G; Castle, J R
2012-08-01
Because declining glucose levels should be detected quickly in persons with Type 1 diabetes, a lag between blood glucose and subcutaneous sensor glucose can be problematic. It is unclear whether the magnitude of sensor lag is lower during falling glucose than during rising glucose. Initially, we analysed 95 data segments during which glucose changed and during which very frequent reference blood glucose monitoring was performed. However, to minimize confounding effects of noise and calibration error, we excluded data segments in which there was substantial sensor error. After these exclusions, and combination of data from duplicate sensors, there were 72 analysable data segments (36 for rising glucose, 36 for falling). We measured lag in two ways: (1) the time delay at the vertical mid-point of the glucose change (regression delay); and (2) determination of the optimal time shift required to minimize the difference between glucose sensor signals and blood glucose values drawn concurrently. Using the regression delay method, the mean sensor lag for rising vs. falling glucose segments was 8.9 min (95%CI 6.1-11.6) vs. 1.5 min (95%CI -2.6 to 5.5, P<0.005). Using the time shift optimization method, results were similar, with a lag that was higher for rising than for falling segments [8.3 (95%CI 5.8-10.7) vs. 1.5 min (95% CI -2.2 to 5.2), P<0.001]. Commensurate with the lag results, sensor accuracy was greater during falling than during rising glucose segments. In Type 1 diabetes, when noise and calibration error are minimized to reduce effects that confound delay measurement, subcutaneous glucose sensors demonstrate a shorter lag duration and greater accuracy when glucose is falling than when rising. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
A near infrared holographic glucose sensor.
Vezouviou, Evangelia; Lowe, Christopher R
2015-06-15
Real-time glucose monitoring has been beneficial in reducing health complications associated with diabetes as well as a decrease in mortality. This report describes a novel holographic platform, fabricated via laser ablation on chitosan hydrogel with gold nanoparticles with a replaying in visible and near IR. The sensor responded with a 12 nm and 7 nm shift in wavelength at glucose concentrations in the 0-70 mM range and in the visible and near IR, respectively, at pH 7.4 and an ionic strength of 154 mM. The sensor did not respond to potential interferences found in the interstitial fluid, such as fructose, vitamin C and lactate, at their respective normal concentrations and was stable to fluctuations in temperature, pH and ionic strength. The characteristics of this sensor suggests that it may be applicable for use as an implanted device for the real time monitoring of glucose concentrations in the interstitial fluid using near IR as the interrogating medium. Copyright © 2015 Elsevier B.V. All rights reserved.
CMOS image sensors as an efficient platform for glucose monitoring.
Devadhasan, Jasmine Pramila; Kim, Sanghyo; Choi, Cheol Soo
2013-10-07
Complementary metal oxide semiconductor (CMOS) image sensors have been used previously in the analysis of biological samples. In the present study, a CMOS image sensor was used to monitor the concentration of oxidized mouse plasma glucose (86-322 mg dL(-1)) based on photon count variation. Measurement of the concentration of oxidized glucose was dependent on changes in color intensity; color intensity increased with increasing glucose concentration. The high color density of glucose highly prevented photons from passing through the polydimethylsiloxane (PDMS) chip, which suggests that the photon count was altered by color intensity. Photons were detected by a photodiode in the CMOS image sensor and converted to digital numbers by an analog to digital converter (ADC). Additionally, UV-spectral analysis and time-dependent photon analysis proved the efficiency of the detection system. This simple, effective, and consistent method for glucose measurement shows that CMOS image sensors are efficient devices for monitoring glucose in point-of-care applications.
Modeling the Error of the Medtronic Paradigm Veo Enlite Glucose Sensor.
Biagi, Lyvia; Ramkissoon, Charrise M; Facchinetti, Andrea; Leal, Yenny; Vehi, Josep
2017-06-12
Continuous glucose monitors (CGMs) are prone to inaccuracy due to time lags, sensor drift, calibration errors, and measurement noise. The aim of this study is to derive the model of the error of the second generation Medtronic Paradigm Veo Enlite (ENL) sensor and compare it with the Dexcom SEVEN PLUS (7P), G4 PLATINUM (G4P), and advanced G4 for Artificial Pancreas studies (G4AP) systems. An enhanced methodology to a previously employed technique was utilized to dissect the sensor error into several components. The dataset used included 37 inpatient sessions in 10 subjects with type 1 diabetes (T1D), in which CGMs were worn in parallel and blood glucose (BG) samples were analyzed every 15 ± 5 min Calibration error and sensor drift of the ENL sensor was best described by a linear relationship related to the gain and offset. The mean time lag estimated by the model is 9.4 ± 6.5 min. The overall average mean absolute relative difference (MARD) of the ENL sensor was 11.68 ± 5.07% Calibration error had the highest contribution to total error in the ENL sensor. This was also reported in the 7P, G4P, and G4AP. The model of the ENL sensor error will be useful to test the in silico performance of CGM-based applications, i.e., the artificial pancreas, employing this kind of sensor.
A wire-based dual-analyte sensor for glucose and lactate: in vitro and in vivo evaluation.
Ward, W Kenneth; House, Jody L; Birck, Jonathan; Anderson, Ellen M; Jansen, Lawrence B
2004-06-01
Continuous measurement of lactate is potentially useful for detecting physical exhaustion and for monitoring critical care conditions characterized by hypoperfusion, such as heart failure. In some conditions, it may be desirable to monitor more than one metabolic parameter concurrently. For this reason, we designed and fabricated twisted wire-based microelectrodes that can measure both lactate and glucose. These dual-analyte sensors were characterized in vitro by measuring their response to the analyte of interest and to assess whether they were susceptible to interference from the other analyte. When measured in stirred aqueous buffer, lactate sensors detected a very small amount of crosstalk from glucose in vitro, although this signal was less than 3% of the response to lactate. Glucose sensors did not detect crosstalk from lactate. Sensors were implanted subcutaneously in rats and tested during infusions of lactate and glucose. Each sensing electrode responded rapidly to changes in its analyte concentration, and there was no evidence of in vivo crosstalk. This study constitutes proof of the concept that oxidase-based, amperometric wire microsensors can detect changes in glucose and lactate during subcutaneous implantation in rats.
Accuracy of continuous glucose monitoring during exercise in type 1 diabetes pregnancy.
Kumareswaran, Kavita; Elleri, Daniela; Allen, Janet M; Caldwell, Karen; Nodale, Marianna; Wilinska, Malgorzata E; Amiel, Stephanie A; Hovorka, Roman; Murphy, Helen R
2013-03-01
Performance of continuous glucose monitors (CGMs) may be lower when glucose levels are changing rapidly, such as occurs during physical activity. Our aim was to evaluate accuracy of a current-generation CGM during moderate-intensity exercise in type 1 diabetes (T1D) pregnancy. As part of a study of 24-h closed-loop insulin delivery in 12 women with T1D (disease duration, 17.6 years; glycosylated hemoglobin, 6.4%) during pregnancy (gestation, 21 weeks), we evaluated the Freestyle Navigator(®) sensor (Abbott Diabetes Care, Alameda, CA) during afternoon (15:00-18:00 h) and morning (09:30-12:30 h) exercise (55 min of brisk walking on a treadmill followed by a 2-h recovery), compared with sedentary conditions (18:00-09:00 h). Plasma (reference) glucose, measured at regular 15-30-min intervals with the YSI Ltd. (Fleet, United Kingdom) model YSI 2300 analyzer, was used to assess CGM performance. Sensor accuracy, as indicated by the larger relative absolute difference (RAD) between paired sensor and reference glucose values, was lower during exercise compared with rest (median RAD, 11.8% vs. 18.4%; P<0.001). These differences remained significant when correcting for plasma glucose relative rate of change (P<0.001). Analysis by glucose range showed lower accuracy during hypoglycemia for both sedentary (median RAD, 24.4%) and exercise (median RAD, 32.1%) conditions. Using Clarke error grid analysis, 96% of CGM values were clinically safe under resting conditions compared with only 87% during exercise. Compared with sedentary conditions, accuracy of the Freestyle Navigator CGM was lower during moderate-intensity exercise in pregnant women with T1D. This difference was particularly marked in hypoglycemia and could not be solely explained by the glucose rate of change associated with physical activity.
Wentholt, I M E; Maran, A; Masurel, N; Heine, R J; Hoekstra, J B L; DeVries, J H
2007-05-01
We quantified the occurrence and duration of nocturnal hypoglycaemia in individuals with Type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) or multiple-injection therapy (MIT) using a continuous subcutaneous glucose sensor. A microdialysis sensor was worn at home by 24 patients on CSII (mean HbA(1c) 7.8 +/- 0.9%) and 33 patients on MIT (HbA(1c) 8.7 +/- 1.3%) for 48 h. Occurrence and duration of nocturnal hypoglycaemia were assessed and using multivariate regression analysis, the association between HbA(1c), diabetes duration, treatment type (CSII vs. MIT), fasting and bedtime blood glucose values, total daily insulin dose and mean nocturnal glucose concentrations, and hypoglycaemia occurrence and duration was investigated. Nocturnal hypoglycaemia < or = 3.9 mmol/l occurred in 33.3% of both the CSII- (8/24) and MIT-treated patients (11/33). Mean (+/- sd; median, interquartile range) duration of hypoglycaemia < or = 3.9 mmol/l was 78 (+/- 76; 57, 23-120) min per night for the CSII- and 98 (+/- 80; 81, 32-158) min per night for the MIT-treated group. Multivariate regression analysis showed that bedtime glucose value had the strongest association with the occurrence (P = 0.026) and duration (P = 0.032) of nocturnal hypoglycaemia. Microdialysis continuous glucose monitoring has enabled more precise quantification of nocturnal hypoglycaemia occurrence and duration in Type 1 diabetic patients. Occurrence and duration of nocturnal hypoglycaemia were mainly associated with bedtime glucose value.
Design, development, and evaluation of a novel microneedle array-based continuous glucose monitor.
Jina, Arvind; Tierney, Michael J; Tamada, Janet A; McGill, Scott; Desai, Shashi; Chua, Beelee; Chang, Anna; Christiansen, Mark
2014-05-01
The development of accurate, minimally invasive continuous glucose monitoring (CGM) devices has been the subject of much work by several groups, as it is believed that a less invasive and more user-friendly device will result in greater adoption of CGM by persons with insulin-dependent diabetes. This article presents the results of preliminary clinical studies in subjects with diabetes of a novel prototype microneedle-based continuous glucose monitor. In this device, an array of tiny hollow microneedles is applied into the epidermis from where glucose in interstitial fluid (ISF) is transported via passive diffusion to an amperometric glucose sensor external to the body. Comparison of 1396 paired device glucose measurements and fingerstick blood glucose readings for up to 72-hour wear in 10 diabetic subjects shows the device to be accurate and well tolerated by the subjects. Overall mean absolute relative difference (MARD) is 15% with 98.4% of paired points in the A+B region of the Clarke error grid. The prototype device has demonstrated clinically accurate glucose readings over 72 hours, the first time a microneedle-based device has achieved such performance. © 2014 Diabetes Technology Society.
A photonic crystal fiber glucose sensor filled with silver nanowires
NASA Astrophysics Data System (ADS)
Yang, X. C.; Lu, Y.; Wang, M. T.; Yao, J. Q.
2016-01-01
We report a photonic crystal fiber glucose sensor filled with silver nanowires in this paper. The proposed sensor is both analyzed by COMSOL multiphysics software and demonstrated by experiments. The extremely high average spectral sensitivity 19009.17 nm/RIU for experimental measurement is obtained, equivalent to 44.25 mg/dL of glucose in water, which is lower than 70 mg/dL for efficient detection of hypoglycemia episodes. The silver nanowires diameter which may affect the sensor's spectral sensitivity is also discussed and an optimal range of silver nanowires diameter 90-120 nm is obtained. We expect that the sensor can provide an effective platform for glucose sensing and potentially leading to a further development towards minimal-invasive glucose measurement.
Use of continuous glucose monitoring in patients with type 1 diabetes.
Ellis, Samuel L; Naik, Ramachandra G; Gemperline, Kate; Garg, Satish K
2008-08-01
The prevalence of type 1 diabetes continues to increase worldwide at a rate higher than previously projected, while the number of patients achieving American Diabetes Association (ADA) glycated hemoglobin (A1c) goals remains suboptimal. There are numerous barriers to patients achieving A1c targets including increased frequency of severe hypoglycemia associated with lowering plasma glucose as measured by lower A1c values. Continuous glucose monitoring (CGM) was first approved for retrospective analysis and now has advanced to the next step in diabetes management with the approval of real-time glucose sensing. Real-time CGM, in short term studies, has been shown to decrease A1c values, improve glucose variability (GV), and minimize the time and number of hypoglycemic events in patients with type 1 diabetes. These products are approved for adjunctive use to self-monitoring of blood glucose (SMBG), but future long-term studies are needed to document their safety, efficacy, ability to replace SMBG as a tool of monitoring, and ultimately utility into closed-loop insulin delivery systems. New algorithms will need to be developed that account for rapid changes in the glucose values, so that accuracy of the sensor data can be maintained. In addition, for better clinical care and usage, algorithms also need to be developed for both patients and the providers to guide them for their ongoing diabetes care.
Toward minimally invasive, continuous glucose monitoring in vivo
NASA Astrophysics Data System (ADS)
Vrancic, Christian; Gretz, Norbert; Kröger, Niels; Neudecker, Sabine; Pucci, Annemarie; Petrich, Wolfgang
2012-01-01
Diabetes mellitus is a disorder of glucose metabolism and it is one of the most challenging diseases, both from a medical and economic perspective. People with diabetes can benefit from a frequent or even continuous monitoring of their blood glucose concentrations. The approach presented here takes advantage of the observational nature of biomedical vibrational spectroscopy in contrast to chemical reactions which consume glucose. The particular technique employed here is based on the high sensitivity of mid-infrared transmission spectroscopy where strong vibrational bands of glucose can be monitored at wavelengths around 10 μm. The strong absorption of water in this spectral region was mitigated by the use of quantum cascade lasers and very short interaction path lengths below 50 μm. Various sensor concepts have been explored. In one of the concepts, the interaction of mid-infrared radiation with glucose is established within a miniature measurement cavity, formed by a gap between two silver halide fibers. In recent experiments, an additional quantum cascade laser was used for reference purposes. The long-term drift could significantly be reduced for time intervals > 1000 s, e. g., by more than 60% for a 3 hour interval. This extension for the compensation of long-term drifts of the measurement system in vitro is an important contribution towards the applicability in vivo.
Defect-Mediated Molecular Interaction and Charge Transfer in Graphene Mesh-Glucose Sensors.
Kwon, Sun Sang; Shin, Jae Hyeok; Choi, Jonghyun; Nam, SungWoo; Park, Won Il
2017-04-26
We report the role of defects in enzymatic graphene field-effect transistor sensors by introducing engineered defects in graphene channels. Compared with conventional graphene sensors (Gr sensors), graphene mesh sensors (GM sensors), with an array of circular holes, initially exhibited a higher irreversible response to glucose, involving strong chemisorption to edge defects. However, after immobilization of glucose oxidase, the irreversibility of the responses was substantially diminished, without any reduction in the sensitivity of the GM sensors (i.e., -0.53 mV/mM for the GM sensor vs -0.37 mV/mM for Gr sensor). Furthermore, multiple cycle operation led to rapid sensing and improved the reversibility of GM sensors. In addition, control tests with sensors containing a linker showed that sensitivity was increased in Gr sensors but decreased in GM sensors. Our findings indicate that edge defects can be used to replace linkers for immobilization of glucose oxidase and improve charge transfer across glucose oxidase-graphene interfaces.
Yasuzawa, Mikito; Omura, Yuya; Hiura, Kentaro; Li, Jiang; Fuchiwaki, Yusuke; Tanaka, Masato
2015-01-01
Cellulose nanofiber aqueous solution, which remained virtually transparent for more than one week, was prepared by using the clear upper layer of diluted cellulose nanofiber solution produced by wet jet milling. Glucose oxidase (GOx) was easily dissolved in this solution and GOx-immobilized electrode was easily fabricated by simple repetitious drops of GOx-cellulose solution on the surface of a platinum-iridium electrode. Glucose sensor properties of the obtained electrodes were examined in phosphate buffer solution of pH 7.4 at 40°C. The obtained electrode provided a glucose sensor response with significantly high response speed and good linear relationship between glucose concentration and response current. After an initial decrease of response sensitivity for a few days, relatively constant sensitivity was obtained for about 20 days. Nevertheless, the influence of electroactive compounds such as ascorbic acid, uric acid and acetoaminophen were not negletable.
Glucose Sensor Using U-Shaped Optical Fiber Probe with Gold Nanoparticles and Glucose Oxidase.
Chen, Kuan-Chieh; Li, Yu-Le; Wu, Chao-Wei; Chiang, Chia-Chin
2018-04-16
In this study, we proposed a U-shaped optical fiber probe fabricated using a flame heating method. The probe was packaged in glass tube to reduce human factors during experimental testing of the probe as a glucose sensor. The U-shaped fiber probe was found to have high sensitivity in detecting the very small molecule. When the sensor was dipped in solutions with different refractive indexes, its wavelength or transmission loss changed. We used electrostatic self-assembly to bond gold nanoparticles and glucose oxidase (GOD) onto the sensor’s surface. The results over five cycles of the experiment showed that, as the glucose concentration increased, the refractive index of the sensor decreased and its spectrum wavelength shifted. The best wavelength sensitivity was 2.899 nm/%, and the linearity was 0.9771. The best transmission loss sensitivity was 5.101 dB/%, and the linearity was 0.9734. Therefore, the proposed U-shaped optical fiber probe with gold nanoparticles and GOD has good potential for use as a blood sugar sensor in the future.
Endocytosis and Vacuolar Degradation of the Yeast Cell Surface Glucose Sensors Rgt2 and Snf3*
Roy, Adhiraj; Kim, Jeong-Ho
2014-01-01
Sensing and signaling the presence of extracellular glucose is crucial for the yeast Saccharomyces cerevisiae because of its fermentative metabolism, characterized by high glucose flux through glycolysis. The yeast senses glucose through the cell surface glucose sensors Rgt2 and Snf3, which serve as glucose receptors that generate the signal for induction of genes involved in glucose uptake and metabolism. Rgt2 and Snf3 detect high and low glucose concentrations, respectively, perhaps because of their different affinities for glucose. Here, we provide evidence that cell surface levels of glucose sensors are regulated by ubiquitination and degradation. The glucose sensors are removed from the plasma membrane through endocytosis and targeted to the vacuole for degradation upon glucose depletion. The turnover of the glucose sensors is inhibited in endocytosis defective mutants, and the sensor proteins with a mutation at their putative ubiquitin-acceptor lysine residues are resistant to degradation. Of note, the low affinity glucose sensor Rgt2 remains stable only in high glucose grown cells, and the high affinity glucose sensor Snf3 is stable only in cells grown in low glucose. In addition, constitutively active, signaling forms of glucose sensors do not undergo endocytosis, whereas signaling defective sensors are constitutively targeted for degradation, suggesting that the stability of the glucose sensors may be associated with their ability to sense glucose. Therefore, our findings demonstrate that the amount of glucose available dictates the cell surface levels of the glucose sensors and that the regulation of glucose sensors by glucose concentration may enable yeast cells to maintain glucose sensing activity at the cell surface over a wide range of glucose concentrations. PMID:24451370
A dual sensor for real-time monitoring of glucose and oxygen
Zhang, Liqiang; Su, Fengyu; Buizer, Sean; Lu, Hongguang; Gao, Weimin; Tian, Yanqing; Meldrum, Deirdre
2013-01-01
A dual glucose and oxygen sensor in a polymer format was developed. The dual sensor composed of a blue emitter as the glucose probe, a red emitter as an oxygen probe, and a yellow emitter as a built-in reference probe which does not respond to either glucose or oxygen. All the three probes were chemically immobilized in a polyacrylamide-based matrix. Therefore, the dual sensor possesses three well separated emission colors and ratiometric approach is applicable for analysis of the glucose and oxygen concentration at biological conditions. The sensor was applied for real-time monitoring of glucose and oxygen consumption of bacterial cells, Escherichia coli (E. coli) and Bacillus subtilis (B. subtilis), and mammalian cells of mouse macrophage J774 and human cervical cancer HeLa cell lines. On the other hand, in order to achieve satisfactory sensing performance for glucose, compositions of the matrices among poly(2-hydroxyethyl methacrylate), polyacrylamide, and poly(6-aminohexyl methacrylamide) which is a linker polymer for grafting the glucose probe, were optimized. PMID:24090834
Fang, Lu; Liang, Bo; Yang, Guang; Hu, Yichuan; Zhu, Qin; Ye, Xuesong
2017-11-15
A minimally invasive glucose biosensor capable of continuous monitoring of subcutaneous glucose has been developed in this study. This sensor was prepared using electropolymerized conductive polymer polyaniline (PANI) nanofibers as an enzyme immobilization material and polyurethane (PU)/epoxy-enhanced polyurethane (E-PU) bilayer coating as a protective membrane. The sensor showed almost the same sensitivity (63nA/mM) and linearity (0-20mM with the correlation coefficient r 2 of 0.9997) in both PBS and bovine serum tests. When stored in 37°C bovine serum, the sensor's sensitivity gradually increased about 30% of the initial value within the first 13 days and then remained stable for the rest of the study period of 53 days. In vivo implantation experiments using mice models showed real-time response to the variation of blood glucose with an average signal delay of about 8min. Continuous monitoring showed that the sensor response increased for the first 12 days and then entered a stable period for 14 days. The sensor's baseline (530±10nA) and the total response to 1ml 50% dextrose injection were almost the same (267±15nA) in the stable period. The in vivo stable performances indicated that the sensor could be used as an implantable device for long-term invasive monitoring of blood glucose. Copyright © 2017 Elsevier B.V. All rights reserved.
Continuous Glucose Monitoring and Trend Accuracy
Gottlieb, Rebecca; Le Compte, Aaron; Chase, J. Geoffrey
2014-01-01
Continuous glucose monitoring (CGM) devices are being increasingly used to monitor glycemia in people with diabetes. One advantage with CGM is the ability to monitor the trend of sensor glucose (SG) over time. However, there are few metrics available for assessing the trend accuracy of CGM devices. The aim of this study was to develop an easy to interpret tool for assessing trend accuracy of CGM data. SG data from CGM were compared to hourly blood glucose (BG) measurements and trend accuracy was quantified using the dot product. Trend accuracy results are displayed on the Trend Compass, which depicts trend accuracy as a function of BG. A trend performance table and Trend Index (TI) metric are also proposed. The Trend Compass was tested using simulated CGM data with varying levels of error and variability, as well as real clinical CGM data. The results show that the Trend Compass is an effective tool for differentiating good trend accuracy from poor trend accuracy, independent of glycemic variability. Furthermore, the real clinical data show that the Trend Compass assesses trend accuracy independent of point bias error. Finally, the importance of assessing trend accuracy as a function of BG level is highlighted in a case example of low and falling BG data, with corresponding rising SG data. This study developed a simple to use tool for quantifying trend accuracy. The resulting trend accuracy is easily interpreted on the Trend Compass plot, and if required, performance table and TI metric. PMID:24876437
Continuous glucose monitors: current status and future developments.
Lane, Jennifer E; Shivers, Joseph P; Zisser, Howard
2013-04-01
Advances in diabetes technologies allow patients to manage their diabetes with greater precision and flexibility. Many recent studies show that continuous glucose monitors (CGMs) can be used to tighten glycemic control safely and to ease certain burdens of diabetes self-management. The following summary reflects the most recent findings in CGM and provides an overall review of who would most benefit from CGM use. Benefits of CGM may vary based on age, type of diabetes, pregnancy, health, sleep, or heart rate. Accuracy and reliability are critical in current uses of CGM and especially for new and future systems that automate insulin partially (e.g., low glucose suspend) or entirely (e.g., 'fully closed-loop' artificial pancreas). Clinicians are simultaneously testing available products in new patient groups such as the critically ill and type 2 diabetes patients not using mealtime insulin. In a widening set of circumstances, use of CGM has been shown to promote safer and more effective glycemic control than self-monitoring of blood glucose. Imperfections remain in certain scenarios such as hypoglycemia and in certain populations such as young children. Ongoing research on sensors and calibration software should translate to better systems.
Continuous glucose monitoring: 40 years, what we've learned and what's next.
Gifford, Raeann
2013-07-22
After 40 years of research and development, today continuous glucose monitoring (CGM) is demonstrating the benefit it provides for millions with diabetes. To provide in vivo accuracy, new permselective membranes and mediated systems have been developed to prevent enzyme saturation and to minimize interference signals. Early in vivo implanted sensor research clearly showed that the foreign body response was a more difficult issue to overcome. Understanding the biological interface and circumventing the inflammatory response continue to drive development of a CGM sensor with accuracy and reliability performance suitable in a closed-loop artificial pancreas. Along with biocompatible polymer development, other complimentary algorithm and data analysis techniques have improved the performance of commercial systems significantly. For example, the mean average relative difference of Dexcom's CGM system improved from 26 to 14% and its use-life was extended from 3 to 7 d. Significant gains in usability, including size, flexibility, insertion, calibration, and data interface, have been incorporated into new generations of commercial CGM systems. Besides Medtronic, Dexcom, and Abbott, other major players are also investing in CGM. Becton Dickinson is conducting clinical trials with an optical galactose glucose binding system. Development of fully implanted sensor systems fulfills the desire for a discreet, reliable CGM system. Research continues to find innovative ways to help make living with diabetes easier and more normal, and new segments are being pursued (intensive care unit, surgery, behavior modification) in which CGM is being utilized. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Evanescent Wave Absorption Based Fiber Sensor for Measuring Glucose Solution Concentration
NASA Astrophysics Data System (ADS)
Marzuki, Ahmad; Candra Pratiwi, Arni; Suryanti, Venty
2018-03-01
An optical fiber sensor based on evanescent wave absorption designed for measuring glucose solution consentration was proposed. The sensor was made to detect absorbance of various wavelength in the glucose solution. The sensing element was fabricated by side polishing of multimode polymer optical fiber to form a D-shape. The sensing element was immersed in different concentration of glucoce solution. As light propagated through the optical fiber, the evanescent wave interacted with the glucose solution. Light was absorbed by the glucose solution. The larger concentration the glucose solution has, the more the evanescent wave was absorbed in particular wavelenght. Here in this paper, light absorbtion as function of glucose concentration was measured as function of wavelength (the color of LED). We have shown that the proposed sensor can demonstrated an increase of light absorption as function of glucose concentration.
Glycolysis Controls Plasma Membrane Glucose Sensors To Promote Glucose Signaling in Yeasts
Cairey-Remonnay, Amélie; Deffaud, Julien; Wésolowski-Louvel, Micheline; Lemaire, Marc
2014-01-01
Sensing of extracellular glucose is necessary for cells to adapt to glucose variation in their environment. In the respiratory yeast Kluyveromyces lactis, extracellular glucose controls the expression of major glucose permease gene RAG1 through a cascade similar to the Saccharomyces cerevisiae Snf3/Rgt2/Rgt1 glucose signaling pathway. This regulation depends also on intracellular glucose metabolism since we previously showed that glucose induction of the RAG1 gene is abolished in glycolytic mutants. Here we show that glycolysis regulates RAG1 expression through the K. lactis Rgt1 (KlRgt1) glucose signaling pathway by targeting the localization and probably the stability of Rag4, the single Snf3/Rgt2-type glucose sensor of K. lactis. Additionally, the control exerted by glycolysis on glucose signaling seems to be conserved in S. cerevisiae. This retrocontrol might prevent yeasts from unnecessary glucose transport and intracellular glucose accumulation. PMID:25512610
Mediation of in vivo glucose sensor inflammatory response via nitric oxide release.
Gifford, Raeann; Batchelor, Melissa M; Lee, Youngmi; Gokulrangan, Giridharan; Meyerhoff, Mark E; Wilson, George S
2005-12-15
In vivo glucose sensor nitric oxide (NO) release is a means of mediating the inflammatory response that may cause sensor/tissue interactions and degraded sensor performance. The NO release (NOr) sensors were prepared by doping the outer polymeric membrane coating of previously reported needle-type electrochemical sensors with suitable lipophilic diazeniumdiolate species. The Clarke error grid correlation of sensor glycemia estimates versus blood glucose measured in Sprague-Dawley rats yielded 99.7% of the points for NOr sensors and 96.3% of points for the control within zones A and B (clinically acceptable) on Day 1, with a similar correlation for Day 3. Histological examination of the implant site demonstrated that the inflammatory response was significantly decreased for 100% of the NOr sensors at 24 h. The NOr sensors also showed a reduced run-in time of minutes versus hours for control sensors. NO evolution does increase protein nitration in tissue surrounding the sensor, which may be linked to the suppression of inflammation. This study further emphasizes the importance of NO as an electroactive species that can potentially interfere with glucose (peroxide) detection. The NOr sensor offers a viable option for in vivo glucose sensor development.
Glucose Sensor Using U-Shaped Optical Fiber Probe with Gold Nanoparticles and Glucose Oxidase
Chen, Kuan-Chieh; Li, Yu-Le; Wu, Chao-Wei
2018-01-01
In this study, we proposed a U-shaped optical fiber probe fabricated using a flame heating method. The probe was packaged in glass tube to reduce human factors during experimental testing of the probe as a glucose sensor. The U-shaped fiber probe was found to have high sensitivity in detecting the very small molecule. When the sensor was dipped in solutions with different refractive indexes, its wavelength or transmission loss changed. We used electrostatic self-assembly to bond gold nanoparticles and glucose oxidase (GOD) onto the sensor’s surface. The results over five cycles of the experiment showed that, as the glucose concentration increased, the refractive index of the sensor decreased and its spectrum wavelength shifted. The best wavelength sensitivity was 2.899 nm/%, and the linearity was 0.9771. The best transmission loss sensitivity was 5.101 dB/%, and the linearity was 0.9734. Therefore, the proposed U-shaped optical fiber probe with gold nanoparticles and GOD has good potential for use as a blood sugar sensor in the future. PMID:29659536
Characterization of Porous, Dexamethasone-Releasing Polyurethane Coatings for Glucose Sensors
Vallejo-Heligon, Suzana G.; Klitzman, Bruce; Reichert, William M.
2014-01-01
Commercially available implantable needle-type glucose sensors for diabetes management are robust analytically but can be unreliable clinically primarily due to tissue-sensor interactions. Here, we present the physical, drug release, and bioactivity characterization of tubular, porous dexamethasone (Dex) releasing polyurethane coatings designed to attenuate local inflammation in the tissue-sensor interface. Porous polyurethane coatings were produced by the salt-leaching/gas-foaming method. Scanning electron microscopy (SEM) and Micro-computed tomography (Micro-CT) showed a controlled porosity and coating thickness. In vitro drug release from coatings monitored over two weeks presented an initial fast release followed by a slower release. Total release from coatings was highly dependent on initial drug loading amount. Functional in vitro testing of glucose sensors deployed with porous coatings against glucose standards demonstrated that highly porous coatings minimally affected signal strength and response rate. Bioactivity of the released drug was determined by monitoring Dex-mediated, dose-dependent apoptosis of human peripheral blood derived monocytes in culture. Acute animal studies were used to determine the appropriate Dex payload for the implanted porous coatings. Pilot short-term animal studies showed that Dex released from porous coatings implanted in rat subcutis attenuated the initial inflammatory response to sensor implantation. These results suggest that deploying sensors with the porous, Dex-releasing coatings is a promising strategy to improve glucose sensor performance. PMID:25065548
Continuous glucose monitoring microsensor with a nanoscale conducting matrix and redox mediator
NASA Astrophysics Data System (ADS)
Pesantez, Daniel
The major limiting factor in kidney clinical transplantation is the shortage of transplantable organs. The current inability to distinguish viability from non-viability on a prospective basis represents a major obstacle in any attempt to expand organ donor criteria. Consequently, a way to measure and monitor a relevant analyte to assess kidney viability is needed. For the first time, the initial development and characterization of a metabolic microsensor to assess kidney viability is presented. The rate of glucose consumption appears to serve as an indicator of kidney metabolism that may distinguish reversible from irreversible kidney damage. The proposed MetaSense (Metabolic Sensor) microdevice would replace periodic laboratory diagnosis tests with a continuous monitor that provides real-time data on organ viability. Amperometry, a technique that correlates an electrical signal with analyte concentration, is used as a method to detect glucose concentrations. A novel two-electrode electrochemical sensing cell design is presented. It uses a modified metallic working electrode (WE) and a bare metallic reference electrode (RE) that acts as a pseudo-reference/counter electrode as well. The proposed microsensor has the potential to be used as a minimally invasive sensor for its reduced number of probes and very small dimensions achieved by micromachining and lithography. In order to improve selectivity of the microdevice, two electron transfer mechanisms or generations were explored. A first generation microsensor uses molecular oxygen as the electron acceptor in the enzymatic reaction and oxidizes hydrogen peroxide (H2O2) to get the electrical signal. The microsensor's modified WE with conductive polymer polypyrrole (PPy) and corresponding enzyme glucose oxidase (GOx) immobilized into its matrix, constitutes the electrochemical detection mechanism. Photoluminescence spectroscopic analysis confirmed and quantified enzyme immobilized concentrations within the matrix. In
Continuous glucose monitoring and clinical trials.
Heinemann, Lutz
2009-07-01
The use of glucose sensors during clinical trials seems like a great idea at first glance. Continuous glucose monitoring (CGM) should allow the gathering of more detailed information about metabolic control, without requiring much additional effort. In principle, CGM can reduce the duration of such studies and the number of participants required. The aim of this commentary is to highlight some of the reasons why, in practice, at least some of these hopes have not been realized. It is not only that a new technology requires extensive training of the study personnel; the practical handling of the devices and the time and effort required to download and analyze the data are often grossly underestimated initially. In addition, one must select the best endpoints for describing the level of metabolic control in view of the overwhelming amount of information provided by CGM. Several measures and endpoints were proposed as (potential) parameters that would be more meaningful than the standard parameters currently used to describe glucose profiles. Unfortunately, most of these proposed parameters have not, as yet, been proven to be more meaningful. Calibration is another critical aspect of using CGM that must be addressed. How this procedure is handled in practice has a profound impact on the quality of the glucose recordings. Finally, shall the current measurement results be displayed to the study participant or not? CGM can help prevent severe hypoglycemic episodes, but this can profoundly affect the study outcome in a manner that is unrelated to basic aim of the study (e.g., comparing medications that are designed to control glycemia). Therefore, the use of CGM in clinical trials requires much more careful consideration than was initially thought. Copyright 2009 Diabetes Technology Society.
Glucose sensor realized with photonic crystal fiber-based Sagnac interferometer
NASA Astrophysics Data System (ADS)
An, Guowen; Li, Shuguang; An, Yinghong; Wang, Haiyang; Zhang, Xuenan
2017-12-01
A compact glucose sensor is proposed by using a short length of photonic crystal fiber inserted in a Sagnac loop interferometer. Spectrum shift in response to the RI of glucose solution with a high average sensitivity of 22 130 nm/RIU is achieved, equivalent to 0.76 mg/dL of glucose in water, which is lower than 70 mg/dL for efficient detection of hypoglycemia episodes. And the simplicity of the fiber structure makes the sensor production very cost effective. We aimed to provide a potential effective method for glucose detection in patients with hypoglycemia.
Fluorescence Intensity- and Lifetime-Based Glucose Sensing Using Glucose/Galactose-Binding Protein
Pickup, John C.; Khan, Faaizah; Zhi, Zheng-Liang; Coulter, Jonathan; Birch, David J. S.
2013-01-01
We review progress in our laboratories toward developing in vivo glucose sensors for diabetes that are based on fluorescence labeling of glucose/galactose-binding protein. Measurement strategies have included both monitoring glucose-induced changes in fluorescence resonance energy transfer and labeling with the environmentally sensitive fluorophore, badan. Measuring fluorescence lifetime rather than intensity has particular potential advantages for in vivo sensing. A prototype fiber-optic-based glucose sensor using this technology is being tested.Fluorescence technique is one of the major solutions for achieving the continuous and noninvasive glucose sensor for diabetes. In this article, a highly sensitive nanostructured sensor is developed to detect extremely small amounts of aqueous glucose by applying fluorescence energy transfer (FRET). A one-pot method is applied to produce the dextran-fluorescein isothiocyanate (FITC)-conjugating mesoporous silica nanoparticles (MSNs), which afterward interact with the tetramethylrhodamine isothiocyanate (TRITC)-labeled concanavalin A (Con A) to form the FRET nanoparticles (FITC-dextran-Con A-TRITC@MSNs). The nanostructured glucose sensor is then formed via the self-assembly of the FRET nanoparticles on a transparent, flexible, and biocompatible substrate, e.g., poly(dimethylsiloxane). Our results indicate the diameter of the MSNs is 60 ± 5 nm. The difference in the images before and after adding 20 μl of glucose (0.10 mmol/liter) on the FRET sensor can be detected in less than 2 min by the laser confocal laser scanning microscope. The correlation between the ratio of fluorescence intensity, I(donor)/I(acceptor), of the FRET sensor and the concentration of aqueous glucose in the range of 0.04–4 mmol/liter has been investigated; a linear relationship is found. Furthermore, the durability of the nanostructured FRET sensor is evaluated for 5 days. In addition, the recorded images can be converted to digital images by
Highly Selective and Sensitive Self-Powered Glucose Sensor Based on Capacitor Circuit.
Slaughter, Gymama; Kulkarni, Tanmay
2017-05-03
Enzymatic glucose biosensors are being developed to incorporate nanoscale materials with the biological recognition elements to assist in the rapid and sensitive detection of glucose. Here we present a highly sensitive and selective glucose sensor based on capacitor circuit that is capable of selectively sensing glucose while simultaneously powering a small microelectronic device. Multi-walled carbon nanotubes (MWCNTs) is chemically modified with pyrroloquinoline quinone glucose dehydrogenase (PQQ-GDH) and bilirubin oxidase (BOD) at anode and cathode, respectively, in the biofuel cell arrangement. The input voltage (as low as 0.25 V) from the biofuel cell is converted to a stepped-up power and charged to the capacitor to the voltage of 1.8 V. The frequency of the charge/discharge cycle of the capacitor corresponded to the oxidation of glucose. The biofuel cell structure-based glucose sensor synergizes the advantages of both the glucose biosensor and biofuel cell. In addition, this glucose sensor favored a very high selectivity towards glucose in the presence of competing and non-competing analytes. It exhibited unprecedented sensitivity of 37.66 Hz/mM.cm 2 and a linear range of 1 to 20 mM. This innovative self-powered glucose sensor opens new doors for implementation of biofuel cells and capacitor circuits for medical diagnosis and powering therapeutic devices.
77 FR 30016 - Clinical Study Design and Performance of Hospital Glucose Sensors
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-21
...] Clinical Study Design and Performance of Hospital Glucose Sensors AGENCY: Food and Drug Administration, HHS... Sensors.'' The purpose of this public meeting is to discuss clinical study design considerations and performance metrics for innovative glucose sensors intended to be used in hospital point of care settings...
Wireless enzyme sensor system for real-time monitoring of blood glucose levels in fish.
Endo, Hideaki; Yonemori, Yuki; Hibi, Kyoko; Ren, Huifeng; Hayashi, Tetsuhito; Tsugawa, Wakako; Sode, Koji
2009-01-01
Periodic checks of fish health and the rapid detection of abnormalities are thus necessary at fish farms. Several studies indicate that blood glucose levels closely correlate to stress levels in fish and represent the state of respiratory or nutritional disturbance. We prepared a wireless enzyme sensor system to determine blood glucose levels in fish. It can be rapidly and conveniently monitored using the newly developed needle-type enzyme sensor, consisting of a Pt-Ir wire, Ag/AgCl paste, and glucose oxidase. To prevent the effects of interfering anionic species, such as uric acid and ascorbic acid, on the sensor response, the Pt-Ir electrode was coated with Nafion, and then glucose oxidase was immobilized on the coated electrode. The calibration curve of the glucose concentration was linear, from 0.18 to 144mg/dl, and the detection limit was 0.18mg/dl. The sensor was used to wirelessly monitor fish glucose levels. The sensor-calibrated glucose levels and actual blood glucose levels were in excellent agreement. The fluid of the inner sclera of the fish eyeball (EISF) was a suitable site for sensor implantation to obtain glucose sample. There was a close correlation between glucose concentrations in the EISF and those in the blood. Glucose concentrations in fish blood could be monitored in free-swimming fish in an aquarium for 3 days.
Continuous Glucose Monitoring: Current Use in Diabetes Management and Possible Future Applications.
Vettoretti, Martina; Cappon, Giacomo; Acciaroli, Giada; Facchinetti, Andrea; Sparacino, Giovanni
2018-05-01
The recent announcement of the production of new low-cost continuous glucose monitoring (CGM) sensors, the approval of marketed CGM sensors for making treatment decisions, and new reimbursement criteria have the potential to revolutionize CGM use. After briefly summarizing current CGM applications, we discuss how, in our opinion, these changes are expected to extend CGM utilization beyond diabetes patients, for example, to subjects with prediabetes or even healthy individuals. We also elaborate on how the integration of CGM data with other relevant information, for example, health records and other medical device/wearable sensor data, will contribute to creating a digital data ecosystem that will improve our understanding of the etiology and complications of diabetes and will facilitate the development of data analytics for personalized diabetes management and prevention.
Obermaier, Karin; Schmelzeisen-Redeker, Günther; Schoemaker, Michael; Klötzer, Hans-Martin; Kirchsteiger, Harald; Eikmeier, Heino; del Re, Luigi
2013-07-01
Even though a Clinical and Laboratory Standards Institute proposal exists on the design of studies and performance criteria for continuous glucose monitoring (CGM) systems, it has not yet led to a consistent evaluation of different systems, as no consensus has been reached on the reference method to evaluate them or on acceptance levels. As a consequence, performance assessment of CGM systems tends to be inconclusive, and a comparison of the outcome of different studies is difficult. Published information and available data (as presented in this issue of Journal of Diabetes Science and Technology by Freckmann and coauthors) are used to assess the suitability of several frequently used methods [International Organization for Standardization, continuous glucose error grid analysis, mean absolute relative deviation (MARD), precision absolute relative deviation (PARD)] when assessing performance of CGM systems in terms of accuracy and precision. The combined use of MARD and PARD seems to allow for better characterization of sensor performance. The use of different quantities for calibration and evaluation, e.g., capillary blood using a blood glucose (BG) meter versus venous blood using a laboratory measurement, introduces an additional error source. Using BG values measured in more or less large intervals as the only reference leads to a significant loss of information in comparison with the continuous sensor signal and possibly to an erroneous estimation of sensor performance during swings. Both can be improved using data from two identical CGM sensors worn by the same patient in parallel. Evaluation of CGM performance studies should follow an identical study design, including sufficient swings in glycemia. At least a part of the study participants should wear two identical CGM sensors in parallel. All data available should be used for evaluation, both by MARD and PARD, a good PARD value being a precondition to trust a good MARD value. Results should be analyzed and
Continuous glucose monitoring and hypoglycemia unawareness in type 1 diabetes: a pilot study.
Zalzali, Mohamed; Houdelet-Guerinot, Valérie; Socquard, Eric; Thierry, Aurore; Delemer, Brigitte; Lukas-Croisier, Céline
2017-09-01
Looking for strict normoglycemia in type 1 diabetes increases the risk of hypoglycemia, exposing to hypoglycemia unawareness. It has been shown that the early correction of hypoglycemia can help recovering the perception of hypoglycemia. The purpose of this prospective study was to assess the value of sensor-augmented insulin-pump therapy to treat hypoglycemia unawareness. Eleven patients with type 1 diabetes and partial or total hypoglycemia unawareness received sensor-augmented insulin-pump therapy combined to the low blood glucose-suspend feature (Paradigm® Veo™ pump and Enlite® sensors) for three months. Eighty per cent of the patients improved their hypoglycemia unawareness with an increase in the hypoglycemia perception threshold of 31 mg/dL as evaluated by blinded continuous glucose monitoring. These results were correlated to a self-assessment quiz evaluation. Results were sustained at six months (three months after patients stopped using the system). Sensitive neuropathy, untreated hypoglycemia and the area under the curve for hypoglycemia events were associated with less chance of recovery. These devices were globally considered by the patients as simple to use, with no major disadvantages and only a single withdrawal occurred. Sensor-augmented insulin-pump therapy should be considered as a possible treatment of hypoglycemia unawareness.
The Accuracy Benefit of Multiple Amperometric Glucose Sensors in People With Type 1 Diabetes
Castle, Jessica R.; Pitts, Amy; Hanavan, Kathryn; Muhly, Rhonda; El Youssef, Joseph; Hughes-Karvetski, Colleen; Kovatchev, Boris; Ward, W. Kenneth
2012-01-01
OBJECTIVE To improve glucose sensor accuracy in subjects with type 1 diabetes by using multiple sensors and to assess whether the benefit of redundancy is affected by intersensor distance. RESEARCH DESIGN AND METHODS Nineteen adults with type 1 diabetes wore four Dexcom SEVEN PLUS subcutaneous glucose sensors during two 9-h studies. One pair of sensors was worn on each side of the abdomen, with each sensor pair placed at a predetermined distance apart and 20 cm away from the opposite pair. Arterialized venous blood glucose levels were measured every 15 min, and sensor glucose values were recorded every 5 min. Sensors were calibrated once at the beginning of the study. RESULTS The use of four sensors significantly reduced very large errors compared with one sensor (0.4 vs. 2.6% of errors ≥50% from reference glucose, P < 0.001) and also improved overall accuracy (mean absolute relative difference, 11.6 vs. 14.8%, P < 0.001). Using only two sensors also significantly improved very large errors and accuracy. Intersensor distance did not affect the function of sensor pairs. CONCLUSIONS Sensor accuracy is significantly improved with the use of multiple sensors compared with the use of a single sensor. The benefit of redundancy is present even when sensors are positioned very closely together (7 mm). These findings are relevant to the design of an artificial pancreas device. PMID:22357189
The accuracy benefit of multiple amperometric glucose sensors in people with type 1 diabetes.
Castle, Jessica R; Pitts, Amy; Hanavan, Kathryn; Muhly, Rhonda; El Youssef, Joseph; Hughes-Karvetski, Colleen; Kovatchev, Boris; Ward, W Kenneth
2012-04-01
To improve glucose sensor accuracy in subjects with type 1 diabetes by using multiple sensors and to assess whether the benefit of redundancy is affected by intersensor distance. Nineteen adults with type 1 diabetes wore four Dexcom SEVEN PLUS subcutaneous glucose sensors during two 9-h studies. One pair of sensors was worn on each side of the abdomen, with each sensor pair placed at a predetermined distance apart and 20 cm away from the opposite pair. Arterialized venous blood glucose levels were measured every 15 min, and sensor glucose values were recorded every 5 min. Sensors were calibrated once at the beginning of the study. The use of four sensors significantly reduced very large errors compared with one sensor (0.4 vs. 2.6% of errors ≥50% from reference glucose, P < 0.001) and also improved overall accuracy (mean absolute relative difference, 11.6 vs. 14.8%, P < 0.001). Using only two sensors also significantly improved very large errors and accuracy. Intersensor distance did not affect the function of sensor pairs. Sensor accuracy is significantly improved with the use of multiple sensors compared with the use of a single sensor. The benefit of redundancy is present even when sensors are positioned very closely together (7 mm). These findings are relevant to the design of an artificial pancreas device.
Joseph, Jeffrey I; Torjman, Marc C; Strasma, Paul J
2015-07-01
Hyperglycemia, hypoglycemia, and glycemic variability have been associated with increased morbidity, mortality, length of stay, and cost in a variety of critical care and non-critical care patient populations in the hospital. The results from prospective randomized clinical trials designed to determine the risks and benefits of intensive insulin therapy and tight glycemic control have been confusing; and at times conflicting. The limitations of point-of-care blood glucose (BG) monitoring in the hospital highlight the great clinical need for an automated real-time continuous glucose monitoring system (CGMS) that can accurately measure the concentration of glucose every few minutes. Automation and standardization of the glucose measurement process have the potential to significantly improve BG control, clinical outcome, safety and cost. © 2015 Diabetes Technology Society.
Continuous Glucose Monitoring in Newborn Infants
Thomas, Felicity; Signal, Mathew; Harris, Deborah L.; Weston, Philip J.; Harding, Jane E.; Shaw, Geoffrey M.
2014-01-01
Neonatal hypoglycemia is common and can cause serious brain injury. Continuous glucose monitoring (CGM) could improve hypoglycemia detection, while reducing blood glucose (BG) measurements. Calibration algorithms use BG measurements to convert sensor signals into CGM data. Thus, inaccuracies in calibration BG measurements directly affect CGM values and any metrics calculated from them. The aim was to quantify the effect of timing delays and calibration BG measurement errors on hypoglycemia metrics in newborn infants. Data from 155 babies were used. Two timing and 3 BG meter error models (Abbott Optium Xceed, Roche Accu-Chek Inform II, Nova Statstrip) were created using empirical data. Monte-Carlo methods were employed, and each simulation was run 1000 times. Each set of patient data in each simulation had randomly selected timing and/or measurement error added to BG measurements before CGM data were calibrated. The number of hypoglycemic events, duration of hypoglycemia, and hypoglycemic index were then calculated using the CGM data and compared to baseline values. Timing error alone had little effect on hypoglycemia metrics, but measurement error caused substantial variation. Abbott results underreported the number of hypoglycemic events by up to 8 and Roche overreported by up to 4 where the original number reported was 2. Nova results were closest to baseline. Similar trends were observed in the other hypoglycemia metrics. Errors in blood glucose concentration measurements used for calibration of CGM devices can have a clinically important impact on detection of hypoglycemia. If CGM devices are going to be used for assessing hypoglycemia it is important to understand of the impact of these errors on CGM data. PMID:24876618
Gellynck, Karolien; Kodeck, Valérie; Van De Walle, Elke; Kersemans, Ken; De Vos, Filip; Declercq, Heidi; Dubruel, Peter; Vlaminck, Lieven
2015-01-01
Continuous glucose monitoring (CGM) is crucial in diabetic care. Long-term CGM systems however require an accurate sensor as well as a suitable measuring environment. Since large intravenous sensors are not feasible, measuring inside the interstitial fluid is considered the best alternative. This option, unfortunately, has the drawback of a lag time with blood glucose values. A good strategy to circumvent this is to enhance tissue integration and enrich the peri-implant vasculature. Implants of different optically transparent biomaterials (poly(methyl-methacrylate) [PMMA] and poly(dimethylsiloxane) [PDMS]) – enabling glucose monitoring in the near-infrared (NIR) spectrum – were surface-treated and subsequently implanted in goats at various implantation sites for up to 3 months. The overall in vivo biocompatibility, tissue integration, and vascularization at close proximity of the surfaces of these materials were assessed. Histological screening showed similar tissue reactions independent of the implantation site. No significant inflammation reaction was observed. Tissue integration and vascularization correlated, to some extent, with the biomaterial composition. A modification strategy, in which a vascular endothelial-cadherin antibody was coupled to the biomaterials surface through a dopamine layer, showed significantly enhanced vascularization 3 months after subcutaneous implantation. Our results suggest that the developed strategy enables the creation of tissue interactive NIR transparent packaging materials, opening the possibility of continuous glucose monitoring. PMID:25304314
Krushinitskaya, Olga; Tønnessen, Tor Inge; Jakobsen, Henrik; Johannessen, Erik
2011-10-15
Continuous surveillance of blood glucose is a prerogative of maintaining a tight glycaemic control in people suffering from diabetes mellitus. Implantable sensor technology offers the potential of conducting direct long term continuous glucose measurements, but current size restrictions and operational challenges have limited their applications. The osmotic sensor utilises diffusion to create a hydrostatic pressure that is independent of sensor operation and power consumption. This permits ultra-low power architectures to be realized with a minimal start-up time in a package suitable for miniaturization. In contrast, osmotic sensors suffer from the inability of their membranes to discriminate between different constituents in blood or the interstitial fluid that are of comparable size to glucose. By implementing an affinity assay based on the competitive bonding between concanavalin A and dextran, the selectivity of the membrane can be transferred to the glucose specific recognition of the affinity assay. The osmotic effect from the physiological levels of several key metabolites and nutritional components has been addressed identifying in particular ethanol, lactate and amino acids as potential interfering constituents. Both ascorbic acid and mannose would have a normal physiological concentration that is too low to be detected. The studies shows that an osmotic glucose sensor equipped with the con A-dextran affinity assay, is able to filter out potential interfering constituents present in blood, plasma and the interstitial fluid yet retaining a pressure that is proportional to glucose only. Copyright © 2011 Elsevier B.V. All rights reserved.
Critical role of tissue mast cells in controlling long-term glucose sensor function in vivo.
Klueh, Ulrike; Kaur, Manjot; Qiao, Yi; Kreutzer, Donald L
2010-06-01
Little is known about the specific cells, mediators and mechanisms involved in the loss of glucose sensor function (GSF) in vivo. Since mast cells (MC) are known to be key effector cells in inflammation and wound healing, we hypothesized that MC and their products are major contributors to the skin inflammation and wound healing that controls GSF at sites of sensor implantation. To test this hypothesis we utilized a murine model of continuous glucose monitoring (CGM) in vivo in both normal C57BL/6 mice (mast cell sufficient), as well as mast cell deficient B6.Cg-Kit(W-sh)/HNihrJaeBsmJ (Sash) mice over a 28 day CGM period. As expected, both strains of mice displayed excellent CGM for the first 7 days post sensor implantation (PSI). CGM in the mast cell sufficient C57BL/6 mice was erratic over the remaining 21 days PSI. CGM in the mast cell deficient Sash mice displayed excellent sensor function for the entire 28 day of CGM. Histopathologic evaluation of implantation sites demonstrated that tissue reactions in Sash mice were dramatically less compared to the reactions in normal C57BL/6 mice. Additionally, mast cells were also seen to be consistently associated with the margins of sensor tissue reactions in normal C57BL/6 mice. Finally, direct injection of bone marrow derived mast cells at sites of sensor implantation induced an acute and dramatic loss of sensor function in both C57BL/6 and Sash mice. These results demonstrate the key role of mast cells in controlling glucose sensor function in vivo. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
Amperometric Glucose Sensor Using Thermostable Co-Factor Binding Glucose Dehydrogenase
NASA Astrophysics Data System (ADS)
Nakazawa, Yukie; Yamazaki, Tomohiko; Tsugawa, Wakako; Ikebukuro, Kazunori; Sode, Koji
A thermostable mediator-type enzyme glucose sensor was constructed. The electrode was fabricated using chemically cross-linked thermostable co-factor binding glucose dehydrogenase (GDH) from thermophilic bacteria in carbon paste matrix. The electrode responded directly proportional to D-glucose concentration from 0.01 mM to 3 mM in stirred buffer containing 1 mM 1-methoxyphenazinemethosulfate as a mediator with the steady-state mode. The storage stability was examined by incubating the enzyme electrode at 50oC during the measurement. The cross-linked GDH immobilized electrode showed good storage stability. Ninety percent of its initial response was retained after incubation in buffer solution for 9 days at 50oC. The flow injection analysis (FIA) glucose sensing system was also constructed by immobilizing the cross-linked GDH and ferrocene as a mediator in the carbon paste matrix. The FIA system was able to measure 600 samples for 100 h.
Evaluation of the performance of a novel system for continuous glucose monitoring.
Zschornack, Eva; Schmid, Christina; Pleus, Stefan; Link, Manuela; Klötzer, Hans-Martin; Obermaier, Karin; Schoemaker, Michael; Strasser, Monika; Frisch, Gerhard; Schmelzeisen-Redeker, Günther; Haug, Cornelia; Freckmann, Guido
2013-07-01
The performance of a continuous glucose monitoring (CGM) system in the early stage of development was assessed in an inpatient setting that simulates daily life conditions of people with diabetes. Performance was evaluated at low glycemic, euglycemic, and high glycemic ranges as well as during phases with rapid glucose excursions. Each of the 30 participants with type 1 diabetes (15 female, age 47 ± 12 years, hemoglobin A1c 7.7% ± 1.3%) wore two sensors of the prototype system in parallel for 7 days. Capillary blood samples were measured at least 16 times per day (at least 15 times per daytime and at least once per night). On two subsequent study days, glucose excursions were induced. For performance evaluation, the mean absolute relative difference (MARD) between CGM readings and paired capillary blood glucose readings and precision absolute relative difference (PARD), i.e., differences between paired CGM readings were calculated. Overall aggregated MARD was 9.2% and overall aggregated PARD was 7.5%. During induced glucose excursions, MARD was 10.9% and PARD was 7.8%. Lowest MARD (8.5%) and lowest PARD (6.4%) were observed in the high glycemic range (euglycemic range, MARD 9.1% and PARD 7.4%; low glycemic range, MARD 12.3% and PARD 12.4%). The performance of this prototype CGM system was, particularly in the hypoglycemic range and during phases with rapid glucose fluctuations, better than performance data reported for other commercially available systems. In addition, performance of this prototype sensor was noticeably constant over the whole study period. This prototype system is not yet approved, and performance of this CGM system needs to be further assessed in clinical studies. © 2013 Diabetes Technology Society.
A Robust, Enzyme-Free Glucose Sensor Based on Lysine-Assisted CuO Nanostructures.
Baloach, Qurrat-Ul-Ain; Tahira, Aneela; Mallah, Arfana Begum; Abro, Muhammad Ishaq; Uddin, Siraj; Willander, Magnus; Ibupoto, Zafar Hussain
2016-11-14
The production of a nanomaterial with enhanced and desirable electrocatalytic properties is of prime importance, and the commercialization of devices containing these materials is a challenging task. In this study, unique cupric oxide (CuO) nanostructures were synthesized using lysine as a soft template for the evolution of morphology via a rapid and boiled hydrothermal method. The morphology and structure of the synthesized CuO nanomaterial were characterized using scanning electron microscopy (SEM) and X-ray diffraction (XRD), respectively. The prepared CuO nanostructures showed high potential for use in the electrocatalytic oxidation of glucose in an alkaline medium. The proposed enzyme-free glucose sensor demonstrated a robust response to glucose with a wide linear range and high sensitivity, selectivity, stability, and reproducibility. To explore its practical feasibility, the glucose content of serum samples was successfully determined using the enzyme-free sensor. An analytical recovery method was used to measure the actual glucose from the serum samples, and the results were satisfactory. Moreover, the presented glucose sensor has high chemical stability and can be reused for repetitive measurements. This study introduces an enzyme-free glucose sensor as an alternative tool for clinical glucose quantification.
A Robust, Enzyme-Free Glucose Sensor Based on Lysine-Assisted CuO Nanostructures
Baloach, Qurrat-ul-Ain; Tahira, Aneela; Mallah, Arfana Begum; Abro, Muhammad Ishaq; Uddin, Siraj; Willander, Magnus; Ibupoto, Zafar Hussain
2016-01-01
The production of a nanomaterial with enhanced and desirable electrocatalytic properties is of prime importance, and the commercialization of devices containing these materials is a challenging task. In this study, unique cupric oxide (CuO) nanostructures were synthesized using lysine as a soft template for the evolution of morphology via a rapid and boiled hydrothermal method. The morphology and structure of the synthesized CuO nanomaterial were characterized using scanning electron microscopy (SEM) and X-ray diffraction (XRD), respectively. The prepared CuO nanostructures showed high potential for use in the electrocatalytic oxidation of glucose in an alkaline medium. The proposed enzyme-free glucose sensor demonstrated a robust response to glucose with a wide linear range and high sensitivity, selectivity, stability, and reproducibility. To explore its practical feasibility, the glucose content of serum samples was successfully determined using the enzyme-free sensor. An analytical recovery method was used to measure the actual glucose from the serum samples, and the results were satisfactory. Moreover, the presented glucose sensor has high chemical stability and can be reused for repetitive measurements. This study introduces an enzyme-free glucose sensor as an alternative tool for clinical glucose quantification. PMID:27854253
Matsuda, Erin; Brennan, Patricia
abilities vary in each model from 0.05 units/hour to 30 units/hour . Information from the pump can be uploaded to online registries allowing providers to review trends and usage. It is imperative the information is reviewed concurrently with glucose monitoring results in order to ensure appropriate dosing and treatment .The intervention considered in this systematic review is the use of continuous glucose monitoring (CGM) in conjunction with a CSII. CGM utilises a sensor placed in the interstitial subcutaneous tissue, which then measures glucose levels. This is accomplished with "electrochemical sensors that use glucose oxidase and measure an electric current generated when glucose reacts with oxygen. The sensors are coated with a specialised membrane to make them biocompatible" . The CGM has programmable high and low levels to alert the user when the limit is being reached. Information regarding continuous glucose levels can then be downloaded and reviewed. Based on the report, providers, patients, and caregivers may assess trends and consider changing basal rates or bolus doses .CGM sensors currently do not offer a closed-loop solution. The user must enter insulin dosing information into the pump, taking into account the present glucose level and duration of action of the insulin. Currently, CGMs are regarded as a supplemental method for assessing the effectiveness of glucose control. Existing studies are underway to improve accuracy and communication between the sensor and insulin pump with the goal to develop an artificial pancreas . Currently, CGM sensors must be calibrated with a glucometer, as specified by the manufacturer .The comparison for this review is the standard of care, self-glucose monitoring (SGM), in patients with insulin pumps . SGM is accomplished with a glucometer and blood sample typically obtained from a finger prick. The Diabetes Control and Complications Trial (DCCT) demonstrated frequency of monitoring improves glycemic control and decreases the
Highly sensitive glucose sensors based on enzyme-modified whole-graphene solution-gated transistors
NASA Astrophysics Data System (ADS)
Zhang, Meng; Liao, Caizhi; Mak, Chun Hin; You, Peng; Mak, Chee Leung; Yan, Feng
2015-02-01
Noninvasive glucose detections are convenient techniques for the diagnosis of diabetes mellitus, which require high performance glucose sensors. However, conventional electrochemical glucose sensors are not sensitive enough for these applications. Here, highly sensitive glucose sensors are successfully realized based on whole-graphene solution-gated transistors with the graphene gate electrodes modified with an enzyme glucose oxidase. The sensitivity of the devices is dramatically improved by co-modifying the graphene gates with Pt nanoparticles due to the enhanced electrocatalytic activity of the electrodes. The sensing mechanism is attributed to the reaction of H2O2 generated by the oxidation of glucose near the gate. The optimized glucose sensors show the detection limits down to 0.5 μM and good selectivity, which are sensitive enough for non-invasive glucose detections in body fluids. The devices show the transconductances two orders of magnitude higher than that of a conventional silicon field effect transistor, which is the main reason for their high sensitivity. Moreover, the devices can be conveniently fabricated with low cost. Therefore, the whole-graphene solution-gated transistors are a high-performance sensing platform for not only glucose detections but also many other types of biosensors that may find practical applications in the near future.
Highly sensitive glucose sensors based on enzyme-modified whole-graphene solution-gated transistors
Zhang, Meng; Liao, Caizhi; Mak, Chun Hin; You, Peng; Mak, Chee Leung; Yan, Feng
2015-01-01
Noninvasive glucose detections are convenient techniques for the diagnosis of diabetes mellitus, which require high performance glucose sensors. However, conventional electrochemical glucose sensors are not sensitive enough for these applications. Here, highly sensitive glucose sensors are successfully realized based on whole-graphene solution-gated transistors with the graphene gate electrodes modified with an enzyme glucose oxidase. The sensitivity of the devices is dramatically improved by co-modifying the graphene gates with Pt nanoparticles due to the enhanced electrocatalytic activity of the electrodes. The sensing mechanism is attributed to the reaction of H2O2 generated by the oxidation of glucose near the gate. The optimized glucose sensors show the detection limits down to 0.5 μM and good selectivity, which are sensitive enough for non-invasive glucose detections in body fluids. The devices show the transconductances two orders of magnitude higher than that of a conventional silicon field effect transistor, which is the main reason for their high sensitivity. Moreover, the devices can be conveniently fabricated with low cost. Therefore, the whole-graphene solution-gated transistors are a high-performance sensing platform for not only glucose detections but also many other types of biosensors that may find practical applications in the near future. PMID:25655666
NASA Astrophysics Data System (ADS)
Reis, Louis G.
With the increasing prevalence of diabetes in the United States and worldwide, blood glucose monitoring must be accurate and reliable. Current enzymatic sensors have numerous disadvantages that make them unreliable and unfavorable among patients. Recent research in glucose affinity sensors correct some of the problems that enzymatic sensors experience. Dextran and concanavalin A are two of the more common components used in glucose affinity sensors. When these sensors were first explored, a model was derived to predict the response time of a glucose affinity sensor using concanavalin A and dextran. However, the model assumed the system was linear and fell short of calculating times representative of the response times determined through experimental tests with the sensors. In this work, a new model that uses the Stokes-Einstein Equation to demonstrate the nonlinear behavior of the glucose affinity assay was developed to predict the response times of similar glucose affinity sensors. In addition to the device tested by the original linear model, additional devices were identified and tested with the proposed model. The nonlinear model was designed to accommodate the many different variations between systems. The proposed model was able to accurately calculate response times for sensors using the concanavalin A-dextran affinity assay with respect to the experimentally reported times by the independent research groups. Parameter studies using the nonlinear model were able to identify possible setbacks that could compromise the response of thesystem. Specifically, the model showed that the improper use of asymmetrical membranes could increase the response time by as little as 20% or more as the device is miniaturized. The model also demonstrated that systems using the concanavalin Adextran assay would experience higher response times in the hypoglycemic range. This work attempted to replicate and improve an osmotic glucose affinity sensor. The system was designed to
Re-usable electrochemical glucose sensors integrated into a smartphone platform.
Bandodkar, Amay J; Imani, Somayeh; Nuñez-Flores, Rogelio; Kumar, Rajan; Wang, Chiyi; Mohan, A M Vinu; Wang, Joseph; Mercier, Patrick P
2018-03-15
This article demonstrates a new smartphone-based reusable glucose meter. The glucose meter includes a custom-built smartphone case that houses a permanent bare sensor strip, a stylus that is loaded with enzyme-carbon composite pellets, and sensor instrumentation circuits. A custom-designed Android-based software application was developed to enable easy and clear display of measured glucose concentration. A typical test involves the user loading the software, using the stylus to dispense an enzymatic pellet on top of the bare sensor strip affixed to the case, and then introducing the sample. The electronic module then acquires and wirelessly transmits the data to the application software to be displayed on the screen. The deployed pellet is then discarded to regain the fresh bare sensor surface. Such a unique working principle allows the system to overcome challenges faced by previously reported reusable sensors, such as enzyme degradation, leaching, and hysteresis effects. Studies reveal that the enzyme loaded in the pellets are stable for up to 8 months at ambient conditions, and generate reproducible sensor signals. The work illustrates the significance of the pellet-based sensing system towards realizing a reusable, point-of-care sensor that snugly fits around a smartphone and which does not face issues usually common to reusable sensors. The versatility of this system allows it to be easily modified to detect other analytes for application in a wide range of healthcare, environmental and defense domains. Copyright © 2017 Elsevier B.V. All rights reserved.
Zueger, Thomas; Diem, Peter; Mougiakakou, Stavroula; Stettler, Christoph
2012-07-01
Data on the influence of calibration on accuracy of continuous glucose monitoring (CGM) are scarce. The aim of the present study was to investigate whether the time point of calibration has an influence on sensor accuracy and whether this effect differs according to glycemic level. Two CGM sensors were inserted simultaneously in the abdomen on either side of 20 individuals with type 1 diabetes. One sensor was calibrated predominantly using preprandial glucose (calibration(PRE)). The other sensor was calibrated predominantly using postprandial glucose (calibration(POST)). At minimum three additional glucose values per day were obtained for analysis of accuracy. Sensor readings were divided into four categories according to the glycemic range of the reference values (low, ≤4 mmol/L; euglycemic, 4.1-7 mmol/L; hyperglycemic I, 7.1-14 mmol/L; and hyperglycemic II, >14 mmol/L). The overall mean±SEM absolute relative difference (MARD) between capillary reference values and sensor readings was 18.3±0.8% for calibration(PRE) and 21.9±1.2% for calibration(POST) (P<0.001). MARD according to glycemic range was 47.4±6.5% (low), 17.4±1.3% (euglycemic), 15.0±0.8% (hyperglycemic I), and 17.7±1.9% (hyperglycemic II) for calibration(PRE) and 67.5±9.5% (low), 24.2±1.8% (euglycemic), 15.5±0.9% (hyperglycemic I), and 15.3±1.9% (hyperglycemic II) for calibration(POST). In the low and euglycemic ranges MARD was significantly lower in calibration(PRE) compared with calibration(POST) (P=0.007 and P<0.001, respectively). Sensor calibration predominantly based on preprandial glucose resulted in a significantly higher overall sensor accuracy compared with a predominantly postprandial calibration. The difference was most pronounced in the hypo- and euglycemic reference range, whereas both calibration patterns were comparable in the hyperglycemic range.
Fabrication of a Flexible Amperometric Glucose Sensor Using Additive Processes
Du, Xiaosong; Durgan, Christopher J.; Matthews, David J.; Motley, Joshua R.; Tan, Xuebin; Pholsena, Kovit; Árnadóttir, Líney; Castle, Jessica R.; Jacobs, Peter G.; Cargill, Robert S.; Ward, W. Kenneth; Conley, John F.; Herman, Gregory S.
2015-01-01
This study details the use of printing and other additive processes to fabricate a novel amperometric glucose sensor. The sensor was fabricated using a Au coated 12.7 μm thick polyimide substrate as a starting material, where micro-contact printing, electrochemical plating, chloridization, electrohydrodynamic jet (e-jet) printing, and spin coating were used to pattern, deposit, chloridize, print, and coat functional materials, respectively. We have found that e-jet printing was effective for the deposition and patterning of glucose oxidase inks with lateral feature sizes between ~5 to 1000 μm in width, and that the glucose oxidase was still active after printing. The thickness of the permselective layer was optimized to obtain a linear response for glucose concentrations up to 32 mM and no response to acetaminophen, a common interfering compound, was observed. The use of such thin polyimide substrates allow wrapping of the sensors around catheters with high radius of curvature ~250 μm, where additive and microfabrication methods may allow significant cost reductions. PMID:26634186
First clinical evaluation of a new long-term subconjunctival glucose sensor.
Müller, Achim Josef; Knuth, Monika; Nikolaus, Katharina Sibylle; Herbrechtsmeier, Peter
2012-07-01
To evaluate the feasibility of an implantable subconjunctival glucose monitoring system (SGMS) for glucose monitoring in humans, we investigated the in vivo performance of the sensor in a clinical trial with five patients. The new SGMS consists of an implantable ocular mini implant (OMI) and a hand-held fluorescence photometer. The implantable subconjunctival glucose sensor is composed of a fluorescence resonance energy transfer system based on Concanavalin A chemistry, embedded in a nelfilcon polymer hydrogel disk. Blood glucose changes in humans were induced by oral glucose intake and insulin injections. The in vivo response of the new SGMS was tested in a first human clinical study with five diabetes patients. The OMI was well tolerated in the eyes of the patients. The SGMS exhibited high correlation coefficients (>0.88) with blood glucose changes and a good stability of the sensor response to glucose for the study period of 2 weeks. Lag times were in the range of 5-10 min. A total of 98% of all data pairs was in the clinical acceptable ranges A and B of the consensus error grid. For the first time, the possibility to measure glucose in vivo in the subconjunctival interstitial fluid for a period of 2 weeks was demonstrated in a human clinical trial. © 2012 Diabetes Technology Society.
Croce, Robert A; Vaddiraju, Santhisagar; Papadimitrakopoulos, Fotios; Jain, Faquir C
2012-10-01
The performance of implantable electrochemical glucose sensors is highly dependent on the flux-limiting (glucose, H(2)O(2), O(2)) properties of their outer membranes. A careful understanding of the diffusion profiles of the participating species throughout the sensor architecture (enzyme and membrane layer) plays a crucial role in designing a robust sensor for both in vitro and in vivo operation. This paper reports the results from the mathematical modeling of Clark's first generation amperometric glucose sensor coated with layer-by-layer assembled outer membranes in order to obtain and compare the diffusion profiles of various participating species and their effect on sensor performance. Devices coated with highly glucose permeable (HAs/Fe(3+)) membranes were compared with devices coated with PSS/PDDA membranes, which have an order of magnitude lower permeability. The simulation showed that the low glucose permeable membrane (PSS/PDDA) sensors exhibited a 27% higher amperometric response than the high glucose permeable (HAs/Fe(3+)) sensors. Upon closer inspection of H(2)O(2)diffusion profiles, this non-typical higher response from PSS/PDDA is not due to either a larger glucose flux or comparatively larger O(2) concentrations within the sensor geometry, but rather is attributed to a 48% higher H(2)O(2) concentration in the glucose oxidase enzyme layer of PSS/PDDA coated sensors as compared to HAs/Fe(3+) coated ones. These simulated results corroborate our experimental findings reported previously. The high concentration of H(2)O(2) in the PSS/PDDA coated sensors is due to the low permeability of H(2)O(2) through the PSS/PDDA membrane, which also led to an undesired increase in sensor response time. Additionally, it was found that this phenomenon occurs for all enzyme thicknesses investigated (15, 20 and 25 nm), signifying the need for a holistic approach in designing outer membranes for amperometric biosensors.
Poitout, V; Moatti-Sirat, D; Reach, G; Zhang, Y; Wilson, G S; Lemonnier, F; Klein, J C
1993-07-01
We have developed a miniaturized glucose sensor which has been shown previously to function adequately when implanted in the subcutaneous tissue of rats and dogs. Following a glucose load, the sensor output increases, making it possible to calculate a sensitivity coefficient to glucose in vivo, and an extrapolated background current in the absence of glucose. These parameters are used for estimating at any time the apparent subcutaneous glucose concentration from the current. In the previous studies, this calibration was performed a posteriori, on the basis of the retrospective analysis of the changes in blood glucose and in the current generated by the sensor. However, for clinical application of the system, an on line estimation of glucose concentration would be necessary. Thus, this study was undertaken in order to assess the possibility of calibrating the sensor in real time, using a novel calibration procedure and a monitoring unit which was specifically designed for this purpose. This electronic device is able to measure, to filter and to store the current. During an oral glucose challenge, when a stable current is reached, it is possible to feed the unit with two different values of blood glucose and their corresponding times. The unit calculates the in vivo parameters, transforms every single value of current into an estimation of the glucose concentration, and then displays this estimation. In this study, 11 sensors were investigated of which two did not respond to glucose. In the other nine trials, the volunteers were asked to record every 30 s what appeared on the display during the secondary decrease in blood glucose.(ABSTRACT TRUNCATED AT 250 WORDS)
Koskun, Yağmur; Şavk, Aysun; Şen, Betül; Şen, Fatih
2018-06-20
Glucose enzyme biosensors have been used for a variety of applications such as medical diagnosis, bioprocess engineering, beverage industry and environmental scanning etc. and there is still a growing interest in glucose sensors. For this purpose, addressed herein, as a novel glucose sensor, highly sensitive activated carbon (AC) decorated monodisperse nickel and palladium alloy nanocomposites modified glassy carbon electrode (Ni-Pd@AC/GCE NCs) have been synthesized by in-situ reduction technique. Raman Spectroscopy (RS), X-ray Photoelectron Spectroscopy (XPS), X-ray Diffraction (XRD), Transmission Electron Microscopy (TEM), cyclic voltammetry (CV) and chronoamperometry (CA) were used for the characterization of the prepared non-enzymatic glucose sensor. The characteristic sensor properties of the Ni-Pd@AC/GCE electrode were compared with Ni-Pd NCs/GCE, Ni@AC/GCE and Pd@AC/GCE and the results demonstrate that the AC is very effective in the enhancement of the electrocatalytic properties of sensor. In addition, the Ni-Pd@AC/GCE nanocomposites showed a very low detection limit of 0.014 μM, a wide linear range of 0.01 mM-1 mM and a very high sensitivity of 90 mA mM -1 cm -2 . Furthermore, the recommended sensor offer the various advantageous such as facile preparation, fast response time, high selectivity and sensitivity. Lastly, monodisperse Ni-Pd@AC/GCE was utilized to detect glucose in real sample species. Copyright © 2018 Elsevier B.V. All rights reserved.
A needle-type sensor for monitoring glucose in whole blood.
Yang, Q; Atanasov, P; Wilkins, E
1997-01-01
A new surface-process technology employing electrochemical fixation of a bioactive substance (enzyme and heparin) to a sensor electrode was developed to provide biocompatability and functionality. The fabrication process includes electroentrapment of glucose oxidase and heparin on a platinum electrode by using 1,3-phenylenediamine codeposition. Electrochemically grown 1,3-phenylenediamine was also used as the outer coating of the sensor's enzyme electrode in order to extend the linear range. The sensor shows a sensitivity of 3 nA/mM and a linear range from 40 to 400 mg/dL at 37 degrees C when tested in whole blood. This sensor is characterized by a fast response. The sensor shows a minimum change in its performance when stored inactive in buffer for 12 weeks. When tested at physiologic glucose levels, the sensor demonstrates satisfactory low interference from common interfering substances. This technology seems promising for the preparation of implantable intravascular biosensors.
Zecchin, Chiara; Facchinetti, Andrea; Sparacino, Giovanni; Dalla Man, Chiara; Manohar, Chinmay; Levine, James A; Basu, Ananda; Kudva, Yogish C; Cobelli, Claudio
2013-10-01
In type 1 diabetes mellitus (T1DM), physical activity (PA) lowers the risk of cardiovascular complications but hinders the achievement of optimal glycemic control, transiently boosting insulin action and increasing hypoglycemia risk. Quantitative investigation of relationships between PA-related signals and glucose dynamics, tracked using, for example, continuous glucose monitoring (CGM) sensors, have been barely explored. In the clinic, 20 control and 19 T1DM subjects were studied for 4 consecutive days. They underwent low-intensity PA sessions daily. PA was tracked by the PA monitoring system (PAMS), a system comprising accelerometers and inclinometers. Variations on glucose dynamics were tracked estimating first- and second-order time derivatives of glucose concentration from CGM via Bayesian smoothing. Short-time effects of PA on glucose dynamics were quantified through the partial correlation function in the interval (0, 60 min) after starting PA. Correlation of PA with glucose time derivatives is evident. In T1DM, the negative correlation with the first-order glucose time derivative is maximal (absolute value) after 15 min of PA, whereas the positive correlation is maximal after 40-45 min. The negative correlation between the second-order time derivative and PA is maximal after 5 min, whereas the positive correlation is maximal after 35-40 min. Control subjects provided similar results but with positive and negative correlation peaks anticipated of 5 min. Quantitative information on correlation between mild PA and short-term glucose dynamics was obtained. This represents a preliminary important step toward incorporation of PA information in more realistic physiological models of the glucose-insulin system usable in T1DM simulators, in development of closed-loop artificial pancreas control algorithms, and in CGM-based prediction algorithms for generation of hypoglycemic alerts.
Skin-Attachable, Stretchable Electrochemical Sweat Sensor for Glucose and pH Detection.
Oh, Seung Yun; Hong, Soo Yeong; Jeong, Yu Ra; Yun, Junyeong; Park, Heun; Jin, Sang Woo; Lee, Geumbee; Oh, Ju Hyun; Lee, Hanchan; Lee, Sang-Soo; Ha, Jeong Sook
2018-04-25
As part of increased efforts to develop wearable healthcare devices for monitoring and managing physiological and metabolic information, stretchable electrochemical sweat sensors have been investigated. In this study, we report on the fabrication of a stretchable and skin-attachable electrochemical sensor for detecting glucose and pH in sweat. A patterned stretchable electrode was fabricated via layer-by-layer deposition of carbon nanotubes (CNTs) on top of patterned Au nanosheets (AuNS) prepared by filtration onto stretchable substrate. For the detection of glucose and pH, CoWO 4 /CNT and polyaniline/CNT nanocomposites were coated onto the CNT-AuNS electrodes, respectively. A reference electrode was prepared via chlorination of silver nanowires. Encapsulation of the stretchable sensor with sticky silbione led to a skin-attachable sweat sensor. Our sensor showed high performance with sensitivities of 10.89 μA mM -1 cm -2 and 71.44 mV pH -1 for glucose and pH, respectively, with mechanical stability up to 30% stretching and air stability for 10 days. The sensor also showed good adhesion even to wet skin, allowing the detection of glucose and pH in sweat from running while being attached onto the skin. This work suggests the application of our stretchable and skin-attachable electrochemical sensor to health management as a high-performance healthcare wearable device.
Technologies for Continuous Glucose Monitoring: Current Problems and Future Promises
Vaddiraju, Santhisagar; Burgess, Diane J; Tomazos, Ioannis; Jain, Faquir C; Papadimitrakopoulos, Fotios
2010-01-01
Devices for continuous glucose monitoring (CGM) are currently a major focus of research in the area of diabetes management. It is envisioned that such devices will have the ability to alert a diabetes patient (or the parent or medical care giver of a diabetes patient) of impending hypoglycemic/hyperglycemic events and thereby enable the patient to avoid extreme hypoglycemic/hyperglycemic excursions as well as minimize deviations outside the normal glucose range, thus preventing both life-threatening events and the debilitating complications associated with diabetes. It is anticipated that CGM devices will utilize constant feedback of analytical information from a glucose sensor to activate an insulin delivery pump, thereby ultimately realizing the concept of an artificial pancreas. Depending on whether the CGM device penetrates/breaks the skin and/or the sample is measured extracorporeally, these devices can be categorized as totally invasive, minimally invasive, and noninvasive. In addition, CGM devices are further classified according to the transduction mechanisms used for glucose sensing (i.e., electrochemical, optical, and piezoelectric). However, at present, most of these technologies are plagued by a variety of issues that affect their accuracy and long-term performance. This article presents a critical comparison of existing CGM technologies, highlighting critical issues of device accuracy, foreign body response, calibration, and miniaturization. An outlook on future developments with an emphasis on long-term reliability and performance is also presented. PMID:21129353
Rapid changes in local extracellular rat brain glucose observed with an in vivo glucose sensor.
Hu, Y; Wilson, G S
1997-04-01
A needle-type electrochemically based microsensor for glucose (110 microns o.d.) is described. This sensor, designed for monitoring transient glucose content changes in response to neural stimuli, has a response time of approximately 5 s and has been shown to be free of interference from endogenous electroactive species such as ascorbate, urate, and various neurotransmitters. It exhibits linear response to glucose up to 10 mM. The usefulness of the sensor has been demonstrated by examining the time-dependent interstitial glucose concentration in the rat hippocampus in response to KCl depolarization and by stimulation of glutamate neurons through a perforant pathway. Simultaneous monitoring of oxygen is also carried out and demonstrates that for both oxygen and glucose there is substantial local depletion of both species and that their pools are replenished by increased regional cerebral blood flow. The transient initial rapid (10-13 s) decrease up to 20-34%, observed on a time scale comparable to that for neurotransmitter release, may be involved in a recently suggested astrocytic uptake for glutamate-stimulated aerobic glycolysis possibly needed to meet energy homeostasis in brain. These studies demonstrate the importance of microsensors in monitoring transient events linked to neuronal stimulation.
Can continuous glucose monitoring be used for the treatment of diabetes.
Reach, G; Wilson, G S
1992-03-15
In the case of the glucose sensor, clinicians and chemists must cooperate in interdisciplinary research to carefully define the analytical problem. Although not specifically discussed in this article, another group that must participate in this effort is engineers. Their expertise is needed to design the monitoring and control unit that contains the alarm and pump systems. The glucose sensor must operate reliably in an in vivo environment, provide the clinical information needed, and be easy to operate and manufacture.
Choleau, C; Klein, J C; Reach, G; Aussedat, B; Demaria-Pesce, V; Wilson, G S; Gifford, R; Ward, W K
2002-08-01
Calibration, i.e. the transformation in real time of the signal I(t) generated by the glucose sensor at time t into an estimation of glucose concentration G(t), represents a key issue for the development of a continuous glucose monitoring system. To compare two calibration procedures. In the one-point calibration, which assumes that I(o) is negligible, S is simply determined as the ratio I/G, and G(t) = I(t)/S. The two-point calibration consists in the determination of a sensor sensitivity S and of a background current I(o) by plotting two values of the sensor signal versus the concomitant blood glucose concentrations. The subsequent estimation of G(t) is given by G(t) = (I(t)-I(o))/S. A glucose sensor was implanted in the abdominal subcutaneous tissue of nine type 1 diabetic patients during 3 (n = 2) and 7 days (n = 7). The one-point calibration was performed a posteriori either once per day before breakfast, or twice per day before breakfast and dinner, or three times per day before each meal. The two-point calibration was performed each morning during breakfast. The percentages of points present in zones A and B of the Clarke Error Grid were significantly higher when the system was calibrated using the one-point calibration. Use of two one-point calibrations per day before meals was virtually as accurate as three one-point calibrations. This study demonstrates the feasibility of a simple method for calibrating a continuous glucose monitoring system.
NASA Astrophysics Data System (ADS)
Heise, H. Michael; Damm, Uwe; Kondepati, Venkata R.
2006-02-01
For clinical research, in-vivo blood glucose monitoring is an ongoing important topic to improve glycemic control in patients with non-adequate blood glucose regulation. Critically ill patients received much interest, since the intensive insulin therapy treatment, as established for diabetics, reduces mortality significantly. Despite the existence of commercially available, mainly amperometric biosensors, continued interest is in infrared spectroscopic techniques for reagent-free glucose monitoring. For stable long-term operation, avoiding also sensor recalibration, a bed-side device coupled to a micro-dialysis probe was developed for quasi-continuous glucose monitoring. Multivariate calibration is required for glucose concentration prediction due to the complex composition of dialysates from interstitial body fluid. Measurements were carried out with different test persons, each experiment lasting for more than 8 hours. Owing to low dialysis recovery rates, glucose concentrations in the dialysates were between 0.83 and 4.44 mM. Standard errors of prediction (SEP) obtained with Partial Least Squares (PLS) calibration and different cross-validation strategies were mainly between 0.13 and 0.18 mM based on either full interval data or specially selected spectral variables.
Mouthguard biosensor with telemetry system for monitoring of saliva glucose: A novel cavitas sensor.
Arakawa, Takahiro; Kuroki, Yusuke; Nitta, Hiroki; Chouhan, Prem; Toma, Koji; Sawada, Shin-Ichi; Takeuchi, Shuhei; Sekita, Toshiaki; Akiyoshi, Kazunari; Minakuchi, Shunsuke; Mitsubayashi, Kohji
2016-10-15
We develop detachable "Cavitas sensors" to apply to the human oral cavity for non-invasive monitoring of saliva glucose. A salivary biosensor incorporating Pt and Ag/AgCl electrodes on a mouthguard support with an enzyme membrane is developed and tested. Electrodes are formed on the polyethylene terephthalate glycol (PETG) surface of the mouthguard. The Pt working electrode is coated with a glucose oxidase (GOD) membrane. The biosensor seamlessly is integrated with a glucose sensor and a wireless measurement system. When investigating in-vitro performance, the biosensor exhibits a robust relationship between output current and glucose concentration. In artificial saliva composed of salts and proteins, the glucose sensor is capable of highly sensitive detection over a range of 5-1000µmol/L of glucose, which encompasses the range of glucose concentrations found in human saliva. We demonstrate the ability of the sensor and wireless communication module to monitor saliva glucose in a phantom jaw imitating the structure of the human oral cavity. Stable and long-term real-time monitoring (exceeding 5h) with the telemetry system is achieved. The mouthguard biosensor will be useful as a novel method for real-time non-invasive saliva glucose monitoring for better management of dental patients. Copyright © 2015 Elsevier B.V. All rights reserved.
Non-enzymatic electrochemical glucose sensor based on NiMoO4 nanorods
NASA Astrophysics Data System (ADS)
Wang, Dandan; Cai, Daoping; Huang, Hui; Liu, Bin; Wang, Lingling; Liu, Yuan; Li, Han; Wang, Yanrong; Li, Qiuhong; Wang, Taihong
2015-04-01
A non-enzymatic glucose sensor based on the NiMoO4 nanorods has been fabricated for the first time. The electrocatalytic performance of the NiMoO4 nanorods’ modified electrode toward glucose oxidation was evaluated by cyclic voltammetry and amperometry. The NiMoO4 nanorods’ modified electrode showed a greatly enhanced electrocatalytic property toward glucose oxidation, as well as an excellent anti-interference and a good stability. Impressively, good accuracy and high precision for detecting glucose concentration in human serum samples were obtained. These excellent sensing properties, combined with good reproducibility and low cost, indicate that NiMoO4 nanorods are a promising candidate for non-enzymatic glucose sensors.
Evaluating the accuracy and large inaccuracy of two continuous glucose monitoring systems.
Leelarathna, Lalantha; Nodale, Marianna; Allen, Janet M; Elleri, Daniela; Kumareswaran, Kavita; Haidar, Ahmad; Caldwell, Karen; Wilinska, Malgorzata E; Acerini, Carlo L; Evans, Mark L; Murphy, Helen R; Dunger, David B; Hovorka, Roman
2013-02-01
This study evaluated the accuracy and large inaccuracy of the Freestyle Navigator (FSN) (Abbott Diabetes Care, Alameda, CA) and Dexcom SEVEN PLUS (DSP) (Dexcom, Inc., San Diego, CA) continuous glucose monitoring (CGM) systems during closed-loop studies. Paired CGM and plasma glucose values (7,182 data pairs) were collected, every 15-60 min, from 32 adults (36.2±9.3 years) and 20 adolescents (15.3±1.5 years) with type 1 diabetes who participated in closed-loop studies. Levels 1, 2, and 3 of large sensor error with increasing severity were defined according to absolute relative deviation greater than or equal to ±40%, ±50%, and ±60% at a reference glucose level of ≥6 mmol/L or absolute deviation greater than or equal to ±2.4 mmol/L,±3.0 mmol/L, and ±3.6 mmol/L at a reference glucose level of <6 mmol/L. Median absolute relative deviation was 9.9% for FSN and 12.6% for DSP. Proportions of data points in Zones A and B of Clarke error grid analysis were similar (96.4% for FSN vs. 97.8% for DSP). Large sensor over-reading, which increases risk of insulin over-delivery and hypoglycemia, occurred two- to threefold more frequently with DSP than FSN (once every 2.5, 4.6, and 10.7 days of FSN use vs. 1.2, 2.0, and 3.7 days of DSP use for Level 1-3 errors, respectively). At levels 2 and 3, large sensor errors lasting 1 h or longer were absent with FSN but persisted with DSP. FSN and DSP differ substantially in the frequency and duration of large inaccuracy despite only modest differences in conventional measures of numerical and clinical accuracy. Further evaluations are required to confirm that FSN is more suitable for integration into closed-loop delivery systems.
Klueh, Ulrike; Czajkowski, Caroline; Ludzinska, Izabela; Qiao, Yi; Frailey, Jackman; Kreutzer, Donald L.
2016-01-01
The accumulation of macrophages (MΦ) at the sensor-tissue interface is thought to be a major player in controlling tissue reactions and sensor performance in vivo. Nevertheless until recently no direct demonstration of the causal relationship between MΦ aggregation and loss of sensor function existed. Using a Continuous Glucose Monitoring (CGM) murine model we previously demonstrated that genetic deficiencies of MΦ or depletion of MΦ decreased MΦ accumulation at sensor implantation sites, which led to significantly enhanced CGM performance, when compared to normal mice. Additional studies in our laboratories have also demonstrated that MΦ can act as “metabolic sinks” by depleting glucose levels at the implanted sensors in vitro and in vivo. In the present study we extended these observations by demonstrating that MΦ chemokine (CCL2) and receptor (CCR2) knockout mice displayed a decrease in inflammation and MΦ recruitment at sensor implantation sites, when compared to normal mice. This decreased MΦ recruitment significantly enhanced CGM performance when compared to control mice. These studies demonstrated the importance of the CCL2 family of chemokines and related receptors in MΦ recruitment and sensor performance and suggest chemokine targets for enhancing CGM in vivo. PMID:27376197
Garg, Satish K; Smith, James; Beatson, Christie; Lopez-Baca, Benita; Voelmle, Mary; Gottlieb, Peter A
2009-02-01
This study evaluated the accuracy and safety of two continuous glucose monitoring (CGM) systems, the SEVEN (DexCom, San Diego, CA) and the Navigator (Abbott Diabetes Care, Alameda, CA), with the YSI laboratory measurements of blood glucose (blood glucose meter manufactured by YSI, Yellow Springs, OH), when worn concurrently in adults with type 1 diabetes. Fourteen subjects with type 1 diabetes, 33 +/- 6 (mean +/- SD) years old, were enrolled in this study. All subjects wore both sensors concurrently over three consecutive 5-day CGM sessions (15-day wear). On Days 5, 10, and 15, subjects participated in an 8-h in-clinic session where measurements from the CGM systems were collected and compared with YSI measurements every 15 min. At the end of Day 5 and 10 in-clinic sessions, the sensors were removed, and new sensors were inserted for the following CGM session despite the SEVEN system's recommended use for up to 7 days. The mean absolute relative difference (ARD) for the two CGM devices versus YSI was not different: 16.8% and 16.1% for SEVEN and Navigator, respectively (P = 0.38). In the hypoglycemic region (YSI value <80 mg/dL), the mean ARD for SEVEN was lower than for Navigator (21.5% vs. 29.8%, respectively; P = 0.001). The data analyses were similar when compared with self-monitoring of blood glucose (SMBG) values. Thirteen additional Navigator replacement devices were issued compared to two for the SEVEN. A total of three versus 14 skin reactions were reported with the SEVEN and Navigator insertion area, respectively. Glucose measurements with the SEVEN and Navigator were found to be similar compared with YSI and SMBG measurements, with the exception of the hypoglycemic range where the SEVEN performed better. However, the Navigator caused more skin area reactions.
Analysis of glucose responses to automated insulin suspension with sensor-augmented pump therapy.
Ly, Trang T; Nicholas, Jennifer A; Retterath, Adam; Davis, Elizabeth A; Jones, Timothy W
2012-07-01
The advent of sensor-augmented pump therapy with a low-glucose suspend (LGS) function (Medtronic Paradigm Veo System), allowing insulin to be automatically suspended for up to 2 h when sensor glucose falls below a preset threshold, has the potential to reduce the duration of hypoglycemia. In this article, we analyzed blood glucose profiles following a full 2-h insulin suspension activated by the LGS function, as well as examined different patterns of use among patients. Data from a cohort of participants using the Veo System for up to 6 months were analyzed to determine the time and duration of insulin suspension activated by the LGS function. We further evaluated overnight suspend events with no patient response occurring prior to 3:00 a.m., which allowed us to determine the pattern of sensor glucose values with no patient intervention during and after the period of insulin suspension. There were 3,128 LGS events during the 2,493 days evaluated. The median duration was 11.2 min, and 36% of events occurred overnight. There were 126 full 2-h suspend events that occurred overnight with no patient response, occurring before 3:00 a.m. For these events, the mean sensor glucose at the end of the 2-h suspend period was 99 ± 6 mg/dL ([means ± SE] 5.5 ± 0.3 mmol/L). The mean sensor glucose 2 h after insulin delivery resumed was 155 ± 10 mg/dL (8.6 ± 0.6 mmol/L). There were no episodes of severe hypoglycemia or diabetic ketoacidosis. Analyses of sensor glucose patterns following insulin suspension activated by LGS suggest that this technology is safe and unlikely to be associated with adverse outcomes.
Pin-based electrochemical glucose sensor with multiplexing possibilities.
Rama, Estefanía C; Costa-García, Agustín; Fernández-Abedul, M Teresa
2017-02-15
This work describes the use of mass-produced stainless-steel pins as low-cost electrodes to develop simple and portable amperometric glucose biosensors. A potentiostatic three-electrode configuration device is designed using two bare pins as reference and counter electrodes, and a carbon-ink coated pin as working electrode. Conventional transparency film without any pretreatment is used to punch the pins and contain the measurement solution. The interface to the potentiostat is very simple since it is based on a commercial female connection. This electrochemical system is applied to glucose determination using a bienzymatic sensor phase (glucose oxidase/horseradish peroxidase) with ferrocyanide as electron-transfer mediator, achieving a linear range from 0.05 to 1mM. It shows analytical characteristics comparable to glucose sensors previously reported using conventional electrodes, and its application for real food samples provides good results. The easy modification of the position of the pins allows designing different configurations with possibility of performing simultaneous measurements. This is demonstrated through a specific design that includes four pin working-electrodes. Different concentrations of antibody labeled with alkaline phosphatase are immobilized on the pin-heads and after enzymatic conversion of 3-indoxylphosphate and silver nitrate, metallic silver is determined by anodic stripping voltammetry. Copyright © 2016 Elsevier B.V. All rights reserved.
Fang, Yuxin; Wang, Shenjun; Liu, Yangyang; Xu, Zhifang; Zhang, Kuo; Guo, Yi
2018-07-01
A minimally invasive glucose microbiosensor based the flexibly integrated electrode for continuous monitoring glucose in vivo has been developed in this study. This was achieved by coating needle-type microelectrode with Cu nanoflowers, nafion, glucose oxidase (GOD) and polyurethane (PU) membranes, successfully prepared with layer-by-layer deposition. The Cu nanomaterials provided a large specific surface area and electrocatalytic activity for glucose detection. The PU layers as mass-transport limiting membranes significantly enhanced the linearity and stability of sensors. The resulting biosensor exhibited a wide linear range of 0-20 mM, with a good sensitivity of 42.38 nA mM -1 (correlation coefficient r 2 was 0.99) and a fast response time of less than 15 s. In vivo implantable experiments using anesthetized rats showed excellent real-time response to the variation of blood glucose concentration. And the variation tendency of sensor output was consistent with that using the glucose meter. Overall, the results supported the suitability of this microsensor for measuring rapid changes of glucose in vivo. This work offers a promising approach in implantable device applications related to diabetes management as well as other medical diagnosis. Copyright © 2018 Elsevier B.V. All rights reserved.
A microfluidic glucose sensor incorporating a novel thread-based electrode system.
Gaines, Michelle; Gonzalez-Guerrero, Maria Jose; Uchida, Kathryn; Gomez, Frank A
2018-05-01
An electrochemical sensor for the detection of glucose using thread-based electrodes and fabric is described. This device is relatively simple to fabricate and can be used for multiple readings after washing with ethanol. The fabrication of the chip consisted of two steps. First, three thread-based electrodes (reference, working, and counter) were fabricated by painting pieces of nylon thread with either layered silver ink and carbon ink or silver/silver chloride ink. The threads were then woven into a fabric chip with a beeswax barrier molded around the edges in order to prevent leaks from the tested solutions. A thread-based working electrode consisting of one layer of silver underneath two layers of carbon was selected to fabricate the final sensor system. Using the chip, a PBS solution containing glucose oxidase (GOx) (10 mg/mL), potassium ferricyanide (K 3 [Fe(CN) 6 ]) (10 mg/mL) as mediator, and different concentrations of glucose (0-25 mM), was measured by cyclic voltammetry (CV). It was found that the current output from the oxidation of glucose was proportional to the glucose concentrations. This thread-based electrode system is a viable sensor platform for detecting glucose in the physiological range. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment.
2018-01-01
Type 1 diabetes is a condition in which the pancreas produces little or no insulin. People with type 1 diabetes must manage their blood glucose levels by monitoring the amount of glucose in their blood and administering appropriate amounts of insulin via injection or an insulin pump. Continuous glucose monitoring may be beneficial compared to self-monitoring of blood glucose using a blood glucose meter. It provides insight into a person's blood glucose levels on a continuous basis, and can identify whether blood glucose levels are trending up or down. We conducted a health technology assessment, which included an evaluation of clinical benefit, value for money, and patient preferences related to continuous glucose monitoring. We compared continuous glucose monitoring with self-monitoring of blood glucose using a finger-prick and a blood glucose meter. We performed a systematic literature search for studies published since January 1, 2010. We created a Markov model projecting the lifetime horizon of adults with type 1 diabetes, and performed a budget impact analysis from the perspective of the health care payer. We also conducted interviews and focus group discussions with people who self-manage their type 1 diabetes or support the management of a child with type 1 diabetes. Twenty studies were included in the clinical evidence review. Compared with self-monitoring of blood glucose, continuous glucose monitoring improved the percentage of time patients spent in the target glycemic range by 9.6% (95% confidence interval 8.0-11.2) to 10.0% (95% confidence interval 6.75-13.25) and decreased the number of severe hypoglycemic events.Continuous glucose monitoring was associated with higher costs and small increases in health benefits (quality-adjusted life-years). Incremental cost-effectiveness ratios (ICERs) ranged from $592,206 to $1,108,812 per quality-adjusted life-year gained in analyses comparing four continuous glucose monitoring interventions to usual care
Hirsch, Irl B; Verderese, Carol A
2017-11-01
Recent consensus statements strongly advocate downloading and interpreting continuous glucose data for diabetes management in patients with type 1 or 2 diabetes. Supplementing periodic glycated hemoglobin (A1C) testing with intermittent continuous glucose monitoring (CGM) using a standardized report form known as the ambulatory glucose profile (AGP) is an evolving standard of care. The rationale for this approach and its implementation with a recently approved novel monitoring technology are explored. Search of the medical literature, professional guidelines, and real-world evidence guided this introduction of an integrative practice framework that uses AGP in conjunction with intermittent flash continuous glucose monitoring (FCGM) as a supplement to A1C testing. The combination of intermittent continuous glucose pattern analysis, standardized glucose metrics, and a readily interpretable data report has the potential to practically extend the recognized benefits of CGM to more patients and clarify the relationship between A1C and average glucose levels in individual cases. Novel FCGM technologies portend greater use of continuous forms of glucose monitoring and wider adoption of AGP report analysis. Additional formal and empirical evidence is needed to more fully characterize best practice. A1C = glycated hemoglobin; AGP = ambulatory glucose profile; CGM = continuous glucose monitoring; FCGM = flash continuous glucose monitoring; IQR = interquartile range; SMBG = self-monitoring of blood glucose.
El Awwa, A; Soliman, A; Al-Ali, M; Yassin, M; De Sanctis, V
2012-09-01
In obese adolescents pancreatic beta-cells may not be able to cope with insulin resistance leading to hyperglycemia and type2 diabetes (T2DM To assess oral glucose tolerance, 72-h continuous blood glucose concentrations (CGM) and calculate homeostatic model assessment (HOMA), and the quantitative insulin sensitivity check index (QUICKI) in 13 adolescents with simple obesity (BMI SDS=4 ± 1.06). OGTT performed in 13 obese adolescents (13.47 ± 3 years) revealed 3 cases (23%) with impaired fasting glucose (IFG: fasting glucose >5.6 mmol/L), 4 cases (30%) with impaired glucose tolerance (IGT: 2h blood glucose >7.8 <11.1 mmol/L), and none with diabetes. Using the continuous glucose monitoring system ( CGMS), IFG was detected in 4 cases, the maximum serum blood glucose (BG : 2h or more after meal) was >7.8 and <11.1 mmol/L (IGT) in 9 children (69%) and >11.1 mmol/L (diabetes) in one case (7.6%). Five cases had a minimum BG recorded of <2.7 mmol/L (hypoglycemia). No glycemic abnormality was detected using HbA1C (5.7 ± 0.3%). 11/13 patients had HOMA values >2.6 and QUICKI values <0.35 denoting insulin resistance. Beta cell mass percent (B %) = 200 ± 94.8% and insulin sensitivity values (IS)=50.4 ± 45.5% denoted insulin resistance with hyper-insulinaemia and preserved beta cell mass. In obese adolescents, CGMS is superior to OGTT and HbA1C in detecting glycemic abnormalities, which appears to be secondary to insulin resistance.
Liu, Lin; Lv, Hongying; Teng, Zhenyuan; Wang, Chengyin; Wang, Guoxiu
2015-01-01
This review presents a comprehensive attempt to conclude and discuss various glucose biosensors based on core@shell magnetic nanomaterials. Owing to good biocompatibility and stability, the core@shell magnetic nanomaterials have found widespread applications in many fields and draw extensive attention. Most magnetic nanoparticles possess an intrinsic enzyme mimetic activity like natural peroxidases, which invests magnetic nanomaterials with great potential in the construction of glucose sensors. We summarize the synthesis of core@shell magnetic nanomaterials, fundamental theory of glucose sensor and the advances in glucose sensors based on core@shell magnetic nanomaterials. The aim of the review is to provide an overview of the exploitation of the core@shell magnetic nanomaterials for glucose sensors construction.
Picard, Sylvie; Hanaire, Hélène; Baillot-Rudoni, Sabine; Gilbert-Bonnemaison, Elisabeth; Not, Didier; Reznik, Yves; Guerci, Bruno
2016-03-01
Continuous glucose monitoring (CGM) and sensor-augmented pump (SAP) therapy improve glucose control provided good adherence. In France, not only diabetologists, nurses, and dieticians but also nurses employed by homecare providers (HCPNs) are together involved in the initiation and/or follow-up of continuous subcutaneous insulin injection (CSII) and SAP training. The SENLOCOR Study is an observational study designed to assess SAP adherence over 6 months (primary objective). Secondary objectives included the impact of SAP on metabolic control and patients' satisfaction. CGM initiation (M0) was performed within 3 months after CSII. CGM adherence, defined by sensor wear >70% of the time, glycated hemoglobin (HbA1c) levels, and satisfaction questionnaires were collected at inclusion and at 3 (M3) and 6 (M6) months. The analysis population was 234 patients, including 27 children. Of the physicians, 88.0% were involved in SAP education for the whole cohort (median time, 45 min), whereas HCPNs were involved in CGM training for 190 patients (81.2%) (median time: at M0, 156 min; at M3, 20 min). Good adherence was obtained in 86.1% (M0-M3) and 68.9% (M3-M6) of the patients. The HbA1c level decreased from 8.16 ± 1.35% (M0) to 7.67 ± 1.01% (M6) in 189 patients (change, -0.48%; 95% confidence interval, -0.64, -0.33). The percentage of patients who experienced severe hypoglycemia decreased from 20.7% (M0) to 13.6% (M3) and 13.3% (M6). Satisfaction scores were high. In patients with type 1 diabetes, a 6-month training on SAP involving a multidisciplinary team, and especially HCPNs, improved metabolic control with a high level of adherence and satisfaction.
Continuous glucose monitoring systems for type 1 diabetes mellitus.
Langendam, Miranda; Luijf, Yoeri M; Hooft, Lotty; Devries, J Hans; Mudde, Aart H; Scholten, Rob J P M
2012-01-18
Self-monitoring of blood glucose is essential to optimise glycaemic control in type 1 diabetes mellitus. Continuous glucose monitoring (CGM) systems measure interstitial fluid glucose levels to provide semi-continuous information about glucose levels, which identifies fluctuations that would not have been identified with conventional self-monitoring. Two types of CGM systems can be defined: retrospective systems and real-time systems. Real-time systems continuously provide the actual glucose concentration on a display. Currently, the use of CGM is not common practice and its reimbursement status is a point of debate in many countries. To assess the effects of CGM systems compared to conventional self-monitoring of blood glucose (SMBG) in patients with diabetes mellitus type 1. We searched The Cochrane Library, MEDLINE, EMBASE and CINAHL for the identification of studies. Last search date was June 8, 2011. Randomised controlled trials (RCTs) comparing retrospective or real-time CGM with conventional self-monitoring of blood glucose levels or with another type of CGM system in patients with type 1 diabetes mellitus. Primary outcomes were glycaemic control, e.g. level of glycosylated haemoglobin A1c (HbA1c) and health-related quality of life. Secondary outcomes were adverse events and complications, CGM derived glycaemic control, death and costs. Two authors independently selected the studies, assessed the risk of bias and performed data-extraction. Although there was clinical and methodological heterogeneity between studies an exploratory meta-analysis was performed on those outcomes the authors felt could be pooled without losing clinical merit. The search identified 1366 references. Twenty-two RCTs meeting the inclusion criteria of this review were identified. The results of the meta-analyses (across all age groups) indicate benefit of CGM for patients starting on CGM sensor augmented insulin pump therapy compared to patients using multiple daily injections of
Strauss, A; Tiurbe, C; Chodnevskaja, I; Thiede, A; Timm, S; Ulrichs, K; Moskalenko, V
2008-03-01
Adult pig islet isolation has greatly improved in the past few years. Islet grafts may now be tested in large animals. Continuous Glucose Monitoring System (CGMS) was applied to diabetic Goettingen Minipigs (GMP) to improve the management of hyperglycemia and hypoglycemia and their welfare before transplantation. GMP (25-35 kg) received a minipig diet once daily. Diabetes was induced by streptozotocin (STZ; 150 mg/kg intravenous [IV]; n = 5) or by surgical pancreatectomy (PGMP; n = 3). Interstitial glucose concentration (IGC) was monitored continuously with an implanted sensor; CGMS was calibrated using conventional blood glucose tests 3-4 times per day; CGMS data were fed into the monitor memory and analyzed using CGMS software. Glucose sensors were handled accurately. Diabetes occurred 2-3 days after STZ or immediately after pancreatectomy with basal C-peptide secretion of <0.4 ng/mL (measured using intravenous glucose tolerance test) and prompt loss of body weight. Insulin substitution was necessary to keep the GMP in good condition for up to 5-6 months, with stable body weight and normal behavior. Some GMP became hypoglycemic, which was only documented by CGMS, but not by conventional glucose assays. Tight glucose control and substitution of exocrine enzymes (Creon 25,000 E/d) reduced morbidity of the PGMP, which was then comparable with that of STZ-GMP. The CGMS, developed for humans, is equally suitable for the 2 GMP diabetes models. Close-meshed glucose monitoring and insulin treatment improved the general condition of the diabetic GMP, ie, the islet graft recipients, and will thus greatly add to posttransplantation success.
Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment
Vandersluis, Stacey; Kabali, Conrad; Djalalov, Sandjar; Gajic-Veljanoski, Olga; Wells, David; Holubowich, Corinne
2018-01-01
Background Type 1 diabetes is a condition in which the pancreas produces little or no insulin. People with type 1 diabetes must manage their blood glucose levels by monitoring the amount of glucose in their blood and administering appropriate amounts of insulin via injection or an insulin pump. Continuous glucose monitoring may be beneficial compared to self-monitoring of blood glucose using a blood glucose meter. It provides insight into a person's blood glucose levels on a continuous basis, and can identify whether blood glucose levels are trending up or down. Methods We conducted a health technology assessment, which included an evaluation of clinical benefit, value for money, and patient preferences related to continuous glucose monitoring. We compared continuous glucose monitoring with self-monitoring of blood glucose using a finger-prick and a blood glucose meter. We performed a systematic literature search for studies published since January 1, 2010. We created a Markov model projecting the lifetime horizon of adults with type 1 diabetes, and performed a budget impact analysis from the perspective of the health care payer. We also conducted interviews and focus group discussions with people who self-manage their type 1 diabetes or support the management of a child with type 1 diabetes. Results Twenty studies were included in the clinical evidence review. Compared with self-monitoring of blood glucose, continuous glucose monitoring improved the percentage of time patients spent in the target glycemic range by 9.6% (95% confidence interval 8.0–11.2) to 10.0% (95% confidence interval 6.75–13.25) and decreased the number of severe hypoglycemic events. Continuous glucose monitoring was associated with higher costs and small increases in health benefits (quality-adjusted life-years). Incremental cost-effectiveness ratios (ICERs) ranged from $592,206 to $1,108,812 per quality-adjusted life-year gained in analyses comparing four continuous glucose monitoring
Ramachandran, K.; Raj kumar, T.; Babu, K. Justice; Gnana kumar, G.
2016-01-01
The facile, time and cost efficient and environmental benign approach has been developed for the preparation of Nickel (Ni)-Cobalt (Co) alloy nanowires filled multiwalled carbon nanotubes (MWCNTs) with the aid of mesoporous silica nanoparticles (MSN)/Ni-Co catalyst. The controlled incorporation of Ni-Co nanostructures in the three dimensional (3D) pore structures of MSN yielded the catalytically active system for the MWCNT growth. The inner surface of MWCNTs was quasi-continuously filled with face-centered cubic (fcc) structured Ni-Co nanowires. The as-prepared nanostructures were exploited as non-enzymatic electrochemical sensor probes for the reliable detection of glucose. The electrochemical measurements illustrated that the fabricated sensor exhibited an excellent electrochemical performance toward glucose oxidation with a high sensitivity of 0.695 mA mM−1 cm−2, low detection limit of 1.2 μM, a wide linear range from 5 μM–10 mM and good selectivity. The unprecedented electrochemical performances obtained for the prepared nanocomposite are purely attributed to the synergistic effects of Ni-Co nanowires and MWCNTs. The constructed facile, selective and sensitive glucose sensor has also endowed its reliability in analyzing the human serum samples, which wide opened the new findings for exploring the novel nanostructures based glucose sensor devices with affordable cost and good stability. PMID:27833123
NASA Astrophysics Data System (ADS)
Ramachandran, K.; Raj Kumar, T.; Babu, K. Justice; Gnana Kumar, G.
2016-11-01
The facile, time and cost efficient and environmental benign approach has been developed for the preparation of Nickel (Ni)-Cobalt (Co) alloy nanowires filled multiwalled carbon nanotubes (MWCNTs) with the aid of mesoporous silica nanoparticles (MSN)/Ni-Co catalyst. The controlled incorporation of Ni-Co nanostructures in the three dimensional (3D) pore structures of MSN yielded the catalytically active system for the MWCNT growth. The inner surface of MWCNTs was quasi-continuously filled with face-centered cubic (fcc) structured Ni-Co nanowires. The as-prepared nanostructures were exploited as non-enzymatic electrochemical sensor probes for the reliable detection of glucose. The electrochemical measurements illustrated that the fabricated sensor exhibited an excellent electrochemical performance toward glucose oxidation with a high sensitivity of 0.695 mA mM-1 cm-2, low detection limit of 1.2 μM, a wide linear range from 5 μM-10 mM and good selectivity. The unprecedented electrochemical performances obtained for the prepared nanocomposite are purely attributed to the synergistic effects of Ni-Co nanowires and MWCNTs. The constructed facile, selective and sensitive glucose sensor has also endowed its reliability in analyzing the human serum samples, which wide opened the new findings for exploring the novel nanostructures based glucose sensor devices with affordable cost and good stability.
Enzymatic and non-enzymatic electrochemical glucose sensor based on carbon nano-onions
NASA Astrophysics Data System (ADS)
Mohapatra, Jeotikanta; Ananthoju, Balakrishna; Nair, Vishnu; Mitra, Arijit; Bahadur, D.; Medhekar, N. V.; Aslam, M.
2018-06-01
A high sensitive glucose sensing characteristic has been realized in carbon nano-onions (CNOs). The CNOs of mean size 30 nm were synthesized by an energy-efficient, simple and inexpensive combustion technique. These as-synthesized CNOs could be employed as an electrochemical sensor by covalently immobilizing the glucose oxidase enzyme on them via carbodiimide chemistry. The sensitivity achieved by such a sensor is 26.5 μA mM-1 cm-2 with a linear response in the range of 1-10 mM glucose. Further to improve the catalytic activity of the CNOs and also to make them enzyme free, platinum nanoparticles of average size 2.5 nm are decorated on CNOs. This sensor fabricated using Pt-decorated CNOs (Pt@CNOs) nanostructure has shown an enhanced sensitivity of 21.6 μA mM-1 cm-2 with an extended linear response in the range of 2-28 mM glucose. Through these attempts we demonstrate CNOs as a versatile biosensing platform.
Aernouts, Ben; Sharma, Sandeep; Gellynck, Karolien; Vlaminck, Lieven; Cornelissen, Maria; Saeys, Wouter
2016-10-01
Near-infrared (NIR) spectroscopy offers a promising technological platform for continuous glucose monitoring in the human body. Moreover, these measurements could be performed in vivo with an implantable single-chip based optical sensor. However, a thin tissue layer may grow in the optical path of the sensor. As most biological tissues are highly scattering, they only allow a small fraction of the collimated light to pass, significantly reducing the light throughput. To quantify the effect of a thin tissue layer in the optical path, the bulk optical properties of serum and tissue samples grown on implanted dummy sensors were characterized using double integrating sphere and unscattered transmittance measurements. The estimated bulk optical properties were then used to calculate the light attenuation through a thin tissue layer. The combination band of glucose was found to be the better option, relative to the first overtone band, as the absorptivity of glucose molecules is higher, while the reduction in unscattered transmittance due to tissue growth is less. Additionally, as the wound tissue was found to be highly scattering, the unscattered transmittance of the tissue layer is expected to be very low. Therefore, a sensor configuration which measures the diffuse transmittance and/or reflectance instead was recommended. (a) Dummy sensor; (b) explanted dummy sensor in tissue lump; (c) removal of dummy sensor from tissue lump; and (d) 900 µm slices of tissue lump. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Heinrich, Gabriel; Breen, Matthew; Benware, Sheila; Vollum, Nicole; Morris, Kristin; Knutsen, Chad; Kowalski, Joseph D.; Campbell, Scott; Biehler, Jerry; Vreeke, Mark S.; Vanderwerf, Scott M.; Castle, Jessica R.; Cargill, Robert S.
2017-01-01
Abstract Background: Labeling prohibits delivery of insulin at the site of subcutaneous continuous glucose monitoring (CGM). Integration of the sensing and insulin delivery functions into a single device would likely increase the usage of CGM in persons with type 1 diabetes. Methods: To understand the nature of such interference, we measured glucose at the site of bolus insulin delivery in swine using a flexible electrode strip that was laminated to the outer wall of an insulin delivery cannula. In terms of sensing design, we compared H2O2-measuring sensors biased at 600 mV with redox mediator-type sensors biased at 175 mV. Results: In H2O2-measuring sensors, but not in sensors with redox-mediated chemistry, a spurious rise in current was seen after insulin lis-pro boluses. This prolonged artifact was accompanied by electrode poisoning. In redox-mediated sensors, the patterns of sensor signals acquired during delivery of saline and without any liquid delivery were similar to those acquired during insulin delivery. Conclusion: Considering in vitro and in vivo findings together, it became clear that the mechanism of interference is the oxidation, at high bias potentials, of phenolic preservatives present in insulin formulations. This effect can be avoided by the use of redox mediator chemistry using a low bias potential. PMID:28221814
NASA Astrophysics Data System (ADS)
Lin, Jing-Jenn; Wu, You-Lin; Hsu, Po-Yen
2007-10-01
In this paper, we present a novel dry-type glucose sensor based on a metal-oxide-semiconductor capacitor (MOSC) structure using SiO2 as a gate dielectric in conjunction with a horseradish peroxidase (HRP) + glucose oxidase (GOD) catalyzing layer. The tested glucose solution was dropped directly onto the window opened on the SiO2 layer, with a coating of HRP + GOD catalyzing layer on top of the gate dielectric. From the capacitance-voltage (C-V) characteristics of the sensor, we found that the glucose solution can induce an inversion layer on the silicon surface causing a gate leakage current flowing along the SiO2 surface. The gate current changes Δ I before and after the drop of glucose solution exhibits a near-linear relationship with increasing glucose concentration. The Δ I sensitivity is about 1.76 nA cm-2 M-1, and the current is quite stable 20 min after the drop of the glucose solution is tested.
Accuracy of the Enlite 6-day glucose sensor with guardian and Veo calibration algorithms.
Keenan, Desmond Barry; Mastrototaro, John Joseph; Zisser, Howard; Cooper, Kenneth A; Raghavendhar, Gautham; Lee, Scott W; Yusi, Jonathan; Bailey, Timothy S; Brazg, Ronald Leonard; Shah, Rajiv V
2012-03-01
This study investigates the accuracy of a newly developed, next-generation subcutaneous glucose sensor, evaluated for 6-day use. Seventy-nine subjects (53 men, 26 women) with type 1 diabetes and 18 subjects (14 men, four women) with type 2 diabetes completed a three-center, prospective, sensor accuracy study. The mean age for the group was 42.2±15.0 years (mean±SD), ranging from 18 to 71 years, with a mean glycosylated hemoglobin level of 7.6±1.5%, ranging from 5.5% to 14%. Subjects wore Enlite™ sensors (Medtronic Diabetes, Northridge, CA) in the abdominal and buttocks region for two separate 7-day periods and calibrated with a home-use blood glucose meter. Subjects participated in an in-clinic testing day where frequent sampled plasma glucose samples were acquired every 15 min for 10 h. Sensor data was retrospectively processed with Guardian(®) REAL-Time (Medtronic) and Paradigm(®) Veo™ (Medtronic) calibration routines, and accuracy metrics were calculated for each algorithm and sensor location. Physiological time lag for each measurement site was calculated. Based on 6,404 plasma-sensor glucose paired points, the Enlite sensor with Veo calibration algorithm produced a mean absolute relative difference of 13.86% with 97.3% of points within the A+B zones of the Clarke error grid. Threshold-only alarms detected 90.1% of hypoglycemia and 90% of hyperglycemia. Mean time lag measured at the abdominal region was 7.94±6.48 min compared with 11.70±6.71 min (P<0.0001) at the buttocks area. The Enlite sensor accurately measures glucose when compared with gold standard laboratory measurements over its 6-day use. Sensors placed in the buttocks region exhibited greater time lags than sensors placed in the abdomen.
Matsumoto, T; Saito, S; Ikeda, S
2006-03-23
This paper reports on a multilayer membrane amperometric glucose sensor fabricated using planar techniques. It is characterized by good reproducibility and suitable for large-scale production. The glucose sensor has 82 electrode sets formed on a single glass substrate, each with a platinum working electrode (WE), a platinum counter electrode (CE) and an Ag/AgCl reference electrode (RE). The electrode sets are coated with a membrane consisting of five layers: gamma-aminopropyltriethoxysilane (gamma-APTES), Nafion, glucose oxidase (GOX), gamma-APTES and perfluorocarbon polymer (PFCP), in that order. Tests have shown that the sensor has acceptably low dispersion (relative standard deviation, R.S.D.=42.9%, n=82), a wide measurement range (1.11-111 mM) and measurement stability over a 27-day period. Measurements of the glucose concentration in a control human urine sample demonstrated that the sensor has very low dispersion (R.S.D.=2.49%, n=10).
Li, Jiang; Koinkar, Pankaj; Fuchiwaki, Yusuke; Yasuzawa, Mikito
2016-12-15
A low invasive type glucose sensor, which has a sensing region at the tip of a fine pointed electrode, was developed for continuous glucose monitoring. Platinum-iridium alloy electrode with a surface area of 0.045mm(2) was settled at the middle of pointed PEEK (Polyetheretherketone) tubing and was employed as sensing electrode. Electrodeposition of glucose oxidase in the presence of surfactant, Triton X-100, was performed for high-density enzyme immobilization followed by the electropolymerization of o-phenylenediamine for the formation of functional entrapping and permselective polymer membrane. Ag/AgCl film was coated on the surface of PEEK tubing as reference electrode. Amperometric responses of the prepared sensors to glucose were measured at a potential of 0.60V (vs. Ag/AgCl). The prepared electrode showed the sensitivity of 2.55μA/cm(2) mM with high linearity of 0.9986, within the glucose concentration range up to 21mM. The detection limit (S/N=3) was determined to be 0.11mM. The glucose sensor properties were evaluated in phosphate buffer solution and in vivo monitoring by the implantation of the sensors in rabbit, while conventional needle type sensors as a reference were used. The results showed that change in output current of the proposed sensor fluctuated similar with one in output current of the conventional needle type sensors, which was also in similar accordance with actual blood sugar level measured by commercially glucose meter. One-point calibration method was used to calibrate the sensor output current. Copyright © 2016 Elsevier B.V. All rights reserved.
Novak, Matthew T.; Yuan, Fan; Reichert, William M.
2013-01-01
Background Tissue response to indwelling glucose sensors remains a confounding barrier to clinical application. While the effects of fully formed capsular tissue on sensor response have been studied, little has been done to understand how tissue interactions occurring before capsule formation hinder sensor performance. Upon insertion in subcutaneous tissue, the sensor is initially exposed to blood, blood borne constituents, and interstitial fluid. Using human whole blood as a simple ex vivo experimental system, the effects of protein accumulation at the sensor surface (biofouling effects) and cellular consumption of glucose in both the biofouling layer and in the bulk (metabolic effects) on sensor response were assessed. Methods Medtronic MiniMed SofSensor glucose sensors were incubated in whole blood, plasma-diluted whole blood, and cell-free platelet-poor plasma (PPP) to analyze the impact of different blood constituents on sensor function. Experimental conditions were then simulated using MATLAB to predict the relative impacts of biofouling and metabolic effects on the observed sensor responses. Results Protein biofouling in PPP in both the experiments and the simulations was found to have no interfering effect upon sensor response. Experimental results obtained with whole and dilute blood showed that the sensor response was markedly affected by blood borne glucose-consuming cells accumulated in the biofouling layer and in the surrounding bulk. Conclusions The physical barrier to glucose transport presented by protein biofouling does not hinder glucose movement to the sensor surface, and the consumption of glucose by inflammatory cells, and not erythrocytes, proximal to the sensor surface has a substantial effect on sensor response and may be the main culprit for anomalous sensor behavior immediately following implantation. PMID:24351181
[From insulin pump and continuous glucose monitoring to the artificial pancreas].
Apablaza, Pamela; Soto, Néstor; Codner, Ethel
2017-05-01
Technology for diabetes care has undergone major development during recent decades. These technological advances include continuous subcutaneous insulin infusion (CSII), also known as insulin pumps, and real-time continuous glucose monitoring system (RT-CGMS). The integration of CSII and RT-CGMS into a single device has led to sensor-augmented pump therapy and more recently, a technology that has automated delivery of basal insulin therapy, known as hybrid system. These new technologies have led to benefits in attaining better metabolic control and decreasing the incidence of severe hypoglycemia, especially in patients with type 1 diabetes. This review describes the types of technologies currently available or under investigation for these purposes, their benefits and disadvantages, recommendations and the appropriate patient selection for their use. The clinical use of the hybrid system and artificial pancreas seem to be possible in the near future.
Carbon nanotube mat as mediator-less glucose sensor electrode.
Ryu, Jongeun; Kim, Hansang; Lee, Sangeui; Hahn, H Thomas; Lashmore, David
2010-02-01
In this paper, the direct electron transfer of glucose oxidase (GOx) on carbon nanotube (CNT) mat electrode is demonstrated. Because of the electrical conductivity and mechanical strength of CNT mat, it can be used as an electrode as well as a catalyst support. Therefore, the preparation process for the CNT mat based sensor electrode is simpler than that of the conventional CNT dispersed sensor electrodes. GOx was covalently immobilized on the oxidized CNT mat, which is connected to a wire by using silver paste and epoxy glue. Attenuated Total Reflectance Fourier Transform-Infrared (ATR-FTIR) result shows transmittance peaks at 1637 cm(-1) and 1525 cm(-1) which are corresponding to the band I and II of amide. Cyclic voltammetric shows a pair of well-defined redox peaks with the average formal potential of -0.425 V (vs. Ag/AgCl reference electrode) in the phosphate buffered saline solution (1 x PBS, pH 7.4). Calculated electron transfer rate constant and the surface density of GOx were 1.71 s(-1) and (3.27 +/- 0.20) x 10(-13) mol/cm2, respectively. Cyclic voltammograms of GOx-CNT mat in glucose solution show that the immobilized GOx retains its catalytic activity to glucose. The amperometric sensor response showed a linear dependence on the glucose concentration in the range of 0.2 mM to 2.18 mM with a detection sensitivity of 4.05 microA mM(-1) cm(-2). The Michaelis-Menten constant of the immobilized GOx was calculated to be 2.18 mM.
Wang, Lanfang; Zhu, Weiqi; Lu, Wenbo; Qin, Xiufang; Xu, Xiaohong
2018-07-15
A novel plasmon aided non-enzymatic glucose sensor was first constructed based on the unique half-rough Au/NiAu multilayered nanowire arrays. These multilayered and half-rough nanowires provide high chemical activity and large surface area for glucose oxidation in an alkaline solution. Under visible light irradiation, the surface plasmons originated from Au part enhance the electron transfer in the vertically aligned nanowires, leading to high sensitivity and wide detection range. The resulting sensor exhibits a wide glucose detection concentration range, low detection limit, and high sensitivity for plasmon aided non-enzymatic glucose sensor. Moreover, the detection sensitivity is enhanced by almost 2 folds compared to that in the dark, which significantly enhanced the performance of Au/NiAu multilayered nanowire arrays sensor. An excellent selectivity and acceptable stability were also achieved. These results indicate that surface plasmon aided nanostructures are promising new platforms for the construction of non-enzymatic glucose sensors. Copyright © 2018 Elsevier B.V. All rights reserved.
A high-performance nonenzymatic glucose sensor made of CuO-SWCNT nanocomposites.
Quoc Dung, Nguyen; Patil, Dewyani; Jung, Hyuck; Kim, Dojin
2013-04-15
Nanocomposites of CuO and single-wall carbon nanotubes (SWCNTs) were synthesized using an arc-discharging graphite rod that contained copper wires. Simultaneous arc discharges produced a CuO-SWCNT composite network. The crystalline structure and morphology of the CuO-SWCNT composite films were investigated using XRD, Raman spectroscopy, FE-SEM and TEM. The electrochemical properties were investigated by cyclic voltammogram and amperometric measurements in a 0.1 M NaOH solution. The CuO content in the CuO-SWCNT nanocomposites was optimized for nonenzymatic glucose detection. The glucose sensing properties of the optimized CuO-SWCNT electrode showed good stability, selectivity, and linear glucose detection that ranged from 0.05 to 1800 μM with a higher sensitivity of 1610 μA cm⁻² mM⁻¹, a quick response time of 1-2 s, and the lowest limit of detection at 50 nM. The sensing performance was better than the pure CuO and SWCNT sensors, and the synergetic effect of the composite sensor was attributed to the high conductivity network of highly porous nanowires. The sensor also showed a good response in a human serum sample, which proves its high potential towards a commercial nonenzymatic glucose sensor. Copyright © 2012 Elsevier B.V. All rights reserved.
An ENG resonator-based microwave sensor for the characterization of aqueous glucose
NASA Astrophysics Data System (ADS)
Kumari, Ratnesh; Patel, Piyush N.; Yadav, Rahul
2018-02-01
This work proposes a microwave filter with a notched frequency of transmission using an epsilon negative (ENG) unit-cell resonator as a sensor device. The device finds important application for the characterization of life-saving samples such as glucose. The ENG structure consists of two complementary geometries in the shape of ring and horn. The structure efficiently inhibits the incoming RF signal and creates a stopband resonance at 2.074 GHz. The printed circuit board of the layout was realized using FR-4 substrate of relative permittivity ɛ r = 4.4, and height of 1.6 mm. It is experimentally seen that in the complementary area of horn and circular ring, the glucose sample perturbs the air-dielectric fringing fields which exist over the complementary area and modifies the frequency of stopband resonance. A change in sensor resonance was recorded and calibrated for different concentrations of glucose sample. The sensor exhibits a linear response for glucose concentration ranging from 20 to 100 mg ml-1 in the sensing area.
Sharifi, Amin; Varsavsky, Andrea; Ulloa, Johanna; Horsburgh, Jodie C.; McAuley, Sybil A.; Krishnamurthy, Balasubramanian; Jenkins, Alicia J.; Colman, Peter G.; Ward, Glenn M.; MacIsaac, Richard J.; Shah, Rajiv; O’Neal, David N.
2015-01-01
Background: Current electrochemical glucose sensors use a single electrode. Multiple electrodes (redundancy) may enhance sensor performance. We evaluated an electrochemical redundant sensor (ERS) incorporating two working electrodes (WE1 and WE2) onto a single subcutaneous insertion platform with a processing algorithm providing a single real-time continuous glucose measure. Methods: Twenty-three adults with type 1 diabetes each wore two ERSs concurrently for 168 hours. Post-insertion a frequent sampling test (FST) was performed with ERS benchmarked against a glucose meter (Bayer Contour Link). Day 4 and 7 FSTs were performed with a standard meal and venous blood collected for reference glucose measurements (YSI and meter). Between visits, ERS was worn with capillary blood glucose testing ≥8 times/day. Sensor glucose data were processed prospectively. Results: Mean absolute relative deviation (MARD) for ERS day 1-7 (3,297 paired points with glucose meter) was (mean [SD]) 10.1 [11.5]% versus 11.4 [11.9]% for WE1 and 12.0 [11.9]% for WE2; P < .0001. ERS Clarke A and A+B were 90.2% and 99.8%, respectively. ERS day 4 plus day 7 MARD (1,237 pairs with YSI) was 9.4 [9.5]% versus 9.6 [9.7]% for WE1 and 9.9 [9.7]% for WE2; P = ns. ERS day 1-7 precision absolute relative deviation (PARD) was 9.9 [3.6]% versus 11.5 [6.2]% for WE1 and 10.1 [4.4]% for WE2; P = ns. ERS sensor display time was 97.8 [6.0]% versus 91.0 [22.3]% for WE1 and 94.1 [14.3]% for WE2; P < .05. Conclusions: Electrochemical redundancy enhances glucose sensor accuracy and display time compared with each individual sensing element alone. ERS performance compares favorably with ‘best-in-class’ of non-redundant sensors. PMID:26499476
Assessment of hypoglycaemia awareness using continuous glucose monitoring.
Kubiak, T; Hermanns, N; Schreckling, H J; Kulzer, B; Haak, T
2004-05-01
To investigate the possibility of assessing hypoglycaemia awareness in patients with Type 1 diabetes using continuous glucose monitoring. Twenty patients with Type 1 diabetes were investigated. Ten patients with Type 1 diabetes and strongly impaired hypoglycaemia awareness were compared with 10 patients with intact hypoglycaemia awareness regarding quality of hypoglycaemia perception (number of undetected hypoglycaemic episodes per 24 h, glucose level < 3.3 mmol/l). Hypoglycaemia detection was assessed using the event function of the Continuous Glucose Monitoring System (CGMS; Medtronic MiniMed, Northridge, CA, USA). Patients were instructed to enter an event upon suspecting being hypoglycaemic. Satisfactory CGMS performance could be achieved [mean r = 0.893 between calibration measurements and CGMS data, mean absolute difference (MAD) = 20.6%], although artefacts were observable and had to be controlled. Hypoglycaemia unaware patients showed a significantly higher total number of hypoglycaemic episodes (P < 0.05), number of undetected hypoglycaemic episodes (P < 0.01), and mean glucose levels (P < 0.05). Even in aware patients, undetected hypoglycaemia was observable. No significant differences regarding occurrence of nocturnal hypoglycaemia were observable. The possibility of direct assessment of hypoglycaemia awareness using continuous glucose monitoring was demonstrated. Its application in clinical practice could be of use for assessing hypoglycaemia perception and evaluating the impact of treatment changes on hypoglycaemia awareness.
Accuracy of a continuous glucose monitoring system in dogs and cats with diabetic ketoacidosis.
Reineke, Erica L; Fletcher, Daniel J; King, Lesley G; Drobatz, Kenneth J
2010-06-01
(1) To determine the ability of a continuous interstitial glucose monitoring system (CGMS) to accurately estimate blood glucose (BG) in dogs and cats with diabetic ketoacidosis. (2) To determine the effect of perfusion, hydration, body condition score, severity of ketosis, and frequency of calibration on the accuracy of the CGMS. Prospective study. University Teaching Hospital. Thirteen dogs and 11 cats diagnosed with diabetic ketoacidosis were enrolled in the study within 24 hours of presentation. Once BG dropped below 22.2 mmol/L (400 mg/dL), a sterile flexible glucose sensor was placed aseptically in the interstitial space and attached to the continuous glucose monitoring device for estimation of the interstitial glucose every 5 minutes. BG measurements were taken with a portable BG meter every 2-4 hours at the discretion of the primary clinician and compared with CGMS glucose measurements. The CGMS estimates of BG and BG measured on the glucometer were strongly associated regardless of calibration frequency (calibration every 8 h: r=0.86, P<0.001; calibration every 12 h: r=0.85, P<0.001). Evaluation of this data using both the Clarke and Consensus error grids showed that 96.7% and 99% of the CGMS readings, respectively, were deemed clinically acceptable (Zones A and B errors). Interpatient variability in the accuracy of the CGMS glucose measurements was found but was not associated with body condition, perfusion, or degree of ketosis. A weak association between hydration status of the patient as assessed with the visual analog scale and absolute percent error (Spearman's rank correlation, rho=-0.079, 95% CI=-0.15 to -0.01, P=0.03) was found, with the device being more accurate in the more hydrated patients. The CGMS provides clinically accurate estimates of BG in patients with diabetic ketoacidosis.
MWCNT-ruthenium oxide composite paste electrode as non-enzymatic glucose sensor.
Tehrani, Ramin M A; Ab Ghani, Sulaiman
2012-01-01
A non-enzymatic glucose sensor of multi-walled carbon nanotube-ruthenium oxide/composite paste electrode (MWCNT-RuO(2)/CPE) was developed. The electrode was characterized by using XRD, SEM, TEM and EIS. Meanwhile, cyclic voltammetry and amperometry were used to check on the performances of the MWCNT-RuO(2)/CPE towards glucose. The proposed electrode has displayed a synergistic effect of RuO(2) and MWCNT on the electrocatalytic oxidation of glucose in 3M NaOH. This was possible via the formation of transitions of two redox pairs, viz. Ru(VI)/Ru(IV) and Ru(VII)/Ru(VI). A linear range of 0.5-50mM glucose and a limit of detection of 33 μM glucose (S/N=3) were observed. There was no significant interference observable from the traditional interferences, viz. ascorbic acid and uric acid. Indeed, results so obtained have indicated that the developed MWCNT-RuO(2)/CPE would pave the way for a better future to glucose sensor development as its fabrication was without the use of any enzyme. Copyright © 2012 Elsevier B.V. All rights reserved.
Battelino, T; Conget, I; Olsen, B; Schütz-Fuhrmann, I; Hommel, E; Hoogma, R; Schierloh, U; Sulli, N; Bolinder, J
2012-12-01
The aim of this multicentre, randomised, controlled crossover study was to determine the efficacy of adding continuous glucose monitoring (CGM) to insulin pump therapy (CSII) in type 1 diabetes. Children and adults (n = 153) on CSII with HbA(1c) 7.5-9.5% (58.5-80.3 mmol/mol) were randomised to (CGM) a Sensor On or Sensor Off arm for 6 months. After 4 months' washout, participants crossed over to the other arm for 6 months. Paediatric and adult participants were separately electronically randomised through the case report form according to a predefined randomisation sequence in eight secondary and tertiary centres. The primary outcome was the difference in HbA(1c) levels between arms after 6 months. Seventy-seven participants were randomised to the On/Off sequence and 76 to the Off/On sequence; all were included in the primary analysis. The mean difference in HbA(1c) was -0.43% (-4.74 mmol/mol) in favour of the Sensor On arm (8.04% [64.34 mmol/mol] vs 8.47% [69.08 mmol/mol]; 95% CI -0.32%, -0.55% [-3.50, -6.01 mmol/mol]; p < 0.001). Following cessation of glucose sensing, HbA(1c) reverted to baseline levels. Less time was spent with sensor glucose <3.9 mmol/l during the Sensor On arm than in the Sensor Off arm (19 vs 31 min/day; p = 0.009). The mean number of daily boluses increased in the Sensor On arm (6.8 ± 2.5 vs 5.8 ± 1.9, p < 0.0001), together with the frequency of use of the temporary basal rate (0.75 ± 1.11 vs 0.26 ± 0.47, p < 0.0001) and manual insulin suspend (0.91 ± 1.25 vs 0.70 ± 0.75, p < 0.018) functions. Four vs two events of severe hypoglycaemia occurred in the Sensor On and Sensor Off arm, respectively (p = 0.40). Continuous glucose monitoring was associated with decreased HbA(1c) levels and time spent in hypoglycaemia in individuals with type 1 diabetes using CSII. More frequent self-adjustments of insulin therapy may have contributed to these effects.
Hatada, Mika; Loew, Noya; Inose-Takahashi, Yuka; Okuda-Shimazaki, Junko; Tsugawa, Wakako; Mulchandani, Ashok; Sode, Koji
2018-06-01
Enzyme based electrochemical biosensors are divided into three generations according to their type of electron transfer from the cofactors of the enzymes to the electrodes. Although the 3rd generation sensors using direct electron transfer (DET) type enzymes are ideal, the number of enzyme types which possess DET ability is limited. In this study, we report of a glucose sensor using mediator-modified glucose dehydrogenase (GDH), that was fabricated by a new quick-and-easy method using the pre-functionalized amine reactive phenazine ethosulfate (arPES). Thus mediator-modified GDH obtained the ability to transfer electrons to bulky electron acceptors as well as electrodes. The concentration of glucose was successfully measured using electrodes with immobilized PES-modified GDH, without addition of external electron mediators. Therefore, continuous monitoring systems can be developed based on this "2.5th generation" electron transfer principle utilizing quasi-DET. Furthermore, we successfully modified two other diagnostically relevant enzymes, glucoside 3-dehydrogenase and lactate oxidase, with PES. Therefore, various kinds of diagnostic enzymes can achieve quasi-DET ability simply by modification with arPES, suggesting that continuous monitoring systems based on the 2.5th generation principle can be developed for various target molecules. Copyright © 2018 Elsevier B.V. All rights reserved.
Continuous glucose monitoring in acute coronary syndrome.
Rodríguez-Quintanilla, Karina Alejandra; Lavalle-González, Fernando Javier; Mancillas-Adame, Leonardo Guadalupe; Zapata-Garrido, Alfonso Javier; Villarreal-Pérez, Jesús Zacarías; Tamez-Pérez, Héctor Eloy
2013-01-01
Diabetes mellitus is an independent risk factor for cardiovascular disease. To compare the efficacy of devices for continuous glucose monitoring and capillary glucose monitoring in hospitalized patients with acute coronary syndrome using the following parameters: time to achieve normoglycemia, period of time in normoglycemia, and episodes of hypoglycemia. We performed a pilot, non-randomized, unblinded clinical trial that included 16 patients with acute coronary artery syndrome, a capillary or venous blood glucose ≥ 140 mg/dl, and treatment with a continuous infusion of fast acting human insulin. These patients were randomized into 2 groups: a conventional group, in which capillary measurement and recording as well as insulin adjustment were made every 4h, and an intervention group, in which measurement and recording as well as insulin adjustment were made every hour with a subcutaneous continuous monitoring system. Student's t-test was applied for mean differences and the X(2) test for qualitative variables. We observed a statistically significant difference in the mean time for achieving normoglycemia, favoring the conventional group with a P = 0.02. Continuous monitoring systems are as useful as capillary monitoring for achieving normoglycemia. Copyright © 2012 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.
Mesoporous ZnS–NiS Nanocomposites for Nonenzymatic Electrochemical Glucose Sensors
Wei, Chengzhen; Cheng, Cheng; Zhao, Junhong; Wang, Zhangtao; Wu, Haipeng; Gu, Kaiyue; Du, Weimin; Pang, Huan
2015-01-01
Mesoporous ZnS–NiS composites are prepared via ion- exchange reactions using ZnS as the precursor. The prepared mesoporous ZnS–NiS composite materials have large surface areas (137.9 m2 g−1) compared with the ZnS precursor. More importantly, the application of these mesoporous ZnS–NiS composites as nonenzymatic glucose sensors was successfully explored. Electrochemical sensors based on mesoporous ZnS–NiS composites exhibit a high selectivity and a low detection limit (0.125 μm) toward the oxidation of glucose, which can mainly be attributed to the morphological characteristics of the mesoporous structure with high specific surface area and a rational composition of the two constituents. In addition, the mesoporous ZnS–NiS composites coated on the surface of electrodes can be used to modify the mass transport regime, and this alteration can, in favorable circumstances, facilitate the amperometric discrimination between species. These results suggest that such mesoporous ZnS–NiS composites are promising materials for nonenzymatic glucose sensors. PMID:25861568
Abellán-Llobregat, A.; Jeerapan, I.; Bandodkar, A.; Vidal, L.; Canals, A.; Wang, J.; Morallón, E.
2017-01-01
Here we present two types of all-printable, highly stretchable, and inexpensive devices based on platinum (Pt)-decorated graphite for glucose determination in physiological fluids. Said devices are: a non-enzymatic sensor and an enzymatic biosensor, the latter showing promising results. Glucose has been quantified by measuring hydrogen peroxide (H2O2) reduction by chronoamperometry at -0.35 V (vs pseudo-Ag/AgCl) using glucose-oxidase immobilized on Pt-decorated graphite. The sensor performs well for the quantification of glucose in phosphate buffer solution (0.25 M PBS, pH 7.0), with a working range between 33 μM and 0.9 mM, high sensitivity and selectivity, and a low limit of detection (LOD). Thus it provides an alternative non-invasive and on-body quantification of glucose levels in human perspiration. This biosensor has been successfully applied on real human perspiration samples and results also show a significant correlation between glucose concentration in perspiration and glucose concentration in blood measured by a commercial glucose meter. PMID:28167366
Nanomaterial-based Electrochemical Sensors for the Detection of Glucose and Cholesterol
NASA Astrophysics Data System (ADS)
Ahmadalinezhad, Asieh
designed glucose biosensor exhibits a wide linear range, up to 18 mM glucose, as well as high sensitivity and selectivity. Glucose measurements of human serum using the developed biosensor showed excellent agreement with the data recorded by a commercial blood glucose monitoring assay. Finally, we fabricated an enzyme-free glucose sensor based on nanoporous palladium-cadmium (PdCd) networks. A hydrothermal method was applied in the synthesis of PdCd nanomaterials. The effect of the composition of the PdCd nanomaterials on the performance of the electrode was investigated by cyclic voltammetry (CV). Amperometric studies showed that the nanoporous PdCd electrode was responsive to the direct oxidation of glucose with high electrocatalytic activity. The sensitivity of the sensor for continuous glucose monitoring was 146.21 microAmM--1cm--2, with linearity up to 10 mM and a detection limit of 0.05 mM. In summary, the electrochemical biosensors proposed in my PhD study exhibited high sensitivity and selectivity for the continuous monitoring of analytes in the presence of common interference species. Our results have shown that the performance of the biosensors is significantly dependent on the dimensions and morphologies of nanostructured materials. The unique nanomaterials-based platforms proposed in this dissertation open the door to the design and fabrication of high-performance electrochemical biosensors for medical diagnostics.
Kim, Dong-Min; Moon, Jong-Min; Lee, Won-Chul; Yoon, Jang-Hee; Choi, Cheol Soo; Shim, Yoon-Bo
2017-05-15
A non-enzymatic potentiometric glucose sensor for the determination of glucose in the micomolar level in saliva was developed based on a molecularly imprinted polymer (MIP) binding on a conducting polymer layer. A MIP containing acrylamide, and aminophenyl boronic acid, as a host molecule to glucose, was immobilized on benzoic acid-functionalized poly(terthiophene) (pTBA) by the amide bond formation onto a gold nanoparticles deposited-screen printed carbon electrode (pTBA/AuNPs/SPCE). Aromatic boronic acid was incorporated into the MIP layer to stably capture glucose and create a potentiometric signal through the changed pKa value of polymer film by the formation of boronate anion-glucose complex with generation of H + ions by the cis-diol reaction. Reversible binding and extraction of glucose on the sensor surface was observed using a quartz crystal microbalance. Each layer of the sensor probe was characterized by cyclic voltammetry, electrochemical impedance spectroscopy, X-ray photoelectron spectroscopy, and atomic force microscopy. The potentiometric response at the optimized conditions exhibited a wide linear dynamic range of 3.2×10 -7 to 1.0×10 -3 M, with a detection limit of 1.9 (±0.15)×10 -7 M. The sensor probe revealed an excellent selectivity and sensitivity for glucose compared to other saccharides. In addition, the reliability of the proposed glucose sensor was evaluated in physiological fluid samples of saliva and finger prick blood. Copyright © 2016 Elsevier B.V. All rights reserved.
Hassan, Hafeez Ul; Nielsen, Kristian; Aasmul, Soren; Bang, Ole
2015-01-01
We demonstrate that the light excitation and capturing efficiency of fluorescence based fiber-optical sensors can be significantly increased by using a CPC (Compound Parabolic Concentrator) tip instead of the standard plane-cut tip. We use Zemax modelling to find the optimum CPC tip profile and fiber length of a polymer optical fiber diabetes sensor for continuous monitoring of glucose levels. We experimentally verify the improved performance of the CPC tipped sensor and the predicted production tolerances. Due to physical size requirements when the sensor has to be inserted into the body a non-optimal fiber length of 35 mm is chosen. For this length an average improvement in efficiency of a factor of 1.7 is experimentally demonstrated and critically compared to the predicted ideal factor of 3 in terms of parameters that should be improved through production optimization. PMID:26713213
Hassan, Hafeez Ul; Nielsen, Kristian; Aasmul, Soren; Bang, Ole
2015-12-01
We demonstrate that the light excitation and capturing efficiency of fluorescence based fiber-optical sensors can be significantly increased by using a CPC (Compound Parabolic Concentrator) tip instead of the standard plane-cut tip. We use Zemax modelling to find the optimum CPC tip profile and fiber length of a polymer optical fiber diabetes sensor for continuous monitoring of glucose levels. We experimentally verify the improved performance of the CPC tipped sensor and the predicted production tolerances. Due to physical size requirements when the sensor has to be inserted into the body a non-optimal fiber length of 35 mm is chosen. For this length an average improvement in efficiency of a factor of 1.7 is experimentally demonstrated and critically compared to the predicted ideal factor of 3 in terms of parameters that should be improved through production optimization.
Ulf, Samuelsson; Ragnar, Hanas; Arne, Whiss Per; Johnny, Ludvigsson
2008-08-01
HbA1c levels are influenced by the glycemic control of previous 2-3 months. Sometimes patients have surprisingly low HbA1c in spite of many correctly measured high blood glucose values, which is difficult to explain. As glucose sensors give an objective picture based on glucose readings several times per minute over 24 hours, we used the area under the curve (AUC) of such subcutaneous glucose profiles to evaluate their relationship with HbA1c. Thirty-two patients were randomized into two study arms, one open and the other blinded. Both arms had 8 pump users and 8 patients with multiple daily injections (MDI). After three months the two arms crossed over. Both study arms wore a continuous glucose monitoring system (CGMS) for 3 days every 2 weeks. HbA1c was determined before and after each 3-month study period. There was no relationship between HbA1c and s.c. glucose AUC or between HbA1c and the number of peaks >15.0 mmol/L when all CGMS profiles during the 6 months were taken together. Children on MDI showed a positive relationship between HbA1c and AUC (P<0.01) as well as the number of peaks (P<0.01). Children with a negative relationship between HbA1c and AUC generally had fewer fluctuations in blood glucose values, whereas children with a positive relationship had wide fluctuations. between s.c. glucose AUC and HbA1c, the results indicate that wide blood glucose fluctuations may be related to high HbA1c values. Therefore, complications and therapeutic interventions should aim at reducing such fluctuations. Although there was no relationship between s.c. glucose AUC and HbA1c, the results indicate that wide blood glucose fluctuations may be related to high HbA1c values. Therefore, complications and therapeutic interventions should aim at reducing such fluctuations.
Doping Ag in ZnO Nanorods to Improve the Performance of Related Enzymatic Glucose Sensors.
Zhou, Fan; Jing, Weixuan; Liu, Pengcheng; Han, Dejun; Jiang, Zhuangde; Wei, Zhengying
2017-09-27
In this paper, the performance of a zinc oxide (ZnO) nanorod-based enzymatic glucose sensor was enhanced with silver (Ag)-doped ZnO (ZnO-Ag) nanorods. The effect of the doped Ag on the surface morphologies, wettability, and electron transfer capability of the ZnO-Ag nanorods, as well as the catalytic character of glucose oxidase (GOx) and the performance of the glucose sensor was investigated. The results indicate that the doped Ag slightly weakens the surface roughness and hydrophilicity of the ZnO-Ag nanorods, but remarkably increases their electron transfer ability and enhances the catalytic character of GOx. Consequently, the combined effects of the above influencing factors lead to a notable improvement of the performance of the glucose sensor, that is, the sensitivity increases and the detection limit decreases. The optimal amount of the doped Ag is determined to be 2 mM, and the corresponding glucose sensor exhibits a sensitivity of 3.85 μA/(mM·cm²), detection limit of 1.5 μM, linear range of 1.5 × 10 -3 -6.5 mM, and Michaelis-Menten constant of 3.87 mM. Moreover, the glucose sensor shows excellent selectivity to urea, ascorbic acid, and uric acid, in addition to displaying good storage stability. These results demonstrate that ZnO-Ag nanorods are promising matrix materials for the construction of other enzymatic biosensors.
Doping Ag in ZnO Nanorods to Improve the Performance of Related Enzymatic Glucose Sensors
Zhou, Fan; Jing, Weixuan; Liu, Pengcheng; Han, Dejun; Jiang, Zhuangde; Wei, Zhengying
2017-01-01
In this paper, the performance of a zinc oxide (ZnO) nanorod-based enzymatic glucose sensor was enhanced with silver (Ag)-doped ZnO (ZnO-Ag) nanorods. The effect of the doped Ag on the surface morphologies, wettability, and electron transfer capability of the ZnO-Ag nanorods, as well as the catalytic character of glucose oxidase (GOx) and the performance of the glucose sensor was investigated. The results indicate that the doped Ag slightly weakens the surface roughness and hydrophilicity of the ZnO-Ag nanorods, but remarkably increases their electron transfer ability and enhances the catalytic character of GOx. Consequently, the combined effects of the above influencing factors lead to a notable improvement of the performance of the glucose sensor, that is, the sensitivity increases and the detection limit decreases. The optimal amount of the doped Ag is determined to be 2 mM, and the corresponding glucose sensor exhibits a sensitivity of 3.85 μA/(mM·cm2), detection limit of 1.5 μM, linear range of 1.5 × 10−3–6.5 mM, and Michaelis-Menten constant of 3.87 mM. Moreover, the glucose sensor shows excellent selectivity to urea, ascorbic acid, and uric acid, in addition to displaying good storage stability. These results demonstrate that ZnO-Ag nanorods are promising matrix materials for the construction of other enzymatic biosensors. PMID:28953217
Glucose metabolism disorder in obese children assessed by continuous glucose monitoring system.
Zou, Chao-Chun; Liang, Li; Hong, Fang; Zhao, Zheng-Yan
2008-02-01
Continuous glucose monitoring system (CGMS) can measure glucose levels at 5-minute intervals over a few days, and may be used to detect hypoglycemia, guide insulin therapy, and control glucose levels. This study was undertaken to assess the glucose metabolism disorder by CGMS in obese children. Eighty-four obese children were studied. Interstitial fluid (ISF) glucose levels were measured by CGMS for 24 hours covering the time for oral glucose tolerance test (OGTT). Impaired glucose tolerance (IGT), impaired fasting glucose (IFG), type 2 diabetic mellitus (T2DM) and hypoglycemia were assessed by CGMS. Five children failed to complete CGMS test. The glucose levels in ISF measured by CGMS were highly correlated with those in capillary samples (r=0.775, P<0.001). However, the correlation between ISF and capillary glucose levels was lower during the first hour than that in the later time period (r=0.722 vs r=0.830), and the ISF glucose levels in 69.62% of children were higher than baseline levels in the initial 1-3 hours. In 79 obese children who finished the CGMS, 2 children had IFG, 2 had IGT, 3 had IFG + IGT, and 2 had T2DM. Nocturnal hypoglycemia was noted during the overnight fasting in 11 children (13.92%). Our data suggest that glucose metabolism disorder including hyperglycemia and hypoglycemia is very common in obese children. Further studies are required to improve the precision of the CGMS in children.
Supraoptic oxytocin and vasopressin neurons function as glucose and metabolic sensors
Song, Zhilin; Levin, Barry E.; Stevens, Wanida
2014-01-01
Neurons in the supraoptic nuclei (SON) produce oxytocin and vasopressin and express insulin receptors (InsR) and glucokinase. Since oxytocin is an anorexigenic agent and glucokinase and InsR are hallmarks of cells that function as glucose and/or metabolic sensors, we evaluated the effect of glucose, insulin, and their downstream effector ATP-sensitive potassium (KATP) channels on calcium signaling in SON neurons and on oxytocin and vasopressin release from explants of the rat hypothalamo-neurohypophyseal system. We also evaluated the effect of blocking glucokinase and phosphatidylinositol 3 kinase (PI3K; mediates insulin-induced mobilization of glucose transporter, GLUT4) on responses to glucose and insulin. Glucose and insulin increased intracellular calcium ([Ca2+]i). The responses were glucokinase and PI3K dependent, respectively. Insulin and glucose alone increased vasopressin release (P < 0.002). Oxytocin release was increased by glucose in the presence of insulin. The oxytocin (OT) and vasopressin (VP) responses to insulin+glucose were blocked by the glucokinase inhibitor alloxan (4 mM; P ≤ 0.002) and the PI3K inhibitor wortmannin (50 nM; OT: P = 0.03; VP: P ≤ 0.002). Inactivating KATP channels with 200 nM glibenclamide increased oxytocin and vasopressin release (OT: P < 0.003; VP: P < 0.05). These results suggest that insulin activation of PI3K increases glucokinase-mediated ATP production inducing closure of KATP channels, opening of voltage-sensitive calcium channels, and stimulation of oxytocin and vasopressin release. The findings are consistent with SON oxytocin and vasopressin neurons functioning as glucose and “metabolic” sensors to participate in appetite regulation. PMID:24477542
Supraoptic oxytocin and vasopressin neurons function as glucose and metabolic sensors.
Song, Zhilin; Levin, Barry E; Stevens, Wanida; Sladek, Celia D
2014-04-01
Neurons in the supraoptic nuclei (SON) produce oxytocin and vasopressin and express insulin receptors (InsR) and glucokinase. Since oxytocin is an anorexigenic agent and glucokinase and InsR are hallmarks of cells that function as glucose and/or metabolic sensors, we evaluated the effect of glucose, insulin, and their downstream effector ATP-sensitive potassium (KATP) channels on calcium signaling in SON neurons and on oxytocin and vasopressin release from explants of the rat hypothalamo-neurohypophyseal system. We also evaluated the effect of blocking glucokinase and phosphatidylinositol 3 kinase (PI3K; mediates insulin-induced mobilization of glucose transporter, GLUT4) on responses to glucose and insulin. Glucose and insulin increased intracellular calcium ([Ca(2+)]i). The responses were glucokinase and PI3K dependent, respectively. Insulin and glucose alone increased vasopressin release (P < 0.002). Oxytocin release was increased by glucose in the presence of insulin. The oxytocin (OT) and vasopressin (VP) responses to insulin+glucose were blocked by the glucokinase inhibitor alloxan (4 mM; P ≤ 0.002) and the PI3K inhibitor wortmannin (50 nM; OT: P = 0.03; VP: P ≤ 0.002). Inactivating K ATP channels with 200 nM glibenclamide increased oxytocin and vasopressin release (OT: P < 0.003; VP: P < 0.05). These results suggest that insulin activation of PI3K increases glucokinase-mediated ATP production inducing closure of K ATP channels, opening of voltage-sensitive calcium channels, and stimulation of oxytocin and vasopressin release. The findings are consistent with SON oxytocin and vasopressin neurons functioning as glucose and "metabolic" sensors to participate in appetite regulation.
Cho, Seong Je; Noh, Hui-Bog; Won, Mi-Sook; Cho, Chul-Ho; Kim, Kwang Bok; Shim, Yoon-Bo
2018-01-15
A selective nonenzymatic glucose sensor was developed based on the direct oxidation of glucose on hierarchical CuCo bimetal-coated with a glucose-imprinted polymer (GIP). Glucose was introduced into the GIP composed of Nafion and polyurethane along with aminophenyl boronic acid (APBA), which was formed on the bimetal electrode formed on a screen-printed electrode. The extraction of glucose from the GIP allowed for the selective permeation of glucose into the bimetal electrode surface for oxidation. The GIP-coated bimetal sensor probe was characterized using electrochemical and surface analytical methods. The GIP layer coated on the NaOH pre-treated bimetal electrode exhibited a dynamic range between 1.0µM and 25.0mM with a detection limit of 0.65±0.10µM in phosphate buffer solution (pH 7.4). The anodic responses of uric acid, acetaminophen, dopamine, ascorbic acid, L-cysteine, and other saccharides (monosaccharides: galactose, mannose, fructose, and xylose; disaccharides: sucrose, lactose, and maltose) were not detected using the GIP-coated bimetal sensor. The reliability of the sensor was evaluated by the determination of glucose in artificial and whole blood samples. Copyright © 2017 Elsevier B.V. All rights reserved.
Glucose-sensitive QCM-sensors via direct surface RAFT polymerization.
Sugnaux, Caroline; Klok, H-A
2014-08-01
Thin, phenylboronic acid-containing polymer coatings are potentially attractive sensory layers for a range of glucose monitoring systems. This contribution presents the synthesis and properties of glucose-sensitive polymer brushes obtained via surface RAFT polymerization of 3-methacrylamido phenylboronic acid (MAPBA). This synthetic strategy is attractive since it allows the controlled growth of PMAPBA brushes with film thicknesses of up to 20 nm via direct polymerization of MAPBA without the need for additional post-polymerization modification or deprotection steps. QCM-D sensor chips modified with a PMAPBA layer respond with a linear change in the shift of the fundamental resonance frequency over a range of physiologically relevant glucose concentrations and are insensitive toward the presence of fructose, thus validating the potential of these polymer brush films as glucose sensory thin coatings. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Non-enzymatic glucose sensor based on electrodeposited copper on carbon paste electrode (Cu/CPE)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nurani, Dita Arifa, E-mail: d.arifa@sci.ui.ac.id; Wibowo, Rahmat; Fajri, Iqbal Farhan El
The development of non-enzymatic glucose sensor has much attention due to their applications in glucose monitoring. In this research, copper oxide is used as a non-enzymatic glucose sensor by oxidizing glucose to gluconolactone. Copper was electrodeposited on Carbon paste electrode (CPE) at constant potential. The experimental condition was varied in electrodeposition of Cu with the following parameters: Electrodeposition time 60 s, 120 s and 180 s and potential reduction -0.166 V, -0.266 V and -0.366 V. The effective performance of these working electrodes in sensing glucose was investigated. The Cu/CPE which used -0.366 V potential reduction and 120 s electrodeposition time shows the bestmore » performance. The amperometric response current in concentration range 1.6-62.5 mM of glucose gives the good linearity R{sup 2} = 0.9988, low detection limit 0.6728 mM and high sensitivity 1183.59 µA mM{sup −1}cm{sup −2}. Furthermore this sensor exhibited a good repeatability with %RSD = 1.31% (n=10) and high stability with %RSD = 1.51% (n=5 days). The homogeneity of Cu particles on CPE was investigated by Scanning Electron Microscope (SEM).« less
Preparation of Glucose Sensor Using Polydimethylsiloxane / Polypyrrole Complex
NASA Astrophysics Data System (ADS)
Yasuzawa, Mikito; Inoue, Shigeru; Imai, Shinji
New glucose oxidase (GOD) immobilized glucose sensors were prepared by the electropolymerization of 1-(6-D-gluconamidohexyl) pyrrole (GHP) on the platinum wire electrode precoated with the mixture solution of pyrrole derivative GHP, polydimethylsiloxane (PDS) and Nafion. The addition of Nafion into the precoating mixture solution was essential to obtain suitable sensor sensitivity. However, the sensitivity was about the half of that of the electrode without PDS precoating. Although, the introduction of Nafion was effective to improve the long-term stability of the enzyme-immobilized electrode, the electrode prepared using Nafion, PDS and GHP performed excellent long-term stability even at the measurement and storage temperatures of 40°C. Relatively constant response current was obtained over 30 days under the condition of 40°C and over 9 months measured at 25°C. Moreover, the GOD-immobilized GHP polymer film prepared on the electrode precoated with GHP, PDS and Nafion solution, was found to have excellent hemocompatibility from the result of platelet rich plasma contacting test.
Thabit, Hood; Leelarathna, Lalantha; Wilinska, Malgorzata E; Elleri, Daniella; Allen, Janet M; Lubina-Solomon, Alexandra; Walkinshaw, Emma; Stadler, Marietta; Choudhary, Pratik; Mader, Julia K; Dellweg, Sibylle; Benesch, Carsten; Pieber, Thomas R; Arnolds, Sabine; Heller, Simon R; Amiel, Stephanie A; Dunger, David; Evans, Mark L; Hovorka, Roman
2015-11-01
Closed-loop (CL) systems modulate insulin delivery based on glucose levels measured by a continuous glucose monitor (CGM). Accuracy of the CGM affects CL performance and safety. We evaluated the accuracy of the Freestyle Navigator(®) II CGM (Abbott Diabetes Care, Alameda, CA) during three unsupervised, randomized, open-label, crossover home CL studies. Paired CGM and capillary glucose values (10,597 pairs) were collected from 57 participants with type 1 diabetes (41 adults [mean±SD age, 39±12 years; mean±SD hemoglobin A1c, 7.9±0.8%] recruited at five centers and 16 adolescents [mean±SD age, 15.6±3.6 years; mean±SD hemoglobin A1c, 8.1±0.8%] recruited at two centers). Numerical accuracy was assessed by absolute relative difference (ARD) and International Organization for Standardization (ISO) 15197:2013 15/15% limits, and clinical accuracy was assessed by Clarke error grid analysis. Total duration of sensor use was 2,002 days (48,052 h). Overall sensor accuracy for the capillary glucose range (1.1-27.8 mmol/L) showed mean±SD and median (interquartile range) ARD of 14.2±15.5% and 10.0% (4.5%, 18.4%), respectively. Lowest mean ARD was observed in the hyperglycemic range (9.8±8.8%). Over 95% of pairs were in combined Clarke error grid Zones A and B (A, 80.1%, B, 16.2%). Overall, 70.0% of the sensor readings satisfied ISO criteria. Mean ARD was consistent (12.3%; 95% of the values fall within ±3.7%) and not different between participants (P=0.06) within the euglycemic and hyperglycemic range, when CL is actively modulating insulin delivery. Consistent accuracy of the CGM within the euglycemic-hyperglycemic range using the Freestyle Navigator II was observed and supports its use in home CL studies. Our results may contribute toward establishing normative CGM performance criteria for unsupervised home use of CL.
Amperometric Glucose Sensors: Sources of Error and Potential Benefit of Redundancy
Castle, Jessica R.; Kenneth Ward, W.
2010-01-01
Amperometric glucose sensors have advanced the care of patients with diabetes and are being studied to control insulin delivery in the research setting. However, at times, currently available sensors demonstrate suboptimal accuracy, which can result from calibration error, sensor drift, or lag. Inaccuracy can be particularly problematic in a closed-loop glycemic control system. In such a system, the use of two sensors allows selection of the more accurate sensor as the input to the controller. In our studies in subjects with type 1 diabetes, the accuracy of the better of two sensors significantly exceeded the accuracy of a single, randomly selected sensor. If an array with three or more sensors were available, it would likely allow even better accuracy with the use of voting. PMID:20167187
McAuley, Sybil A; Dang, Tri T; Horsburgh, Jodie C; Bansal, Anubhuti; Ward, Glenn M; Aroyan, Sarkis; Jenkins, Alicia J; MacIsaac, Richard J; Shah, Rajiv V; O'Neal, David N
2016-05-01
Orthogonal redundancy for glucose sensing (multiple sensing elements utilizing distinct methodologies) may enhance performance compared to nonredundant sensors, and to sensors with multiple elements utilizing the same technology (simple redundancy). We compared the performance of a prototype orthogonal redundant sensor (ORS) combining optical fluorescence and redundant electrochemical sensing via a single insertion platform to an electrochemical simple redundant sensor (SRS). Twenty-one adults with type 1 diabetes wore an ORS and an SRS concurrently for 7 days. Following sensor insertion, and on Day 4 with a standardized meal, frequent venous samples were collected for reference glucose measurement (laboratory [YSI] and meter) over 3 and 4 hours, respectively. Between study visits reference capillary blood glucose testing was undertaken. Sensor data were processed prospectively. ORS mean absolute relative difference (MARD) was (mean ± SD) 10.5 ± 13.2% versus SRS 11.0 ± 10.4% (P = .34). ORS values in Clarke error grid zones A and A+B were 88.1% and 97.6%, respectively, versus SRS 86.4% and 97.8%, respectively (P = .23 and P = .84). ORS Day 1 MARD (10.7 ± 10.7%) was superior to SRS (16.5 ± 13.4%; P < .0001), and comparable to ORS MARD for the week. ORS sensor survival (time-averaged mean) was 92.1% versus SRS 74.4% (P = .10). ORS display time (96.0 ± 5.8%) was equivalent to SRS (95.6 ± 8.9%; P = .87). Combining simple and orthogonal sensor redundancy via a single insertion is feasible, with accuracy comparing favorably to current generation nonredundant sensors. Addition of an optical component potentially improves sensor reliability compared to electrochemical sensing alone. Further improvement in optical sensing performance is required prior to clinical application. © 2016 Diabetes Technology Society.
Zhao, Yuxin; He, Zhaoyang; Yan, Zifeng
2013-01-21
In the pursuit of electrocatalysts with great economic and ecological values for non-enzymatic glucose sensors, one-dimensional copper@carbon (Cu@C) core-shell coaxial nanowires (NWs) have been successfully prepared via a simple continuous flow wet-chemistry approach from electroplating wastewater. The as-obtained products were characterized by X-ray powder diffraction, scanning electron microscopy, transmission electron microscopy, selected area electron diffraction, energy dispersive X-ray spectroscopy and Raman spectroscopy. The electrocatalytic activity of the modified electrodes by Cu@C NWs towards glucose oxidation was investigated by cyclic voltammetry and chronoamperometry. It was found that the as-obtained Cu@C NWs showed good electrochemical properties and could be used as an electrochemical sensor for the detection of glucose molecules. Compared to the other electrodes including the bare Nafion/glassy carbon electrode (GCE) and several hot hybrid nanostructures modified GCE, a substantial decrease in the overvoltage of the glucose oxidation was observed at the Cu@C NWs electrodes with oxidation starting at ca. 0.20 V vs. Ag/AgCl (3 M KCl). At an applied potential of 0.65 V, Cu@C NWs electrodes had a high and reproducible sensitivity of 437.8 µA cm(-2) mM(-1) to glucose. Linear responses were obtained with a detection limit of 50 nM. More importantly, the proposed electrode also had good stability, high resistance against poisoning by chloride ion and commonly interfering species. These good analytical performances make Cu@C NWs promising for the future development of enzyme-free glucose sensors.
A wearable diffuse reflectance sensor for continuous monitoring of cutaneous blood content
NASA Astrophysics Data System (ADS)
Zakharov, P.; Talary, M. S.; Caduff, A.
2009-09-01
An optical diffuse reflectance sensor for characterization of cutaneous blood content and optimized for continuous monitoring has been developed as part of a non-invasive multisensor system for glucose monitoring. A Monte Carlo simulation of the light propagation in the multilayered skin model has been performed in order to estimate the optimal geometrical separation of the light source and detector for skin and underlying tissue. We have observed that the pathlength within the upper vascular plexus of the skin which defines the sensor sensitivity initially grows with increasing source-detector distance (SDD) before reaching a maximum at 3.5 mm and starts to decay with further increase. At the same time, for distances above 2.4 mm, the sensor becomes sensitive to muscle blood content, which decreases the specificity to skin perfusion monitoring. Thus, the SDDs in the range from 1.5 mm to 2.4 mm satisfy the requirements of sensor sensitivity and specificity. The hardware implementation of the system has been realized and tested in laboratory experiments with a venous occlusion procedure and in an outpatient clinical study in 16 patients with type 1 diabetes mellitus. For both testing procedures, the optical sensor demonstrated high sensitivity to perfusion change provoking events. The general build-up of cutaneous blood under the sensor has been observed which can be associated with pressure-induced vasodilation as a response to the sensor application.
Ionic pH and glucose sensors fabricated using hydrothermal ZnO nanostructures
NASA Astrophysics Data System (ADS)
Wang, Jyh-Liang; Yang, Po-Yu; Hsieh, Tsang-Yen; Juan, Pi-Chun
2016-01-01
Hydrothermally synthesized aluminum-doped ZnO (AZO) nanostructures have been adopted in extended-gate field-effect transistor (EGFET) sensors to demonstrate the sensitive and stable pH and glucose sensing characteristics of AZO-nanostructured EGFET sensors. The AZO-nanostructured EGFET sensors exhibited the following superior pH sensing characteristics: a high current sensitivity of 0.96 µA1/2/pH, a high linearity of 0.9999, less distortion of output waveforms, a small hysteresis width of 4.83 mV, good long-term repeatability, and a wide sensing range from pHs 1 to 13. The glucose sensing characteristics of AZO-nanostructured biosensors exhibited the desired sensitivity of 60.5 µA·cm-2·mM-1 and a linearity of 0.9996 up to 13.9 mM. The attractive characteristics of high sensitivity, high linearity, and repeatability of using ionic AZO-nanostructured EGFET sensors indicate their potential use as electrochemical and disposable biosensors.
Analysis: Continuous Glucose Monitoring in the Intensive Care Unit
Kenneth Ward, W.
2012-01-01
Control of glycemia in hospitalized patients is important; hypoglycemia is associated with increased mortality, and hyperglycemia is associated with adverse outcomes. For these reasons, though no such device is currently available, continuous glucose monitoring (CGM) is an attractive option, especially in the critical care setting. Schierenbeck and coauthors, in this issue of Journal of Diabetes Science and Technology, report on the use of a specialized central catheter designed to monitor glucose continuously in post cardiac surgery patients. This catheter, which was indwelled within the great veins, was specially designed with a separate lumen and membrane that allowed continuous glucose microdialysis. Accuracy was quite good, better than has been reported with the use of commercially-available CGM devices. Ideally, further development of this quite promising catheter-based device would allow it to be used also to deliver fluids and drugs, thus avoiding the need for a second catheter elsewhere. PMID:23294782
Dunn, Timothy C; Hayter, Gary A; Doniger, Ken J; Wolpert, Howard A
2014-07-01
The objective was to develop an analysis methodology for generating diabetes therapy decision guidance using continuous glucose (CG) data. The novel Likelihood of Low Glucose (LLG) methodology, which exploits the relationship between glucose median, glucose variability, and hypoglycemia risk, is mathematically based and can be implemented in computer software. Using JDRF Continuous Glucose Monitoring Clinical Trial data, CG values for all participants were divided into 4-week periods starting at the first available sensor reading. The safety and sensitivity performance regarding hypoglycemia guidance "stoplights" were compared between the LLG method and one based on 10th percentile (P10) values. Examining 13 932 hypoglycemia guidance outputs, the safety performance of the LLG method ranged from 0.5% to 5.4% incorrect "green" indicators, compared with 0.9% to 6.0% for P10 value of 110 mg/dL. Guidance with lower P10 values yielded higher rates of incorrect indicators, such as 11.7% to 38% at 80 mg/dL. When evaluated only for periods of higher glucose (median above 155 mg/dL), the safety performance of the LLG method was superior to the P10 method. Sensitivity performance of correct "red" indicators of the LLG method had an in sample rate of 88.3% and an out of sample rate of 59.6%, comparable with the P10 method up to about 80 mg/dL. To aid in therapeutic decision making, we developed an algorithm-supported report that graphically highlights low glucose risk and increased variability. When tested with clinical data, the proposed method demonstrated equivalent or superior safety and sensitivity performance. © 2014 Diabetes Technology Society.
Gómez, Ana M; Marín Sánchez, Alejandro; Muñoz, Oscar M; Colón Peña, Christian Alejandro
2015-12-01
Insulin pump therapy associated with continuous glucose monitoring has shown a positive clinical impact on diabetes control and reduction of hypoglycemia episodes. There are descriptions of the performance of this device in other populations, but its precision and accuracy in Colombia and Latin America are unknown, especially in the routine outpatient setting. Data from 33 type 1 and type 2 diabetes patients with sensor-augmented pump therapy with threshold suspend automation, MiniMed Paradigm® Veo™ (Medtronic, Northridge, California), managed at Hospital Universitario San Ignacio (Bogotá, Colombia) and receiving outpatient treatment, were analyzed. Simultaneous data from continuous glucose monitoring and capillary blood glucose were compared, and their precision and accuracy were calculating with different methods, including Clarke error grid. Analyses included 2,262 continuous glucose monitoring -reference paired glucose values. A mean absolute relative difference of 20.1% was found for all measurements, with a value higher than 23% for glucose levels ≤75mg/dL. Global compliance with the ISO criteria was 64.9%. It was higher for values >75mg/dl (68.3%, 1,308 of 1,916 readings), than for those ≤ 75mg/dl (49.4%, 171 of 346 readings). Clinical accuracy, as assessed by the Clarke error grid, showed that 91.77% of data were within the A and B zones (75.6% in hypoglycemia). A good numerical accuracy was found for continuous glucose monitoring in normo and hyperglycemia situations, with low precision in hypoglycemia. The clinical accuracy of the device was adequate, with no significant safety concerns for patients. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.
NASA Astrophysics Data System (ADS)
Madhurantakam, Sasya; Karnam, Jayanth Babu; Rayappan, John Bosco Balaguru; Krishnan, Uma Maheswari
2017-11-01
Carbon nanotubes (CNTs) have been extensively explored for a diverse range of applications due to their unique electrical and mechanical properties. CNT-incorporated electrochemical sensors have exhibited enhanced sensitivity towards the analyte molecule due to the excellent electron transfer properties of CNTs. In addition, CNTs possess a large surface area-to-volume ratio that favours the adhesion of analyte molecules as well as enhances the electroactive area. Most of the electrochemical sensors have employed CNTs as a nano-interface to promote electron transfer and as an immobilization matrix for enzymes. The present work explores the potential of CNTs to serve as a catalytic interface for the enzymeless quantification of glucose. The figure of merits for the enzymeless sensor was comparable to the performance of several enzyme-based sensors reported in literature. The developed sensor was successfully employed to determine the glucose utilization of unstimulated and stimulated macrophages. The significant difference in the glucose utilization levels in activated macrophages and quiescent cells observed in the present investigation opens up the possibilities of new avenues for effective medical diagnosis of inflammatory disorders.
Fonseca, Vivian A; Grunberger, George; Anhalt, Henry; Bailey, Timothy S; Blevins, Thomas; Garg, Satish K; Handelsman, Yehuda; Hirsch, Irl B; Orzeck, Eric A; Roberts, Victor Lawrence; Tamborlane, William
2016-08-01
Barriers to continuous glucose monitoring (CGM) use continue to hamper adoption of this valuable technology for the management of diabetes. The American Association of Clinical Endocrinologists and the American College of Endocrinology convened a public consensus conference February 20, 2016, to review available CGM data and propose strategies for expanding CGM access. Conference participants agreed that evidence supports the benefits of CGM in type 1 diabetes and that these benefits are likely to apply whenever intensive insulin therapy is used, regardless of diabetes type. CGM is likely to reduce healthcare resource utilization for acute and chronic complications, although real-world analyses are needed to confirm potential cost savings and quality of life improvements. Ongoing technological advances have improved CGM accuracy and usability, but more innovations in human factors, data delivery, reporting, and interpretation are needed to foster expanded use. The development of a standardized data report using similar metrics across all devices would facilitate clinician and patient understanding and utilization of CGM. Expanded CGM coverage by government and private payers is an urgent need. CGM improves glycemic control, reduces hypoglycemia, and may reduce overall costs of diabetes management. Expanding CGM coverage and utilization is likely to improve the health outcomes of people with diabetes. A1C = glycated hemoglobin AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology ASPIRE = Automation to Simulate Pancreatic Insulin Response CGM = continuous glucose monitoring HRQOL = health-related quality of life ICER = incremental cost-effectiveness ratio JDRF = Juvenile Diabetes Research Foundation MARD = mean absolute relative difference MDI = multiple daily injections QALY = quality-adjusted life years RCT = randomized, controlled trial SAP = sensor-augmented pump SMBG = self-monitoring of blood glucose STAR = Sensor
An In-Line Photonic Biosensor for Monitoring of Glucose Concentrations
Al-Halhouli, Ala'aldeen; Demming, Stefanie; Alahmad, Laila; LIobera, Andreu; Büttgenbach, Stephanus
2014-01-01
This paper presents two PDMS photonic biosensor designs that can be used for continuous monitoring of glucose concentrations. The first design, the internally immobilized sensor, consists of a reactor chamber, micro-lenses and self-alignment structures for fiber optics positioning. This sensor design allows optical detection of glucose concentrations under continuous glucose flow conditions of 33 μL/h based on internal co-immobilization of glucose oxidase (GOX) and horseradish peroxidase (HRP) on the internal PDMS surface of the reactor chamber. For this design, two co-immobilization methods, the simple adsorption and the covalent binding (PEG) methods were tested. Experiments showed successful results when using the covalent binding (PEG) method, where glucose concentrations up to 5 mM with a coefficient of determination (R2) of 0.99 and a limit of detection of 0.26 mM are detectable. The second design is a modified version of the internally immobilized sensor, where a microbead chamber and a beads filling channel are integrated into the sensor. This modification enabled external co-immobilization of enzymes covalently onto functionalized silica microbeads and allows binding a huge amount of HRP and GOX enzymes on the microbeads surfaces which increases the interaction area between immobilized enzymes and the analyte. This has a positive effect on the amount and rate of chemical reactions taking place inside the chamber. The sensor was tested under continuous glucose flow conditions and was found to be able to detect glucose concentrations up to 10 mM with R2 of 0.98 and a limit of detection of 0.7 mM. Such results are very promising for the application in photonic LOC systems used for online analysis. PMID:25157552
Bacteria-Templated NiO Nanoparticles/Microstructure for an Enzymeless Glucose Sensor
Vaidyanathan, Settu; Cherng, Jong-Yuh; Sun, An-Cheng; Chen, Chien-Yen
2016-01-01
The bacterial-induced hollow cylinder NiO (HCNiO) nanomaterial was utilized for the enzymeless (without GOx) detection of glucose in basic conditions. The determination of glucose in 0.05 M NaOH solution with high sensitivity was performed using cyclic voltammetry (CV) and amperometry (i–t). The fundamental electrochemical parameters were analyzed and the obtained values of diffusion coefficient (D), heterogeneous rate constant (ks), electroactive surface coverage (Г), and transfer coefficient (alpha-α) are 1.75 × 10−6 cm2/s, 57.65 M−1·s−1, 1.45 × 10−10 mol/cm2, and 0.52 respectively. The peak current of the i–t method shows two dynamic linear ranges of calibration curves 0.2 to 3.5 µM and 0.5 to 250 µM for the glucose electro-oxidation. The Ni2+/Ni3+ couple with the HCNiO electrode and the electrocatalytic properties were found to be sensitive to the glucose oxidation. The green chemistry of NiO preparation from bacteria and the high catalytic ability of the oxyhydroxide (NiOOH) is the good choice for the development of a glucose sensor. The best obtained sensitivity and limit of detection (LOD) for this sensor were 3978.9 µA mM−1·cm−2 and 0.9 µM, respectively. PMID:27409615
Bacteria-Templated NiO Nanoparticles/Microstructure for an Enzymeless Glucose Sensor.
Vaidyanathan, Settu; Cherng, Jong-Yuh; Sun, An-Cheng; Chen, Chien-Yen
2016-07-11
The bacterial-induced hollow cylinder NiO (HCNiO) nanomaterial was utilized for the enzymeless (without GOx) detection of glucose in basic conditions. The determination of glucose in 0.05 M NaOH solution with high sensitivity was performed using cyclic voltammetry (CV) and amperometry (i-t). The fundamental electrochemical parameters were analyzed and the obtained values of diffusion coefficient (D), heterogeneous rate constant (ks), electroactive surface coverage (Г), and transfer coefficient (alpha-α) are 1.75 × 10(-6) cm²/s, 57.65 M(-1)·s(-1), 1.45 × 10(-10) mol/cm², and 0.52 respectively. The peak current of the i-t method shows two dynamic linear ranges of calibration curves 0.2 to 3.5 µM and 0.5 to 250 µM for the glucose electro-oxidation. The Ni(2+)/Ni(3+) couple with the HCNiO electrode and the electrocatalytic properties were found to be sensitive to the glucose oxidation. The green chemistry of NiO preparation from bacteria and the high catalytic ability of the oxyhydroxide (NiOOH) is the good choice for the development of a glucose sensor. The best obtained sensitivity and limit of detection (LOD) for this sensor were 3978.9 µA mM(-1)·cm(-2) and 0.9 µM, respectively.
Preparation of glucose sensors using gold nanoparticles modified diamond electrode
NASA Astrophysics Data System (ADS)
Fachrurrazie; Ivandini, T. A.; Wibowo, W.
2017-04-01
A glucose sensor was successfully developed by immobilizing glucose oxidase (GOx) at boron-doped diamond (BDD) electrodes. Prior to GOx immobilization, the BDD was modified with gold nanoparticles (AuNPs). To immobilize AuNPs, the gold surface was modified to nitrogen termination. The characterization of the electrode surface was performed using an X-ray photoelectron spectroscopy and a scanning electron microscope, while the electrochemical properties of the enzyme electrode were characterized using cyclic voltammetry. Cyclic voltammograms of the prepared electrode for D-glucose in phosphate buffer solution pH 7 showed a new reduction peak at +0.16 V. The currents of the peak were linear in the concentration range of 0.1 M to 0.9 M, indicated that the GOx-AuNP-BDD can be applied for electrochemical glucose detection.
Edge, Julie; Acerini, Carlo; Campbell, Fiona; Hamilton-Shield, Julian; Moudiotis, Chris; Rahman, Shakeel; Randell, Tabitha; Smith, Anne; Trevelyan, Nicola
2017-06-01
To determine accuracy, safety and acceptability of the FreeStyle Libre Flash Glucose Monitoring System in the paediatric population. Eighty-nine study participants, aged 4-17 years, with type 1 diabetes were enrolled across 9 diabetes centres in the UK. A factory calibrated sensor was inserted on the back of the upper arm and used for up to 14 days. Sensor glucose measurements were compared with capillary blood glucose (BG) measurements. Sensor results were masked to participants. Clinical accuracy of sensor results versus BG results was demonstrated, with 83.8% of results in zone A and 99.4% of results in zones A and B of the consensus error grid. Overall mean absolute relative difference (MARD) was 13.9%. Sensor accuracy was unaffected by patient factors such as age, body weight, sex, method of insulin administration or time of use (day vs night). Participants were in the target glucose range (3.9-10.0 mmol/L) ∼50% of the time (mean 12.1 hours/day), with an average of 2.2 hours/day and 9.5 hours/day in hypoglycaemia and hyperglycaemia, respectively. Sensor application, wear/use of the device and comparison to self-monitoring of blood glucose were rated favourably by most participants/caregivers (84.3-100%). Five device related adverse events were reported across a range of participant ages. Accuracy, safety and user acceptability of the FreeStyle Libre System were demonstrated for the paediatric population. Accuracy of the system was unaffected by subject characteristics, making it suitable for a broad range of children and young people with diabetes. NCT02388815. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
An alternative sensor-based method for glucose monitoring in children and young people with diabetes
Edge, Julie; Acerini, Carlo; Campbell, Fiona; Hamilton-Shield, Julian; Moudiotis, Chris; Rahman, Shakeel; Randell, Tabitha; Smith, Anne; Trevelyan, Nicola
2017-01-01
Objective To determine accuracy, safety and acceptability of the FreeStyle Libre Flash Glucose Monitoring System in the paediatric population. Design, setting and patients Eighty-nine study participants, aged 4–17 years, with type 1 diabetes were enrolled across 9 diabetes centres in the UK. A factory calibrated sensor was inserted on the back of the upper arm and used for up to 14 days. Sensor glucose measurements were compared with capillary blood glucose (BG) measurements. Sensor results were masked to participants. Results Clinical accuracy of sensor results versus BG results was demonstrated, with 83.8% of results in zone A and 99.4% of results in zones A and B of the consensus error grid. Overall mean absolute relative difference (MARD) was 13.9%. Sensor accuracy was unaffected by patient factors such as age, body weight, sex, method of insulin administration or time of use (day vs night). Participants were in the target glucose range (3.9–10.0 mmol/L) ∼50% of the time (mean 12.1 hours/day), with an average of 2.2 hours/day and 9.5 hours/day in hypoglycaemia and hyperglycaemia, respectively. Sensor application, wear/use of the device and comparison to self-monitoring of blood glucose were rated favourably by most participants/caregivers (84.3–100%). Five device related adverse events were reported across a range of participant ages. Conclusions Accuracy, safety and user acceptability of the FreeStyle Libre System were demonstrated for the paediatric population. Accuracy of the system was unaffected by subject characteristics, making it suitable for a broad range of children and young people with diabetes. Trial registration number NCT02388815. PMID:28137708
A Noninvasive In Vivo Glucose Sensor Based on Mid-Infrared Quantum Cascade Laser Spectroscopy
NASA Astrophysics Data System (ADS)
Werth, Alexandra; Liakat, Sabbir; Xu, Laura; Gmachl, Claire
Diabetes affects over 387 million people worldwide; a number which grows every year. The most common method of measuring blood glucose concentration involves a finger prick which for some can be a harrowing process. Therefore, a portable, accurate, noninvasive glucose sensor can significantly improve the quality of life for many of these diabetics who draw blood multiple times a day to monitor their glucose levels. We have implemented a noninvasive, mobile glucose sensor using a mid-infrared (MIR) quantum cascade laser (QCL), integrating sphere, and thermal electrically (TE) cooled detector. The QCL is scanned from 8 - 10 microns wavelength over which are distinct absorption features of glucose molecules with little competition of absorption from other molecules found in the blood and interstitial fluid. The obtained absorption spectra are analyzed using a neural network algorithm which relates the small changes in absorption to the changing glucose concentration. The integrating sphere has increased the signal-to-noise ratio from a previous design, allowing us to use the TE-cooled detector which increases mobility without loss of accuracy.
Yu, Songlin; Li, Dachao; Chong, Hao; Sun, Changyue; Yu, Haixia; Xu, Kexin
2013-01-01
Because mid-infrared (mid-IR) spectroscopy is not a promising method to noninvasively measure glucose in vivo, a method for minimally invasive high-precision glucose determination in vivo by mid-IR laser spectroscopy combined with a tunable laser source and small fiber-optic attenuated total reflection (ATR) sensor is introduced. The potential of this method was evaluated in vitro. This research presents a mid-infrared tunable laser with a broad emission spectrum band of 9.19 to 9.77μm(1024~1088 cm−1) and proposes a method to control and stabilize the laser emission wavelength and power. Moreover, several fiber-optic ATR sensors were fabricated and investigated to determine glucose in combination with the tunable laser source, and the effective sensing optical length of these sensors was determined for the first time. In addition, the sensitivity of this system was four times that of a Fourier transform infrared (FT-IR) spectrometer. The noise-equivalent concentration (NEC) of this laser measurement system was as low as 3.8 mg/dL, which is among the most precise glucose measurements using mid-infrared spectroscopy. Furthermore, a partial least-squares regression and Clarke error grid were used to quantify the predictability and evaluate the prediction accuracy of glucose concentration in the range of 5 to 500 mg/dL (physiologically relevant range: 30~400 mg/dL). The experimental results were clinically acceptable. The high sensitivity, tunable laser source, low NEC and small fiber-optic ATR sensor demonstrate an encouraging step in the work towards precisely monitoring glucose levels in vivo. PMID:24466493
A novel multicomponent redox polymer nanobead based high performance non-enzymatic glucose sensor.
Gopalan, A I; Muthuchamy, N; Komathi, S; Lee, K-P
2016-10-15
The fabrication of a highly sensitive electrochemical non-enzymatic glucose sensor based on copper nanoparticles (Cu NPs) dispersed in a graphene (G)-ferrocene (Fc) redox polymer multicomponent nanobead (MCNB) is reported. The preparation of MCNB involves three major steps, namely: i) the preparation of a poly(aniline-co-anthranilic acid)-grafted graphene (G-PANI(COOH), ii) the covalent linking of ferrocene to G-PANI(COOH) via a polyethylene imine (PEI), and iii) the electrodeposition of Cu NPs. The prepared MCNB (designated as G-PANI(COOH)-PEI-Fc/Cu-MCNB), contains a conductive G-PANI(COOH), electron mediating Fc, and electrocatalytic Cu NPs that make it suitable for ultrasensitive non-enzymatic electrochemical sensing. The morphology, structure, and electro activities of MCNB were characterized. Electrochemical measurements showed that the G-PANI(COOH)-PEI-Fc/Cu-MCNB/GCE modified electrode exhibited good electrocatalytic behavior towards the detection of glucose in a wide linear range (0.50 to 15mM), with a low detection limit (0.16mM) and high sensitivity (14.3µAmM(-1)cm(-2)). Besides, the G-PANI(COOH)-PEI-Fc/Cu-MCNB/GCE sensor electrode did not respond to the presence of electroactive interferrants (such as uric acid, ascorbic acid, and dopamine) and saccharides or carbohydrates (fructose, lactose, d-isoascorbic acid, and dextrin), demonstrating its selectivity towards glucose. The fabricated NEG sensor exhibited high precision for measuring glucose in serum samples, with an average RSD of 4.3% and results comparable to those of commercial glucose test strips. This reliability and stability of glucose sensing indicates that G-PANI(COOH)-PEI-Fc/Cu-MCNB/GCE would be a promising material for the non-enzymatic detection of glucose in physiological fluids. Copyright © 2015 Elsevier B.V. All rights reserved.
Liu, Zhiguang; Guo, Yujing; Dong, Chuan
2015-05-01
In this report, a new nanocomposite was successfully synthesized by chemical deposition of nickel nanoparticles (NiNPs) on polyvinylpyrrolidone (PVP) stabilized graphene nanosheets (GNs) with chitosan (CS) as the protective coating. The as obtained nanocomposite (PVP-GNs-NiNPs-CS) was characterized by X-ray photoelectron spectroscopy (XPS) and transmission electron microscopy (TEM). Benefiting from the synergistic effect of GNs (large surface area and high conductivity), NiNPs (high electrocatalytic activity towards the glucose oxidation) and CS (good film-forming and antifouling ability), a nonenzymatic electrochemical glucose sensor was established. The nanocomposite displays greatly enhanced electrocatalytic activity towards the glucose oxidation in NaOH solution. The PVP-GNs-NiNPs-CS based electrochemical glucose sensor demonstrates good sensitivity, wide linear range (0.1 μM-0.5 mM), outstanding detection limit (30 nM), attractive selectivity, good reproducibility, high stability as well as prominent feasibility for the real sample analysis. The proposed experiment might open up a new possibility for widespread use of non-enzymatic sensors for monitoring blood glucose owing to its advantages of low cost, simple preparation and excellent properties for glucose detection. Copyright © 2015 Elsevier B.V. All rights reserved.
A glucose oxidase-coupled DNAzyme sensor for glucose detection in tears and saliva.
Liu, Chengcheng; Sheng, Yongjie; Sun, Yanhong; Feng, Junkui; Wang, Shijin; Zhang, Jin; Xu, Jiacui; Jiang, Dazhi
2015-08-15
Biosensors have been widely investigated and utilized in a variety of fields ranging from environmental monitoring to clinical diagnostics. Glucose biosensors have triggered great interest and have been widely exploited since glucose determination is essential for diabetes diagnosis. In here, we designed a novel dual-enzyme biosensor composed of glucose oxidase (GOx) and pistol-like DNAzyme (PLDz) to detect glucose levels in tears and saliva. First, GOx, as a molecular recognition element, catalyzes the oxidation of glucose forming H2O2; then PLDz recognizes the produced H2O2 as a secondary signal and performs a self-cleavage reaction promoted by Mn(2+), Co(2+) and Cu(2+). Thus, detection of glucose could be realized by monitoring the cleavage rate of PLDz. The slope of the cleavage rate of PLDz versus glucose concentration curve was fitted with a Double Boltzmann equation, with a range of glucose from 100 nM to 10mM and a detection limit of 5 μM. We further applied the GOx-PLDz 1.0 biosensor for glucose detection in tears and saliva, glucose levels in which are 720±81 μM and 405±56 μM respectively. Therefore, the GOx-PLDz 1.0 biosensor is able to determine glucose levels in tears and saliva as a noninvasive glucose biosensor, which is important for diabetic patients with frequent/continuous glucose monitoring requirements. In addition, induction of DNAzyme provides a new approach in the development of glucose biosensors. Copyright © 2015 Elsevier B.V. All rights reserved.
Accuracy and reliability of continuous glucose monitoring systems: a head-to-head comparison.
Luijf, Yoeri M; Mader, Julia K; Doll, Werner; Pieber, Thomas; Farret, Anne; Place, Jerome; Renard, Eric; Bruttomesso, Daniela; Filippi, Alessio; Avogaro, Angelo; Arnolds, Sabine; Benesch, Carsten; Heinemann, Lutz; DeVries, J Hans
2013-08-01
This study assessed the accuracy and reliability of three continuous glucose monitoring (CGM) systems. We studied the Animas® (West Chester, PA) Vibe™ with Dexcom® (San Diego, CA) G4™ version A sensor (G4A), the Abbott Diabetes Care (Alameda, CA) Freestyle® Navigator I (NAV), and the Medtronic (Northridge, CA) Paradigm® with Enlite™ sensor (ENL) in 20 patients with type 1 diabetes mellitus. All systems were investigated both in a clinical research center (CRC) and at home. In the CRC, patients received a meal with a delayed and increased insulin dose to induce a postprandial glucose peak and nadir. Hereafter, randomization determined which two of the three systems would be worn at home until the end of functioning, attempting use beyond manufacturer-specified lifetime. Patients performed at least five reference finger sticks per day. An analysis of variance was performed on all data points ≥15 min apart. Overall average mean absolute relative difference (MARD) (SD) measured at the CRC was 16.5% (14.3%) for NAV and 16.4% (15.6%) for ENL, outperforming G4A at 20.5% (18.2%) (P<0.001). Overall MARD when assessed at home was 14.5% (16.7%) for NAV and 16.5 (18.8%) for G4A, outperforming ENL at 18.9% (23.6%) (P=0.006). Median time until end of functioning was similar: 10.0 (1.0) days for G4A, 8.0 (3.5) days for NAV, and 8.0 (1.5) days for ENL (P=0.119). In the CRC, G4A was less accurate than NAV and ENL sensors, which seemed comparable. However, at home, ENL was less accurate than NAV and G4A. Moreover, CGM systems often show sufficient accuracy to be used beyond manufacturer-specified lifetime.
De Block, Christophe; Manuel-y-Keenoy, Begoña; Rogiers, Peter; Jorens, Philippe; Van Gaal, Luc
2008-08-01
Stress hyperglycemia recently became a major therapeutic target in the Intensive Care Unit (ICU) since it occurs in most critically ill patients and is associated with adverse outcome, including increased mortality. Intensive insulin therapy to achieve normoglycemia may reduce mortality, morbidity and the length of ICU and in-hospital stay. However, obtaining normoglycemia requires extensive efforts from the medical staff, including frequent glucose monitoring and adjustment of insulin dose. Current insulin titration is based upon discrete glucose measurements, which may miss fast changes in glycemia and which does not give a full picture of overall glycemic control. Recent evidence suggests that continuous monitoring of glucose levels may help to signal glycemic excursions and eventually to optimize insulin titration in the ICU. In this review we will summarise monitoring and treatment strategies to achieve normoglycemia in the ICU, with special emphasis on the possible advantages of continuous glucose monitoring.
Molazemhosseini, Alireza; Liu, Chung Chiun
2018-01-01
A cuprous oxide (Cu2O) thin layer served as the base for a non-enzymatic glucose sensor in an alkaline medium, 0.1 NaOH solution, with a linear range of 50–200 mg/dL using differential pulse voltammetry (DPV) measurement. An X-ray photoelectron spectroscopy (XPS) study confirmed the formation of the cuprous oxide layer on the thin gold film sensor prototype. Quantitative detection of glucose in both phosphate-buffered saline (PBS) and undiluted human serum was carried out. Neither ascorbic acid nor uric acid, even at a relatively high concentration level (100 mg/dL in serum), interfered with the glucose detection, demonstrating the excellent selectivity of this non-enzymatic cuprous oxide thin layer-based glucose sensor. Chronoamperometry and single potential amperometric voltammetry were used to verify the measurements obtained by DPV, and the positive results validated that the detection of glucose in a 0.1 M NaOH alkaline medium by DPV measurement was effective. Nickel, platinum, and copper are commonly used metals for non-enzymatic glucose detection. The performance of these metal-based sensors for glucose detection using DPV were also evaluated. The cuprous oxide (Cu2O) thin layer-based sensor showed the best sensitivity for glucose detection among the sensors evaluated. PMID:29316652
Continuous Glucose Monitoring: A Review of Successes, Challenges, and Opportunities.
Rodbard, David
2016-02-01
Continuous glucose monitoring (CGM) provides information unattainable by intermittent capillary blood glucose, including instantaneous real-time display of glucose level and rate of change of glucose, alerts and alarms for actual or impending hypo- and hyperglycemia, "24/7" coverage, and the ability to characterize glycemic variability. Progressively more accurate and precise, reasonably unobtrusive, small, comfortable, user-friendly devices connect to the Internet to share information and are sine qua non for a closed-loop artificial pancreas. CGM can inform, educate, motivate, and alert people with diabetes. CGM is medically indicated for patients with frequent, severe, or nocturnal hypoglycemia, especially in the presence of hypoglycemia unawareness. Surprisingly, despite tremendous advances, utilization of CGM has remained fairly limited to date. Barriers to use have included the following: (1) lack of Food and Drug Administration approval, to date, for insulin dosing ("nonadjuvant use") in the United States and for use in hospital and intensive care unit settings; (2) cost and variable reimbursement; (3) need for recalibrations; (4) periodic replacement of sensors; (5) day-to-day variability in glycemic patterns, which can limit the predictability of findings based on retrospective, masked "professional" use; (6) time, implicit costs, and inconvenience for uploading of data for retrospective analysis; (7) lack of fair and reasonable reimbursement for physician time; (8) inexperience and lack of training of physicians and other healthcare professionals regarding interpretation of CGM results; (9) lack of standardization of software methods for analysis of CGM data; and (10) need for professional medical organizations to develop and disseminate additional clinical practice guidelines regarding the role of CGM. Ongoing advances in technology and clinical research have addressed several of these barriers. Use of CGM in conjunction with an insulin pump with
Continuous Glucose Monitoring: A Review of Successes, Challenges, and Opportunities
2016-01-01
Abstract Continuous glucose monitoring (CGM) provides information unattainable by intermittent capillary blood glucose, including instantaneous real-time display of glucose level and rate of change of glucose, alerts and alarms for actual or impending hypo- and hyperglycemia, “24/7” coverage, and the ability to characterize glycemic variability. Progressively more accurate and precise, reasonably unobtrusive, small, comfortable, user-friendly devices connect to the Internet to share information and are sine qua non for a closed-loop artificial pancreas. CGM can inform, educate, motivate, and alert people with diabetes. CGM is medically indicated for patients with frequent, severe, or nocturnal hypoglycemia, especially in the presence of hypoglycemia unawareness. Surprisingly, despite tremendous advances, utilization of CGM has remained fairly limited to date. Barriers to use have included the following: (1) lack of Food and Drug Administration approval, to date, for insulin dosing (“nonadjuvant use”) in the United States and for use in hospital and intensive care unit settings; (2) cost and variable reimbursement; (3) need for recalibrations; (4) periodic replacement of sensors; (5) day-to-day variability in glycemic patterns, which can limit the predictability of findings based on retrospective, masked “professional” use; (6) time, implicit costs, and inconvenience for uploading of data for retrospective analysis; (7) lack of fair and reasonable reimbursement for physician time; (8) inexperience and lack of training of physicians and other healthcare professionals regarding interpretation of CGM results; (9) lack of standardization of software methods for analysis of CGM data; and (10) need for professional medical organizations to develop and disseminate additional clinical practice guidelines regarding the role of CGM. Ongoing advances in technology and clinical research have addressed several of these barriers. Use of CGM in conjunction with an
Biostability of an implantable glucose sensor chip
NASA Astrophysics Data System (ADS)
Fröhlich, M.; Birkholz, M.; Ehwald, K. E.; Kulse, P.; Fursenko, O.; Katzer, J.
2012-12-01
Surface materials of an implantable microelectronic chip intended for medical applications were evaluated with respect to their long-term stability in bio-environments. The sensor chip shall apply in a glucose monitor by operating as a microviscosimeter according to the principle of affinity viscosimetry. A monolithic integration of a microelectromechanical system (MEMS) into the sensor chip was successfully performed in a combined 0.25 μm CMOS/BiCMOS technology. In order to study material durability and biostability of the surfaces, sensor chips were exposed to various in vitro and in vivo tests. Corrosional damage of SiON, SiO2 and TiN surfaces was investigated by optical microscopy, ellipsometry and AFM. The results served for optimizing the Back-end-of-Line (BEoL) stack, from which the MEMS was prepared. Corrosion of metal lines could significantly be reduced by improving the topmost passivation layer. The experiments revealed no visible damage of the actuator or other functionally important MEMS elements. Sensor chips were also exposed to human body fluid for three month by implantation into the abdomen of a volunteer. Only small effects were observed for layer thickness and Ra roughness after explantation. In particular, TiN as used for the actuator beam showed no degradation by biocorrosion. The highest degradation rate of about 50 nm per month was revealed for the SiON passivation layer. These results suggest that the sensor chip may safely operate in subcutaneous tissue for a period of several months.
Soto, Robert J; Schoenfisch, Mark H
2015-06-17
The utility of continuous glucose monitoring devices remains limited by an obstinate foreign body response (FBR) that degrades the analytical performance of the in vivo sensor. A number of novel materials that resist or delay the FBR have been proposed as outer, tissue-contacting glucose sensor membranes as a strategy to improve sensor accuracy. Traditionally, researchers have examined the ability of a material to minimize the host response by assessing adsorbed cell morphology and tissue histology. However, these techniques do not adequately predict in vivo glucose sensor function, necessitating sensor performance evaluation in a relevant animal model prior to human testing. Herein, the effects of critical experimental parameters, including the animal model and data processing methods, on the reliability and usefulness of preclinical sensor performance data are considered. © 2015 Diabetes Technology Society.
Wadwa, R Paul; Laffel, Lori M; Shah, Viral N; Garg, Satish K
2018-06-01
Frequent use of continuous glucose monitoring (CGM) systems is associated with improved glycemic outcomes in persons with diabetes, but the need for calibrations and sensor insertions are often barriers to adoption. In this study, we evaluated the performance of G6, a sixth-generation, factory-calibrated CGM system specified for 10-day wear. The study enrolled participants of ages 6 years and up with type 1 diabetes or insulin-treated type 2 diabetes at 11 sites in the United States. Participation involved one sensor wear period of up to 10 days. Adults wore the system on the abdomen; youth of ages 6-17 years could choose to wear it on the abdomen or upper buttocks. Clinic sessions for frequent comparison with reference blood glucose measurements took place on days 1, 4-5, 7, and/or 10. Participants of ages 13 years and up underwent purposeful supervised glucose manipulation during in-clinic sessions. During the study, participants calibrated the systems once daily. However, analysis was performed on glucose values that were derived from reprocessed raw sensor data, independently of self-monitored blood glucose values used for calibration. Reprocessing used assigned sensor codes and a factory-calibration algorithm. Performance evaluation included the proportion of CGM values that were within ±20% of reference glucose values >100 mg/dL or within ±20 mg/dL of reference glucose values ≤100 mg/dL (%20/20), the analogous %15/15, and the mean absolute relative difference (MARD, expressed as a percentage) between temporally matched CGM and reference values. Data from 262 study participants (21,569 matched CGM reference pairs) were analyzed. The overall %15/15, %20/20, and MARD were 82.4%, 92.3%, and 10.0%, respectively. Matched pairs from 134 adults and 128 youth of ages 6-17 years were similar with respect to %20/20 (92.4% and 91.9%) and MARD (9.9% and 10.1%). Overall %20/20 values on days 1 and 10 of sensor wear were 88.6% and 90.6%, respectively. The system
Laffel, Lori
2016-02-01
This study was designed to evaluate accuracy, performance, and safety of the Dexcom (San Diego, CA) G4(®) Platinum continuous glucose monitoring (CGM) system (G4P) compared with the Dexcom G4 Platinum with Software 505 algorithm (SW505) when used as adjunctive management to blood glucose (BG) monitoring over a 7-day period in youth, 2-17 years of age, with diabetes. Youth wore either one or two sensors placed on the abdomen or upper buttocks for 7 days, calibrating the device twice daily with a uniform BG meter. Participants had one in-clinic session on Day 1, 4, or 7, during which fingerstick BG measurements (self-monitoring of blood glucose [SMBG]) were obtained every 30 ± 5 min for comparison with CGM, and in youth 6-17 years of age, reference YSI glucose measurements were obtained from arterialized venous blood collected every 15 ± 5 min for comparison with CGM. The sensor was removed by the participant/family after 7 days. In comparison of 2,922 temporally paired points of CGM with the reference YSI measurement for G4P and 2,262 paired points for SW505, the mean absolute relative difference (MARD) was 17% for G4P versus 10% for SW505 (P < 0.0001). In comparison of 16,318 temporally paired points of CGM with SMBG for G4P and 4,264 paired points for SW505, MARD was 15% for G4P versus 13% for SW505 (P < 0.0001). Similarly, error grid analyses indicated superior performance with SW505 compared with G4P in comparison of CGM with YSI and CGM with SMBG results, with greater percentages of SW505 results falling within error grid Zone A or the combined Zones A plus B. There were no serious adverse events or device-related serious adverse events for either the G4P or the SW505, and there was no sensor breakoff. The updated algorithm offers substantial improvements in accuracy and performance in pediatric patients with diabetes. Use of CGM with improved performance has potential to increase glucose time in range and improve glycemic outcomes for youth.
McGarraugh, Geoffrey
2010-01-01
Continuous glucose monitoring (CGM) devices available in the United States are approved for use as adjuncts to self-monitoring of blood glucose (SMBG); all CGM alarms require SMBG confirmation before treatment. In this report, an analysis method is proposed to determine the CGM threshold alarm accuracy required to eliminate SMBG confirmation. The proposed method builds on the Clinical and Laboratory Standards Institute (CLSI) guideline for evaluating CGM threshold alarms using data from an in-clinic study of subjects with type 1 diabetes. The CLSI method proposes a maximum time limit of +/-30 minutes for the detection of hypo- and hyperglycemic events but does not include limits for glucose measurement accuracy. The International Standards Organization (ISO) standard for SMBG glucose measurement accuracy (ISO 15197) is +/-15 mg/dl for glucose <75 mg/dl and +/-20% for glucose > or = 75 mg/dl. This standard was combined with the CLSI method to more completely characterize the accuracy of CGM alarms. Incorporating the ISO 15197 accuracy margins, FreeStyle Navigator CGM system alarms detected 70 mg/dl hypoglycemia within 30 minutes at a rate of 70.3%, with a false alarm rate of 11.4%. The device detected high glucose in the range of 140-300 mg/dl within 30 minutes at an average rate of 99.2%, with a false alarm rate of 2.1%. Self-monitoring of blood glucose confirmation is necessary for detecting and treating hypoglycemia with the FreeStyle Navigator CGM system, but at high glucose levels, SMBG confirmation adds little incremental value to CGM alarms. 2010 Diabetes Technology Society.
Data-driven strategies for robust forecast of continuous glucose monitoring time-series.
Fiorini, Samuele; Martini, Chiara; Malpassi, Davide; Cordera, Renzo; Maggi, Davide; Verri, Alessandro; Barla, Annalisa
2017-07-01
Over the past decade, continuous glucose monitoring (CGM) has proven to be a very resourceful tool for diabetes management. To date, CGM devices are employed for both retrospective and online applications. Their use allows to better describe the patients' pathology as well as to achieve a better control of patients' level of glycemia. The analysis of CGM sensor data makes possible to observe a wide range of metrics, such as the glycemic variability during the day or the amount of time spent below or above certain glycemic thresholds. However, due to the high variability of the glycemic signals among sensors and individuals, CGM data analysis is a non-trivial task. Standard signal filtering solutions fall short when an appropriate model personalization is not applied. State-of-the-art data-driven strategies for online CGM forecasting rely upon the use of recursive filters. Each time a new sample is collected, such models need to adjust their parameters in order to predict the next glycemic level. In this paper we aim at demonstrating that the problem of online CGM forecasting can be successfully tackled by personalized machine learning models, that do not need to recursively update their parameters.
Kamann, Stefanie; Aerts, Olivier; Heinemann, Lutz
2018-05-01
In the past decade, new diabetes technologies, including continuous glucose monitoring (CGM) systems, support patients with diabetes in their daily struggle with achieving a good glucose control. However, shortly after the first CGM systems appeared on the market, also the first concerns about adverse skin reactions were raised. Most patients claimed to suffer from (sometimes severe) skin irritation, or even allergy, which they related to the (acrylate-based) adhesive part of the device. For a long time the actual substance that caused these skin reactions with, for example, the Flash Glucose Monitoring system (iscCGM; Freestyle® Libre) could not be identified; however, recently Belgian and Swedish dermatologists reported that the majority of their patients that have developed a contact-allergic while using iscCGM react sensitively to a specific acrylate, that is, isobornyl acrylate (IBOA). Subsequently they showed by means of gas chromatography-mass spectrometry that this substance is present in the case of the glucose sensor attached by an adhesive to the skin. We report three additional cases from Germany, including a 10-year-old boy, suffering from severe allergic contact dermatitis to IBOA.
Liu, Yang; Teng, Hong; Hou, Haoqing; You, Tianyan
2009-07-15
A novel nonenzymatic glucose sensor was developed based on the renewable Ni nanoparticle-loaded carbon nanofiber paste (NiCFP) electrode. The NiCF nanocomposite was prepared by combination of electrospinning technique with thermal treatment method. The scanning electron microscopy (SEM) and transmission electron microscopy (TEM) images showed that large amounts of spherical nanoparticles were well dispersed on the surface or embedded in the carbon nanofibers. And the nanoparticles were composed of Ni and NiO, as revealed by energy dispersive X-ray spectroscopy (EDX) and X-ray powder diffraction (XRD). In application to nonenzymatic glucose determination, the renewable NiCFP electrodes, which were constructed by simply mixing the electrospun nanocomposite with mineral oil, exhibited strong and fast amperometric response without being poisoned by chloride ions. Low detection limit of 1 microM with wide linear range from 2 microM to 2.5 mM (R=0.9997) could be obtained. The current response of the proposed glucose sensor was highly sensitive and stable, attributing to the electrocatalytic performance of the firmly embedded Ni nanoparticles as well as the chemical inertness of the carbon-based electrode. The good analytical performance, low cost and straightforward preparation method made this novel electrode material promising for the development of effective glucose sensor.
Colvin, Arthur E; Jiang, Hui
2013-05-01
Understanding and improving in vivo materials related to signal stability and preservation for active chemical sensor and biosensor transduction systems is critical in achieving implantable medical sensors for long-term in vivo applications. During human in vivo clinical testing of an implantable glucose sensor based on a glucose sensitive hydrogel, post-explant analysis showed that the boronate recognition element had been oxidized from the fluorescent indicator, causing a rapid loss of signal within hours after implant. Additional wet-bench analytical evidence and reproduction in vitro suggests reactive oxygen species, particularly hydrogen peroxide (H2O2), stemming from natural inflammatory response to the material, to be the cause of the observed oxidative de-boronation. A 3-nm thick deposition of metallic platinum (Pt) placed by plasma sputtering onto the porous surface of the hydrogel, showed immediate protection from sensor signal loss due to oxidation both in vitro and in vivo, greatly extending the useful lifetime of the implantable glucose sensor from 1 day to an expected ≥6 months. This finding may represent a new strategy to protect an implanted material and/or device from in vivo oxidative damage, leading to much improved overall stability and reliability for long-term applications. Copyright © 2012 Wiley Periodicals, Inc.
López Gutiérrez, Sònia; Pavía Sesma, Carlos
2010-10-01
At present times, Continuous Glucose Monitoring is a recommended method to detect glucemia fluctuations in patients who have diabetes, due to the fine correlation between interstitial glucose and capillary glucemia. The objective of this project is obtain a glucose register during a 48 hour period in a group of Type I diabetes patients who have an irregular metabolic control and to evaluate effectiveness of treatment employed, as well as evaluating compliance of the therapeutic norms established for each patient. At the same time, the authors plan to test the usefulness of a graphical register for diabetic education. After applying an anesthetic cream in the lateral umbilical zone, a subcutaneous catheter connected to a GLUCODAY, Menarini Diagnostics glucose sensor is inserted which, by means of a continuous sequence taking measures in interstitial liquid, registers a value every three minutes for as long as this connection is maintained. After a maximum 48 hour period, data are transferred to a computer and by means of the corresponding computer program, a graphic register for each patient is produced. Informed consent has been obtained from each patient. There were 23 patients in this study group, each diagnosed to have Type I diabetes; eight of these patients, two girls and six boys, were pre-puberty aged while 15, six girls and nine boys, were adolescents. Two of the pre-puberty patients had pathological antecedents, in one case celiac and the other thyroid disease. Two of the puberty aged patients had a history of chronic lymphocytic thyroid disease under opo-therapeutic treatment. Individual analysis of each case permits health professionals to detect a series of facts: it is difficult to comply with glucemic objectives in this group of adolescents having diabetes, with insulin treatment installed and researchers detect postprandial hyper-glucemia which do not appear when using capillary glucemias carried out by habitual methods. Study observations manifest a
Fox, Larry A; Balkman, Emilie; Englert, Kim; Hossain, Jobayer; Mauras, Nelly
2017-06-01
This study explored the safety of using real-time sensor glucose (SG) data for treatment decisions in adolescents with poorly controlled type 1 diabetes. Ten adolescents with type 1 diabetes, HbA1c ≥9% on insulin pumps were admitted to the clinical research center and a continuous glucose sensor was inserted. Plasma glucose was measured at least hourly using Yellow Springs Instrument's (YSI) glucose analyzer. Starting at dinner, SG rather than YSI was used for treatment decisions unless YSI was <70 mg/dL (<3.9 mmol/L) or specific criteria indicating SG and YSI were very discordant were met. Participants were discharged after lunch the next day. Ten participants (seven males; 15.2-17.8 year old) completed the study. The range of differences between high glucose correction doses using SG vs YSI for calculations was -2 (SG < YSI dose) to +1 (SG > YSI dose); this difference was two units in only 2 of 23 correction doses given (all SG < YSI dose). There were five episodes of mild hypoglycemia in two patients, two of which occurred after using SG for dose calculations. There was no severe hypoglycemia and no YSI glucose >350 mg/dL (19.4 mmol/L). Mean (±SE) pre- and postmeal YSI glucose were 163 ± 11 and 183 ± 12 mg/dL (9.1 ± 0.6 and 10.2 ± 0.7 mmol/L), respectively. Use of real-time continuous glucose monitoring for treatment decisions was safe and did not result in significant over- or undertreatment. Use of SG for treatment decisions under supervised inpatient conditions is a suitable alternative to repeated fingerstick glucose monitoring. Outpatient studies using SG in real-time are needed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Ng, Tzu Shan; Chew, Shu Yih; Rangasamy, Premmala; Mohd Desa, Mohd N; Sandai, Doblin; Chong, Pei Pei; Than, Leslie Thian Lung
2015-01-01
Candida glabrata is an emerging human fungal pathogen that has efficacious nutrient sensing and responsiveness ability. It can be seen through its ability to thrive in diverse range of nutrient limited-human anatomical sites. Therefore, nutrient sensing particularly glucose sensing is thought to be crucial in contributing to the development and fitness of the pathogen. This study aimed to elucidate the role of SNF3 (Sucrose Non Fermenting 3) as a glucose sensor and its possible role in contributing to the fitness and survivability of C. glabrata in glucose-limited environment. The SNF3 knockout strain was constructed and subjected to different glucose concentrations to evaluate its growth, biofilm formation, amphotericin B susceptibility, ex vivo survivability and effects on the transcriptional profiling of the sugar receptor repressor (SRR) pathway-related genes. The CgSNF3Δ strain showed a retarded growth in low glucose environments (0.01 and 0.1%) in both fermentation and respiration-preferred conditions but grew well in high glucose concentration environments (1 and 2%). It was also found to be more susceptible to amphotericin B in low glucose environment (0.1%) and macrophage engulfment but showed no difference in the biofilm formation capability. The deletion of SNF3 also resulted in the down-regulation of about half of hexose transporters genes (four out of nine). Overall, the deletion of SNF3 causes significant reduction in the ability of C. glabrata to sense limited surrounding glucose and consequently disrupts its competency to transport and perform the uptake of this critical nutrient. This study highlighted the role of SNF3 as a high affinity glucose sensor and its role in aiding the survivability of C. glabrata particularly in glucose limited environment.
"Smart tattoo" glucose biosensors and effect of coencapsulated anti-inflammatory agents.
Srivastava, Rohit; Jayant, Rahul Dev; Chaudhary, Ayesha; McShane, Michael J
2011-01-01
Minimally invasive glucose biosensors with increased functional longevity form one of the most promising techniques for continuous glucose monitoring. In the present study, we developed a novel nanoengineered microsphere formulation comprising alginate microsphere glucose sensors and anti-inflammatory-drug-loaded alginate microspheres. The formulation was prepared and characterized for size, shape, in vitro drug release, biocompatibility, and in vivo acceptability. Glucose oxidase (GOx)- and Apo-GOx-based glucose sensors were prepared and characterized. Sensing was performed both in distilled water and simulated interstitial body fluid. Layer-by-layer self-assembly techniques were used for preventing drug and sensing chemistry release. Finally, in vivo studies, involving histopathologic examination of subcutaneous tissue surrounding the implanted sensors using Sprague-Dawley rats, were performed to test the suppression of inflammation and fibrosis associated with glucose sensor implantation. The drug formulation showed 100% drug release with in 30 days with zero-order release kinetics. The GOx-based sensors showed good enzyme retention and enzyme activity over a period of 1 month. Apo-GOx-based visible and near-infrared sensors showed good sensitivity and analytical response range of 0-50 mM glucose, with linear range up to 12 mM glucose concentration. In vitro cell line studies proved biocompatibility of the material used. Finally, both anti-inflammatory drugs were successful in controlling the implant-tissue interface by suppressing inflammation at the implant site. The incorporation of anti-inflammatory drug with glucose biosensors shows promise in improving sensor biocompatibility, thereby suggesting potential application of alginate microspheres as "smart tattoo" glucose sensors with increased functional longevity. © 2010 Diabetes Technology Society.
Grunberger, George; Handelsman, Yehuda; Bloomgarden, Zachary T; Fonseca, Vivian A; Garber, Alan J; Haas, Richard A; Roberts, Victor L; Umpierrez, Guillermo E
2018-03-01
This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician. AACE/ACE Task Force on Integration of Insulin Pumps and Continuous Glucose Monitoring in the Management of Patients With Diabetes Mellitus Chair George Grunberger, MD, FACP, FACE Task Force Members Yehuda Handelsman, MD, FACP, FNLA, MACE Zachary T. Bloomgarden, MD, MACE Vivian A. Fonseca, MD, FACE Alan J. Garber, MD, PhD, FACE Richard A. Haas, MD, FACE Victor L. Roberts, MD, MBA, FACP, FACE Guillermo E. Umpierrez, MD, CDE, FACP, FACE Abbreviations: AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology A1C = glycated hemoglobin BGM = blood glucose monitoring CGM = continuous glucose monitoring CSII = continuous subcutaneous insulin infusion DM = diabetes mellitus FDA = Food & Drug Administration MDI = multiple daily injections T1DM = type 1 diabetes mellitus T2DM = type 2 diabetes mellitus SAP = sensor-augmented pump SMBG = self-monitoring of blood glucose STAR 3 = Sensor-Augmented Pump Therapy for A1C Reduction phase 3 trial.
Noninvasive Diagnostic Devices for Diabetes through Measuring Tear Glucose
Zhang, Jin; Hodge, William; Hutnick, Cindy; Wang, Xianbin
2011-01-01
This article reviews the development of a noninvasive diagnostic for diabetes by detecting ocular glucose. Early diagnosis and daily management are very important to diabetes patients to ensure a healthy life. Commercial blood glucose sensors have been used since the 1970s. Millions of diabetes patients have to prick their finger for a drop of blood 4–5 times a day to check blood glucose levels—almost 1800 times annually. There is a strong need to have a noninvasive device to help patients to manage the disease easily and painlessly. Instead of detecting the glucose in blood, monitoring the glucose level in other body fluids may provide a feasible approach for noninvasive diagnosis and diabetes control. Tear glucose has been studied for several decades. This article reviews studies on ocular glucose and its monitoring methods. Attempts to continuously monitor the concentration of tear glucose by using contact lens-based sensors are discussed as well as our current development of a nanostructured lens-based sensor for diabetes. This disposable biosensor for the detection of tear glucose may provide an alternative method to help patients manage the disease conveniently. PMID:21303640
Noninvasive diagnostic devices for diabetes through measuring tear glucose.
Zhang, Jin; Hodge, William; Hutnick, Cindy; Wang, Xianbin
2011-01-01
This article reviews the development of a noninvasive diagnostic for diabetes by detecting ocular glucose. Early diagnosis and daily management are very important to diabetes patients to ensure a healthy life. Commercial blood glucose sensors have been used since the 1970s. Millions of diabetes patients have to prick their finger for a drop of blood 4-5 times a day to check blood glucose levels--almost 1800 times annually. There is a strong need to have a noninvasive device to help patients to manage the disease easily and painlessly. Instead of detecting the glucose in blood, monitoring the glucose level in other body fluids may provide a feasible approach for noninvasive diagnosis and diabetes control. Tear glucose has been studied for several decades. This article reviews studies on ocular glucose and its monitoring methods. Attempts to continuously monitor the concentration of tear glucose by using contact lens-based sensors are discussed as well as our current development of a nanostructured lens-based sensor for diabetes. This disposable biosensor for the detection of tear glucose may provide an alternative method to help patients manage the disease conveniently. © 2010 Diabetes Technology Society.
Nano-Engineered Biomimetic Optical Sensors for Glucose Monitoring in Diabetes.
Rauf, Sajid; Hayat Nawaz, Muhammad Azhar; Badea, Mihaela; Marty, Jean Louis; Hayat, Akhtar
2016-11-17
Diabetes is a rapidly growing disease that can be monitored at an individual level by controlling the blood glucose level, hence minimizing the negative impact of the disease. Significant research efforts have been focused on the design of novel and improved technologies to overcome the limitations of existing glucose analysis methods. In this context, nanotechnology has enabled the diagnosis at the single cell and molecular level with the possibility of incorporation in advanced molecular diagnostic biochips. Recent years have witnessed the exploration and synthesis of various types of nanomaterials with enzyme-like properties, with their subsequent integration into the design of biomimetic optical sensors for glucose monitoring. This review paper will provide insights on the type, nature and synthesis of different biomimetic nanomaterials. Moreover, recent developments in the integration of these nanomaterials for optical glucose biosensing will be highlighted, with a final discussion on the challenges that must be addressed for successful implementation of these nano-devices in the clinical applications is presented.
Nano-Engineered Biomimetic Optical Sensors for Glucose Monitoring in Diabetes
Rauf, Sajid; Hayat Nawaz, Muhammad Azhar; Badea, Mihaela; Marty, Jean Louis; Hayat, Akhtar
2016-01-01
Diabetes is a rapidly growing disease that can be monitored at an individual level by controlling the blood glucose level, hence minimizing the negative impact of the disease. Significant research efforts have been focused on the design of novel and improved technologies to overcome the limitations of existing glucose analysis methods. In this context, nanotechnology has enabled the diagnosis at the single cell and molecular level with the possibility of incorporation in advanced molecular diagnostic biochips. Recent years have witnessed the exploration and synthesis of various types of nanomaterials with enzyme-like properties, with their subsequent integration into the design of biomimetic optical sensors for glucose monitoring. This review paper will provide insights on the type, nature and synthesis of different biomimetic nanomaterials. Moreover, recent developments in the integration of these nanomaterials for optical glucose biosensing will be highlighted, with a final discussion on the challenges that must be addressed for successful implementation of these nano-devices in the clinical applications is presented. PMID:27869658
Fang, Yu-Lin; Wang, Chen-Tung; Chiang, Chia-Chin
2016-09-09
The study proposes a small U-shaped bending-induced interference optical fiber sensor; this novel sensor is a probe-type sensor manufactured using a mechanical device, a heat source, optical fiber and a packaging module. This probe-type sensor overcomes the shortcomings of conventional optical fibers, including being difficult to repair and a tendency to be influenced by external forces. We manufactured three types of sensors with different curvature radiuses. Specifically, sensors with three radiuses (1.5 mm, 2.0 mm, and 3.0 mm) were used to measure common water and glucose solutions with concentrations of between 6% and 30% (the interval between concentrations was 4%). The results show that the maximal sensitivity was 0.85 dB/% and that the linearly-dependent coefficient was 0.925. The results further show that not only can the small U-shaped bending-induced interference optical fiber sensor achieve high sensitivity in the measurement of glucose solutions, but that it can also achieve great stability and repeatability.
Kovatchev, Boris P; Clarke, William L; Breton, Marc; Brayman, Kenneth; McCall, Anthony
2005-12-01
Continuous glucose monitors (CGMs) collect detailed blood glucose (BG) time series, which carry significant information about the dynamics of BG fluctuations. In contrast, the methods for analysis of CGM data remain those developed for infrequent BG self-monitoring. As a result, important information about the temporal structure of the data is lost during the translation of raw sensor readings into clinically interpretable statistics and images. The following mathematical methods are introduced into the field of CGM data interpretation: (1) analysis of BG rate of change; (2) risk analysis using previously reported Low/High BG Indices and Poincare (lag) plot of risk associated with temporal BG variability; and (3) spatial aggregation of the process of BG fluctuations and its Markov chain visualization. The clinical application of these methods is illustrated by analysis of data of a patient with Type 1 diabetes mellitus who underwent islet transplantation and with data from clinical trials. Normative data [12,025 reference (YSI device, Yellow Springs Instruments, Yellow Springs, OH) BG determinations] in patients with Type 1 diabetes mellitus who underwent insulin and glucose challenges suggest that the 90%, 95%, and 99% confidence intervals of BG rate of change that could be maximally sustained over 15-30 min are [-2,2], [-3,3], and [-4,4] mg/dL/min, respectively. BG dynamics and risk parameters clearly differentiated the stages of transplantation and the effects of medication. Aspects of treatment were clearly visualized by graphs of BG rate of change and Low/High BG Indices, by a Poincare plot of risk for rapid BG fluctuations, and by a plot of the aggregated Markov process. Advanced analysis and visualization of CGM data allow for evaluation of dynamical characteristics of diabetes and reveal clinical information that is inaccessible via standard statistics, which do not take into account the temporal structure of the data. The use of such methods improves the
Continuous-Reading Cryogen Level Sensor
NASA Technical Reports Server (NTRS)
Barone, F. E.; Fox, E.; Macumber, S.
1984-01-01
Two pressure transducers used in system for measuring amount of cryogenic liquid in tank. System provides continuous measurements accurate within 0.03 percent. Sensors determine pressure in liquid and vapor in tank. Microprocessor uses pressure difference to compute mass of cryogenic liquid in tank. New system allows continuous sensing; unaffected by localized variations in composition and density as are capacitance-sensing schemes.
Helminen, Olli; Pokka, Tytti; Tossavainen, Päivi; Ilonen, Jorma; Knip, Mikael; Veijola, Riitta
2016-10-01
Continuous glucose monitoring (CGM) parameters, self-monitored blood glucose (SMBG), HbA1c and oral glucose tolerance test (OGTT) were studied during preclinical type 1 diabetes mellitus. Ten asymptomatic children with multiple (⩾2) islet autoantibodies (cases) and 10 age and sex-matched autoantibody-negative controls from the Type 1 Diabetes Prediction and Prevention (DIPP) Study were invited to 7-day CGM with Dexcom G4 Platinum Sensor. HbA1c and two daily SMBG values (morning and evening) were analyzed. Five-point OGTTs were performed and carbohydrate intake was assessed by food records. The matched pairs were compared with the paired sample t-test. The cases showed higher mean values and higher variation in glucose levels during CGM compared to the controls. The time spent ⩾7.8mmol/l was 5.8% in the cases compared to 0.4% in the controls (p=0.040). Postprandial CGM values were similar except after the dinner (6.6mmol/l in cases vs. 6.1mmol/l in controls; p=0.023). When analyzing the SMBG values higher mean level, higher evening levels, as well as higher variation were observed in the cases when compared to the controls. HbA1c was significantly higher in the cases [5.7% (39mmol/mol) vs. 5.3% (34mmol/mol); p=0.045]. No differences were observed in glucose or C-peptide levels during OGTT. Daily carbohydrate intake was slightly higher in the cases (254.2g vs. 217.7g; p=0.034). Glucose levels measured by CGM and SMBG are useful indicators of dysglycemia during preclinical type 1 diabetes mellitus. Increased evening glucose values seem to be common in children with preclinical type 1 diabetes mellitus. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Chu, Byung Hwan; Kang, Byoung Sam; Hung, Sheng Chun; Chen, Ke Hung; Ren, Fan; Sciullo, Andrew; Gila, Brent P; Pearton, Stephen J
2010-01-01
Immobilized aluminum gallium nitride (AlGaN)/GaN high electron mobility transistors (HEMTs) have shown great potential in the areas of pH, chloride ion, and glucose detection in exhaled breath condensate (EBC). HEMT sensors can be integrated into a wireless data transmission system that allows for remote monitoring. This technology offers the possibility of using AlGaN/GaN HEMTs for extended investigations of airway pathology of detecting glucose in EBC without the need for clinical visits. HEMT structures, consisting of a 3-microm-thick undoped GaN buffer, 30-A-thick Al(0.3)Ga(0.7)N spacer, and 220-A-thick silicon-doped Al(0.3)Ga(0.7)N cap layer, were used for fabricating the HEMT sensors. The gate area of the pH, chloride ion, and glucose detection was immobilized with scandium oxide (Sc(2)O(3)), silver chloride (AgCl) thin film, and zinc oxide (ZnO) nanorods, respectively. The Sc(2)O(3)-gated sensor could detect the pH of solutions ranging from 3 to 10 with a resolution of approximately 0.1 pH. A chloride ion detection limit of 10(-8) M was achieved with a HEMT sensor immobilized with the AgCl thin film. The drain-source current of the ZnO nanorod-gated AlGaN/GaN HEMT sensor immobilized with glucose oxidase showed a rapid response of less than 5 seconds when the sensor was exposed to the target glucose in a buffer with a pH value of 7.4. The sensor could detect a wide range of concentrations from 0.5 nM to 125 microM. There is great promise for using HEMT-based sensors to enhance the detection sensitivity for glucose detection in EBC. Depending on the immobilized material, HEMT-based sensors can be used for sensing different materials. These electronic detection approaches with rapid response and good repeatability show potential for the investigation of airway pathology. The devices can also be integrated into a wireless data transmission system for remote monitoring applications. This sensor technology could use the exhaled breath condensate to measure the
Chu, Byung Hwan; Kang, Byoung Sam; Hung, Sheng Chun; Chen, Ke Hung; Ren, Fan; Sciullo, Andrew; Gila, Brent P.; Pearton, Stephen J.
2010-01-01
Background Immobilized aluminum gallium nitride (AlGaN)/GaN high electron mobility transistors (HEMTs) have shown great potential in the areas of pH, chloride ion, and glucose detection in exhaled breath condensate (EBC). HEMT sensors can be integrated into a wireless data transmission system that allows for remote monitoring. This technology offers the possibility of using AlGaN/GaN HEMTs for extended investigations of airway pathology of detecting glucose in EBC without the need for clinical visits. Methods HEMT structures, consisting of a 3-μm-thick undoped GaN buffer, 30-Å-thick Al0.3Ga0.7N spacer, and 220-Å-thick silicon-doped Al0.3Ga0.7N cap layer, were used for fabricating the HEMT sensors. The gate area of the pH, chloride ion, and glucose detection was immobilized with scandium oxide (Sc2O3), silver chloride (AgCl) thin film, and zinc oxide (ZnO) nanorods, respectively. Results The Sc2O3-gated sensor could detect the pH of solutions ranging from 3 to 10 with a resolution of ∼0.1 pH. A chloride ion detection limit of 10-8 M was achievedt with a HEMT sensor immobilized with the AgCl thin film. The drain–source current of the ZnO nanorod-gated AlGaN/GaN HEMT sensor immobilized with glucose oxidase showed a rapid response of less than 5 seconds when the sensor was exposed to the target glucose in a buffer with a pH value of 7.4. The sensor could detect a wide range of concentrations from 0.5 nM to 125 μM. Conclusion There is great promise for using HEMT-based sensors to enhance the detection sensitivity for glucose detection in EBC. Depending on the immobilized material, HEMT-based sensors can be used for sensingt different materials. These electronic detection approaches with rapid response and good repeatability show potential for the investigation of airway pathology. The devices can also be integrated into a wireless data transmission system for remote monitoring applications. This sensor technology could use the exhaled breath condensate to
Sensor Life and Overnight Closed Loop: A Randomized Clinical Trial.
Tauschmann, Martin; Allen, Janet M; Wilinska, Malgorzata E; Ruan, Yue; Thabit, Hood; Acerini, Carlo L; Dunger, David B; Hovorka, Roman
2017-05-01
Closed-loop (CL) systems direct insulin delivery based on continuous glucose monitor (CGM) sensor values. CGM accuracy varies with sensor life, being least accurate on day 1 of sensor insertion. We evaluated the effect of sensor life (enhanced Enlite, Medtronic MiniMed, Northridge, CA) on overnight CL. In an open-label, randomized, 2-period, inpatient crossover pilot study, 12 adolescents on insulin pump (age 16.7 ± 1.9 years; HbA1c 66 ± 10 mmol/mol) attended a clinical research facility on 2 overnight occasions. In random order, participants received CL on day 1 or on day 3-4 after sensor insertion. During both periods, glucose was automatically controlled by a model predictive control algorithm informed by sensor glucose. Plasma glucose was measured every 30 to 60 min. During overnight CL (22:30 to 07:30), the proportion of time with plasma glucose readings in the target range (3.9-8.0 mmol/l, primary endpoint) when initiated on day 1 of sensor insertion vs day 3-4 were comparable (58 ± 32% day 1 vs 56 ± 36% day 3-4; P = .34), and there were no significant differences between interventions in terms of mean plasma glucose ( P = .26), percentage time above 8.0 mmol/l ( P = .49), and time spent below 3.9 mmol/l ( P = .93). Sensor accuracy varied with sensor life (mean absolute relative difference 19.8 ± 15.0% on day 1 and 13.7 ± 10.2% on day 3 to 4). Sensor glucose tended to under-read plasma glucose inflating benefits of CL on glucose control. In spite of differences in sensor accuracy, overnight CL glucose control informed by sensor glucose on day 1 or day 3-4 after sensor insertion was comparable. The model predictive controller appears to mitigate against sensor inaccuracies.
Glucose metabolism in batch and continuous cultures of Gluconacetobacter diazotrophicus PAL 3.
Luna, María F; Bernardelli, Cecilia E; Galar, María L; Boiardi, José L
2006-03-01
Periplasmic glucose oxidation (by way of a pyrrolo-quinoline-quinone [PQQ]-linked glucose dehydrogenase [GDH]) was observed in continuous cultures of Gluconacetobacter diazotrophicus regardless of the carbon source (glucose or gluconate) and the nitrogen source (N(2) or NH(3)). Its synthesis was stimulated by conditions of high energetic demand (i.e., N(2)-fixation) and/or C-limitation. Under C-excess conditions, PQQ-GDH synthesis increased with the glucose concentration in the culture medium. In batch cultures, PQQ-GDH was actively expressed in very early stages with higher activities under conditions of N(2)-fixation. Hexokinase activity was almost absent under any culture condition. Cytoplasmic nicotinamide adenine dinucleotide (NAD)-linked glucose dehydrogenase (GDH) was expressed in continuous cultures under all tested conditions, and its synthesis increased with the glucose concentration. In contrast, low activities of this enzyme were detected in batch cultures. Periplasmic oxidation, by way of PQQ-GDH, seems to be the principal pathway for metabolism of glucose in G. Diazotrophicus, and NAD-GDH is an alternative route under certain environmental conditions.
Mangrola, Devna; Cox, Christine; Furman, Arianne S; Krishnan, Sridevi; Karakas, Sidika E
2018-01-01
When glucose records from self blood glucose monitoring (SBGM) do not reflect estimated average glucose from glycosylated hemoglobin (HgBA1) or when patients' clinical symptoms are not explained by their SBGM records, clinical management of diabetes becomes a challenge. Our objective was to determine the magnitude of differences in glucose values reported by SBGM versus those documented by continuous glucose monitoring (CGM). The CGM was conducted by a clinical diabetes educator (CDE)/registered nurse by the clinic protocol, using the Medtronic iPRO2 ™ system. Patients continued SBGM and managed their diabetes without any change. Data from 4 full days were obtained, and relevant clinical information was recorded. De-identified data sets were provided to the investigators. Data from 61 patients, 27 with type 1 diabetes (T1DM) and 34 with T2DM were analyzed. The lowest, highest, and average glucose recorded by SBGM were compared to the corresponding values from CGM. The lowest glucose values reported by SBGM were approximately 25 mg/dL higher in both T1DM ( P = .0232) and T2DM ( P = .0003). The highest glucose values by SBGM were approximately 30 mg/dL lower in T1DM ( P = .0005) and 55 mg/dL lower in T2DM ( P<.0001). HgBA1c correlated with the highest and average glucose by SBGM and CGM. The lowest glucose values were seen most frequently during sleep and before breakfast; the highest were seen during the evening and postprandially. SBGM accurately estimates the average glucose but underestimates glucose excursions. CGM uncovers glucose patterns that common SBGM patterns cannot. CDE = certified diabetes educator; CGM = continuous glucose monitoring; HgBA1c = glycosylated hemoglobin; MAD = mean absolute difference; SBGM = self blood glucose monitoring; T1DM = type 1 diabetes; T2DM = type 2 diabetes.
Youssef, Joseph El; Engle, Julia M.; Massoud, Ryan G.; Ward, W. Kenneth
2010-01-01
Abstract Background A cause of suboptimal accuracy in amperometric glucose sensors is the presence of a background current (current produced in the absence of glucose) that is not accounted for. We hypothesized that a mathematical correction for the estimated background current of a commercially available sensor would lead to greater accuracy compared to a situation in which we assumed the background current to be zero. We also tested whether increasing the frequency of sensor calibration would improve sensor accuracy. Methods This report includes analysis of 20 sensor datasets from seven human subjects with type 1 diabetes. Data were divided into a training set for algorithm development and a validation set on which the algorithm was tested. A range of potential background currents was tested. Results Use of the background current correction of 4 nA led to a substantial improvement in accuracy (improvement of absolute relative difference or absolute difference of 3.5–5.5 units). An increase in calibration frequency led to a modest accuracy improvement, with an optimum at every 4 h. Conclusions Compared to no correction, a correction for the estimated background current of a commercially available glucose sensor led to greater accuracy and better detection of hypoglycemia and hyperglycemia. The accuracy-optimizing scheme presented here can be implemented in real time. PMID:20879968
Volkenhoff, Anne; Hirrlinger, Johannes; Kappel, Johannes M; Klämbt, Christian; Schirmeier, Stefanie
2018-04-01
All complex nervous systems are metabolically separated from circulation by a blood-brain barrier (BBB) that prevents uncontrolled leakage of solutes into the brain. Thus, all metabolites needed to sustain energy homeostasis must be transported across this BBB. In invertebrates, such as Drosophila, the major carbohydrate in circulation is the disaccharide trehalose and specific trehalose transporters are expressed by the glial BBB. Here we analyzed whether glucose is able to contribute to energy homeostasis in Drosophila. To study glucose influx into the brain we utilized a genetically encoded, FRET-based glucose sensor expressed in a cell type specific manner. When confronted with glucose all brain cells take up glucose within two minutes. In order to characterize the glucose transporter involved, we studied Drosophila Glut1, the homologue of which is primarily expressed by the BBB-forming endothelial cells and astrocytes in the mammalian nervous system. In Drosophila, however, Glut1 is expressed in neurons and is not found at the BBB. Thus, Glut1 cannot contribute to initial glucose uptake from the hemolymph. To test whether gap junctional coupling between the BBB forming cells and other neural cells contributes to glucose distribution we assayed these junctions using RNAi experiments and only found a minor contribution of gap junctions to glucose metabolism. Our results provide the entry point to further dissect the mechanisms underlying glucose distribution and offer new opportunities to understand brain metabolism. Copyright © 2017 Elsevier Ltd. All rights reserved.
Madhu, Rajesh; Veeramani, Vediyappan; Chen, Shen-Ming; Manikandan, Arumugam; Lo, An-Ya; Chueh, Yu-Lun
2015-07-29
Herein, we report the preparation of Pongam seed shells-derived activated carbon and cobalt oxide (∼2-10 nm) nanocomposite (PSAC/Co3O4) by using a general and facile synthesis strategy. The as-synthesized PSAC/Co3O4 samples were characterized by a variety of physicochemical techniques. The PSAC/Co3O4-modified electrode is employed in two different applications such as high performance nonenzymatic glucose sensor and supercapacitor. Remarkably, the fabricated glucose sensor is exhibited an ultrahigh sensitivity of 34.2 mA mM(-1) cm(-2) with a very low detection limit (21 nM) and long-term durability. The PSAC/Co3O4 modified stainless steel electrode possesses an appreciable specific capacitance and remarkable long-term cycling stability. The obtained results suggest the as-synthesized PSAC/Co3O4 is more suitable for the nonenzymatic glucose sensor and supercapacitor applications outperforming the related carbon based modified electrodes, rendering practical industrial applications.
Freckmann, Guido; Hagenlocher, Sven; Baumstark, Annette; Jendrike, Nina; Gillen, Ralph C; Rössner, Katja; Haug, Cornelia
2007-09-01
This study investigated continuous glucose profiles in nondiabetic subjects. Continuous interstitial glucose measurement was performed under everyday life conditions (2 days) and after ingestion of four meals with standardized carbohydrate content (50 grams), but with different types of carbohydrates and variable protein and fat content. Twenty-four healthy volunteers (12 female, 12 male, age 27.1 +/- 3.6 years) participated in the study. Each subject wore two microdialysis devices (SCGM1, Roche Diagnostics) simultaneously. The mean 24-hour interstitial glucose concentration under everyday life conditions was 89.3 +/- 6.2 mg/dl (mean +/- SD, n = 21), and mean interstitial glucose concentrations at daytime and during the night were 93.0 +/- 7.0 and 81.8 +/- 6.3 mg/dl, respectively. The highest postprandial glucose concentrations were observed after breakfast: 132.3 +/- 16.7 mg/dl (range 101-168 mg/dl); peak concentrations after lunch and dinner were 118.2 +/- 13.4 and 123.0 +/- 16.9 mg/dl, respectively. Mean time to peak glucose concentration was between 46 and 50 minutes. After ingestion of standardized meals with fast absorption characteristics, peak interstitial glucose concentrations were 133.2 +/- 14.4 and 137.2 +/- 21.1 mg/dl, respectively. Meals with a higher fiber, protein, and fat content induced a smaller increase and a slower decrease of postprandial glucose concentrations with peak values of 99.2 +/- 10.5 and 122.1 +/- 20.4 mg/dl, respectively. This study provided continuous glucose profiles in nondiabetic subjects and demonstrated that differences in meal composition are reflected in postprandial interstitial glucose concentrations. Regarding the increasing application of continuous glucose monitoring in diabetic patients, these data suggest that detailed information about the ingested meals is important for adequate interpretation of postprandial glucose profiles.
Rapid Prototyping of a High Sensitivity Graphene Based Glucose Sensor Strip.
Tehrani, Farshad; Reiner, Lisa; Bavarian, Behzad
2015-01-01
A rapid prototyping of an inexpensive, disposable graphene and copper nanocomposite sensor strip using polymeric flexible substrate for highly sensitive and selective nonenzymatic glucose detection has been developed and tested for direct oxidization of glucose. The CuNPs were electrochemically deposited on to the graphene sheets to improve electron transfer rates and to enhance electrocatalytic activity toward glucose. The graphene based electrode with CuNPs demonstrated a high degree of sensitivity (1101.3 ± 56 μA/mM.cm2), excellent selectivity (without an interference with Ascorbic Acid, Uric Acid, Dopamine, and Acetaminophen), good stability with a linear response to glucose ranging from 0.1 mM to 0.6 mM concentration, and detection limits of 0.025 mM to 0.9 mM. Characterization of the electrodes was performed by scanning electron microscopy (FESEM and SEM). The electrochemical properties of the modified graphene electrodes were inspected by cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and amperometry.
Non-Enzymatic Glucose Sensor Composed of Carbon-Coated Nano-Zinc Oxide
Chung, Ren-Jei; Wang, An-Ni; Liao, Qing-Liang; Chuang, Kai-Yu
2017-01-01
Nowadays glucose detection is of great importance in the fields of biological, environmental, and clinical analyzes. In this research, we report a zinc oxide (ZnO) nanorod powder surface-coated with carbon material for non-enzymatic glucose sensor applications through a hydrothermal process and chemical vapor deposition method. A series of tests, including crystallinity analysis, microstructure observation, and electrochemical property investigations were carried out. For the cyclic voltammetric (CV) glucose detection, the low detection limit of 1 mM with a linear range from 0.1 mM to 10 mM was attained. The sensitivity was 2.97 μA/cm2mM, which is the most optimized ever reported. With such good analytical performance from a simple process, it is believed that the nanocomposites composed of ZnO nanorod powder surface-coated with carbon material are promising for the development of cost-effective non-enzymatic electrochemical glucose biosensors with high sensitivity. PMID:28336869
Rapid Prototyping of a High Sensitivity Graphene Based Glucose Sensor Strip
Tehrani, Farshad; Reiner, Lisa; Bavarian, Behzad
2015-01-01
A rapid prototyping of an inexpensive, disposable graphene and copper nanocomposite sensor strip using polymeric flexible substrate for highly sensitive and selective nonenzymatic glucose detection has been developed and tested for direct oxidization of glucose. The CuNPs were electrochemically deposited on to the graphene sheets to improve electron transfer rates and to enhance electrocatalytic activity toward glucose. The graphene based electrode with CuNPs demonstrated a high degree of sensitivity (1101.3±56 μA/mM.cm2), excellent selectivity (without an interference with Ascorbic Acid, Uric Acid, Dopamine, and Acetaminophen), good stability with a linear response to glucose ranging from 0.1 mM to 0.6 mM concentration, and detection limits of 0.025 mM to 0.9 mM. Characterization of the electrodes was performed by scanning electron microscopy (FESEM and SEM). The electrochemical properties of the modified graphene electrodes were inspected by cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and amperometry. PMID:26678700
A non-invasive blood glucose meter design using multi-type sensors
NASA Astrophysics Data System (ADS)
Nguyen, D.; Nguyen, Hienvu; Roveda, Janet
2012-10-01
In this paper, we present a design of a multi optical modalities blood glucose monitor. The Monte Carlo tissues optics simulation with typical human skin model suggests the SNR ratio for a detector sensor is 104 with high sensitivity that can detect low blood sugar limit at 1 mMole/dL ( <20 mg/dL). A Bayesian filtering algorithm is proposed for multisensor fusion to identify whether e user has the danger of having diabetes. The new design has real time response (on the average of 2 minutes) and provides great potential to perform real time monitoring for blood glucose.
Prevention of hypoglycemia using risk assessment with a continuous glucose monitoring system.
Choleau, Carine; Dokladal, Petr; Klein, Jean-Claude; Ward, W Kenneth; Wilson, George S; Reach, Gérard
2002-11-01
Due to the lag between sugar intake and the beginning of recovery from hypoglycemia, it is necessary to intervene in an anticipatory way if one wants to prevent, not only detect, hypoglycemia. This article presents the principle of a hypoglycemia prevention system based on risk assessment. The risk situation can be defined as the moment when the system estimates that the glucose concentration is expected to reach a hypoglycemia threshold in less than a given time (e.g., 20 min). Since there are well-known discrepancies between blood and interstitial glucose concentrations, the aim of this experimental study performed in nondiabetic rats was first to validate this strategy, and second to determine whether it can work when the glucose concentration is estimated by a glucose sensor in subcutaneous tissue rather than in blood. We used a model of controlled decrease in blood glucose concentration. A glucose infusion, the profile of which mimicked the appearance of glucose from an intragastric load, was administered either when hypoglycemia was detected or on the basis of risk recognition. Despite the lag between the beginning of the load and that of the increase in blood glucose concentration, which was in all experiments 15-20 min, hypoglycemia was fully prevented without overshoot hyperglycemia in the groups of rats in which the glucose load was started when the hypoglycemia risk was detected, on the basis of either blood or interstitial glucose concentration. This was, of course, not the case when the same glucose load was infused at the detection of the hypoglycemia threshold.
NASA Astrophysics Data System (ADS)
Palve, Yogesh Pandit; Jha, Neetu
2018-05-01
In this research work we have developed high sensitive and selective glucose sensor based on copper oxide-graphene composite which is prepared by green synthesis method and used for nonenzymatic glucose sensor. In present paper we report that present method highly selective, simple, efficient, accurate, ecofriendly, less toxic. The prepared composite were characterized by material characterization like SEM, XRD and also by electrochemical characterization like CV, chronoamperometry represents that copper oxide-graphene shows excellent electrocatalytic activity towards glucose, exhibiting a good sensitivity of 103.84 µA mM-1 cm-2, a fast response time 2s, a low detection limit 0.00033µM and linear range from 10 µM-3000 µM. The present sensor can successfully apply for determination of glucose concentration in human blood sample.
McGarraugh, Geoffrey; Bergenstal, Richard
2009-03-01
The objective of the analysis was to compare detection of hypoglycemic episodes (glucose <70 mg/dL lasting >15 min) with the FreeStyle Navigator Continuous Glucose Monitoring System (FSN-CGM) (Abbott Diabetes Care, Alameda, CA) alarms to detection with traditional finger stick testing at an average frequency of eight tests per day. The performance of FSN-CGM alarms was evaluated in a clinic setting using 58 subjects with type 1 diabetes mellitus (T1DM) monitoring interstitial glucose concentration over a 5-day period compared to reference YSI measurements (instrument manufactured by YSI, Yellow Springs, OH) at 15-min intervals. Finger stick glucose testing was evaluated in the home environment with 91 subjects with TIDM monitoring with the blood glucose meter integrated into the FreeStyle Navigator (FSN-BG) over a 20-day period. The reference was FSN-CGM with results masked from the subjects. Blood glucose values <=85 mg/dL were considered the optimal treatment level to avoid or reverse hypoglycemia. With a threshold alarm setting of 85 mg/dL, 90.6% of hypoglycemic episodes were detected within +/- 30 min by FSN-CGM in the clinic study. When the alarm was activated, YSI glucose was <= 85 mg/dL 77.2% of the time. In the home environment, the average FSN-BG testing frequency was 7.9 tests per day. Hypoglycemia was verified within +/- 30 min by FSN-BG measurements <= 85 mg/dL at a rate of 27.5%. Even with a high rate of FSN-BG testing, hypoglycemia detected by FSN-CGM was verified by patients with T1DM very infrequently. A high rate of hypoglycemia detection with a moderate rate of unnecessary alarms can be attained using FSN-CGM.
Tehrani, Farshad; Bavarian, Behzad
2016-01-01
A novel and highly sensitive disposable glucose sensor strip was developed using direct laser engraved graphene (DLEG) decorated with pulse deposited copper nanocubes (CuNCs). The high reproducibility (96.8%), stability (97.4%) and low cost demonstrated by this 3-step fabrication method indicates that it could be used for high volume manufacturing of disposable glucose strips. The fabrication method also allows for a high degree of flexibility, allowing for control of the electrode size, design, and functionalization method. Additionally, the excellent selectivity and sensitivity (4,532.2 μA/mM.cm2), low detection limit (250 nM), and suitable linear range of 25 μM–4 mM, suggests that these sensors may be a great potential platform for glucose detection within the physiological range for tear, saliva, and/or sweat. PMID:27306706
NASA Astrophysics Data System (ADS)
Tehrani, Farshad; Bavarian, Behzad
2016-06-01
A novel and highly sensitive disposable glucose sensor strip was developed using direct laser engraved graphene (DLEG) decorated with pulse deposited copper nanocubes (CuNCs). The high reproducibility (96.8%), stability (97.4%) and low cost demonstrated by this 3-step fabrication method indicates that it could be used for high volume manufacturing of disposable glucose strips. The fabrication method also allows for a high degree of flexibility, allowing for control of the electrode size, design, and functionalization method. Additionally, the excellent selectivity and sensitivity (4,532.2 μA/mM.cm2), low detection limit (250 nM), and suitable linear range of 25 μM-4 mM, suggests that these sensors may be a great potential platform for glucose detection within the physiological range for tear, saliva, and/or sweat.
Galderisi, Alfonso; Schlissel, Elise; Cengiz, Eda
2017-09-23
Decades after the invention of insulin pump, diabetes management has encountered a technology revolution with the introduction of continuous glucose monitoring, sensor-augmented insulin pump therapy and closed-loop/artificial pancreas systems. In this review, we discuss the significance of the 2016 Endocrine Society Guidelines for insulin pump therapy and continuous glucose monitoring and summarize findings from relevant diabetes technology studies that were conducted after the publication of the 2016 Endocrine Society Guidelines. The 2016 Endocrine Society Guidelines have been a great resource for clinicians managing diabetes in this new era of diabetes technology. There is good body of evidence indicating that using diabetes technology systems safely tightens glycemic control while managing both type 1 and type 2 diabetes. The first-generation diabetes technology systems will evolve as we gain more experience and collaboratively work to improve them with an ultimate goal of keeping people with diabetes complication and burden-free until the cure for diabetes becomes a reality.
Heinemann, Lutz
2018-04-01
At the 2017 10th annual International Conference on Advanced Technologies and Treatments for Diabetes (ATTD) in Paris, France, four speakers presented their perspectives on the roles of continuous glucose monitoring (CGM) and of blood glucose monitoring (BGM) in patient management within one symposium. These presentations included discussions of the differences in the accuracy of CGM and BGM, a clinical perspective on the physiological reasons behind differences in CGM and BGM values, and an overview of the impact of variations in device accuracy on patients with diabetes. Subsequently a short summary of these presentations is given, highlighting the value of good accuracy of BGM or CGM systems and the ongoing need for standardization. The important role of both BGM and CGM in patient management was a theme across all presentations.
NASA Astrophysics Data System (ADS)
Zhang, Li; Ye, Chen; Li, Xu; Ding, Yaru; Liang, Hongbo; Zhao, Guangyu; Wang, Yan
2018-06-01
Bimetal catalysts are good alternatives for non-enzymatic glucose sensors owing to their low cost, high activity, good conductivity, and ease of fabrication. In the present study, a self-supported CuNi/C electrode prepared by electrodepositing Cu nanoparticles on a Ni-based metal-organic framework (MOF) derivate was used as a non-enzymatic glucose sensor. The porous construction and carbon scaffold inherited from the Ni-MOF guarantee good kinetics of the electrode process in electrochemical glucose detection. Furthermore, Cu nanoparticles disturb the array structure of MOF derived films and evidently enhance their electrochemical performances in glucose detection. Electrochemical measurements indicate that the CuNi/C electrode possesses a high sensitivity of 17.12 mA mM-1 cm-2, a low detection limit of 66.67 nM, and a wider linearity range from 0.20 to 2.72 mM. Additionally, the electrode exhibits good reusability, reproducibility, and stability, thereby catering to the practical use of glucose sensors. Similar values of glucose concentrations in human blood serum samples are detected with our electrode and with the method involving glucose-6-phosphate dehydrogenase; the results further demonstrate the practical feasibility of our electrode.
Jones, Susan M; Quarry, Jill L; Caldwell-McMillan, Molly; Mauger, David T; Gabbay, Robert A
2005-04-01
We attempted to identify an optimal insulin pump meal bolus by comparing postprandial sensor glucose values following three methods of insulin pump meal bolusing for a consistent pizza meal. Twenty-four patients with type 1 diabetes participated in a study to compare postprandial glucose values following three meal bolus regimens for a consistent evening pizza meal. Each participant utilized the following insulin lispro regimens on consecutive evenings, and glucose values were tracked by the Continuous Glucose Monitoring System (CGMS, Medtronic MiniMed, Northridge, CA): (a) single-wave bolus (100% of insulin given immediately); (b) 4-h dual-wave bolus (50% of insulin given immediately and 50% given over a 4-h period); and (c) 8-h dual-wave bolus (50% of insulin given immediately and 50% given over a 8-h period). Total insulin bolus amount was kept constant for each pizza meal. Divergence in blood glucose among the regimens was greatest at 8-12 h. The 8-h dual-wave bolus provided the best glycemic control and lowest mean glucose values (singlewave bolus, 133 mg/dL; 4-h dual-wave bolus, 145 mg/dL; 8-h dual-wave bolus, 104 mg/dL), leading to a difference in mean glucose of 29 mg/dL for the single-wave bolus versus the 8-h dual-wave bolus and 42 mg/dL for the 4-h dual-wave bolus versus the 8-h dual-wave bolus. The lower mean glucose in the 8-h dual-wave bolus was not associated with any increased incidence of hypoglycemia. Use of a dual-wave bolus extended over an 8-h period following a pizza meal provided significantly less postprandial hyperglycemia in the late postprandial period (8-12 h) with no increased risk of hypoglycemia.
Wagner, Julie A; Tennen, Howard; Feinn, Richard; Osborn, Chandra Y
2015-04-01
We investigated whether self-reported racial discrimination was associated with continuous glucose levels and variability in individuals with diabetes, and whether diabetes distress mediated these associations. Seventy-four Black and White women with type 2 diabetes completed the Experience of Discrimination scale, a measure of lifetime racial discrimination, and the Problem Areas in Diabetes, a measure of diabetes distress. Participants wore a continuous glucose monitor for 24 h after 8 h of fasting, a standard meal, and a 4-h run in period. Higher discrimination predicted higher continuous mean glucose and higher standard deviation of glucose. For both mean and standard deviation of glucose, a race × discrimination interaction indicated a stronger relationship between discrimination and glucose for Whites than for Blacks. Diabetes distress mediated the discrimination-mean glucose relationship. Whites who report discrimination may be uniquely sensitive to distress. These preliminary findings suggest that racial discrimination adversely affects glucose control in women with diabetes, and does so indirectly through diabetes distress. Diabetes distress may be an important therapeutic target to reduce the ill effects of racial discrimination in persons with diabetes.
Hu, Da-Gang; Zhang, Quan-Yan; An, Jian-Ping; You, Chun-Xiang; Hao, Yu-Jin
2016-01-01
Glucose induces anthocyanin accumulation in many plant species; however, the molecular mechanism involved in this process remains largely unknown. Here, we found that apple hexokinase MdHXK1, a glucose sensor, was involved in sensing exogenous glucose and regulating anthocyanin biosynthesis. In vitro and in vivo assays suggested that MdHXK1 interacted directly with and phosphorylated an anthocyanin-associated bHLH transcription factor (TF) MdbHLH3 at its Ser361 site in response to glucose. Furthermore, both the hexokinase_2 domain and signal peptide are crucial for the MdHXK1-mediated phosphorylation of MdbHLH3. Moreover, phosphorylation modification stabilized MdbHLH3 protein and enhanced its transcription of the anthocyanin biosynthesis genes, thereby increasing anthocyanin biosynthesis. Finally, a series of transgenic analyses in apple calli and fruits demonstrated that MdHXK1 controlled glucose-induced anthocyanin accumulation at least partially, if not completely, via regulating MdbHLH3. Overall, our findings provide new insights into the mechanism of the glucose sensor HXK1 modulation of anthocyanin accumulation, which occur by directly regulating the anthocyanin-related bHLH TFs in response to a glucose signal in plants. PMID:27560976
Clinical Use of Continuous Glucose Monitoring in Adults with Type 1 Diabetes.
Slattery, David; Choudhary, Pratik
2017-05-01
With the emphasis on intensive management of type 1 diabetes, data from studies support frequent monitoring of glucose levels to improve glycemic control and reduce glucose variability, which can be related to an increase in macro and microvascular complications. However, few perform capillary blood glucose that frequently. There are currently two available alternatives that this review will discuss, continuous glucose monitoring (CGM) and flash glucose monitoring. CGM has become an important diagnostic and therapeutic option in optimizing diabetes management. CGM systems are now more accurate, smaller, and easier to use compared to original models. Randomized controlled trials (RCTs) have demonstrated that CGM can improve Hemoglobin A1c (HbA1C) and reduce glucose variability in both continuous subcutaneous insulin infusion and multiple daily injection users. When used in an automated "insulin-suspend" system, reduced frequency of hypoglycemia and shorter time spent in hypoglycemic range have been demonstrated. Despite the potential benefits CGM has to offer in clinical practice, concerns exist on the accuracy of these devices and patient compliance with therapy, which may prevent the true clinical benefit of CGM being achieved, as observed in RCTs. Flash glucose monitoring systems FreeStyle ® Libre™ (Abbott Diabetes Care, Alameda, CA) are as accurate as many CGM systems available and have the added benefit of being factory calibrated. Studies have shown that flash glucose monitoring systems are very well tolerated by patients and effectively reduce glucose variability, increasing time in range.
Mahmoudi, Zeinab; Johansen, Mette Dencker; Christiansen, Jens Sandahl
2014-01-01
Background: The purpose of this study was to investigate the effect of using a 1-point calibration approach instead of a 2-point calibration approach on the accuracy of a continuous glucose monitoring (CGM) algorithm. Method: A previously published real-time CGM algorithm was compared with its updated version, which used a 1-point calibration instead of a 2-point calibration. In addition, the contribution of the corrective intercept (CI) to the calibration performance was assessed. Finally, the sensor background current was estimated real-time and retrospectively. The study was performed on 132 type 1 diabetes patients. Results: Replacing the 2-point calibration with the 1-point calibration improved the CGM accuracy, with the greatest improvement achieved in hypoglycemia (18.4% median absolute relative differences [MARD] in hypoglycemia for the 2-point calibration, and 12.1% MARD in hypoglycemia for the 1-point calibration). Using 1-point calibration increased the percentage of sensor readings in zone A+B of the Clarke error grid analysis (EGA) in the full glycemic range, and also enhanced hypoglycemia sensitivity. Exclusion of CI from calibration reduced hypoglycemia accuracy, while slightly increased euglycemia accuracy. Both real-time and retrospective estimation of the sensor background current suggest that the background current can be considered zero in the calibration of the SCGM1 sensor. Conclusions: The sensor readings calibrated with the 1-point calibration approach indicated to have higher accuracy than those calibrated with the 2-point calibration approach. PMID:24876420
Dong, Qiuchen; Huang, Yikun; Song, Donghui; Wu, Huixiang; Cao, Fei; Lei, Yu
2018-07-30
Both pH-sensitive and glucose-responsive rhodium oxide nanocorals (Rh 2 O 3 NCs) were synthesized through electrospinning followed by high-temperature calcination. The as-prepared Rh 2 O 3 NCs were systematically characterized using various advanced techniques including scanning electron microscopy, X-ray powder diffraction and Raman spectroscopy, and then employed as a dual functional nanomaterial to fabricate a dual sensor for both non-enzymatic glucose sensing and solid-state pH monitoring. The sensing performance of the Rh 2 O 3 NCs based dual sensor toward pH and glucose was evaluated using open circuit potential, cyclic voltammetry and amperometric techniques, respectively. The results show that the as-prepared Rh 2 O 3 NCs not only maintain accurate and reversible pH sensitivity of Rh 2 O 3 , but also demonstrate a good electrocatalytic activity toward glucose oxidation in alkaline medium with a sensitivity of 11.46 μA mM -1 cm -2 , a limit of detection of 3.1 μM (S/N = 3), and a reasonable selectivity against various interferents in non-enzymatic glucose detection. Its accuracy in determining glucose in human serum samples was further demonstrated. These features indicate that the as-prepared Rh 2 O 3 NCs hold great promise as a dual-functional sensing material in the development of a high-performance sensor forManjakkal both solid-state pH and non-enzymatic glucose sensing. Copyright © 2018 Elsevier B.V. All rights reserved.
Glucose Sensing with Surface-Enhanced Raman Spectroscopy
NASA Astrophysics Data System (ADS)
Yonzon, Chanda Ranjit; Lyandres, Olga; Shah, Nilam C.; Dieringer, Jon A.; Van Duyne, Richard P.
Since the discovery of SERS nearly thirty years ago, it has progressed from model-system studies of pyridine to state-of-the-art surface-science studies coupled with real-world applications. We have demonstrated a SERS-based glucose sensor as an example of the latter. A SERS-active surface functionalized with a mixed SAM was shown to partition and departition glucose efficiently. The two components of the SAM, DT and MH, provide the appropriate balance of hydrophobic and hydrophilic groups. The DT/MH-functionalized SERS surface partitioned and departitioned glucose in less than 1 min, which indicates that the sensor can be used in real-time, continuous sensing. Furthermore, quantitative glucose measurements, in the physiological concentration range, in a mixture of interfering analytes and in bovine plasma were also demonstrated. Finally, the DT/MH-functionalized SERS surface showed temporal stability for at least 10 days in bovine plasma, making it a potential candidate for implantable sensing.
Hsieh, Shuchen; Hsieh, Shu-Ling; Hsieh, Chiung-Wen; Lin, Po-Chiao; Wu, Chun-Hsin
2013-01-01
Efficient maintenance of glucose homeostasis is a major challenge in diabetes therapy, where accurate and reliable glucose level detection is required. Though several methods are currently used, these suffer from impaired response and often unpredictable drift, making them unsuitable for long-term therapeutic practice. In this study, we demonstrate a method that uses a functionalized atomic force microscope (AFM) cantilever as the sensor for reliable glucose detection with sufficient sensitivity and selectivity for clinical use. We first modified the AFM tip with aminopropylsilatrane (APS) and then adsorbed glucose-specific lectin concanavalin A (Con A) onto the surface. The Con A/APS-modified probes were then used to detect glucose by monitoring shifts in the cantilever resonance frequency. To confirm the molecule-specific interaction, AFM topographical images were acquired of identically treated silicon substrates which indicated a specific attachment for glucose-Con A and not for galactose-Con A. These results demonstrate that by monitoring the frequency shift of the AFM cantilever, this sensing system can detect the interaction between Con A and glucose, one of the biomolecule recognition processes, and may assist in the detection and mass quantification of glucose for clinical applications with very high sensitivity.
Continued Optical Sensor Operations in a Laser Environment
2012-10-01
Power (W) Aperture (mm) Intensity at target (W/m2) Gain of laser to desired signal handheld 532 0.5 1.5 1120 @ 25 km 5.6 × 1024 Industrial diode ...AIR UNIVERSITY AIR WAR COLLEGE Continued Optical Sensor Operations in a Laser Environment WILLIAM J. DIEHL Commander, USN...COVERED 00-00-2012 to 00-00-2012 4. TITLE AND SUBTITLE Continued Optical Sensor Operations in a Laser Environment 5a. CONTRACT NUMBER 5b. GRANT
Using meta-differential evolution to enhance a calculation of a continuous blood glucose level.
Koutny, Tomas
2016-09-01
We developed a new model of glucose dynamics. The model calculates blood glucose level as a function of transcapillary glucose transport. In previous studies, we validated the model with animal experiments. We used analytical method to determine model parameters. In this study, we validate the model with subjects with type 1 diabetes. In addition, we combine the analytic method with meta-differential evolution. To validate the model with human patients, we obtained a data set of type 1 diabetes study that was coordinated by Jaeb Center for Health Research. We calculated a continuous blood glucose level from continuously measured interstitial fluid glucose level. We used 6 different scenarios to ensure robust validation of the calculation. Over 96% of calculated blood glucose levels fit A+B zones of the Clarke Error Grid. No data set required any correction of model parameters during the time course of measuring. We successfully verified the possibility of calculating a continuous blood glucose level of subjects with type 1 diabetes. This study signals a successful transition of our research from an animal experiment to a human patient. Researchers can test our model with their data on-line at https://diabetes.zcu.cz. Copyright © 2016 The Author. Published by Elsevier Ireland Ltd.. All rights reserved.
Tura, Andrea; Sbrignadello, Stefano; Cianciavicchia, Domenico; Pacini, Giovanni; Ravazzani, Paolo
2010-01-01
In recent years there has been considerable interest in the study of glucose-induced dielectric property variations of human tissues as a possible approach for non-invasive glycaemia monitoring. We have developed an electromagnetic sensor, and we tested in vitro its ability to estimate variations in glucose concentration of different solutions with similarities to blood (sodium chloride and Ringer-lactate solutions), differing though in the lack of any cellular components. The sensor was able to detect the effect of glucose variations over a wide range of concentrations (∼78–5,000 mg/dL), with a sensitivity of ∼0.22 mV/(mg/dL). Our proposed system may thus be useful in a new approach for non-invasive and non-contact glucose monitoring. PMID:22219665
Kerr, David; Olateju, Tolu
2010-06-01
Pascal's Wager is a suggestion posed by the French Philosopher, Blaise Pascal, that even though the existence of God cannot be determined through reason, a person should wager that God exists because he or she has everything to gain and nothing to lose. In the area of consideration here, the optimum experimental trial of the combined use of continuous subcutaneous insulin infusion and real-time continuous glucose monitoring in free-living individuals with type 1 diabetes providing rock-solid evidence of clinical benefit has not been performed. Nevertheless, there is considerable enthusiasm for combining the technologies among healthcare professionals, patients, and manufacturers based on the belief that this approach to diabetes care must be beneficial beyond the available evidence (i.e., reason).
Femtosecond laser micromachining of compound parabolic concentrator fiber tipped glucose sensors.
Hassan, Hafeez Ul; Lacraz, Amédée; Kalli, Kyriacos; Bang, Ole
2017-03-01
We report on highly accurate femtosecond (fs) laser micromachining of a compound parabolic concentrator (CPC) fiber tip on a polymer optical fiber (POF). The accuracy is reflected in an unprecedented correspondence between the numerically predicted and experimentally found improvement in fluorescence pickup efficiency of a Förster resonance energy transfer-based POF glucose sensor. A Zemax model of the CPC-tipped sensor predicts an optimal improvement of a factor of 3.96 compared to the sensor with a plane-cut fiber tip. The fs laser micromachined CPC tip showed an increase of a factor of 3.5, which is only 11.6% from the predicted value. Earlier state-of-the-art fabrication of the CPC-shaped tip by fiber tapering was of so poor quality that the actual improvement was 43% lower than the predicted improvement of the ideal CPC shape.
Femtosecond laser micromachining of compound parabolic concentrator fiber tipped glucose sensors
NASA Astrophysics Data System (ADS)
Hassan, Hafeez Ul; Lacraz, Amédée; Kalli, Kyriacos; Bang, Ole
2017-03-01
We report on highly accurate femtosecond (fs) laser micromachining of a compound parabolic concentrator (CPC) fiber tip on a polymer optical fiber (POF). The accuracy is reflected in an unprecedented correspondence between the numerically predicted and experimentally found improvement in fluorescence pickup efficiency of a Förster resonance energy transfer-based POF glucose sensor. A Zemax model of the CPC-tipped sensor predicts an optimal improvement of a factor of 3.96 compared to the sensor with a plane-cut fiber tip. The fs laser micromachined CPC tip showed an increase of a factor of 3.5, which is only 11.6% from the predicted value. Earlier state-of-the-art fabrication of the CPC-shaped tip by fiber tapering was of so poor quality that the actual improvement was 43% lower than the predicted improvement of the ideal CPC shape.
Hommel, E; Olsen, B; Battelino, T; Conget, I; Schütz-Fuhrmann, I; Hoogma, R; Schierloh, U; Sulli, N; Gough, H; Castañeda, J; de Portu, S; Bolinder, J
2014-10-01
To investigate the impact of continuous glucose monitoring (CGM) on health-related quality of life (HRQOL), treatment satisfaction (TS) medical resource use, and indirect costs in the SWITCH study. SWITCH was a multicentre, randomized, crossover study. Patients with type 1 diabetes (n = 153) using continuous subcutaneous insulin infusion (CSII) were randomized to a 12 month sensor-On/Off or sensor-Off/On sequence (6 months each treatment), with a 4-month washout between periods. HRQOL in children and TS in adults were measured using validated questionnaires. Medical resource utilization data were collected. In adults, TS was significantly higher in the sensor-On arm, and there were significant improvements in ratings for treatment convenience and flexibility. There were no clinically significant differences in children's HRQOL or parents' proxy ratings. The incidence of severe hypoglycaemia, unscheduled visits, or diabetes-related hospitalizations did not differ significantly between the two arms. Adult patients made fewer telephone consultations during the sensor-On arm; children's caregivers made similar numbers of telephone consultations during both arms, and calls were on average only 3 min longer during the sensor-On arm. Regarding indirect costs, children with >70 % sensor usage missed fewer school days, compared with the sensor-Off arm (P = 0.0046) but there was no significant difference in the adults days of work off. The addition of CGM to CSII resulted in better metabolic control without imposing an additional burden on the patient or increased medical resource use, and offered the potential for cost offsets.
An On-Chip Disposable Salivary Glucose Sensor for Diabetes Control.
Du, Yunqing; Zhang, Wenjun; Wang, Ming L
2016-11-01
Self-management of blood glucose (BG) is considered a norm for diabetes control. However, this invasive process is uncomfortable for patients, especially when intensive measurements with frequent finger pricks are required. Saliva, an alternative body fluid that is easily accessible and contains trace amount of glucose can be potentially used for the noninvasive monitoring of diabetes. As a solution for real-time glucose measurements using saliva for diabetic care, we have developed an on-chip disposable glucose nano-biosensor through a layer-by-layer assembly process. In this work, a clinical study of 10 healthy subjects was conducted to determine the potential usefulness of salivary glucose (SG) sensors for glycemic control. Findings revealed (1) the individual BG/SG ratio at fasting was consistent over an entire year when there was no significant change of personal health; (2) the individual SG levels tracked closely with BG levels after meals; (3) a time difference of 15-30 minutes exists between peak levels of BG and SG; (4) 2 hours after a meal, the BG/SG ratio returned to a similar value at fasting. We propose to measure fasting and pre- and 2-hour postprandial SG levels for self-management of glycemic levels. As a result, this article is not intended to replace the common BG tests. With preliminary results, we believe SG itself could be used as means for reliable diabetes monitoring and a potential fluid for prognosis of future disease. © 2016 Diabetes Technology Society.
Retinal lipid and glucose metabolism dictates angiogenesis through lipid sensor Ffar1
Joyal, Jean-Sébastien; Sun, Ye; Gantner, Marin L.; Shao, Zhuo; Evans, Lucy P.; Saba, Nicholas; Fredrick, Thomas; Burnim, Samuel; Kim, Jin Sung; Patel, Gauri; Juan, Aimee M.; Hurst, Christian G.; Hatton, Colman J.; Cui, Zhenghao; Pierce, Kerry A.; Bherer, Patrick; Aguilar, Edith; Powner, Michael B.; Vevis, Kristis; Boisvert, Michel; Fu, Zhongjie; Levy, Emile; Fruttiger, Marcus; Packard, Alan; Rezende, Flavio A.; Maranda, Bruno; Sapieha, Przemyslaw; Chen, Jing; Friedlander, Martin; Clish, Clary B.; Smith, Lois E.H.
2016-01-01
Tissues with high metabolic rates often use lipid as well as glucose for energy, conferring a survival advantage during feast and famine.1 Current dogma suggests that high-energy consuming photoreceptors depend on glucose.2,3 Here we show that retina also uses fatty acids (FA) β-oxidation for energy. Moreover, we identify a lipid sensor Ffar1 that curbs glucose uptake when FA are available. Very low-density lipoprotein receptor (VLDLR), expressed in tissues with a high metabolic rate, facilitates the uptake of triglyceride-derived FA.4,5 Vldlr is present in photoreceptors.6 In Vldlr−/− retinas, Ffar1, sensing high circulating lipid levels despite decreased FA uptake5, suppresses glucose transporter Glut1. This impaired glucose entry into photoreceptors results in a dual lipid/glucose fuel shortage and reduction in the Krebs cycle intermediate α-ketoglutarate (KG). Low α-KG levels promote hypoxia-induced factor-1α (Hif1a) stabilization and vascular endothelial growth factor (Vegfa) secretion by starved Vldlr−/− photoreceptors, attracting neovessels to supply fuel. These aberrant vessels invading normally avascular photoreceptors in Vldlr−/− retinas are reminiscent of retinal angiomatous proliferation (RAP), a subset of neovascular age-related macular degeneration (AMD)7, associated with high vitreous VEGF levels in humans. Dysregulated lipid and glucose photoreceptor energy metabolism may therefore be a driving force in neovascular AMD and other retinal diseases. PMID:26974308
Improvement of sensitive CuO NFs-ITO nonenzymatic glucose sensor based on in situ electrospun fiber.
Liu, Guangyue; Zheng, Baozhan; Jiang, Yanshu; Cai, Yuqing; Du, Juan; Yuan, Hongyan; Xiao, Dan
2012-11-15
CuO nanofibers (NFs), prepared by electrospinning and calcination technologies, have been applied for the fabrication of glucose sensors with high sensitivity and selectivity. Cu(NO(3))(2) and polyvinylpyrrolidone (PVP) composite nanofibers were initially electrospun on the surface of indium tin oxide (ITO) glass, and then the CuO NFs-ITO electrode was formed simply by removing PVP through heat treatment. The structures and morphologies of CuO nanofibers were characterized by X-ray diffraction, scanning electron microscopy and thermogravimetric analysis. The direct electrocatalytic oxidation of glucose in alkaline medium at CuO NFs-ITO electrode has also been investigated in detail with cyclic voltammetry, chronoamperometry and electrochemical impedance spectroscopy. The effects of NaOH concentration, electrospinning time, Cu(NO(3))(2):PVP mass ratios and calcination temperature on the response to glucose were investigated. Under optimized experimental conditions, the CuO NFs-ITO electrode produced high and reproducible sensitivity to glucose of 873 μA mM(-1)cm(-2). Linear responses were obtained over a concentration range from 0.20 μM to 1.3mM with a detection limit of 40 nM (S/N=3). The CuO NFs-ITO electrode also has good selectivity, stability and fast amperometic sensing of glucose, thus it can be used for the future development of non-enzymatic glucose sensors. Copyright © 2012 Elsevier B.V. All rights reserved.
Gustavsson, Natalia; Wang, Xiaorui; Wang, Yue; Seah, Tingting; Xu, Jun; Radda, George K; Südhof, Thomas C; Han, Weiping
2010-11-09
Insulin secretion is a complex and highly regulated process. It is well established that cytoplasmic calcium is a key regulator of insulin secretion, but how elevated intracellular calcium triggers insulin granule exocytosis remains unclear, and we have only begun to define the identities of proteins that are responsible for sensing calcium changes and for transmitting the calcium signal to release machineries. Synaptotagmins are primarily expressed in brain and endocrine cells and exhibit diverse calcium binding properties. Synaptotagmin-1, -2 and -9 are calcium sensors for fast neurotransmitter release in respective brain regions, while synaptotagmin-7 is a positive regulator of calcium-dependent insulin release. Unlike the three neuronal calcium sensors, whose deletion abolished fast neurotransmitter release, synaptotagmin-7 deletion resulted in only partial loss of calcium-dependent insulin secretion, thus suggesting that other calcium-sensors must participate in the regulation of insulin secretion. Of the other synaptotagmin isoforms that are present in pancreatic islets, the neuronal calcium sensor synaptotagmin-9 is expressed at the highest level after synaptotagmin-7. In this study we tested whether synaptotagmin-9 participates in the regulation of glucose-stimulated insulin release by using pancreas-specific synaptotagmin-9 knockout (p-S9X) mice. Deletion of synaptotagmin-9 in the pancreas resulted in no changes in glucose homeostasis or body weight. Glucose tolerance, and insulin secretion in vivo and from isolated islets were not affected in the p-S9X mice. Single-cell capacitance measurements showed no difference in insulin granule exocytosis between p-S9X and control mice. Thus, synaptotagmin-9, although a major calcium sensor in the brain, is not involved in the regulation of glucose-stimulated insulin release from pancreatic β-cells.
Samuei, Sara; Fakkar, Jila; Rezvani, Zolfaghar; Shomali, Ashkan; Habibi, Biuck
2017-03-15
In the present work, a novel nanocomposite based on the graphene quantum dots and CoNiAl-layered double-hydroxide was successfully synthesized by co-precipitation method. To achieve the morphological, structural and compositional information, the resulted nanocomposite was characterized by scanning electron microscopy X-ray diffraction, thermal gravimetric analysis, Fourier transform infrared spectroscopy, and photoluminescence. Then, the nanocomposite was used as a modifier to fabricate a modified carbon paste electrode as a non-enzymatic sensor for glucose determination. Electrochemical behavior and determination of glucose at the nanocomposite modified carbon paste electrode were investigated by cyclic voltammetry and chronoamperometry methods, respectively. The prepared sensor offered good electrocatalytic properties, fast response time, high reproducibility and stability. At the optimum conditions, the constructed sensor exhibits wide linear range; 0.01-14.0 mM with a detection limit of 6 μM (S/N = 3) and high sensitivity of 48.717 μAmM -1 . Finally, the sensor was successfully applied to determine the glucose in real samples which demonstrated its applicability. Copyright © 2017 Elsevier Inc. All rights reserved.
Hsieh, Helen V.; Sherman, Douglas B.; Andaluz, Sandra A.; Amiss, Terry J.; Pitner, J. Bruce
2012-01-01
Background Site-selective modification of proteins at two separate locations using two different reagents is highly desirable for biosensor applications employing fluorescence resonance energy transfer (FRET), but few strategies are available for such modification. To address this challenge, sequential selective modification of two cysteines in glucose/galactose binding protein (GGBP) was demonstrated using a technique we call “ligand protection.” Method In this technique, two cysteines were introduced in GGBP and one cysteine is rendered inaccessible by the presence of glucose, thus allowing sequential attachment of two different thiol-reactive reagents. The mutant E149C/A213C/L238S was first labeled at E149C in the presence of the ligand glucose. Following dialysis and removal of glucose, the protein was labeled with a second dye, either Texas Red (TR) C5 bromoacetamide or TR C2 maleimide, at the second site, A213C. Results Changes in glucose-dependent fluorescence were observed that were consistent with FRET between the nitrobenzoxadiazole and TR fluorophores. Comparison of models and spectroscopic properties of the C2 and C5 TR FRET constructs suggests the greater rigidity of the C2 linker provides more efficient FRET. Conclusions The ligand protection strategy provides a simple method for labeling GGBP with two different fluorophores to construct FRET-based glucose sensors with glucose affinity within the human physiological glucose range (1–30 mM). This general strategy may also have broad utility for other protein-labeling applications. PMID:23294773
[CGM-continuous glucose monitoring - statement of the Austrian Diabetes Association].
Schütz-Fuhrmann, Ingrid; Schober, Edith; Rami, Birgit; Stadler, Marietta; Bischof, Martin; Fortunat, Sandra; Laimer, Markus; Weitgasser, Raimund; Prager, Rudolf
2012-12-01
This position statement represents the recommendations of the Austrian Diabetes Association regarding the clinical diagnostic and therapeutic application, safety and benefits of continuous subcutaneous glucose monitoring systems in patients with diabetes mellitus, based on current evidence.
[CGM-Continuous Glucose Monitoring--Statement of the Austrian Diabetes Association].
Schütz-Fuhrmann, Ingrid; Rami-Merhar, Birgit; Hofer, Sabine; Stadler, Marietta; Bischof, Martin; Zlamal-Fortunat, Sandra; Laimer, Markus; Weitgasser, Raimund; Prager, Rudolf
2016-04-01
This position statement represents the recommendations of the Austrian Diabetes Association regarding the clinical diagnostic and therapeutic application, safety and benefits of continuous subcutaneous glucose monitoring systems in patients with diabetes mellitus, based on current evidence.
Measurement of Non-Invasive Blood Glucose Level Based Sensor Color TCS3200 and Arduino
NASA Astrophysics Data System (ADS)
Kurniadi Wardana, Humaidillah; Indahwati, Elly; Arifah Fitriyah, Lina
2018-04-01
Design and measurement of Arduino-based urinary (non-invasive) urine glucose using RGB tcs3200 sensor. This research was conducted by making use of the urine in diabetes patients detected by sensor colours then measured levels of colour based on the RGB colour of the urine of diabetics. The detection is done on 4 urine samples with each consisting of 3 diabetics and 1 non-diabetics. Equipment used in this research, among others, Arduino Uno, colour sensor tcs3200, LCD 16x4. The results showed that the detection of RGB values in diabetics 230 with blue and not diabetics 200 with red.
Non-invasive optical detection of glucose in cell culture nutrient medium
NASA Technical Reports Server (NTRS)
Cote, Gerald L.
1993-01-01
The objective of the proposed research was to begin the development of a non-invasive optical sensor for measuring glucose concentration in the output medium of cell cultures grown in a unique NASA bioreactor referred to as an integrated rotating-wall vessel (IRWV). The input, a bovine serum based nutrient media, has a known glucose concentration. The cells within the bioreactor digest a portion of the glucose. Thus, the non-invasive optical sensor is needed to monitor the decrease in glucose due to cellular consumption since the critical parameters for sustained cellular productivity are glucose and pH. Previous glucose sensing techniques have used chemical reactions to quantify the glucose concentration. Chemical reactions, however, cannot provide for continuous, real time, non-invasive measurement as is required in this application. Our effort while in the fellowship program was focused on the design, optical setup, and testing of one bench top prototype non-invasive optical sensor using a mid-infrared absorption spectroscopy technique. Glucose has a fundamental vibrational absorption peak in the mid-infrared wavelength range at 9.6 micron. Preliminary absorption data using a CO2 laser were collected at this wavelength for water based glucose solutions at different concentrations and one bovine serum based nutrient medium (GTSF) with added glucose. The results showed near linear absorption responses for the glucose-in-water data with resolutions as high at 108 mg/dl and as low as 10 mg/dl. The nutrient medium had a resolution of 291 mg/dl. The variability of the results was due mainly to thermal and polarization drifts of the laser while the decrease in sensitivity to glucose in the nutrient medium was expected due to the increase in the number of confounders present in the nutrient medium. A multispectral approach needs to be used to compensate for these confounders. The CO2 laser used for these studies was wavelength tunable (9.2 to 10.8 micrometers), however
McGarraugh, Geoffrey V; Clarke, William L; Kovatchev, Boris P
2010-05-01
The purpose of the analysis was to compare the clinical utility of data from traditional self-monitoring of blood glucose (SMBG) to that of continuous glucose monitoring (CGM). A clinical study of the clinical accuracy of the FreeStyle Navigator CGM System (Abbott Diabetes Care, Alameda, CA), which includes SMBG capabilities, was conducted by comparison to the YSI blood glucose analyzer (YSI Inc., Yellow Springs, OH) using 58 subjects with type 1 diabetes. The Continuous Glucose-Error Grid Analysis (CG-EGA) was used as the analytical tool. Using CG-EGA, the "clinically accurate," "benign errors," and "clinical errors" were 86.8%, 8.7%, and 4.5% for SMBG and 92.7%, 3.7%, and 3.6% for CGM, respectively. If blood glucose is viewed as a process in time, SMBG would provide accurate information about this process 86.8% of the time, whereas CGM would provide accurate information about this process 92.7% of the time (P < 0.0001). In the hypoglycemic range, however, SMBG is more accurate as the "clinically accurate," "benign errors," and "clinical errors" were 83.5%, 6.4%, and 10.1% for SMBG and 57.1%, 8.4%, and 34.5% (P < 0.0001) for CGM, respectively. While SMBG produces more accurate instantaneous glucose values than CGM, control of blood glucose involves a system in flux, and CGM provides more detailed insight into the dynamics of that system. In the normal and elevated glucose ranges, the additional information about the direction and rate of glucose change provided by the FreeStyle Navigator CGM System increases the ability to make correct clinical decisions when compared to episodic SMBG tests.
Johnson, P J; Wiedmeyer, C E; LaCarrubba, A; Messer, N T; Dingfelder, H A; Cogswell, A M; Amorim, J R R; Ganjam, V K
2011-01-01
The combined glucose-insulin test (CGIT) is helpful for evaluating insulin sensitivity. A continuous glucose monitoring system (CGMS) reports changes in interstitial glucose concentrations as they occur in the blood. Use of the CGMS minimizes animal contact and may be useful when performing a CGIT. Results obtained using a CGMS are useful for the evaluation of glucose responses during the evaluation of insulin sensitivity in equids. Seven mature, obese ponies. Ponies were equipped with CGMS for determination of interstitial glucose concentrations. Glucose (150 mg/kg, i.v.) and insulin (0.1 U/kg, i.v.) were administered and blood glucose concentrations determined at (minutes after time zero) 1, 5, 15, 25, 35, 45, 60, 75, 90, 105, and 120 with a hand-held glucometer. Blood chemistry results were compared with simultaneously obtained results using CGMS. Concordance coefficients determined for comparison of blood glucose concentrations determined by a hand-held glucometer and those determined by CGMS after the zero time point were 0.623, 0.764, 0.834, 0.854, and 0.818 (for delays of 0, 5, 10, 15, and 20 minutes, respectively). Interstitial glucose concentrations obtained by the CGMS compared favorably to blood glucose concentrations. CGMS may be useful for assessment of glucose dynamics in the CGIT. Copyright © 2010 by the American College of Veterinary Internal Medicine.
An integrated optical sensor for measuring glucose concentration
NASA Astrophysics Data System (ADS)
Liu, Y.; Hering, P.; Scully, M. O.
1992-01-01
We used an optical sensor combined with a Mach-Zehnder interferometric waveguide and optical fibers to measure slight changes of aqueous sugar concentrations. The merits of this sensor are simplicity, reliability, high sensitivity and continuous monitoring. The technique is based on the fact that the refractive index of sugar solution changes with the concentration of sugar. In the experiment, one arm of the interferometer is clad with glue and is thus isolated from the sugar solution. The other one is exposed to the sugar solution. A single mode fiber is directly glued onto the interferometric waveguide, to guide the light into the interferometer. If the concentration of sugar covering the waveguide changes, the phase of propagating light in the exposed arm will be changed, while the phase in the other arm is fixed. Hence the output intensity from the interferometer is directly related to the concentration of the sugar solution. The result of this experiment yields the relation between the sugar concentration and output signal. From 0% to 1% concentration of sugar solution, there is only a 1.4×10-3 refractive index difference. Two sets of experimental data have been obtained, showing a linear relation between the sugar concentration and the output signal from our sensor. This sensor could be used for continuous monitoring of blood sugar in the human body.
Optical glucose monitoring using vertical cavity surface emitting lasers (VCSELs)
NASA Astrophysics Data System (ADS)
Talebi Fard, Sahba; Hofmann, Werner; Talebi Fard, Pouria; Kwok, Ezra; Amann, Markus-Christian; Chrostowski, Lukas
2009-08-01
Diabetes Mellitus is a common chronic disease that has become a public health issue. Continuous glucose monitoring improves patient health by stabilizing the glucose levels. Optical methods are one of the painless and promising methods that can be used for blood glucose predictions. However, having accuracies lower than what is acceptable clinically has been a major concern. Using lasers along with multivariate techniques such as Partial Least Square (PLS) can improve glucose predictions. This research involves investigations for developing a novel optical system for accurate glucose predictions, which leads to the development of a small, low power, implantable optical sensor for diabetes patients.
Kurasawa, Shintaro; Koyama, Shouhei; Ishizawa, Hiroaki; Fujimoto, Keisaku; Chino, Shun
2017-11-23
This paper describes and verifies a non-invasive blood glucose measurement method using a fiber Bragg grating (FBG) sensor system. The FBG sensor is installed on the radial artery, and the strain (pulse wave) that is propagated from the heartbeat is measured. The measured pulse wave signal was used as a collection of feature vectors for multivariate analysis aiming to determine the blood glucose level. The time axis of the pulse wave signal was normalized by two signal processing methods: the shortest-time-cut process and 1-s-normalization process. The measurement accuracy of the calculated blood glucose level was compared with the accuracy of these signal processing methods. It was impossible to calculate a blood glucose level exceeding 200 mg/dL in the calibration curve that was constructed by the shortest-time-cut process. In the 1-s-normalization process, the measurement accuracy of the blood glucose level was improved, and a blood glucose level exceeding 200 mg/dL could be calculated. By verifying the loading vector of each calibration curve to calculate the blood glucose level with a high measurement accuracy, we found the gradient of the peak of the pulse wave at the acceleration plethysmogram greatly affected.
Determination of Glucose Concentration in Yeast Culture Medium
NASA Astrophysics Data System (ADS)
Hara, Seiichi; Kishimoto, Tomokazu; Muraji, Masafumi; Tsujimoto, Hiroaki; Azuma, Masayuki; Ooshima, Hiroshi
The present paper describes a sensor for measuring the glucose concentration of yeast culture medium. The sensor determines glucose concentration by measuring the yield of hydrogen peroxide produced by glucose oxidase, which is monitored as luminescence using photomultiplier. The present sensor is able to measure low glucose concentration in media in which yeast cells keep respiration state. We herein describe the system and the characteristics of the glucose sensor.
Bay, Christiane; Kristensen, Peter Lommer; Pedersen-Bjergaard, Ulrik; Tarnow, Lise; Thorsteinsson, Birger
2013-05-01
A reliable method to detect biochemical nocturnal hypoglycemia is highly needed, especially in patients with recurrent severe hypoglycemia. We evaluated reliability of nocturnal continuous glucose monitoring (CGM) in patients with type 1 diabetes at high risk of severe hypoglycemia. Seventy-two type 1 diabetes patients with recurrent severe hypoglycemia (two or more events within the last year) participated for 4 nights in blinded CGM recordings (Guardian(®) REAL-Time CGMS and Sof-Sensor(®); Medtronic MiniMed, Northridge, CA). Blood was drawn hourly from 23:00 to 07:00 h for plasma glucose (PG) measurements (gold standard). Valid data were obtained in 217 nights. The sensitivity of CGM was 65% (95% confidence interval, 53-77%) below 4 mmol/L, 40% (24-56%) below 3 mmol/L, and 17% (0-47%) below 2.2 mmol/L. PG and CGM readings correlated in the total measurement range (Spearman's ρ=0.82; P<0.001). In the normo- and hyperglycemic ranges CGM underestimated PG by 1.1 mmol/L (0.9-1.2 mmol/L) (P<0.001); in contrast, in the hypoglycemic range (PG<4 mmol/L) CGM overestimated PG levels by 1.0 mmol/L (P<0.001). The mean absolute relative differences in the hypo- (≤3.9 mmol/L), normo- (4-9.9 mmol/L), and hyperglycemic (≥10 mmol/L) ranges were 45% (37-53%), 23% (22-25%), and 20% (19-21%), respectively. Continuous glucose error grid analysis indicated a clinical accuracy of 56%, 99%, and 93% in the hypo-, normo-, and hyperglycemic ranges, respectively. The accuracy in the hypoglycemic range of nocturnal CGM data using Sof-Sensor is suboptimal in type 1 diabetes patients at high risk of severe hypoglycemia. To ensure clinical useful sensitivity in detection of nocturnal hypoglycemic episodes, an alarm threshold should not be lower than 4 mmol/L.
Franzese, Adriana; Valerio, Giuliana; Buono, Pietro; Spagnuolo, Maria Immacolata; Sepe, Angela; Mozzillo, Enza; De Simone, Ilaria; Raia, Valeria
2008-02-01
In cystic fibrosis (CF), diabetes mellitus (DM) is associated with progression of pulmonary disease and nutritional impairment. To compare oral glucose tolerance test (OGTT) and continuous glucose monitoring system (CGMS) in patients with CF with early glucose derangements. Thirty-two patients with CF (5-20 years) with intermediate glucose values > 7.7 mmol/l during OGTT received a CGMS registration. Patients were classified into those with normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and DM, according to glucose values at 120 min of OGTT and during CGMS. Furthermore BMI z-scores, forced expiratory volume in 1 second (FEV1%), number of respiratory infections/year, enzyme supplementation, and HbA1c were evaluated. OGTT and CGMS derangements were in agreement in 43.7% of the patients. BMI z-scores, FEV1%, number of respiratory infections/ year, enzyme supplementation, and HbA1c did not differ among the three groups. HbA1c, correlated positively with 120 min OGTT (r = 0.34; p = 0.059), CGMS area (r = 0.35; p = 0.048) and the number of respiratory infections, and negatively with FEV1%. Intermediate glucose values during OGTT should be considered as a screening test in patients with CF. CGMS can be useful in studying the early occurrence of glucose derangements in selected patients.
Fluorescence intensity- and lifetime-based glucose sensing using glucose/galactose-binding protein.
Pickup, John C; Khan, Faaizah; Zhi, Zheng-Liang; Coulter, Jonathan; Birch, David J S
2013-01-01
We review progress in our laboratories toward developing in vivo glucose sensors for diabetes that are based on fluorescence labeling of glucose/galactose-binding protein. Measurement strategies have included both monitoring glucose-induced changes in fluorescence resonance energy transfer and labeling with the environmentally sensitive fluorophore, badan. Measuring fluorescence lifetime rather than intensity has particular potential advantages for in vivo sensing. A prototype fiber-optic-based glucose sensor using this technology is being tested. © 2013 Diabetes Technology Society.
McGarraugh, Geoffrey
2010-01-01
Continuous glucose monitoring (CGM) devices available in the United States are approved for use as adjuncts to self-monitoring of blood glucose (SMBG). Alarm evaluation in the Clinical and Laboratory Standards Institute (CLSI) guideline for CGM does not specifically address devices that employ both CGM and SMBG. In this report, an alarm evaluation method is proposed for these devices. The proposed method builds on the CLSI method using data from an in-clinic study of subjects with type 1 diabetes. CGM was used to detect glycemic events, and SMBG was used to determine treatment. To optimize detection of a single glucose level, such as 70 mg/dl, a range of alarm threshold settings was evaluated. The alarm characterization provides a choice of alarm settings that trade off detection and false alarms. Detection of a range of high glucose levels was similarly evaluated. Using low glucose alarms, detection of 70 mg/dl within 30 minutes increased from 64 to 97% as alarm settings increased from 70 to 100 mg/dl, and alarms that did not require treatment (SMBG >85 mg/dl) increased from 18 to 52%. Using high glucose alarms, detection of 180 mg/dl within 30 minutes increased from 87 to 96% as alarm settings decreased from 180 to 165 mg/dl, and alarms that did not require treatment (SMBG <180 mg/dl) increased from 24 to 42%. The proposed alarm evaluation method provides information for choosing appropriate alarm thresholds and reflects the clinical utility of CGM alarms. 2010 Diabetes Technology Society.
Hypoglycemia and blood glucose fluctuations in the application of a sensor-augmented insulin pump.
Luo, Pei; Cheng, Qianpeng; Chen, Bin; Li, Yang; Wu, Jinxiao; Zhang, Xingguang; Jiao, Xiumin; Zhao, Jing; Lv, Xiaofeng
2013-12-01
The purpose of this study was to understand the effect of sensor-augmented insulin pump (SAP) use on hypoglycemia and blood glucose (BG) fluctuations. Sixty patients with type 2 diabetes mellitus were randomly assigned to three groups of treatment with SAP, continuous subcutaneous insulin infusion (CSII), or multiple daily injection (MDI) therapy for 6 days. Parameters of glycemic control that were determined included mean BG concentration (MBG), SD of BG (SDBG), mean amplitude of glycemic excursions (MAGE), absolute means of daily differences (MODD), 24-h area under the curve at 10 h (AUC10), 24-h area under the curve at 3.9 h (AUC3.9), and Low Blood Glucose Index (LBGI). No significant differences were observed among the three groups in terms of MBG, SDBG, MAGE, or MODD at the beginning of treatment. The MBG, SDBG, MAGE, MODD, and total AUC10 of the SAP group improved over the 4 days of the intervention compared with the CSII and MDI groups; however, no significant differences were observed among the three groups in terms of total AUC3.9 and LBGI. Compared with CSII and MDI therapy, SAP therapy was able to rapidly lower mean BG and reduce BG level fluctuations with no increased risks of hypoglycemia.
In Vivo and Ex Vivo Transcutaneous Glucose Detection Using Surface-Enhanced Raman Spectroscopy
NASA Astrophysics Data System (ADS)
Ma, Ke
Diabetes mellitus is widely acknowledged as a large and growing health concern. The lack of practical methods for continuously monitoring glucose levels causes significant difficulties in successful diabetes management. Extensive validation work has been carried out using surface-enhanced Raman spectroscopy (SERS) for in vivo glucose sensing. This dissertation details progress made towards a Raman-based glucose sensor for in vivo, transcutaneous glucose detection. The first presented study combines spatially offset Raman spectroscopy (SORS) with SERS (SESORS) to explore the possibility of in vivo, transcutaneous glucose sensing. A SERS-based glucose sensor was implanted subcutaneously in Sprague-Dawley rats. SERS spectra were acquired transcutaneously and analyzed using partial least-squares (PLS). Highly accurate and consistent results were obtained, especially in the hypoglycemic range. Additionally, the sensor demonstrated functionality at least17 days after implantation. A subsequent study further extends the application of SESORS to the possibility of in vivo detection of glucose in brain through skull. Specifically, SERS nanoantennas were buried in an ovine tissue behind a bone with 8 mm thickness and detected by using SESORS. In addition, quantitative detection through bones by using SESORS was also demonstrated. A device that could measure glucose continuously as well as noninvasively would be of great use to patients with diabetes. The inherent limitation of the SESORS approach may prevent this technique from becoming a noninvasive method. Therefore, the prospect of using normal Raman spectroscopy for glucose detection was re-examined. Quantitative detection of glucose and lactate in the clinically relevant range was demonstrated by using normal Raman spectroscopy with low power and short acquisition time. Finally, a nonlinear calibration method called least-squares support vector machine regression (LS-SVR) was investigated for analyzing spectroscopic
Harper, Alice; Anderson, Mark R.
2010-01-01
In 1962, Clark and Lyons proposed incorporating the enzyme glucose oxidase in the construction of an electrochemical sensor for glucose in blood plasma. In their application, Clark and Lyons describe an electrode in which a membrane permeable to glucose traps a small volume of solution containing the enzyme adjacent to a pH electrode, and the presence of glucose is detected by the change in the electrode potential that occurs when glucose reacts with the enzyme in this volume of solution. Although described nearly 50 years ago, this seminal development provides the general structure for constructing electrochemical glucose sensors that is still used today. Despite the maturity of the field, new developments that explore solutions to the fundamental limitations of electrochemical glucose sensors continue to emerge. Here we discuss two developments of the last 15 years; confining the enzyme and a redox mediator to a very thin molecular films at electrode surfaces by electrostatic assembly, and the use of electrodes modified by carbon nanotubes (CNTs) to leverage the electrocatalytic effect of the CNTs to reduce the oxidation overpotential of the electrode reaction or for the direct electron transport to the enzyme. PMID:22163652
CHINNAYELKA, SWETHA; McSHANE, and MICHAEL J.
2015-01-01
Fluorescent sensing systems offer the potential for noninvasive monitoring with implantable devices, but they require carrier technologies that provide suitable immobilization, accessibility, and biocompatibility while maintaining adequate response characteristics. A recent development towards this goal is a highly specific and sensitive competitive binding assay for glucose using apo-glucose oxidase (apo-GOx) as the recognition element and dextran as the competing ligand; this has been demonstrated as a glucose sensor system by encapsulating the competitive binding assay in semipermeable microcapsule carriers. This paper describes the extension of this sensor design to longer wavelengths in an attempt to increase the applicability to in vivo monitoring. The glucose sensitivity of the tetramethylrhodamine isothiocyanate-dextran (TD) and cyanine Cy5-apo-GOx (CAG) complexes showed five to 10 times greater specificity for β-D-glucose over other sugars. Microcapsules loaded with TD/CAG complexes exhibited a linear, totally reversible response in the range of 0–720 mg/dL, with a sensitivity (percent change in intensity ratio) of 0.06%/(mg/dL). The decrease in sensitivity observed with the use of longer-wavelength dyes is most likely to be compensated with the deeper penetration of light and reduced tissue scattering. These findings imply that the encapsulation of sensing assay elements in microcapsules is a simple and translatable method for the fabrication of stable biosensors, and optimization of resonance energy transfer pairs and assay component preparation will further improve the response to approach clinically relevant performance. PMID:16800748
Mori, Akihiro; Kurishima, Miyuki; Oda, Hitomi; Saeki, Kaori; Arai, Toshiro; Sako, Toshinori
2013-01-31
Monitoring of blood glucose concentration is important to evaluate the diabetic status of dogs. Continuous glucose monitoring systems (CGMS) have been applied in veterinary medicine for glucose monitoring in diabetic dogs. The purpose of the study was to evaluate the daily glycemic profiles obtained with CGMS and compare glucose fluctuations between day- and night-time in diabetic dogs. Five diabetic dogs were used in this study and were treated with either NPH insulin or insulin detemir. For data analyses, day-time was defined as 9:00 am-9:00 pm and night-time as 9:00 pm-9:00 am. Using glucose profiles, we determined the mean glucose concentrations (1- and 12-hr intervals), and times spent in hyperglycemia >200 mg/dl or hypoglycemia <60 mg/dl. None of the parameters differed significantly between day-time and night-time in dogs treated with NPH insulin or insulin detemir. In conclusion, this study confirmed, using CGMS, that there are no differences in glucose fluctuations between day- and night-time, in diabetic dogs on a similar feeding regimen and insulin administration.
NASA Astrophysics Data System (ADS)
Du, Chao; Wang, Qi
2017-10-01
As one of the key parameters in biological and chemical reactions, glucose concentration objectively reflects the characteristics of reactions, so the real-time monitoring of glucose concentration is important in the field of biochemical. Meanwhile, the influence from temperature should be considered. The fiber sensors have been studied extensively for decades due to the advantages of small size, immunity to electromagnetic interference and high sensitivity, which are suitable for the application of biochemical sensing. A long period fiber grating (LPFG) sensor induced by electric-arc discharge has been fabricated and demonstrated for simultaneous measurement of glucose concentration and temperature. The proposed sensor was fabricated by inscribing a sing mode fiber (SMF) with periodic electric-arc discharge technology. During the fabrication process, the electric-arc discharge technology was produced by a commercial fusion splicer, and the period of inscribed LPFG was determined by the movement of translation stages. A serials of periodic geometrical deformations would be formed in SMF after the fabrication, and the discharge intensity and discharge time can be adjusted though the fusion splicer settings screen. The core mode can be coupled into the cladding modes at certain wavelength when they satisfy the phase-matching conditions, and there will be several resonance dips in the transmission spectrum in LPFG. The resonance dips formed by the coupling between cladding modes and core mode have different sensitivity responses, so the simultaneous measurement for multi-parameter can be realized by monitoring the wavelength shifts of the resonance dips. Compared with the LPFG based on conventional SMF, the glucose concentration sensitivity has been obviously enhanced by etching the cladding with hydrofluoric acid solution. Based on the independent measured results, a dual-parameter measurement matrix has been built for signal demodulation. Because of the easy
Continuous, real time microwave plasma element sensor
Woskov, Paul P.; Smatlak, Donna L.; Cohn, Daniel R.; Wittle, J. Kenneth; Titus, Charles H.; Surma, Jeffrey E.
1995-01-01
Microwave-induced plasma for continuous, real time trace element monitoring under harsh and variable conditions. The sensor includes a source of high power microwave energy and a shorted waveguide made of a microwave conductive, refractory material communicating with the source of the microwave energy to generate a plasma. The high power waveguide is constructed to be robust in a hot, hostile environment. It includes an aperture for the passage of gases to be analyzed and a spectrometer is connected to receive light from the plasma. Provision is made for real time in situ calibration. The spectrometer disperses the light, which is then analyzed by a computer. The sensor is capable of making continuous, real time quantitative measurements of desired elements, such as the heavy metals lead and mercury.
Continuous, real time microwave plasma element sensor
Woskov, P.P.; Smatlak, D.L.; Cohn, D.R.; Wittle, J.K.; Titus, C.H.; Surma, J.E.
1995-12-26
Microwave-induced plasma is described for continuous, real time trace element monitoring under harsh and variable conditions. The sensor includes a source of high power microwave energy and a shorted waveguide made of a microwave conductive, refractory material communicating with the source of the microwave energy to generate a plasma. The high power waveguide is constructed to be robust in a hot, hostile environment. It includes an aperture for the passage of gases to be analyzed and a spectrometer is connected to receive light from the plasma. Provision is made for real time in situ calibration. The spectrometer disperses the light, which is then analyzed by a computer. The sensor is capable of making continuous, real time quantitative measurements of desired elements, such as the heavy metals lead and mercury. 3 figs.
Zhang, Xuejun; Wu, Ze; Liu, Fu; Fu, Qiangqiang; Chen, Xiaoyong; Xu, Jian; Zhang, Zhaochuan; Huang, Yunyun; Tang, Yong; Guo, Tuan; Albert, Jacques
2018-01-01
We propose and demonstrate hydrogen peroxide (H2O2) and glucose concentration measurements using a plasmonic optical fiber sensor. The sensor utilizes a tilted fiber Bragg grating (TFBG) written in standard single mode communication fiber. The fiber is over coated with an nm-scale film of silver that supports surface plasmon resonances (SPRs). Such a tilted grating SPR structure provides a high density of narrow spectral resonances (Q-factor about 105) that overlap with the broader absorption band of the surface plasmon waves in the silver film, thereby providing an accurate tool to measure small shifts of the plasmon resonance frequencies. The H2O2 to be detected acts as an oxidant to etch the silver film, which has the effect of gradually decreasing the SPR attenuation. The etching rate of the silver film shows a clear relationship with the H2O2 concentration so that monitoring the progressively increasing attenuation of a selected surface plasmon resonance over a few minutes enables us to measure the H2O2 concentration with a limit of detection of 0.2 μM. Furthermore, the proposed method can be applied to the determination of glucose in human serum for a concentration range from 0 to 12 mM (within the physiological range of 3-8 mM) by monitoring the H2O2 produced by an enzymatic oxidation process. The sensor does not require accurate temperature control because of the inherent temperature insensitivity of TFBG devices referenced to the core mode resonance. A gold mirror coated on the fiber allows the sensor to work in reflection, which will facilitate the integration of the sensor with a hypodermic needle for in vitro measurements. The present study shows that Ag-coated TFBG-SPR can be applied as a promising type of sensing probe for optical detection of H2O2 and glucose detection in human serum. PMID:29675315
Zhang, Xuejun; Wu, Ze; Liu, Fu; Fu, Qiangqiang; Chen, Xiaoyong; Xu, Jian; Zhang, Zhaochuan; Huang, Yunyun; Tang, Yong; Guo, Tuan; Albert, Jacques
2018-04-01
We propose and demonstrate hydrogen peroxide (H 2 O 2 ) and glucose concentration measurements using a plasmonic optical fiber sensor. The sensor utilizes a tilted fiber Bragg grating (TFBG) written in standard single mode communication fiber. The fiber is over coated with an nm-scale film of silver that supports surface plasmon resonances (SPRs). Such a tilted grating SPR structure provides a high density of narrow spectral resonances (Q-factor about 10 5 ) that overlap with the broader absorption band of the surface plasmon waves in the silver film, thereby providing an accurate tool to measure small shifts of the plasmon resonance frequencies. The H 2 O 2 to be detected acts as an oxidant to etch the silver film, which has the effect of gradually decreasing the SPR attenuation. The etching rate of the silver film shows a clear relationship with the H 2 O 2 concentration so that monitoring the progressively increasing attenuation of a selected surface plasmon resonance over a few minutes enables us to measure the H 2 O 2 concentration with a limit of detection of 0.2 μM. Furthermore, the proposed method can be applied to the determination of glucose in human serum for a concentration range from 0 to 12 mM (within the physiological range of 3-8 mM) by monitoring the H 2 O 2 produced by an enzymatic oxidation process. The sensor does not require accurate temperature control because of the inherent temperature insensitivity of TFBG devices referenced to the core mode resonance. A gold mirror coated on the fiber allows the sensor to work in reflection, which will facilitate the integration of the sensor with a hypodermic needle for in vitro measurements. The present study shows that Ag-coated TFBG-SPR can be applied as a promising type of sensing probe for optical detection of H 2 O 2 and glucose detection in human serum.
International Consensus on Use of Continuous Glucose Monitoring.
Danne, Thomas; Nimri, Revital; Battelino, Tadej; Bergenstal, Richard M; Close, Kelly L; DeVries, J Hans; Garg, Satish; Heinemann, Lutz; Hirsch, Irl; Amiel, Stephanie A; Beck, Roy; Bosi, Emanuele; Buckingham, Bruce; Cobelli, Claudio; Dassau, Eyal; Doyle, Francis J; Heller, Simon; Hovorka, Roman; Jia, Weiping; Jones, Tim; Kordonouri, Olga; Kovatchev, Boris; Kowalski, Aaron; Laffel, Lori; Maahs, David; Murphy, Helen R; Nørgaard, Kirsten; Parkin, Christopher G; Renard, Eric; Saboo, Banshi; Scharf, Mauro; Tamborlane, William V; Weinzimer, Stuart A; Phillip, Moshe
2017-12-01
Measurement of glycated hemoglobin (HbA 1c ) has been the traditional method for assessing glycemic control. However, it does not reflect intra- and interday glycemic excursions that may lead to acute events (such as hypoglycemia) or postprandial hyperglycemia, which have been linked to both microvascular and macrovascular complications. Continuous glucose monitoring (CGM), either from real-time use (rtCGM) or intermittently viewed (iCGM), addresses many of the limitations inherent in HbA 1c testing and self-monitoring of blood glucose. Although both provide the means to move beyond the HbA 1c measurement as the sole marker of glycemic control, standardized metrics for analyzing CGM data are lacking. Moreover, clear criteria for matching people with diabetes to the most appropriate glucose monitoring methodologies, as well as standardized advice about how best to use the new information they provide, have yet to be established. In February 2017, the Advanced Technologies & Treatments for Diabetes (ATTD) Congress convened an international panel of physicians, researchers, and individuals with diabetes who are expert in CGM technologies to address these issues. This article summarizes the ATTD consensus recommendations and represents the current understanding of how CGM results can affect outcomes. © 2017 by the American Diabetes Association.
Chan, Christine L; Hope, Emma; Thurston, Jessica; Vigers, Timothy; Pyle, Laura; Zeitler, Philip S; Nadeau, Kristen J
2018-04-19
In cystic fibrosis (CF), HbA 1c is thought to underestimate glycemia. However, few studies have directly assessed the relationship between HbA 1c and average glucose in CF. We determined the relationships among glycemic markers-HbA 1c , fructosamine (FA), glycated albumin (%GA), and 1,5-anhydroglucitol (1,5-AG)-and continuous glucose monitoring (CGM) in CF, hypothesizing that alternate markers would better predict average sensor glucose (ASG) than HbA 1c . CF participants and a group of healthy control subjects (HC), ages 6-25 years, wore CGM for up to 7 days. Pearson correlations assessed the relationships between CGM variables and HbA 1c , FA, %GA, and 1,5-AG. The regression line between HbA 1c and ASG was compared in CF versus HC. Linear regressions determined whether alternate markers predicted ASG after adjustment for HbA 1c . CF ( n = 93) and HC ( n = 29) groups wore CGM for 5.2 ± 1 days. CF participants were 14 ± 3 years of age and 47% were male, with a BMI z score -0.1 ± 0.8 and no different from HCs in age, sex, or BMI. Mean HbA 1c in CF was 5.7 ± 0.8% (39 ± 9 mmol/mol) vs. HC 5.1 ± 0.2% (32 ± 2 mmol/mol) ( P < 0.0001). All glycemic markers correlated with ASG ( P ≤ 0.01): HbA 1c ( r = 0.86), FA ( r = 0.69), %GA ( r = 0.83), and 1,5-AG ( r = -0.26). The regression line between ASG and HbA 1c did not differ in CF versus HC ( P = 0.44). After adjustment for HbA 1c , %GA continued to predict ASG ( P = 0.0009) in CF. HbA 1c does not underestimate ASG in CF as previously assumed. No alternate glycemic marker correlated more strongly with ASG than HbA 1c . %GA shows strong correlation with ASG and added to the prediction of ASG beyond HbA 1c . However, we are not advocating use of HbA 1c for diabetes screening in CF based on these results. Further study will determine whether glycemic measures other than ASG differ among different types of diabetes for a given HbA 1c . © 2018 by the American Diabetes Association.
Distiller, Larry A; Cranston, Iain; Mazze, Roger
2016-11-01
In 2014, an innovative blinded continuous glucose monitoring system was introduced with automated ambulatory glucose profile (AGP) reporting. The clinical use and interpretation of this new technology has not previously been described. Therefore we wanted to understand its use in characterizing key factors related to glycemic control: glucose exposure, variability, and stability, and risk of hypoglycemia in clinical practice. Clinicians representing affiliated diabetes centers throughout South Africa were trained and subsequently were given flash glucose monitoring readers and 2-week glucose sensors to use at their discretion. After patient use, sensor data were collected and uploaded for AGP reporting. Complete data (sensor AGP with corresponding clinical information) were obtained for 50 patients with type 1 (70%) and type 2 diabetes (30%), irrespective of therapy. Aggregated analysis of AGP data comparing patients with type 1 versus type 2 diabetes, revealed that despite similar HbA1c values between both groups (8.4 ± 2 vs 8.6 ± 1.7%, respectively), those with type 2 diabetes had lower mean glucose levels (9.2 ± 3 vs 10.3 mmol/l [166 ± 54 vs 185 mg/dl]) and lower indices of glucose variability (3.0 ± 1.5 vs 5.0 ± 1.9 mmol/l [54 ± 27 vs 90 ± 34.2 mg/dl]). This highlights key areas for future focus. Using AGP, the characteristics of glucose exposure, variability, stability, and hypoglycemia risk and occurrence were obtained within a short time and with minimal provider and patient input. In a survey at the time of the follow-up visit, clinicians indicated that aggregated AGP data analysis provided important new clinical information and insights. © 2016 Diabetes Technology Society.
Jeong, Hun; Nguyen, Dang Mao; Lee, Min Sang; Kim, Hong Gun; Ko, Sang Cheol; Kwac, Lee Ku
2018-09-01
Herein, we successfully developed a novel three dimensional (3D) opened networks based on nitrogen doped graphene‑carbon nanotubes attaching with gold nanoparticles (N-GR-CNTs/AuNPs) to apply for non-enzymatic glucose determination. It was demonstrated that the N-GR-CNTs/AuNPs modified electrode exhibited good behavior for glucose detection with a long linear range of 2 μM to 19.6 mM, high sensitivity of 0.9824 μA·mM -1 ·cm -2 , low detection limit of 500 nM, and negligible interference effect. The high performance of the N-GR-CNTs/AuNPs based sensor was assumed due to the outstanding catalytic activity of AuNPs well dispersing on N-GR-CNTs networks, which exhibited as a perfect supporting scaffold due to the enhanced electrical conductivity and large surface area. The obtained results indicated that the N-GR-CNTs/AuNPs hybrid is highly promising for sensitive and selective detection of glucose in sensor application. Copyright © 2018 Elsevier B.V. All rights reserved.
... costs will be covered. What is an artificial pancreas? A CGM is one part of the “artificial pancreas” systems that are beginning to reach people with ... has played an important role in developing artificial pancreas technology. An artificial pancreas replaces manual blood glucose ...
NASA Astrophysics Data System (ADS)
Dolai, Bholanath; Bhaumik, Atanu; Pramanik, Nabakumar; Ghosh, Kalyan Sundar; Atta, Ananta Kumar
2018-07-01
Naphthaldimine-based glucose derivatives 1 and 3 have been designed, synthesized and characterized. In aqueous media, glucose derivative 1, exhibited high selectivity and sensitivity towards Cu2+ ion in comparison with various cations and anions. In presence of Cu2+, sensor 1 has provided significant naked-eye detectable color change. The formation of 1-Cu2+ complex has been analyzed by UV-vis spectroscopy, 1H NMR titration experiments, mass spectrometry and DFT (density functional theory) calculations. Limit of detection of 1 as a colorimetric sensor for Cu2+ ion is found to be 0.23 μM, much lower than recommended value of World Health Organization (WHO), which makes to Cu2+ sensor 1 more effective and useful.
Ilany, Jacob; Bhandari, Hamad; Nabriski, Dan; Toledano, Yoel; Konvalina, Noa; Cohen, Ohad
2018-05-01
To evaluate the glycaemic control achieved by prandial once-daily insulin glulisine injection timing adjustment, based on a continuous glucose monitoring sensor, in comparison to once-daily insulin glulisine injection before breakfast in patients with type 2 diabetes who are uncontrolled with once-daily basal insulin glargine. This was a 24-week open-label, randomized, controlled, multicentre trial. At the end of an 8-week period of basal insulin optimization, patients with HbA1c ≥ 7.5% and FPG < 130 mg/dL were randomized (1:1) to either arm A (no sensor) or arm B (sensor) to receive 16-week intensified prandial glulisine treatment. Patients in arm A received pre-breakfast glulisine, and patients in arm B received glulisine before the meal with the highest glucose elevation based on sensor data. The primary outcome was mean HbA1c at week 24 and secondary outcomes included rates of hypoglycaemic events and insulin dosage. A total of 121 patients were randomized to arm A (n = 61) or arm B (n = 60). There was no difference in mean HbA1c at week 24 between arms A and B (8.5% ± 1.2% vs 8.4% ± 1.0%; P = .66). The prandial insulin glulisine dosage for arm A and arm B was 9.3 and 10.1 units, respectively (P = .39). The frequency of hypoglycaemic events did not differ between study arms (36.1% vs 51.7%; P = .08). Using a CGM sensor to identify the meal with the highest glucose excursion and adjusting the timing of prandial insulin treatment did not show any advantage in terms of glycaemic control or safety in our patients. © 2018 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
Choudhary, P; Geddes, J; Freeman, J V; Emery, C J; Heller, S R; Frier, B M
2010-06-01
Impaired awareness of hypoglycaemia (IAH) is a major risk factor for severe hypoglycaemia in Type 1 diabetes. Although biochemical hypoglycaemia is asserted to be more frequent in IAH, this has not been estimated accurately. The aim of this study was to use Continuous Glucose Monitoring (CGM) to quantify hypoglycaemia in IAH and evaluate its use in identifying impaired awareness of hypoglycaemia. Ninety-five patients with Type 1 diabetes were classified as having normal (n = 74) or impaired awareness (n = 21) using an established method of assessing hypoglycaemia awareness. Hypoglycaemia exposure was assessed prospectively over 9-12 months using weekly 4-point capillary home blood glucose monitoring (HBGM), 5 days of CGM and prospective reporting of severe hypoglycaemia. The frequencies of biochemical and severe hypoglycaemia were compared in patients with normal and impaired awareness of hypoglycaemia. Patients with impaired awareness had a 3-fold higher incidence of severe hypoglycaemia than those with normal awareness [incidence rate ratio (IRR) 3.37 (95% CI 1.30-8.7); P = 0.01] and 1.6-fold higher incidence of hypoglycaemia on weekly HBGM [IRR 1.63 (95% CI 1.09-2.44); P = 0.02]. No significant differences were observed with CGM [IRR for sensor glucose < or = 3.0 mmol/l 1.47 (95% CI 0.91-2.39); P = 0.12; IRR for sensor glucose < or = 2.2 mmol/l 1.23 (95% CI 0.76-1.98); P = 0.40]. Patients with Type 1 diabetes with impaired awareness had a 3-fold higher risk of severe hypoglycaemia and 1.6-fold higher incidence of biochemical hypoglycaemia measured with weekly glucose monitoring compared with normal awareness, but 5 days of CGM did not differentiate those with impaired from those with normal awareness.
Soft, smart contact lenses with integrations of wireless circuits, glucose sensors, and displays
Park, Jihun; Kim, Joohee; Kim, So-Yun; Cheong, Woon Hyung; Jang, Jiuk; Park, Young-Geun; Na, Kyungmin; Kim, Yun-Tae; Heo, Jun Hyuk; Lee, Chang Young; Lee, Jung Heon; Bien, Franklin; Park, Jang-Ung
2018-01-01
Recent advances in wearable electronics combined with wireless communications are essential to the realization of medical applications through health monitoring technologies. For example, a smart contact lens, which is capable of monitoring the physiological information of the eye and tear fluid, could provide real-time, noninvasive medical diagnostics. However, previous reports concerning the smart contact lens have indicated that opaque and brittle components have been used to enable the operation of the electronic device, and this could block the user’s vision and potentially damage the eye. In addition, the use of expensive and bulky equipment to measure signals from the contact lens sensors could interfere with the user’s external activities. Thus, we report an unconventional approach for the fabrication of a soft, smart contact lens in which glucose sensors, wireless power transfer circuits, and display pixels to visualize sensing signals in real time are fully integrated using transparent and stretchable nanostructures. The integration of this display into the smart lens eliminates the need for additional, bulky measurement equipment. This soft, smart contact lens can be transparent, providing a clear view by matching the refractive indices of its locally patterned areas. The resulting soft, smart contact lens provides real-time, wireless operation, and there are in vivo tests to monitor the glucose concentration in tears (suitable for determining the fasting glucose level in the tears of diabetic patients) and, simultaneously, to provide sensing results through the contact lens display. PMID:29387797
Soft, smart contact lenses with integrations of wireless circuits, glucose sensors, and displays.
Park, Jihun; Kim, Joohee; Kim, So-Yun; Cheong, Woon Hyung; Jang, Jiuk; Park, Young-Geun; Na, Kyungmin; Kim, Yun-Tae; Heo, Jun Hyuk; Lee, Chang Young; Lee, Jung Heon; Bien, Franklin; Park, Jang-Ung
2018-01-01
Recent advances in wearable electronics combined with wireless communications are essential to the realization of medical applications through health monitoring technologies. For example, a smart contact lens, which is capable of monitoring the physiological information of the eye and tear fluid, could provide real-time, noninvasive medical diagnostics. However, previous reports concerning the smart contact lens have indicated that opaque and brittle components have been used to enable the operation of the electronic device, and this could block the user's vision and potentially damage the eye. In addition, the use of expensive and bulky equipment to measure signals from the contact lens sensors could interfere with the user's external activities. Thus, we report an unconventional approach for the fabrication of a soft, smart contact lens in which glucose sensors, wireless power transfer circuits, and display pixels to visualize sensing signals in real time are fully integrated using transparent and stretchable nanostructures. The integration of this display into the smart lens eliminates the need for additional, bulky measurement equipment. This soft, smart contact lens can be transparent, providing a clear view by matching the refractive indices of its locally patterned areas. The resulting soft, smart contact lens provides real-time, wireless operation, and there are in vivo tests to monitor the glucose concentration in tears (suitable for determining the fasting glucose level in the tears of diabetic patients) and, simultaneously, to provide sensing results through the contact lens display.
Thomas, Felicity; Signal, Mathew; Harris, Deborah L; Weston, Philip J; Harding, Jane E; Shaw, Geoffrey M; Chase, J Geoffrey
2014-05-01
Neonatal hypoglycemia is common and can cause serious brain injury. Continuous glucose monitoring (CGM) could improve hypoglycemia detection, while reducing blood glucose (BG) measurements. Calibration algorithms use BG measurements to convert sensor signals into CGM data. Thus, inaccuracies in calibration BG measurements directly affect CGM values and any metrics calculated from them. The aim was to quantify the effect of timing delays and calibration BG measurement errors on hypoglycemia metrics in newborn infants. Data from 155 babies were used. Two timing and 3 BG meter error models (Abbott Optium Xceed, Roche Accu-Chek Inform II, Nova Statstrip) were created using empirical data. Monte-Carlo methods were employed, and each simulation was run 1000 times. Each set of patient data in each simulation had randomly selected timing and/or measurement error added to BG measurements before CGM data were calibrated. The number of hypoglycemic events, duration of hypoglycemia, and hypoglycemic index were then calculated using the CGM data and compared to baseline values. Timing error alone had little effect on hypoglycemia metrics, but measurement error caused substantial variation. Abbott results underreported the number of hypoglycemic events by up to 8 and Roche overreported by up to 4 where the original number reported was 2. Nova results were closest to baseline. Similar trends were observed in the other hypoglycemia metrics. Errors in blood glucose concentration measurements used for calibration of CGM devices can have a clinically important impact on detection of hypoglycemia. If CGM devices are going to be used for assessing hypoglycemia it is important to understand of the impact of these errors on CGM data. © 2014 Diabetes Technology Society.
Byers, S R; Beemer, O M; Lear, A S; Callan, R J
2014-01-01
Persistent hyperglycemia is common in alpacas and typically requires insulin administration for resolution; however, little is known about alpacas' response to different insulin formulations. To evaluate the effects of 3 insulin formulations on blood glucose concentrations and the use of a continuous glucose monitoring (CGM) system in alpacas. Six healthy alpacas. The CGM was installed in the left paralumbar fossa at the start of this crossover study and recorded data every 5 minutes. Regular insulin, NPH insulin, insulin glargine, and dextrose were administered to each alpaca over a 2-week period. Blood samples were collected for glucose testing at 0, 1, 2, 4, 6, 8, and 12 hours, and then every 6 hours after each administration of insulin or dextrose. Data were compared by using method comparison techniques, error grid plots, and ANOVA. Blood glucose concentrations decreased most rapidly after regular insulin administration when administered IV or SC as compared to the other formulations. The NPH insulin produced the longest suppression of blood glucose. The mean CGM interstitial compartment glucose concentrations were typically lower than the intravascular compartment glucose concentrations. The alpacas had no adverse reactions to the different insulin formulations. The NPH insulin might be more appropriate for long-term use in hyperglycemic alpacas because of its extended duration of action. A CGM is useful in monitoring glucose trends and reducing blood collection events, but it should not be the sole method for determining treatment protocols. Copyright © 2014 by the American College of Veterinary Internal Medicine.
Picher, Maria M; Küpcü, Seta; Huang, Chun-Jen; Dostalek, Jakub; Pum, Dietmar; Sleytr, Uwe B; Ertl, Peter
2013-05-07
In the current work we have developed a lab-on-a-chip containing embedded amperometric sensors in four microreactors that can be addressed individually and that are coated with crystalline surface protein monolayers to provide a continuous, stable, reliable and accurate detection of blood glucose. It is envisioned that the microfluidic device will be used in a feedback loop mechanism to assess natural variations in blood glucose levels during hemodialysis to allow the individual adjustment of glucose. Reliable and accurate detection of blood glucose is accomplished by simultaneously performing (a) blood glucose measurements, (b) autocalibration routines, (c) mediator-interferences detection, and (d) background subtractions. The electrochemical detection of blood glucose variations in the absence of electrode fouling events is performed by integrating crystalline surface layer proteins (S-layer) that function as an efficient antifouling coating, a highly-oriented immobilization matrix for biomolecules and an effective molecular sieve with pore sizes of 4 to 5 nm. We demonstrate that the S-layer protein SbpA (from Lysinibacillus sphaericus CCM 2177) readily forms monomolecular lattice structures at the various microchip surfaces (e.g. glass, PDMS, platinum and gold) within 60 min, eliminating unspecific adsorption events in the presence of human serum albumin, human plasma and freshly-drawn blood samples. The highly isoporous SbpA-coating allows undisturbed diffusion of the mediator between the electrode surface, thus enabling bioelectrochemical measurements of glucose concentrations between 500 μM to 50 mM (calibration slope δI/δc of 8.7 nA mM(-1)). Final proof-of-concept implementing the four microfluidic microreactor design is demonstrated using freshly drawn blood. Accurate and drift-free assessment of blood glucose concentrations (6. 4 mM) is accomplished over 130 min at 37 °C using immobilized enzyme glucose oxidase by calculating the difference between
NASA Astrophysics Data System (ADS)
Tanaka, Y.; Tajima, T.; Seyama, M.
2018-02-01
We propose a differential photoacoustic spectroscopy (PAS), wherein two wavelengths of light with the same absorbance are selected, and differential signal is linearized by one of the two signals for a non-invasive blood glucose monitoring. PAS has the possibility to overcome the strong optical scattering in tissue, but there are still remaining issues: the water background and instability due to the variation in acoustic resonance conditions. A change in sample solution temperature is one of the causes of the variation in acoustic resonance conditions. Therefore, in this study, we investigated the sensitivity against glucose concentration under the condition where the temperature of the sample water solution ranges 30 to 40 °C. The glucose concentration change is simulated by shifting the wavelength of irradiated laser light, which can effectively change optical absorption. The temperature also affects optical absorption and the acoustic resonance condition (acoustic velocity). A distributed-feedback (DFB) laser, tunable wavelength laser (TWL) and an acoustic sensor were used to obtain the differential PAS signal. The wavelength of the DFB laser was 1.382 μm, and that of TWL was switched from 1.600 to 1.610 μm to simulate the glucose concentration change. Optical absorption by glucose occurs at around 1.600 μm. The sensitivities against temperature are almost the same: 1.9 and 1.8 %/°C for 1.600 and 1.610 μm. That is, the glucose dependence across the whole temperature range remains constant. This implies that temperature correction is available.
Lessan, N; Hannoun, Z; Hasan, H; Barakat, M T
2015-02-01
Ramadan fasting represents a major shift in meal timing and content for practicing Muslims. This study used continuous glucose monitoring (CGM) to assess changes in markers of glycaemic excursions during Ramadan fasting to investigate the short-term safety of this practice in different groups of patients with diabetes. A total of 63 subjects (56 with diabetes, seven healthy volunteers; 39 male, 24 female) had CGM performed during, before and after Ramadan fasting. Mean CGM curves were constructed for each group for these periods that were then used to calculate indicators of glucose control and excursions. Post hoc data analyses included comparisons of different medication categories (metformin/no medication, gliptin, sulphonylurea and insulin). Medication changes during Ramadan followed American Diabetes Association guidelines. Among patients with diabetes, there was a significant difference in mean CGM curve during Ramadan, with a slow fall during fasting hours followed by a rapid rise in glucose level after the sunset meal (iftar). The magnitude of this excursion was greatest in the insulin-treated group, followed by the sulphonylurea-treated group. Markers of control deteriorated in a small number (n=3) of patients. Overall, whether fasting or non-fasting, subjects showed no statistically significant changes in mean interstitial glucose (IG), mean amplitude of glycaemic excursion (MAGE), high and low blood glucose indices (HBGI/LBGI), and number of glucose excursions and rate of hypoglycaemia. The main change in glycaemic control with Ramadan fasting in patients with diabetes is in the pattern of excursions. Ramadan fasting caused neither overall deterioration nor improvement in the majority of patients with good baseline glucose control. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Bergenstal, Richard M; Strock, Ellie; Mazze, Roger; Powers, Margaret A; Monk, Arlene M; Richter, Sara; Souhami, Elisabeth; Ahrén, Bo
2017-05-01
In the parent study of this analysis, patients with type 2 diabetes received lixisenatide before breakfast or the main meal of the day. This substudy was designed to examine the effect of lixisenatide administered before breakfast or the main meal of the day on continuously assessed 24-hour patient glucose profiles. A subset of patients from the parent study underwent 2 14-day periods of continuous glucose monitoring (CGM) at the start and end of the 24-week study. Ambulatory glucose profile analysis was used to measure changes over time in detailed aspects of the glucose profiles. The breakfast group consumed a standardized meal during both CGM periods to determine change in 4-hour glycemic response. Data were available for 69 patients in the substudy, 40 from the original breakfast group and 29 from the main meal group. Between baseline and end of study, mean (standard deviation) total glucose exposure decreased from 4198.1 (652.3) to 3681.2 (699.6) mg/dL*24 h in the breakfast group (P < .0001) and from 4127.9 (876.8) to 3880.9 (1165.0) mg/dL*24 h in the main meal group (P = .0224). For patients included in the substudy, HbA 1c decreased by approximately 0.6% in both groups. Mean (standard deviation) 4-hour total glucose exposure fell by 168.9 (158.4) mg/dL*4 h (P < .0001) from baseline. This analysis demonstrates that lixisenatide has beneficial effects on components of the 24-hour glucose profile, which endure beyond the meal at which it is administered. Continuous glucose monitoring analysis detects changes not captured using HbA 1c alone. Copyright © 2016 John Wiley & Sons, Ltd.
Accuracy evaluation of a new real-time continuous glucose monitoring algorithm in hypoglycemia.
Mahmoudi, Zeinab; Jensen, Morten Hasselstrøm; Dencker Johansen, Mette; Christensen, Toke Folke; Tarnow, Lise; Christiansen, Jens Sandahl; Hejlesen, Ole
2014-10-01
The purpose of this study was to evaluate the performance of a new continuous glucose monitoring (CGM) calibration algorithm and to compare it with the Guardian(®) REAL-Time (RT) (Medtronic Diabetes, Northridge, CA) calibration algorithm in hypoglycemia. CGM data were obtained from 10 type 1 diabetes patients undergoing insulin-induced hypoglycemia. Data were obtained in two separate sessions using the Guardian RT CGM device. Data from the same CGM sensor were calibrated by two different algorithms: the Guardian RT algorithm and a new calibration algorithm. The accuracy of the two algorithms was compared using four performance metrics. The median (mean) of absolute relative deviation in the whole range of plasma glucose was 20.2% (32.1%) for the Guardian RT calibration and 17.4% (25.9%) for the new calibration algorithm. The mean (SD) sample-based sensitivity for the hypoglycemic threshold of 70 mg/dL was 31% (33%) for the Guardian RT algorithm and 70% (33%) for the new algorithm. The mean (SD) sample-based specificity at the same hypoglycemic threshold was 95% (8%) for the Guardian RT algorithm and 90% (16%) for the new calibration algorithm. The sensitivity of the event-based hypoglycemia detection for the hypoglycemic threshold of 70 mg/dL was 61% for the Guardian RT calibration and 89% for the new calibration algorithm. Application of the new calibration caused one false-positive instance for the event-based hypoglycemia detection, whereas the Guardian RT caused no false-positive instances. The overestimation of plasma glucose by CGM was corrected from 33.2 mg/dL in the Guardian RT algorithm to 21.9 mg/dL in the new calibration algorithm. The results suggest that the new algorithm may reduce the inaccuracy of Guardian RT CGM system within the hypoglycemic range; however, data from a larger number of patients are required to compare the clinical reliability of the two algorithms.
Retinal lipid and glucose metabolism dictates angiogenesis through the lipid sensor Ffar1.
Joyal, Jean-Sébastien; Sun, Ye; Gantner, Marin L; Shao, Zhuo; Evans, Lucy P; Saba, Nicholas; Fredrick, Thomas; Burnim, Samuel; Kim, Jin Sung; Patel, Gauri; Juan, Aimee M; Hurst, Christian G; Hatton, Colman J; Cui, Zhenghao; Pierce, Kerry A; Bherer, Patrick; Aguilar, Edith; Powner, Michael B; Vevis, Kristis; Boisvert, Michel; Fu, Zhongjie; Levy, Emile; Fruttiger, Marcus; Packard, Alan; Rezende, Flavio A; Maranda, Bruno; Sapieha, Przemyslaw; Chen, Jing; Friedlander, Martin; Clish, Clary B; Smith, Lois E H
2016-04-01
Tissues with high metabolic rates often use lipids, as well as glucose, for energy, conferring a survival advantage during feast and famine. Current dogma suggests that high-energy-consuming photoreceptors depend on glucose. Here we show that the retina also uses fatty acid β-oxidation for energy. Moreover, we identify a lipid sensor, free fatty acid receptor 1 (Ffar1), that curbs glucose uptake when fatty acids are available. Very-low-density lipoprotein receptor (Vldlr), which is present in photoreceptors and is expressed in other tissues with a high metabolic rate, facilitates the uptake of triglyceride-derived fatty acid. In the retinas of Vldlr(-/-) mice with low fatty acid uptake but high circulating lipid levels, we found that Ffar1 suppresses expression of the glucose transporter Glut1. Impaired glucose entry into photoreceptors results in a dual (lipid and glucose) fuel shortage and a reduction in the levels of the Krebs cycle intermediate α-ketoglutarate (α-KG). Low α-KG levels promotes stabilization of hypoxia-induced factor 1a (Hif1a) and secretion of vascular endothelial growth factor A (Vegfa) by starved Vldlr(-/-) photoreceptors, leading to neovascularization. The aberrant vessels in the Vldlr(-/-) retinas, which invade normally avascular photoreceptors, are reminiscent of the vascular defects in retinal angiomatous proliferation, a subset of neovascular age-related macular degeneration (AMD), which is associated with high vitreous VEGFA levels in humans. Dysregulated lipid and glucose photoreceptor energy metabolism may therefore be a driving force in macular telangiectasia, neovascular AMD and other retinal diseases.
Glucose-responsive hydrogel electrode for biocompatible glucose transistor
NASA Astrophysics Data System (ADS)
Kajisa, Taira; Sakata, Toshiya
2017-12-01
In this paper, we propose a highly sensitive and biocompatible glucose sensor using a semiconductor-based field effect transistor (FET) with a functionalized hydrogel. The principle of the FET device contributes to the easy detection of ionic charges with high sensitivity, and the hydrogel coated on the electrode enables the specific detection of glucose with biocompatibility. The copolymerized hydrogel on the Au gate electrode of the FET device is optimized by controlling the mixture ratio of biocompatible 2-hydroxyethylmethacrylate (HEMA) as the main monomer and vinylphenylboronic acid (VPBA) as a glucose-responsive monomer. The gate surface potential of the hydrogel FETs shifts in the negative direction with increasing glucose concentration from 10 μM to 40 mM, which results from the increase in the negative charges on the basis of the diol-binding of PBA derivatives with glucose molecules in the hydrogel. Moreover, the hydrogel coated on the gate suppresses the signal noise caused by the nonspecific adsorption of proteins such as albumin. The hydrogel FET can serve as a highly sensitive and biocompatible glucose sensor in in vivo or ex vivo applications such as eye contact lenses and sheets adhering to the skin.
Yamada, Eijiro; Okada, Shuichi; Nakajima, Yasuyo; Bastie, Claire C; Vatish, Manu; Tagaya, Yuko; Osaki, Aya; Shimoda, Yoko; Shibusawa, Ryo; Saito, Tsugumichi; Okamura, Takashi; Ozawa, Atsushi; Yamada, Masanobu
2017-01-01
Optimum therapy for patients with diabetes depends on both acute and long-term changes in plasma glucose, generally assessed by glycated hemoglobin (HbA1c) levels. However, the correlation between HbA1c and circulating glucose has not been fully determined. Therefore, we carefully examined this correlation when glucose levels were assessed by continuous glucose monitoring (CGM). Fifty-one patients (70% female, 30% male) were examined; among them were 28 with type 1 diabetes and 23 with type 2 diabetes. Clinically determined HbA1c levels were compared with blood glucose determined by CGM during a short time period. Changes in HbA1c levels up to 8.0% showed a clear and statistically strong correlation (R = 0.6713; P<.0001) with mean blood glucose levels measured by CGM, similar to that observed in the A1c-derived Average Glucose study in which patients were monitored for a longer period. However, we found no statistical correlation (R = 0.0498; P = .83) between HbA1c and CGM-assessed glucose levels in our patient population when HbA1c was >8.0%. Short-term CGM appears to be a good clinical indicator of long-term glucose control (HbA1c levels); however, cautions should be taken while interpreting CGM data from patients with HbA1c levels >8.0%. Over- or underestimation of the actual mean glucose from CGM data could potentially increase the risks of inappropriate treatment. As such, our results indicate that a more accurate analysis of CGM data might be useful to adequately tailor clinical treatments. ADAG = A1c-Derived Average Glucose CGM = continuous glucose monitoring %CV = percent coefficient of variation HbA1c = glycated hemoglobin.
Rumpler, M; Mader, J K; Fischer, J P; Thar, R; Granger, J M; Deliane, F; Klimant, I; Aberer, F; Sinner, F; Pieber, T R; Hajnsek, M
2017-02-15
The combination of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion can be used to improve the treatment of patients with diabetes. The aim of this study was to advance an existing preclinical single-port system for clinical application by integrating the sensors of a phosphorescence based CGM system into a standard insulin infusion set. The extracorporeal optical phase fluorimeter was miniaturised and is now comparable with commercial CGM systems regarding size, weight and wear comfort. Sensor chemistry was adapted to improve the adhesion of the sensor elements on the insulin infusion set. In-vitro tests showed a linear correlation of R 2 =0.998 between sensor values and reference glucose values in the range of 0-300mg/dl. Electrical and cytotoxicity tests showed no negative impact on human health. Two single-port devices were tested in each of 12 patients with type 1 diabetes mellitus in a clinical set-up for 12h. Without additional data processing, the overall median absolute relative difference (median ARD) was 22.5%. For some of the used devices the median ARD was even well below 10%. The present results show that individual glucose sensors performance of the single-port system is comparable with commercial CGM systems but further improvements are needed. The new system offers a high extent of safety and usability by combining insulin infusion and continuous glucose measurement in a single-port system which could become a central element in an artificial pancreas for an improved treatment of patients with type 1 diabetes mellitus. Copyright © 2016 Elsevier B.V. All rights reserved.
Caduff, Andreas; Talary, Mark S; Mueller, Martin; Dewarrat, Francois; Klisic, Jelena; Donath, Marc; Heinemann, Lutz; Stahel, Werner A
2009-05-15
In vivo variations of blood glucose (BG) are affecting the biophysical characteristics (e.g. dielectric and optical) of skin and underlying tissue (SAUT) at various frequencies. However, the skin impedance spectra for instance can also be affected by other factors, perturbing the glucose related information, factors such as temperature, skin moisture and sweat, blood perfusion as well as body movements affecting the sensor-skin contact. In order to be able to correct for such perturbing factors, a Multisensor system was developed including sensors to measure the identified factors. To evaluate the quality of glucose monitoring, the Multisensor was applied in 10 patients with Type 1 diabetes. Glucose was administered orally to induce hyperglycaemic excursions at two different study visits. For analysis of the sensor signals, a global multiple linear regression model was derived. The respective coefficients of the variables were determined from the sensor signals of this first study visit (R(2)=0.74, MARD=18.0%--mean absolute relative difference). The identical set of modelling coefficients of the first study visit was re-applied to the test data of the second study visit to evaluate the predictive power of the model (R(2)=0.68, MARD=27.3%). It appears as if the Multisensor together with the global linear regression model applied, allows for tracking glucose changes non-invasively in patients with diabetes without requiring new model coefficients for each visit. Confirmation of these findings in a larger study group and under less experimentally controlled conditions is required for understanding whether a global parameterisation routine is feasible.
NASA Astrophysics Data System (ADS)
Marie, Mohammed; Manoharan, Anishkumar; Kuchuk, Andrian; Ang, Simon; Manasreh, M. O.
2018-03-01
An enzyme-free glucose sensor based on vertically grown zinc oxide nanorods (NRs) functionalized with ferric oxide (Fe2O3) is investigated. The well-aligned and high density ZnO NRs were synthesized on an FTO/glass substrate by a sol-gel and hydrothermal growth method. A dip-coating technique was utilized to modify the surface of the as-grown ZnO NRs with Fe2O3. The immobilized surface was coated with a layer of nafion membrane. The fabricated glucose sensor was characterized amperometrically at room temperature using three electrodes stationed in the phosphate buffer solution, where ZnO NRs/Fe2O3/nafion membrane was the sensing or working electrode, and platinum plate and silver/silver chloride were used as the counter and reference electrodes, respectively. The proposed non-enzymatic and modified glucose sensor exhibited a high sensitivity in the order of 0.052 μA cm-2 (mg/dL)-1, a lower detection limit of around 0.95 mmol L-1, a sharp and fast response time of ˜1 s, and a linear response to changes in glucose concentrations from 100-400 mg dL-1. The linear amperometric response of the sensor covers the physiological and clinical interest of glucose levels for diabetic patients. The device continues to function accurately after multiple measurements with a good reproducibility. The proposed glucose sensor is expected to be used clinically for in vivo monitoring of glucose.
Rosenthal, Mark; Ugele, Bernhard; Lipowsky, Gerd; Küster, Helmut
2006-02-01
The aim of this prospective observational study was to compare a bedside test with the reference laboratory method in routine postnatal glucose monitoring. Term newborns with increased risk or clinical signs of hypoglycemia were screened with a bedside test. In case of a glucose value below 2.25 mmol/L, a second blood sample was taken and a duplicate glucose measurement done in the laboratory using a bedside test (Accutrend sensor) and the reference laboratory method (hexokinase method) at the same time and from the same sample. From 110 term newborns, 122 blood samples were obtained for duplicate measurements (median 1.69 mmol/L, SD 0.45 mmol/L). Of these 122, Accutrend correctly identified 97% as being <2.25 mmol/L by the laboratory method. A Bland-Altman plot revealed a mean underestimation of the Accutrend of only -0.09 mmol/L. However, due to high scattering, the maximal over- and underestimation was 0.89 and 1.39 mmol/L, respectively. Only 75% of the results from the Accutrend were within +/-20% of the result of the laboratory method. If the cut-off for low glucose concentrations was set 0.6 mmol/L higher for the bedside test as compared to the laboratory method, all patients except one would have been correctly identified as hypoglycemic. When using the Accutrend sensor, single infants with even marked hypoglycemia might be missed. Some delay in receiving accurate measurements might be more helpful for clinical decisions and long-term outcome than immediate but potentially misleading results.
Perovskite LaTiO₃-Ag0.2 nanomaterials for nonenzymatic glucose sensor with high performance.
Wang, Yin-zhu; Zhong, Hui; Li, Xiao-mo; Jia, Fei-fei; Shi, Yi-xiang; Zhang, Wei-guang; Cheng, Zhi-peng; Zhang, Li-li; Wang, Ji-kui
2013-10-15
In this paper, a nonenzymatic glucose biosensor based on perovskite LaTiO3-Ag0.2(LTA) modified electrode was presented. The morphology and the composition of the perovskite LaTiO₃-Ag0.2 nanomaterials were characterized by using scanning electron microscopy (SEM) and X-ray diffraction (XRD) respectively. The LaTiO₃-Ag0.2(LTA) composite was investigated by electrochemical characterization using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). Under optimal conditions, CV and chronoamperometry (I-t) study revealed that, compared with the bare glassy carbon electrode (GCE), the modified electrode showed a remarkable increase in the efficiency of the electrocatalytic oxidation of glucose, starting at around +0.70 V (vs. Ag/AgCl). The prepared sensor exhibited a high sensitivity of 784.14 µAmM⁻¹ cm⁻², a low detection limit of 2.1×10⁻⁷ M and a wide linear range from 2.5 µM to 4 mM (R=0.9997). More importantly, the LTA modified electrode was also relatively insensitive to commonly interfering species such as ascorbic acid (AA), uric acid (UA), dopamine (DA) in high potential. Moreover, the nonenzymatic sensor was applied to the determination of glucose in human serum samples and the results were in good agreement with clinical data. Electrodes modified with perovskite nanomaterials are highly promising for nonenzymatic electrochemical detection of glucose because of their high sensitivity, fast response, excellent stability and good reproducibility. Copyright © 2013 Elsevier B.V. All rights reserved.
Hajime, Maiko; Okada, Yosuke; Mori, Hiroko; Otsuka, Takashi; Kawaguchi, Mayuko; Miyazaki, Megumi; Kuno, Fumi; Sugai, Kei; Sonoda, Satomi; Tanaka, Kenichi; Kurozumi, Akira; Narisawa, Manabu; Torimoto, Keiichi; Arao, Tadashi; Tanaka, Yoshiya
2018-01-01
High fluctuations in blood glucose are associated with various complications. The correlation between glycated hemoglobin (HbA1c) level and fluctuations in blood glucose level has not been studied in Japanese patients with type 2 diabetes. In the present study, blood glucose profile stratified by HbA1c level was evaluated by continuous glucose monitoring (CGM) in Japanese type 2 diabetes patients. Our retrospective study included 294 patients with type 2 diabetes who were divided by HbA1c level into five groups (≥6.0 to <7.0%, ≥7.0 to <8.0%, ≥8.0 to <9.0%, ≥9.0 to <10.0% and ≥10%). The correlation between HbA1c level and CGM data was analyzed. The primary end-point was the difference in blood glucose fluctuations among the HbA1c groups. The mean blood glucose level increased significantly with increasing HbA1c (P trend < 0.01). The standard deviation increased with increases in HbA1c (P trend < 0.01). The mean amplitude of glycemic excursions did not vary significantly with HbA1c. The levels of maximum blood glucose, minimum blood glucose, each preprandial blood glucose, each postprandial maximum blood glucose, range of increase in postprandial glucose from pre-meal to after breakfast, the area under the blood concentration-time curve >180 mg/dL and percentage of the area under the blood concentration-time curve >180 mg/dL were higher with higher HbA1c. Mean glucose level and pre-breakfast blood glucose level were significant and independent determinants of HbA1c. In Japanese patients treated for type 2 diabetes, the mean amplitude of glycemic excursions did not correlate with HbA1c, making it difficult to assess blood glucose fluctuations using HbA1c. Parameters other than HbA1c are required to evaluate fluctuations in blood glucose level in patients receiving treatment for type 2 diabetes. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia
Helton, Kristen L; Ratner, Buddy D; Wisniewski, Natalie A
2011-01-01
This article is the second part of a two-part review in which we explore the biomechanics of the sensor–tissue interface as an important aspect of continuous glucose sensor biocompatibility. Part I, featured in this issue of Journal of Diabetes Science and Technology, describes a theoretical framework of how biomechanical factors such as motion and pressure (typically micromotion and micropressure) affect tissue physiology around a sensor and in turn, impact sensor performance. Here in Part II, a literature review is presented that summarizes examples of motion or pressure affecting sensor performance. Data are presented that show how both acute and chronic forces can impact continuous glucose monitor signals. Also presented are potential strategies for countering the ill effects of motion and pressure on glucose sensors. Improved engineering and optimized chemical biocompatibility have advanced sensor design and function, but we believe that mechanical biocompatibility, a rarely considered factor, must also be optimized in order to achieve an accurate, long-term, implantable sensor. PMID:21722579
Prabhudesai, Sumant; Kanjani, Amruta; Bhagat, Isha; Ravikumar, Karnam G; Ramachandran, Bala
2015-11-01
The aim of this prospective, observational study was to determine the accuracy of a real-time continuous glucose monitoring system (CGMS) in children with septic shock. Children aged 30 days to 18 years admitted to the Pediatric Intensive Care Unit with septic shock were included. A real-time CGMS sensor was used to obtain interstitial glucose readings. CGMS readings were compared statistically with simultaneous laboratory blood glucose (BG). Nineteen children were included, and 235 pairs of BG-CGMS readings were obtained. BG and CGMS had a correlation coefficient of 0.61 (P < 0.001) and a median relative absolute difference of 17.29%. On Clarke's error grid analysis, 222 (94.5%) readings were in the clinically acceptable zones (A and B). When BG was < 70, 70-180, and > 180 mg/dL, 44%, 100%, and 76.9% readings were in zones A and B, respectively (P < 0.001). The accuracy of CGMS was not affected by the presence of edema, acidosis, vasopressors, steroids, or renal replacement therapy. On receiver operating characteristics curve analysis, a CGMS reading <97 mg/dL predicted hypoglycemia (sensitivity 85.2%, specificity 75%, area under the curve [AUC] =0.85). A reading > 141 mg/dL predicted hyperglycemia (sensitivity 84.6%, specificity 89.6%, AUC = 0.87). CGMS provides a fairly, accurate estimate of BG in children with septic shock. It is unaffected by a variety of clinical variables. The accuracy over extremes of blood sugar may be a concern. We recommend larger studies to evaluate its use for the early detection of hypoglycemia and hyperglycemia.
FRET-based glucose monitoring for bioprocessing
NASA Astrophysics Data System (ADS)
Bartolome, Amelita; Smalls-Mantey, Lauren; Lin, Debora; Rao, Govind; Tolosa, Leah
2006-02-01
The glucose-mediated conformational changes in the glucose binding protein (GBP) have been exploited in the development of fluorescence based glucose sensors. The fluorescence response is generated by a polarity sensitive dye attached to a specific site. Such fluorescent sensors respond to submicromolar glucose at diffusion-controlled rates mimicking the wild type. However, such sensors have been limited to in vitro glucose sensing because of the preliminary dye-labeling step. In the study described here, the dye-labeling step is omitted by genetically encoding the GBP with two green fluorescent mutants namely, the green fluorescent protein (GFP) and the yellow fluorescent protein (YFP) in the N- and C-terminal ends, respectively. These two GFP mutants comprise a fluorescence resonance energy transfer (FRET) donor and acceptor pair. Thus, when glucose binds with GBP, the conformational changes affect the FRET efficiency yielding a dose-dependent response. A potential application for this FRET-based glucose biosensor is online glucose sensing in bioprocessing and cell culture. This was demonstrated by the measurement of glucose consumption in yeast fermentation. Further development of this system should yield in vivo measurement of glucose in bioprocesses.
Korstanje, Ron; Ryan, Jennifer L; Savage, Holly S; Lyons, Bonnie L; Kane, Kevin G; Sukoff Rizzo, Stacey J
2017-09-01
Previous studies with continuous glucose monitoring in mice have been limited to several days or weeks, with the mouse's physical attachment to the equipment affecting behavior and measurements. In the current study, we measured blood glucose and body temperature at 10-second intervals for 12 weeks in a cohort of NOD/ShiLtJ female mice using wireless telemetry. This allowed us to obtain a high-resolution profile of the circadian rhythm of these two parameters and the onset of hyperglycemic development in real time. The most striking observations were the elevated nocturnal concentrations of glucose into the diabetic range days before elevations in diurnal glucose (when glucose concentrations are historically measured) and the strong, negative correlation between elevated blood glucose concentrations and body temperature with a steady decline of the body temperature with diabetes development. Taken together, this technological advancement provides improved resolution in the study of the disease trajectory of diabetes in mouse models, including relevant translatability to the current technologies of continuous glucose monitoring now regularly used in patients. Copyright © 2017 Endocrine Society.
Continuous operation of an ultra-low-power microcontroller using glucose as the sole energy source.
Lee, Inyoung; Sode, Takashi; Loew, Noya; Tsugawa, Wakako; Lowe, Christopher Robin; Sode, Koji
2017-07-15
An ultimate goal for those engaged in research to develop implantable medical devices is to develop mechatronic implantable artificial organs such as artificial pancreas. Such devices would comprise at least a sensor module, an actuator module, and a controller module. For the development of optimal mechatronic implantable artificial organs, these modules should be self-powered and autonomously operated. In this study, we aimed to develop a microcontroller using the BioCapacitor principle. A direct electron transfer type glucose dehydrogenase was immobilized onto mesoporous carbon, and then deposited on the surface of a miniaturized Au electrode (7mm 2 ) to prepare a miniaturized enzyme anode. The enzyme fuel cell was connected with a 100 μF capacitor and a power boost converter as a charge pump. The voltage of the enzyme fuel cell was increased in a stepwise manner by the charge pump from 330mV to 3.1V, and the generated electricity was charged into a 100μF capacitor. The charge pump circuit was connected to an ultra-low-power microcontroller. Thus prepared BioCapacitor based circuit was able to operate an ultra-low-power microcontroller continuously, by running a program for 17h that turned on an LED every 60s. Our success in operating a microcontroller using glucose as the sole energy source indicated the probability of realizing implantable self-powered autonomously operated artificial organs, such as artificial pancreas. Copyright © 2016 Elsevier B.V. All rights reserved.
Capoccia, D; Coccia, F; Guida, A; Rizzello, M; De Angelis, F; Silecchia, G; Leonetti, F
2015-01-01
The study was carried out on type 2 diabetic obese patients who underwent laparoscopic sleeve gastrectomy (LSG). Patients underwent regular glycemic controls throughout 3 years and all patients were defined cured from diabetes according to conventional criteria defined as normalization of fasting glucose levels and glycated hemoglobin in absence of antidiabetic therapy. After 3 years of follow-up, Continuous Glucose Monitoring (CGM) was performed in each patient to better clarify the remission of diabetes. In this study, we found that the diabetes resolution after LSG occurred in 40% of patients; in the other 60%, even if they showed a normal fasting glycemia and A1c, patients spent a lot of time in hyperglycemia. During the oral glucose tolerance test (OGTT), we found that 2 h postload glucose determinations revealed overt diabetes only in a small group of patients and might be insufficient to exclude the diagnosis of diabetes in the other patients who spent a lot of time in hyperglycemia, even if they showed a normal glycemia (<140 mg/dL) at 120 minutes OGTT. These interesting data could help clinicians to better individualize patients in which diabetes is not resolved and who could need more attention in order to prevent chronic complications of diabetes.
Augusto, Gustavo A; Sousa, André G P; Perazo, Marcela N A; Correa-Giannella, Maria L C; Nery, Marcia; Melo, Karla F S de
2009-06-01
Continuous glucose monitoring system is a valuable instrument to measure glycemic control, which uses a retrospective calibration based upon 3 to 4 capillary glucose meter values inserted by the patient each day. We evaluated the interference of calibration during the dawn period in the system accuracy. The monitoring data were retrospectively divided into two groups: with (Group A) or without (Group B) the dawn period calibration (between 1:00 and 5:00 AM). Accuracy of the method was expressed by relative absolute difference. Thirty-four continuous glucose monitoring data were evaluated comprising a total of 112 nights. A total of 289 paired readings were analyzed - 195 in Group A and 94 in Group B. We did not find a difference in relative absolute difference (RAD%) in any analyzed period of day by adding dawn calibration. These data suggest that dawn calibration does not alter accuracy of method.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wu, Hong; Wang, Jun; Kang, Xinhuang
2009-09-01
The bionanocomposite film consisting of glucose oxidase/Pt/functional graphene sheets/chitosan (GOD/Pt/FGS/chitosan) for glucose sensing was described. With the electrocatalytic synergy of FGS and Pt nanoparticles to hydrogen peroxide, a sensitive biosensor with detection limit of 0.6 µM glucose was achieved. The biosensor also had good reproducibility, long term stability and negligible interfering signals from ascorbic acid and uric acid comparing to the response to glucose. The large surface area and good conductivity of graphene suggests that graphene is a potential candidate for sensor material. The hybrid nanocomposite glucose sensor provides new opportunity for clinical diagnosis and point-of-care applications.
Maegawa, Hiroshi; Morino, Katsutaro; Nishio, Yoshihiko; Sato, Toshiyuki; Okada, Seiki; Kikkawa, Yasuo; Watanabe, Toshihiro; Nakajima, Hiromu; Kashiwagi, Atsunori
2016-01-01
Background Management of postprandial hyperglycemia is a key aspect in diabetes treatment. We developed a novel system to measure glucose area under the curve (AUC) using minimally invasive interstitial fluid extraction technology (MIET) for simple monitoring of postprandial glucose excursions. In this study, we evaluated the relationship between our system and continuous glucose monitoring (CGM) by comparing glucose AUC obtained using MIET with that obtained using CGM for a long duration. Methods Twenty diabetic inpatients wearing a CGM system were enrolled. For MIET measurement, a plastic microneedle array was applied to the skin as pretreatment, and hydrogels were placed on the pretreated area to collect interstitial fluid. Hydrogels were replaced every 2 or 4 hours and AUC was predicted on the basis of glucose and sodium ion levels. Results AUC predicted by MIET correlated well with that measured by CGM (r=0.93). Good performances of both consecutive 2- and 4-hour measurements were observed (measurement error: 11.7%±10.2% for 2 hours and 11.1%±7.9% for 4 hours), indicating the possibility of repetitive measurements up to 8 hours. The influence of neither glucose fluctuation nor average glucose level over the measurement accuracy was observed through 8 hours. Conclusion Our system showed good relationship with AUC values from CGM up to 8 hours, indicating that single pretreatment can cover a large portion of glucose excursion in a day. These results indicated possibility of our system to contribute to convenient monitoring of glucose excursions for a long duration. PMID:27535643
Ugi, Satoshi; Maegawa, Hiroshi; Morino, Katsutaro; Nishio, Yoshihiko; Sato, Toshiyuki; Okada, Seiki; Kikkawa, Yasuo; Watanabe, Toshihiro; Nakajima, Hiromu; Kashiwagi, Atsunori
2016-08-01
Management of postprandial hyperglycemia is a key aspect in diabetes treatment. We developed a novel system to measure glucose area under the curve (AUC) using minimally invasive interstitial fluid extraction technology (MIET) for simple monitoring of postprandial glucose excursions. In this study, we evaluated the relationship between our system and continuous glucose monitoring (CGM) by comparing glucose AUC obtained using MIET with that obtained using CGM for a long duration. Twenty diabetic inpatients wearing a CGM system were enrolled. For MIET measurement, a plastic microneedle array was applied to the skin as pretreatment, and hydrogels were placed on the pretreated area to collect interstitial fluid. Hydrogels were replaced every 2 or 4 hours and AUC was predicted on the basis of glucose and sodium ion levels. AUC predicted by MIET correlated well with that measured by CGM (r=0.93). Good performances of both consecutive 2- and 4-hour measurements were observed (measurement error: 11.7%±10.2% for 2 hours and 11.1%±7.9% for 4 hours), indicating the possibility of repetitive measurements up to 8 hours. The influence of neither glucose fluctuation nor average glucose level over the measurement accuracy was observed through 8 hours. Our system showed good relationship with AUC values from CGM up to 8 hours, indicating that single pretreatment can cover a large portion of glucose excursion in a day. These results indicated possibility of our system to contribute to convenient monitoring of glucose excursions for a long duration.
Visavachaipan, Nipapat; Aledo, Alexander; Franklin, Bonita H; Brar, Preneet C
2013-01-01
Acute lymphoblastic leukemia (ALL) maintenance therapy (MT) has been occasionally associated with symptomatic hypoglycemia (SH), attributed to purine analog (mercaptopurine [6-MP]). This hypoglycemia has been hypothesized to affect substrate utilization of gluconeogenic precursor alanine in the liver. An overweight 5-year-old boy with ALL was evaluated for SH (lethargy and vomiting) that occurred 8-10 h after fasting while receiving daily 6-MP. Hypoglycemic episodes (>20 episodes per month) occurred predominantly around midmorning but not during the 5-day dexamethasone pulse. The adrenocorticotropic hormone test yielded a normal cortisol response, which ruled out pituitary adrenal suppression. A 12-h overnight fasting glucose was 49 mg/dL, with suppressed insulin response <2 IU/mL, low C-peptide of 0.5 ng/mL, high insulin-like growth factor-binding protein >160 ng/mL, high free fatty acid of 2.64 mmol/L, and negative glucagon stimulation test (change in blood glucose [BG] <5 mg/dL). These results ruled out hyperinsulinism. The patient was placed on cornstarch therapy 5 h prior to dosing with 6-MP. This treatment reduced the SH events to fewer than two episodes per month. To study the efficacy of cornstarch, the patient was fitted with the iPro™ professional continuous glucose monitoring system (CGMS) (Medtronic MiniMed, Northridge, CA) with a preset low alarm at 70 mg/dL, which was worn for a period of 5 days while the patient was on cornstarch. With 1,000 sensor reading the BG range was 65-158 mg/dL, and the percentage mean absolute difference between sensor and finger-stick BG readings (the parent monitored his BG four times a day) was 9.4%. There were no hypoglycemic episodes detected by the CGMS while the patient was on cornstarch. After the cessation of chemotherapy, a 15-h fasting study was performed, and the CGMS was placed. Results showed resolution of hypoglycemia. The CGMS helped us devise an effective management plan for our patient. CGMS proved useful
Rawlings, Renata A; Shi, Hang; Yuan, Lo-Hua; Brehm, William; Pop-Busui, Rodica; Nelson, Patrick W
2011-12-01
Several metrics of glucose variability have been proposed to date, but an integrated approach that provides a complete and consistent assessment of glycemic variation is missing. As a consequence, and because of the tedious coding necessary during quantification, most investigators and clinicians have not yet adopted the use of multiple glucose variability metrics to evaluate glycemic variation. We compiled the most extensively used statistical techniques and glucose variability metrics, with adjustable hyper- and hypoglycemic limits and metric parameters, to create a user-friendly Continuous Glucose Monitoring Graphical User Interface for Diabetes Evaluation (CGM-GUIDE©). In addition, we introduce and demonstrate a novel transition density profile that emphasizes the dynamics of transitions between defined glucose states. Our combined dashboard of numerical statistics and graphical plots support the task of providing an integrated approach to describing glycemic variability. We integrated existing metrics, such as SD, area under the curve, and mean amplitude of glycemic excursion, with novel metrics such as the slopes across critical transitions and the transition density profile to assess the severity and frequency of glucose transitions per day as they move between critical glycemic zones. By presenting the above-mentioned metrics and graphics in a concise aggregate format, CGM-GUIDE provides an easy to use tool to compare quantitative measures of glucose variability. This tool can be used by researchers and clinicians to develop new algorithms of insulin delivery for patients with diabetes and to better explore the link between glucose variability and chronic diabetes complications.
NASA Astrophysics Data System (ADS)
Xie, Nanjie; Zhang, Hao; Liu, Bo; Wu, Jixuan; Song, Binbin; Han, Tingting
2017-11-01
A highly sensitive microfluidic sensor based on a microfiber-assisted Mach-Zehnder interferometer (MAMZI) is proposed and experimentally demonstrated for the detection of low-concentration glucose solution. A segment of microfiber tapered from standard single-mode fiber (SMF) is spliced between two SMFs with pre-designed lateral offset to constitute the miniaturized MAMZI probe. The transmission spectral response to environmental refractive index variation has been experimentally investigated for glucose concentration ranges of 300 mg dL-1 to 3000 mg dL-1 and 0 to 270 mg dL-1 and the glucose concentration detection limit is 3 mg dL-1, and the experimentally observed transmission spectral responses are in accordance with our theoretical simulation results. Owing to its high sensitivity, non-enzymatic operation method, ease of fabrication and compact size, our proposed MAMZI for glucose sensing is anticipated to be employed in biomedical applications.
Metrics for glycaemic control - from HbA1c to continuous glucose monitoring.
Kovatchev, Boris P
2017-07-01
As intensive treatment to lower levels of HbA 1c characteristically results in an increased risk of hypoglycaemia, patients with diabetes mellitus face a life-long optimization problem to reduce average levels of glycaemia and postprandial hyperglycaemia while simultaneously avoiding hypoglycaemia. This optimization can only be achieved in the context of lowering glucose variability. In this Review, I discuss topics that are related to the assessment, quantification and optimal control of glucose fluctuations in diabetes mellitus. I focus on markers of average glycaemia and the utility and/or shortcomings of HbA 1c as a 'gold-standard' metric of glycaemic control; the notion that glucose variability is characterized by two principal dimensions, amplitude and time; measures of glucose variability that are based on either self-monitoring of blood glucose data or continuous glucose monitoring (CGM); and the control of average glycaemia and glucose variability through the use of pharmacological agents or closed-loop control systems commonly referred to as the 'artificial pancreas'. I conclude that HbA 1c and the various available metrics of glucose variability reflect the management of diabetes mellitus on different timescales, ranging from months (for HbA 1c ) to minutes (for CGM). Comprehensive assessment of the dynamics of glycaemic fluctuations is therefore crucial for providing accurate and complete information to the patient, physician, automated decision-support or artificial-pancreas system.
Chan, Christine L; Pyle, Laura; Newnes, Lindsey; Nadeau, Kristen J; Zeitler, Philip S; Kelsey, Megan M
2015-03-01
The optimal screening test for diabetes and prediabetes in obese youth is controversial. We examined whether glycosylated hemoglobin (HbA1c) or the oral glucose tolerance test (OGTT) is a better predictor of free-living glycemia as measured by continuous glucose monitoring (CGM). This was a cross-sectional study of youth 10-18 years old, body mass index (BMI) 85th percentile or greater, with diabetes risk factors. Participants (n = 118) with BMI 85th percentile or greater, not on medications for glucose management, were recruited from primary care and pediatric endocrinology clinics around Denver, Colorado. HbA1c, fasting plasma glucose, and 2-hour glucose were collected and all participants wore a blinded CGM for 72 hours. CGM outcomes were determined and descriptive statistics calculated. Performance characteristics at current American Diabetes Association cutpoints were compared with CGM outcomes. CGM data were successfully collected on 98 obese youth. Those with prediabetes had significantly higher average glucose, area under the curve (AUC), peak glucose, and time greater than 120 and greater than 140 mg/dL (P < .01) on CGM than youth with normal HbA1c or OGTT. HbA1c had a greater magnitude of correlation to CGM average glucose, AUC, and minimum glucose; 2-hour glucose had a greater magnitude of correlation to CGM SD, peak glucose, and time greater than 140 and greater than 200 mg/dL. However, there were no overall differences in the strength comparisons between 2-hour glucose and HbA1c correlations to CGM outcomes. In obese youth, HbA1c and 2-hour glucose performed equally well at predicting free-living glycemia on CGM, suggesting that both are valid tests for dysglycemia screening.
Control of three different continuous pharmaceutical manufacturing processes: Use of soft sensors.
Rehrl, Jakob; Karttunen, Anssi-Pekka; Nicolaï, Niels; Hörmann, Theresa; Horn, Martin; Korhonen, Ossi; Nopens, Ingmar; De Beer, Thomas; Khinast, Johannes G
2018-05-30
One major advantage of continuous pharmaceutical manufacturing over traditional batch manufacturing is the possibility of enhanced in-process control, reducing out-of-specification and waste material by appropriate discharge strategies. The decision on material discharge can be based on the measurement of active pharmaceutical ingredient (API) concentration at specific locations in the production line via process analytic technology (PAT), e.g. near-infrared (NIR) spectrometers. The implementation of the PAT instruments is associated with monetary investment and the long term operation requires techniques avoiding sensor drifts. Therefore, our paper proposes a soft sensor approach for predicting the API concentration from the feeder data. In addition, this information can be used to detect sensor drift, or serve as a replacement/supplement of specific PAT equipment. The paper presents the experimental determination of the residence time distribution of selected unit operations in three different continuous processing lines (hot melt extrusion, direct compaction, wet granulation). The mathematical models describing the soft sensor are developed and parameterized. Finally, the suggested soft sensor approach is validated on the three mentioned, different continuous processing lines, demonstrating its versatility. Copyright © 2018 Elsevier B.V. All rights reserved.
A comparative effectiveness analysis of three continuous glucose monitors.
Damiano, Edward R; El-Khatib, Firas H; Zheng, Hui; Nathan, David M; Russell, Steven J
2013-02-01
To compare three continuous glucose monitoring (CGM) devices in subjects with type 1 diabetes under closed-loop blood glucose (BG) control. Six subjects with type 1 diabetes (age 52 ± 14 years, diabetes duration 32 ± 14 years) each participated in two 51-h closed-loop BG control experiments in the hospital. Venous plasma glucose (PG) measurements (GlucoScout, International Biomedical) obtained every 15 min (2,360 values) were paired in time with corresponding CGM glucose (CGMG) measurements obtained from three CGM devices, the Navigator (Abbott Diabetes Care), the Seven Plus (DexCom), and the Guardian (Medtronic), worn simultaneously by each subject. Errors in paired PG-CGMG measurements and data reporting percentages were obtained for each CGM device. The Navigator had the best overall accuracy, with an aggregate mean absolute relative difference (MARD) of all paired points of 11.8 ± 11.1% and an average MARD across all 12 experiments of 11.8 ± 3.8%. The Seven Plus and Guardian produced aggregate MARDs of all paired points of 16.5 ± 17.8% and 20.3 ± 18.0%, respectively, and average MARDs across all 12 experiments of 16.5 ± 6.7% and 20.2 ± 6.8%, respectively. Data reporting percentages, a measure of reliability, were 76% for the Seven Plus and nearly 100% for the Navigator and Guardian. A comprehensive head-to-head-to-head comparison of three CGM devices for BG values from 36 to 563 mg/dL revealed marked differences in performance characteristics that include accuracy, precision, and reliability. The Navigator outperformed the other two in these areas.
Miniaturized pulse oximeter sensor for continuous vital parameter monitoring
NASA Astrophysics Data System (ADS)
Fiala, Jens; Reichelt, Stephan; Werber, Armin; Bingger, Philipp; Zappe, Hans; Förster, Katharina; Klemm, Rolf; Heilmann, Claudia; Beyersdorf, Friedhelm
2007-07-01
A miniaturized photoplethysmographic sensor system which utilizes the principle of pulse oximetry is presented. The sensor is designed to be implantable and will permit continuous monitoring of important human vital parameters such as arterial blood oxygen saturation as well as pulse rate and shape over a long-term period in vivo. The system employs light emitting diodes and a photo transistor embedded in a transparent elastic cu. which is directly wrapped around an arterial vessel. This paper highlights the specific challenges in design, instrumentation, and electronics associated with that sensor location. In vitro measurements were performed using an artificial circulation system which allows for regulation of the oxygen saturation and pulsatile pumping of whole blood through a section of a domestic pig's arterial vessel. We discuss our experimental results compared to reference CO-oximeter measurements and determine the empirical calibration curve. These results demonstrate the capabilities of the pulse oximeter implant for measurement of a wide range of oxygen saturation levels and pave the way for a continuous and mobile monitoring of high-risk cardiovascular patients.
Charleer, Sara; Mathieu, Chantal; Nobels, Frank; Gillard, Pieter
2018-06-01
Nowadays, most Belgian patients with type 1 diabetes use flash glucose monitoring (FreeStyle Libre [FSL]; Abbott Diabetes Care, Alameda, California) to check their glucose values, but some patients find the sensor on the upper arm too visible. The aim of the present study was to compare the accuracy and precision of FSL sensors when placed on different sites. A total of 23 adults with type 1 diabetes used three FSL sensors simultaneously for 14 days on the upper arm, abdomen and upper thigh. FSL measurements were compared with capillary blood glucose (BG) measurements obtained with a built-in FSL BG meter. The aggregated mean absolute relative difference was 11.8 ± 12.0%, 18.5 ± 18.4% and 12.3 ± 13.8% for the arm, abdomen (P = .002 vs arm) and thigh (P = .5 vs arm), respectively. Results of Clarke error grid analysis for the arm and thigh were similar (zone A: 84.9% vs 84.5%; P = .6), while less accuracy was seen for the abdomen (zone A: 69.4%; P = .01). Apart from the first day, the accuracy of FSL sensors on the arm and thigh was more stable across the 14-day wear duration than accuracy of sensors on the abdomen, which deteriorated mainly during week 2 (P < .0005). The aggregated precision absolute relative difference was markedly lower for the arm/thigh (10.9 ± 11.9%) compared with the arm/abdomen (20.9 ± 22.8%; P = .002). Our results indicate that the accuracy and precision of FSL sensors placed on the upper thigh are similar to the upper arm, whereas the abdomen performed unacceptably poorly. © 2018 John Wiley & Sons Ltd.
Rossetti, P; Porcellati, F; Fanelli, C G; Bolli, G B
2006-06-01
These studies were designed to evaluate the accuracy of a microdialysis-based subcutaneous glucose sensor (GlucoDay, A. Menarini Diagnostics, Firenze, Italy) compared with a standard reference method of plasma glucose measurement during insulin-induced hypoglycemia. Nine subjects without diabetes were studied in eu-, hypo-, and hyperglycemia (clamp technique). The GlucoDay was calibrated against one arterialized plasma glucose measurement (Glucose Analyzer, Beckman, Brea, CA), and plasma glucose estimates every 3 min were compared with paired plasma glucose values. Accuracy of glucose estimates was not homogeneously distributed among subjects and depended on stability of the sensor's current signal during spontaneous euglycemia (R +/- -0.68). Linear regression analysis showed a good correlation between the two methods of measurement (R = 0.9), Deming regression showed the inclusion of the unit in the confidence interval of the slope (slope 0.95, 95% confidence interval 0.87-1.02), and the accuracy of the GlucoDay reached 40 +/- 15% (American Diabetes Association criteria). The mean relative difference was 6 +/- 8% in euglycemia, 13 +/- 14% during plasma glucose fall, 5 +/- 22% in the hypoglycemic plateau, and -14 +/- 16% during recovery from hypoglycemia. The Bland-Altman analysis indicated a bias of -1.9 +/- 16.6 mg/dL, whereas the Error Grid Analysis showed 94% of the Gluco- Day measurements in the acceptable zones of the grid. The time to reach the glycemic nadir was longer when measured with the GlucoDay (90 +/- 5 vs. 72.5 +/- 9 min, P < 0.05). However, absolute values of glycemic nadir, time spent in hypoglycemia, and the rate of fall of glycemia and the rate of recovery from the hypoglycemia were not statistically different. GlucoDay closely monitors changes in plasma glucose before, during, and after hypoglycemia. However, these results can be achieved only if calibration of the GlucoDay is performed under conditions of sensor signal stability. Similar
Rawlings, Renata A.; Shi, Hang; Yuan, Lo-Hua; Brehm, William; Pop-Busui, Rodica
2011-01-01
Abstract Background Several metrics of glucose variability have been proposed to date, but an integrated approach that provides a complete and consistent assessment of glycemic variation is missing. As a consequence, and because of the tedious coding necessary during quantification, most investigators and clinicians have not yet adopted the use of multiple glucose variability metrics to evaluate glycemic variation. Methods We compiled the most extensively used statistical techniques and glucose variability metrics, with adjustable hyper- and hypoglycemic limits and metric parameters, to create a user-friendly Continuous Glucose Monitoring Graphical User Interface for Diabetes Evaluation (CGM-GUIDE©). In addition, we introduce and demonstrate a novel transition density profile that emphasizes the dynamics of transitions between defined glucose states. Results Our combined dashboard of numerical statistics and graphical plots support the task of providing an integrated approach to describing glycemic variability. We integrated existing metrics, such as SD, area under the curve, and mean amplitude of glycemic excursion, with novel metrics such as the slopes across critical transitions and the transition density profile to assess the severity and frequency of glucose transitions per day as they move between critical glycemic zones. Conclusions By presenting the above-mentioned metrics and graphics in a concise aggregate format, CGM-GUIDE provides an easy to use tool to compare quantitative measures of glucose variability. This tool can be used by researchers and clinicians to develop new algorithms of insulin delivery for patients with diabetes and to better explore the link between glucose variability and chronic diabetes complications. PMID:21932986
NASA Astrophysics Data System (ADS)
Birkholz, M.; Ehwald, K.-E.; Basmer, T.; Kulse, P.; Reich, C.; Drews, J.; Genschow, D.; Haak, U.; Marschmeyer, S.; Matthus, E.; Schulz, K.; Wolansky, D.; Winkler, W.; Guschauski, T.; Ehwald, R.
2013-06-01
The progressive scaling in semiconductor technology allows for advanced miniaturization of intelligent systems like implantable biosensors for low-molecular weight analytes. A most relevant application would be the monitoring of glucose in diabetic patients, since no commercial solution is available yet for the continuous and drift-free monitoring of blood sugar levels. We report on a biosensor chip that operates via the binding competition of glucose and dextran to concanavalin A. The sensor is prepared as a fully embedded micro-electromechanical system and operates at GHz frequencies. Glucose concentrations derive from the assay viscosity as determined by the deflection of a 50 nm TiN actuator beam excited by quasi-electrostatic attraction. The GHz detection scheme does not rely on the resonant oscillation of the actuator and safely operates in fluidic environments. This property favorably combines with additional characteristics—(i) measurement times of less than a second, (ii) usage of biocompatible TiN for bio-milieu exposed parts, and (iii) small volume of less than 1 mm3—to qualify the sensor chip as key component in a continuous glucose monitor for the interstitial tissue.
Long wavelength fluorescence based biosensors for in vivo continu