Showing papers on "Glucose Measurement published in 2008"

Integrated receiver for continuous analyte sensor

Abstract: A system is provided for monitoring glucose in a host, including a continuous glucose sensor that produces a data stream indicative of a host's glucose concentration and an integrated receiver that receives the data stream from the continuous glucose sensor and calibrates the data stream using a single point glucose monitor that is integral with the integrated receiver. The integrated receiver obtains a glucose value from the single point glucose monitor, calibrates the sensor data stream received from the continuous glucose sensor, and displays one or both of the single point glucose measurement values and the calibrated continuous glucose sensor values on the user interface.

Accuracy of bedside glucose measurement from three glucometers in critically ill patients.

Abstract: Objective: Implementation of strict glucose control in most intensive care units has resulted in increased use of point-ofcare glucose devices in the intensive care unit. The aim of this study was to determine the reliability of point-of-care testing glucose meters among critically ill patients under intensive insulin treatment. Design: Prospective observational study. Patients: Intensive care unit and non-intensive care unit patients in a tertiary care teaching hospital. Measurements: A glucose oxidase method was used to validate the point-of-care testing devices. Three different point-ofcare testing devices, Accu-Chek Sensor (Roche Diagnostics), Precision (Abbott Diagnostics), and HemoCue were tested. Glucose measurements were performed in duplicate by an experienced technician under standardized conditions in the hospital’s laboratory, using arterial (intensive care unit patients) and arterial or venous (non-intensive care unit patients) heparinized whole blood samples. Main Results: A strong correlation was found between the glucose oxidase method and the Accu-Chek device (r 2 .9596, p < 0.001). Mean absolute difference between the glucose oxidase and Accu-Chek was 0.32 mmol/L (95% confidence interval 0.84 to 1.48 mmol/L). Using the International Organization for Standardization (ISO) criteria, 27 of 197 samples (13.7%) were inaccurate. In all samples that failed to meet the ISO criteria, glucose values measured by the Accu-Chek device were higher compared with the glucose oxidase method. In another set of experiments among intensive care unit patients, strong positive correlations were also found between the other point-ofcare testing devices and the glucose oxidase method. However, paired samples from Accu-Chek, HemoCue, and Precision failed the ISO criteria in 9 of 82 (11.0%), 4 of 82 (4.9%), and 11 of 82 (13.4%) of cases, respectively. In non-intensive care unit patients paired samples from Accu-Chek, HemoCue, and Precision failed the ISO criteria in 3 of 120 (2.5%), 11 of 120 (9.2%), and 16 of 120 (13.3%) cases, respectively. Conclusions: Under standardized conditions, glucose results from three point-of-care testing devices were inaccurate in both intensive care unit and non-intensive care unit patients. Among intensive care unit patients, inaccurate glucose readings were most frequently falsely elevated, resulting in misinterpretation of high glucose values with subsequent inappropriate insulin administration or masking of true hypoglycemia. (Crit Care Med 2008; 36:3062–3066)

Combination communication device and medical device for communicating wirelessly with a remote medical device

Abstract: An electronic device may selectively disable a bolus advice process according to which the electronic device recommends delivery of a bolus amount of a drug to a body of a user based on a plurality of factors including glucose concentration of the user. The electronic device may include a glucose measuring facility configured to measure glucose concentration of a body fluid sample, and a processor including a memory having instructions stored therein that comprise the bolus advice process. The memory may further have instructions stored therein that are executable by the processor to request a glucose concentration measurement by the glucose measurement facility prior to executing, or as part of, the bolus advice process, and to disable execution of the bolus advice process if a glucose concentration value resulting from the requested glucose concentration measurement is less than a threshold value.

Clinically important factors influencing the diagnostic measurement of pleural fluid pH and glucose.

Abstract: Rationale: Accurate pleural fluid pH and glucose measurement is a key component in the diagnosis and management of patients with pleural effusion. Standardized methods of pleural fluid collection have not been defined. Objectives: To assess the effect of common clinical factors that may distort measurement accuracy of pleural fluid pH and glucose. Methods: Ninety-two exudative pleural aspirates were collected in commercially available blood gas syringes. Measurements and Main Results: Samples were analyzed immediately using a blood gas analyzer. The effects of residual air, lidocaine, heparin, and delay in analysis (24 h) on pH and glucose measurement accuracy were assessed. Pleural fluid pH was significantly increased by residual air (mean ± SD, 0.08 ± 0.07; 95% confidence interval [CI], 0.06 to 0.09; P < 0.001) and significantly decreased by residual lidocaine (0.2 ml; mean change in pH, −0.15 ± 0.09; 95% CI, −0.13 to −0.18; P < 0.001) and residual heparin (mean change in pH, −0.02 ± 0.05; 95% CI, −0.01 to −0.04; P = 0.027). Pleural fluid pH was stable at room temperature for 1 hour and significantly increased at 4 (mean ± SD, 0.03 ± 0.07; 95% CI, 0.01 to 0.04; P = 0.003) and 24 hours (0.05 ± 0.12; 95% CI, 0.03 to 0.08; P < 0.001). Pleural fluid glucose concentration was not clinically significantly altered by residual air, lidocaine (up to 0.4 ml), or 24-hour analysis delay. Conclusions: Accuracy of measured pleural pH is critically dependent on sample collection method. Residual air, lidocaine, and analysis delay significantly alter pH and may impact on clinical management. Pleural fluid glucose concentration is not significantly influenced by these factors. Protocols defining appropriate sampling and analysis methods are needed.

Computer-assisted glucose control in critically ill patients.

Abstract: Intensive insulin therapy is associated with the risk of hypoglycemia and increased costs of material and personnel. We therefore evaluated the safety and efficiency of a computer-assisted glucose control protocol in a large population of critically ill patients. Observational cohort study in three intensive care units (32 beds) in a 1,300-bed university teaching hospital. All 2,800 patients admitted to the surgical, neurosurgical, and cardiothoracic units; the study period started at each ICU after implementation of Glucose Regulation for Intensive Care Patients (GRIP), a freely available computer-assisted glucose control protocol. We analysed compliance in relation to recommended insulin pump rates and glucose measurement frequency. Patients were on GRIP-ordered pump rates 97% of time. Median measurement time was 5 min late (IQR 20 min early to 34 min late). Hypoglycemia was uncommon (7% of patients for mild hypoglycemia, < 3.5 mmol/l; 0.86% for severe hypoglycemia, < 2.2 mmol/l). Our predefined target range (4.0–7.5 mmol/l) was reached after a median of 5.6 h (IQR 0.2–11.8) and maintained for 89% (70–100%) of the remaining stay at the ICU. The number of measurements needed was 5.9 (4.8–7.3) per patient per day. In-hospital mortality was 10.1%. Our computer-assisted glucose control protocol provides safe and efficient glucose regulation in routine intensive care practice. A low rate of hypoglycemic episodes was achieved with a considerably lower number of glucose measurements than used in most other schemes.

Method and glucose monitoring system for monitoring individual metabolic response and for generating nutritional feedback

Abstract: A system and method for monitoring individual metabolic response and for generating nutritional feedback involve monitoring of a glucose level in a qualified subject. The method comprises the step of consecutively performing a plurality of measurements of a glucose level in the qualified subject by a measuring device. In the measuring device first data corresponding to the measured glucose level is generated. This data is further transmitted to an analysis device. There, second data is generated representing at least one measure for variability of a glucose level of the subject from a time-series of glucose measurements represented by the first data. The second data is compared with reference data and a result of the comparison is further processed for generating a conclusion about nutritional quality of foodstuffs consumed by the subject and/or about a risk of long-term health complications of the subject. Finally, feedback is provided corresponding to the conclusion on an output device.

Equilibrium non-consuming fluorescence sensor for real time intravascular glucose measurement

Abstract: Embodiments of the present invention relates to analyte sensors. In particular, the preferred embodiments of the present invention relate to non-consuming intravascular glucose sensors based on fluorescence chemistry.

Predictive control based system and method for control of insulin delivery in diabetes using glucose sensing

Abstract: A system and method for providing optimal insulin injections to a subject, using a controller, a continuous glucose monitor, and an insulin delivery unit is disclosed. The controller possesses a discrete-time, linear model predictive control law, means for sending information to the insulin delivery unit, and means for receiving information from the CGM. The control law implemented is derived from a discrete-time model of glucose insulin dynamics and an aggressiveness parameter. The result is that using only glucose measurements obtained from sensor readings and, prior values of external insulin infusion and meal and exercise announcement the optimal insulin injection necessary to safely regulate blood glucose can be calculated.

The association between hyperglycemia and fracture risk in middle age. A prospective, population-based study of 22,444 men and 10,902 women.

Abstract: Aims: Type 1 diabetes mellitus is associated with increased fracture risk, whereas the risk associated with type 2 diabetes is less obvious. Elevated fasting blood glucose and high 2-h glucose during an oral glucose tolerance test indicate impaired glucose tolerance or diabetes. The associations among fasting blood glucose, 2-h glucose, and the risk of fracture were investigated. Methods: The Malmo Preventive Project consists of 22,444 men (44 ± 6.6 yr) and 10,902 women (50 ±7.4 yr), with a follow-up of 19 yr (±3.9) and 15 yr (±4.5) for incident fractures. Baseline assessment included multiple examinations and lifestyle information. A logistic regression model was used. Adjustments were made for age, body mass index (BMI), and smoking. Results: Low-energy fractures were recorded in 1246 men and 1236 women. A 2-h glucose measurement between 4.3 and 6.2 mmol/liter in men (second and third quartile), and above 6.5 mmol/liter in women (third and fourth quartile), adjusted for age, BMI, and smoking, was signif...

Optical systems and methods for ratiometric measurement of blood glucose concentration

Abstract: Novel optical devices, methods and systems relating to the detection of glucose, and more particularly to real-time glucose monitoring, are disclosed herein. More particularly, various hardware and methodological means are disclosed for ratiometric correction of optical glucose measurements for artifacts of optical systems.

An optical biosensor for the rapid determination of glucose in human serum

Abstract: An optical glucose biosensor based on the immobilization of glucose oxidase in a sensing film was developed. The sensing film consisted of an organically modified silicate film embedded with tri(4,7-diphenyl-1,10-phenanthroline) ruthenium(II) perchlorate and a polyvinyl alcohol sol–gel matrix with immobilized glucose oxidase. A kinetic curve simulation method was employed for glucose measurements, as a result of which the measurement time was less than 1 min for each sample analysis. The detection limit (S/N = 3) of the glucose optical sensor was 3.6 × 10−6 mol L−1 with linear ranges from 0.00 to 0.50 mmol L−1 (Y = 358.25X−2.93, R2 = 0.9954) and 0.50 to 3.00 mmol L−1 (Y = 430.12X−46.43, R2 = 0.9972). In addition, the appearance of the sensing film, and effects of the amounts of immobilized enzyme, pH, temperature, ionic strength, and co-existing substances (including heavy metal ions and organic compounds) were investigated. The glucose values estimated by this optical biosensor correlated well with those determined using the conventional method for human serum samples.

Pilot Studies of Transdermal Continuous Glucose Measurement in Outpatient Diabetic Patients and in Patients during and after Cardiac Surgery

Abstract: Background:We tested the hypothesis that glucose can be measured continuously and reliably in patients in diverse settings using a transdermal biosensor coupled to a permeated skin site. In addition, we compared a novel, abrasion-based skin permeation method to an ultrasound-based method for transdermal continuous glucose monitoring.Method:Transdermal continuous glucose monitors were applied to patients with diabetes (study I), patients undergoing cardiac surgery (study II), and healthy volunteers (study III). Reference blood glucose measurements were performed with glucometers or standard blood glucose analyzers. At the conclusion of the 24-hour study, data were postprocessed for comparison with the reference blood glucose values collected during the study period.Results:Data were validated for 10 subjects for 12 hours in study I, 8 subjects for 24 hours in study II, and 6 subjects in study III. The transdermal continuous glucose monitors usually required 1 hour of warm up. Depending on the study setting...

Non-Invasive Glucose Measurement by Use of Metabolic Heat Conformation Method

Abstract: A non-invasive glucose measurement system based on the method of metabolic heat conformation (MHC) is presented in this paper. This system consists of three temperature sensors, two humidity sensors, an infrared sensor and an optical measurement device. The glucose level can be deduced from the quantity of heat dissipation, blood flow rate of local tissue and degree of blood oxygen saturation. The methodology of the data process and the measurement error are also analyzed. The system is applied in a primary clinical test. Compared with the results of a commercial automated chemistry analyzer, the correlation coefficient of the collected data from the system is 0.856. Result shows that the correlation coefficient improves when the factor of heat dissipated by evaporation of the skin is added in. A non-invasive method of measuring the blood flow rate of local tissue by heat transmission between skin and contacted conductor is also introduced. Theoretical derivation and numerical simulation are completed as well. The so-called normalized difference mean (NDM) is chosen to express the quantity of the blood flow rate. The correlation coefficient between the blood flow rates by this method and the results of a Doppler blood flow meter is equal to 0.914.

System and method for glycemic control

Abstract: Disclosed is a glucose monitoring system The system includes a glucose sensor to periodically perform a plurality of glucose measurements in interstitial fluid, and a processor to determine one or more HbA1c values representative of a patient's glycosylated hemoglobin levels based on the periodic glucose measurements In some embodiments, the glucose sensor is coupled to a therapeutic fluid (eg, insulin) dispensing pump

Glucose and Insulin Measurements from the Oral Glucose Tolerance Test and Mortality Prediction

Abstract: Objective: To verify what information from oral glucose tolerance testing (OGTT) independently predicts mortality. Research Design and Methods: 1401 initially non-diabetic participants from the Baltimore Longitudinal Study of Aging, aged 17-95 years, with one or more OGTT (median=2, range 1-8) with insulin and glucose measurements measured every 20 minutes over 2 hours. Proportional hazard using the longitudinally collected data and Bayesian model averaging were used to examine the association of OGTT measurements individually and grouped with mortality adjusting for covariates. Results: Participants were followed for a median 20.3 years (range 0.5 – 40 years). The first hour OGTT glucose and insulin levels increased only modestly with age; whereas levels during the second hour increased more than 4% per decade. Individually, the 100- and 120-minute glucose measures and the fasting and 100-minute insulin levels were all independent predictors of mortality. When all measures were considered together, only higher 120-minute glucose was a significant independent risk factor for mortality. Conclusion: The steeper rise with age of the OGTT 2-hour glucose values and the prognostic primacy of the 120 minute glucose value for mortality is consistent with previous reports and suggests the value of using the OGTT in clinical practice.

Optical Absorption Glucose Measurements Using 2.3- $\mu$ m Vertical-Cavity Semiconductor Lasers

Abstract: Continuous glucose monitoring has been shown to help diabetes mellitus patients stabilize their glucose levels, leading to improved patient health. One promising technique for monitoring blood glucose concentration is to use optical absorption spectroscopy. This letter proposes the use of thermally tunable 2.3-mum vertical-cavity surface-emitting lasers to obtain blood absorption spectra. The partial least squares technique is used to determine the glucose concentration from the spectra obtained in aqueous glucose solutions.

Blood glucose dynamics.

Abstract: Measurement of blood glucose concentration is central to the diagnosis and treatment of diabetes. Although there are large numbers of historic glucose measurements in individuals with diabetes, until recently there have been very few data sets that were recorded continuously or sampled frequently enough to reveal intrinsic blood glucose dynamics, or the change in blood glucose with time. There have even fewer such recordings from individuals not having diabetes to serve as a therapeutic target. As a result, blood glucose dynamics have generally not been used in the diagnosis or treatment of the disease. Although present blood glucose monitoring is based largely on discrete measurements, future monitoring will likely focus on analysis of blood glucose excursions. New measurements are now being obtained, and there is a need for new methods of analysis to extract the maximal information from the data. Several approaches are demonstrated here for characterization of blood glucose dynamics, and a patient profiling system is proposed. An example of new insights is the observation that there are four time scales of blood glucose variations in individuals without diabetes, and these time scales are modified or lost in diabetes.

In silico testing--impact on the progress of the closed loop insulin infusion for critically ill patients project.

Abstract: Background: In silico testing was used extensively in the European Commission-funded Closed Loop Insulin Infusion for Critically Ill Patients (Clinicip) project, which aimed to develop prototype systems for closed loop glucose control in the critically ill. This article presents two examples of how the simulation environment was utilized in this project. Methods: The in silico simulation environment was used to simulate a 48-hour clinical trial in a surgical intensive care unit to achieve tight glycemic control. A set of 10 critically ill synthetic subjects was selected for two different studies. In the first study, two sets of clinical trials were simulated using two versions of a model predictive control (MPC)-based glucose control algorithm: MPC Version 0.1.5 with hourly glucose measurements and updated MPC Version 1.4.3 with variable 1- to 4-hour glucose sampling. In the second study, four sets of clinical trials were simulated with four levels of measurement error at 2, 5, 7, and 15% coefficient of variation corresponding to the measurement error of commercially available glucose measuring devices. Results: In the first study, more frequent glucose measurements associated with MPC Version 0.1.5 facilitated more efficacious and safer glucose control compared to that obtained with the prolonged and variable glucose sampling rate associated with MPC Version 1.4.3. In the second study, a marked deterioration in safety measures was observed in studies performed with a measurement error of 15%. Conclusions: The presented simulation studies highlighted two important uses of in silico simulation environment in the Clinicip project. The impressive progress and successful completion of the Clinicip project would not be possible without computer-based simulations.

Glucose Control and Use of Continuous Glucose Monitoring in the Intensive Care Unit: A Critical Review

Abstract: 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.

Kalman filter based glucose control at small set points during fed-batch cultivation of Saccharomyces cerevisiae.

Abstract: A glucose control system is presented, which is able to control cultivations of Saccharomyces cerevisiae even at low glucose concentrations. Glucose concentrations are determined using a special flow injection analysis (FIA) system, which does not require a sampling module. An extended Kalman filter is employed for smoothing the glucose measurements as well as for the prediction of glucose and biomass concentration, the maximum specific growth rate, and the volume of the culture broth. The predicted values are utilized for feedforward/feedback control of the glucose concentration at set points of 0.08 and 0.05 g/L. The controller established well-defined conditions over several hours up to biomass concentrations of 13.5 and 20.7 g/L, respectively. The specific glucose uptake rates at both set points were 1.04 and 0.68 g/g/h, respectively. It is demonstrated that during fed-batch cultivation an overall pure oxidative metabolism of glucose is maintained at the lower set point and a specific ethanol production rate of 0.18 g/g/h at the higher set point.

Automated Blood Sampling and Glucose Sensing in Critical Care Settings

Abstract: Background: Tight glycemic control (TGC) studies in intensive care units (ICU) have shown substantial improvements in clinical outcomes. However, implementation of TGC in ICU practice is partly constrained by the lack of automated continuous blood glucose monitoring systems that can facilitate clinically accurate feedback of glycemic data. The aim of this work is to develop a portable automated blood sampling system for integration with a glucose sensor for use in critical care settings. Methods: Clinical prototypes for glucose sensing in blood were developed based on two distinct technologies: midinfrared laser absorption spectroscopy and electrochemistry. Concurrently, an automated peripheral venous blood sampling system was developed for integration with the glucose sensing system. Results: The glucose sensing prototypes were validated clinically with various biological samples in a continuous mode. A customized micropump was employed in conjunction with a novel peripheral venous catheter system to automatically sample blood from the subject’s forearm. Microvolumes of blood were sampled in continuous and intermittent modes at clinically relevant user-defined frequencies. The clinical feasibility of blood sampling, along with continuous glucose sensing, was demonstrated. Conclusion: Cascade’s automated peripheral venous blood sampling system, in combination with a flow-through glucose sensor system, offers several advantages over current state-of-the-art systems. This includes the potential for significantly improved workflow in the ICU, minimal discomfort to the patient, and accurate glucose measurement in whole blood, thus helping achieve tight glycemic control.

Calibrated analyte concentration measurements in mixtures

Abstract: The concentration of analytes in a complex mixture can be ascertained by spectroscopic measurement, even if the spectra of substances other than the analyte overlap with that of the analyte. Both independently measured concentrations of the analyte in a training set and of the analyte spectrum are used. Variances in the spectral data attributable to the analyte are isolated from spectral variances from other causes, such as compositional changes associated with different samples that are independent of the analyte. For the special case of noninvasive glucose measurements on the skin of biological organisms, the volume averaged glucose in the sample is predicted from the blood glucose. A test for over-fitting of the data is also described.

Can mixed venous blood be used to measure insulin action during the hyperinsulinemic clamp

Abstract: Mandatory use of arterialized venous blood for glucose measurement during insulin clamp studies can preclude its use in obese subjects. In order to assess the distortion produced by performing clamp studies with mixed venous blood, we have carried out the present study. Sixteen subjects (BMI range 21-53 kg/m2) whose glucose tolerance varied from normal to diabetic, had hyperinsulinemic clamps performed at plasma insulin concentrations approximately 250 microU/ml above basal, using arterialized venous (a.v.) blood for plasma glucose and insulin measurements. The test was repeated on the same subjects, but mixed venous (m.v.) blood was substituted for a.v. blood to determine plasma glucose and insulin concentrations. During the two studies, the mean (+/- SEM) steady state plasma glucose (a.v. = 110.6 +/- 8.8 mg/dl; m.v. = 111.3 +/- 9.8 mg/dl) and the mean incremental increases in insulin concentrations (a.v. = 263 +/- 20 microU/ml; m.v. = 273 +/- 21 microU/ml) were essentially identical. Furthermore, there was almost a perfect correlation between the individual values obtained for both SSPG (r = 0.97, p less than 0.001) and incremental insulin levels (r = 0.98, p less than 0.001) with the two methods. In addition, the amounts of glucose metabolized calculated from the two methods were very similar (a.v. = 4.96 +/- 0.67 mg/kg/min; m.v. = 5.25 +/- 0.76 mg/kg/min) and the two determinations of M were highly correlated (r = 0.97, p less than 0.001). Finally, the relative rank order of the M values obtained for the 16 subjects during the two studies were extremely comparable.(ABSTRACT TRUNCATED AT 250 WORDS)

Translating Hemoglobin A1c into Average Blood Glucose: Implications for Clinical Chemistry

Abstract: Measurement of hemoglobin A1c (Hb A1c)1 is a fundamental component of the management of patients with diabetes mellitus. Hb A1c measurement provides an indication of chronic exposure to glucose and is extensively used for both monitoring long-term glycemic status and evaluating whether an individual patient has attained adequate metabolic control. The patient’s Hb A1c value is used by clinicians to determine whether glucose-lowering therapy is adequate. A recent report (1) establishes a mathematical relationship between Hb A1c and the average glucose (AG) concentration in blood. The findings presented are likely to have considerable impact on the way Hb A1c is reported by clinical laboratories and used by healthcare providers (and patients). The importance and potential consequences of the study are the focus of this Perspective. The efficacy of therapy to lower blood glucose in patients with diabetes mellitus is assessed by 2 complementary methods, glucose measurement, which is performed by patients, and Hb A1c measurement. Patients perform self-monitoring of blood glucose (SMBG) by using hand-held meters to measure their own blood glucose concentrations. It is recommended that patients on insulin perform SMBG 4 times a day. The dose of the insulin injection is determined by the glucose value. Many modern meters store the results of all the glucose measurements, which can be downloaded and accessed by the physician during the patient’s visit. The second method for monitoring therapy to lower blood glucose is measurement of glycohemoglobin, most commonly performed by assaying Hb A1c. Glycohemoglobin is formed by the attachment of glucose to hemoglobin by a nonenzymatic process, termed glycation. The erythrocyte membrane is permeable to glucose, which enters the cell, where it binds to hemoglobin. The unstable product, termed an aldimine, undergoes an Amadori rearrangement to form a stable …

An analysis of how to measure glucose during glucose clamps: are glucose meters ready for research?

Abstract: This article provides a perspective on the challenges of appropriate glucose measurement in the context of glucose clamp experiments. In a first step, the core outcome parameters of a clamp experiment, the blood glucose target level, and the glucose infusion rate will be identified. The relation of these core parameters to glucose measurement are discussed. From there, the core quality parameters of glucose measurement within a clinical research setting are identified and assessed in light of their practical implications, with a specific consideration of the work presented by Cohen et al. in this issue of the Journal of Diabetes Science and Technology.

Clinical Application and Challenges of Blood Glucose Measurement Technology for Self-Monitoring

Abstract: Patients and many physicians believe that modern blood glucose meters provide reliable results under all circumstances. The aim of this (mini-)review is to critically review a number of aspects that should be taken into account for successful self-monitoring of blood glucose (SMBG). Usage and practical knowledge of patients about the optimal knowledge of SMBG appear to be lower than one expects. A number of factors like coding and calibration have an impact on the reliability of the measurement. Unfortunately, we have no standard procedure to evaluate the quality of the glucose measurement by the meters. In practice, SMBG is more than simply the glucose measurement; it involves many steps that also have a critical impact on the final outcome. We will also highlight that the digital number provided at the end of this diagnostics procedure is of no help per se; it requires a translation in an adequate therapeutic action. Most of the aspects mentioned have not gained thorough scientific interest in ...