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Glucose Sensors: Revolution in Diabetes Management 2016
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Glucose Sensors: Revolution in Diabetes Management 2016

A special issue of Sensors (ISSN 1424-8220). This special issue belongs to the section "Chemical Sensors".

Deadline for manuscript submissions: closed (15 October 2016) | Viewed by 186121

Special Issue Editors

Prof. Dr. Giovanni Sparacino

E-Mail Website
Guest Editor
Department of Information Engineering, University of Padova, Padova, Italy
Interests: sensors and algorithms for continuous glucose monitoring; deconvolution and parameter estimation techniques for the study of physiological systems; linear and nonlinear biological time-series analysis; measurement and processing of biomedical signals (EEG, event-related potentials, local field potentials, fNIRS, etc.) for clinical research and applications
Special Issues, Collections and Topics in MDPI journals
Dr. Andrea Facchinetti

E-Mail Website
Guest Editor
Department of Information Engineering, University of Padova, Via G. Gradenigo 6B, 35131 Padova PD, Italy
Interests: signal processing and classification of biomedical signals; algorithms and software to improve both performance and usability of continuous glucose monitoring (CGM) sensors; statistical methods and machine learning techniques to analyze big data in medicine
Special Issues, Collections and Topics in MDPI journals
Dr. J. Hans DeVries

E-Mail Website
Guest Editor
Department of Endocrinology Academic Medical Center at the University of Amsterdam Meibergdreef 9 1100 DD Amsterdam, The Netherlands
Interests: Diabetes mellitus, with a focus on diabetes technology, hospital normoglycaemia, insulin and glp-1 based therapies

Special Issue Information

Dear Colleagues,

Diabetes is one of the most challenging socio-health emergencies of the third millennium.  About 350 million people worldwide are estimated to be diabetic (50% of whom are undiagnosed), but this number is rapidly increasing due to aging populations and sedentary lifestyles, with the prospective of exceeding 500 million cases in 2030. Every year, 1.5 million deaths can be directly attributed to diabetes. In Western countries, the economic cost of diabetes can exceed 15% of the budget of national health systems. Therefore, impact of innovative methodologies and technologies for diabetes management can be extremely high.
Most of the existing methodologies and technologies for diabetes management rely on the capability of correctly measuring glucose concentration levels in the blood by using suitable sensors. The most widely used approach is self-monitoring blood glucose (SMBG), three to four times a day, through portable minimally-invasive lancing sensor devices, which exploit the glucose-oxidase enzyme, but, in the last 15 years, Continuous Glucose Monitoring (CGM) sensors have been developed which can provide measurements, in real time, with a 1–5 min sampling period and for several consecutive days/weeks. Most of CGM sensors exploit glucose-oxidase, but devices based on different principles, e.g., fluorescence or skin dielectric properties, have been also proposed.

The development of glucose sensor technologies and methodologies for the treatment of diabetes, universally accessible and easily usable from both the patients’ and physicians’ point of view, present several challenging aspects in different areas of scientific research, ranging from medicine to physics, electronics, chemistry, ergonomics, data analysis and signal processing, and software development to mention but a few. This Special Issue aims at presenting the latest technologies and methodologies developed in this interdisciplinary field of science. Topics include, but are not limited to, the following:

    - Physiology of glucose sensing
    - Technologies for glucose sensing
    - Calibration of glucose sensors
    - Online algorithms for glucose sensors (including denoising, prediction, classification)
    - E-health, m-health and personal healthcare systems applications of glucose sensors in diabetes     management
    - New populations: elderly, obese, type 2
    - Glucose sensor requirements for open-loop vs. closed-loop clinical use
    - Non-adjunctive use of continuous glucose monitoring sensors

Dr. Giovanni Sparacino
Dr. Andrea Facchinetti
Dr. J. Hans DeVries
Guest Editors

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Keywords

  • glucose sensors
  • continuous glucose monitoring sensors
  • self-monitoring blood glucose sensors
  • non-invasive glucose sensors
  • implanted glucose sensors
  • calibration of glucose sensors
  • evaluation of glucose sensors
  • validation of glucose sensors

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Published Papers (15 papers)

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Research

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1657 KiB  
Article
Use of Wearable Sensors and Biometric Variables in an Artificial Pancreas System
by Kamuran Turksoy, Colleen Monforti, Minsun Park, Garett Griffith, Laurie Quinn and Ali Cinar
Sensors 2017, 17(3), 532; https://doi.org/10.3390/s17030532 - 7 Mar 2017
Cited by 24 | Viewed by 7703
Abstract
An artificial pancreas (AP) computes the optimal insulin dose to be infused through an insulin pump in people with Type 1 Diabetes (T1D) based on information received from a continuous glucose monitoring (CGM) sensor. It has been recognized that exercise is a major [...] Read more.
An artificial pancreas (AP) computes the optimal insulin dose to be infused through an insulin pump in people with Type 1 Diabetes (T1D) based on information received from a continuous glucose monitoring (CGM) sensor. It has been recognized that exercise is a major challenge in the development of an AP system. The use of biometric physiological variables in an AP system may be beneficial for prevention of exercise-induced challenges and better glucose regulation. The goal of the present study is to find a correlation between biometric variables such as heart rate (HR), heat flux (HF), skin temperature (ST), near-body temperature (NBT), galvanic skin response (GSR), and energy expenditure (EE), 2D acceleration-mean of absolute difference (MAD) and changes in glucose concentrations during exercise via partial least squares (PLS) regression and variable importance in projection (VIP) in order to determine which variables would be most useful to include in a future artificial pancreas. PLS and VIP analyses were performed on data sets that included seven different types of exercises. Data were collected from 26 clinical experiments. Clinical results indicate ST to be the most consistently important (important for six out of seven tested exercises) variable over all different exercises tested. EE and HR are also found to be important variables over several types of exercise. We also found that the importance of GSR and NBT observed in our experiments might be related to stress and the effect of changes in environmental temperature on glucose concentrations. The use of the biometric measurements in an AP system may provide better control of glucose concentration. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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Article
Continuous Glucose Monitoring Enables the Detection of Losses in Infusion Set Actuation (LISAs)
by Daniel P. Howsmon, Faye Cameron, Nihat Baysal, Trang T. Ly, Gregory P. Forlenza, David M. Maahs, Bruce A. Buckingham, Juergen Hahn and B. Wayne Bequette
Sensors 2017, 17(1), 161; https://doi.org/10.3390/s17010161 - 15 Jan 2017
Cited by 20 | Viewed by 6774
Abstract
Reliable continuous glucose monitoring (CGM) enables a variety of advanced technology for the treatment of type 1 diabetes. In addition to artificial pancreas algorithms that use CGM to automate continuous subcutaneous insulin infusion (CSII), CGM can also inform fault detection algorithms that alert [...] Read more.
Reliable continuous glucose monitoring (CGM) enables a variety of advanced technology for the treatment of type 1 diabetes. In addition to artificial pancreas algorithms that use CGM to automate continuous subcutaneous insulin infusion (CSII), CGM can also inform fault detection algorithms that alert patients to problems in CGM or CSII. Losses in infusion set actuation (LISAs) can adversely affect clinical outcomes, resulting in hyperglycemia due to impaired insulin delivery. Prolonged hyperglycemia may lead to diabetic ketoacidosis—a serious metabolic complication in type 1 diabetes. Therefore, an algorithm for the detection of LISAs based on CGM and CSII signals was developed to improve patient safety. The LISA detection algorithm is trained retrospectively on data from 62 infusion set insertions from 20 patients. The algorithm collects glucose and insulin data, and computes relevant fault metrics over two different sliding windows; an alarm sounds when these fault metrics are exceeded. With the chosen algorithm parameters, the LISA detection strategy achieved a sensitivity of 71.8% and issued 0.28 false positives per day on the training data. Validation on two independent data sets confirmed that similar performance is seen on data that was not used for training. The developed algorithm is able to effectively alert patients to possible infusion set failures in open-loop scenarios, with limited evidence of its extension to closed-loop scenarios. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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888 KiB  
Article
Continuous Glucose Monitoring Sensors: Past, Present and Future Algorithmic Challenges
by Andrea Facchinetti
Sensors 2016, 16(12), 2093; https://doi.org/10.3390/s16122093 - 9 Dec 2016
Cited by 127 | Viewed by 14498
Abstract
Continuous glucose monitoring (CGM) sensors are portable devices that allow measuring and visualizing the glucose concentration in real time almost continuously for several days and are provided with hypo/hyperglycemic alerts and glucose trend information. CGM sensors have revolutionized Type 1 diabetes (T1D) management, [...] Read more.
Continuous glucose monitoring (CGM) sensors are portable devices that allow measuring and visualizing the glucose concentration in real time almost continuously for several days and are provided with hypo/hyperglycemic alerts and glucose trend information. CGM sensors have revolutionized Type 1 diabetes (T1D) management, improving glucose control when used adjunctively to self-monitoring blood glucose systems. Furthermore, CGM devices have stimulated the development of applications that were impossible to create without a continuous-time glucose signal, e.g., real-time predictive alerts of hypo/hyperglycemic episodes based on the prediction of future glucose concentration, automatic basal insulin attenuation methods for hypoglycemia prevention, and the artificial pancreas. However, CGM sensors’ lack of accuracy and reliability limited their usability in the clinical practice, calling upon the academic community for the development of suitable signal processing methods to improve CGM performance. The aim of this paper is to review the past and present algorithmic challenges of CGM sensors, to show how they have been tackled by our research group, and to identify the possible future ones. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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Article
Remote Blood Glucose Monitoring in mHealth Scenarios: A Review
by Giordano Lanzola, Eleonora Losiouk, Simone Del Favero, Andrea Facchinetti, Alfonso Galderisi, Silvana Quaglini, Lalo Magni and Claudio Cobelli
Sensors 2016, 16(12), 1983; https://doi.org/10.3390/s16121983 - 24 Nov 2016
Cited by 30 | Viewed by 9722
Abstract
Glucose concentration in the blood stream is a critical vital parameter and an effective monitoring of this quantity is crucial for diabetes treatment and intensive care management. Effective bio-sensing technology and advanced signal processing are therefore of unquestioned importance for blood glucose monitoring. [...] Read more.
Glucose concentration in the blood stream is a critical vital parameter and an effective monitoring of this quantity is crucial for diabetes treatment and intensive care management. Effective bio-sensing technology and advanced signal processing are therefore of unquestioned importance for blood glucose monitoring. Nevertheless, collecting measurements only represents part of the process as another critical task involves delivering the collected measures to the treating specialists and caregivers. These include the clinical staff, the patient’s significant other, his/her family members, and many other actors helping with the patient treatment that may be located far away from him/her. In all of these cases, a remote monitoring system, in charge of delivering the relevant information to the right player, becomes an important part of the sensing architecture. In this paper, we review how the remote monitoring architectures have evolved over time, paralleling the progress in the Information and Communication Technologies, and describe our experiences with the design of telemedicine systems for blood glucose monitoring in three medical applications. The paper ends summarizing the lessons learned through the experiences of the authors and discussing the challenges arising from a large-scale integration of sensors and actuators. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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3181 KiB  
Article
A Robust, Enzyme-Free Glucose Sensor Based on Lysine-Assisted CuO Nanostructures
by Qurrat-ul-Ain Baloach, Aneela Tahira, Arfana Begum Mallah, Muhammad Ishaq Abro, Siraj Uddin, Magnus Willander and Zafar Hussain Ibupoto
Sensors 2016, 16(11), 1878; https://doi.org/10.3390/s16111878 - 14 Nov 2016
Cited by 24 | Viewed by 6169
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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2105 KiB  
Article
Non-Enzymatic Glucose Sensing Using Carbon Quantum Dots Decorated with Copper Oxide Nanoparticles
by Houcem Maaoui, Florina Teodoresu, Qian Wang, Guo-Hui Pan, Ahmed Addad, Radhouane Chtourou, Sabine Szunerits and Rabah Boukherroub
Sensors 2016, 16(10), 1720; https://doi.org/10.3390/s16101720 - 18 Oct 2016
Cited by 45 | Viewed by 9250
Abstract
Perturbations in glucose homeostasis is critical for human health, as hyperglycemia (defining diabetes) leads to premature death caused by macrovascular and microvascular complications. However, the simple and accurate detection of glucose in the blood at low cost remains a challenging task, although it [...] Read more.
Perturbations in glucose homeostasis is critical for human health, as hyperglycemia (defining diabetes) leads to premature death caused by macrovascular and microvascular complications. However, the simple and accurate detection of glucose in the blood at low cost remains a challenging task, although it is of great importance for the diagnosis and therapy of diabetic patients. In this work, carbon quantum dots decorated with copper oxide nanostructures (CQDs/Cu2O) are prepared by a simple hydrothermal approach, and their potential for electrochemical non-enzymatic glucose sensing is evaluated. The proposed sensor exhibits excellent electrocatalytic activity towards glucose oxidation in alkaline solutions. The glucose sensor is characterized by a wide concentration range from 6 µM to 6 mM, a sensitivity of 2.9 ± 0.2 µA·µM−1·cm−2, and a detection limit of 6 µM at a signal-to-noise ratio S/N = 3. The sensors are successfully applied for glucose determination in human serum samples, demonstrating that the CQDs/Cu2O-based glucose sensor satisfies the requirements of complex sample detection with adapted potential for therapeutic diagnostics. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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3253 KiB  
Article
Mid-Infrared Photoacoustic Detection of Glucose in Human Skin: Towards Non-Invasive Diagnostics
by Jonas Kottmann, Julien M. Rey and Markus W. Sigrist
Sensors 2016, 16(10), 1663; https://doi.org/10.3390/s16101663 - 10 Oct 2016
Cited by 84 | Viewed by 13258
Abstract
Diabetes mellitus is a widespread metabolic disease without cure. Great efforts are being made to develop a non-invasive monitoring of the blood glucose level. Various attempts have been made, including a number of non-optical approaches as well as optical techniques involving visible, near- [...] Read more.
Diabetes mellitus is a widespread metabolic disease without cure. Great efforts are being made to develop a non-invasive monitoring of the blood glucose level. Various attempts have been made, including a number of non-optical approaches as well as optical techniques involving visible, near- and mid-infrared light. However, no true breakthrough has been achieved so far, i.e., there is no fully non-invasive monitoring device available. Here we present a new study based on mid-infrared spectroscopy and photoacoustic detection. We employ two setups, one with a fiber-coupled photoacoustic (PA) cell and a tunable quantum cascade laser (QCL), and a second setup with two QCLs at different wavelengths combined with PA detection. In both cases, the PA cells are in direct skin contact. The performance is tested with an oral glucose tolerance test. While the first setup often gives reasonable qualitative agreement with ordinary invasive blood glucose measurements, the dual-wavelength approach yields a considerably improved stability and an uncertainty of only ±30 mg/dL of the blood glucose concentration level at a confidence level of 90%. This result is achieved without advanced data treatment such as principal component analysis involving extended wavelength ranges. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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1828 KiB  
Communication
A Human Serum-Based Enzyme-Free Continuous Glucose Monitoring Technique Using a Needle-Type Bio-Layer Interference Sensor
by Dongmin Seo, Sung-Ho Paek, Sangwoo Oh, Sungkyu Seo and Se-Hwan Paek
Sensors 2016, 16(10), 1581; https://doi.org/10.3390/s16101581 - 24 Sep 2016
Cited by 8 | Viewed by 6825
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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2626 KiB  
Article
A Portable Real-Time Ringdown Breath Acetone Analyzer: Toward Potential Diabetic Screening and Management
by Chenyu Jiang, Meixiu Sun, Zhennan Wang, Zhuying Chen, Xiaomeng Zhao, Yuan Yuan, Yingxin Li and Chuji Wang
Sensors 2016, 16(8), 1199; https://doi.org/10.3390/s16081199 - 30 Jul 2016
Cited by 47 | Viewed by 7747
Abstract
Breath analysis has been considered a suitable tool to evaluate diseases of the respiratory system and those that involve metabolic changes, such as diabetes. Breath acetone has long been known as a biomarker for diabetes. However, the results from published data by far [...] Read more.
Breath analysis has been considered a suitable tool to evaluate diseases of the respiratory system and those that involve metabolic changes, such as diabetes. Breath acetone has long been known as a biomarker for diabetes. However, the results from published data by far have been inconclusive regarding whether breath acetone is a reliable index of diabetic screening. Large variations exist among the results of different studies because there has been no “best-practice method” for breath-acetone measurements as a result of technical problems of sampling and analysis. In this mini-review, we update the current status of our development of a laser-based breath acetone analyzer toward real-time, one-line diabetic screening and a point-of-care instrument for diabetic management. An integrated standalone breath acetone analyzer based on the cavity ringdown spectroscopy technique has been developed. The instrument was validated by using the certificated gas chromatography-mass spectrometry. The linear fittings suggest that the obtained acetone concentrations via both methods are consistent. Breath samples from each individual subject under various conditions in total, 1257 breath samples were taken from 22 Type 1 diabetic (T1D) patients, 312 Type 2 diabetic (T2D) patients, which is one of the largest numbers of T2D subjects ever used in a single study, and 52 non-diabetic healthy subjects. Simultaneous blood glucose (BG) levels were also tested using a standard diabetic management BG meter. The mean breath acetone concentrations were determined to be 4.9 ± 16 ppm (22 T1D), and 1.5 ± 1.3 ppm (312 T2D), which are about 4.5 and 1.4 times of the one in the 42 non-diabetic healthy subjects, 1.1 ± 0.5 ppm, respectively. A preliminary quantitative correlation (R = 0.56, p < 0.05) between the mean individual breath acetone concentration and the mean individual BG levels does exist in 20 T1D subjects with no ketoacidosis. No direct correlation is observed in T1D subjects, T2D subjects, and healthy subjects. The results from a relatively large number of subjects tested indicate that an elevated mean breath acetone concentration exists in diabetic patients in general. Although many physiological parameters affect breath acetone, under a specifically controlled condition fast (<1 min) and portable breath acetone measurement can be used for screening abnormal metabolic status including diabetes, for point-of-care monitoring status of ketone bodies which have the signature smell of breath acetone, and for breath acetone related clinical studies requiring a large number of tests. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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2370 KiB  
Article
Nitrogen-Doped Carbon Dots as A New Substrate for Sensitive Glucose Determination
by Hanxu Ji, Feng Zhou, Jiangjiang Gu, Chen Shu, Kai Xi and Xudong Jia
Sensors 2016, 16(5), 630; https://doi.org/10.3390/s16050630 - 4 May 2016
Cited by 54 | Viewed by 9300
Abstract
Nitrogen-doped carbon dots are introduced as a novel substrate suitable for enzyme immobilization in electrochemical detection metods. Nitrogen-doped carbon dots are easily synthesised from polyacrylamide in just one step. With the help of the amino group on chitosan, glucose oxidase is immobilized on [...] Read more.
Nitrogen-doped carbon dots are introduced as a novel substrate suitable for enzyme immobilization in electrochemical detection metods. Nitrogen-doped carbon dots are easily synthesised from polyacrylamide in just one step. With the help of the amino group on chitosan, glucose oxidase is immobilized on nitrogen-doped carbon dots-modified carbon glassy electrodes by amino-carboxyl reactions. The nitrogen-induced charge delocalization at nitrogen-doped carbon dots can enhance the electrocatalytic activity toward the reduction of O2. The specific amino-carboxyl reaction provides strong and stable immobilization of GOx on electrodes. The developed biosensor responds efficiently to the presence of glucose in serum samples over the concentration range from 1 to 12 mM with a detection limit of 0.25 mM. This novel biosensor has good reproducibility and stability, and is highly selective for glucose determination under physiological conditions. These results indicate that N-doped quantum dots represent a novel candidate material for the construction of electrochemical biosensors. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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Review

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2605 KiB  
Review
Current and Emerging Technology for Continuous Glucose Monitoring
by Cheng Chen, Xue-Ling Zhao, Zhan-Hong Li, Zhi-Gang Zhu, Shao-Hong Qian and Andrew J. Flewitt
Sensors 2017, 17(1), 182; https://doi.org/10.3390/s17010182 - 19 Jan 2017
Cited by 227 | Viewed by 52319
Abstract
Diabetes has become a leading cause of death worldwide. Although there is no cure for diabetes, blood glucose monitoring combined with appropriate medication can enhance treatment efficiency, alleviate the symptoms, as well as diminish the complications. For point-of-care purposes, continuous glucose monitoring (CGM) [...] Read more.
Diabetes has become a leading cause of death worldwide. Although there is no cure for diabetes, blood glucose monitoring combined with appropriate medication can enhance treatment efficiency, alleviate the symptoms, as well as diminish the complications. For point-of-care purposes, continuous glucose monitoring (CGM) devices are considered to be the best candidates for diabetes therapy. This review focuses on current growth areas of CGM technologies, specifically focusing on subcutaneous implantable electrochemical glucose sensors. The superiority of CGM systems is introduced firstly, and then the strategies for fabrication of minimally-invasive and non-invasive CGM biosensors are discussed, respectively. Finally, we briefly outline the current status and future perspective for CGM systems. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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411 KiB  
Review
The Clinical Benefits and Accuracy of Continuous Glucose Monitoring Systems in Critically Ill Patients—A Systematic Scoping Review
by Sigrid C. J. Van Steen, Saskia Rijkenberg, Jacqueline Limpens, Peter H. J. Van der Voort, Jeroen Hermanides and J. Hans DeVries
Sensors 2017, 17(1), 146; https://doi.org/10.3390/s17010146 - 14 Jan 2017
Cited by 45 | Viewed by 8731
Abstract
Continuous Glucose Monitoring (CGM) systems could improve glycemic control in critically ill patients. We aimed to identify the evidence on the clinical benefits and accuracy of CGM systems in these patients. For this, we performed a systematic search in Ovid MEDLINE, from inception [...] Read more.
Continuous Glucose Monitoring (CGM) systems could improve glycemic control in critically ill patients. We aimed to identify the evidence on the clinical benefits and accuracy of CGM systems in these patients. For this, we performed a systematic search in Ovid MEDLINE, from inception to 26 July 2016. Outcomes were efficacy, accuracy, safety, workload and costs. Our search retrieved 356 articles, of which 37 were included. Randomized controlled trials on efficacy were scarce (n = 5) and show methodological limitations. CGM with automated insulin infusion improved time in target and mean glucose in one trial and two trials showed a decrease in hypoglycemic episodes and time in hypoglycemia. Thirty-two articles assessed accuracy, which was overall moderate to good, the latter mainly with intravascular devices. Accuracy in critically ill children seemed lower than in adults. Adverse events were rare. One study investigated the effect on workload and cost, and showed a significant reduction in both. In conclusion, studies on the efficacy and accuracy were heterogeneous and difficult to compare. There was no consistent clinical benefit in the small number of studies available. Overall accuracy was moderate to good with some intravascular devices. CGM systems seemed however safe, and might positively affect workload and costs. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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4868 KiB  
Review
A Review on Microfluidic Paper-Based Analytical Devices for Glucose Detection
by Shuopeng Liu, Wenqiong Su and Xianting Ding
Sensors 2016, 16(12), 2086; https://doi.org/10.3390/s16122086 - 8 Dec 2016
Cited by 96 | Viewed by 13844
Abstract
Glucose, as an essential substance directly involved in metabolic processes, is closely related to the occurrence of various diseases such as glucose metabolism disorders and islet cell carcinoma. Therefore, it is crucial to develop sensitive, accurate, rapid, and cost effective methods for frequent [...] Read more.
Glucose, as an essential substance directly involved in metabolic processes, is closely related to the occurrence of various diseases such as glucose metabolism disorders and islet cell carcinoma. Therefore, it is crucial to develop sensitive, accurate, rapid, and cost effective methods for frequent and convenient detections of glucose. Microfluidic Paper-based Analytical Devices (μPADs) not only satisfying the above requirements but also occupying the advantages of portability and minimal sample consumption, have exhibited great potential in the field of glucose detection. This article reviews and summarizes the most recent improvements in glucose detection in two aspects of colorimetric and electrochemical μPADs. The progressive techniques for fabricating channels on μPADs are also emphasized in this article. With the growth of diabetes and other glucose indication diseases in the underdeveloped and developing countries, low-cost and reliably commercial μPADs for glucose detection will be in unprecedentedly demand. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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4806 KiB  
Review
Conducting Polymers and Their Applications in Diabetes Management
by Yu Zhao, Luyao Cao, Lanlan Li, Wen Cheng, Liangliang Xu, Xinyu Ping, Lijia Pan and Yi Shi
Sensors 2016, 16(11), 1787; https://doi.org/10.3390/s16111787 - 26 Oct 2016
Cited by 28 | Viewed by 8673
Abstract
Advances in conducting polymers (CPs) have promoted the development of diabetic monitoring and treatment, which is of great significance in human healthcare and modern medicine. CPs are special polymers with physical and electrochemical features resembling metals, inorganic semiconductors and non-conducting polymers. To improve [...] Read more.
Advances in conducting polymers (CPs) have promoted the development of diabetic monitoring and treatment, which is of great significance in human healthcare and modern medicine. CPs are special polymers with physical and electrochemical features resembling metals, inorganic semiconductors and non-conducting polymers. To improve and extend their properties, the fabrication of CPs and CP composites has attracted intensive attention in recent decades. Some CPs are biocompatible and suitable for biomedical use. Thus, the intriguing properties of CPs make wearable, noninvasive, continuous diabetes managing devices and other potential applications in diabetes possible in the near future. To highlight the recent advances of CPs and their derived materials (especially in conducting polymer hydrogels), here we discuss their fabrication and characterization, review the current state-of-the-art research in diabetes management based on these materials and describe current challenges as well as future potential research directions. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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4352 KiB  
Review
Responsive Boronic Acid-Decorated (Co)polymers: From Glucose Sensors to Autonomous Drug Delivery
by Gertjan Vancoillie and Richard Hoogenboom
Sensors 2016, 16(10), 1736; https://doi.org/10.3390/s16101736 - 19 Oct 2016
Cited by 31 | Viewed by 9723
Abstract
Boronic acid-containing (co)polymers have fascinated researchers for decades, garnering attention for their unique responsiveness toward 1,2- and 1,3-diols, including saccharides and nucleotides. The applications of materials that exert this property are manifold including sensing, but also self-regulated drug delivery systems through responsive membranes [...] Read more.
Boronic acid-containing (co)polymers have fascinated researchers for decades, garnering attention for their unique responsiveness toward 1,2- and 1,3-diols, including saccharides and nucleotides. The applications of materials that exert this property are manifold including sensing, but also self-regulated drug delivery systems through responsive membranes or micelles. In this review, some of the main applications of boronic acid containing (co)polymers are discussed focusing on the role of the boronic acid group in the response mechanism. We hope that this summary, which highlights the importance and potential of boronic acid-decorated polymeric materials, will inspire further research within this interesting field of responsive polymers and polymeric materials. Full article
(This article belongs to the Special Issue Glucose Sensors: Revolution in Diabetes Management 2016)
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