Search Results (77)

Diabetes Mellitus is a chronic metabolic disorder characterized by elevated blood glucose due to defects in insulin secretion or action, or both, leading to serious short- and long-term complications if not effectively managed. However, there is limited qualitative evidence exploring how youths diagnosed with Type 1 Diabetes Mellitus (T1DM) experience disease onset, management, complications, emotional adaptation, and education within the South African public healthcare system. The study aims to investigate the lived experiences of youths living with T1DM in a selected public hospital in Limpopo province, South Africa. The objectives were to explore and describe the lived experiences of youths living with T1DM. A qualitative, explorative, descriptive, and contextual design was used to gain a thorough understanding of the experiences of youths living with T1DM. A non-probability sampling technique was used to select 12 participants using a pre-determined criterion. Data were collected through individual semi-structured interviews using an interview guide. The data were analyzed using Colaizzi’s method, where themes and sub-themes were developed with the inclusion of an independent coder. Measures to ensure trustworthiness and ethical considerations were adhered to throughout the study. The findings revealed that, despite the participants sharing the same diagnosis, they experience multiple interrelated barriers that significantly hindered effective self-care management, such as limited access to diabetic diet, glucometers and supplies, treatment and informational-related barriers, school-related challenges, transportation constraints and inadequate social support. Furthermore, the findings highlighted gaps in early recognition of symptoms, standardized diabetes education, psychosocial support, and continuity of care. The study recommends the need for holistic, patient-centred, and contextualized interventions that do not only address medical management but the socioeconomic, educational, and psychological needs of youths. Full article

Numerous studies have shown that remote monitoring of heart failure patients can reduce hospital readmission rates and mortality. This dataset includes multimodal physiological and inertial signals (acceleration and angular velocity data) recorded with PerHeart—a remote health monitoring platform intended for heart failure patients. In the pilot, which took place in Poland, 27 participants’ health was monitored for one month using the platform with commercially available devices (blood pressure meters, pulse oximeters, bathroom scales, thermometers, and glucometers), resulting in over four thousand physiological measurements. Eight adults were additionally monitored for gait and activity analysis using custom wrist sensors with inertial measurement units, yielding 2536 h of movement data collected over 204 days with almost 690,000 steps detected. Full article

Background: Point-of-care (POC) glucometers are essential for rapid blood glucose monitoring but are subject to interference and hematocrit variations. This study evaluated the analytical performance of the new Cobas Pulse glucometer against the Accu-Chek Inform II meter in the presence of N-acetylcysteine (NAC, 0.32–2.5 mmol/L), ascorbic acid (0.28–2.84 mmol/L), D-galactose (5.5–27 mmol/L), hemolysis (0.5–5 g/L hemoglobin), icterus (200–1600 μmol/L bilirubin), lipemia (2.5–15 g/L Intralipid), and hematocrit variations (20–60%). Methods: Interference testing followed CLSI EP07 guidelines using three whole blood pools with low (2.0–2.7 mmol/L), medium (4.5–7.4 mmol/L), and high (16.3–23 mmol/L) glucose levels. Interferents were spiked into these whole blood pools. Duplicate glucose levels were measured by 2 Pulse meters and 2 Inform II meters. The results were then assessed using the international standards, e.g., ISO 15197:2017 criteria (±15% or ±0.83 mmol/L). Results: Accu-Chek Inform II showed severe positive interference from galactose (up to 446.3%, p < 0.001), ascorbic acid (up to 98.8%, p = 0.002), and NAC (up to 61.4%, p = 0.001), exceeding ISO limits. Cobas Pulse demonstrated minimal interference (maximum biases: −3.7% for galactose, −4.4% for ascorbic acid, 7.7% for NAC, all p > 0.05). Both meters showed similar hematocrit-dependent bias (positive at 20–30%, negative at 50–60%) and acceptable performance for hemolysis, icterus (≤800 μmol/L), and lipemia. Conclusions: Compared to the Accu-Chek Inform II, the Cobas Pulse demonstrated greater resilience to interferences. Cobas Pulse meets strict accuracy standards (±10% for hospital use) with low interference, which makes it suitable for care of critically ill patients. The Cobas Pulse is more dependable for POCT across various clinical situations, supporting its role in critical care. Full article

Accurate perioperative glucose monitoring is essential in dogs undergoing general anesthesia, yet most validation studies of handheld glucometers have been performed under stable outpatient conditions. This prospective clinical validation study evaluated the analytical agreement, diagnostic performance, and ISO 15197 compliance of a human-calibrated (Accu-Chek) and a veterinary-specific (Centrivet GK) handheld glucometer compared with a laboratory spectrophotometric reference method in 34 anesthetized dogs (99 paired measurements per device). Linear mixed-effects modeling demonstrated significant method effects (p < 0.001), with the veterinary-specific device overestimating glucose concentrations relative to the reference method (β = 20.79 mg/dL; 95% CI: 8.08–33.50; p = 0.001), whereas the human-calibrated device did not differ significantly (β = 7.18 mg/dL; 95% CI: −5.53–19.89; p = 0.267). Bland–Altman analysis showed mean bias of 4.44 mg/dL (95% CI: 0.73–8.16) for the human-calibrated device and 22.72 mg/dL (95% CI: 18.22–27.21) for the veterinary-specific device. Passing–Bablok regression identified proportional bias only for the veterinary-specific device (slope 1.19; 95% CI: 1.01–1.34). ISO compliance was 69.7% and 39.4%, respectively. For hyperglycemia detection, AUC values were 0.9566 (95% CI: 0.8955–1.0000) and 0.9757 (95% CI: 0.9479–1.0000); for hypoglycemia, 0.8567 (95% CI: 0.7557–0.9578) and 0.7376 (95% CI: 0.6056–0.8697). In anesthetized dogs, the human-calibrated device demonstrated superior analytical robustness, whereas the veterinary-specific device showed greater bias and variability. Full article

Early recognition of vascular compromise is essential for reconstructive flap survival. In human surgery, local glucose monitoring is widely used as an objective indicator of perfusion, but its application in veterinary patients is still limited. This report describes postoperative glucose measurement as a simple and minimally invasive method for evaluating flap viability in two dogs. This report describes two prospectively observed clinical cases in which local glucose measurement was applied as an adjunctive monitoring tool during postoperative flap management. Local glucose values were measured with a handheld glucometer at predefined flap and control sites. Serial readings were compared with daily assessments of flap color, temperature, turgor, and wound integrity. A previously suggested threshold of 60–62 mg/dL was used as a reference for potential perfusion compromise. In Case 1, a phalangeal fillet flap showed a brief glucose decline on postoperative days 2–3, followed by normalization and uneventful healing. In Case 2, which underwent advancement flap reconstruction after wound dehiscence, glucose values remained persistently below 60 mg/dL and preceded visible ischemia and distal necrosis. Local glucose monitoring provided rapid and clinically meaningful information about flap perfusion. Transient decreases reflected reversible postoperative congestion, whereas persistent hypoglycemia indicated progressive ischemia. These findings support the use of glucose monitoring as an adjunct in small-animal reconstructive surgery. Full article

Background/Objective: Type 2 Diabetes Mellitus (T2DM) represents a major increasing burden for primary care systems worldwide. Digital health interventions (DHIs) have been proposed as scalable tools to improve glycemic control, yet uncertainty remains regarding which intervention characteristics yield the greatest benefit. To evaluate the effectiveness of DHIs on HbA1c levels in adults with T2DM and to examine whether intervention duration, engagement intensity, glucometer integration, and healthcare provider involvement modify glycemic outcomes. Data Sources: PubMed, Embase, Cochrane Library, and JMIR databases were systematically searched for relevant studies published between January 2020 and May 2025. Study Eligibility Criteria: Randomized controlled trials comparing DHIs plus usual care versus usual care alone in adults with T2DM and reporting HbA1c as the primary outcome. Methods: Data were extracted using the Jadad scale and TIDieR framework. Random-effects meta-analysis estimated pooled mean differences (MD) in HbA1c with 95% CIs. Subgroup analyses examined effects by intervention characteristics. Heterogeneity and sources of variance were assessed through Cochran’s Q, I², meta-regression, and sensitivity analyses (leave-one-out and trim-and-fill). Results: Thirteen RCTs (n ≈ 20,000) met inclusion criteria. DHIs achieved significant HbA1c reductions (range 0.01% to 1.57%; pooled MD −1.08%; 95% CI −1.18 to −0.99; p = 0.001). Short-term (≤6 months), low-intensity interventions showed the largest effect sizes (MD −1.16%, 95% CI 0.94 to 1.39). Glucometer integration and healthcare provider involvement contributed minimally to additional benefit. Meta-regression confirmed substantial heterogeneity, but no single factor explained variance across studies. Limitations: Considerable heterogeneity across interventions and variability in engagement measurement may limit the generalizability of findings. Conclusions: Short-term, low-intensity DHIs significantly improve glycemic control in primary care populations with T2DM. Advanced meta-analytic techniques confirm the robustness of these effects, providing practical guidance for selecting and implementing effective digital interventions in routine diabetes care. Full article

Accurate, non-invasive glucose monitoring remains a major challenge in biomedical sensing. We present a high-sensitivity planar microwave biosensor that progresses from a 2-cell hexagonal array to an 8-cell hexagonal array, and finally to a 16-cell double-honeycomb (DHC-CSRR) architecture to enhance field confinement and resonance strength. Full-wave simulations using Debye-modeled glucose phantoms demonstrate that the optimized 16-cell array on a Rogers RO3210 substrate substantially increases the electric field intensity and transmission response |S₂₁| sensitivity compared with FR-4 and previous multi-CSRR designs. In vitro measurements using pharmacy-grade glucose solutions (5–25%) and saline mixtures with added glucose, delivered through an acrylic channel aligned to the sensing region, confirm the simulated trends. In vivo, vector network analyzer (VNA) tests were conducted on four human subjects (60–150 mg/dL), comparing single- and dual-finger placements. The FR-4 substrate (${\mathsf{\epsilon }}_{\mathrm{r}}$ = 4.4) provided higher frequency sensitivity (2.005 MHz/(mg/dL)), whereas the Rogers RO3210 substrate (${\mathsf{\epsilon }}_{\mathrm{r}}$ = 10.2) achieved greater amplitude sensitivity (9.35 × 10⁻² dB/(mg/dL)); dual-finger contact outperformed single-finger placement for both substrates. Repeated intra-day VNA measurements yielded narrow 95% confidence intervals on |S₂₁|, with an overall uncertainty of approximately ±0.5 dB across the tested glucose levels. Motivated by the larger |S₂₁| response on Rogers, we adopted amplitude resolution as the primary metric and built a compact prototype using the AD8302-EVALZ with a custom 3D-printed enclosure to enhance measurement precision. In a cohort of 31 participants, capillary blood glucose was obtained using a commercial glucometer, after which two fingers were placed on the sensing region; quadratic voltage-to-glucose calibration yielded R² = 0.980, root–mean–square error (RMSE) = 2.316 mg/dL, overall accuracy = 97.833%, and local sensitivity = 1.099 mg/dL per mV, with anthropometric variables (weight, height, age) showing no meaningful correlation. Clarke Error Grid Analysis placed 100% of paired measurements in Zone A, indicating clinically acceptable agreement with the reference meter. Benchmarking against commercial continuous glucose monitoring systems highlights substrate selection as a dominant lever for amplitude sensitivity and positions the proposed fully non-invasive, consumable-free architecture as a promising route toward portable RF-based glucose monitors, while underscoring the need for larger cohorts, implementation on flexible biocompatible substrates, and future regulatory pathways. Full article

This study explored the feasibility of noninvasive blood glucose (BG) estimation using near-infrared (NIR) spectroscopy with dog blood samples. A sensor module employing three representative wavelengths (770 nm, 850 nm, and 970 nm) was tested on an artificial blood vessel (ABV) and a thin pig skin (TPS) model. BG concentrations were adjusted through dilution and enrichment with injection-grade water and glucose solution, and reference values were obtained from three commercial invasive glucometers. Correlations between NIR spectral responses and glucose variations were quantitatively evaluated using linear, multiple, partial least squares (PLS), logistic regression, regularized linear models, and multilayer perceptron (MLP) analysis. The results revealed distinct negative correlations at 850 nm and 970 nm, identifying these wavelengths as promising candidates for noninvasive glucose sensing. Furthermore, an NIR–glucose database generated from actual dog blood was established, which may serve as a valuable resource for the development of future noninvasive glucose monitoring systems. Full article

Background/Objectives: Optimal postprandial glycemic control is crucial to maintain time in range (TIR:3.9–10.0 mmol/L, 70–180 mg/dL) and time in tight range (TITR:3.9–7.8 mmol/L, 70–140 mg/dL), both important to reduce microvascular complications in type 1 diabetes mellitus (T1DM). However, insulin dosing based on carbohydrate counting fails to compensate for delayed hyperglycemia from protein and fat. This study evaluated two advanced insulin dosing algorithms designed to improve postprandial control in adolescents with T1DM. Methods: In this randomized, prospective, double-blind, crossover trial, 58 adolescents with T1DM (median age 15.5 years) were enrolled, all using continuous subcutaneous insulin infusion and a continuous glucose monitoring system in non-automated mode. For two consecutive days, participants consumed standardized mixed meals for breakfast (50 g of carbohydrates, 200 kcal from protein and fat) and received an extended bolus delivered for four hours, based on the Pankowska Equation (PE, i.e., Fat-Protein Units × Insulin-to-Carbohydrate Ratio (ICR)) and the Sieradzki Equation (SE, i.e., 30% × Carbohydrate Units × ICR). Postprandial glucose was monitored for five hours using a glucometer and Continuous Glucose Monitoring (CGM). The primary outcome was the capillary blood glucose level at predefined time points. The secondary outcomes were the frequency of hypoglycemia and glycemic variability parameters. Results: Both methods kept postprandial glucose within the recommended TIR. The SE method provided longer TITR (82.51% vs. 70.49%, p = 0.6281) and fewer hypoglycemic episodes at 180 and 300 min. Glucose levels at 60 min, were higher after PE (136 ± 35.2 mg/dL vs. 124 ± 32.2 mg/dL, p = 0.016). Conclusions: Both algorithms provided effective postprandial control after a mixed meal, but SE achieved a longer TITR and fewer late hypoglycemic events. Full article

Background: Occupational accidents, injuries, and illnesses are serious problems for organizations. Workplace sleepiness is a major issue that affects occupational safety and productivity. Workplace sleepiness is influenced by sleep, diet, and blood glucose levels, but the causal relationship is unclear. This scoping review aimed to investigate the factors affecting work productivity, with a particular focus on the impact of sleepiness caused by food intake and blood glucose level on productivity. Methods: PubMed, and Web of Science were used to search terms, such as “workplace,” “sleepiness or postprandial hypoglycemia,” “productivity,” and “measurement.” The following studies were included: (1) those with working hours evaluations; (2) that excluded patients with diabetes, heart diseases, or other diseases; (3) that excluded patients with mental illness; (4) that did not limit the evaluation of sleepiness at work to sleep only; (5) with publications after 2014; and (6) that were research articles. Results: The search yielded 521 articles. Nine papers met the inclusion criteria. Six studies assessed blood glucose levels, six assessed sleepiness, and one simultaneously assessed blood glucose and sleepiness. The Karolinska Sleepiness Scale (KSS) is the most frequently used sleep measure. Most studies have assessed the effects of controlled diets. Although some studies have used continuous glucometers, their evaluation of blood glucose levels has been limited. The extracted literature also included mild exercise and control of environmental illumination as a countermeasure against sleepiness. Conclusions: Although few studies have analyzed the causes and countermeasures of sleepiness in the workplace, sleepiness affects work productivity, diet affects sleepiness, and several methods for suppressing sleepiness have been researched. However, a few studies have directly evaluated the effects of blood glucose fluctuations and sleepiness on work productivity. These results suggest that further research into the relationship between sleepiness at work and related biological signals and blood glucose fluctuations will be important in understanding the causes, as it will form the basis for measures to improve work productivity. Full article

Background: Small-molecule tyrosine kinase inhibitors (SMTKIs), widely used in cancer chemotherapy, have been reported to variably affect glycaemic control and metabolism, with some agents demonstrating hypoglycaemic effects while others show hyperglycaemic properties. This study aims to elucidate how small-molecule tyrosine kinase inhibitors affect glucose metabolism in C2C12 cells in vitro. Specifically, this study investigated their impact on glucose uptake, AKT expression, GLUT4 expression and translocation, and IL-6 expression. Methods: In this study, skeletal muscle (C2C12) preparations were separately treated with small-molecule tyrosine kinase inhibitors; imatinib, dasatinib, axitinib, and erlotinib for 24 h. Thereafter, the effect of the test drugs was assessed on cell viability using the MTT assay, while glucose uptake was determined by measuring residual glucose concentrations in the culture medium with a glucometer. The expression of AKT, GLUT4, and IL-6 and translocation of GLUT4 were evaluated using ELISA. Furthermore, the effect of the drugs was assessed on insulin-stimulated AKT phosphorylation and GLUT4 translocation. Imatinib, dasatinib, axitinib, and erlotinib were selected due to their effect of glucose metabolism, highlighted in the literature. Results and Discussion: C2C12 cells treated with SMTKIs were viable after 24 h. A concentration-dependent increase in glucose uptake in C2C12 cells treated with imatinib was observed as the concentration of imatinib increased. Axitinib, dasatinib, and erlotinib demonstrated glucose uptake levels comparable to the control across all concentrations. SMTKIs demonstrated an increase in GLUT4 translocation in the absence of insulin. GLUT4 expression was unchanged in cells treated with small-molecule tyrosine kinase inhibitors compared to the control. Small-molecule tyrosine kinase inhibitors showed an increase in AKT expression. C2C12 cells treated with SMTKI were observed to have elevated IL-6 expression compared to the control. Conclusions: The results show that SMTKIs, in particular dasatinib, impact glucose metabolism in C2C12 cells via their effect on GLUT4 translocation and expression and AKT expression. Dasatinib shows promising potential with regard to antidiabetic capabilities. Further research is needed to better understand SMKI effects on metabolic homeostasis, which can perhaps inform future therapeutic strategies. Full article

Background: The oral glucose tolerance test (OGTT) is the gold standard for diagnosing diabetes; however, its use is often limited by the need for laboratory infrastructure, trained personnel, and extended turnaround times. In contrast, glucometer-based OGTT offers a convenient and affordable alternative, especially in resource-limited settings. Objective: This narrative review aims to assess the diagnostic accuracy of glucometer-based OGTT compared to standard laboratory-based OGTT, while also evaluating its feasibility and potential application in diabetes screening programs. Evidence Summary: Studies consistently demonstrate a strong correlation between capillary glucose levels measured by glucometers and venous plasma glucose concentrations obtained through standard laboratory methods. Many studies reported high sensitivity and specificity, often exceeding 90%, particularly when using well-calibrated, newer-generation devices. These findings support the diagnostic utility of glucometer-based OGTT in various populations, although performance may vary by device model and clinical context. Standardization of testing protocols remains essential for consistent results. Conclusions: Glucometer-based OGTT shows promise as a reliable, rapid and cost-effective diagnostic approach, particularly in low-resource and community-based settings. While it is not a complete substitute for laboratory-based OGTT, it offers substantial advantages in accessibility, affordability, and scalability. Continued research with newer-generation glucometers and standardized testing protocols is essential to support broader clinical implementation and public health integration. Full article

Background: Efforts have been joined to set the parameters for the reliability of glucometers, yet once they are on the market, they are not further tested for the maintenance of accuracy, specificity, or precision. Methods: This comparative analytical study investigated the precision of commonly used glucometers in Saudi Arabia, namely Accu-Chek Instant^®, On-Call Sharp^®, and ConTour^®, as well as the effects of vitamin C, acetaminophen, and maltose on glucose readings. Ten milliliters of blood was drawn in lithium heparin from healthy volunteers (n = 9). Six samples were divided into two groups of three. One group was designed for normal glucose levels. The second group was designed for high glucose levels by adding a dextrose solution. The last three samples were designed for low glucose levels by leaving the sample for 24 h at room temperature and then following with centrifuge and plasma extraction. Results: This study showed that only Accu-Chek Instant met the International Organization for Standardization (ISO) standard for precision across all dextrose concentrations, along with intra-class correlation values ranging from 0.95–1 (p < 0.001). By spiking the plasma samples with sub-therapeutic, therapeutic, and overdose concentrations of the metabolites, we found that vitamin C had a more evident interference on glucose readings compared to acetaminophen and maltose. Conclusions: The ascertainment of the precision of glucometers and the effects of interferences on them are vital in preventing the improper administration of insulin, which can lead to serious complications. Full article

Pancreatic cystic lesions (PCLs) are increasingly identified via computerized tomography (CT) and magnetic resonance (MR), with a prevalence of 2–45%. Distinguishing mucinous PCLs (M-PCLs), which include intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) that can progress to pancreatic ductal adenocarcinoma, from non-mucinous PCLs (NM-PCLs) is essential. Carcinoembryonic antigen (CEA) remains widely used but often demonstrates limited sensitivity and specificity. In contrast, endoscopic ultrasound-guided measurement of intracystic glucose more accurately differentiates PCL subtypes, as tumor-related metabolic changes lower cyst fluid glucose in mucinous lesions. Numerous prospective and retrospective studies suggest a glucose cut-off between 30 and 50 mg/dL, yielding a sensitivity of 88–95% and specificity of 76–91%, frequently outperforming CEA. Additional benefits include immediate point-of-care assessment via standard glucometers and minimal interference from blood contamination. DNA-based biomarkers, including KRAS and GNAS mutations, enhance specificity (up to 99%) but exhibit moderate sensitivity (61–71%) and necessitate specialized, expensive platforms. Molecular analyses can be crucial in high-risk lesions, yet their uptake is constrained by technical challenges. In practice, combining glucose assessment with targeted molecular assays refines risk stratification and informs the choice between surgical resection or active surveillance. Future investigations should establish standardized glucose thresholds, improve the cost-effectiveness of genetic testing, and integrate advanced biomarkers into routine protocols. Ultimately, these strategies aim to optimize patient management, limit unnecessary interventions for benign lesions, and ensure timely therapy for lesions at risk of malignant transformation. Full article

Portable blood glucose meters (PBGMs) are essential for detecting glycemic disorders. In Brazil, veterinary devices are scarce, and human devices are used as an alternative. This study evaluated the accuracy of three human glucometers: Accu-Chek Guide^® (ACG), Accu-Chek Guide Me^® (ACGM) (Roche), and EcoCheck^® (EC) (Eco Diagnóstica). A total of 419 glycemic samples were collected and compared to the glucose oxidase method (GOM), which is considered to be the gold standard. Despite a strong positive correlation compared to the GOM (ACG r = 0.96; ACGM r = 0.9; EC r = 0.89; p < 0.0001), when evaluated by the criteria defined by ISO 15197:2013 for analytical precision, no PG obtained 99% of the readings within the range of +/− 15 for glucose levels < 100 mg/dL and +/− 15% for glucose levels > 100 mg/dL (ACG = 57.9%, ACGM = 47.9%, and EC = 28.4%). ACG was the only PG that fully met the clinical precision criteria according to ISO 15197:2013, with 100% of its measurements in Zones A+B of the error grid. Despite analytical inaccuracy, the ACG PBGM proved to be the best among the devices tested in this study for use in dogs with whole blood samples, not generating any negative impact on animal health. Full article