Investigation and Analysis on the Management Standard of Blood Glucose Monitoring for Clinical Nurses in Nyingchi Region of Tibet

Background: In participating in the medical support work in the Nyingchi area of Tibet, the author found that the medical education resources in this area are scarce, and the clinical nurses in this area have relatively insufficient knowledge about blood glucose monitoring and management. Accurately understanding the knowledge-attitude/belief-practice (KAP) level of nurses in Nyingchi area on blood glucose management is of great significance to the development of blood glucose monitoring management guidance for nurses in this area. Therefore, this study investigated the current status of the management of blood glucose monitoring management standards for clinical nurses in Nyingchi, Tibet. Objective: To investigate and analyze the current situation of clinical nurses in Nyingchi region of Tibet to grasp the regulation of blood glucose monitoring and guide the implementation of the norm of blood glucose monitoring for clinical nurses. Methods: The research survey was carried out from March to April 2020. Random sampling method was used to select 134 clinical in-service nurses in Nyingchii, Tibet. The self-designed knowledge-attitude/belief-practice survey questionnaire for clinical nurses’ blood glucose monitoring and management in Tibet was used. Nurses’ blood glucose monitoring management “KAP” scores and related influencing factors are analyzed. Results: Blood sugar monitoring and management knowledge score is (36.78 ± 6.80), attitude dimension is (42.48 ± 6.42), practice dimension is (61.87 ± 10.24) and total score is (304.73 ± 36.24). The nurse’s department and whether to participate in diabetes training are the main influencing factors of the blood glucose monitoring management norms, knowledge and behavior (both P < 0.05). Conclusion: The standard knowledge of blood glucose monitoring and management of clinical nurses in Nyingchi region of Tibet is at the middle level, positive attitude and unsatisfactory behavior. Nursing managers should conduct standardized training for clinical nurses in blood glucose monitoring, develop the training mode of diabetes specialty nursing talents in Nyingchi area, and construct a complete management system of diabetes specialty nursing.

Differences in the system accuracy acceptability of four types of blood glucose monitoring systems against five different standards

Objective:This study aimed to evaluate the system accuracy of four types of blood glucose monitoring systems(BGMSs)and explore the differences in the system accuracy acceptability of each BGMS against five different standards.Methods:The glucose measurement values obtained from four types of BGMSs(Roche Accu-Chek® Performa,Bayer Contour™ TS,Sinomedisite Glupad® H1 Plus,and Sinocare® Gold-Accu)were evaluated against the reference values obtained from the biochemical analyzer of the central laboratory.The system accuracy acceptability of each BGMS was determined using the criteria specified in five standards,namely the International Organization for Standardization(ISO)15197:2003,Clinical Laboratory Standards Institute(CLSI)POCT12-A3,ISO 15197:2013,Chinese Society of Laboratory Medicine(CSLM)consensus,and US Food and Drug Administration(FDA)guidelines.Results:From 2018 to 2022,10,980 pairs of measurement values were obtained from 366 glucose meters of four types of BGMSs.Significant correlations were observed between the glucose measurement values from the BGMSs and the reference values from the biochemical analyzer of the central laboratory.The correlation coefficient r was 0.995 for Roche Accu-Chek® Performa,0.994 for Bayer Contour™ TS,0.983 for Sinomedisite Glupad® H1 Plus,and 0.997 for SinocareR Gold-Accu.The acceptability criteria specified in ISO 15197:2003 were met by 100.00%(135/135)of the glucose meters of Roche Accu-Chek® Performa,100.00%(109/109)of Bayer Contour™ TS,81.61%(71/87)of Sinomedisite Glupad® H1 Plus,and 100.00%(35/35)of SinocareR Gold-Accu.Whereas,the acceptability criteria specified in ISO 15197:2013 were met by 99.26%(134/135)of the glucose meters of Roche Accu-Chek® Performa,88.07%(96/109)of Bayer Contour™ TS,58.62%(51/87)of Sinomedisite Glupad R H1 Plus,and 91.43%(32/35)of SinocareR Gold-Accu.Conclusions:Among the four types of BGMSs evaluated,the glucose meters of Roche Accu-Chek® Performa exhibited superior system accuracy.The system accuracy acceptability of each BGMS varied significantly against the acceptability criteria specified in the five different standards.

Detection and management of perioperative blood glucose abnormalities

Diabetes mellitus is a common chronic disease.With the improvement of living standards,the prevalence of diabetes mellitus in China is increasing.There are now more people with diabetes in China(>100 million)than in any other country.About half of these people with diabetes need to undergo at least one procedure in their lifetime.Diabetic patients have a much higher probability of perioperative dysglycemia than the normal population,which has a great impact on their prognosis.In addition,non-diabetic patients may also have abnormal blood glucose levels due to various reasons during the perioperative period,which will also lead to a series of adverse consequences.This ar ticle reviews the perioperative blood glucose management of patients to provide a reference for improving their health status.

Effect of temperature on noninvasive blood glucose monitoring in vivo using optical coherence tomography-corrigendum

The authors would like to apologize for some mistakes in the letter on Chinese Optics Letters vol. 12, no. 11, page 111701 and wish to make the corrections described below：

Self-monitoring of blood glucose in gestational diabetes mellitus patients during the COVID-19 pandemic in low- and middle-income countries

Self-monitoring of blood glucose(SMBG)is critical for gestational diabetes mellitus(GDM)care.However,there are several hurdles to its practice during the coronavirus disease 2019(COVID-19)pandemic in GDM patients in low-and middle-income countries when GDM care recommendations emphasize telemedicine-based care.Based on available knowledge,this letter proposes the following barriers to SMBG in these GDM patients during the ongoing COVID-19 pandemic:Poor internet connectivity,affordability of SMBG and digital applications to connect with healthcare providers,government-imposed social mobility restriction,psychological stress,and mental health conditions.Nevertheless,definitive evidence will only be acquired from rigorous research.

Parsimonious Model for Blood Glucose Level Monitoring in Type 2 Diabetes patients

To establish the parsimonious model for blood glucose monitoring in patients with type 2 diabetes receiving oral hypoglycemic agent treatment. One hundred and fifty-nine adult Chinese type 2 diabetes patients were randomized to receive rapid-acting or sustained-release gliclazide therapy for 12 weeks.

Review of minimally invasive continuous glucose monitoring technology & instruments

Continuous blood glucose monitoring is important for the diagnosis,treatment,and study of diabetes. many organizations have been working on this subject in recent two decades. Glucose concentration in interstitial fluid is closely related to the blood glucose levels. Minimally invasive continuous blood glucose monitoring technology based on the glucose detection in interstitial fluid develops rapidly and gets more and more attentions from the patients and the doctors,due to its instantaneous real-time display of glucose level,"24/7"coverage,and the ability to characterize glycemic variability. According to the different detection methods,most of the continuous glucose monitoring technology could be divided into two kinds: subcutaneous implantation method and transdermal extraction method. This paper review s the recent development of minimally invasive blood glucose monitoring technology and instruments. The mainly remained challenges and related research directions are presented as well.

Glucagon-like peptide-1 receptor agonists as a possible intervention to delay the onset of type 1 diabetes:A new horizon

Type 1 diabetes(T1D)is a chronic autoimmune condition that destroys insulinproducing beta cells in the pancreas,leading to insulin deficiency and hyperglycemia.The management of T1D primarily focuses on exogenous insulin replacement to control blood glucose levels.However,this approach does not address the underlying autoimmune process or prevent the progressive loss of beta cells.Recent research has explored the potential of glucagon-like peptide-1 receptor agonists(GLP-1RAs)as a novel intervention to modify the disease course and delay the onset of T1D.GLP-1RAs are medications initially developed for treating type 2 diabetes.They exert their effects by enhancing glucose-dependent insulin secretion,suppressing glucagon secretion,and slowing gastric emptying.Emerging evidence suggests that GLP-1RAs may also benefit the treatment of newly diagnosed patients with T1D.This article aims to highlight the potential of GLP-1RAs as an intervention to delay the onset of T1D,possibly through their potential immunomodulatory and anti-inflammatory effects and preservation of beta-cells.This article aims to explore the potential of shifting the paradigm of T1D management from reactive insulin replacement to proactive disease modification,which should open new avenues for preventing and treating T1D,improving the quality of life and long-term outcomes for individuals at risk of T1D.

Evaluation of hybrid closed-loop insulin delivery system in type 1 diabetes in real-world clinical practice:One-year observational study

BACKGROUND In 2016,the Food and Drug Administration approved the first hybrid closed-loop(HCL)insulin delivery system for adults with type 1 diabetes(T1D).There is limited information on the impact of using HCL systems on patient-reported outcomes(PROs)in patients with T1D in real-world clinical practice.In this independent study,we evaluated glycemic parameters and PROs over one year of continuous use of Medtronic’s 670G HCL in real-world clinical practice.AIM To assess the effects of hybrid closed loop system on glycemic control and quality of life in adults with T1D.METHODS We evaluated 71 patients with T1D(mean age:45.5±12.1 years;59%females;body weight:83.8±18.7 kg,body mass index:28.7±5.6 kg/m2,A1C:7.6%±0.8%)who were treated with HCL at Joslin Clinic from 2017 to 2019.We measured A1C and percent of glucose time-in-range(%TIR)at baseline and 12 months.We measured percent time in auto mode(%TiAM)for the last two weeks preceding the final visit and assessed PROs through several validated quality-of-life surveys related to general health and diabetes management.RESULTS At 12 mo,A1C decreased by 0.3%±0.1%(P=0.001)and%TIR increased by 8.1%±2.5%(P=0.002).The average%TiAM was only 64.3%±32.8%and was not associated with A1C,%TIR or PROs.PROs,provided at baseline and at the end of the study,showed that the physical functioning submodule of 36Item Short-Form Health Survey increased significantly by 22.9%(P<0.001).Hypoglycemia fear survey/worry scale decreased significantly by 24.9%(P<0.000);Problem Areas In Diabetes reduced significantly by-17.2%(P=0.002).The emotional burden submodules of dietary diversity score reduced significantly by-44.7%(P=0.001).Furthermore,analysis of Clarke questionnaire showed no increase in awareness of hypoglycemic episodes.WHO-5 showed no improvements in subject’s wellbeing among participants after starting the 670G HCL system.Finally,analysis of Pittsburgh Sleep Quality Index showed no difference in sleep quality,sleep latency,or duration of sleep from baseline to 12 mo.CONCLUSION The use of HCL in real-world clinical practice for one year was associated with significant improvements in A1C,%TIR,physical functioning,hypoglycemia fear,emotional distress,and emotional burden related to diabetes management.However,these changes were not associated with time in auto mode.

Accuracy evaluation of Roche Accu-Chek Performa blood glucose meters at low glucose concentrations:A nine-year retrospective study

Objective:To evaluate the accuracy of Roche Accu-Chek Performa glucose meters at a low glucose concentration of<5.55 mmol/L(100 mg/dL)over a 9-year period.Methods:The accuracy of the Roche Accu-Chek Performa glucose meters at low glucose concentrations was evaluated using annual comparison data for 9 consecutive years from 2015 to 2023,according to the acceptability criteria specified in International Organization for Standardization(ISO)15197:2013.Blood samples with low glucose concentrations of<5.55 mmol/L were prepared by incubation and glycolysis.The glucose concentration was detected using Roche Accu-Chek Performa glucose meters and a biochemical analyzer in the central laboratory.Results:A total of 2978 pairs of comparison results from 211 glucose meters at a low glucose concentration of<5.55 mmol/L were retrospectively analyzed from 2015 to 2023.The clinical use duration spanned from 1 to 9 years and 40.76%(86 out of 211 glucose meters)had been used for more than 2 years.The correlation coefficient r between glucose meter measurements and laboratory reference values was 0.98(p<0.001).The mean according to Roche Accu-Chek Performa glucose meters was 0.05 mmol/L(0.9 mg/dL)higher than that of the biochemical analyzer(Z=-13.82,p<0.0001).The results showed that 100.00%(211 out of 211)of the Roche Accu-Chek Performa glucose meters met the acceptability criteria specified in ISO 15197:2013.At a low glucose concentration of<5.55 mmol/L,99.90%(2975 out of 2978)of the comparative data pairs in the error distribution fell within the range of±0.83 mmol/L(15 mg/dL).Parkes consensus error grid analysis showed that 100.00%(2978 out of 2978)of comparative data pairs fell within region A.Conclusions:This study demonstrated that Roche Accu-Chek Performa glucose meters successfully met the accuracy standards of ISO 15197:2013 for measuring blood glucose within the hypoglycemic range.Greater attention should be given to the performance of blood glucose monitoring systems in the low glycemic range,especially for patients with diabetes who are prone to hypoglycemia and require precise measurements.