Psychological problems related to capillary blood glucose testing and insulin injection among diabetes patients

Objective:This review is aimed at explaining the psychological problems related to capillary blood glucose(CBG)testing and insulin injection,as well as recommending essential strategies to solve the fear thereof.Methods:Databases,including PubMed,Cumulative Index of Nursing and Allied Health Literature(CINAHL),Scopus,and Google Scholar,were searched to extract the relevant articles.Initially,the terms used to retrieve related studies were"fear of blood glucose monitoring","anxiety capillary blood glucose testing and insulin injection","psychological problems on blood glucose monitoring and insulin injection","diabetes management",and"diabetes mellitus".Results:Results showed that the psychological problems related to CBG testing and insulin injection were associated with the stress and depression experienced during diabetes self-monitoring of blood glucose.This psychological issue has its impacts such as nonadherence to medication as well as a lack of self-discipline in terms of CBG testing and insulin injection.Inadequate information,inappropriate perception,and pain/discomfort during pricking of fingers were the main reasons for the psychological issues in CBG testing and self-injection of insulin.Conclusions:The expected benefits of this review include the explanation of the issues related to the psychological problems in CBG testing and insulin injection among type 2 diabetes mellitus(T2DM)patients.This review article also provides the recommendations on providing counseling and empowering the patients on CBG monitoring and insulin injection.Moreover,family members should provide psychological support to reduce fear,anxiety,and distress arising from CBG testing and insulin injection.

USING CAPILLARY WHOLE BLOOD GLUCOSE TEST IN SCREENING FOR GESTATIONAL DIABETES MELLITUS

To discuss whether the capillary whole blood glucose （CBG） test can be used in glucose screening test （GST） for gestational diabetes mellitus （GDM） compared to the venous plasma glucose （ VPG） method, and to determine the cutoff value of CBG. Methods This was a self-control test. The 50-g oral GST was conducted among 1 557 pregnant women between 24-28 weeks. Every woman was measured CBG and VPG at the same time and same arm. Three hundred and forty women underwent 100-g 3-h oral glucose tolerance test （OGTT）. Receiver operation curve （ROC） was used to determine the potential cutoff level of CBG and VPG. Diagnose criteria of GDM was based on NDDG criteria. OGTT diagnosed GDM and VPG ≥ 7. 8 mmol/L were used as golden standard for ROC. Results There was good relationship between CBG and VPG （ P 〈0.01 ）. Correlation coefficient was O. 86. The value of CBG was lower than VPG. The statistical and high-sensitivity cutoff values were 7. 4 mmol/L in CBG and 7. 8 mmol/L in VPG when GDM was used as golden standard. Cutoff value of CBG was 7. 0 mmol/L when VPG≥7. 8 mmol/L was used as golden standard. The pregnant outcomes of positive cases of three thresholds had no significant differences. But it was better in case of the pregnant woman when the CBG value was more than 7. 4 mmol/L. Conclusion CBG can be used in GST, the threshold of CBG was suggested as 7. 4 mmol/L. CBG test was more convenience and effective than VPG test.

Comparison of Capillary and Venous Glucose Concentrations:A Real-world Study in Patients Undergoing Fluorodeoxyglucose-positron Emission Tomography

Objective Fasting capillary blood glucose(CBG)must be measured before fluorodeoxyglucose-positron emission tomography(FDG-PET)imaging.In this study,we aimed to investigate whether a recently measured fasting venous blood glucose(VBG)concentration could be substituted for CBG.Methods This retrospective study included 520 of 1,378 patients who had undergone FDG-PET at our institution in June 2022.None of the study patients had a history of diabetes mellitus.Each study patient’s CBG was measured immediately before FDG administration,whereas the VBG(VBG<7.8 mmol/L)was measured within one week before and after PET imaging.We used Bland−Altman plots to compare the two blood glucose concentrations.Results The 520 participants(315 male,205 female;ages 13-87 years)accounted for 37.7%(520/1378)of all patients.The median CBG and VBG were 5.7 mmol/L(interquartile range,5.2-6.2 mmol/L)and 5.1 mmol/L(interquartile range,4.8-5.8 mmol/L),respectively.There was a moderate positive correlation between CBG and VBG(r=0.4370,95%CI:0.3625-0.5059,P<0.0001).Bland-Altman plots revealed that only 5.8%(30/520)of the dots exceeded the 95%limits of agreement and these were all within acceptable limits,indicating that the bias was not clinically significant.Conclusion When performing FDG-PET on patients without diabetes,a VBG of<7.8 mmol/L within the previous week may be an acceptable alternative to CBG.

A 2-way cross-over,open-labeled trial to compare efficacy and safety of insulin Aspart and Novolin R delivered with CSII in 21 Chinese diabetic patients

Background Subcutaneous absorption is accelerated by the monomeric conformation of insulin Aspart, which provides good glycemic control with a lower risk of hypoglycemia and less body weight increase. In the present study we investigated the efficacy and safety of a rapid-acting human insulin analogue （insulin Aspart） delivered with continuous subcutaneous insulin infusion （CSII） into Chinese diabetic patients. Methods A total of 21 patients with type 1 or type 2 diabetes were recruited for the 2-way cross-over, open-labeled trial, and then randomized to Group A （n=-10, treated with insulin Aspart） or Group B （n=11, treated with Novolin R）. Insulin Aspart and Novolin R were administered by CSII. Capillary glucose concentrations were measured at 8 time points, pre-prandial and postprandial, bedtime （10 pm）, midnight （2 am） every day during the treatment. Results The average capillary glucose profiles for the day were much better controlled in Group A than in Group B （P〈0.01）. The blood glucose levels were particularly better controlled in Group A than in Group B at pre-breakfast （（6.72±1.24） mmol/L vs （7.84±1.58） mmol/L, P=0.014）, post-breakfast （（8.96±2.41） mmol/L vs （11.70±3.11） mmol/L, P=0.0028）, post-supper （（8.15±2.10） mmol/L vs （10.07±2.36） mmol/L, P=0.008）, bed time （（7.73±1.72） mmol/L vs （9.39±.2.05） mmol/L, P=0.007） and midnight （（6.32±1.16） mmol/L vs （7.48±1.36） mmol/L, P=0.0049）. There was no significant difference in the frequency of hypoglycemic episodes between the two groups. Conclusion Insulin Aspart results in better control of blood glucose levels than regular human insulin （Novolin R） in diabetic patients during delivery by CSII.