Efficacy of blood glucose self-monitoring on glycemic control in patients with non-insulin-treated type 2 diabetes: A meta-analysis

Objective:To evaluate the efficacy of blood glucose self-monitoring on glycemic control in patients with non-insulin-treated type 2 diabetes by performing a meta-analysis.Methods:Randomized controlled trials(RCTs)of the efficacy of blood glucose selfmonitoring were collected from the PubMed,EMBASE,Cochrane Library,CNKI,and VIP databases.Data were analyzed by RevMan 5.1 software.Results:Seven RCTs were included in this meta-analysis.The results indicated that blood glucose self-monitoring significantly reduced the glycated hemoglobin(HbA1c)level by 0.41%.Subgroup analysis showed that while implementation of a diabetes management regimen based on the blood glucose self-monitoring results effectively reduced the HbA1c level by 0.42%,no significant improvement in HbA1c level control was observed with the implementation of blood glucose self-monitoring alone.Conclusion:Blood glucose self-monitoring combined with diabetes management effectively improves glycemic control in patients with non-insulin-treated type 2 diabetes.

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.

Practice of Glycemic Self-Monitoring in Diabetic Patients Followed at the Endocrinology Department of Donka University Hospital in Guinea

Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.

Recent developments in non-invasive blood glucose monitoring technology

Diabetes mellitus is a huge and significantly grow ing problem. Continuous and real-time monitoring of blood glucose plays a key role for the people with diabetes,which can help them to control glucose concentration more effectively. However,current blood glucose monitoring methods require blood by needle-pricking,which limit the detection frequency. It is necessary to develop non-invasive blood glucose monitoring methods to achieve the ideal therapeutic and management of diabetes. In this paper,the developments and challenges of non-invasive blood glucose monitoring technologies in recent years are reviewed. And the bottleneck and the developing trends are also analyzed.

Self-monitoring of blood glucose in type 2 diabetic patients in China：current status and influential factors

Background Self-monitoring of blood glucose （SMBG） by individuals with type 2 diabetes （T2D） is crucial for long-term health,yet numerous cultural,economic and health factors can reduce SMBG.Most studies on SMBG adherence have come out of the US and Europe,and their relevance to Asia is unclear.The aims of the present study were to assess the current state of SMBG in China and analyze demographic and diabetes-related characteristics that may influence it.Methods In this multi-center,cross-sectional study,5 953 individuals with T2D from 50 medical centers in 29 provinces across China filled out a standardized questionnaire that requested information on demographic characteristics,education level,occupation,income,lifestyle risk factors,duration of diabetes,chronic complications,and frequency of SMBG.Respondents were also asked whether their glycosylated hemoglobin （HbA1c） had been checked in the past 6 months.The most recent values for fasting plasma glucose,2-hour postprandial blood glucose and HbA1c were recovered from medical records.Results Only 1 130 respondents （18.98％） performed SMBG with the recommended frequency,while 4 823 （81.02％） did not.In fact,nearly 2 105 （35.36％） reported never performing SMBG.In the subset of 3 661 individuals on insulin therapy,only 266 （7.27％） performed SMBG at least once a day,while 1 210 （33.05％） never performed it.In contrast,895 of 2 292 individuals （39.05％） on diet/exercise therapy or oral hypoglycemic therapy never performed it.Multivariate Logistic regression identified several factors associated with SMBG adherence：female gender,higher education level,higher income,longer T2D duration and education about SMBG.Conclusions SMBG adherence in our Chinese population with T2D was less frequent than that in developed countries.Several factors influence SMBG adherence：gender,education level,income,T2D duration,therapy regimen and exposure to education about SMBG.

3ehavioral Analysis of Chinese Adult Patients with Type 1 Diabetes on Self-monitoring of Blood Glucose

Background： The information-motivation-behavioral skills （IMB） model of health behavior is an effective tool to evaluate the behavior of diabetes self-management. The purpose of this study was to explore behavioral factors affecting the practice of self-monitoring of blood glucose （SMBG） within the frame of IMB model of health behavioral among adult patients with type 1 diabetes in a single diabetes clinic in China. Methods： A questionnaire with three subscales on SMBG information, motivation, and behavioral skills based on IMB model was developed. Validity and reliability of the measures were examined and guaranteed. Adult patients with type 1 diabetes visiting our diabetes clinic from January to March 2012 （n = 55） were consecutively interviewed. The self-completion questionnaires were administered and finished at face-to-face interviews among these patients. Both descriptive and correlational analyses were made. Results： Fifty-five patients finished the questionnaires, with the median duration of diabetes 4.5 years and the median of SMBG frequency 2.00. Specific SMBG information deficits, motivation obstacles, and behavioral skill limitations were identified in a substantial proportion of participants. Scores of SMBG motivation （r - 0.299, P = 0.026） and behavioral skills （r = 0.425, P = 0.001） were significantly correlated with SMBG frequency. The multiple correlation of SMBG information, SMBG motivation, and SMBG behavioral skills with SMBG frequency was R - 0.411 （R2 = 0.169, P = 0.023）. Conclusions： Adult patients with type 1 diabetes in our clinic had substantial SMBG information deficits, motivation obstacles, and skill limitations. This information provided potential-focused education targets for diabetes health-care providers.

人体血糖浓度无创伤检测的必要测量条件

给出近红外光谱分析技术中测量精度与仪器精度和测量方法之间的传递函数,并通过葡萄糖水溶液浓度测量的基础研究进行了验证和分析.结果表明,它不仅能为光谱方法可达到的测量精度提供一种估计手段,还可以给出采用不同测量方法时实现预期测量精度所必需的仪器精度.这为血糖无创伤检测技术乃至近红外光谱分析技术的设计实现及其测量精度分析提供了理论依据.

智能仪器低功耗设计在便携式血糖仪中的应用

从硬件和软件设计角度,介绍便携式智能仪器低功耗设计的若干关键技术。在便携式血糖仪的研制中,采用了多种低功耗措施来降低系统功耗。测试表明,在保证测试精度的前提下,合理采用低功耗技术能提高整机性能、降低系统功耗、确保便携式血糖仪长时间连续运行。

快速血糖仪与生化分析仪检测血糖结果比较

目的研究快速血糖仪与生化分析仪测定血糖的差异性及相关性,探讨快速血糖仪测定血糖的可靠性。方法同时用快速血糖仪和生化分析仪测定内分泌科90位病人的血糖。结果两种方法均具有良好的精密度和高度相关性(P<0.001);当血糖>22.2mmol/L时,两种方法的结果差别有显著性意义(P<0.05),当血糖≤22.2mmol/L时,其结果无显著性差别(P>0.05)。结论快速血糖仪测定血糖精密度高,结果准确可靠。只是对于极端浓度血糖(如血糖>22.2mmol/L),最好是抽静脉血在生化分析仪上复查血糖。

临床血糖检验中快速血糖仪与常规生化仪检验结果研究

目的探究临床血糖检验中快速血糖仪与常规生化仪检验结果。方法选取本院血糖检验者80例作为研究对象,随机分为研究组和参照组,每组40例。研究组用快速血糖仪检测,参照组用常规生化仪检验,观察两组血糖检查时间、检查费用以及血糖值,并进行统计学分析。结果研究组检查时间(0.59±0.34)min和检查费用(5.34±1.25)元均优于参照组,比较显示存在统计学差异(P<0.05);研究组糖尿病者血糖值(6.78±1.23)mmol/L和非糖尿病血糖值(6.56±2.01)mmol/L检查结果与参照组(6.56±2.01、4.37±1.57)mmol/L比较显示无统计学差异(P>0.05)。结论快速血糖仪与常规生化仪对人体血糖检查不存在统计学意义,但快速血糖仪在检查时间、费用等方面具有较大优势,值得临床医生推广应用。

51台患者血糖仪准确性及相关影响因素研究

目的:评价患者血糖仪的准确性及相关影响因素。方法:对51例糖尿病患者测定静脉血浆血糖(VPG),同时用自己的血糖仪测定毛细血管血糖(CBG);填写自制调查表,做相关统计分析。结果:CBG与VPG相关性良好;但仍有测定结果超误差20%范围。血糖仪误差与血糖监测频率等无明显相关性;试纸价格等对血糖仪使用频率产生一定影响。结论:血糖仪应注意定期质检;注意提高患者的自我管理意识。

干生化仪与水剂生化仪检测血糖和尿素氮的对比研究

目的评价干生化仪与水剂生化仪检测血糖和尿素氮的可靠性和临床应用情况。方法分别在干生化仪与水剂生化仪上检测血糖和尿素氮,通过对2项结果的分析来探讨干生化仪与水剂生化仪的可比性及其临床应用选择。结果干生化仪与水剂生化仪检测血糖和尿素氮的相关性良好,二者的相关系数分别为r=0.992、0.997。2台仪器具有良好的可比性。干生化仪与水剂生化仪检测血糖和尿素氮其回归方程、线性范围均符合要求,r值均在0.996以上,具有较好的准确度。结论在处理少量标本时,干生化仪出结果迅速、准确,适合急诊检验;而水剂生化仪在处理大量标本时速度较快且费用较低,适合常规批量检验。

无创血糖检测光声信号的特征提取

针对有创血糖监测会带来二次感染的风险而提出的无创血糖检测方法,该方法的信号特征在复杂环境下不易提取。为了更方便地提取出光声信号,提出了一种基于Laplace小波变换提取光声信号的方法。结合光声原理、压电陶瓷等效电路模型,提取光声信号的基本特征信号,采用该基本特征信号作为Laplace小波基,在实际制作的光声检测系统,对100mg/d L^400mg/d L四组不同浓度的葡萄糖溶液的实际信号分析,经提取后的光声信号与葡萄糖浓度有显著线性特征。

Effects of intermittent fasting on health markers in those with type 2 diabetes:A pilot study

AIMTo determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).METHODSWe describe a three-phase observational study (baseline 2 wk, intervention 2 wk, follow-up 2 wk) designed to determine the clinical, biochemical, and tolerability of IF in community-dwelling volunteer adults with T2DM. Biochemical, anthropometric, and physical activity measurements (using the Yale Physical Activity Survey) were taken at the end of each phase. Participants reported morning, afternoon and evening self-monitored blood glucose (SMBG) and fasting duration on a daily basis throughout all study stages, in addition to completing a remote food photography diary three times within each study phase. Fasting blood samples were collected on the final days of each study phase.RESULTSAt baseline, the ten participants had a confirmed diagnosis of T2DM and were all taking metformin, and on average were obese [mean body mass index (BMI) 36.90 kg/m2]. We report here that a short-term period of IF in a small group of individuals with T2DM led to significant group decreases in weight (-1.395 kg, P = 0.009), BMI (-0.517, P = 0.013), and at-target morning glucose (SMBG). Although not a study requirement, all participants preferentially chose eating hours starting in the midafternoon. There was a significant increase (P < 0.001) in daily hours fasted in the IF phase (+5.22 h), although few attained the 18-20 h fasting goal (mean 16.82 ± 1.18). The increased fasting duration improved at-goal (< 7.0 mmol/L) morning SMBG to 34.1%, from a baseline of 13.8%. Ordinal Logistic Regression models revealed a positive relationship between the increase in hours fasted and fasting glucose reaching target values (χ2 likelihood ratio = 8.36, P = 0.004) but not for afternoon or evening SMBG (all P > 0.1). Postprandial SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither insulin resistance (HOMA-IR), nor inflammatory markers (C-reactive protein) normalized during the IF phase. IF led to an overall spontaneous decrease in caloric intake as measured by food photography (Remote Food Photography Method). The data demonstrated discernable trends during IF for lower energy, carbohydrate, and fat intake when compared to baseline. Physical activity, collected by a standardized measurement tool (Yale Physical Activity Survey), increased during the intervention phase and subsequently decreased in the follow-up phase. IF was well tolerated in the majority of individuals with 6/10 participants stating they would continue with the IF regimen after the completion of the study, in a full or modified capacity (i.e., every other day or reduced fasting hours).CONCLUSIONThe results from this pilot study indicate that short-term daily IF may be a safe, tolerable, dietary intervention in T2DM patients that may improve key outcomes including body weight, fasting glucose and postprandial variability. These findings should be viewed as exploratory, and a larger, longer study is necessary to corroborate these findings.

WJD 5^(th) Anniversary Special Issues(2): Type 2 diabetes Structured SMBG in early management of T2DM: Contributions from the St Carlos study

Diabetes mellitus type 2(T2DM)is a global pandemic that will affect 300 million people in the next decade.It has been shown that early and aggressive treatment of T2DM from the onset decreases complications,and the patient’s active role is necessary to achieve better glycemic control.In order to achieve glycemic control targets,an active attitude in patients is needed,and selfmonitoring of blood glucose(SMBG)plays a significant role.Nowadays,SMBG has become an important component of modern therapy for diabetes mellitus,and is even more useful if it is performed in a structured way.SMBG aids physicians and patients to achieve a specific level of glycemic control and to prevent hypoglycemia.In addition,SMBG empowers patients to achieve nutritional and physical activity goals,and helps physicians to optimize the different hypoglycemic therapies as demonstrated in the St Carlos study.This article describes the different ways of using this educational and therapeutic tool from the medical point of view as well as from the patient’s perspective.

快速血糖仪及常规生化仪的血糖临床检验的效果分析

目的探讨快速血糖仪与常规生化仪在临床血糖检验中的应用效果。方法将50例有血糖检测需求的患者归入本文研究范畴中,同时应用常规法、快速法两种不同的检测方式,仪器各为生化仪、快速血糖仪,患者均同样降糖治疗,统计两种方法治疗前、后空腹血糖(FPG)与餐后2h血糖(2hPG)结果;记录两种方法单次、多次检测平均值;观察两种方法误诊情况。结果两种方法治疗前、后的FPG、2hPG结果差异无统计学意义;常规法单次、多次检测平均值结果与快速法差异无统计学意义;常规法、快速法误诊率比较差异无统计学意义。结论快速血糖仪在血糖检测过程中,其对血糖指标的诊断效果与常规生化仪相近,误诊率相似,准确性表现良好,但快速血糖仪实际应用更为便捷、迅速,值得推广。

临床血糖检验中快速血糖仪与常规生化仪检验结果对比

目的 对比快速血糖仪和常规生化仪在临床血糖检验中的应用价值。方法 240例接受血糖检验的受检者作为研究对象,分别使用快速血糖仪和常规生化仪进行检验。比较不同仪器检测血糖结果、检测需血量与检测时间。结果 快速血糖仪、常规生化仪检验糖尿病患者与健康志愿者的空腹血糖、餐后2 h血糖水平比较,差异无统计学意义(P>0.05)。快速血糖仪检测需血量(0.04±0.01)ml少于常规生化仪的(2.35±0.34)ml,检测时间(1.03±0.22)min短于常规生化仪的(35.09±7.56)min,差异有统计学意义(P<0.05)。结论 无论是快速血糖仪还是常规生化仪都可以对血糖水平进行准确检测,但快速血糖仪在实际应用中操作更为简便,需血量少,检测更加快速,优势更为显著,可以在临床上推广应用。

动态血糖监测2型糖尿病患者全天血糖漂移变化的临床意义

【目的】探讨2型糖尿病（T2DM ）患者全天血糖漂移变化及波动趋势的临床意义，为合理治疗方案提供临床依据。【方法】采用雷兰动态血糖监测系统（CGMS）对325例T2DM 患者进行连续72 h动态血糖监测。根据血糖波动系数为≤2．0组和＞2．0组，了解两组患者的糖化血红蛋白（HBA1C ）、日内的平均血糖水平（24hMBG）、三餐前后平均血糖水平、日内最大血糖漂移幅度（LAGE）、日内平均血糖漂移幅度（MAGE）及漂移次数（NGE）、血糖波动系数、不同血糖水平所占日内时间百分比（PT ），对比评价两组患者全天血糖漂移变化的特点。【结果】血糖波动系数＞2．0者共275例，发生低血糖126例（45．8％），血糖波动系数≤2．0者共50例，发生低血糖18例（36．0％）。HBA1C不能反映血糖水平波动的幅度和频率。两组比较，血糖波动系数＞2．0组较≤2．0组发生高血糖及血糖漂移≥11．1 mmol/L 的时间及幅度明显增多（ P ＜0．05）。【结论】血糖波动系数＞2．0组患者较≤2．0组血糖漂移于较高水平，漂移幅度增大，两组均有低血糖发生。CGMS有助于详细地评估T2DM患者血糖漂移变化的趋势及特征。

电子灸治疗糖尿病周围神经病变的临床研究

目的观察电子灸治疗肝肾亏虚型糖尿病周围神经病变的临床疗效。方法将90例肝肾亏虚型糖尿病周围神经病变患者随机分为治疗组44例和对照组46例。治疗组采用温热电针艾绒隔热穴位治疗,对照组采用中药熏洗足部治疗。两组均治疗10次为1个疗程,共治疗3个疗程。观察两组治疗前后全血黏度、血脂、空腹血糖水平、糖化血红蛋白水平及密歇根神经筛查量表(MNSI)评分的变化情况。结果两组治疗前后全血黏度各项指标、血脂各项指标、空腹血糖水平及糖化血红蛋白水平差值比较,差异均无统计学意义(P>0.05)。两组治疗后MNSI评分组内及组间比较,差异均具有统计学意义(P<0.01);两组治疗前后MNSI评分差值比较,差异具有统计学意义(P<0.01)。结论电子灸是一种治疗糖尿病周围神经病变的有效方法。