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Abnormal blood glucose (BG) levels often seen in critically ill horses are significantly associated with adverse patient outcomes and increased mortality. Rapid and accurate BG monitoring is now considered an essential component of evidence-based equine practice and can provide critical information quickly for treatment. Although several point-of-care (POC) BG monitoring hand-held devices are commercially available for veterinary use, none contains a unique algorithm validated for use in horses. The AlphaTrak 3 (AT3) BG monitoring system is a first-of-its-kind device with an equine-specific algorithm that allows stall-side clinical decision making, and frequent monitoring at minimal cost. As such, AT3 is potentially a preferred alternative to more costly and time-consuming standard diagnostic reference laboratory methods. The objective of this study was to determine the accuracy of the AT3 device in measuring BG levels in equine whole blood samples in comparison to results obtained by the Beckman Coulter AU480 reference analyzer per ISO15197:2013 specifications. Accuracy of the AT3 equine algorithm were initially verified by testing equine blood samples with artificially adjusted blood glucose levels followed by its validation in a field study. Testing with artificially adjusted equine samples (n=129) showed that 98.9% of glucose measurements ranging from 29 to 479 mg/dL fell within ISO accuracy threshold of ±15mg/dL or ±15% of the average reference value. In addition, 100% of the AT3 measurements fell in consensus error grid (CEG) zone A, which indicates that test outcomes have a minimal likelihood of adverse clinical impact. In a follow-up field study involving 96 horses, 98.4% of AT3 measurements met the ISO accuracy threshold and 99.2% of AT3 measurements fell in CEG zone A. These results demonstrate that the AT3 glucometer has a high degree of accuracy in horses and is a dependable, convenient, and cost-effective device for accurately monitoring equine BG levels in farm or clinical settings. [ABSTRACT FROM AUTHOR]

Several people must frequently evaluate their blood glucose since it is an important indicator of health problems mainly diabetes. Different medical systems are commercialized to measure blood glucose levels; some are invasive others are noninvasive. The main purpose of this article is to develop a non-invasive device for measuring blood glucose levels based on the detection and analysis of the photoplethysmogram signal. The developed systems include an optical sensor to detect the photoplethysmography (PPG) signal, digitalizing and acquiring boards to a computer and a software program to process and analyze the digitalized PPG signal regarding some features extracted from its waveform. These features are the systolic amplitude Sa and the b/a amplitude ratio in the second derivative PPG (SDPPG) waveform. An invasive glucometer is also used along with the Sa and b/a ratio determined from the developed system to generate a calibration model which is used to deduce blood glucose level (BGL) values. The result showed that the calibration model using the b/a ratio is more accurate for non-invasive blood level measurement then that of Sa with a difference in glucose estimation around 2 mg/dl and with the correlation coefficient (R²) of the glucose level prediction between 0.8904 and 0.9775. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the effectiveness of a smart non-invasive blood glucose monitor prototype during pregnancy through clinical validation. The monitor utilizes near-infrared spectroscopy combined with AI big data analysis of photoelectric volumetric pulse wave data to achieve non-invasive monitoring of blood glucose in women during pregnancy. The research team developed a monitor that employs a sensing chip, effectively overcoming the problems of weak signals and individual differences in non-invasive blood glucose monitoring. The user experience is enhanced by visualizing the test results on the accompanying cell phone APP (application) of the smart non-invasive pregnancy blood glucose monitor. Clinical validation revealed that the non-invasive monitoring data for pregnant women aged 20~30 years significantly differed from those obtained via traditional blood glucose measurement methods, whereas no significant difference (P

Glucose is a simple sugar molecule. The chemical formula of this sugar molecule is C6H12O6. This means that the glucose molecule contains six carbon atoms (C), twelve hydrogen atoms (H), and six oxygen atoms (O). In human blood, the molecule glucose circulates as blood sugar. Normally, after eating or drinking, our bodies break down the sugars in food and use them to obtain energy for our cells. To execute this process, our pancreas produces insulin. Insulin "pulls" sugar from the blood and puts it into the cells for use. If someone has diabetes, their pancreas cannot produce enough insulin. As a result, the level of glucose in their blood rises. This can lead to many potential complications, including blindness, disease, nerve damage, amputation, stroke, heart attack, damage to blood vessels, etc. In this study, a non-invasive and therefore easily usable method for monitoring blood glucose was developed. With the experiment carried out, it was possible to measure glucose levels continuously, thus eliminating the disadvantages of invasive systems. Near-IR sensors (optical sensors) were used to estimate the concentration of glucose in blood; these sensors have a wavelength of 940 nm. The sensor was placed on a small black parallelepiped-shaped box on the tip of the finger and the output of the optical sensor was then connected to a microcontroller at the analogue input. Another sensor used, but only to provide more medical information, was the heartbeat sensor, inserted into an armband (along with the microprocessor). After processing and linear regression analysis, the glucose level was predicted, and data were sent via the Bluetooth network to a developed APP. The results of the implemented device were compared with available invasive methods (commercial products). The hardware consisted of a microcontroller, a near-IR optical sensor, a heartbeat sensor, and a Bluetooth module. Another objective of this experiment using low-cost and low-power hardware was to not carry out complex processing of data from the sensors. Our practical laboratory experiment resulted in an error of 2.86 per cent when compared to a commercial product, with a hardware cost of EUR 8 and a consumption of 50 mA. [ABSTRACT FROM AUTHOR]

Microwaves can safely and non-destructively illuminate and penetrate dielectric materials, making them an attractive solution for various medical tasks, including detection, diagnosis, classification, and monitoring. Their inherent electromagnetic properties, portability, cost-effectiveness, and the growth in computing capabilities have encouraged the development of numerous microwave sensing and imaging systems in the medical field, with the potential to complement or even replace current gold-standard methods. This review aims to provide a comprehensive update on the latest advances in medical applications of microwaves, particularly focusing on the near-field ones working within the 1–15 GHz frequency range. It specifically examines significant strides in the development of clinical devices for brain stroke diagnosis and classification, breast cancer screening, and continuous blood glucose monitoring. The technical implementation and algorithmic aspects of prototypes and devices are discussed in detail, including the transceiver systems, radiating elements (such as antennas and sensors), and the imaging algorithms. Additionally, it provides an overview of other promising cutting-edge microwave medical applications, such as knee injuries and colon polyps detection, torso scanning and image-based monitoring of thermal therapy intervention. Finally, the review discusses the challenges of achieving clinical engagement with microwave-based technologies and explores future perspectives. [ABSTRACT FROM AUTHOR]

Stress is the inherent sensation of being unable to handle demands and occurrences. If not properly managed, stress can develop into a chronic condition, leading to the onset of additional chronic health issues, such as cardiovascular illnesses and diabetes. Various stress meters have been suggested in the past, along with diverse approaches for its estimation. However, in the case of more serious health issues, such as hypertension and diabetes, the results can be significantly improved. This study presents the design and implementation of a distributed wearable-sensor computing platform with multiple channels. The platform aims to estimate the stress levels in diabetes patients by utilizing a fuzzy logic algorithm that is based on the assessment of several physiological indicators. Additionally, a mobile application was created to monitor the users' stress levels and integrate data on their blood pressure and blood glucose levels. To obtain better performance metrics, validation experiments were carried out using a medical database containing data from 128 patients with chronic diabetes, and the initial results are presented in this study. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is one of the most prevalent diseases that is growing rapidly around the world. Early intervention of blood glucose level not only helps to improve the management of diabetes mellitus but also reduces the cost of treatment. The aim of this review article is to provide an updated report on state of art technologies for minimally invasive, invasive and non-invasive glucose monitoring devices and sensors which are commercially available and provides a review of recent advancements and future prospects in this field. This article also explores the use of machine learning and deep learning algorithms for predicting the risk of diabetes mellitus based on blood glucose data. It emphasizes the importance of data quality in improving the accuracy of predictive models. It highlights the challenges faced in glucose monitoring and provides possible solutions. It concludes by emphasizing the potential of non-invasive wearable devices and artificial intelligence models in enhancing diabetes management and improving patient outcomes. Overall, this article provides a comprehensive overview of the methodology, techniques, algorithms, and available market devices for blood glucose monitoring, highlighting the importance of early diagnosis and accurate prediction in diabetes management. [ABSTRACT FROM AUTHOR]

Abstract Accurate non‐invasive monitoring of blood glucose (BG) is a challenging issue in the therapy of diabetes. Here near‐infrared (NIR) photoplethysmography (PPG) sensor based on a vapor‐deposited mixed tin‐lead hybrid perovskite photodetector is developed. The device shows a high detectivity of 5.32 × 1012 Jones and a large linear dynamic range (LDR) of 204 dB under NIR light, guaranteeing accurate extraction of eleven features from the PPG signal. By a combination of machine learning, accurate prediction of blood glucose level with mean absolute relative difference (MARD) as small as 2.48% is realized. The self‐powered PPG sensor also works for real‐time outdoor healthcare monitors using sunlight as a light source. The potential for early diabetes diagnoses by the perovskite PPG sensor is demonstrated.

Abnormal blood glucose (BG) levels often seen in critically ill horses are significantly associated with adverse patient outcomes and increased mortality. Rapid and accurate BG monitoring is now considered an essential component of evidence-based equine practice and can provide critical information quickly for treatment. Although several point-of-care (POC) BG monitoring hand-held devices are commercially available for veterinary use, none contains a unique algorithm validated for use in horses. The AlphaTrak 3 (AT3) BG monitoring system is a first-of-its-kind device with an equine-specific algorithm that allows stall-side clinical decision making, and frequent monitoring at minimal cost. As such, AT3 is potentially a preferred alternative to more costly and time-consuming standard diagnostic reference laboratory methods. The objective of this study was to determine the accuracy of the AT3 device in measuring BG levels in equine whole blood samples in comparison to results obtained by the Beckman Coulter AU480 reference analyzer per ISO15197:2013 specifications. Accuracy of the AT3 equine algorithm were initially verified by testing equine blood samples with artificially adjusted blood glucose levels followed by its validation in a field study. Testing with artificially adjusted equine samples (n = 129) showed that 98.9% of glucose measurements ranging from 29 to 479 mg/dL fell within ISO accuracy threshold of ±15 mg/dL or ±15% of the average reference value. In addition, 100% of the AT3 measurements fell in consensus error grid (CEG) zone A, which indicates that test outcomes have a minimal likelihood of adverse clinical impact. In a follow-up field study involving 96 horses, 98.4% of AT3 measurements met the ISO accuracy threshold and 99.2% of AT3 measurements fell in CEG zone A. These results demonstrate that the AT3 glucometer has a high degree of accuracy in horses and is a dependable, convenient, and cost-effective device for accurately monitoring equine BG levels in farm or clinical settings.

1,5-Anhydroglucitol (1,5-AG) is sensitive to short-term glucose fluctuations and postprandial hyperglycemia, which has great potential in the clinical application of diabetes as a nontraditional blood glucose monitoring indicator. A large number of studies have found that 1,5-AG can be used to screen for diabetes, manage diabetes, and predict the perils of diabetes complications (diabetic nephropathy, diabetic cardiovascular disease, diabetic retinopathy, diabetic pregnancy complications, diabetic peripheral neuropathy, etc.). Additionally, 1,5-AG and b cells are also associated with each other. As a noninvasive blood glucose monitoring indicator, salivary 1,5-AG has much more benefit for clinical application; however, it cannot be ignored that its detection methods are not perfect. Thus, a considerable stack of research is still needed to establish an accurate and simple enzyme assay for the detection of salivary 1,5-AG. More clinical studies will also be required in the future to confirm the normal reference range of 1,5-AG and its role in diabetes complications to further enhance the blood glucose monitoring system for diabetes. [ABSTRACT FROM AUTHOR]

Real-time monitoring of physiological indicators inside the body is pivotal for contemporary diagnostics and treatments. Implantable electrodes can not only track specific biomarkers but also facilitate therapeutic interventions. By modifying biometric components, implantable electrodes enable in situ metabolite detection in living tissues, notably beneficial in invasive glucose monitoring, which effectively alleviates the self-blood-glucose-managing burden for patients. However, the development of implantable electrochemical electrodes, especially multi-channel sensing devices, still faces challenges: (1) The complexity of direct preparation hinders functionalized or multi-parameter sensing on a small scale. (2) The fine structure of individual electrodes results in low spatial resolution for sensor functionalization. (3) There is limited conductivity due to simple device structures and weakly conductive electrode materials (such as silicon or polymers). To address these challenges, we developed multiple-channel electrochemical microneedle electrode arrays (MCEMEAs) via a separated functionalization and assembly process. Two-dimensional microneedle (2dMN)-based and one-dimensional microneedle (1dMN)-based electrodes were prepared by laser patterning, which were then modified as sensing electrodes by electrochemical deposition and glucose oxidase decoration to achieve separated functionalization and reduce mutual interference. The electrodes were then assembled into 2dMN- and 1dMN-based multi-channel electrochemical arrays (MCEAs), respectively, to avoid damaging functionalized coatings. In vitro and in vivo results demonstrated that the as-prepared MCEAs exhibit excellent transdermal capability, detection sensitivity, selectivity, and reproducibility, which was capable of real-time, in situ glucose concentration monitoring. [ABSTRACT FROM AUTHOR]

Introduction: According to the Centers for Disease Control, 11.8% of adults diagnosed with diabetes have severe vision difficulty or blindness, a complication of uncontrolled diabetes. The study evaluated the accessibility features of the most commonly used injectable products for diabetes and blood glucose monitors and obtained recommendations from manufacturers regarding use of these products in patients with visual disabilities. Additionally, accessibility of the medication guides was assessed using a checklist and screen reader. Methods: Selection of the most commonly prescribed insulin products, GLP-1 receptor agonist drugs, and blood glucose monitors were identified from the ClinCalc DrugStats database and ADA list. The accessibility features of these products were determined from the medication guides and verification of the information with the manufacturers were done in August 2022. All medication guides were then assessed using a checklist and tested with a screen reader for accessibility. Descriptive statistics were used to report the data. Results: No injectable products or glucose monitoring systems were fully accessible and manufacturers advised to use the product with caution and/or required assistance from a caregiver or family member. In evaluating the 14 medication guides for accessibility using the checklist, the most common issues were lack of structured headings to help with navigation, no descriptions for images, and tables did not have appropriate headers. Conclusions: Due to the lack of accessible features on diabetes medical devices and glucose monitoring systems, healthcare professionals can seek alternatives to assist this patient population to effectively manage their therapy.

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 article reviews the perioperative blood glucose management of patients to provide a reference for improving their health status.

Capillary blood glucose (CBG) is fundamental for diabetes mellitus management. However, it is still unclear whether the first or the subsequent blood drops most accurately reflect patients' blood glucose levels. 128 healthy volunteers were included in this prospective cohort study from November 2021 to December 2021. Capillary blood glucose concentrations of the first four blood drops, measured using glucose meters were compared with venous blood concentrations of the respective donors, measured using an in-lab hexokinase method. ANOVA, the Spearman correlation coefficient and Bland-Altman plots were used to analyze the data. The mean plasma glucose concentration was 90.46 mg/dl with an SD of ± 14.416 (5.02 ± 0.8 mmol/l). There were statistically strong correlations among the glucose concentrations of all capillary blood drops (correlation coefficients of r > 0.8). The first capillary blood drops showed the lowest mean difference to plasma blood glucose concentrations (+4.92 mg/dl; +0.27 mmol/l), followed by the third drop (+7.28 mg/dl; +0.4 mmol/l), second drop (+7.30 mg/dl; +0.4 mmol/l) and fourth drop (+8.87 mg/dl; +0.49 mmol/l). There is a strong correlation and good agreement between the different capillary blood drops, making all blood drops equally suitable for blood glucose monitoring. In practice, the given setting (clinical or patient self-monitoring) should be considered upon choosing a specific blood drop. • Blood glucose shows a strong correlation between the first four capillary drops. • The 1st capillary drop has the lowest mean glucose difference to according plasma. • A practical approach is justified when choosing the right capillary blood drop. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is one of the most world’s common disease. Global digitalization reveals new opportunities in diabetes mellitus patient man-agement. Various applications and devices are currently available to improve patient’s glucose levels. Apart from continuous glucose monitoring devices traditional methods of blood glucose monitoring are widely used. The development of special applications and options for glucometers to connect with mobile devices essentially improved data analysis and allowed to improve treatment efficacy.

Background Adherence to insulin and blood glucose monitoring (BGM) is insufficient in adolescents and young adults (AYAs) with type 1 diabetes (T1D) worldwide and in Qatar. Little is known about the factors related to being aware of suboptimal adherence and the beliefs related to suboptimal adherence in this group. This qualitative study investigated factors related to awareness of, and beliefs about suboptimal adherence, as well as the existence of specific action plans to combat suboptimal adherence using the I-Change model. Methods The target group was comprised of 20 Arab AYAs (17–24 years of age) with T1D living in Qatar. Participants were interviewed via semi-structured, face-to-face individual interviews, which were audio-recorded, transcribed verbatim, and analyzed using the Framework Method. Results Suboptimal adherence to insulin, and particularly to BGM, in AYAs with T1D was identified. Some AYAs reported to have little awareness about the consequences of their suboptimal adherence and how this can adversely affect optimal diabetes management. Participants also associated various disadvantages to adherence ( e.g., hypoglycemia, pain, among others) and reported low self-efficacy in being adherent ( e.g., when outside home, in a bad mood, among others). Additionally, goal setting and action-planning often appeared to be lacking. Factors facilitating adherence were receiving support from family and healthcare providers, being motivated, and high self-efficacy. Conclusions Interventions that increase awareness concerning the risks of suboptimal adherence of AYAs with T1D are needed, that increase motivation to adhere by stressing the advantages, creating support and increasing self-efficacy, and that address action planning and goal parameters.

Microwaves can safely and non-destructively illuminate and penetrate dielectric materials, making them an attractive solution for various medical tasks, including detection, diagnosis, classification, and monitoring. Their inherent electromagnetic properties, portability, cost-effectiveness, and the growth in computing capabilities have encouraged the development of numerous microwave sensing and imaging systems in the medical field, with the potential to complement or even replace current gold-standard methods. This review aims to provide a comprehensive update on the latest advances in medical applications of microwaves, particularly focusing on the near-field ones working within the 1–15 GHz frequency range. It specifically examines significant strides in the development of clinical devices for brain stroke diagnosis and classification, breast cancer screening, and continuous blood glucose monitoring. The technical implementation and algorithmic aspects of prototypes and devices are discussed in detail, including the transceiver systems, radiating elements (such as antennas and sensors), and the imaging algorithms. Additionally, it provides an overview of other promising cutting-edge microwave medical applications, such as knee injuries and colon polyps detection, torso scanning and image-based monitoring of thermal therapy intervention. Finally, the review discusses the challenges of achieving clinical engagement with microwave-based technologies and explores future perspectives.

Glucose is a simple sugar molecule. The chemical formula of this sugar molecule is C6H12O6. This means that the glucose molecule contains six carbon atoms (C), twelve hydrogen atoms (H), and six oxygen atoms (O). In human blood, the molecule glucose circulates as blood sugar. Normally, after eating or drinking, our bodies break down the sugars in food and use them to obtain energy for our cells. To execute this process, our pancreas produces insulin. Insulin “pulls” sugar from the blood and puts it into the cells for use. If someone has diabetes, their pancreas cannot produce enough insulin. As a result, the level of glucose in their blood rises. This can lead to many potential complications, including blindness, disease, nerve damage, amputation, stroke, heart attack, damage to blood vessels, etc. In this study, a non-invasive and therefore easily usable method for monitoring blood glucose was developed. With the experiment carried out, it was possible to measure glucose levels continuously, thus eliminating the disadvantages of invasive systems. Near-IR sensors (optical sensors) were used to estimate the concentration of glucose in blood; these sensors have a wavelength of 940 nm. The sensor was placed on a small black parallelepiped-shaped box on the tip of the finger and the output of the optical sensor was then connected to a microcontroller at the analogue input. Another sensor used, but only to provide more medical information, was the heartbeat sensor, inserted into an armband (along with the microprocessor). After processing and linear regression analysis, the glucose level was predicted, and data were sent via the Bluetooth network to a developed APP. The results of the implemented device were compared with available invasive methods (commercial products). The hardware consisted of a microcontroller, a near-IR optical sensor, a heartbeat sensor, and a Bluetooth module. Another objective of this experiment using low-cost and low-power hardware was to not carry out complex processing of data from the sensors. Our practical laboratory experiment resulted in an error of 2.86 per cent when compared to a commercial product, with a hardware cost of EUR 8 and a consumption of 50 mA.

Stress is the inherent sensation of being unable to handle demands and occurrences. If not properly managed, stress can develop into a chronic condition, leading to the onset of additional chronic health issues, such as cardiovascular illnesses and diabetes. Various stress meters have been suggested in the past, along with diverse approaches for its estimation. However, in the case of more serious health issues, such as hypertension and diabetes, the results can be significantly improved. This study presents the design and implementation of a distributed wearable-sensor computing platform with multiple channels. The platform aims to estimate the stress levels in diabetes patients by utilizing a fuzzy logic algorithm that is based on the assessment of several physiological indicators. Additionally, a mobile application was created to monitor the users’ stress levels and integrate data on their blood pressure and blood glucose levels. To obtain better performance metrics, validation experiments were carried out using a medical database containing data from 128 patients with chronic diabetes, and the initial results are presented in this study.

Abstract Background China has the largest number of individuals with type 2 diabetes mellitus (T2DM) in the world, and most lack knowledge about glycemic control and health management. This trial will examine whether a smartphone application can improve blood glucose management among individuals with T2DM. Methods This will be a 2-center, factorial design, equal proportional distribution, superiority trial conducted in outpatient endocrinology clinics at two tertiary hospitals in Chengdu, China. The trial will enroll smartphone-literature individuals at least 18 years old who have been diagnosed with T2DM based on glycosylated hemoglobin (HbA1c) of at least 7.0%. Individuals will be randomly assigned to receive routine care with standard education about T2DM and glycemic control (Control), routine care as well as weekly telephone reminders to self-monitor blood glucose (Reminder), routine care and a smartphone application providing information about glycemic control and health management with T2DM (App), or the combination of routine care, the smartphone application, and weekly telephone reminders (App + Reminder). After 6 months of these interventions, participants will be analyzed for the primary outcome of HbA1c as well as the secondary outcomes of blood glucose monitoring frequency, body mass index, blood pressure, knowledge about diabetes, health beliefs related to diabetes, diabetes self-management behavior, and satisfaction with the smartphone application. Discussion This trial will determine whether a smartphone application can improve glycemic management among Chinese with T2DM. The findings may help guide the development of effective applications in China and elsewhere. Trial registration Registration in the Chinese Clinical Trial Registry (ChiCTR) under registration number ChiCTR2100042297: https://www.chictr.org.cn/bin/userProject . 17 January 2021.

DM is a global medico-social problem, characterized by threatening trends in the spread and development of complications. One of the key elements of the system of effective treatment of DM is the continuous supply of patients with hypoglycemic preparations & means of means of glycemic control. Therefore, it is advisable to investigate approaches to ensuring the availability of MT for the prevention, diagnosis & treatment of DM in different countries. The purpose of the work is to analyze the condition & problems of providing patients with the necessary pharmaceuticals & diagnostic products to achieve the appropriate level of compensation for diabetes. The research used: analysis of documents, marketing analysis, comparison, generalization, mathematical and statistical methods, graphic method. The analysis of official statistics shows a constant increase in the incidence of diabetes in the world among the population of different ages. Analysis of international experience shows significant differences in approaches to the organization of care for patients with diabetes, in particular, reimbursement of the cost of insulin therapy & glycemic control. In low- and middle-income countries, due to insufficient financing of antidiabetic measures, higher rates of mortality & disability related to complications of DM are recorded. In Ukraine, a government program for the reimbursement of sugar-lowering drugs has been introduced to increase the availability of drugs. Reimbursement is subject to 45 insulin preparations for 12 INNs (of which 18 are without copayment). According to the NHS, 226,200 patients receive insulin under PMG (since 2019, 2.27 mln prescriptions have been paid). The analysis of prescriptions shows that insulin analogues of foreign production are most often used. Based on the results of the research on the availability of modern MTs for the diagnosis and treatment of diabetes, it can be concluded that a wide range of glycemic control tools, including Continuous Monitoring Systems, are available on the domestic market. Providing patients with means of glycemic control is carried out at the expense of regional programs. The problem of providing patients with DM with the necessary medicines & medical devices requires a complex solution & coordination of central & local authorities actions. The priority direction of improving the efficiency and accessibility of medical care for patients with DM is to carry out proper OMT diagnosis & treatment of DM in order to include them in the reimbursement lists & procurement nomenclature.

Abstract Over 25 years ago, the World Health Organization (WHO) acknowledged the importance of effective prevention, detection and treatment of neonatal hypoglycaemia, and declared it to be a global priority. Neonatal hypoglycaemia is common, linked to poor neurosensory outcomes and, if untreated, can cause seizures and death. Neonatal mortality in low and lower-middle income countries constitutes an estimated 89% of overall neonatal deaths. Factors contributing to high mortality rates include malnutrition, infectious diseases, poor maternal wellbeing and resource constraints on both equipment and staff, leading to delayed diagnosis and treatment. The incidence of neonatal hypoglycaemia in low and lower-middle income countries remains unclear, as data are not collected. Data from high-resource settings shows that half of all at-risk babies will develop hypoglycaemia, using accepted clinical thresholds for treatment. Most at-risk babies are screened and treated, with treatment aiming to increase blood glucose concentration and, therefore, available cerebral fuel. The introduction of buccal dextrose gel as a first-line treatment for neonatal hypoglycaemia has changed the care of millions of babies and families in high-resource settings. Dextrose gel has now also been shown to prevent neonatal hypoglycaemia. In low and lower-middle income countries, there are considerable barriers to resources which prevent access to reliable blood glucose screening, diagnosis, and treatment, leading to inequitable health outcomes when compared with developed countries. Babies born in low-resource settings do not have access to basic health care and are more likely to suffer from unrecognised neonatal hypoglycaemia, which contributes to the burden of neurosensory delay and death.

Background Adherence to insulin and blood glucose monitoring (BGM) is insufficient in adolescents and young adults (AYAs) with type 1 diabetes (T1D) worldwide and in Qatar. Little is known about the factors related to being aware of suboptimal adherence and the beliefs related to suboptimal adherence in this group. This qualitative study investigated factors related to awareness of, and beliefs about suboptimal adherence, as well as the existence of specific action plans to combat suboptimal adherence using the I-Change model. Methods The target group was comprised of 20 Arab AYAs (17–24 years of age) with T1D living in Qatar. Participants were interviewed via semi-structured, face-to-face individual interviews, which were audio-recorded, transcribed verbatim, and analyzed using the Framework Method. Results Suboptimal adherence to insulin, and particularly to BGM, in AYAs with T1D was identified. Some AYAs reported to have little awareness about the consequences of their suboptimal adherence and how this can adversely affect optimal diabetes management. Participants also associated various disadvantages to adherence (e.g., hypoglycemia, pain, among others) and reported low self-efficacy in being adherent (e.g., when outside home, in a bad mood, among others). Additionally, goal setting and action-planning often appeared to be lacking. Factors facilitating adherence were receiving support from family and healthcare providers, being motivated, and high self-efficacy. Conclusions Interventions that increase awareness concerning the risks of suboptimal adherence of AYAs with T1D are needed, that increase motivation to adhere by stressing the advantages, creating support and increasing self-efficacy, and that address action planning and goal parameters.

Background: Type 2 diabetes (T2D), a major risk factor for cardiovascular disease and other adverse health conditions, is on the rise in Singapore. TRIPOD is a randomized controlled trial aimed to determine whether complementing usual care with an evidence-based diabetes management package (DMP) —comprising access to an evidence-based app, health coaching, pedometer, glucometer and weighing scale, with or without a financial rewards scheme (M-POWER rewards), can improve mean HbA1c levels at months 6 and 12. Methods: The protocol was published in Trials, accessible via https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-3749-x1. This manuscript updates the protocol with changes to the study design due to challenges with recruitment and presents baseline characteristics. Key updates include changing the arm allocation ratio from 1:1:1 (Arm 1-Usual Care: Arm 2-DMP: Arm 3-DMP+M-POWER rewards) to 10:1:10, the sample size from 339 to 269, the intervention period from two to one year, and the primary hypothesis to focus solely on differences between Usual Care and DMP+M-POWER rewards. Recruitment for the study began on 19 October 2019 and ended on 4 June 2022. Results: The average age of participants was 55.0 (SD9.7) years old and 64.2% were male. The majority of participants (76.8%) were Chinese, 4.9% Malay and 18.3% Indian and of other ethnicities. 67.0% had a monthly household income of SGD$4000 or more. The mean baseline HbA1c was 8.10% (SD 0.95) and the mean body mass index was 26.8 kg/m2 (SD 5.3). Discussion: The final participant completed month 12 follow-up data collection on 8 June 2023. All pre-planned analyses will be conducted and final results reported. Trial registration: ClinicalTrials.govNCT03800680. Registered on 11 January 2019. [ABSTRACT FROM AUTHOR]

Experts suggest that people with type 1 diabetes (T1DM) should be discouraged from fasting during Ramadan, even though both adolescents and adults insist on performing their fast despite the jurisprudential excuse. The objective was to evaluate the behavior and attitudes of a population with T1DM during Ramadan and outside. A descriptive study was carried out on 63 T1DM subjects at the level of two health establishments located in the city of Constantine (eastern Algeria). The interviews took place between April 13th and May 12th, 2021 during Ramadan. The R.3.2.4 software was used for the comparison tests. The significance level retained was 0.05. The study involved 63 subjects with T1DM (30 females and 33 males) of whom 26 subjects aged < 18 years and 37 subjects aged ≥ 18 years (P = 0.001). The mean age was 21.2 ± 5.7 years (12–42 years). The average duration of pathology since diagnosis was 6.6 ± 4.5 years. Glycated hemoglobin (Hb1Ac) was between 5.60% and 16.10% with an average of 8.1 ± 0.2%. The results revealed that 28.6% of the patients practiced Ramadan fasting with an average of 13.8 ± 10.4 days. Only 31.7% consulted their doctors before observing Ramadan, 77.8% controlled their blood sugar mainly before breaking the fast. COVID-19 affected 15.9% of subjects and hyperglycemia was the most recorded diabetes-related complication. Despite the health risks, subjects with T1DM insisted on fasting during the month of Ramadan. Thence it is vital to adhere to a healthy lifestyle with early clinical monitoring. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a widespread chronic metabolic disorder that requires regular blood glucose level surveillance. Current invasive techniques, such as finger-prick tests, often result in discomfort, leading to infrequent monitoring and potential health complications. The primary objective of this study was to design a novel, portable, non-invasive system for diabetes detection using breath samples, named DiabeticSense, an affordable digital health device for early detection, to encourage immediate intervention. The device employed electrochemical sensors to assess volatile organic compounds in breath samples, whose concentrations differed between diabetic and non-diabetic individuals. The system merged vital signs with sensor voltages obtained by processing breath sample data to predict diabetic conditions. Our research used clinical breath samples from 100 patients at a nationally recognized hospital to form the dataset. Data were then processed using a gradient boosting classifier model, and the performance was cross-validated. The proposed system attained a promising accuracy of 86.6%, indicating an improvement of 20.72% over an existing regression technique. The developed device introduces a non-invasive, cost-effective, and user-friendly solution for preliminary diabetes detection. This has the potential to increase patient adherence to regular monitoring. [ABSTRACT FROM AUTHOR]

Measuring blood glucose concentrations via capillary (fingerprick) blood glucose monitoring or continuous (interstitial) glucose monitoring is an important aspect of management for many people with diabetes. Blood glucose monitoring informs patient self-management strategies, which can improve the patient's engagement in their own care and reduce barriers to achieving recommended blood glucose targets. Blood glucose monitoring also informs clinician-guided management plans. Compared to capillary blood glucose monitoring, continuous glucose monitoring in people using insulin significantly improves glycaemic metrics and is associated with improved patient-reported outcomes. Even with good glycaemic metrics, patients using continuous glucose monitoring should still have access to capillary blood glucose monitoring for correlation of hypoglycaemic readings when accuracy may be compromised or if there is a malfunction with the continuous blood glucose monitor. [ABSTRACT FROM AUTHOR]

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Real-time monitoring of physiological indicators inside the body is pivotal for contemporary diagnostics and treatments. Implantable electrodes can not only track specific biomarkers but also facilitate therapeutic interventions. By modifying biometric components, implantable electrodes enable in situ metabolite detection in living tissues, notably beneficial in invasive glucose monitoring, which effectively alleviates the self-blood-glucose-managing burden for patients. However, the development of implantable electrochemical electrodes, especially multi-channel sensing devices, still faces challenges: (1) The complexity of direct preparation hinders functionalized or multi-parameter sensing on a small scale. (2) The fine structure of individual electrodes results in low spatial resolution for sensor functionalization. (3) There is limited conductivity due to simple device structures and weakly conductive electrode materials (such as silicon or polymers). To address these challenges, we developed multiple-channel electrochemical microneedle electrode arrays (MCEMEAs) via a separated functionalization and assembly process. Two-dimensional microneedle (2dMN)-based and one-dimensional microneedle (1dMN)-based electrodes were prepared by laser patterning, which were then modified as sensing electrodes by electrochemical deposition and glucose oxidase decoration to achieve separated functionalization and reduce mutual interference. The electrodes were then assembled into 2dMN- and 1dMN-based multi-channel electrochemical arrays (MCEAs), respectively, to avoid damaging functionalized coatings. In vitro and in vivo results demonstrated that the as-prepared MCEAs exhibit excellent transdermal capability, detection sensitivity, selectivity, and reproducibility, which was capable of real-time, in situ glucose concentration monitoring.

Nearly 5 million people are now living with diabetes in the UK, with many receiving treatment and management in the community. With their unique and intimate insight into patients' lives, the community nurse is well-placed to offer support, education and advocacy to those who might be struggling to manage their condition. Francesca Ramadan explores the multiple ways in which a community nurse might facilitate a preventative, holistic and personalised approach to diabetes treatment and management. [ABSTRACT FROM AUTHOR]

Background: Continuous glucose monitoring (CGM) can help manage diabetes mellitus (DM) and prevent hypoglycemia. This study aimed to evaluate the performance and usability of a novel SiJoy GS1 CGM system. Methods: This multicenter trial enrolled participants with DM. Based on the comparison of glucose values measured by SiJoy GS1 CGM and venous blood glucose test, the 20/20% consistency and mean absolute relative difference (MARD%) were calculated, as well as Clarke and consensus error grid analysis. Product usability was evaluated by questionnaire completed by participants. Any occurrence of adverse events (AE) was documented. Results: Seventy participants were included in the study. The mean age of participants was 41.5 ± 13.2 years, among which 29 (42.0%) were male, with the DM course of 8.6 ± 7.5 years. A total of 39 (56.5%) of them had type 1 DM, 24 (34.8%) had type 2 DM, and 6 (8.7%) were others for DM. The 20/20% consistency achieved 91.82%, which was higher than the target 65%. The percentage of A + B zones of Clarke and consensus error grid was 99.22% and 99.90%, respectively. The MARD value was 8.83% ± 4.03%. The mean score of usability questionnaire was 86.59 ± 5.17 out of 90. AE were observed in only one participant (mild fever), and no severe AEs occurred. Conclusions: The SiJoy GS1 CGM system achieved satisfactory performance and usability. No severe AEs occurred and mild AE was reported in only one case. [ABSTRACT FROM AUTHOR]

The prevalence of diabetes continues to rise exponentially and contributes significantly to morbidity, mortality, and health care resource utilization. Individuals with diabetes have adopted continuous glucose monitoring (CGM) as their preferred method for glucose measurement. Primary care clinicians should become proficient in utilizing this technology in their practices. This case-based article provides practical guidance in CGM interpretation allowing patients to become successful partners in diabetes self-management. Our approach to data interpretation and shared decision-making is applicable to all current CGM systems. [ABSTRACT FROM AUTHOR]

Studies that investigate use of diabetes technologies such as blood glucose monitoring (BGM) and continuous glucose monitoring (CGM) often report contradictory findings regarding efficacy and clinical utility. Whereas some studies of a given technology have shown no benefit, others have reported significant benefits. These incongruities derive from how the technology is viewed. Is it viewed as a tool, or is it an intervention? In this article, we discuss earlier studies that illustrate the contrast between use of BGM as a tool versus use as an intervention, compare and contrast the roles of BGM and CGM as tools and/or interventions in diabetes management, and suggest that CGM can function effectively as both. [ABSTRACT FROM AUTHOR]

Objective To investigate the current situation of blood glucose monitoring in type 1 diabetes mellitus (T1DM) patients and its impact on glycemic control. Methods The study was a cross-sectional survey. T1DM patients or their guardians who visited the Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University from October to December 2021 were selected as the research subjects. The patients' age, course of diabetes, current treatment plan, education level, continuous glucose monitoring (CGM) and self-monitoring blood glucose (SMBG) were assessed by questionnaire. The glycated hemoglobin A1c (HbA1c) was measured. According to the Guidelines for the diagnosis and treatment of type 1 diabetes mellitus in China (2021 edition), HbA1c<7.0% is defined as HbA1c meeting the standard. Patients were divided into CGM group and SMBG group based on blood glucose monitoring methods. Mann-Whitney U test, chi-square test were used for inter-group comparison, and multivariate logistic regression analysis was used to analyze the influencing factors of HbA1c compliance and different blood glucose monitoring methods. Results A total of 197 patients with T1DM were included, with an average age of 27.0 (18.2, 41.0) years and a course of disease of 5.0 (2.0, 9.8) years. The utilization rates of CGM and SMBG were 61.4% (121/197) and 38.6% (76/197), respectively. The HbA1c in the CGM group was lower than that in the SMBG group [6.6% (6.1%, 7.5%) and 7.5% (6.4%, 9.5%), Z=3.19, P<0.001], and the compliance rates of HbA1c in the 2 groups were 62.1% (51/95) and 40.0% (24/60), respectively. The difference was statistically significant (χ²=7.22, P<0.01). After adjustment for age, diabetes course and current treatment, logistic regression analysis showed that the use of CGM (OR=2.028, 95%CI 1.012-2.042, P<0.05) and education level (OR=1.571, 95%CI 1.209-2.042, P<0.01) were correlated with HbA1c standard. Conclusion In our real-world data, 61.4% of the patients with T1DM were using a CGM device, which was associated with improved glycemic control. [ABSTRACT FROM AUTHOR]

Over 25 years ago, the World Health Organization (WHO) acknowledged the importance of effective prevention, detection and treatment of neonatal hypoglycaemia, and declared it to be a global priority. Neonatal hypoglycaemia is common, linked to poor neurosensory outcomes and, if untreated, can cause seizures and death. Neonatal mortality in low and lower-middle income countries constitutes an estimated 89% of overall neonatal deaths. Factors contributing to high mortality rates include malnutrition, infectious diseases, poor maternal wellbeing and resource constraints on both equipment and staff, leading to delayed diagnosis and treatment. The incidence of neonatal hypoglycaemia in low and lower-middle income countries remains unclear, as data are not collected. Data from high-resource settings shows that half of all at-risk babies will develop hypoglycaemia, using accepted clinical thresholds for treatment. Most at-risk babies are screened and treated, with treatment aiming to increase blood glucose concentration and, therefore, available cerebral fuel. The introduction of buccal dextrose gel as a first-line treatment for neonatal hypoglycaemia has changed the care of millions of babies and families in high-resource settings. Dextrose gel has now also been shown to prevent neonatal hypoglycaemia. In low and lower-middle income countries, there are considerable barriers to resources which prevent access to reliable blood glucose screening, diagnosis, and treatment, leading to inequitable health outcomes when compared with developed countries. Babies born in low-resource settings do not have access to basic health care and are more likely to suffer from unrecognised neonatal hypoglycaemia, which contributes to the burden of neurosensory delay and death. [ABSTRACT FROM AUTHOR]

Hyperglycemia, a stress-induced physiological condition, is associated with severe complications, including sepsis, multiple organ failure, and higher mortality rates. The seminal 2001 Leuven study highlighted the potential for strict blood glucose control (80-110 mg/dL) to lower mortality rates by 34% among critically ill surgical patients. Consequently, monitoring blood glucose levels in ICU patients has become imperative. This study aims to use recent medical technology advancements to streamline the monitoring of blood glucose levels, traditionally requiring trained personnel to operate a blood glucose monitor. We used the OptiScanner to collect patient blood data, separate plasma, and acquire mid-IR-related data. XGBoost was used to improve the prediction of blood glucose concentration based on patient classification types and its performance was compared with two other machine learning algorithms. We also used the LASSO model to predict plasma blood glucose concentrations. Additionally, we applied SHAP (SHapley Additive exPlanations) to identify critical wavelengths in the classifier and compared these with the functional groups corresponding to the actual IR spectrum. Our experimental findings demonstrate that XGBoost exhibits promising performance. Furthermore, the interpretation of the model is in alignment with domain knowledge. Through this study, we emphasize the potential of advanced medical technology, particularly machine learning algorithms such as XGBoost, to improve the efficacy and precision of blood glucose monitoring in ICU settings.

Objective To investigate the current situation of blood glucose monitoring in type 1 diabetes mellitus (T1DM) patients and its impact on glycemic control. Methods The study was a cross‑sectional survey. T1DM patients or their guardians who visited the Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University from October to December 2021 were selected as the research subjects. The patients′ age, course of diabetes, current treatment plan, education level, continuous glucose monitoring (CGM) and self‑monitoring blood glucose (SMBG) were assessed by questionnaire. The glycated hemoglobin A1c (HbA1c ) was measured. According to the Guidelines for the diagnosis and treatment of type 1 diabetes mellitus in China (2021 edition), HbA1c <7.0% is defined as HbA1c meeting the standard. Patients were divided into CGM group and SMBG group based on blood glucose monitoring methods. Mann‑Whitney U test, chi‑square test were used for inter‑group comparison, and multivariate logistic regression analysis was used to analyze the influencing factors of HbA1c compliance and different blood glucose monitoring methods. Results A total of 197 patients with T1DM were included, with an average age of 27.0 (18.2, 41.0) years and a course of disease of 5.0 (2.0, 9.8) years. The utilization rates of CGM and SMBG were 61.4% (121/197) and 38.6% (76/197), respectively. The HbA1c in the CGM group was lower than that in the SMBG group [6.6% (6.1%, 7.5%) and 7.5% (6.4%, 9.5%), Z=3.19, P<0.001], and the compliance rates of HbA1c in the 2 groups were 62.1% (51/95) and 40.0% (24/60), respectively. The difference was statistically significant (χ² =7.22, P<0.01). After adjustment for age, diabetes course and current treatment, logistic regression analysis showed that the use of CGM (OR=2.028, 95%CI 1.012-2.042, P<0.05) and education level (OR=1.571, 95%CI 1.209-2.042, P<0.01) were correlated with HbA1c standard. Conclusion In our real‑world data, 61.4% of the patients with T1DM were using a CGM device, which was associated with improved glycemic control. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is one of the most commonly encountered pregnancy complications and is associated with multiple adverse perinatal outcomes. Technology has progressed to address the unique challenges patients face in managing diabetes mellitus in pregnancy. Technology has bolstered diabetes mellitus education with smartphone applications focused on nutrition counseling and carbohydrate intake advice. Continuous glucose monitors and insulin infusion systems have shown benefit by simplifying glycemic monitoring and insulin administration. Improvements in glycemic control and perinatal outcomes have been seen with continuous glucose monitor use when compared with intermittent blood glucose monitoring, and more pregnant people are using insulin pumps instead of multiple daily insulin injections. Hybrid closed-loop systems are emerging and are able to integrate continuous glucose monitoring and insulin pump technologies while maximizing automated features in the nonpregnant population, but these have not been endorsed for use in pregnancy yet. Applying telehealth practices has been associated with high patient satisfaction among those with diabetes mellitus in pregnancy, and leveraging remote patient monitoring through telehealth platforms and short-range wireless technologies can reduce the burden of patient visits. As technology becomes more integrated into routine management of diabetes mellitus in pregnancy, practitioners should emphasize individualized counseling and device selection to ensure patient autonomy and safety.

Numerous food organizations have identified excessive calorie consumption and accompanying ailments as significant health risks associated with high sugar consumption. Administering stevioside (ST), sucralose (SU), and the two synergically (SU+ST) affected normal rats' weight gain. In the current study, SU showed the highest undesired effect. Indeed, administering the three treatments to diabetic rats (DR) did not improve the rats' weight gain. Although, insulin injection synergically with the treatments improved the weight gain, as recorded after three weeks. The best-improving rate was observed in the ST group. After the administration of ST and ST+SU to the DR, the blood glucose level (GL) was positively affected, with SU having no effects on reducing the GL. A considerable reduction in serum insulin (SIL) was noted in the DR+SU group. On the contrary, ST did not negatively affect the SIL, rather an improvement was recorded. In addition, giving SU did not significantly affect the ALT level in the DR or normal rats (NR). A significant improvement in total bilirubin (TBILI) was observed when insulin was injected with ST or SU in DR groups. Further, triglycerides (TG) after administering ST, SU, or ST+SU to NR had no significant difference compared to the control group (NR). Although, the three treatments markedly but not significantly lowered TG in the DR. For total cholesterol (CHO), both DR and NR had no significant effect after the three treatments. No histopathological alterations were recorded in the NR group. Diffuse and severe atrophy of the islands of Langerhans due to depletion of their cells and mild papillary hyperplasia of the pancreatic ducts were represented by a slightly folded ductal basement membrane and newly formed ductules in STZ-DR. Simultaneous atrophy and absence of the cells of islands of Langerhans besides ductal hyperplasia were evident in DR+SU. Hyperplastic ductal epithelium and atrophic Langerhans cells were seen in DR+SU+In. Degeneration and mild atrophy were observed in the islands of Langerhans structures. There was essentially no noticeable change after utilizing ST. A slight shrinkage of the Langerhans' islets was detected in DR+ST. In DR+ST+In, no histopathological alterations in the islands of Langerhans were recorded. Congestion in the stromal blood vessels associated with degenerative and necrotic changes in the cells of the islands of Langerhans in DR+SU+ST was observed. In NR+SU, congestion of the blood vessels associated with mild atrophy in the islands of Langerhans and dilatation in stromal blood vessels was noticed. In conclusion, ST is safe, and SU should be taken cautiously, such as mixing with ST and/or taken at a very low concentration to avoid its drastic effect on the human body. [ABSTRACT FROM AUTHOR]

Aim: Flash glucose monitoring provides a range of glucose metrics. In the current study, we aim to identify those that indicate that glycaemic targets can be consistently met and contrast the total (t‐CV) and within‐day coefficient of variation (wd‐CV) to guide the assessment of glucose variability and hypoglycaemia exposure. Methods: De‐identified data from Flash readers were collected. The readers were sorted into 10 equally sized groups of scan frequency followed by quartiles of estimated A1c (eA1c). A similar grouping was performed for the total coefficient of variation (t‐CV) and within‐day coefficient of variation (wd‐CV). In addition, analysis of the association of time below 54 mg/dl and glucose variability measured by t‐CV and wd‐CV was performed. Results: The dataset included 1 002 946 readers. Readers sorted by 10 equal groups of scan rate and quartiles by eA1c, t‐CV and wd‐CV represented 25 074 readers per group. The association of lower eA1c with higher time in range and reduced time above range was clear. The correlation of eA1c quartiles and time below range was not consistent. An association between glucose variability and hypoglycaemia was found. Both wd‐CV and t‐CV were associated with time below range. For achieving the consensus target of <1% time below 54 mg/dl, the associated wd‐CV and t‐CV values were 33.5% and 39.5%, respectively. Conclusions: The type of CV reported by the different continuous glucose monitoring systems should be acknowledged. CV <36% might not be adequate to ensure low hypoglycaemia exposure. To our knowledge, the majority of continuous glucose monitoring reports the t‐CV. Appropriate thresholds should be used to identify patients that would probably meet time below range targets (t‐CV <40% or wd‐CV <34%). [ABSTRACT FROM AUTHOR]

Aim: The objective of the present real-life study in France was to assess and compare characteristics and outcomes in a cohort of pregnant women with type 1 diabetes (T1D) using intermittently scanned continuous glucose monitoring (isCGM) or conventional blood glucose monitoring (BGM). Material and Methods: We performed an observational study of a cohort of 153 women with T1D: 77 women were using isCGM, and 76 were using BGM. We compared the groups' maternal characteristics and maternal-fetal complications. The level of HbA1c was measured before pregnancy and then four times (after 8–12, 24–28, 30–33, and 35–37 weeks of gestation). Results: The two groups were similar in terms of age, prepregnancy BMI, diabetes duration, and diabetic vascular complications. There were no significant intergroup differences in the obstetric history. The spontaneous abortion rate was lower in the isCGM group than in the blood glucose monitoring group (5.3% vs. 20%, respectively; p =.0129), while the prepregnancy and first-trimester HbA1c levels were similar. There were no significant intergroup differences in the incidence of other maternal-fetal complications. Conclusions: This observational study demonstrates that isCGM use is associated with lower spontaneous abortion compared with conventional BGM. Large prospective studies are needed to corroborate our findings and fully understand the relationship between glucose data at the time of conception/early pregnancy and foetal outcome. [ABSTRACT FROM AUTHOR]

Capillary blood glucose monitoring is a standard safety protocol before administering insulin. Over the past 12 months, there has been a notable increase in patients under the district nursing service using a flash glucose sensor (FGS), which is a portable technological device inserted into the skin via a stamp-like mechanism. The device sits in the interstitial fluid under the skin; the device can be scanned using a sensor to obtain glucose readings, which can eliminate the need for capillary finger pricking. From experience, some people opt for this device, considering the pain and inconvenience associated with capillary finger pricking. Despite some patients already utilising FGS, some community teams may still have to take a capillary finger prick before insulin administration, depending on local trust policy. Interestingly, while looking into the reasons for this, one discovered some contradictory concerns over the safety of FGS due to a difference in time lag, where interstitial fluid readings differ from blood glucose readings. However, new national guidelines reflect the push towards this technological innovation that could revolutionise patient care in glucose monitoring and diabetes management. [ABSTRACT FROM AUTHOR]