The use of non-invasive blood glucose detection techniques can help diabetic patients to alleviate the pain of intrusive detection, reduce the cost of detection, and achieve real-time monitoring and effective control of blood glucose. Given the existing limitations of the minimally invasive or invasive blood glucose detection methods, such as low detection accuracy, high cost and complex operation, and the laser source's wavelength and cost, this paper, based on the non-invasive blood glucose detector developed by the research group, designs a non-invasive blood glucose detection method. It is founded on dual-wavelength near-infrared light diffuse reflection by using the 1 550 nm near-infrared light as measuring light to collect blood glucose information and the 1 310 nm near-infrared light as reference light to remove the effects of water molecules in the blood. Fourteen volunteers were recruited for in vivo experiments using the instrument to verify the effectiveness of the method. The results indicated that 90.27% of the measured values of non-invasive blood glucose were distributed in the region A of Clarke error grid and 9.73% in the region B of Clarke error grid, all meeting clinical requirements. It is also confirmed that the proposed non-invasive blood glucose detection method realizes relatively ideal measurement accuracy and stability.
ObjectiveTo understand the relation between blood glucose regulating hormones and gastric cancer, so as to provide some new ideas for diagnosis and treatment of gastric cancer. MethodBy reviewing and screening relevant domestic and foreign literatures, the latest researches on the relation between blood glucose regulating hormones and gastric cancer were summarized. ResultsThe insulin, glucagon, adrenaline, growth hormone, and the other blood glucose regulating hormones all played the roles in promoting the occurrence and development of gastric cancer. However, glucocorticoids and somatostatin were protective hormones that maintained gastric homeostasis and inhibited the proliferation of gastric cancer cells. ConclusionBlood glucose regulating hormones play some roles in diagnosis and treatment of gastric cancer, but specific mechanisms such as interaction between blood glucose regulating hormones, role of glucose metabolism in biological behavior of gastric cancer, and effect of blood glucose regulating hormones on oncogene initiation are unclear, so prospective clinical control studies still need to be studied.
ObjectiveTo investigate the change of blood glucose and its clinical significance in patients with acute pancreatitis (AP). MethodsThe regularity of blood glucose change and the relation between the regularity and the prognosis were analyzed in 115 patients with AP and hyperglycemia.ResultsBlood glucose was increased with a median (M) of 8.7 mmol/L，18.45 mmol/L and 27.22 mmol/L, which gradually decreased to normal value within 3-17 days, 7-26 days and 24-46 days after treatment,respectively in patients with mild AP, type Ⅰ of severe acute pancreatitis (SAP) and type Ⅱ of SAP. There was marked statistical difference among the three groups. A smaller dose of regular insulin was used for 36 patients with mild AP; however, a larger dose of regular insulin was used for all 30 patients with SAP.ConclusionThe level of blood glucose, the dose of regular insulin and the duration of hyperglycemia increase with the severity of AP.
ObjectiveTo explore the relationship between glycated hemoglobin (HbA1c) level and blood glucose fluctuations after coronary artery bypass grafting (CABG) and adverse events in non-diabetic patients, thus providing theoretical support for intensive preoperative blood glucose management in patients undergoing CABG surgery.MethodsA total of 304 patients undergoing CABG with or without valvular surgery from October 2013 to December 2017 were enrolled in this prospective, single-center, observational cohort study. We classified them into two different groups which were a low-level group and a high-level group according to the HbA1c level. There were 102 males and 37 females, aged 36–85 (61.5±9.5) years in the low-level group, and 118 males and 47 females aged 34–85 (63.1±9.4) years in the high-level group. The main results were different in hospital mortality and perioperative complications including in-hospital death, myocardial infarction, sternal incision infection, new stroke, new-onset renal failure and multiple organ failure. To assess the effects of confounding factors, multivariate logistic regression analysis was used.Results Postoperative blood glucose fluctuation was more pronounced in the high-level group than that in the low-level group before admission [0.8 (0.6, 1.2) mmol/L vs. 1.0 (0.8, 1.8) mmol/L, P<0.01]. This study also suggested that the incidence of major adverse events was significantly lower in the low-level group compared with the high-level group (P=0.001). Multivariate logistic regression analyses to correct the influence of other confounding factors showed that HbA1c (OR=2.773, P=0.002) and postoperative blood glucose fluctuations (OR=3.091, P<0.001) could still predict the occurrence of postoperative adverse events.ConclusionHbA1c on admission can effectively predict blood glucose fluctuations in 24 hours after surgery. Secondly, HbA1c on admission and postoperative blood glucose fluctuations can further predict postoperative adverse events. It is suggested that we control the patient's preoperative HbA1c at a low level, which is beneficial to control postoperative blood glucose fluctuation and postoperative adverse events.
Objective To investigate the long-term dynamic changes of liver function and glucose-lipid metabolism in human immunodeficiency virus (HIV)-infected patients with metabolic dysfunction-associated fatty liver disease (MAFLD) after antiretroviral therapy (ART). Methods HIV-infected patients who visited Public Health Clinical Center of Chengdu between October 1st, 2012 and June 30th, 2013 were recruited and divided into two groups according to whether they had MAFLD or not. All of them were treated with the first-line regimen of tenofovir + lamivudine + efavirenz for 156 weeks, and the anthropometric indices, liver function, and levels of glucose, lipids and uric acid were measured at baseline and at each follow-up time point. In addition, the long-term dynamic characteristics of liver function and glucose and lipid metabolism parameters of the two groups were compared during the 156 weeks of ART treatment. Results A total of 61 male HIV-infected patients were enrolled. The prevalence of MAFLD in them was 31.1% (19/61) at baseline and increased by 4.9 percentage points per year after ART. Before the start of follow-up (week 0), the levels of alanine aminotransferase (ALT) [(46.23±27.09) vs. (28.00±17.43) U/L, P=0.002] and γ-glutamyl transpeptidase (GGT) [(41.46±9.89) vs. (24.02±10.72) U/L, P<0.001] were higher in the MAFLD group than those in the non-MAFLD group, while the between-group differences in the levels of aspartate aminotransferase (AST) [(33.33±15.61) vs. (28.98±12.43) U/L, P=0.248] and alkaline phosphatase [(85.30±21.27) vs. (83.41±24.47) U/L, P=0.773] were not statistically significant. During the 156-week follow-up period, the 4 items of liver function gradually increased in the MAFLD group, especially from week 120 onwards, 3 of which (ALT, AST and GGT) were significantly higher than those in the non-MAFLD group (P<0.05). In addition, the levels of fasting blood glucose, triglyceride, total cholesterol, and low-density lipoprotein were also significantly higher in the MAFLD group than those in the non-MAFLD group at some time points during the 156-week follow-up period (P<0.05). Conclusions Compared with HIV-infected patients without MAFLD, HIV-infected patients with MAFLD are more likely to develop impaired liver function and disorders of glucose and lipid metabolism during long-term tenofovir + lamivudine + efavirenz regimen ART treatment. Therefore, close clinical monitoring of liver function and glucose and lipid metabolism related parameters is required for such patients.
摘要:目的:探讨经尿道前列腺电切术中糖尿病患者血糖变化以及处理对策。方法:2006年7月~ 2009年1月共对80例患有前列腺增生合并糖尿病患者行TURP,同期对80例单纯性前列腺增生患者进行相同手术,回顾分析其术前、术中30 min、60 min、90 min 指尖血糖变化及干预情况。结果:治疗组80例患者,51例术中血糖值明显低于术前,分别为1.8～3 mmol/L;对照组术前与术中血糖值基本一致,血糖波动于4.5～5.6 mmol/L。结论:糖尿病患者糖的储备能力差,在行经尿道电切术中易发生低血糖综合征,术中及时的血糖监测及干预对保证患者的安全有重要意义。Abstract: Objective: To study the changes and measures against the glucose in the operation of the Diabetes by TURP. Methods:Eighty patients with prostate combining diabetes operated from July 2006 to Jan. 2009 were reviewed, and 80 prostate treated at the same period with the same operation measure were selected as control. The preoperative glucose, intraoperative glucose (30′, 60′,90′) of fingertip, and countermeasures were studied and compared between the two groups. Results:Fiftyone cases of the experimental group of intraoperative blood glucose was significantly lower than preoperative values, respectively 1.83 mmol/ L; control group preoperative and intraoperative blood glucose values were basically the same, blood glucose fluctuations in the 4.55.6 mmol/L. Conclusion: The capacity in patients with diabetes is poor, easy to hypoglycemia syndrome in the act of TURP surgery, intraoperative blood glucose monitoring and timely intervention to ensure patient safety significance.
Objective To investigate the accuracy of continuous glucose monitoring (CGM) system in emergency critically ill patients. Methods Critically ill patients admitted to the Intensive Care Unit of Department of Emergency Medicine, West China Hospital of Sichuan University between August 2022 and February 2023 were continuously enrolled. Blood glucose monitoring was performed using CGM system, while blood glucose in the patient’s fingertips was monitored every 4 hours. The correlation and consistency of blood glucose values between CGM system and fingertip glucose detection were compared. Results A total of 52 patients were included, and 1 504 matching blood glucose pairs were formed with fingertip blood glucose values. The overall correlation coefficient was 0.874 (P<0.001), the mean absolute relative difference was 14.50%, and the highest mean absolute relative difference (31.76%) was observed in the hypoglycemic range (<3.9 mmol/L). The percentage of CGM system blood glucose within ±15%, ±20% and ±30% of fingertip blood glucose was 56.65%, 75.56% and 94.75%, respectively. The intra-group correlation coefficient between CGM system blood glucose and fingertip blood glucose was 0.85 on the consistency test, and the Bland-Altman plot showed acceptable clinical accuracy. Conclusions The overall accuracy of the application of CGM system in critically ill patients is reasonable, but the accuracy in the range of low blood glucose values is poor. Whether the auxiliary use of CGM system can improve the blood glucose management of critically ill patients and reduce medical costs needs to be further studied.
Objective To evaluate the accuracy of newer-generation home blood glucose meter (Accu-Check? Integra) in patients with impaired glucose regulation (IGR) and newly-diagnosed type 2 diabetes mellitus. Methods A cross-sectional study was performed on 109 cases with newly-diagnosed type 2 diabetes or IGR who were asked to take oral glucose tolerance test (OGTT), while paired samples, that were Accu-Check? Integra in capillary blood glucose (CBG) and laboratory glucose in venous plasma glucose (VPG ), were taken simultaneously. Taking VPG as the reference value, the accuracy of the home glucose meter was assessed according to the international standardization organization (ISO), including, the accuracy was studied by means of Median absolute difference (Median AD) and Median absolute relative difference (Median RAD), the consistency of CBG and VPG was studied by Clarke Error Grid analysis, the correlation of CBG and VPG was analyzed according to liner regression analysis, and the sensitivity and specificity for hyperglycemia were also calculated. Results There were 292 VPG values paired with CBG values, among which 93.49% of CBG values met ISO home glucose meter criteria, the median AD was 7.2 mg/dL, and the median RAD was 4.76%. Paired glucose measurements from the Accu-Check Integra meter and laboratory glucose measurement demonstrated that 100% of paired points in the overall subject population fell in zones A and B of the Clarke Error Grid. The CBG value was well correlated to VPG value in the overall level, and the sensitivity and specificity were 94.6% and 95.7% respectively for hyperglycemia. Conclusion The newer-generation home blood glucose meter (Accu-Check? Integra) demonstrates a high degree of accuracy, and it can precisely report the real value of blood glucose.
ObjectiveTo investigate the association between the admission fasting blood glucose-to-albumin ratio (FAR) and short-term prognosis in patients with abdominal aortic aneurysm (AAA) underwent open surgical repair (OSR) or endovascular aneurysm repair (EVAR). MethodsA retrospective study was conducted on patients with AAA who underwent OSR or EVAR at Nanjing Drum Tower Hospital from January 2020 to January 2024 and met the inclusion criteria. The receiver operating characteristic (ROC) curve was used to evaluate the discriminative ability of the FAR for in-hospital mortality after AAA surgery and to determine its optimal cutoff value. Patients were then divided into a low-FAR group (FAR below the cutoff) and a high-FAR group (FAR equal to or above the cutoff) based on this value. Logistic regression analysis, Cox proportional hazards regression models, and Kaplan-Meier survival curves were employed to examine the relation between FAR and postoperative severe complications (Clavien-Dindo grade Ⅲ or above) as well as in-hospital all-cause mortality. ResultsA total of 191 patients were included in this study. The area under the ROC curve of FAR for predicting in-hospital mortality was 0.707 [95%CI (0.637, 0.770)], with an optimal cutoff value of 2.33. There were 164 patients in the low-FAR group and 27 in the high-FAR group. The incidence of postoperative severe complications and in-hospital all-cause mortality were significantly higher in the high-FAR group compared to the low-FAR group [22.22% (6/27) vs. 12.20% (20/164), χ2=5.22, P=0.029; 14.81% (4/27) vs. 2.44% (4/164), χ2=6.03, P=0.014]. An elevated FAR was identified as a risk factor for both postoperative severe complications [OR (95%CI)=1.49 (1.27, 1.88), P=0.018] and in-hospital all-cause mortality [OR (95%CI)=1.35 (1.29, 3.06, P=0.047]. Kaplan-Meier survival analysis showed significantly worse survival in patients with a high-FAR compared to those with a low-FAR (χ2=10.44, P=0.001). ConclusionElevated AAR is a risk factor for poor in-hospital prognosis in AAA patients treated with OSR or EVAR and may serve as a valuable marker for assessing short-term outcomes.
Blood glucose monitoring has become the weakest point in the overall management of diabetes in China. Long-term monitoring of blood glucose levels in diabetic patients has become an important means of controlling the development of diabetes and its complications, so that technological innovations in blood glucose testing methods have far-reaching implications for accurate blood glucose testing. This article discusses the basic principles of minimally invasive and non-invasive blood glucose testing assays, including urine glucose assays, tear assays, methods of extravasation of tissue fluid, and optical detection methods, etc., focuses on the advantages of minimally invasive and non-invasive blood glucose testing methods and the latest relevant results, and summarizes the current problems of various testing methods and prospects for future development trends.