Life Glucose Monitoring

The ideal glucose monitoring system should be non invasive, should allow continuous or frequent monitoring over long periods without the need to replace the changeable parts (strip, transdermal patch, etc.), should interfere minimally with daily life, and, last but not least, should be low in cost. 

FIGURE 33-19 Photograph of a blood glucose monitor for in home use. The meter (a) contains the electronics and display. A droplet of blood is placed on a test strip (b). which is placed at the top of the meter. The test strip contains immobilized glucose oxidase and electrodes for the amperometric detection system. (Courtesy of Life-Scan. Inc., Milpitas. CA.)... 

There can be no question that the availabihty of affordable home blood glucose monitoring has revolutionised the quahty of life experienced by diabetics. However, there are some inherent limitations with an enzymatic approach. The systems have to be stored appropriately, they are specific only for a few saccharides and in most cases they become unstable under harsh conditions and hence cannot be sterilised. For this reason, much work has been focused on the development of synthetic sensors with the capacity to monitor saccharides under a broad range of environmental conditions, and thus allow access to a wider spread of diagnostic applications. 

Pleus S, Schmid C, Link M, Zschomack E, Klotzer HM, Haug C, Freckmann G (2013) Performance evaluation of a continuous glucose monitoring system under conditions similar to daily life. J Diabetes Sci Technol 7(4) 833—841... 

Ramchandani N, Arya S, Ten S, Bhandari S (2011) Real-life utilization of real-time etmtin-uous glucose monitoring the complete picture. J Diabetes Sci Technol 5(4) 860-870... 

Kropff J, Bruttomesso D, Doll W, Farret A, Galasso S, Luijf YM, Mader JK, Place J, Boscari F, Pieber TR, Renard E, DeVries JH (2015) Accuracy of two continuous glucose monitoring systems. A head-to-head comparison under clinical research centre and daily life conditions. Diabetes Obes Metab 17(4) 343-349... 

Monitor blood glucose several times daily in patients with CFRD or those taking systemic corticosteroids. Follow glycosylated hemoglobin levels on an outpatient basis to assess long-term glucose control. Levels may be falsely low in CF due to a shorter red blood cell half-life. 

Uses Chronic asthma Actions Topical steroid Dose Two inhalations tid-qid or 4 inhal bid Caution [C, ] Contra Component aU gy Disp Met-dose inhaler SE Cough, oral candidiasis Interactions T Risk of GI bleed W/ ASA, NSAIDs T effects W/ sakneterol, troleandomycin -1- effects W/barbiturates, hydantoins, pheny-toin, rifampin T effects OF diuretics, insulin, oral hypoglycemics, K supl, salicylates, somatrem, live virus vaccines EMS May affect glucose(hyperglycemia) monitor ECG for hypokalemia (flattened T waves) concurrent ASA/NSAID use may t risk of GI bleeding OD Acute OD unlikely to cause life-threatening Sxs, chronic OD may lead to S/Sxs of muscle weakness, and osteoporosis symptomatic and supportive... 

Analytical chemistry impacts on every aspect of modern life. The food and drink we consume is tested for chemical residues and appropriate nutritional content by analytical chemists. Our health is monitored by chemical tests (e.g. cholesterol, glucose), and international trade is underpinned by measurements of what is being traded (e.g. minerals, petroleum). Courts rely more and more on forensic evidence provided by chemistry (e.g. DNA, gun-shot residues), and the war on terrorism has caused new research into detection of explosives and their components. Every chemical measurement must deliver a result that is sufficiently accurate to allow the user to make appropriate decisions it must be fit for purpose. 

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