Diabetes: Glucose Monitoring

Topics in Bioengineering

Diabetes background: Trivia

• What are the three main types?– Type I (children, no insulin)– Type II (adults, insulin

resistance)– Gestational (resolves after

pregnancy• What cells make insulin?– Beta cells

• Where are they found?– Pancreas, Islets of

Langerhans

• How many people in the US?– 20 million

• How many people worldwide?– 346 million (type II only!)

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/ http://en.wikipedia.org/wiki/Diabetes_mellitus

Diabetes – huge healthcare problem!

• Type I is autoimmune, causes unknown (requires insulin)

• Life-long, no cure• Type II linked with obesity

(sometimes managed/ reversed with drugs, lifestyle changes)

• Gestational: if not carefully managed, serious risks for mother and baby

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/ http://en.wikipedia.org/wiki/Diabetes_mellitus

Complications:• Cardiovascular diseases (risk

doubled)• Diabetic retinopathy (impaired

vision, blindness)• Diabetic nephropathy (chronic

kidney disease, dialysis)• Diabetic neuropathy (numbness,

tingling foot ulcers amputation)

How is it managed?

• Insulin first available in 1921• Blood glucose must be tightly

monitored and controlled glucose biosensors

• Types:– Finger prick (still most common?)– Continuous (insert sensor SubQ)– Microdialysis (still requires SubQ

implant)– Reverse iontophoresis

(noninvasive)

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/ http://en.wikipedia.org/wiki/Diabetes_mellitusTMH Lee (2008) Sensors. 8:5535-5559.

Commercially Available Finger-Prick Glucose Meters

TMH Lee (2008) Sensors. 8:5535-5559. Table 1.

Inseong

Tamada et al. (1995) Nature Medicine.

Figure 1

Inseongi.v. insulin oralglucose i.v.

Tamada et al. (1995) Nature Medicine.

Figure 2

Maura

Tamada et al. (1995) Nature Medicine.

Table 1

Maura

Tamada et al. (1995) Nature Medicine.

Figure 3

Michael

What does it look like?

Tamada’s version was probably something like this…

https://www.google.com/search?q=transdermal%20extraction%20of%20glucose&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-

8&hl=en&tbm=isch&source=og&sa=N&tab=wi&ei=XB6hUMTrOIa50QHl9IAQ&biw=1366&bih=644&sei=dh6hUMj8AfDh0wGvqoGoDQ

Modern version? Commercially/clinically available?

Paige

Shrinidhi

CGMS Gold (Medtronic)Needle-type

http://www.medtronic.co.jp/about-medtronic/news-release/2009/2009-13/index.htmhttp://www.diabetesdaily.com/voices/2012/07/my-lovehate-relationship-with-the-cgm-continuous-glucose-monitor/ http://216.71.46.171/diabetesforum/articles/2003/2003_A2/04%20weitgasser%202003%20A2.htm

GlucoDay (A. Menarini)Microdialysis

Wentholt et al. (2005) Diabetes Care. Figure 1

Shrinidhi

Wentholt et al. (2005) Diabetes Care. Figure 2

Anna

Wentholt et al. (2005) Diabetes Care. Figure 3

Felix

Wrap-upKevin