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Diabetes: Glucose Monitoring. Topics in Bioengineering 11/12/2012. 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
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Diabetes: Glucose Monitoring Topics in Bioengineering 11/12/2012
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 • Complications: • Cardiovascular diseases (risk doubled) • Diabetic retinopathy (impaired vision, blindness) • Diabetic nephropathy (chronic kidney disease, dialysis) • Diabetic neuropathy (numbness, tingling foot ulcers amputation) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/ http://en.wikipedia.org/wiki/Diabetes_mellitus
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_mellitus TMH Lee (2008) Sensors. 8:5535-5559.
Commercially Available Finger-Prick Glucose Meters Julianne? TMH Lee (2008) Sensors. 8:5535-5559. Table 1.
Suzy Tamada et al. (1995) Nature Medicine. Figure 1
Ashley Tamada et al. (1995) Nature Medicine. Figure 2
Julianne Tamada et al. (1995) Nature Medicine. Table 1
Ashley Tamada et al. (1995) Nature Medicine. Figure 3
What does it look like? Tamada’s version was probably something like this… Modern version? Commercially/clinically available? 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
GlucoDay (A. Menarini) Microdialysis CGMS Gold (Medtronic) Needle-type http://www.medtronic.co.jp/about-medtronic/news-release/2009/2009-13/index.htm http://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
Philicia Wentholt et al. (2005) Diabetes Care. Figure 1
Kelsey Wentholt et al. (2005) Diabetes Care. Figure 2
Kelsey Wentholt et al. (2005) Diabetes Care. Figure 3