Glucose Monitoring in Acute Care: Technologies on the Horizon

Abstract

Current glucose monitoring technology appears inadequate for the management of diabetic surgical and in critically ill patients requiring intensive insulin therapy. Subcutaneous sensors measure interstitial fluid glucose, and this technology has not yet been shown to provide the timely and accurate measurements necessary for intravenous insulin administration in surgical and critical care patients on intensive insulin therapy. Technologies under development that may be more suitable for surgical and intensive care unit patients are the automated intermittent type glucose monitors and central catheter glucose monitors. Improved accuracy, patient safety, incorporation of control algorithms, and alleviation of added nursing labor are important factors for consideration with future acute care glucose monitors. Hospital costs for these monitors are difficult to estimate but may be relatively low if their use can be related to better patient outcome, reduced labor costs, and increased job satisfaction for the nursing staff.

Electronic and Thermal Properties of Graphene and Recent Advances in Graphene Based Electronics Applications

“…As predicted by the World Health Organization (WHO), the number of diabetes patients has been gradually increasing [147], and such patients require the continuous monitoring of glucose levels in the interstitial fluid. Currently, only invasive methods are available for monitoring the glucose in the blood [148,149,150]. Lipani et al demonstrated a noninvasive, transdermal, path-selective, and specific glucose monitoring and detection system based on a miniaturized device array platform fabricated by a graphene thin-film method or screen-printing technology [151].…”

Multicenter Observational Study of the First-Generation Intravenous Blood Glucose Monitoring System in Hospitalized Patients

“…89 Clinicians in the future may utilize this near-continuous glucose monitoring system to perform a prospective randomized clinical trial to determine whether clinical outcome can be improved (decreased morbidity, mortality, length of stay, and hospital cost) as a result of optimized insulin therapy and BG control (avoidance of hyperglycemia, hypoglycemia, and glycemic variability). 61,79,90 A nearcontinuous IV glucose monitoring system that is safe, accurate, reliable, and user-friendly has great potential to be integrated with a computer controller and infusion pumps for IV insulin and IV glucose to produce a closed-loop in-hospital artificial pancreas.…”

Pilot Evaluation of a Prototype Critical Care Blood Glucose Monitor in Normal Volunteers

“…Regardless of which method is used, the process is laborintensive 27,28 and a recognized limitation to the practice of IIT. [29][30][31][32] Availability of an in-hospital automated BG monitor could facilitate implementation of IIT protocols through more effective titration of insulin therapy, improved BG control, and avoidance of hypoglycemia.…”