Insight into continuous glucose monitoring: from medical basics to commercialized devices

Abstract

According to the latest statistics, more than 537 million people around the world struggle with diabetes and its adverse consequences. As well as acute risks of hypo-or hyper-glycemia, long-term vascular complications may occur, including coronary heart disease or stroke, as well as diabetic nephropathy leading to end-stage disease, neuropathy or retinopathy. Therefore, there is an urgent need to improve diabetes management to reduce the risk of complications but also to improve patient's quality life. The impact of continuous glucose monitoring (CGM) is well recognized, in this regard. The current review aims at introducing the basic principles of glucose sensing, including electrochemical and optical detection, summarizing CGM technology, its requirements, advantages and disadvantages. The role of CGM systems in the clinical diagnostics/personal testing, difficulties in their utilization and recommendations are also discussed. In the end, challenges and prospects in future CGM systems are discussed and non-invasive, wearable glucose biosensors are introduced. Though the scope of this review is CGMs and provides information about medical issues and analytical principles, consideration of broader use will be critical in future if the right systems are to be selected for effective diabetes management.

Gut-targeted therapies for type 2 diabetes mellitus: A review

“…In fact, this trend can already be seen in Table 1 , as some devices are no longer standalone gastrointestinal stimulation devices, but rather a treatment system. Lastly, one of the future directions will be electrical stimulation devices with personalized feedback[ 23 , 24 ]. Whether it is physical mechanical pressure stimulation or stimulation from sound waves and light waves, the core therapeutic goal is to control blood glucose within the ideal range.…”

Recent Advances in Applied Electrochemistry: A Review

“…The enzymatic reaction byproducts diffuse through the sensing membrane and are then oxidized or reduced on the electrode surface at a fixed potential that depends on the electrode material [140,141]. Typically, in the case of first-generation enzymatic glucose biosensors, the enzymatic oxidation of glucose by GOx leads to the production of hydrogen peroxide (H 2 O 2 ), which is oxidized at a positive potential of +0.7 V vs. a Ag/AgCl reference electrode or reduced at negative potentials (between −0.2 and 0 V) using mediators that lower the detection potentials and prevent interference problems [142]. Glucose biosensors are devices commonly used to monitor blood glucose levels in diabetic patients and represent one of the most widely used applications for glucose monitoring worldwide [143].…”

Integrated electronic/fluidic microneedle system for glucose sensing and insulin delivery

“…Individuals with diabetes mellitus utilize self-monitoring of blood glucose (SMBG) technologies, primarily employing finger prick sampling, to obtain real-time glycemic data. Subsequently, manual insulin injections are administered for optimal glucose regulation 10 - 13 . However, the need for frequent SMBG operations can cause tissue trauma and discomfort 14 , 15 , and the intermittent nature of blood sample collection fails to accurately reflect the body's glucose fluctuations 16 , 17 .…”