1. Diabetes: Glucose Monitoring
Topics in Bioengineering

2. 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!)

3. 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)

4. 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)
TMH Lee (2008) Sensors. 8:

5. Commercially Available Finger-Prick Glucose Meters
TMH Lee (2008) Sensors. 8: Table 1.

6. Inseong

7. i.v. insulin
glucose
i.v.
oral
Inseong
Tamada et al. (1995) Nature Medicine. Figure 1

8. Maura
Tamada et al. (1995) Nature Medicine. Figure 2

9. Maura
Tamada et al. (1995) Nature Medicine. Table 1

10. Michael
Tamada et al. (1995) Nature Medicine. Figure 3

11. What does it look like?
Paige
Tamada’s version was probably something like this…
Modern version? Commercially/clinically available?

12. Shrinidhi

13. GlucoDay (A. Menarini) Microdialysis CGMS Gold (Medtronic) Needle-type

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

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

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

17. Wrap-up
Kevin