bims-glumda 2025-05-04 papers

bims-glumda

Biomed News

on CGM data in management of diabetes

Issue of 2025–05–04
25 papers selected by
Mott Given

Enhancing Continuous Glucose Monitoring: The Role of AI in Supporting AGP Interpretation.
JNCQ1024-Glycemic outcomes and nurse perceptions of continuous glucose monitoring for hospitalized patients.
Adolescent- and Young Adult-Reported Outcomes and Use of Continuous Glucose Monitoring Features: A Report from the CITY Trial.
Continuous Glucose Monitoring User-Wear Experience Fosters Empathy and Learning.
Proposed minimum requirements for market approval of continuous glucose monitoring (CGM) systems: A viewpoint from the IFCC working group on CGM.
Continuous Glucose Monitoring Provides Durable Glycemic Benefit in Adolescents and Young Adults with Type 1 Diabetes: 12-Month Follow-Up Results.
Real-World Accuracy of a Continuous Glucose Monitoring System after Radiologic Exposure.
Real-World Insights Into Hypoglycemia Risk While Driving in Teens and Young Adults With Type 1 Diabetes.
Plasma C-Peptide Level and Continuous Glucose Monitoring-Derived Coefficient of Variation as a Predictable Risk Factor for Hypoglycemia in Koreans with Diabetes.
Similar Perceptions on Continuous Glucose Monitor Use amongst Youth with Type 1 and Type 2 Diabetes.
The experiences of high-risk young adults with type 1 diabetes transitioning to real-time continuous glucose monitoring - A thematic analysis.
Associations of >1-hour versus ≤1-hour meal timing variability (eating jetlag) with plasma glycemic parameters and continuous glucose monitoring measures among pregnant females: A prospective cohort study.
Glycated albumin and fructosamine do not improve accuracy of glycaemic control assessment in patients with conditions reported to affect HbA1c reliability.
Subsequent Device Usage and Caregiver Attitudes to Do-It-Yourself Real-Time Continuous Glucose Monitoring (DIY-rtCGM) among Children with Type 1 Diabetes 3 Months after Participation in a Randomized Controlled Trial.
Current Status of Continuous Glucose Monitoring Use in South Korean Type 1 Diabetes Mellitus Population-Pronounced Age-Related Disparities: Nationwide Cohort Study.
Effects of lacto-vegetarian and vegan diets on glycemic responses and metabolite profiles in healthy adults: A randomized trial using continuous glucose monitoring and targeted metabolomics.
A Deep Sparse Capsule Network for Non-Invasive Blood Glucose Level Estimation Using a PPG Sensor.
Adolescent-Initiated Retrospective Glucose Data Review is Associated With Improved Glycemia in Type 1 Diabetes Mellitus.
Effectiveness of Physical Activity Support Combined With Continuous Glucose Monitoring by a Physical Therapist in Preconception Care for a Woman With Type 2 Diabetes Mellitus: A Case Study.
Improved Fully 3D-Printed SIW-Based Sensor for Non-Invasive Glucose Measurement.
The FreeStyle Libre 2 system demonstrates limited analytical accuracy without resulting in detrimental clinical decisions.
Blood Glucose Prediction Algorithms Require Clinically Relevant Performance Criteria Beyond Accuracy.
Disparities in Glycemic Outcomes Persist in Youth with Type 1 Diabetes and High-Technology Use.
Emission Integral Effect on Non-Invasive Blood Glucose Measurements Made Using Mid-Infrared Passive Spectroscopic Imaging.
Point-of-care colorimetric biosensor for H2O2 and glucose detection utilizing the peroxidase-like activity of 2D bimetallic metal organic framework nanosheets.

J Diabetes Sci Technol. 2025 Apr 28. 19322968251337479

Enhancing Continuous Glucose Monitoring: The Role of AI in Supporting AGP Interpretation.

Tharun Anand Reddy Sure.



Keywords:  AI-driven models; ambulatory glucose profile (AGP); artificial intelligence (AI); clinical validation; clinician judgment; continuous glucose monitoring (CGM); data interpretation; diabetes management; expert opinions; glycemic control; health information integration; hybrid approach; insights; insulin adjustment; machine learning (ML); metabolic decline; patient-specific; personalized therapy; pregnancy metrics; time in range

DOI:  https://doi.org/10.1177/19322968251337479
J Nurs Care Qual. 2024 Oct-Dec 01;39(4):39(4): E68

JNCQ1024-Glycemic outcomes and nurse perceptions of continuous glucose monitoring for hospitalized patients.

DOI: https://doi.org/10.1097/NCQ.0000000000000800
Pediatr Diabetes. 2023 ;2023 6906023

Adolescent- and Young Adult-Reported Outcomes and Use of Continuous Glucose Monitoring Features: A Report from the CITY Trial.

Laurel H Messer, Colleen Bauza, Kellee M Miller, Mark A Clements, Daniel J DeSalvo, Jennifer Sherr, Ruth S Weinstock, Korey Hood, Lori M Laffel.

Objective: To evaluate patterns of continuous glucose monitor (CGM) use and perceptions of quality of life in adolescents/young adults with type 1 diabetes (T1D) after using CGM for up to 52 weeks in the CGM Intervention in Teens and Young (CITY) Adults randomized clinical trial (RCT). Subjects and Methods. Participants with T1D were initially randomized 1 : 1 to use of CGM or blood glucose meter (BGM) for 26 weeks. Following the RCT, participants in the BGM group initiated CGM (BGM-CGM cohort) and participants in the CGM group continued CGM (CGM-CGM cohort) for another 26 weeks. Problem Areas in Diabetes Survey-Pediatric Version (PAID-peds), Glucose Monitoring Satisfaction Survey (GMSS), Hypoglycemia Confidence Scale (HCS), Diabetes Technology Attitudes (DTA), Pittsburgh Sleep Quality Index (PSQI), Benefits of CGM, and Burdens of CGM were completed at baseline, 26 and 52 weeks.
Results: In both cohorts, >70% of participants were wearing CGM > 5 days/week at 52 weeks; 5% discontinued CGM. The majority used the mobile app to receive glucose data. Adolescents (14 to <19 years) were more likely to use SHARE features than young adults (80% versus 41%). CGM-CGM participants had significantly higher scores on GMSS, DTA, and HCS at 52 weeks compared with baseline, and reported higher benefit and lower burden perceptions than at baseline. Similar results were observed for the BGM-CGM cohort.
Conclusions: Improvements in self-reported measures were observed in adolescents and young adults using CGM. As CGM use is also associated with better glycemic control, utilizing CGM may contribute to improving both medical outcomes and emotional health.

DOI: https://doi.org/10.1155/2023/6906023
Am J Pharm Educ. 2025 Apr 23. pii: S0002-9459(25)00055-5. [Epub ahead of print] 101410

Continuous Glucose Monitoring User-Wear Experience Fosters Empathy and Learning.

Alison Lobkovich, Rena Dabish, Alexandra Maria Gavrilidis, Brian Globerman, Helen D Berlie.

   OBJECTIVES: To determine if a continuous glucose monitoring (CGM) user-wear experience brings value to an advanced diabetes elective course by assessing impact on empathy and knowledge.
METHODS: This was a quasi-experimental pre-post intervention study, conducted over two offerings of an advanced diabetes elective course. Third-year pharmacy students participated in a two-part didactic education and user-wear experience involving CGM devices. Students completed a survey at three pre-specified time points to assess empathy and knowledge (foundational and counseling knowledge). Empathy was assessed using the Kiersma-Chen Empathy Scale. Knowledge was assessed using pre-defined multiple-choice questions. Statistical tests include repeated measures Analysis of Variance (ANOVA) and Bonferroni tests for overall and subsection scores on the empathy and knowledge surveys. A partial eta squared was also used to measure effect size for the repeated measures ANOVA test.
RESULTS: Twenty-nine out of the thirty-six enrolled students completed all three surveys. Compared to a traditional lecture, the CGM user-wear experience demonstrated a significant increase in student self-perceived empathy and in counseling knowledge. No change in foundational knowledge was observed.
CONCLUSION: A CGM user-wear experience provides educational value beyond a traditional lecture. Our study showed that educational outcomes such as empathy and counseling knowledge can be achieved by implementing a CGM user-wear experience. An advanced diabetes elective course provides an ideal environment to optimize CGM learning outcomes with a user-wear experience.

Keywords:  continuous glucose monitor; didactic elective; empathy; technology; user-wear

DOI:  https://doi.org/10.1016/j.ajpe.2025.101410
Diabetes Obes Metab. 2025 Apr 28.

Proposed minimum requirements for market approval of continuous glucose monitoring (CGM) systems: A viewpoint from the IFCC working group on CGM.

Working Group on Continuous Glucose Monitoring of the IFCC Scientific Division

DOI: https://doi.org/10.1111/dom.16420
Pediatr Diabetes. 2023 ;2023 6718115

Continuous Glucose Monitoring Provides Durable Glycemic Benefit in Adolescents and Young Adults with Type 1 Diabetes: 12-Month Follow-Up Results.

for the CITY Study Group

Objective: To further evaluate glycemic outcomes during the observational extension phase of the Continuous Glucose Monitoring (CGM) Intervention for Teens and Young Adults randomized clinical trial (RCT). Subjects and Methods. Following a 26-week RCT comparing CGM with blood glucose monitoring (BGM) in 153 adolescents and young adults aged 14 to <25 years old with suboptimally controlled type 1 diabetes, 70 (89%) participants in the BGM group initiated use of CGM (referred to as BGM-CGM cohort), and 70 (95%) participants in the CGM group continued to use of CGM (CGM-CGM cohort) for an additional 26 weeks.
Results: In the CGM-CGM cohort, mean hemoglobin A1c (HbA1c) decreased from 8.9% ± 0.9% (74 ± 9.8 mmol/mol) at randomization to 8.3% ± 1.3% (67 ± 14.2 mmol/mol) at 52 weeks (p < 0.001); however, significant improvement in time in target range (TIR) 70-180 mg/dL was not observed from prerandomization (38% ± 13%) to 52 weeks (41% ± 18%). Median percent time <70 mg/dL decreased from 3.0% before randomization to 1.1% at 52 weeks (p < 0.001). In the BGM-CGM cohort, mean HbA1c decreased from 8.9% ± 1.2% (74 ± 13.1 mmol/mol) before CGM initiation to 8.5% ± 1.3% (69 ± 14.2 mmol/mol) after 26 weeks of CGM use (p < 0.001) and mean TIR increased from 34% ± 12% to 38% ± 15% (p=0.01). The median percent time <70 mg/dL decreased from 3.3% before CGM initiation to 1.2% after 26 weeks of CGM use (p < 0.001). No participants discontinued CGM use during the extension phase.
Conclusions: This further evaluation of CGM supports the findings of the preceding RCT that use of CGM improves glycemic control and reduces hypoglycemia in adolescents and young adults with type 1 diabetes. This trial is registered with NCT03263494.

DOI: https://doi.org/10.1155/2023/6718115
Pediatr Diabetes. 2024 ;2024 2210509

Real-World Accuracy of a Continuous Glucose Monitoring System after Radiologic Exposure.

Siobhan Tellez, Lindsey Hornung, Emily Smith, Andrew Trout, Samuel Brady, Colleen Lowe, Joshua Courter, Maisam Abu-El-Haija, Deborah Elder.

Background: The increasing use of continuous glucose monitor (CGM) necessitates a review of variables that impact accuracy and interrupt use. Manufacturer recommendations include removing CGMs before diagnostic imaging, such as X-ray and computed tomography (CT). Early removal and replacement of CGM components present financial, clinical, and psychosocial burdens to the wearer and interrupt optimal management of diabetes for pediatric patients who receive a total pancreatectomy with islet autotransplantation (TPIAT). The study's aim was to evaluate the effect of scatter dose exposure during X-ray or CT if the CGM remained intact but outside the field of view (FoV).
Materials and Methods: Participants were followed through the first 3 months after TPIAT surgery, managed diabetes with an insulin pump and CGM, and were routinely exposed to diagnostic imaging. Participants' CGMs were unshielded by a protective apron during any X-ray or CT procedures for the duration of the study period, and the transmitter was collected after expiration or removal. Glucometer data was collected from hospital records and home glucometer downloads. Mixed models were used to analyze absolute differences between matched CGM and glucometer values, and Clarke error grid analyses (EGA) were performed. Scatter dose exposure was derived using anthropomorphic phantoms and calculated retrospectively.
Results: A total of 14 patients (median 12.2 years, 64% female) received a median of five diagnostic imaging procedures with a median cumulative scatter dose of 559 µGy. The absolute difference between the CGM and glucometer values was not significantly associated with the cumulative scatter dose (p=0.17) or time from TPIAT (p=0.24) when analyzed in a mixed model. Regardless of scatter dose exposure, time from TPIAT, or glucometer, ≥98% of glucose values fell within zones A and B on EGA.
Conclusion: Scatter dose exposure from diagnostic imaging did not affect the clinical accuracy of CGM values for the duration of transmitter use. Leaving CGM components in place when not in the FoV during diagnostic imaging successfully mitigated interruptions to use and undue burden or cost to participants.

DOI: https://doi.org/10.1155/2024/2210509
Pediatr Diabetes. 2025 ;2025 5053872

Real-World Insights Into Hypoglycemia Risk While Driving in Teens and Young Adults With Type 1 Diabetes.

Kalyan Pamidimukkala, Michael L Ferm, Madhav Erraguntla, Balakrishna Haridas, Achu Byju, Mark Lawley, Sruthi Menon, Carolina Villegas, Siripoom McKay, Daniel J DeSalvo.

  Background: Clinical guidelines on driving for people with diabetes exist, but there are limited studies analyzing glucose data and hypoglycemia risk while driving. No published studies have analyzed teenage or emerging adult drivers with type 1 diabetes (T1D). The primary aim of our pilot study was to explore the glycemic patterns of young drivers with T1D as they relate to clinical guidelines and identify trends that could be used to improve road safety. Methods: In this pilot study, we collected continuous glucose monitoring (CGM) data from five drivers with T1D (median age 19, range 17-21 years) over a 1-month period. The driving trips were divided into two categories: (1) Short trips (<60 min) and (2) Long trips (≥60 min). Hypoglycemia was defined as <70 mg/dL as recorded by CGM for at least four consecutive readings. Trips <10 min were excluded from the analysis. Results: Data on 284 total trips with associated CGM readings were recorded. The average number of trips taken by drivers during the study was 56.8 trips (range 9-82). For short trips (n = 276), no episodes of hypoglycemia occurred when starting glucose was >90 mg/dL (n = 227). For short trips with starting glucose of 70-90 mg/dL (n = 32), each hypoglycemic event (n = 5) had a drop in the first CGM glucose value while driving. Seventeen (5.7%) of short trips started with a glucose <70 mg/dL. A total of eight long trips (>60 min) were recorded, all had a starting CGM value of >90 mg/dL, and none had hypoglycemia events. Conclusions: These real-world findings from a small sample of teenage and young adult drivers with T1D support the American Diabetes Association (ADA) recommendation for starting glucose of >90 mg/dL when driving. Larger studies would be helpful in clearly identifying and improving road safety concerns in young drivers with T1D.

Keywords:  continuous glucose monitoring (CGM); driving; hypoglycemia

DOI:  https://doi.org/10.1155/pedi/5053872
Endocrinol Metab (Seoul). 2025 Apr;40(2): 198-200

Plasma C-Peptide Level and Continuous Glucose Monitoring-Derived Coefficient of Variation as a Predictable Risk Factor for Hypoglycemia in Koreans with Diabetes.

Seung-Hyun Ko.

DOI: https://doi.org/10.3803/EnM.2025.2403
Pediatr Diabetes. 2023 ;2023 1979635

Similar Perceptions on Continuous Glucose Monitor Use amongst Youth with Type 1 and Type 2 Diabetes.

Alexander Phu, Tyger Lin, Jacquelyn A Manfredo, Elizabeth A Brown, Risa M Wolf.

Methods: Youth with T1D and T2D (currently on insulin therapy) without current CGM participated in a prospective CGM study and were given a series of questionnaires when starting CGM intervention. BenCGM and BurCGM questionnaires assessed the participant's perspectives on continuous glucose monitor use, while DDS surveys assessed participants' QoL associated with diabetes. Survey results were compared between T1D and T2D groups, and multivariable analysis was used to assess differences in perceptions of continuous glucose monitor use in youth with diabetes.
Results: Participants with T1D (n = 26, 65.4% male, 42.3% non-Hispanic black, median age 14.2 years, median HbA1c 10.3%) and T2D (n = 41, 39% male, 80.5% non-Hispanic black, median age 16.2 years, median HbA1c 10.3%) scored similarly on the BenCGM, BurCGM, and DDS surveys. In a pooled analysis of both T1D and T2D, there was no difference in survey results by race/ethnicity, but female youth had an increased odd of diabetes-related distress, specifically regimen-related distress.
Conclusions: Youth with T1D and T2D on insulin therapy report similar perspectives on continuous glucose monitor use and QoL measures. Insulin use in both T1D and T2D may carry a similar burden of management, and CGM may help improve quality of life. Trial registration: This trial is registered with NCT04721145, NCT04721158.

DOI: https://doi.org/10.1155/2023/1979635
PLoS One. 2025 ;20(5): e0320702

The experiences of high-risk young adults with type 1 diabetes transitioning to real-time continuous glucose monitoring - A thematic analysis.

Vicky McKechnie, Parizad Avari, Pei Chia Eng, Rebecca Unsworth, Monika Reddy, Stephanie A Amiel, Victoria Salem, Shivani Misra.

BACKGROUND: Real-time continuous glucose monitoring (rtCGM) is now the standard care for people with type 1 diabetes. However, whilst its impact on glycaemic outcomes is well-documented, its psychosocial effects, particularly in young adults experiencing extreme hyperglycaemia, remain poorly understood.
OBJECTIVES: We aimed to explore the psychosocial impact of rtCGM on young adults with extreme hyperglycaemia who thus far have not been studied extensively.
RESEARCH DESIGN AND METHODS: A qualitative study employing semi-structured interviews was undertaken. Young adults 18-25 years (HbA1c >75mmol/mol (9.0%)), naïve to rtCGM, were provided with rtCGM for 6-months. Interviews (centred on barriers to self-management and experience of rtCGM use) were conducted within 2-weeks of recruitment and at the end. An inductive, thematic analysis of interviews was undertaken.
RESULTS: Eight participants (median age (IQR) 23.0 (22.0-24.5) years, 100% non-white ethnicity) were recruited with median HbA1c 94 (88-107) mmol/mol [DCCT 10.8 (10.2-12.1)%.]. All participants used multiple daily insulin injections. Despite low rtCGM wear-time (32.2 (23.1-59.4)%), significant improvements were observed in time in range, but no change in HbA1c. Thematic analysis indicated that high levels of disease burden were reported, with rtCGM-related themes identified: 1) interaction with rtCGM data, 2) feelings of control and trust from using rtCGM, and 3) frustration of technology and alarms. Although participants reported that knowledge of glucose levels on their smartphone was convenient and led to 'greater control', this was countered by alarm-fatigue, technical difficulties and feeling overwhelmed. Three participants prematurely stopped using rtCGM.
CONCLUSIONS: Young adults with high-risk hyperglycaemia have complex relationships with rtCGM. rtCGM may have benefits in this high-risk group, but are likely to require additional support and must be determined on a case-by-case basis as associated effort may contribute to feelings of distress and/or burnout. Implementing structured educational, psychosocial, and technical support, alongside alternative care models such as more frequent check-ins, should be considered in order to enhance self-management practices with rtCGM and address technology-related challenges.

DOI: https://doi.org/10.1371/journal.pone.0320702
Am J Clin Nutr. 2025 Apr 26. pii: S0002-9165(25)00243-6. [Epub ahead of print]

Associations of >1-hour versus ≤1-hour meal timing variability (eating jetlag) with plasma glycemic parameters and continuous glucose monitoring measures among pregnant females: A prospective cohort study.

Yu-En Chen, Chee Wai Ku, Mary Ff Chong, Fabian Yap, Jerry Kok Yen Chan, See Ling Loy, Ling-Wei Chen.

   BACKGROUND: Eating jetlag (EJL), the difference in eating times between weekdays and weekends, disrupts circadian alignment, may affect metabolic health. However, its influence on glucose tolerance and continuous glucose monitoring (CGM) during pregnancy remains unknown.
OBJECTIVE: We aimed to investigate the associations between EJL and glycemic parameters during pregnancy.
METHODS: This secondary analysis was conducted on a cohort of 248 healthy pregnant women from Singapore. EJL, derived from 4-day food diaries at 20 weeks' gestation, was the absolute difference in average meal times between weekdays and weekends for the first (EJLfirst) and last (EJLlast) meals and categorized as ≤1-hour (reference) or >1-hour. Primary outcomes at 25 weeks' gestation included results from the 75g-oral-glucose-tolerance-test, fasting insulin, homeostasis-model-assessment-of-insulin-resistance (HOMA2-IR), and β-cell function (HOMA2-%B). Secondary outcomes at 20 weeks' gestation included glycemic control and variability measured over 10 days using CGM. Skewed glycemic variables were log-transformed for normality, and associations between EJL and glycemic outcomes analyzed using multivariable regressions.
RESULTS: After adjusting for baseline socio-demographic, lifestyle, and dietary factors, EJLlast >1-hour was associated with higher fasting insulin [geometric-mean-ratio (95% confidence-intervals): 1.21 (1.05, 1.39)], HOMA2-IR [1.21 (1.05, 1.39)], HOMA2-%B [1.11 (1.01, 1.22)], and CGM-based measures, including mean glucose [1.05 (1.00, 1.09)], J-index [1.11 (1.01, 1.22)], and glucose-management-indicator [1.03 (1.00, 1.06)]. EJLfirst >1-hour was associated with higher CGM-based mean-amplitude-of-glycemic-excursions (MAGE) [1.09 (1.01, 1.19)]. For CGM-based glycemic variability outcomes (standard deviation, coefficient-of-variation (CV), MAGE), there were interactions between EJLfirst and i) diet quality (adherence to Dietary-Approaches-to-Stop-Hypertension (DASH)) (p-interactions=0.06-0.09), and ii) pre-pregnancy body mass index (BMI) (p-interaction=0.07 for CV). In females with a pre-pregnancy BMI≥23 kg/m2 and low diet quality (DASH score ≤median), EJLfirst >1-hour was associated with higher CGM-based glycemic variability.
CONCLUSIONS: EJL was associated with unfavourable glycemic parameters during pregnancy. Dietary interventions could promote consistent meal timing, especially in higher-risk groups with suboptimal nutritional status.
TRIAL REGISTRATION NUMBER: NCT03803345.

Keywords:  Circadian behaviour; Continuous glucose monitoring; Eating jetlag; Gestational diabetes mellitus; Glycemic variability; Meal irregularity

DOI:  https://doi.org/10.1016/j.ajcnut.2025.04.026
Diabet Med. 2025 Apr 27. e70011

Glycated albumin and fructosamine do not improve accuracy of glycaemic control assessment in patients with conditions reported to affect HbA1c reliability.

Anxious J Niwaha, Priscilla A Balungi, Timothy J McDonald, Andrew T Hattersley, Beverley M Shields, Moffat J Nyirenda, Angus G Jones.

   AIMS: HbA1c testing in African populations may be limited due to high prevalence of hemoglobinopathies, anaemia, malaria and renal impairment. We aimed to assess the performance of glycated albumin (GA) and fructosamine in comparison to HbA1c for determining glycaemic control in Africans living with type 2 diabetes.
METHODS: We compared the relationship between fructosamine, GA, and HbA1c with mean continuous glucose monitoring (CGM) glucose and assessed the impact of sickle cell trait (SCT), anaemia and renal impairment on the relationship between each measure and CGM glucose.
RESULTS: The overall association of HbA1c, GA and fructosamine with CGM glucose was similar (r = 0.88 [95%CI: 0.84, 0.91], 0.84 [0.79, 0.88] and 0.84 [0.79, 0.88]), respectively. For detecting those with mean CGM glucose >8 mmol/L HbA1c had similar diagnostic accuracy to GA and fructosamine, even in those with conditions reported to affect HbA1c performance (n = 63). We found no evidence that SCT (n = 43/192) altered the relationship between HbA1c, fructosamine or GA with CGM glucose (p > 0.3 for all). However, individuals with anaemia showed an underestimation of CGM glucose by HbA1c and fructosamine compared to those without anaemia (p for interaction <0.005 for both). In contrast, GA with average CGM glucose between those with anaemia and those without were not significantly different.
CONCLUSIONS: Switching to fructosamine or GA is unlikely to improve the accuracy of laboratory glycaemic monitoring beyond that of HbA1c in a population with high prevalence of conditions reported to affect HbA1c reliability.

Keywords:  CGM; diabetes; fructosamine; glycated albumin; glycated haemoglobin; monitoring

DOI:  https://doi.org/10.1111/dme.70011
Pediatr Diabetes. 2023 ;2023 3435944

Subsequent Device Usage and Caregiver Attitudes to Do-It-Yourself Real-Time Continuous Glucose Monitoring (DIY-rtCGM) among Children with Type 1 Diabetes 3 Months after Participation in a Randomized Controlled Trial.

Yongwen Zhou, Mona M Elbalshy, Sara E Styles, Hamish Crocket, Craig Jefferies, Esko Wiltshire, Martin I de Bock, Benjamin J Wheeler.

Aim: To assess children's subsequent device usage and caregiver attitudes to do-it-yourself real-time continuous glucose monitoring (DIY-rtCGM) at least 3 months after completing a randomized controlled trial (RCT).
Methods: A brief online questionnaire or telephone call was used to collect the subsequent device usage and caregivers' attitudes from a total of 55 families at least 3 months after their completion of an RCT investigating DIY-rtCGM adapted from their preexisting intermittently scanned glucose sensors plus education on using DIY-rtCGM system. To be eligible for the RCT, children had to be aged 2-13 years, have type 1 diabetes ≥6 months, and be rtCGM naïve. Data collected investigated current CGM use post-RCT and attitudes/user experiences to DIY-rtCGM in the months since RCT study support ended.
Results: Overall, responses from 81.8% (45/55) of caregivers were received. Mean age of children was 9.0 ± 2.7 years, and 31 (68.9%) children used insulin pumps. After 3 months, 44.4% (20/45) of responding caregivers reported ongoing DIY-rtCGM use, and of these, only 13 used DIY-rtCGM as the primary glucose monitoring method 100% of time. Of the 25 (55.6%) families who ceased DIY-rtCGM, 40% (10/25) had transitioned to commercial rtCGM. More than half of families (60%, 12/20) who continued DIY-rtCGM use had a very or extremely positive attitude toward the technology and 75% (15/20) of these families planned to continue DIY-rtCGM use. However, signal loss and sensor inaccuracy remained the major reasons among all responders both for decreased DIY-rtCGM wear time and eventual cessation. Burden of use primarily related to technical errors that could not be solved, and alarms, both of which were reported to contribute to discontinuation.
Conclusions: This study highlights that, among families voluntarily using DIY-rtCGM at least 3 months following support from a trial, more than half have ceased using DIY-rtCGM, with 40% of those discontinuing switching to commercial rtCGM. While overall perceptions of DIY-rtCGM remain largely positive, burdens of use are high and contribute to discontinuation.

DOI: https://doi.org/10.1155/2023/3435944
Diabetes Metab J. 2025 Apr 28.

Current Status of Continuous Glucose Monitoring Use in South Korean Type 1 Diabetes Mellitus Population-Pronounced Age-Related Disparities: Nationwide Cohort Study.

Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim.

   Background: This study aims to identify the status of continuous glucose monitoring (CGM) use among individuals with type 1 diabetes mellitus (T1DM) in South Korea and to investigate whether age-related disparities exist.
Methods: Individuals with T1DM receiving intensive insulin therapy were identified from the Korean National Health Insurance Cohort (2019-2022). Characteristics of CGM users and non-users were compared, and the prescription rates of CGM and sensor- augmented pump (SAP) or automated insulin delivery (AID) systems according to age groups (<19, 19-39, 40-59, and ≥60 years) were analyzed using chi-square tests. Glycosylated hemoglobin (HbA1c) levels and coefficients of variation (CV) among CGM users were also examined.
Results: Among the 56,908 individuals with T1DM, 10,822 (19.0%) used CGM at least once, and 6,073 (10.7%) used CGM continuously. Only 241 (0.4%) individuals utilized either SAP or AID systems. CGM users were younger than non-users. The continuous prescription rate of CGM was highest among individuals aged <19 years (37.0%), followed by those aged 19-39 years (15.8%), 40-59 years (10.7%), and ≥60 years (3.9%) (P<0.001 for between-group differences). Among CGM users, HbA1c levels decreased from 8.7%±2.4% at baseline to 7.2%±1.2% at 24 months, and CV decreased from 36.6%±11.9% at 3 months to 34.1%±12.7% at 24 months.
Conclusion: Despite national reimbursement for CGM devices, the prescription rates of CGM remain low, particularly among older adults. Given the improvements in HbA1c and CV following CGM initiation, more efforts are needed to increase CGM utilization and reduce age-related disparities.

Keywords:  Continuous glucose monitoring; Diabetes mellitus, type 1; Digital health; Glycated hemoglobin; Health status disparities; Pancreas, artificial

DOI:  https://doi.org/10.4093/dmj.2024.0804
Clin Nutr. 2025 Apr 23. pii: S0261-5614(25)00112-8. [Epub ahead of print]49 138-148

Effects of lacto-vegetarian and vegan diets on glycemic responses and metabolite profiles in healthy adults: A randomized trial using continuous glucose monitoring and targeted metabolomics.

Xianyu Zhu, Rajagopal Gayathri, Valangaiman Sriram Manasa, Kuzhanthaivelu Abirami, Shilpa N Bhupathiraju, Ranjit Mohan Anjana, D Ian Givens, Anisha Wijeyesekera, Vasudevan Sudha, Viswanathan Mohan, Karani S Vimaleswaran.

   BACKGROUND: Our previous studies have demonstrated that dairy products protect against type 2 diabetes (T2D) and improve cardiometabolic health outcomes. Given that continuous glucose monitoring (CGM) and metabolomics analysis capture different aspects of T2D, this study investigated the effects of dairy and non-dairy products on the glycemic and metabolite profiles in healthy adults following lacto-vegetarian and vegan diets.
METHODS: A parallel randomized feeding trial with 30 participants compared isoenergetic vegan and lacto-vegetarian diets. All participants wore CGM sensors for 14 days to track glucose concentrations. Anthropometric and biochemical characteristics were also measured. In a subgroup of 13 individuals, fasting and postprandial blood samples were collected on days 1 and 15 for metabolomics analysis.
RESULTS: Our CGM data showed higher mean glucose concentrations in the vegan group over 14 days compared to the lacto-vegetarian group (p = 0.0399), after adjusting for age, sex, body mass index, and baseline glucose concentrations. Metabolomics analysis from day 1 to day 15 showed increased postprandial phenylalanine (Phe; p = 0.0189) in the vegan group, while the lacto-vegetarian group showed increased acetyl carnitine (C2; p = 0.00704) and decreased argininosuccinic acid (p = 0.0149).
CONCLUSIONS: Our pilot CGM data suggest a lacto-vegetarian diet may offer better glycemic control, potentially explained by our preliminary metabolomics findings. The increased Phe observed in the vegan group may be explained by a hypothetical mechanism in which higher glucose induces oxidative stress, whereas the increased C2 from dairy in the lacto-vegetarian group may protect against oxidative stress, contributing to lower glucose concentrations. However, larger, longer-term studies with more diverse populations, along with in vitro investigations into biomolecular mechanisms, are needed to confirm these findings.

Keywords:  Acetyl carnitine; CGM; Dairy; Metabolomics; Phenylalanine

DOI:  https://doi.org/10.1016/j.clnu.2025.04.018
Sensors (Basel). 2025 Mar 18. pii: 1868. [Epub ahead of print]25(6):

A Deep Sparse Capsule Network for Non-Invasive Blood Glucose Level Estimation Using a PPG Sensor.

Narmatha Chellamani, Saleh Ali Albelwi, Manimurugan Shanmuganathan, Palanisamy Amirthalingam, Emad Muteb Alharbi, Hibah Qasem Salman Alatawi, Kousalya Prabahar, Jawhara Bader Aljabri, Anand Paul.

  Diabetes, a chronic medical condition, affects millions of people worldwide and requires consistent monitoring of blood glucose levels (BGLs). Traditional invasive methods for BGL monitoring can be challenging and painful for patients. This study introduces a non-invasive, deep learning (DL)-based approach to estimate BGL using photoplethysmography (PPG) signals. Specifically, a Deep Sparse Capsule Network (DSCNet) model is proposed to provide accurate and robust BGL monitoring. The proposed model's workflow includes data collection, preprocessing, feature extraction, and predictions. A hardware module was designed using a PPG sensor and Raspberry Pi to collect patient data. In preprocessing, a Savitzky-Golay filter and moving average filter were applied to remove noise and preserve pulse form and high-frequency components. The DSCNet model was then applied to predict the sugar level. Two models were developed for prediction: a baseline model, DSCNet, and an enhanced model, DSCNet with self-attention. DSCNet's performance was evaluated using Mean Absolute Percentage Error (MAPE), Mean Absolute Error (MAE), Mean Squared Error (MSE), Root Mean Squared Error (RMSE), Mean Absolute Relative Difference (MARD), and coefficient of determination (R2), yielding values of 3.022, 0.05, 0.058, 0.062, 10.81, and 0.98, respectively.

Keywords:  DSCNet; PPG sensor; blood glucose level; deep learning; non-invasive

DOI:  https://doi.org/10.3390/s25061868
Pediatr Diabetes. 2024 ;2024 5218915

Adolescent-Initiated Retrospective Glucose Data Review is Associated With Improved Glycemia in Type 1 Diabetes Mellitus.

David J Chenoweth, Benjamin A Palmer, Andrew W Norris, Michael J Tansey, Catherina T Pinnaro.

Objectives: Regular retrospective review of glucose data is an important aspect of type 1 diabetes (T1D) management. Continuous glucose monitors (CGMs) facilitate retrospective review by capturing glucose data and generating standardized reports. However, only a minority of adults with T1D retrospectively review their glucose data, and adolescents are understudied. The objectives of this study were to determine the prevalence of self-reported retrospective glucose data review by adolescents with T1D, determine factors associated with self-reported retrospective glucose data review, and assess whether self-reported retrospective glucose data review was associated with improved glycemia. Methods: We conducted a cross-sectional survey of adolescents aged 12-18 years with T1D in conjunction with review of the associated electronic medical record, which included age, sex, date of diagnosis, clinic hemoglobin A1c (HbA1c), type of insurance, and CGM data. The survey included the Hypoglycemia Fear Survey (HFS) and questions regarding habits and attitudes associated with retrospective review. Results: 112 out of 218 eligible individuals completed the survey (51%). Fifty-three percent of adolescents who completed the survey reported that they had engaged in retrospective glucose data review. Of these, 88% of individuals reported that they reviewed data regularly. Age, sex, race, type of insurance, and CGM use were not associated with retrospective review status. Self-report of retrospective glucose data review was associated with improved glycemia as measured by HbA1c and time in range (TIR) compared to adolescents who indicated they do not review glucose data (p=0.006 and p=0.04, respectively). There was no difference in HFS scores between reviewers and nonreviewers including the behavioral subscale, worry subscale, and total score. Conclusions: Self-report of retrospective glucose data review was associated with improved glycemia as measured by HbA1c and TIR. Adolescent-initiated glucose data self-review does not appear to be driven by fear of hypoglycemia (FoH).

DOI: https://doi.org/10.1155/2024/5218915
Cureus. 2025 Mar;17(3): e81544

Effectiveness of Physical Activity Support Combined With Continuous Glucose Monitoring by a Physical Therapist in Preconception Care for a Woman With Type 2 Diabetes Mellitus: A Case Study.

Kengo Taketani, Takuo Nomura, Tetsuji Okawa.

  Diabetes mellitus represents a major public health challenge worldwide, with type 2 diabetes mellitus (T2DM) accounting for the majority of cases. Urbanization and lifestyle changes are reportedly contributing to the increasing incidence of T2DM worldwide. The prevalence of T2DM is also increasing among women who wish to become pregnant, owing to the growing overall proportion of women with T2DM, the increasing prevalence of obesity, and the rising average age of childbirth. Preconception care is warranted in this demographic to optimize glycemic control, improve pregnancy outcomes, and reduce the risk of congenital anomalies and perinatal complications. Educational support that includes not only glycemic control but also increased physical activity (PA) and lifestyle modifications is important to delivering effective preconception care. Herein, we report the case of a woman in her 30s with T2DM, hypertension, and dyslipidemia. Her early glycemic control was suboptimal (glycated hemoglobin: 8.9%, time in range (TIR): 36.6%), her pregnancy preparation was delayed, and a personalized PA program was eventually introduced that included continuous glucose monitoring (CGM) reviewed by a physical therapist. The intervention lasted four months and included continuous feedback and adjustments to the timing, intensity, and activity goals of the patient's exercise regimen based on her CGM trends. A specific PA target of 8,000-10,000 steps per day was established to promote increased daily movement. The intervention also incorporated a combination of aerobic exercise (walking) and resistance training tailored to the patient's condition and lifestyle. This intervention led to improvements in her blood glucose markers, treatment satisfaction related to diabetes, health-related quality of life, and independence. The patient's TIR increased from 36.6% to 77%, and her PA increased from 2500 to 9500 steps/day. This case study highlights the potential of CGM to promote real-time feedback and behavior modification in patients with T2DM, particularly those attempting pregnancy. PA support combined with CGM can effectively manage blood glucose levels, increase motivation, and improve overall health in ways that are highly beneficial to integrate into preconception care regimens. This study emphasizes that PA support combined with CGM is effective for increasing glycemic control and PA levels, thus improving lifestyle habits and preparing women with T2DM for pregnancy. We advocate for the wider adoption of PA support interventions combined with CGM by physical therapists as a standard practice in preconception care and emphasize the role of this approach in terms of improving long-term metabolic health prior to conception. Further research is warranted to validate these findings and optimize intervention protocols.

Keywords:  continuous glucose monitoring; physical activity support; physical therapist; preconception care; type 2 diabetes mellitus

DOI:  https://doi.org/10.7759/cureus.81544
Sensors (Basel). 2025 Apr 09. pii: 2382. [Epub ahead of print]25(8):

Improved Fully 3D-Printed SIW-Based Sensor for Non-Invasive Glucose Measurement.

Abdelhak Hamid Allah, Guy Ayissi Eyebe, Frédéric Domingue.

  This paper presents a fully 3D-printed microfluidic microwave sensor based on substrate-integrated waveguide (SIW) technology for detecting glucose levels in liquid, aimed at monitoring diabetic patients. The sensor's design features a circular SIW cavity with an integrated sample holder placed in the cavity's center, maximizing the electric field disturbance from the liquid under test (LUT). Operating in the TM010 mode at a resonance frequency around 5.740 GHz, the sensor detects glucose concentrations by measuring resonance frequency shifts in the S11 reflection response across glucose levels. A conductive sheath partially covers the sample holder to enhance sensitivity and improve the limit of detection (LOD) by increasing field penetration into the LUT. Fabricated using an additive manufacturing electronics (AMEs) method, the sensor is produced in a single pass without post-processing. The experimental validation confirms its high sensitivity of 1.218 MHz/(mg/dL) and a low limit of detection of 0.774 mg/dL in the glucose concentration range (10-200 mg/dL), reflecting typical Type 2 diabetes levels. The key advantages of the sensor include its compactness, enhanced sensitivity and limit of detection, innovative manufacturing, and cost-effectiveness, supporting its potential as a non-invasive glucose monitoring tool. This study establishes a proof of concept for the in vitro measurement of glucose, demonstrating the sensor's ability to provide accurate and reliable results in a controlled environment.

Keywords:  3D printing; SIW; diabetes; glucose monitoring; microwave sensor; non-invasive

DOI:  https://doi.org/10.3390/s25082382
Am J Vet Res. 2025 Apr 25. 1-9

The FreeStyle Libre 2 system demonstrates limited analytical accuracy without resulting in detrimental clinical decisions.

Jessica L Herman, Jonathan A Lidbury, Genna F Atiee, Shannon E Washburn, Carly A Patterson.

   Objective: To evaluate the performance of a second-generation flash glucose monitoring system (FGMS; FreeStyle Libre 2) in nondiabetic dogs during rapidly induced hypoglycemia.
Methods: In a prospective, observational study, regular insulin was administered to 23 healthy dogs to induce hypoglycemia, with subsequent correction. Serial measurements of interstitial glucose with FGMS and blood glucose (BG) with a portable BG monitor (PBGM) were recorded every 10 minutes for 90 minutes. At each time point, blood was also collected for gold standard BG measurement via clinical chemistry analyzer. Analytical and clinical accuracy was determined by fulfillment of International Organization for Standardization 15197:2013 criteria.
Results: For BG values < 100 mg/dL, 67.2% of PBGM measurements and 50.9% of FGMS measurements were within ± 15 mg/dL of the reference method. In Parkes error grid analysis, 94.9% of PBGM and 88.6% of FGMS measurements fell within zones A and B. Readings within higher-risk zones were rare, with no PBGM values and 0.6% of FGMS values in zone D and neither producing readings in zone E.
Conclusions: In this model of rapidly induced hypoglycemia, the FGMS demonstrated limited analytical accuracy compared to the reference standard. However, it rarely produced glucose readings likely to lead to detrimental clinical decisions.
Clinical Relevance: The FreeStyle Libre 2 is clinically useful for monitoring glucose trends in dogs, though results should be interpreted with caution during periods of rapid glycemic change.

Keywords:  FreeStyle Libre 2; canine; diabetes mellitus; flash glucose monitoring system; interstitial glucose

DOI:  https://doi.org/10.2460/ajvr.25.02.0055
Diabetes Technol Ther. 2025 Apr 29.

Blood Glucose Prediction Algorithms Require Clinically Relevant Performance Criteria Beyond Accuracy.

Miriam K Wolff, Hans Georg Schaathun, Sebastien Gros, Rune Volden, Martin Steinert, Anders L Fougner.

  Background: The root mean squared error (RMSE) is commonly used to evaluate blood glucose prediction algorithms. However, it primarily measures how well predictions align with the most likely future values, rather than supporting optimal and proactive treatment decisions. Since diabetes management data predominantly features blood glucose values within the target range, RMSE tends to favor models that consistently predict target-range values, often at the expense of detecting clinically critical events such as rapid fluctuations, hypoglycemia, or hyperglycemia. This study examines how and why RMSE biases evaluations toward trivial models, highlighting the need for alternative performance criteria that better reflect clinical priorities. Methods: We developed the composite glucose prediction metric (CGPM) to integrate three components: RMSE, temporal gain and geometric mean (glycemic event prediction). A custom loss function was designed to emphasize clinically critical predictions during model training. Pareto frontier analysis was used to assess trade-offs among models with comparable performance. Results: CGPM was computed for five blood glucose prediction techniques (zero-order hold, naïve linear regression, ridge regression, ridge regression trained with a custom loss function, and a physiology-based model) applied to the OhioT1DM dataset. The data-driven model with the lowest RMSE performed poorly on glycemic event prediction, highlighting RMSE's bias toward target-range predictions. In contrast, the ridge regressor trained with the custom loss function improved event prediction, showing that clinically weighted optimization mitigates biases. Conclusions: Blood glucose prediction algorithms require evaluation and optimization criteria beyond accuracy to better support optimal treatment decisions. This study introduced the CGPM as an alternative evaluation framework, along with a loss function designed for model optimization that emphasizes clinically critical but rare events. Further clinical validation is needed to refine these criteria and ensure they align more closely with the needs of diabetes management.

Keywords:  Pareto frontier analysis; blood glucose prediction; evaluation metric; loss function; machine learning; predictive modeling

DOI:  https://doi.org/10.1089/dia.2025.0074
Pediatr Diabetes. 2023 ;2023 6646582

Disparities in Glycemic Outcomes Persist in Youth with Type 1 Diabetes and High-Technology Use.

Meryl C Nath, Blake Frey, Joycelyn Atchison, Jessica A Schmitt.

Background: Racial disparities are well described in glycemic outcomes in youth with Type 1 diabetes mellites (T1D). Hemoglobin A1c (HbA1c) has some limitations in comparing glycemia across patient groups as there are individual variations in mean glucose and HbA1c.
Objective: This study aimed to compare glycemic metrics obtained from (Dexcom G6) continuous glucose monitor (CGM) device with HbA1c levels controlling for race, age, duration of diabetes, race, insurance status, and insulin pump use with glycemic control. Subjects and Methods. Data analyzed included 188 patients, majority non-Hispanic White (NHW) (n = 147, 78.2%) and majority privately insured (n = 147, 78.2%). Half of the patients were using insulin pumps, (n = 94, 50.0%) and approximately half were female. Median age was 16.6 (interquartile range: 14.2-18.2) years old with a median age of diabetes diagnosis at 9.3-years old.
Results: Significant differences were observed between NHW and non-Hispanic Black (NHB) patients in terms of HbA1c, 90-day mean glucose, and 90-day time >250 mg/dL (>13.9 mmol/L) (7.6% vs. 9.2%, 181 mg/dL vs. 220 mg/dL, and 16.3% vs. 34.7%, respectively, p < 0.001 for all comparisons). Multiple linear regression analysis was performed to predict the influence of age, duration of diabetes, race, insurance status, and insulin administration on glycemic outcomes. Regression analysis revealed significant equations for all glycemic outcomes, demonstrating a strong correlation (p < 0.0001, p=0.0001, and p < 0.0001, respectively). However, after controlling for these variables, only race and duration of diabetes remained independently associated with glycemic outcomes, suggesting that these factors strongly influence glycemic control independent of age, sex, insurance, and pump use.
Conclusion: Even in a subset of youth with T1D using CGM with high rates of insulin pump use, disparities in glycemic outcomes persist. When evaluating glycemic outcomes, race remained a significant cofactor despite controlling for age, duration of diabetes, sex, insurance status, and insulin administration type. These results add to the existing literature, and demonstrate race remains strong predictor of glycemic outcomes.

DOI: https://doi.org/10.1155/2023/6646582
Sensors (Basel). 2025 Mar 08. pii: 1674. [Epub ahead of print]25(6):

Emission Integral Effect on Non-Invasive Blood Glucose Measurements Made Using Mid-Infrared Passive Spectroscopic Imaging.

Daichi Anabuki, Shiori Tahara, Hibiki Yano, Akira Nishiyama, Kenji Wada, Akiko Nishimura, Ichiro Ishimaru.

  Living bodies emit mid-infrared light (wavelength band centered at approximately 10 µm) with a temperature-dependent intensity. Several studies have shown the possibility of measuring blood glucose levels using the mid-infrared emission of living bodies, and we have demonstrated non-invasive blood glucose measurements through distant wrist measurements (wavelength 8-14 µm) by mid-infrared passive spectroscopic imaging. However, it is not clear why blood glucose is detectable, as there is no formula that shows the effect of material thickness and concentration on emission intensity. In this study, we developed a principle for understanding glucose detection by proposing that an emission integral effect underpins the changes in emission intensity with substance thickness and absorption coefficient. We demonstrate the emission integral effect by measuring the spectral radiance of polypropylene with different thicknesses using mid-infrared passive spectroscopic imaging. The simulation results based on the emission integral effect indicate that in living bodies, dilute components such as glucose are easier to identify than components with high concentrations. Mid-infrared passive spectroscopic imaging offers potential innovative solutions for measuring various substances from a distance, with the emission integral effect acting as the basic working principle.

Keywords:  Fourier-transform spectroscopy; mid-infrared spectroscopy; non-invasive blood glucose sensor; thermal emission spectroscopy; thermal radiation

DOI:  https://doi.org/10.3390/s25061674
Anal Chim Acta. 2025 Jun 22. pii: S0003-2670(25)00387-3. [Epub ahead of print]1356 343993

Point-of-care colorimetric biosensor for H2O2 and glucose detection utilizing the peroxidase-like activity of 2D bimetallic metal organic framework nanosheets.

Yasmeen M Abdelfattah, Amr M Mahmoud, Noha I Abdelaziz, Dina A El Mously.

   BACKGROUND: The applications of natural enzymes are vast, limited only by their protein nature. Therefore, the development of artificial enzyme mimetics, nanozymes, which are stable and have improved activity, has become indispensable for biomedical and diagnostic purposes. Nanozymes have developed into an emergent topic combining nanotechnology and biology due to their vast range of potential uses. In comparison to natural peroxidase, peroxidase-imitating nanozymes have distinct benefits in terms of high stability and low cost for applications in bioanalysis and environmental remediation. The use of metal-organic framework nanoparticles has exhibited enhanced catalytic and enzymatic performance.
RESULTS: In the current work, we present a strategy for synthesizing 2D Ni/Co MOF nanoparticles that have been anchored onto carboxymethyl cellulose (CMC). The resulting composite (Ni/Co-MOF@CMC) 2D nanosheets exhibit a high surface area and abundant catalytic sites, greatly amplifying their peroxidase-like catalytic performance. Additionally, these 2D bimetallic MOFs mimic the peroxidase activity, demonstrated by the distinctive yellow colour upon the oxidation of o-Phenylenediamine (OPD) by hydrogen peroxide. This newly synthesized 2D bimetallic MOF provides a straightforward, simple, selective, and sensitive colorimetric analysis technique for the determination of hydrogen peroxide and glucose. H2O2 could be efficiently detected with a linear range of 10 μM-800 μM and a lower detection limit of 3.28 μM. With the potential to detect minute glucose concentrations as low as 200 μM within a linear range of 200 μM-600 μM.
SIGNIFICANCE AND NOVELTY: This work demonstrates the significant novelty of applying an RGB colour sensor (TCS34725) for the quantitative measurement of H2O2 and glucose which holds great potential as a point-of-care platform for diabetic patients. Consequently, our approach broadens the use of MOFs in biosensing and presents a viable substitute for affordable, and easily accessible diabetes monitoring. These 2D bimetallic MOFs are promising materials for glucose detection applications, expanding the utility of MOFs to include biosensor applications.

Keywords:  Arduino based device; Glucose detection; Metal-organic frameworks; Nanozymes; Peroxidase-like activity

DOI:  https://doi.org/10.1016/j.aca.2025.343993