PubMed · 14971333
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New tools 2003.. https://pubmed.ncbi.nlm.nih.gov/14971333/
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UNLABELLED: It is extremely difficult to assess the prevalence and the total costs of diabetes mellitus for the German health care system. The last sound assessment of the total costs is based on the CODE-2 study, although this study reflects the situation in 1998. METHODS: In this paper we assess again the total costs of diabetes mellitus type 2 and self measurement of blood glucose (SMBG) for the German healthcare system, based on the analysis of a recently published retrospective, multicentre trial dealing with the impact of SMBG on long-term patient outcomes. RESULTS: Overall, yearly costs for the treatment of diabetes mellitus type 2 and its complications amount to Euro 3 196,-per patient. This equals 4.6% to 8.2% of the German healthcare expenditure, in relation to the estimated prevalence of the disease in Germany. The cost difference between the cohorts with and without SMBG was not essential (Euro 290,-higher costs in the cohort with SMBG). CONCLUSIONS: From a public health standpoint, prevention of diabetes mellitus or at least prevention of its complications by optimising glucose metabolism should be given highest priority in times of limited resources for healthcare. SMBG is perhaps a valuable tool to achieve this target.
Self-monitoring of blood glucose has been found to be effective for patients with type I diabetes and for patients with type 2 diabetes taking insulin. There is much debate on the effectiveness of self-monitoring of blood glucose in the management of patients with type 2 diabetes who are not taking insulin. A systematic review of 6 randomised controlled trials comparing self-monitoring of blood glucose with standard care, self-monitoring of urine glucose, or both showed that self-monitoring of blood glucose may be effective in improving glycaemic control in patients with type 2 diabetes who are not using insulin. There was scant data on patient-related outcomes, such as quality of life, well being and satisfaction. Therefore, more large long-term studies of high quality are needed.
A novel biosensor for glucose measurement using functional polymers was fabricated and tested. The biosensor utilizes the physical and chemical functions of hydrophobic polydimethyl siloxane (PDMS) and hydrophilic 2-methacryloyloxyethyl phosphorylcholine (MPC) copolymerized with dodecyl methacrylate (DMA). The glucose sensor was constructed by immobilizing glucose oxidase (GOD) onto a flexible hydrogen peroxide electrode (Pt working electrode and Ag/AgCl counter/reference electrode). The electrodes were fabricated using microelectromechanical systems (MEMS) techniques onto those functional polymers. The sensor showed novel functions of flexibility and it was stretchable so that the sensor could normally work when it was released after expanding to 120% longer than that of normal length. Also, basic characteristics of the sensor were evaluated. The output current of the hydrogen peroxide electrode was linearly related to the hydrogen peroxide concentration in a range of 0.20-2.50 mmol/l, with a correlation coefficient of 0.998. GOD was then immobilized onto the surface of the sensor using MPC polymer. In this case, the current output of the glucose sensor related to the glucose level over a range of 0.06-2.00 mmol/l, with a correlation coefficient of 0.997. The calibration range includes the reported concentration of tear glucose in normal human subject (0.14 mmol/l).