Investigate the accuracy of real-time continuous glucose monitoring system in the type 2 diabetes subjects / 天津医药

Objective To investigate the accuracy of real-time continuous glucose monitoring(RT-CGM)system in the type 2 diabetes mellitus(T2DM). Methods A total of 318 subjects hospitalized between 2013 May to 2014 August were recruited. Each subject received a RT-CGM system. In order to calibrate the interstitial glucose level, finger-stick blood glucose were measured at least four times every day. Patients were divided into three groups according to their finger-stick blood glucose level:≤6.99 mmol/L, 7.0-10.0 mmol/L and≥10.01 mmol/L. Pearson correlation was used to analyze the relationship between the finger-stick glucose and interstitial glucose gained from RT-CGM. Clarke error grid analysis was used to analyze the accuracy of RT-CGM. Results (1)A total of 2, 815 glucose meter values from finger-stick were com?paired with glucose from RT-CGM. A positive relationship(r=0.847)were found between CGM and finger-stick blood glu?cose. The correlation was closer with higher finger-stick blood glucose levels(r=0.457, 0.648 and 0.852 respectively in≤6.99 mmol/L group, 7.0-10.0 mmol/L group and≥10.01 mmol/L group. P0.05). Conclusion RT-CGM provides accu?rate blood glucose values to guide the treatment of diabetes, and the accuracy is more reliable in high glucose environment.

Development of Job Description of Clinical Dietitians in Hospitals by the DACUM Method

The present study was conducted to develop a standardized job description for clinical dietitians working in hospitals. A developing curriculum (DACUM) method was used for the job analysis of clinical dietitians. Based on DACUM analysis with 14 members, including clinical dietitians and professors majoring in clinical nutrition and job analysis, information on the duties, tasks, and task elements of clinical dietitians was determined. To verify the job descriptions derived from DACUM analysis, a total of 46 tertiary and general hospitals with over 500 beds were recruited for the survey. The final developed job description for clinical dietitians included 7 duties, 27 tasks, and 93 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, nutrition monitoring.evaluation, consultation.cooperation, nutrition research, and self-development. The mean scores of perceived importance, performance, and difficulty on the clinical dietitian's task elements (out of a maximum score of 5.0) were 4.5, 3.7, and 3.5, respectively, with significant differences between the items (P<0.001). The perceived importance and performance grid of clinical dietitian's tasks showed that "construction and maintenance of collaboration" (E2) and "activity of quality improvement" (F1) received relatively low scores for performance despite their high importance scores; thus the performance of these tasks requires significant improvement. In conclusion, the job descriptions of clinical dietitians developed from this study are useful for the qualitative improvement of clinical nutrition services in hospitals.

Assessment of Blood Glucose Values Measured by Blood Gas Analyzer or Portable Glucometer / 대한마취과학회지

BACKGROUND: A portable glucometer is commonly used to immediately check the blood glucose level. In the anesthetic field, some blood gas analyzers can also give a rapid indication of the blood sugar level but the accuracy is unknown. Therefore, this study assessed the accuracy of the blood glucose values measured by either a blood gas analyzer or portable glucometer. METHODS: Venous blood from diabetic patients was used to measure the glucose level with either a blood gas analyzer or a portable glucometer. The difference and 5% deviation from reference values was analyzed. These values were also assessed using a Bland-Altman plot and clinical significance was examined using a Clarke error grid. RESULTS: The differences from the reference values were smaller using the blood gas analyzer (1.3 +/- 7.8 mg/dl) than using the portable glucometer (-5.1 +/- 16.7 mg/dl)(P < 0.01). 73.4% of the values measured by the blood gas analyzer and 40.0% of those measured by the portable glucometer were within 5% of the reference value. The 95% limits of agreement in the difference ranged from -14.3 to 16.9 in the blood gas analyzer and -38.5 to 28.2 in the portable glucometer. Error grid analysis showed that 100% of the values measured by the blood gas analyzer were located in zone A. When locating the values measured using the portable glucometer, 95.6% were located in zone A, and the remaining 4.4% are located in zone B. CONCLUSIONS: The blood gas analyzer measures the blood glucose more accurately than the portable glucometer. However, the blood glucose values measured by the portable glucometer are clinically acceptable.