Diabetes is more than just a glucose problem

Diabetes and blood glucose monitoring:
Blood glucose monitoring has revolutionized the treatment of diabetes. Large-scale clinical trials have demonstrated that frequent blood glucose monitoring can aid in the prevention of many of the long-term complications of diabetes, such as diabetic retinopathy, circulatory disorders, and death.

Diabetes is a complex biochemical disorder:
Although blood glucose is the most important biochemical parameter to measure in diabetes, it is not the only parameter of medical interest. Other parameters of medical relevance include glycosylated hemoglobin, used to measure long-term blood glucose control, ketone levels, used to indicate if the patient is at risk for diabetic ketoacidosis, and lipids such as cholesterol, triglycerides, lipoproteins, and chylomicrons, used to indicate the patient's relative risk of cardiovascular disease.

Type 2 diabetes:
Type 2 diabetes is a major illness, affecting over 7% of the US population. Although diabetes is defined as an excess blood-glucose disease, type 2 diabetics also suffer from multiple disorders of fat metabolism. This causes excessive amounts of lipoproteins to circulate in the bloodstream, damaging blood vessels and leading to other cardiovascular disorders. As a result, most type 2 diabetics ultimately succumb to circulatory problems.

Cardiovascular disease:
The biggest complication of diabetes is cardiovascular disease. Two out of three diabetics ultimately die from heart disease and stroke (caused by cardiovascular disease), and many others suffer from other cardiovascular disease complications such as diabetic retinopathy. Much of this cardiovascular disease in turn is caused by the build-up of fatty deposits (lipid rich plaque) in blood vessels and arteries. 

Where does this fat come from?  Elevated levels of circulating lipoproteins, which can become extremely high in diabetics, particularly after meals.  Too bad that these aren't routinely monitored, and in fact are usually missed by conventional triglyceride and lipoprotein assays, which are almost always taken from fasting patients. 

It's time to monitor more than just glucose:
Most diabetics strive to avoid diabetic complications by monitoring their blood glucose several times a day.  They prick their fingers and apply their blood to test-strips at the right times, but their blood glucose monitors only detect glucose. If the diabetics could receive continuous feedback on other medically important analytes, in particular cardiovascular risk analytes, steps could be taken to reduce these complications.



2diabetes.com
This website discusses a number of different technical approaches which will enable elegant next-generation multi-analyte diabetes tests.  The technology here is intended to be incorporated into inexpensive point-of-care test-strip and meter devices that are simple enough and low-cost enough to be used on a daily basis if necessary. 

The technology here is available for license.   We hope that some of this technology will eventually make it into the mass-market diabetes tests for 2010 and beyond.


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