Analytical Challenges in Diabetes Management: Towards Glycated Albumin Point-of-Care Detection

Abstract

Diabetes mellitus is a worldwide-spread chronic metabolic disease that occurs when the pancreas fails to produce enough insulin levels or when the body fails to effectively use the secreted pancreatic insulin, eventually resulting in hyperglycemia. Systematic glycemic control is the only procedure at our disposal to prevent diabetes long-term complications such as cardiovascular disorders, kidney diseases, nephropathy, neuropathy, and retinopathy. Glycated albumin (GA) has recently gained more and more attention as a control biomarker thanks to its shorter lifespan and wider reliability compared to glycated hemoglobin (HbA1c), currently the “gold standard” for diabetes screening and monitoring in clinics. Various techniques such as ion exchange, liquid or affinity-based chromatography and immunoassay can be employed to accurately measure GA levels in serum samples; nevertheless, due to the cost of the lab equipment and complexity of the procedures, these methods are not commonly available at clinical sites and are not suitable to home monitoring. The present review describes the most up-to-date advances in the field of glycemic control biomarkers, exploring in particular the GA with a special focus on the recent experimental analysis techniques, using enzymatic and affinity methods. Finally, analysis steps and fundamental reading technologies are integrated into a processing pipeline, paving the way for future point-of-care testing (POCT). In this view, we highlight how this setup might be employed outside a laboratory environment to reduce the time from measurement to clinical decision, and to provide diabetic patients with a brand-new set of tools for glycemic self-monitoring.

Exploring the Complex Connection Between Diabetes and Cardiovascular Disease: Analyzing Approaches to Mitigate Cardiovascular Risk in Patients With Diabetes

“…Aerobic exercises such as brisk walking, jogging, or swimming have been shown to improve cardiovascular fitness and increase insulin sensitivity. Resistance training has been shown to enhance muscle mass and play a significant role in promoting overall metabolic health [ 33 , 34 ]. The Look AHEAD (Action for Health in Diabetes) trial findings indicated that lifestyle interventions incorporating dietary modifications and physical activity resulted in significant weight reduction and enhancements in cardiovascular risk factors for individuals diagnosed with type 2 diabetes [ 35 ].…”

“…These agents not only lower blood glucose levels by promoting urinary glucose excretion but also offer remarkable cardiovascular benefits. The Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME) trial demonstrated that empagliflozin significantly reduced the risk of major adverse cardiovascular events and cardiovascular death in diabetic patients with established CVD [ 34 ]. Similarly, the Canagliflozin Cardiovascular Assessment Study (CANVAS) showed cardiovascular risk reduction with canagliflozin [ 35 ].…”

Advances in the Management of Diabetes Mellitus: A Focus on Personalized Medicine

“…The effective management of these comorbidities necessitates a comprehensive and interdisciplinary approach to diabetes care. The distribution of access to quality healthcare and resources for diabetes management is uneven, especially in low-resource settings [ 10 ]. Discrepancies in access can result in less-than-optimal healthcare and worsen disparities in health.…”

“…Diabetes mellitus is a versatile metabolic condition that is distinguished by heightened levels of blood glucose caused by either inadequate insulin production or impaired insulin function. Lifestyle factors are known to have a significant impact on the development of diabetes [ 10 , 11 ]. However, it is important to acknowledge that genetics also plays a substantial role in determining an individual’s vulnerability to this disease.…”

“…By utilizing real-time data and receiving personalized feedback, patients are able to make well-informed decisions regarding their diet, exercise, and medication adherence [ 9 ]. This approach fosters a sense of empowerment and ownership over their health [ 10 ].…”