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Novel Approach to Lactate Sensing Diabetes Pre-screening Tool Christine Zhang, Stephanie Wu, Joseph Sun, Wern Ong, Toby Li Problem Statement No Type II Diabetes Pre-screening device exists in the market To address this need, we will create a hydrogel based lactate sensor where lactate level predicts probability of Diabetes II onset Diabetes Chronic illness characterized by high blood sugar Type II diabetes is caused by insufficient insulin levels, most often because the body has become resistant to insulin Insulin is a hormone produced by the pancreas to control blood sugar Indicators/Complications Age Ethnicity Weight Family History Other Symptoms Infections Vision Slow to heal Heart Disease/Stroke High Blood Pressure Blindness Kidney Disease Nervous System Disease (Neuropathy) Amputation Current Testing Methods 3 pre-diabetes tests A1C A1C test Fasting plasma glucose test Oral glucose tolerance test Lactate Sensor Simple More accessible Diabetes Testing Oral Glucose Tolerance (OGTT) Fasting Plasma Glucose (FPG) Diabetes (I & II) Prevalence 25.8 million people (8.3%) U.S. population 18.8 million people diagnosed 7.0 million people undiagnosed 170 million people worldwide 79 million Pre-diabetes (U.S.) 1.9 million cases of diabetes diagnosed in 2010 (U.S.) 300 million people by year 2025 Market Potential 174 Billion: Total Costs of Diagnosed Diabetes (2007) 116 Billion: Direct Medical Costs 58 Billion: Indirect Costs Medical expenditure of diabetics 2.3X higher than non-diabetics Performance Criteria Sense over a large range of lactate levels 0.15 – 0.3 mmol Work in a timely manner <24 hrs. FPG 32 hrs OGTT 10 hrs Low cost < $1 dollar Glucose Monitors $10 Roche diagnostics $190 Accuracy 60% Primary Objective Develop lactate sensitive screening device for prediabetes screening Using lactate sensitive hydrogels Measure volumetric change (directional swelling) Correlate volume change to saliva lactate Levels Predict probability of developing type II diabetes Solution Description Tube filled with lactate sensitive hydrogel polymer Exposure to saliva lactate causes directional swelling of hydrogel polymer Volumetric change to saliva lactate concentration correlated to blood lactate levels Correlation of lactate concentration to development of type-2 diabetes Volume Change Hydrogel Supporting Figures Blood and Saliva Lactate Correlation 12 y = 0.8508x + 0.4099 R² = 0.9572 10 [Saliva Lactate] Probability curve 8 6 4 2 0 0 2 4 6 [Blood Lactate] 8 10 12 Goals Hygienic Non-Invasive Disposable Uniform Cheap < $10 Easy To Use Accurate Factors Polymer Ratio (More DMAEMA = more pH sensitive) Number of Tubes per batch Concentration of Lactate Oxidase [Lactate] Capillary diameter System and Environment Temperature Self Testing Clinical Setting Lactate Conc. Saliva Sample Water pH Proteins Lactate Sensor Volumetric Change Diabetes Prediction Lifestyle Change Blood Test See Physician Experiment Block Diagram Literature Research Calculation of Calibration Curve Hydrogel Synthesis Lactate Sensitive Prototype Testing Sensitivity to Lactate Statistics/Analysis Establishment of real world protocols Application Testing Performance pH 31 30 Volume (mm^3) 29 28 27 26 Batch 1 (Normal) 25 Batch 2 (DMAEMA) 24 23 22 1 2 Sample Performance (Cont.) Batch 7 2 1.8 Height Change (mm) 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 0 0 0.2 0.3 0.4 Lactate Conc. [mmol] 0.5 1 5 Conclusion Hygienic Non-Invasive Disposable Uniform Cheap $0.23/tube Informal Observations Hard to measure volume change Hard to control directional swelling Hydrogel polymer not very sensitive to small lactate concentrations Gradual volumetric change not immediate (hrs) Air bubbles Un-uniform distribution of lactate oxidase Recommendations Colorimetric Assay – Gradient of color change for more specific lactate readings Digital Readout – More accurate saliva lactate readings Testing in a public health application – test viability in large clinical settings (ie. Schools, businesses, clinics) References http://www.who.int/diabetes/publications/en/screeni ng_mnc03.pdf