Monitoring and Diagnosing Metabolic Health with Continuous Glucose Monitoring

Project Title: Monitoring and Diagnosing Metabolic Heath with Continuous Glucose Monitoring

Project Lead's Name: Paul T. Reidy, Ph.D.

Project Lead's Email:

Project Lead's Phone: 513-529-1919

Project Lead's Division: EHS

Primary Department: Kinesiology and Health

Other Team Members and their emails:

  • Faculty: Kevin Ballard,
  • Faculty: Kyle Timmermann,
  • Faculty: Eric Slattery,
  • Faculty: Gretchen Matuszak,
  • Student: Emily Gabel,

List Departments Benefiting or Affected by this proposal: Kinesiology and Health

Estimated Number of Under-Graduate students affected per year (should be number who will actually use solution, not just who is it available to): 400

Estimated Number of Graduate students affected per year (should be number who will actually use solution, not just who is it available to): 40

Describe the problem you are attempting to solve and your approach for solving that problem: Current Problem: Outdated and repeatedly invasive assessment of blood glucose levels with finger pricks and a glucometer that provides minimal temporal resolution.

Our approach to solving the problem: To use a continuous glucose monitor technology that has only a one-time invasive application, yet provide substantial comprehensive temporal resolution (288 assessments per day for 7-10 days) of blood glucose.

The major goal of our proposal is to enhance experiential learning by allowing students to utilize state-of-the-art technology to assess one of the most important indicators of risks and symptoms of diabetes, blood glucose levels in a comprehensive manner not possible using the previous method (finger pricks and a glucometer).

Project Description (Brief):

The Department of Kinesiology and Health has several teaching labs and student-led research projects focused on how lifestyle interventions impact health, specifically metabolic health and blood glucose control. As the incidence of chronic metabolic diseases is rapidly increasing experts in the field of health need to understand factors regulating and methods to assess blood glucose control so they can best treat metabolic dysfunction (inability to use nutrients correctly).

The goal of this proposal is to enhance the education of students regarding detection and treatment of metabolic health concerning glucose control by using a rapidly evolving technology that is highly informative (lots of data) and increasingly more prevalent in clinic practice.

The traditional method to measure blood glucose would be an uncomfortable finger prick and collection of a drop of blood with a glucometer strip that is then placed in a glucometer for a reading. However, to track glucose in response to an event, several of these samples need to be taken over a prolonged time.

Continuous glucose monitoring assesses blood glucose (blood sugar) levels real-time by the placement of a tiny microfiber in a sensor placed under the skin (subcutaneously). See placement of the sensor in the picture to the right. The sensor will transmit the data or be attached to a transmitter that will send the data wirelessly to a separate electronic device (see below picture). The device can track blood glucose changes rapidly to display trends, low levels, or high levels, and the rate that the glucose levels are changing to improve management of metabolic dysfunction. A recent meta-analysis has demonstrated that CGM is an effective means to manage blood glucose.

This biometric technology can be worn for up to 7-10 days with 288 data points per day to produce large sets of data to characterize the glucose levels and give insight into the metabolic health of an individual. The frequency of sampling is essential to capture the full response of glucose to an event, which might be missed with the uncomfortable finger sticks.

The biometric data is imported into specific software for easy identification and characterization of fluctuations in blood glucose. The data can also be exported for more advanced statistical analysis, which offers additional education opportunities. This technology provides a full picture of glucose levels across a day for several days, a function not possible using our current methods.

How would you describe the innovation and/or the significance of your project: The innovation is the ability to provide substantial and detailed measurement (288 assessments per day for 7-10 days) of blood glucose with state of the art technology. This project will significantly impact students by facilitating familiarity with new technology being used with greater incidence on the health field and a more complete understanding of metabolic control of blood glucose.

How will you assess the success of the project: Eric Slattery, the Exercise Science Lab Coordinator in the Department of Kinesiology and Health, is responsible for implementation and tracking Lab equipment usage. Eric has discussed with other project team members ways to implement the continuous glucose monitoring device into KNH 382L (Fitness Assessment and Exercise Prescription), 468U/568L (Physiology of Exercise and Physical Activity), 482/582 (Exercise Management of Chronic Diseases), and 668 (Advanced Exercise Physiology). The Department of Kinesiology and Health has several teaching labs, classes and student-led research projects focused on how lifestyle interventions of diet and physical activity (including exercise) impact health. Since lifestyle­ related diseases are emerging as the leading causes of poor health the students in our classes need to be well prepared to recognize individuals at risk of poor health in their future careers.

In KNH 382L and 482/582, the instructors will implement CGMs in a new multi-week lab to monitor how students' blood glucose fluctuates throughout the week, and to compare across day changes. Students' learning will be assessed through a lab report assignment. Students will relate their data to diseases they've learned about in lectures such as diabetes (Type I and II) and metabolic syndrome. They will also write about their experiences using the CGM device.

In KNH 468U/568L and 668, the instructors will utilize CGMs to improve upon the current glucose tolerance lab. In that lab, students consume an amount of glucose relative to their fat-free mass and either sit or walk (1mph) for 90 minutes. Student learning will be assessed through a lab report assignment. utilizing CGM's will better allow the students to measure and visualize the changes in blood glucose in response to nutrient intake with or without physical activity-a response that is critical to the diagnosis of pre-diabetes and diabetes. Students will evaluate and analyze these data with clinical tools and make lab reports as it relates to the underlying physiology. Gretchen Matuszak, professor for KNH 411/413 Medical Nutrition Therapy I and II will instruct students in the operation of CGM as a tool that clients will use to monitor their glucose control in response to nutrition therapy. Gretchen plans to implement the device into a newly designed laboratory section examining how day-to-day blood glucose fluctuates in response to different diets. Students' learning will be assessed through a summary report assignment. Students will relate their data to diseases they've learned about in lectures such as Diabetes (Type I and II) and metabolic syndrome. They will also have to write about their experiences using the continuous glucose monitoring device. Emily Gabel, a student on this proposal who is also president of the Miami University Student Academy of Nutrition and Dietetics, represents many of the kinesiology and nutrition students and would like to see CGM used in labs.

Eric and Gretchen will aggregate the data about student assessment of learning in these labs/classes using the CGM into a report each semester. Using these reports Dr. Reidy will evaluate our effectiveness in teaching and student learning, as reflected by the usage of the CGM devices. We will then re-evaluate where we can improve the delivery of the material (in both labs and lectures) and maximize our effectiveness in using the CGM to optimize student­ learning outcomes each semester.

Financial Information

Total Amount Requested: $13,654

Is this a multi-year request: Yes

Justification for multi-year request: The devices include a sensor, transmitter and receiver. Software is complimentary with the purchase of the monitors. The receiver does not expire and is charged via a USB cable. This will be a one time purchase in year 1. The sensors have a limited shelf life (-1 year) and are single-use. However, they are relatively inexpensive to replace.

The transmitters last -6 months before they need to be replaced. Our proposal is in a multi-year format to test the product in use for teaching in year 1, and then replace the consumable items the following two years.

Length of multi-year request: 3

The spending plan for multi-year request: The first year we will buy the receivers and a few of the consumable items as we implement CGMs into select classroom and teaching labs. Following the trial period, we will be better prepared to expand the use of CGMs into all our classes in years two and three.

Our hope is that 3 years of successful use of CGM as a highly effective tool of instruction could justify this product for a place in the department budget.

Please see the attached budget for more detail.

Please address how, if at all, this project aligns with University, Divisional, Departmental, or Center strategic goals: This project is aligned with University goals of 1) innovation by making steps toward specific innovation goals #4: "Miami University to becoming a premier destination for developing and disseminating innovations in teaching and learning that catalyze student success" and also #5: "designing a curricular innovation lab for experimentation". This proposal specifically meets those university­ wide goals by 1) using an innovative and relevant tool of the health field to enhance teaching and by 2) altering curriculum through the addition of new labs in current courses and/or improving existing labs.

The project is aligned with College of Education, Health and Society's goals of "being innovative leaders in transforming the lives of those it serves through a holistic, integrated approach that reflects a changing, global society". Specifically, this is through the innovative technology that integrates student experience into their understanding of glucose metabolism, which directly addresses the divisional goal to "Pursue technological innovation necessary for the highest quality of teaching, research, and service activities".

The Department of Kinesiology and Health's mission is "to advance the understanding of health, physical activity, and related cultural practices to improve quality of life and promote healthful, active living". The proposal goals are an exemplification of the vision of the department, "striving for excellence in teaching by providing diverse, unique, engaged, and innovative learning environments and curriculum. In addition, we embrace high quality, unparalleled teaching technologies, and experiential learning with high levels of academic rigor.