If only it didn’t hurt and patients didn’t need to bleed, physicians and diabetes educators would be inundated with blood glucose records, instead of the current situation where many patients have to be cajoled into checking. A new process using near infra-red may be on the way to a technological revolution in blood glucose meter design.
Antoine Kaldany, M.D, Associate Clinical Professor of Medicine at Harvard Medical School and Senior Physician at Joslin Diabetes Center serves as a scientific advisory board member for the company developing a real-world model. He believes that the technology is sound.
“It has been a long-struggle to find an accurate, painless way to measure glucose but their unique use of near infrared technology appears valid,” he said.“As a nephrologist it is very important to get accurate readings for my patients with diabetes. Presently this is difficult. Many of them have nephropathy and repeated checking causes pain and scarring. To be able to offer a non-invasive device available for mass distribution would be game-changing.”
Current blood glucose meters use an enzyme technology to read electrical impulses. Blood glucose strips are coated with enzymes. When they come in contact with blood there is an ion exchange which generates an electrical impulse. The meter then translates the electrons into the numerical value seen on the meter. The system is effective but it needs blood samples for the enzymatic reaction to occur.
The advent of micro-gauge needles and alternate-site testing has made checking easier and less painful, but neither of these advances have quite hit the mark. There is no needle system that is entirely discomfort free and no matter how contained, many bystanders are not comfortable with the sight of other peoples’ blood.
The key to painless accurate blood glucose reading is to find a way to measure a specific unique property of glucose that can be measured non-invasively without interference from non-glucose components. The new technology works with near infrared light. Infrared light is a long wavelength below visible red that is invisible to the naked eye. When near infrared light is shined on cells containing glucose, light energy is generated. Similar to a mirror, the energy is reflected back at a specific wavelength unique to glucose that is read by the meter. The magnitude of the response is proportional to the amount of glucose in the cells.
The meter device, which looks similar to a small pager, can measure glucose from your finger or earlobe. It has a U-shaped indentation in the top where the finger or earlobe is inserted. Once inserted pressure is applied and your finger or earlobe is gently squeezed. This pressure separates the capillary blood from the interstitial fluid and cell mater. The device takes two measurements; the first measures the interstitial fluid and cell mater. Then the pressure on the body part is released and a second reading is made. An accurate reading of the blood glucose is obtained by subtracting the results of the first measurement from the second. The whole process is estimated to take 20 seconds.
Since its initiation, blood glucose monitoring has been hailed as the cornerstone of diabetes control. But it has also become a barrier to patient engagement due to discomfort. The information derived from accurate real-time glucose values is essential to making immediate insulin adjustments as well as overall long-term medical management decisions. Finding a way to take accurate readings without having to prick the skin and draw blood is like catching the brass ring on the carousel. All the non-invasive methods for checking blood glucose developed so far have fallen too far short in accuracy.
The device is now undergoing clinical level trials. If the device proves as promising as thought, it is likely that it will still take years for a fully realized consumer model to hit the market. But it is a dream that has the potential to come true.
Many thanks for Dr. Antoine Kaldany’s and Dr. Aaron Cypess’shelp with this blog.