New methodology to obtain a calibration model for noninvasive near-infrared blood glucose monitoring.

This paper reports new methodology to obtain a calibration model for noninvasive blood glucose monitoring using diffuse reflectance near-infrared (NIR) spectroscopy. Conventional studies of noninvasive blood glucose monitoring with NIR spectroscopy use a calibration model developed by in vivo experimental data sets. In order to create a calibration model, we have used a numerical simulation of light propagation in skin tissue to obtain simulated NIR diffuse reflectance spectra. The numerical simulation method enables us to design parameters affecting the prediction of blood glucose levels and their variation ranges for a data set to create a calibration model using multivariate analysis without any in vivo experiments in advance. By designing the parameters and their variation ranges appropriately, we can prevent a calibration model from chance temporal correlations that are often observed in conventional studies using NIR spectroscopy. The calibration model (regression coefficient vector) obtained by the numerical simulation has a characteristic positive peak at the wavelength around 1600 nm. This characteristic feature of the regression coefficient vector is very similar to those obtained by our previous in vitro and in vivo experimental studies. This positive peak at around 1600 nm also corresponds to the characteristic absorption band of glucose. The present study has reinforced that the characteristic absorbance of glucose at around 1600 nm is useful to predict the blood glucose level by diffuse reflectance NIR spectroscopy. We have validated this new calibration methodology using in vivo experiments. As a result, we obtained a coefficient of determination, r2, of 0.87 and a standard error of prediction (SEP) of 12.3 mg/dL between the predicted blood glucose levels and the reference blood glucose levels for all the experiments we have conducted. These results of in vivo experiments indicate that if the parameters and their vibration ranges are appropriately taken into account in a numerical simulation, the new calibration methodology provides us with a very good calibration model that can predict blood glucose levels with small errors without conducting any experiments in advance to create a calibration model for each individual patient. This new calibration methodology using numerical simulation has promising potential for NIR spectroscopy, especially for noninvasive blood glucose monitoring.

Noninvasive near-infrared blood glucose monitoring using a calibration model built by a numerical simulation method: Trial application to patients in an intensive care unit.

We have applied a new methodology for noninvasive continuous blood glucose monitoring, proposed in our previous paper, to patients in ICU (intensive care unit), where strict controls of blood glucose levels are required. The new methodology can build calibration models essentially from numerical simulation, while the conventional methodology requires pre-experiments such as sugar tolerance tests, which are impossible to perform on ICU patients in most cases. The in vivo experiments in this study consisted of two stages, the first stage conducted on healthy subjects as preliminary experiments, and the second stage on ICU patients. The prediction performance of the first stage was obtained as a correlation coefficient (r) of 0.71 and standard error of prediction (SEP) of 28.7 mg/dL. Of the 323 total data, 71.5% were in the A zone, 28.5% were in the B zone, and none were in the C, D, and E zones for the Clarke error-grid analysis. The prediction performance of the second stage was obtained as an r of 0.97 and SEP of 27.2 mg/dL. Of the 304 total data, 80.3% were in the A zone, 19.7% were in the B zone, and none were in the C, D, and E zones. These prediction results suggest that the new methodology has the potential to realize a noninvasive blood glucose monitoring system using near-infrared spectroscopy (NIRS) in ICUs. Although the total performance of the present monitoring system has not yet reached a satisfactory level as a stand-alone system, it can be developed as a complementary system to the conventional one used in ICUs for routine blood glucose management, which checks the blood glucose levels of patients every few hours.

In vivo noninvasive measurement of blood glucose by near-infrared diffuse-reflectance spectroscopy.

This paper reports in situ noninvasive blood glucose monitoring by use of near-infrared (NIR) diffuse-reflectance spectroscopy. The NIR spectra of the human forearm were measured in vivo by using a pair of source and detector optical fibers separated by a distance of 0.65 mm on the skin surface. This optical geometry enables the selective measurement of dermis tissue spectra due to the skin's optical properties and reduces the interference noise arising from the stratum corneum. Oral glucose intake experiments were performed with six subjects (including a single subject with type I diabetes) whose NIR skin spectra were measured at the forearm. Partial least-squares regression (PLSR) analysis was carried out and calibration equations were obtained with each subject individually. Without exception among the six subjects, the regression coefficient vectors of their calibration models were similar to each other and had a positive peak at around 1600 nm, corresponding to the characteristic absorption peak of glucose. This result indicates that there is every possibility of glucose detection in skin tissue using our measurement system. We also found that there was a good correlation between the optically predicted values and the directly measured values of blood samples with individual subjects. The potential of noninvasive blood glucose monitoring using our methodology was demonstrated by the present study.