ABSTRACT
Diabetes mellitus is a widespread disease with greatly rising patient numbers expected in the future, not only for industrialized countries but also for regions in the developing world. There is a need for efficient therapy, which can be via self-monitoring of blood glucose levels to provide tight glycemic control for reducing the risks of severe health complications. Advancements in diabetes technology can nowadays offer different sensor approaches, even for continuous blood glucose monitoring. Non-invasive blood glucose assays have been promised for many years and various vibrational spectroscopy-based methods of the skin are candidates for achieving this goal. Due to the small spectral signatures of the glucose hidden among a largely variable background, the largest signal-to-noise ratios and multivariate calibration are essential to provide the method applicability for self-monitoring of blood glucose. Besides multiparameter approaches, recently presented devices based on photoplethysmography with wavelengths in the visible and near-infrared range are evaluated for their potential of providing reliable blood glucose concentration predictions. Graphical abstract á .
Subject(s)
Blood Glucose Self-Monitoring/methods , Blood Glucose/analysis , Skin , Spectrum Analysis/methods , Calibration , Diabetes Mellitus/blood , Humans , Photoplethysmography/methods , Sensitivity and SpecificityABSTRACT
Noninvasive blood glucose assays have been promised for many years and various molecular spectroscopy-based methods of skin are candidates for achieving this goal. Due to the small spectral signatures of the glucose used for direct physical detection, moreover hidden among a largely variable background, broad spectral intervals are usually required to provide the mandatory analytical selectivity, but no such device has so far reached the accuracy that is required for self-monitoring of blood glucose (SMBG). A recently presented device as described in this journal, based on photoplethysmographic fingertip images for measuring glucose in a nonspecific indirect manner, is especially evaluated for providing reliable blood glucose concentration predictions.
Subject(s)
Blood Glucose/analysis , Equipment and Supplies , Fingers/diagnostic imaging , Photoplethysmography , Skin/diagnostic imaging , Biosensing Techniques/instrumentation , Biosensing Techniques/methods , Blood Glucose Self-Monitoring/instrumentation , Blood Glucose Self-Monitoring/methods , Calibration , Color , Equipment Design , Fingers/blood supply , Humans , Infrared Rays , Light , Lighting/instrumentation , Lighting/methods , Photoplethysmography/instrumentation , Photoplethysmography/methods , Reproducibility of Results , Skin/blood supply , Spectroscopy, Near-InfraredABSTRACT
Infrared spectroscopy has been applied to analyse glucose and cellular components in whole blood with the aim of developing an online clinical diagnostic and monitoring modality. Leucocyte adsorption onto the CaF(2) windows was observed over a period of several hours under continuous blood flow using a transmission cell of 30 mum path length. This build-up of cellular material on the windows is responsible for diminishing the sample path length under the flow conditions chosen. The adsorption dynamics have been characterised and their impact on glucose monitoring is reported. For short-term monitoring (<2 hours) a standard error of prediction of 11 mg/dL with human citrated blood samples from three different subjects was achieved. Furthermore, the leucocyte build-up was also reported for porcine EDTA blood monitoring. Consequences and testing opportunities with regard to the first stages in the immune cell reaction to the exposure of body-foreign materials to anticoagulated whole blood are discussed.
