One of the most costly chronic illnesses worldwide is diabetes. Cost-effective therapy management is more crucial than ever since the number of patients with diabetes continues to rise, exceeding all projections. Here are few of the modern tools for monitoring blood glucose level.
Sugarsensitive Tattoo
Michael Strano, the Charles and Hilda Roddey Associate Professor of Chemical Engineering at MIT and his team, with funding from MIT’s Deshpande Center for Technological Innovation, are creating the next generation of glucose testing. Their system consists of an ink made of glucose-responsive carbon nanotubes. The ink would be injected under the skin in a design a few centimeters square, creating a sugar-sensitive tattoo. “When near-infrared light is shone on the ink, it would change color in response to the blood glucose level,” he says — a welcome change for the millions of diabetics weary of frequent finger pricks. “The user would have continuous real-time glucose information and wouldn’t have to query at all.”
Sensor under your skin
In Continuous Glucose Monitoring (CGM) a small sensor is placed under your skin — usually on your arm or belly –it measures the glucose levels in the fluid between the cells every few minutes around the clock. Depending on the system, it then sends the data wirelessly to a handheld receiver similar to a cell phone, an app on your smartphone, or an insulin pump. You can download your glucose data and share it with your doctor so they can use it to adjust your treatment plan for better control of your blood sugar. Your doctor will let you know when you need to use fingersticks along with your monitor to manage your diabetes.
Artificial Pancreas
After you eat, your real pancreas lowers blood sugar by releasing the hormone insulin. In order to elevate your blood sugar levels in between meals, it then produces another hormone called glucagon. The goal of an artificial pancreas is the same. Although it’s not quite there yet, the technology is approaching.
Most of the artificial pancreas systems available today are called hybrid closed-loop systems. They’re mainly for people with type 1 diabetes.A closed-loop system monitors your blood glucose level throughout the day using CGM. Based on your blood glucose level, it figures out how much insulin you need and delivers it through a pump. You still need to count carbs at each meal and enter the total into the system to figure out your bolus dose.
Non-invasive CGM
SugarBEAT, from U.K.-based Nemaura Medical, is already approved for use in Europeclaims itself as the first non-invasive CGM in history. It’s a patch that measures the amount of glucose in the fluid beneath your skin by passing a very little electric current through it. This company has requested for FDA approval in the United States, and sugarBEAT already has authorization in Europe.
No interaction with your blood or bodily fluids is necessary for other glucose monitoring techniques. These non-invasive testing techniques use the skin of your finger, abdomen, wrist, or earlobe to measure the amount of glucose in bodily fluids. Some employ radio waves, while others use light. However, they are all able to monitor the signal that glucose emits when it interacts with various energy sources.
While some of these gadgets are approved in Europe, but not in the US. Their accuracy has been one of their main issues. These devices have trouble distinguishing between the signal from glucose and the signals from water and other chemicals in the blood.
Occlusion NIR spectroscopy
Allows non-invasive measurement of glucose as well as hemoglobin and oxygen saturation on finger tip skin; portable, easy-to-use and measures glucose in less than a minute; Technology is technology based on the reflection of NIR light from the skin surface; data-storage capacity, alarm alerts, trend data analysis and integrated wireless telemetry; does not require frequent calibrations; easy calibration procedure; measures glucose continuously for 24 h; good accuracy in clinical trials that was similar to glucose meters.
Future
Researchers are developing devices to detect glucose in sweat, saliva, breath, and ocular fluid, as well as light. Ocular glucose sensors, sweat sensors, and non-invasive intermittent glucose monitoring are being developed, including contact lenses, sweat sensors, and biosensors. These advancements could be more cost-effective in resource-restricted areas or certain populations.
CGM technology is expanding in medical settings, with studies showing reliable results and innovative management innovations. However, challenges include knowledge, staff training, and protocol development. Implementation research is crucial, especially in community hospitals without a dedicated endocrinology team.
–Dr. Subramanian S. Iyer
