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Glycated hemoglobin and blood oxygenation are the two most important factors for monitoring a patient’s average blood glucose and blood oxygen levels. Digital volume pulse acquisition is a convenient method, even for a person with no previous training or experience, can be utilized to estimate the two abovementioned physiological parameters. The physiological basis assumptions are utilized to develop two-finger models for estimating the percent glycated hemoglobin and blood oxygenation levels. The first model consists of a blood-vessel-only hypothesis, whereas the second model is based on a whole-finger model system. The two gray-box systems were validated on diabetic and nondiabetic patients. The mean absolute errors for the percent glycated hemoglobin (%HbA1c) and percent oxygen saturation (%SpO2) were 0.375 and 1.676 for the blood-vessel model and 0.271 and 1.395 for the whole-finger model, respectively. The repeatability analysis indicated that these models resulted in a mean percent coefficient of variation (%CV) of 2.08% and 1.74% for %HbA1c and 0.54% and 0.49% for %SpO2 in the respective models. Herein, both models exhibited similar performances (HbA1c estimation Pearson’s R values were 0.92 and 0.96, respectively), despite the model assumptions differing greatly. The bias values in the Bland–Altman analysis for both models were – 0.03 ± 0.458 and – 0.063 ± 0.326 for HbA1c estimation, and 0.178 ± 2.002 and – 0.246 ± 1.69 for SpO2 estimation, respectively. Both models have a very high potential for use in real-world scenarios. The whole-finger model with a lower standard deviation in bias and higher Pearson’s R value performs better in terms of higher precision and accuracy than the blood-vessel model.

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Clinical devices play a vital role in diagnosing and monitoring people’s health. A pulse oximeter (PO) is one of the most common clinical devices for critical medical care. In this paper, we explain how we developed a wearable PO. We propose a new electronic circuit based on an analog filter that can separate red and green photoplethysmography (PPG) signals, acquire clean PPG signals, and estimate the pulse rate (PR) and peripheral capillary oxygen saturation (SpO2). We propose a PR and SpO2 measurement algorithm with and without the motion artifact. We consider three types of motion artifacts with our acquired clean PPG signal from our proposed electronic circuit. To evaluate our proposed algorithm, we measured the accuracy of our estimated SpO2 and PR. To evaluate the quality of our estimated PR (bpm) and SpO2 (%) with and without the finger motion artifact, we used the quality evaluation metrics: mean absolute percentage error (MAPE), mean absolute error (MAE), and reference closeness factor (RCF). Without the finger motion condition, we found that our proposed wearable PO device achieved an average 2.81% MAPE, 2.08 bpm MAE, 0.97 RCF, and 98.96% SpO2 accuracy. With a finger motion, the proposed wearable PO device achieved an average 4.5% MAPE, 3.66 bpm MAE, 0.96 RCF, and 96.88% SpO2 accuracy. We also show a comparison of our proposed PO device with a commercial Fingertip PO (FPO) device. We have found that our proposed PO device performs better than the commercial FPO device under finger motion conditions. To demonstrate the implementation of our wearable PO, we developed a smartphone app to allow the PO device to share PPG signals, PR, and SpO2 through Bluetooth communication. We also show the possible applications of our proposed PO as a wearable, hand-held PO device, and a PPG signal acquisition system.

Continuous monitoring of blood-glucose concentrations is essential for both diabetic and nondiabetic patients to plan a healthy lifestyle. Noninvasive in vivo blood-glucose measurements help reduce the pain of piercing human fingertips to collect blood. To facilitate noninvasive measurements, this work proposes a Monte Carlo photon simulation-based model to estimate blood-glucose concentration via photoplethysmography (PPG) on the fingertip. A heterogeneous finger model was exposed to light at 660 nm and 940 nm in the reflectance mode of PPG via Monte Carlo photon propagation. The bio-optical properties of the finger model were also deduced to design the photon simulation model for the finger layers. The intensities of the detected photons after simulation with the model were used to estimate the blood-glucose concentrations using a supervised machine-learning model, XGBoost. The XGBoost model was trained with synthetic data obtained from the Monte Carlo simulations and tested with both synthetic and real data (n = 35). For testing with synthetic data, the Pearson correlation coefficient (Pearson’s r) of the model was found to be 0.91, and the coefficient of determination (R2) was found to be 0.83. On the other hand, for tests with real data, the Pearson’s r of the model was 0.85, and R2 was 0.68. Error grid analysis and Bland–Altman analysis were also performed to confirm the accuracy. The results presented herein provide the necessary steps for noninvasive in vivo blood-glucose concentration estimation.