Background: Self-monitoring of blood glucose by diabetics is crucial in the reduction of complications related to diabetes. Current monitoring techniques are invasive and painful, and discourage regular use. The aim of this study was to demonstrate the use of near-infrared (NIR) diffuse reflectance over the 1050–2450 nm wavelength range for noninvasive monitoring of blood glucose. Methods: Two approaches were used to develop calibration models for predicting the concentration of blood glucose. In the first approach, seven diabetic subjects were studied over a 35-day period with random collection of NIR spectra. Corresponding blood samples were collected for analyte analysis during the collection of each NIR spectrum. The second approach involved three nondiabetic subjects and the use of oral glucose tolerance tests (OGTTs) over multiple days to cause fluctuations in blood glucose concentrations. Twenty NIR spectra were collected over the 3.5-h test, with 16 corresponding blood specimens taken for analyte analysis. Results: Statistically valid calibration models were developed on three of the seven diabetic subjects. The mean standard error of prediction through cross-validation was 1.41 mmol/L (25 mg/dL). The results from the OGTT testing of three nondiabetic subjects yielded a mean standard error of calibration of 1.1 mmol/L (20 mg/dL). Validation of the calibration model with an independent test set produced a mean standard error of prediction equivalent to 1.03 mmol/L (19 mg/dL). Conclusions: These data provide preliminary evidence and allow cautious optimism that NIR diffuse reflectance spectroscopy using the 1050–2450 nm wavelength range can be used to predict blood glucose concentrations noninvasively. Substantial research is still required to validate whether this technology is a viable tool for long-term home diagnostic use by diabetics.
Creating a wearable artificial pancreas (AP) by closing the loop between a glucose sensor and an insulin infusion pump has the potential to significantly impact the complications associated with and improve the quality of life of diabetic individuals. Despite recent progress on glucose sensor and insulin infusion technologies, control algorithms built on the simple glucose value efferent and insulin dose afferent model are not efficient and reliable. Based on glucose regulatory mechanisms known to date, their impairment in the diabetic state, and fundamental principles of control theory, some corrections to the present course of research are proposed to facilitate the removal of this barrier. A greater emphasis on model predictive controllers or controllers that exploit a mathematical representation, or model, of the patient's own physiology is proposed. Whole-body physiologically based pharmacokinetics-pharmacodynamics-type models hold the best odds for enabling a successful closed-loop AP. However, two major improvements to the diabetes modeling state of the art are required to make them practical for daily care: integrating hypothalamus-pituitary-adrenal axis and gastrointestinal tract submodels. Although there are simple representations of these in current existence, large concerted efforts between experimentalists and modelers will be required to enhance their accuracy. Finally, changes in hardware that complements controller performance are suggested. For instance, the development of dual control inputs of insulin and glucagon could relax tolerances on controller accuracy.
The SensiCathTM arterial blood gas (ABG) monitoring system allows rapid blood gas and pH measurements using fiber optic sensors in a paracorporeal device. The paracorporeal device location allows blood to be withdrawn from. a vascular access, measured and returned to a patient, without direct handling and blood loss associated with traditional sampling techniques. The disposable device contains three fiber optic sensors and one temperature sensor. The sensors are monitored using a three-channel, solid-state instrument of minimal size and weight. Measurements of pH, pCO2 and P°2 are made at the point of care, on demand, with results available in 60 seconds. Calibration is performed using two prepackaged, sterile, non-toxic, non-pyrogenic solutions. The paracorporeal location allows access for calibration before or during patient utilization, and for quality assurance checks at any time during use.Laboratory data are presented which assess precision and accuracy of the SensiCath system by comparing its performance measured against tonometered gases and a calibrated pH glass electrode. In vivo animal data using a rabbit model compares the SensiCath system performance to two independent standard blood gas analyzers. The clinical utility of the SensiCath system incorporated into standard arterial lines is discussed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.