A history of blood glucose meters and their role in self-monitoring of diabetes mellitus

Abstract

Self-monitoring blood glucose (SMBG) systems have the potential to play an important role in the management of diabetes and in the reduction of risk of serious secondary clinical complications. This review describes the transition from simple urine sugar screening tests to sophisticated meter and reagent strip systems to monitor blood glucose. Significant developments in design and technology over the past four decades are described since the first meter was introduced in 1970. Factors that have influenced this evolution and the challenges to improve analytical performance are discussed. Current issues in the role of SMBG from the clinical, patient and manufacturer perspectives, notably adherence, costs and regulations, are also considered.

American Association Of Clinical Endocrinologists And American College Of Endocrinology 2016 Outpatient Glucose Monitoring Consensus Statement

“…For several decades, urine glucose testing was the mainstay of diabetes monitoring (15). While patients could perform measurements at home and potentially adjust their therapy, the shortcomings of urine glucose testing were well recognized.…”

“…Contaminants on the skin from food sources (fruits, juices, sodas, milk) and even hand lotions can artificially raise capillary blood glucose levels and potentially lead to an overdose of insulin with subsequent hypoglycemia. Acetaminophen is well-known to result in spurious values in CGM systems (15,44,56,164,165). Physical compression of the CGM sensor during sleep can result in seriously low glucose readings.…”

“…It was used for the first blood glucose meter in 1970 (15). Starting in the late 1970s, daily BGM gained wider acceptance as research data began to support the correlation and causation between poor glycemic control and diabetic complications (15)(16)(17)(18)(19)(20)(21)(22)(23). The "glucose hypothesis" was confirmed in the landmark Diabetes Control and Complications Trial (DCCT), the first longterm randomized prospective study to compare intensive (≥4x/day) self-GM coupled with an insulin titration algorithm versus standard therapy using once-daily GM and 1 to 2 daily insulin injections (24).…”

Clinical Implications of Accuracy Measurements of Continuous Glucose Sensors

“…1 In 1987, the ADA suggested the ambitious accuracy goal of 100% of values within 10% of a laboratory reference for glucose levels between 30 and 400 mg/dL. 2 Despite less than optimal accuracy, diabetes control has been transformed by patient self-monitoring of blood glucose (SMBG) and the decisions it enables.…”

Diagnostic Innovations in Developing Urban Settings

“…This was suboptimal, as urinalysis could only detect blood glucose levels elevated above the renal threshold and with an inherent delay in the results. Despite these limitations in at-home monitoring, it was not until the mid-1970s that at-home use of blood glucose readers was considered, and even then, there were signifi cant concerns as to their accuracy, ease of use, and affordability [ 28 ]. The concerns have been addressed through technological advances, and at-home blood glucose monitoring is now an integral part of managing diabetes in developed countries.…”