Transcutaneous glucose measurement using near-infrared spectroscopy during hypoglycemia.

Gabriely, Ilan; Wozniak, Robert; Mevorach, Michèle; Kaplan, Jonathan; Aharon, Yigal; Shamoon, Harry

doi:10.2337/diacare.22.12.2026

Cited by 74 publications

(49 citation statements)

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“…The wavelengths used were shorter than those reported in other studies (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and did not correspond to any glucose infrared absorption bands. Probe design allowed measurement of optical properties down to a depth of 2 mm in the skin, where temperature can be controlled and varied (23)(24)(25)(26).…”

Section: Noninvasive (Ni)mentioning

confidence: 76%

“…Other factors, such as temperature, blood perfusion, tissue compression, blood oxygenation, cutaneous water, and other metabolites or medications that affect tissue blood dynamics are not considered. The wavelengths used in this study (590 -935 nm) do not correspond to any near-infrared glucose absorption bands as did those used in previous studies (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Spectral bands in this wavelength range correspond to blood absorption and thus reflect hemodynamic changes in cutaneous tissue.…”

Section: Discussionmentioning

confidence: 99%

“…Most proposed NI methods for glucose determinations are based on monitoring extremely weak nearinfrared glucose absorption spectral features (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), which overlap with other overtone and combination bands of water, hemoglobin, protein, and fats (1 ). A second approach is to use the effect of glucose on the tissue scattering coefficient (16 -20 ), which is a nonspecific effect that is common to other soluble analytes.…”

Section: Noninvasive (Ni)mentioning

confidence: 99%

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Monitoring Blood Glucose Changes in Cutaneous Tissue by Temperature-modulated Localized Reflectance Measurements

2003

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Background: Most proposed noninvasive methods for glucose measurements do not consider the physiologic response of the body to changes in glucose concentration. Rather than consider the body as an inert matrix for the purpose of glucose measurement, we exploited the possibility that noninvasive measurements of glucose can be approached by investigating their effects on the skin's thermo-optical response. Methods: Glucose concentrations in humans were correlated with temperature-modulated localized reflectance signals at wavelengths between 590 and 935 nm, which do not correspond to any near-infrared glucose absorption wavelengths. Optical signal was collected while skin temperature was modulated between 22 and 38°C over 2 h to generate a periodic set of cutaneous vasoconstricting and vasodilating events, as well as a periodic change in skin light scattering. The method was tested in a series of modified meal tolerance tests involving carbohydrate-rich meals and no-meal or highprotein/no-carbohydrate meals. Results: The optical data correlated with glucose values. Changes in glucose concentrations resulting from a carbohydrate-rich meal were predicted with a model based on a carbohydrate-meal calibration run. For diabetic individuals, glucose concentrations were predicted with a standard error of prediction <1.5 mmol/L and a prediction correlation coefficient 0.73 in 80% of the cases. There were run-to-run differences in predicted glucose concentrations. Non-carbohydrate meals showed a high degree of scatter when predicted by a carbohydrate meal calibration model. Conclusions: Blood glucose concentrations alter thermally modulated optical signals, presumably through physiologic and physical effects. Temperature changes

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Section: Noninvasive (Ni)mentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Noninvasive (Ni)mentioning

confidence: 99%

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Monitoring Blood Glucose Changes in Cutaneous Tissue by Temperature-modulated Localized Reflectance Measurements

2003

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“…Regardless, it is likely that existing CGM devices will be refined and improved. (8)(9)(10)(11) Evaluation of satisfaction with CGM use would be valuable at this early point in the emergence of this technology, but no validated measures exist.…”

mentioning

confidence: 99%

Youth and Parent Satisfaction With Clinical Use of the GlucoWatch G2 Biographer in the Management of Pediatric Type 1 Diabetes

2005

Diabetes Care

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Objectives-A Continuous Glucose Monitor Satisfaction Scale (CGM-SAT) was evaluated during a 6-month randomized, controlled trial of the GlucoWatch G2 Biographer (GW2B; Cygnus, Inc., Redwood City, CA) in youths with type 1 diabetes.Research Design and Methods-At the end of the 6-month trial, 97 parents and 66 older children who had been randomized to the GW2B group completed the CGM-SAT, which assesses satisfaction on 37 items using a 5-point Likert scale. Descriptive analysis, calculation of several reliability estimates and assessment of concurrent validity were performed.Results-The CGM-SAT demonstrated high internal reliability (Cronbach's alpha = 0.95 parents, 0.94 youths ≥ 11 y), split-half reliability (rho = .91 for parents and .93 for youths) and parentadolescent agreement (rho = 0.68; p < .001).Convergent validity was supported by marginally significant associations with treatment adherence and frequency of GW2B use.CGM-SAT scores did not correlate significantly with changes in treatment adherence, quality of life or diabetes-related anxiety from baseline to 6-months. Mean scores on CGM-SAT items indicated that 81% of parental responses and 73% of youths' responses were less favorable than "Neutral". Descriptive analysis indicated the GW2B requires substantial improvement before it can achieve widespread clinical utility and acceptance. Conclusions-The results supported the psychometric properties of the CGM-SAT. The CGM-SAT warrants further research use and cross-validation with other continuous glucose monitors. This study provides a benchmark for comparison with new glucose sensors.

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“…Optical sensors use the principle that the absorption pattern of near-infrared light can be related to glucose concentration [11]. Light is beamed onto a relatively transparent region of tissue such as the fingertip.…”

Section: Glucose Sensorsmentioning

confidence: 99%

Continuous Monitoring of Blood Glucose

Robert¹

2002

Horm Res Paediatr

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Continuous blood glucose monitoring aims to: better evaluate glycaemic variations; better detect hypoglycaemia; and, ultimately, automatize insulin delivery (artificial β cell). The sensors can be fully implantable, with the challenge of constructing durable systems to avoid repeated implantations. In-dwelling needle-like electrodes and microdialysis fibres with a pump that brings the dialysate to the glucose sensor are inserted in the subcutaneous tissue through the skin. The GlucoWatch is an almost non-invasive technique that extracts the extracellular fluid by iontophoresis. In these systems, the glucose oxidase generates the electrical signal, proportional to the glucose concentration. Non-invasive techniques aim at measuring the glucose concentration without breaching the skin, using absorption of light in the infrared spectrum. These techniques have not reached the necessary reliability for use as glycaemic alarms, and even less as artificial β cells. Currently, glucose sensors are mainly used as glycaemic holters to help in the management of insulin therapy.

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Transcutaneous glucose measurement using near-infrared spectroscopy during hypoglycemia.

Abstract: Our findings suggest that the near-infrared spectroscopy method can accurately predict plasma glucose levels during euglycemia and hypoglycemia in humans.

Cited by 74 publications

References 0 publications

Monitoring Blood Glucose Changes in Cutaneous Tissue by Temperature-modulated Localized Reflectance Measurements

Monitoring Blood Glucose Changes in Cutaneous Tissue by Temperature-modulated Localized Reflectance Measurements

Youth and Parent Satisfaction With Clinical Use of the GlucoWatch G2 Biographer in the Management of Pediatric Type 1 Diabetes

Continuous Monitoring of Blood Glucose

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