Abstract
Background:A prototype of a noninvasive glucometer combining skin excitation by a mid-infrared quantum cascade laser with photothermal detection was evaluated in glucose correlation tests including 100 volunteers (41 people with diabetes and 59 healthy people).Methods:Invasive reference measurements using a clinical glucometer and noninvasive measurements at a finger of the volunteer were simultaneously recorded in five-minute intervals starting from fasting glucose values for healthy subjects (low glucose values for diabetes patients) over a two-hour period. A glucose range from >50 to <350 mg/dL was covered. Machine learning algorithms were used to predict glucose values from the photothermal spectra. Data were analyzed for the average percent disagreement of the noninvasive measurements with the clinical reference measurement and visualized in consensus error grids.Results:98.8% (full data set) and 99.1% (improved algorithm) of glucose results were within Zones A and B of the grid, indicating the highest accuracy level. Less than 1% of the data were in Zone C, and none in Zone D or E. The mean and median percent differences between the invasive as a reference and the noninvasive method were 12.1% and 6.5%, respectively, for the full data set, and 11.3% and 6.4% with the improved algorithm.Conclusions:Our results demonstrate that noninvasive blood glucose analysis combining mid-infrared spectroscopy and photothermal detection is feasible and comparable in accuracy with minimally invasive glucometers and finger pricking devices which use test strips. As a next step, a handheld version of the present device for diabetes patients is being developed.
Highlights
Diabetes presents the fastest growing health challenge in this century
We report here a preclinical validation of this method using this prototype in glucose correlation tests with 100 volunteers
We would like to emphasize that no significant delay between the reference measurement in capillary blood and the noninvasive measurement in skin was observed
Summary
Diabetes presents the fastest growing health challenge in this century. around 463 million adults worldwide suffer from diabetes, with a present global prevalence of 8.8% expected to further increase to 9.9% until 2045 (for an overview, see the IDF Diabetes Atlas 20191).At present, diabetes cannot be cured, but the disease can be managed by stringent control of blood glucose levels. The recent introduction of continuously monitoring glucometers (CGM) that use an ultrathin needle measuring tissue glucose has greatly improved this situation, in particular for type 1 diabetes patients (for an overview, see Ref.[2]). These minimally invasive glucometers can continuously measure glucose for up to two weeks, but are to some extent mechanically sensitive and may cause skin irritations. Conclusions: Our results demonstrate that noninvasive blood glucose analysis combining mid-infrared spectroscopy and photothermal detection is feasible and comparable in accuracy with minimally invasive glucometers and finger pricking devices which use test strips. A handheld version of the present device for diabetes patients is being developed
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