- Email: [email protected]
Monitoring Blood Glucose Control: What Does the Future Hold?
Can J Diabetes 39 (2015) 190e191
Contents lists available at ScienceDirect
Canadian Journal of Diabetes journal homepage: www.canadianjournalofdiabetes.com
Innovations in Diabetes Care
Monitoring Blood Glucose Control: What Does the Future Hold? Brett Cameron BSc, Lori Berard RN, CDE * Winnipeg Regional Health Authority, Health Sciences Centre, Winnipeg Diabetes Research Group, Department of Medicine, Section of Endocrinology, University of Manitoba, Winnipeg, Manitoba, Canada
Self-monitoring of blood glucose (SMBG) through multiple daily fingersticks may soon be a thing of the past. Recent advances in semi-invasive and noninvasive SMBG technology could potentially introduce products utilizing innovative technologies that will provide less invasive glucose readings. The Abbott FreeStyle Flash Glucose Monitoring System (Abbott Diabetes Care, Alameda, California, USA); the iQuickIt Saliva Analyzer (Quick, Farmington, Connecticut, USA); GlucoTrack (Integrity Applications, Ashkelon, Israel); Google smart contact lens (Google, Mountainview, California, USA) and Apple iWatch (Apple, Cupertino, California, USA) are just some of the technologies that could revolutionize the way glucose readings are obtained. The Abbott FreeStyle Libre Flash Glucose Monitoring consists of a sensor, sensor applicator and reader that work through improved sensor-based technology. A small sensor applied on top of the skin inserts a tiny filament below the surface of the skin to capture blood glucose readings with little to no pain. A colour touch-screen reader is used to scan over the sensor. The quick scan by the reader provides a current blood glucose value, a trend arrow indicating the direction that the blood glucose values are moving as well as an 8-hour glucose profile. The device utilizes sensors that can be worn for 14 days and does not require a fingerstick for calibration. These improvements minimize the pain and inconvenience of fingerstick monitoring associated with current blood SMBG and continuous glucose monitoring systems (CGM) while providing a longer lasting sensor in comparison to the traditional CGM sensor life of 3 to 7 days. Accurate information regarding the past, present and future direction of glucose readings through minimally invasive technology is a significant improvement to current monitoring practices and devices (1,2). The iQuickIt Saliva analyzer is a noninvasive glucose testing device that uses saliva rather then blood to obtain blood glucose readings. The product works by placing the Draw Wick (test strip) inside the mouth to gather saliva, followed by inserting the strip into the analyzer to get a reading on the iQuickIt monitor, and it has the potential to connect to other personal devices through wireless technology. This product provides a painless alternative for obtaining blood glucose readings (3). GlucoTrack uses the earlobe to provide accurate blood glucose readings. The device captures glucose readings by combining the use of ultrasonic, electromagnetic and thermal technologies to * Address for correspondence: Lori Berard, RN, CDE, Winnipeg Regional Health Authority, Health Sciences Centre Winnipeg, University of Manitoba, Diabetes Research Group, 838-715 McDermot Avenue, Winnipeg, Manitoba R3E 3P4, Canada. E-mail address: [email protected] 1499-2671/$ e see front matter Ó 2015 Canadian Diabetes Association http://dx.doi.org/10.1016/j.jcjd.2015.02.003
form independent measurements that produce a single blood glucose reading. The main unit reader is attached via a cord to the personal ear clip that easily clips to the earlobe. The reading device can be used for up to 3 people. Each person using the device requires his or her own separate personal ear clip that needs to be calibrated only once at the beginning of its 6-month lifespan. This product may offer a comfortable noninvasive way to check blood sugar levels as frequently as desired (4). Products such as the Google Smart contact lens and the Apple iWatch with glucose reading capabilities are innovations that will need extensive research before becoming realities. As an introduction, the Google smart contact lens uses miniature sensors and antennas to capture blood glucose information continuously from tear fluid in the eye, then relays this information to the individual’s mobile device. There is also the potential of having the lenses equipped with LED lights that light up if glucose levels are too high or too low (5). The Apple iWatch is a highly anticipated product that is expected to revolutionize the field of wearable health technology. The first generation of the product is set to contain a specialized sensor that is able to monitor individuals’ heart rates. Apple’s recent hiring of medical sensor experts who specialize in noninvasive CGMs has led to speculation of future iWatch designs with glucose-reading capabilities (6,7). Given the current state of noninvasive CGM, it appears that this technology will not be available any time soon; however, it will be interesting to see how this area and the device develop in the future. Review of the devices and technologies in development as described reveals significant progress in the field of semi-invasive and noninvasive blood glucose testing. The simplicity and comfort provided by these devices may lead to more frequent monitoring, resulting in more information being available to manage glucose levels safely and effectively. Of course, all of these technologies will need to demonstrate accuracy, reliability and cost-effectiveness in order to be alternatives to today’s SMBG environment. Regardless, less painful, bloodless and wireless blood glucose monitoring could be a reality in the very near future. References 1. Watkin J. Improving sensor technology: An introduction to flash glucose monitoring. Barcelona, Spain: Presented at European Association for the Study of Diabetes. Accessed September 2, 2014, http://abbottnextfrontier.com/resources/ pages/easd-2013; 2013. 2. FreeStyle Libre. http://www.freestylelibre.co.uk. Accessed January 29, 2015. 3. iQuickIt Saliva Analyzer. http://iquickitsalivaanalyzer.com. Accessed September 2, 2014.
B. Cameron, L. Berard / Can J Diabetes 39 (2015) 190e191 4. GlucoTrack. http://www.integrity-app.com. Accessed September 2, 2014. 5. Otis B, Parviz B. Introducing our smart contact lens project. Google. http:// googleblog.blogspot.com/2014/01/introducing-our-smart-contact-lens.html. Accessed September 2, 2014.
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6. Apple. https://www.apple.com/watch. Accessed October 15, 2014. 7. Gurman M. iWatch’s novelty emerges as Apple taps sensor and fitness experts. 9to5Mac. http://9to5mac.com/2013/07/18/apple-stacks-iwatch-team-with-sensorfitness-experts. Accessed September 2, 2014.
Contents lists available at ScienceDirect
Canadian Journal of Diabetes journal homepage: www.canadianjournalofdiabetes.com
Innovations in Diabetes Care
Monitoring Blood Glucose Control: What Does the Future Hold? Brett Cameron BSc, Lori Berard RN, CDE * Winnipeg Regional Health Authority, Health Sciences Centre, Winnipeg Diabetes Research Group, Department of Medicine, Section of Endocrinology, University of Manitoba, Winnipeg, Manitoba, Canada
Self-monitoring of blood glucose (SMBG) through multiple daily fingersticks may soon be a thing of the past. Recent advances in semi-invasive and noninvasive SMBG technology could potentially introduce products utilizing innovative technologies that will provide less invasive glucose readings. The Abbott FreeStyle Flash Glucose Monitoring System (Abbott Diabetes Care, Alameda, California, USA); the iQuickIt Saliva Analyzer (Quick, Farmington, Connecticut, USA); GlucoTrack (Integrity Applications, Ashkelon, Israel); Google smart contact lens (Google, Mountainview, California, USA) and Apple iWatch (Apple, Cupertino, California, USA) are just some of the technologies that could revolutionize the way glucose readings are obtained. The Abbott FreeStyle Libre Flash Glucose Monitoring consists of a sensor, sensor applicator and reader that work through improved sensor-based technology. A small sensor applied on top of the skin inserts a tiny filament below the surface of the skin to capture blood glucose readings with little to no pain. A colour touch-screen reader is used to scan over the sensor. The quick scan by the reader provides a current blood glucose value, a trend arrow indicating the direction that the blood glucose values are moving as well as an 8-hour glucose profile. The device utilizes sensors that can be worn for 14 days and does not require a fingerstick for calibration. These improvements minimize the pain and inconvenience of fingerstick monitoring associated with current blood SMBG and continuous glucose monitoring systems (CGM) while providing a longer lasting sensor in comparison to the traditional CGM sensor life of 3 to 7 days. Accurate information regarding the past, present and future direction of glucose readings through minimally invasive technology is a significant improvement to current monitoring practices and devices (1,2). The iQuickIt Saliva analyzer is a noninvasive glucose testing device that uses saliva rather then blood to obtain blood glucose readings. The product works by placing the Draw Wick (test strip) inside the mouth to gather saliva, followed by inserting the strip into the analyzer to get a reading on the iQuickIt monitor, and it has the potential to connect to other personal devices through wireless technology. This product provides a painless alternative for obtaining blood glucose readings (3). GlucoTrack uses the earlobe to provide accurate blood glucose readings. The device captures glucose readings by combining the use of ultrasonic, electromagnetic and thermal technologies to * Address for correspondence: Lori Berard, RN, CDE, Winnipeg Regional Health Authority, Health Sciences Centre Winnipeg, University of Manitoba, Diabetes Research Group, 838-715 McDermot Avenue, Winnipeg, Manitoba R3E 3P4, Canada. E-mail address: [email protected] 1499-2671/$ e see front matter Ó 2015 Canadian Diabetes Association http://dx.doi.org/10.1016/j.jcjd.2015.02.003
form independent measurements that produce a single blood glucose reading. The main unit reader is attached via a cord to the personal ear clip that easily clips to the earlobe. The reading device can be used for up to 3 people. Each person using the device requires his or her own separate personal ear clip that needs to be calibrated only once at the beginning of its 6-month lifespan. This product may offer a comfortable noninvasive way to check blood sugar levels as frequently as desired (4). Products such as the Google Smart contact lens and the Apple iWatch with glucose reading capabilities are innovations that will need extensive research before becoming realities. As an introduction, the Google smart contact lens uses miniature sensors and antennas to capture blood glucose information continuously from tear fluid in the eye, then relays this information to the individual’s mobile device. There is also the potential of having the lenses equipped with LED lights that light up if glucose levels are too high or too low (5). The Apple iWatch is a highly anticipated product that is expected to revolutionize the field of wearable health technology. The first generation of the product is set to contain a specialized sensor that is able to monitor individuals’ heart rates. Apple’s recent hiring of medical sensor experts who specialize in noninvasive CGMs has led to speculation of future iWatch designs with glucose-reading capabilities (6,7). Given the current state of noninvasive CGM, it appears that this technology will not be available any time soon; however, it will be interesting to see how this area and the device develop in the future. Review of the devices and technologies in development as described reveals significant progress in the field of semi-invasive and noninvasive blood glucose testing. The simplicity and comfort provided by these devices may lead to more frequent monitoring, resulting in more information being available to manage glucose levels safely and effectively. Of course, all of these technologies will need to demonstrate accuracy, reliability and cost-effectiveness in order to be alternatives to today’s SMBG environment. Regardless, less painful, bloodless and wireless blood glucose monitoring could be a reality in the very near future. References 1. Watkin J. Improving sensor technology: An introduction to flash glucose monitoring. Barcelona, Spain: Presented at European Association for the Study of Diabetes. Accessed September 2, 2014, http://abbottnextfrontier.com/resources/ pages/easd-2013; 2013. 2. FreeStyle Libre. http://www.freestylelibre.co.uk. Accessed January 29, 2015. 3. iQuickIt Saliva Analyzer. http://iquickitsalivaanalyzer.com. Accessed September 2, 2014.
B. Cameron, L. Berard / Can J Diabetes 39 (2015) 190e191 4. GlucoTrack. http://www.integrity-app.com. Accessed September 2, 2014. 5. Otis B, Parviz B. Introducing our smart contact lens project. Google. http:// googleblog.blogspot.com/2014/01/introducing-our-smart-contact-lens.html. Accessed September 2, 2014.
191
6. Apple. https://www.apple.com/watch. Accessed October 15, 2014. 7. Gurman M. iWatch’s novelty emerges as Apple taps sensor and fitness experts. 9to5Mac. http://9to5mac.com/2013/07/18/apple-stacks-iwatch-team-with-sensorfitness-experts. Accessed September 2, 2014.