Non-invasive blood glucose monitoring technology

Non-invasive blood glucose monitoring technology. The new technology has made the ideal of painless and convenient blood glucose monitoring a reality. Blood glucose can be measured without a needle, and non-invasive blood glucose monitoring technology is gradually becoming popular.

Hypertension and diabetes are the two most common chronic diseases that require long-term management and life-long control. Blood pressure and blood sugar monitoring are one of the most important aspects of management and control.

Blood pressure monitoring is non-invasive, convenient, anytime, anywhere, and can be dynamically observed, but blood glucose monitoring is much more difficult. Traditional blood glucose monitoring methods are a “pain point” of diabetes management.

Regular monitoring of type 2 diabetes is recommended 5 times a day: on an empty stomach, 2 hours after three meals and before going to bed, while type 1 diabetes requires more frequent monitoring. Even so, blood sugar peaks and valleys may be missed.

Intravenous blood sugar needs to be collected in hospitals or medical institutions and then sent for testing. This is troublesome and inefficient. Diabetes in the community may be difficult to achieve. Even in hospitalized patients, frequent blood sampling is painful.

The peripheral blood sugar is much more convenient, so you don’t need to go to the hospital frequently, but it is too painful to repeatedly prick your fingertips to measure blood sugar.

At present, glycosylated hemoglobin, one of the important indicators of blood glucose monitoring, also needs to be measured in the hospital. The key is that glycosylated hemoglobin reflects the average level of the patient for three months, and the fluctuation of blood glucose during the period cannot be timely and objectively assessed.

Unsatisfactory blood glucose monitoring methods are one of the important reasons for poor diabetes management.

If blood glucose measurement can be as painless and convenient as blood pressure measurement, it will greatly improve the efficiency of diabetes management.

The new technology has made the ideal of painless and convenient blood glucose monitoring a reality.

The instant blood glucose meter is a glucose monitoring system composed of a coin-sized sensor and an MP3-sized scanner.

First, a small flexible probe is implanted under the skin, the needle is so small that it is almost insensible and painless when implanted, and then fixed on the dorsal part of the upper arm with an adhesive sheet, which constitutes a transient sensor. The transient sensor calculates the blood glucose concentration by measuring the glucose concentration in the tissue fluid, and replaces the blood glucose level with the sugar content in the interstitial fluid, without the need for blood sampling, which is non-invasive, painless and accurate.

Every time blood glucose is measured, there is no need for blood sampling needles and test strips. Just use the scanner to scan the sensor gently, and the last 8 hours of glucose data and a glucose change trend arrow can be displayed to show that the glucose level is rising, falling or being Change slowly.

The sensor is disposable and replaced every 2 weeks. Moreover, the sensor adopts a waterproof design and can be worn during bathing, swimming and sports. Even with clothing, the scanner can scan and obtain glucose information within 1 second, which is very convenient.

In addition to scanning the sensor to quickly obtain the current glucose reading, the painless instant blood glucose meter can also perform continuous and dynamic glucose detection, providing comprehensive information on glucose changes, and understanding the trend of blood glucose levels.

The hospital version of the instant blood glucose meter can also monitor the dynamic blood glucose changes of multiple people at the same time.

In addition to being painless and convenient, instantaneous dynamic blood glucose monitoring has the following advantages:

• 1. It displays the blood sugar at each time point 24 hours a day, can find the peaks and valleys of blood sugar, and reveal the patient’s complete and objective blood sugar status. For example, it is possible to find nighttime hypoglycemia that cannot be detected by traditional blood glucose monitoring methods.
• 2. After daily behaviors such as eating, exercising, and medication, the blood glucose feedback is very quick and intuitive, which can better guide patients’ lives. With dynamic monitoring, you can see the speed and degree of blood sugar rise after each meal, and you will know that what you eat today is appropriate.
• 3. If you find a rapid decrease in blood sugar, eat in time to avoid serious hypoglycemia events. Similarly, if you find a rapid increase in blood sugar, add medicine in time to avoid acute complications such as ketoacidosis or even hyperosmolar coma.
• 4. In the long run, the use of dynamic blood glucose monitoring can help reduce chronic complications of diabetes and reduce mortality.

On November 27, 2020, the Diabetes Branch of the Chinese Medical Association issued the “Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2020 Edition)”. The new guidelines set “Time Within Target Glucose (TIR)” as a control goal for diabetic patients.

As a result, TIR became popular overnight, and TIR was obtained through painless dynamic blood glucose monitoring technology.

TIR refers to the time (usually expressed in min) during which glucose is within the target range (usually 3.9-10.0mmol/L, or 3.9-7.8mmol/L) within 24 hours, or its percentage.

The TIR International Consensus released in 2019 recommends that the TIR control target for patients with type 1 and type 2 diabetes is> 70%, but it should be highly individualized, while paying attention to hypoglycemia and blood glucose fluctuations.

The new guidelines also adopted this standard.

It is generally believed that TIR is 70%, which is equivalent to 6.7% of glycosylated hemoglobin. TIR has a negative correlation with glycosylated hemoglobin, the lower the TIR, the higher the glycosylated hemoglobin.

TIR can better reflect the occurrence of hypoglycemia and the degree of blood glucose variation under the same glycosylated hemoglobin, while dynamic blood glucose monitoring technology makes up for the shortcomings of traditional blood glucose monitoring.

In addition, TIR can also be used as an indicator of chronic complications of diabetes. Data analysis of the DCCT study showed that for every 10% decrease in TIR, the risk of microalbuminuria increased by 40%, and the risk of retinopathy occurred or progressed by 64% [1].

In addition to the aforementioned microvascular disease, TIR is also significantly associated with macrovascular disease. A cross-sectional analysis of the data of 2215 patients with type 2 diabetes, using continuous glucose monitoring to determine the TIR of 3.9-10.0mmol/L. The results showed that for every 10% increase in TIR, the risk of carotid intima-media thickness (CIMT) decreased by 6.4% [2].

TIR can further predict the risk of death. A retrospective study of 9028 diabetic or non-diabetic critically ill patients showed that the lower the TIR, the greater the risk of death in diabetic patients [3].

In addition, TIR can also be used as an evaluation standard for clinical trials and new drug research, and can provide more comprehensive information than glycosylated hemoglobin [4].

Incorporating TIR into the goal of blood glucose control means raising the “blood glucose control standard” to a new level of quantitative management of “blood glucose control reaching the standard”.

The applicable groups of continuous glucose monitoring technology include:

1. Type 1 diabetes;

2. Type 2 diabetes patients who need intensive insulin therapy;

3. Patients with type 2 diabetes who are treated with hypoglycemic drugs under the guidance of self-blood glucose monitoring still have one of the following conditions:

• ① Unexplainable severe or repeated hypoglycemia, asymptomatic hypoglycemia, and nocturnal hypoglycemia;
• ②Unexplained hyperglycemia, especially fasting hyperglycemia;
• ③The blood sugar fluctuates greatly;
• ④Patients who deliberately maintain hyperglycemia due to fear of hypoglycemia.

4. Patients with gestational diabetes or diabetes complicated with pregnancy.

5. Patients treated with insulin during perioperative period.

6. Patient education: Patients who need to understand the changes in blood sugar caused by diet, exercise, drinking, stress, sleep, and hypoglycemic drugs, and change their lifestyles.

7. Other special conditions, such as diabetic patients with gastroparesis, special types of diabetes, endocrine diseases accompanied by blood sugar changes, etc.

8. Other conditions deemed necessary by specialists.

9. Clinical research.

The new technology makes it possible to continuously monitor glucose without invasiveness and pain.

(sourceinternet, reference only)

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