Could a special glove help give people with diabetes better control over their blood sugar?
A research group, based at the American University of Beirut in Lebanon, thinks it can. They have developed a way to continuously and accurately monitor blood sugar by using electromagnetic radiation and a specially designed glove and sensor.
A wearable, needle-free glucose monitoring device in the shape of a glove and armband using ... [+]
We are living in strange times. Gloves and masks have become the norm when leaving the house and we have all become very preoccupied with our health and that of our friends, families, neighbours and acquaintances — even the random stranger we see across the street.
This seems scary and uncomfortable, as most of us are in the fortunate position of not having to worry about our health on a day-to-day basis. Other than the occasional visit to a family doctor to pick up a prescription, or have a health check, that’s it for most of us.
Not so for people with chronic conditions like diabetes. You may not realize it, but more than 10.5% of the US population — that’s 34.2 million people — has some form of diabetes. Their pancreas stops producing insulin naturally and as a result their body is unable to control its blood sugar levels without help.
This means they and their families have to think about their health every day. Or, more accurately, every hour, and sometimes every few minutes, regardless of whether there is a global pandemic or not. If they don’t, they are at risk for multiple health problems including heart disease, vision problems, kidney disease and even foot amputations. Many people with uncontrolled diabetes also die from the condition each year.
A woman with diabetes uses a glucometer to measure her blood sugar level (Photo by FRANCK FIFE / ... [+]
For people with diabetes who rely on insulin injections, or pumps, to keep their blood sugar down — those with Type 1 diabetes and some with Type 2 — this often means pricking their fingers several times a day to test their blood glucose and make sure it is at a healthy level.
This testing problem has been on people’s minds for a while and it has sparked researchers and innovators to develop new technology to help people with this life-long condition.
“This work represents the first of a kind noninvasive glucose monitoring technique,” explained Rouwaida Kanj, PhD, an associate professor at the American University of Beirut and one of the lead researchers who has developed the new monitor. “Our system is fully non-invasive, continuous and wearable.”
The Value Of Continuity
Continuous glucose monitors, which give regular blood sugar readings without repeated finger-prick testing, have been around in some form since the first such monitor, the Medtronic Minimed, was approved by the FDA in 1999. While this was a landmark ruling, it had many limitations. For example, the FDA approval stated it could only be used in addition to standard blood testing and it was only tested in adults.
Since then, several more have been approved for personal use by people with diabetes. Notably, Dexcom’s STS Continuous Monitor was approved in 2006 and Abbott Laboratories' Freestyle Navigator in 2008 - both these devices have since been updated. They work by testing the glucose levels in fluid found just under the skin and require the insertion of a small sensor. The fully implantable Eversense sensor - made by Senseonics was also approved in 2018.
Diabetic teen equipped with glucose sensor and Freestyle Libre scanner which can just be flashed at ... [+]
Such devices are smaller and more accurate than ever before. They are significant as the so-called ‘artificial pancreas’ cannot be developed without them. This is a looped system that electronically mimics the function of a real, functioning pancreas. It does this by linking up a continuous supply of insulin, in the form of an electronic pump, with a continuous glucose monitor to direct how much insulin the pump should give the wearer in order to reduce their blood sugar.
A fully automated closed loop system is not completely developed yet, current systems still require some user input, but there are a couple of mid-way models already on the market. Medtronic is a leader in the field and has a model already approved by the FDA. At the end of last year another system developed by Tandem and Dexcom was also approved.
Putting The User First
Although some great technology and devices have been developed for people with diabetes over the last decade, there is still a problem with uptake. A lot of personal preference comes into it, but even the most up to date of the FDA-approved continuous glucose monitors are at least semi invasive. They require a sensor to be injected under the skin and taped in place, which can be annoying, or unsightly, for wearers and could restrict some activities.
“There are a lot of other non-invasive glucose monitors,” commented Joseph Costantine, PhD, a senior researcher involved in designing the glucose sensor, also based at the American University of Beirut. “However, our system is unique because it is continuous.”
The eDiamond sensor is able to use the position of the blood vessels to its advantage. The proposed ... [+]
The new device, which the researchers call eDiamond, uses electromagnetic radiation and a sensor designed to focus on blood vessels in the area it is worn to record how much glucose is in the blood at any given time.
The team tested the accuracy of the sensor in a glove and an armband, which were able to quickly and accurately predict blood glucose levels without the time lag seen with some other continuous glucose monitors. The researchers want to make the technology as convenient as possible and have plans to also develop a sock (aimed more at children) and a necklace, using the same sensor technology, but these are still in the development phase.
“The main inspiration for the team came from looking at the hand veins and this is where the idea of the glove and then the whole sequence of accessories, if you want to call it, came to mind,” explained Kanj.
Other glucose monitors that use electromagnetic radiation to sense blood sugar levels have been designed, but none are both continuous and non-invasive. No continuous, completely non-invasive glucose monitors are currently on the market, which is something the Beirut research team hopes to change.
Their work is still at a fairly early stage, and has a few teething problems to iron out. For example, one potential issue with using electromagnetic radiation to sense glucose is that these monitors are highly sensitive to temperature.
“For this reason we made sure to keep the temperature constant throughout the… experiments to remove any potential effects on the recorded signals,” explained Costantine. “We’re planning to add temperature sensors to the system and study further the effect of the temperature in our future developments of the project.”
They also need to test how well the sensor performs under different physiological conditions such as during or after exercise. This can have a significant impact on blood glucose and so far the volunteers who have tested the device have all been sitting still.
The team is now looking for partners to develop the tech further and to hopefully integrate it into an artificial pancreas project with a suitable insulin pump.
Many industrial and academic players have entered this space, although only a few have got as far as getting a device approved and on the market. There is definitely a need for more non-invasive glucose monitoring technology, but it remains to be seen if eDiamond will make it all the way.
This research was published in the journal Science Advances.
