Diabetes- A global burden
The prevalence of diabetes has drastically increased over the years. With approximately 463 million adults between the age of 20 to 70 living with diabetes globally. Alone in 2019, 1.5 million deaths were attributed to diabetes1. Diabetes management is the basic measure that can help in not only reducing diabetes-related deaths but also help in better outcomes of such cases. Over time diabetes leads to damage to organs like the heart, kidneys, eyes, blood vessels, and nerves. What is of more impact is the economic burden the disease causes the society. Diabetes alone exhausts 5 to 25% share of an average Indian household earning.2
Barriers to effective glucose monitoring
Effective diabetes management lies with regular monitoring of the sugar levels and accordingly having lifestyle adjustments. Regular monitoring cannot only reduce the diabetes-related complications but also reduce the casualties associated with uncontrolled diabetes.
While the adjustment to glucose management seems easy, but the barriers can be summarized in three possible factors-
- Poor adherence to the diabetes treatment plan
- Inability to a lifestyle adjustment
- Lack of regular monitoring
A bigger barrier to influence people into glucose monitoring is the currently available devices to check blood glucose levels. The current invasive methodology-based devices have different user acceptance. The majority of users have apprehension about the prick-based method and if given a choice would about a non-invasive option instead. As per a report by the International Federation of diabetes up to 60 percent of people with Type 1 diabetes and 67 percent of those with Type 2 diabetes do not monitor blood glucose as often as recommended.3 Current glucose monitoring methods for the ever-increasing number of diabetic people around the world are invasive, painful, time-consuming, and a constant burden for the household budget. 4
Scope of non-invasive monitoring devices
Non-invasive glucose monitoring is the holy grail when it comes to diabetes management. The methods although in their beginning state will prove to be the game-changer. Such non-invasive monitoring system will not only reduce the fear of self-testing but also lower down the budget of monitoring to quite an extent.
inCheck Glucose Monitor
inCheck glucose monitor is a first of its kind non-invasive touch-based glucose monitoring device. The device uses a PPG sensor to collect vital data that is later converted into values via carefully written and tested algorithms.
- No Pain blood glucose check
- No additional accessory to measure the glucose reading of the stand-alone device.
- Blood Sugar levels between 100-200 with almost 85% accuracy.
- For sugar levels <100 (low sugar) and > 200 (high sugar) , we found that accuracy is still greater than 80%
- Blood Sugar levels between 100-200 with almost 85% accuracy.
- For sugar levels <100 (low sugar) and > 200 (high sugar) , we found that accuracy is still greater than 80%
- Anytime glucose monitoring is now possible with easy to carry design
Technology
inCheck uses the non-invasive PPG or Photoplethysmography technique to detect blood glucose levels. PPG uses illumination of skin and changes in absorption of light through the skin to detect parameters like SpO2, Blood pressure, and Blood Glucose. The mechanism involves using a light-emitting diode (LED) that helps illuminate the skin. A photodetector is also known as a photodiode is present that measures the amount of light that is transmitted through the skin or reflected through the skin.
Figure1: Architecture of data capture via PPG in inCheck User study
A BETA Model of the Non-invasive glucose monitor was rolled out in the market. Buyers were informed regarding their participation in the data capture study. Participants were asked to send the readings from the conventional prick model glucose monitors along with the real-time InCheck readings.
Data shared by users A total of 23000 readings were captured by the devices. A comparison of the readings by the data shared with the users was more than 800 (through images) between December 2020 to March 2021.
inCheck showed that the proposed technology can measure- Blood Sugar levels between 100-200 with almost 85% accuracy.
- For sugar levels <100 (low sugar) and > 200 (high sugar) , we found that accuracy is still greater than 80%
Conclusion
This non-invasive solution with its initial accuracy margin showcases how this can help in diabetes management. The technology removes various barriers that come in the way of blood glucose management.
- The apprehension to prick and take readings
- Cost-saving by reducing the reoccurring strip charges
- Ability to be able to have screening done anytime
- Understanding blood glucose trends throughout the day for better-informed decision
- Medication adjustment and better adherence to glucose management
- In juvenile diabetic patients, such innovation can help the caregivers in ease way of monitoring
- Unnecessary invasive data check when a non-invasive means can quickly give range and readings
inCheck device in the initial BETA phase was able to prove the usability in the study participants. The technology will require more support and research to be able to provide the data in a more accurate fashion. The data capture and the results will have to be tested in a larger group of people. This will help in understanding the data in cases that are in a proper setting to be able to control factors that influence the reading fluctuation.
The PPG-based model has a limitation that depends on usability. The PPG signal quality depends on the subject’s skin tone at measurement, blood oxygen saturation, blood flow rate, and temperature of the skin. The signal strength will be affected by power line interference, motion artifacts, muscle artifacts, high-frequency artifacts, and low amplitude.
Non-invasive glucose monitors have a great scope to influence the users towards regular monitoring. The monitoring option has advanced with time, but such innovation can prove to be of great help.
Reference
- https://www.who.int/news-room/fact-sheets/detail/diabetes
- Oberoi S, Kansra P. Economic menace of diabetes in India: a systematic review [published online ahead of print, 2020 Jun 17]. Int J Diabetes Dev Ctries. 2020;1-12. doi:10.1007/s13410-020-00838-z
- International Diabetes Federation. Integrating Diabetes Evidence into Practice: Challenges and Opportunities to Bridge the Gaps. International Diabetes Federation; 2017;1–74
- Villena Gonzales W, Mobashsher AT, Abbosh A. The Progress of Glucose Monitoring-A Review of Invasive to Minimally and Non-Invasive Techniques, Devices and Sensors. Sensors (Basel). 2019;19(4):800. Published 2019 Feb 15. doi:10.3390/s19040800