Needle-free glucose monitoring, non-invasive glucose monitoring, bloodless glucose monitoring, non-i

22

LIVING

Non-invasion of the body

scratchers

The Holy Grail of diabetes care is needle-free - or

non-invasive - glucose monitoring. Are we there yet?

By Susannah Hickling.

It's hardly any time at all since

anyone who needed to monitor

their glucose levels had to stab

themselves in the finger and

draw blood. Finger-prick testing

might be accurate but it's a painful,

relentless, primitive process that

can leave calluses over time. Small

wonder some people with diabetes

have been reluctant to finger-prick

and have seen poorer control as a

result. But all that is changing with

the advent of 'bloodless' glucose

monitoring - also called non-invasive

glucose monitoring.

What is non-invasive glucose

monitoring? It is a way - and there

are plenty - of measuring glucose

levels without piercing the skin to

sample blood. A review by diabetes

technology experts led by Professor

David Klonoff of the University of

California, San Francisco, of products

for monitoring glucose levels

published in June 2021 in the Journal

of Diabetes Science and Technology

identified three broad categories of

device - minimally invasive, noninvasive

optical and non-invasive

fluid sampling.

Almost everything that is

currently available slots into the

minimally invasive category. This

essentially covers continuous

glucose monitoring (CGM) and

flash technology, which have

brought comfort and convenience

for many. They can bring a better

understanding of your condition,

improved control and less waste,

since you use fewer, if any, disposable

test strips or lancets. But, as the

'minimally invasive' label suggests,

these monitors cannot be said to

be totally non-invasive, though of

course they're a far cry from the

relative brutality of finger-stick

testing. They rely on the need

to puncture the skin in order to

implant a thin sensing filament into

subcutaneous tissue to a depth of

around 4-5mm. The sensor has to be

periodically replaced, usually every 7

or 14 days.

Non-invasive optical glucose

monitoring involves passing a type

of radiation into a vascular area of

the body to extract information on

glucose levels without any need for

needles. Meanwhile, non-invasive

fluid sampling monitoring analyses a

fluid sample - typically tears, sweat,

Afon traditiona l watch with app.

saliva or urine - without piercing

the skin.

For these two types of needle-free

device, perfecting the technology

and replicating the accuracy of

finger-prick testing remain a

major challenge. This has been the

downfall of a number of non-invasive

monitors over the years. This

includes the Google contact lens,

which measured blood sugar in tears

- but, unfortunately, not consistently

enough - and the Gluco Watch,

which used an electrical charge to

bring glucose to the skin surface.

This was discontinued after wearers

reported accuracy issues and skin

irritation.

The sceptics of non-invasive

testing are many, with some believing

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  25. Insulet Omnipod DASH insulin pump with insulin pods, podders, Omnipod DASH Personal Diabetes Manager
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  27. Diabetes kit, diabetes magazine diabetes information
  28. Desang Diabetes Magazine, free diabetes magazine, living with diabetes, the diabetic diet, carb coun
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  31. Diabetes technology education from Diabetes Technology Network DTN
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