BASED ON IOT METHOD OF NON-INVASIVE TECHNIQUIES FOR MEASURING BLOOD GLUCOSE LEVEL

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1 Volume 119 No , ISSN: (on-line version) url: ijpam.eu BASED ON IOT METHOD OF NON-INVASIVE TECHNIQUIES FOR MEASURING BLOOD GLUCOSE LEVEL 1 Mareshamani, SHANTHI SWAROOP REDDY 2 1 Assistant Professor 2 UG Students, Department of Biomedical Engineering BIHER, BIST, Bharath University Chennai mareshamani.bme@bharathuniv.ac.in ABSTRACT: Glucose monitoring devices represent an exciting frontier in diabetes research. Great efforts have been dedicated to the development of non-invasive glucose monitoring devices, which may considerably improve the quality of life for people suffering from diabetes and facilitate their compliance for glucose monitoring. This manuscript reviews past, current and emerging non-invasive glucose monitoring techniques and devices and presents the major challenges they face. Poor glucose specificity and sensitivity, physiological time lag, calibration process and human factors perspective are discussed. Since incorporating user requirements into device development may potentially increase user acceptance and improve patient safety and device effectiveness, special attention is given to usability, user experience and applicability for home use, thus extending previous published reviews. The main conclusion is that a favorable non-invasive glucose monitoring device must overcome the combination of accuracy, usability and applicability challenges. Improving the assessment of device usability and acceptance may shed light on primary user concerns and may thus offer a meaningful step forward in the commercialization of non-invasive glucose monitoring devices. INTRODUCTION: Glucose monitoring devices represent an exciting frontier in diabetes research, holding the potential to improve the lives of over 400 million people worldwide this number is expected to rise by approximately 55% within the next 25 years [1]. During the past few decades there has been an increased need for an economic, compact, painless and convenient noninvasive device which can alleviate the pain associated with the frequent skin pricking and promote frequent glucose testing that helps in control of blood glucose levels [2]. Therefore, efforts are made by researchers to develop such devices [3,4]. Ideally, these technologies should be painless, compact, lightweight, portable and easy to operate. At the same time the should provide reasonably accurate estimations of glucose concentration that are sufficient for critical behavioral, nutritional and drug dosing treatment decisions. Clearly, this is an extremely challenging mission. State of the art developments in glucose monitoring include minimally invasive techniques using body fluids other than blood e.g., sweat, saliva, interstitial fluid ISF, compromising the skin barrier without puncturing blood vessels and non-invasive 11769

2 techniques, that mostly rely on optical methods [5]. Minimally invasive devices that monitor glucose continuously and automatically known as continuous glucose monitoring systems [CGMs] are already available in the market [6]. Non-invasive technologies are aimed to further advance this field by providing means to monitor glucose levels without pricking the skin barrier. These devices can either enable continuous readings similar to CGMs or intermittent readings where users actively perform measurements. During the past two decades great deal of efforts were dedicated to the development of non-invasive glucose monitoring devices. However, most of non-invasive technologies did not meet the required standard of accuracy and failed to run for a durable period of time [6]. This review presents the key challenges that the development of non-invasive devices is facing and discuss the methodologies addressing them. Several reviews have already dealt with this issue, however they lack information regarding, usability, user experience and applicability for home use. Integrating these factors in the device design has the potential to increase user acceptance and result in more successful products that improve patient safety and device effectiveness [7]. Therefore, a human factor perspective should be incorporated to the assessment of past, current and emerging noninvasive glucose monitoring devices. METHOD: Near Infrared Spectroscopy (NIR) Glucose produces one of the weakest NIR absorption signals per concentration unit of the body s major components. NIR spectroscopy measurement enables investigation of tissue depths in the range of 1 to 100 millimeters with a general decrease in penetration depth as the wavelength value is increased. NIR transmission through an ear lobe, finger web and finger cuticle or reflected from the skin of the forearm and lip mucosa has been attempted in the NIR region of 1μm 2μm. NIR diffuse reflectance measurements performed on the finger and cuticle have shown good correlation with blood glucose but 10% of the predictions are not clinically acceptable [8].NIR spectroscopy is based on collecting reflectance or absorption spectra of the tissue with a spectrometer. When near-infrared light illuminates a spot on the skin, the light partially absorbed and scattered as a result of its interaction with chemical components in the illuminated tissue. Light that is not absorbed will be reflected out of the tissue or transmitted through it, before being received by optical detectors. An analysis of changes in the intensity of the light combined with the application of multivariate calibration techniques [10] permits the extraction of the tissue s chemical components, including glucose. Robinson[11] used NIR transmission spectroscopy and the multivariate calibration method to measure blood/tissue glucose concentrations in diabetic subjects. Several conventional spectrometer configurations are designed on transmission sampling in the nm range. The reported average prediction errors vary from 19.8 mg/dl to 37.8 mg/dl in oral glucose tolerance tests (OGTT) conducted on three subjects. In turn, Burmeister and Arnold [12], employed nearinfrared transmission spectroscopy to study noninvasive blood glucose sensing in different measurement sites like cheek, lip, nasal septum, tongue and webbing tissue. The results showed that the tongue, containing the least amount of fat, provided spectra with the highest signal-to-noise ratio. They collected the transmission spectra of the tongue in the nm ranges. Their findings showed a standard error of prediction (SEP) in excess of 54mg/dl for all diabetic subjects [13]. Hiese and Marbach [14] have reported a series of studies on glucose determination in the oral mucosa membrane in the

3 nm spectral range through a diffuse reflectance measurement. The best SEP was 43 mg/dl from a 2-daysingle-person OGTT. Hageman and coworkers [15]used a fiber optic probe to study diffuse reflectance over the nm range on the middle finger of the right hand. The blood glucose concentrations of the test persons were perturbed using carbohydrate loading. The results were evaluated using the partial least squares regression method (PLS) and radial basis function neural networks. In these tests, the mean root square prediction error was 3.6 mg/dl.this method has the advantage that no reagents are required for the measurements and that fiber optical components can be used. As a consequence only insulators are in direct contact with the skin. Furthermore the spectrometer can be constructed without moving parts, leading to a rugged design. METHODLOGY:- Continuous wave light source is used to illuminate the tissue under study. A typical wavelength range nm is used for measurements. The short wavelength region of the near infrared ( nm) has the following advantages that are ideal for non-invasive and in vivo diagnostics. In this range there is an optical window between the region in which visible light is absorbed by blood and skin pigments and the longer wavelengths in which absorption of water predominates. The NIR spectrum consists of overtones and combinations of the fundamental vibrations mainly of the bonds of carbon, nitrogen and oxygen with hydrogen. NIR spectra of aqueous systems show weak, broad and overlapping bands with random baselines. The position and intensity of the signals vary according to the chemical vicinity (hydrogen bonding effects). The influence of dissolved the salts and temperature on the NIR spectra of aqueous systems is well known. Since the normal proportion of glucose in blood and tissue is only about 0.1 percent of the water content the spectral variations due to glucose concentration are extremely small. The evaluation of the recorded spectra is further complicated by several influences: water is a strong absorber and also the main component of living tissue. In addition time dependent biological processes take place, e.g. pulse and respiration. Other sources of variation are erroneous spectral recordings caused for example by irregular pressure of the measuring head on the finger. As a consequence multivariate calibration methods have to be used for evaluating the spectra NIR spectrometer: The equipment for recording the spectra is shown in Fig. and consists of a light source, a fiber optical measuring head and a NIR spectrometer. This spectrometer uses a polychromator with a holographic imaging diffraction grating and an In Gas photo diode array detector with 128 pixels mounted on a glass block. A very compact design (70 mm x 50 mm x 40 mm) with excellent optical performance was achieved by using a high-dispersion grating with extremely short focal length. The optical resolution (Rayleigh criterion) is about 12 nm in the wavelength region from nm. Fiber optical bundles connect light source (tungsten halogen lamp) and spectrometer with the fiber optical measuring head. The fibers illuminating the skin (finger tip) are concentrically arranged around the central part of the bundle which connects to the spectrometer. They compute the calibration coefficients by recording of the spectra from several diabetes patients with varying BG concentration levels. The BG level is determined simultaneously by a conventional glucose analyzer using blood plasma. Diffuse reflectance studies of the inner lip also have shown good correlation with blood glucose and indicated a time lag of 10 minutes between blood glucose and the measurement signal [16]. Salivary glucose levels (a component of lip measurements) did not reflect blood glucose levels. Physical and 11771

4 chemical parameters such as variation in pressure, the temperature, triglyceride and albumin interfere with glucose measurement. Errors can also occur due to environmental variations such as changes in temperature, humidity, skin hydration, carbon dioxide, and atmospheric pressure. Extensive validation and testing of the glucose prediction equation is needed to determine if the glucose correlation is consistent in all clinically important conditions in all types of patients. dation and testing of the glucose prediction equation is needed to determine if the glucose correlation is consistent in all clinically important conditions in all types of patients. DISCUSSION : Non-invasive glucose monitoring holds great promise for improving diabetes management. Successful development of reliable non-invasive glucose monitoring devices that can operate over sustained periods of time has been an elusive goal in diabetes management. This review presents non-invasive technologies and the devices they have been utilized in and discusses key challenges in the development of such devices. Previous reviews typically describe the main non-invasive glucose monitoring technologies and devices, focusing on the technical developmental stages. This papers extends these reviews by providing additional aspects related to user needs in term of device aplicability and user acceptance. These are important and challenging issues that may determine whether a device will clinically and commercially fail or succeed [7]. Specifically, incorporation of usability aspects such as comfort, maintainability, portability and ease of both use and learning may affect patient safety and compliance with non-invasive selfglucose monitoring. Despite this, little research has been done to examine usability, user satisfaction and user acceptance of past, current and emerging non-invasive glucose monitoring devices. Acknowledging the importance of these factors, it should be noted that accuracy issues must first be addressed to produce reliable devices that meet clinically acceptable standards. Nonetheless, the development of commercially successful devices requires manufacturers to adopt usability and applicability perspectives in early stages of development. The main conclusion resulting from this review is that despite great efforts to make diabetes self-monitoring less invasive and cumbersome, many promising technologies that have been explored fail to overcome the tremendous challenges they face. The major challenges involved in the development of truly non-invasive glucose monitoring technologies are related to accuracy, usability and applicability for home use among a variety of people. Only a device that overcomes the combination of these challenges may provide a significant breakthrough in this field Figure 2. Such a device holds the potential to change the current gold standard use of invasive glucose biosensors and improve the quality of life of millions of people with diabetes worldwide. Currently, however, most devices still present a number of meaningful limitations, such as low sensitivity and specificity to glucose and the requirement of a complex and frequent calibration process. [30-35]This indicates that the balance between generalizability and applicability is difficult to achieve. It is necessary to improve the assessment of device usability and acceptance, which may shed light on primary user concerns and may thus offer a meaningful step forward in the commercialization of these devices. A major limitation of current non-invasive devices is that they cannot completely substitute a traditional glucose meter. Therefore, these devices must be under constant improvements, aiming to further advance performance by significantly improving the algorithms, software and device features

5 Additionally, further clinical studies are needed to determine whether utilization of non-invasive devices will indeed lead to enhanced glycemic control in patients using this technology. It should also be noted that the current review did not address the challenge of cost-effectiveness.non-invasive glucose monitoring devices are also economically appealing for consumers as they do not require lancets or strips, however some of the technologies discussed require high cost [40-45]. CONCLUSION: Although there has been much research dedicated to develop a non-invasive glucose monitoring device, the complexity and indirect nature of the measurement process remain barriers to the successful development of truly non-invasive technologies implemented in user-friendly devices. Nonetheless, some of the devices discussed here have made considerable progress in recent years, introducing an exciting opportunity for self-glucose monitoring that offers an adequately accurate and simple way for painless and convenient self-monitoring of glucose levels. Yet, continuous efforts must constantly be made to further evaluate and improve performance, usability and user acceptance, and to clearly illustrate the benefits of using such a device. REFERENCES: 1. Khanaa, V., Thooyamani, K.P., Udayakumar, R., Multi resigncryption protocol scheme for an identification of malicious mobile agent host, World Applied Sciences Journal, V-29, I-14, PP , Khanaa, V., Thooyamani, K.P., Udayakumar, R., A novel approach towards prevention of spam, phising, controlling hierarchical access using Domain Keys, World Applied Sciences Journal, V-29, I- 14, PP , Khanaa, V., Thooyamani, K.P., Udayakumar, R., Dual tree complex wavelet transform for adaptive interferogram residual reduction, Middle - East Journal of Scientific Research, V-20, I-9, PP , Khanaa, V., Thooyamani, K.P., Udayakumar, R., An improved raoblackwellized particle filter for GPS-INS integrated navigation, Middle - East Journal of Scientific Research, V-20, I-9, PP , Khanaa, V., Thooyamani, K.P., Udayakumar, R., WSN based gas leakage detecting and locating system for petrochemical industry, Middle - East Journal of Scientific Research, V-20, I-9, PP , Khanaa, V., Thooyamani, K.P., Udayakumar, R., Information sharing time based controlled system in emergency situations, Middle - East Journal of Scientific Research, V-18, I-12, PP , Kumar, J.R., Vikram, C.J., Naveenchandran, P., Investigation for the performance and emission test using citronella oil in single cylinder diesel engine, Middle - East Journal of Scientific Research, V-12, I-12, PP , Manavalan, S., Golden RenjithNimal, R.J., Efficient and evaluation properties of medicinal products and flowering plant conventional diesel, International Journal of Pure and Applied Mathematics, V-116, I-19 Special Issue, PP ,

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