Diabetes and blood glucose monitoring: Blood glucose monitoring has revolutionized the treatment of diabetes.
Large-scale clinical trials have demonstrated that frequent blood glucose
monitoring can aid in the prevention of many of the long-term complications of
diabetes, such as diabetic retinopathy, circulatory disorders, and death.
Diabetes is a complex biochemical disorder:
Although blood glucose is the most important biochemical parameter to measure in
diabetes, it is not the only parameter of medical interest. Other parameters of
medical relevance include glycosylated hemoglobin, used to measure long-term
blood glucose control, ketone levels, used to indicate if the patient is at risk
for diabetic ketoacidosis, and lipids such as cholesterol, triglycerides,
lipoproteins, and chylomicrons, used to indicate the patient's relative risk of
Type 2 diabetes:
Type 2 diabetes is a major illness, affecting over 7% of the US population.
Although diabetes is defined as an excess blood-glucose disease, type 2
diabetics also suffer from multiple disorders of fat metabolism. This causes
excessive amounts of lipoproteins to circulate in the bloodstream, damaging
blood vessels and leading to other cardiovascular disorders. As a result, most
type 2 diabetics ultimately succumb to circulatory problems.
The biggest complication of diabetes is cardiovascular disease. Two out of three
diabetics ultimately die from heart disease and stroke (caused by cardiovascular
disease), and many others suffer from other cardiovascular disease complications
such as diabetic retinopathy. Much of this cardiovascular disease in turn is
caused by the build-up of fatty deposits (lipid rich plaque) in blood vessels
Where does this fat come from? Elevated levels of circulating
lipoproteins, which can become extremely high in diabetics, particularly after
meals. Too bad that these aren't routinely monitored, and in fact are
usually missed by conventional triglyceride and lipoprotein assays, which are
almost always taken from fasting patients.
It's time to monitor more than just glucose:
Most diabetics strive to avoid diabetic complications by monitoring their blood
glucose several times a day. They prick their fingers and apply their
blood to test-strips at the right times, but their blood glucose monitors only
detect glucose. If the diabetics could receive continuous feedback on other
medically important analytes, in particular cardiovascular risk analytes, steps
could be taken to reduce these complications.
This website discusses a number of different technical approaches which will
enable elegant next-generation multi-analyte diabetes tests. The
technology here is intended to be incorporated into inexpensive point-of-care
test-strip and meter devices that are simple enough and low-cost enough to be
used on a daily basis if necessary.
The technology here is available for
license. We hope that some
of this technology will eventually make it into the mass-market diabetes tests
for 2010 and beyond.