[DOWNLOAD] "Spectroscopic and Clinical Aspects of Noninvasive Glucose Measurements." by Clinical Chemistry * eBook PDF Kindle ePub Free

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eBook details

• Title: Spectroscopic and Clinical Aspects of Noninvasive Glucose Measurements.
• Author : Clinical Chemistry
• Release Date : January 01, 1999
• Genre: Chemistry,Books,Science & Nature,
• Pages : * pages
• Size : 238 KB

Description

Interest in monitoring the glucose concentrations of diabetic patients has increased since the publication of the Diabetes Control and Complications Trials report showing that tight control of blood glucose concentrations, by frequent testing and concomitant adjustment of insulin doses, decreases long-term complications resulting from diabetes (1). A computer simulation based on the Diabetes Control and Complications Trials results estimates an additional 5 years of life, 8 years of sight, 6 years free from kidney disease, and 6 years free from amputations for a diabetic following the tight control vs the standard regimen (2). Noninvasive (NI) [1] monitoring of glucose has been of particular interest because of the pain associated with invasive self-monitoring. Ease of use and reduction of pain can encourage more frequent testing and hence tighter control of the glucose concentration. Patient care needs and the commercial importance of NI glucose monitoring has led to a flurry of "research" by entrepreneurial and commercial concerns that has been published mainly in patent literature. Patents are generally granted on the basis of novelty and potential usefulness, with less regard for accuracy and precision data or experimental design. A large number of NI glucose patents lack scientific rigor and some may be based on wrong or unproven assumptions. Several recent reviews have discussed the importance of NI glucose testing and report on attempts at its measurement (3-7). Despite the dearth of information published in peer-reviewed journals, I will review the different optical methods for NI glucose measurements, physical principles, expected sources of error, and their potential impact on clinical decisions. This review will emphasize the theoretical principles and merits of each technique and the reported error limits. Self-monitoring of blood glucose concentrations has advanced over the past few years. Glucose values determined by home meters correlate well with laboratory results. Because of the importance of precision and accuracy of self-monitoring blood glucose devices, guidelines for the performance of these devices were recommended in 1987 by the American Diabetes Association (8). These goals and performance characteristics of current meters are important as a yardstick for establishing the potential performance of NI technologies. The limits of detection and quantification, the standard deviation of the measurement, the accuracy, and the total error of an NI measurement need to correlate with self-monitoring devices and with measurements in the laboratory. American Diabetes Association guidelines for home glucose monitors state that values should fall within 15% of the readings obtained by a reference method. The goal set for future self-monitoring blood glucose meters is to achieve a variability (system plus user) of less than [+ or -] 10% (8). Evaluation of commercial devices shows that not all meters fulfill this consensus goal (9). The major error component is user error, which includes the volume of the blood droplet, the accuracy with which the blood drop is placed on the pad, hematocrit effects on serum volume, timing, and the effect of temperature on the signalgenerating reaction. An NI measurement can potentially eliminate some of these effects but may have a different set of error sources.

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