Introduction

Most diabetics would agree that measuring their glucose levels is a pain in the…well…finger. That’s because to take a glucose reading diabetics typically must prick their finger with a lancet. Shown at right are the steps typical diabetics currently go through to monitor their blood glucose level. First, a lancet is used to prick a finger (1), drawing forth a small droplet of blood (2). The blood is then added to a strip either separate or built in to the glucose monitor (3). The glucose monitor then gives a reading of the concentration of glucose in the blood (4).

To make matters worse, physicians recommend that this procedure be completed as often as seven times daily. Given the pain and inconvenience of the traditional glucose reading method, there is little wonder why many diabetics monitor their glucose levels less than twice a day.

What Is Diabetes?

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a protein hormone that is released by the body to signal a fed state, activating the uptake of blood glucose and other fuels by the tissues for storage (muscle and adipose tissue) or catabolism (liver), as well as promoting the biosynthesis of macromolecules. So you can see that in a diabetic where the regulatory effects of insulin are severely compromised, glucose levels can get dangerously high.

Blood glucose levels can be maintained by the self-injection of insulin. In the late 1970s, the gene for human insulin was cloned into E. coli, and in 1982, this cloned human insulin became the first recombinant DNA product to be approved for human use. This had the effect of greatly diminishing the previous high cost of insulin treatment using insulin from natural sources (purified from bovine pancreas).

According to the American Diabetes Association (ADA), 5.9% (10.3 million) of the American population has diabetes, and there are over 120 million diabetics worldwide. The ADA believes that an additional 5.4 million people in the U.S. are unaware that they are afflicted with the deadly disease. This affliction is the seventh-leading cause of death in the nation. While the actual cause of diabetes is unknown, genetics and environmental factors such as obesity and lack of exercise are thought to promote the disease.

Importance of Glucose Monitoring

While diabetes is a chronic disease that has no known cure, self-monitoring of sugar levels by patients has transformed the management of diabetes over the last several years, allowing diabetics to achieve and maintain specific glycemic goals. Why is self-monitoring so critical? Without proper management of diabetes, the disease can cause severe long-term health complications, including blindness, kidney disease, heart disease, and nerve damage, potentially leading to amputation or death. Results of blood glucose monitoring are used to assess the efficacy of therapy and to guide modifications in nutrition therapy, exercise, and medications to achieve the best possible blood glucose control. By keeping the concentration of glucose in the blood inside a defined range (100-120 mg/dL), diabetics can lead normal lives. Shown above at left are the daily accouterments of a diabetic: glucose monitor, lancet, alcohol swabs, syringes, needles, insulin, and emergency sugar for over-injection of insulin.

Enter the GlucoWatch® Monitor

As previously described, monitoring blood glucose levels all day is no small ordeal. The GlucoWatch monitor, a newly developed product of Cygnus, Inc., is a wrist-worn device that provides automatic, non-invasive measurement of glucose levels for adults with diabetes. It has a disposable sensor that adheres to the wearer’s wrist, allowing measurement of sugar levels in the interstitial fluids on the outermost layers of the skin of the wrist. Although it is not yet FDA-approved for use by diabetics, and is still being tested and considered an investigative device, diabetics around the world anxiously await its release.

How the GlucoWatch® Monitor Works

Before use, the GlucoWatch monitor must first be calibrated. The wearer may do this by taking an initial glucose measurement using the traditional finger-prick method. Once calibrated, the monitor can provide up to three glucose readings each hour for 12 hours. The GlucoWatch monitor uses reverse iontophoresis to collect glucose molecules through intact skin. Similar to the transdermal medication patches used for smoking cessation and hormone therapy, iontophoresis is a non-invasive, needle-free method of enhancing and controlling the transport of water-soluble ionic (electrically charged) drugs out of the skin and surrounding tissues using a low level of electrical current.

A single-use sensor containing gel collection discs gathers glucose samples. The gel collection discs contain the enzyme glucose oxidase. As glucose enters the discs, it reacts with the glucose oxidase in the gel to form hydrogen peroxide. A biosensor in contact with each gel collection disc detects the hydrogen peroxide and issues an electronic signal. The monitor uses the calibration value initially entered by the wearer to translate the signal into a glucose measurement. The monitor then displays the glucose reading and stores it in memory. In addition to taking glucose readings, the GlucoWatch monitor can sound alarms in response to results outside of high and low values selected for each wearer. This feature can provide a method to reduce the risk of hyperglycemia (abnormal increase of sugar in the blood) and hypoglycemia (abnormal decrease of sugar in the blood).

The GlucoWatch monitor should prove to be an excellent alternative to the painful pricking of traditional glucose reading methods. For many concerned diabetics, it’s about time.

Diabetes and Glucose-Monitoring Web Site Links

Cygnus - The makers of the GlucoWatch®.

Diabetes - Diabetes care and info.

Diabetes Monitor - Comprehensive diabetes Web site.

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