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posted by Fnord666 on Tuesday January 28 2020, @06:01PM   Printer-friendly
from the see-thru-glasses dept.

Researchers hope to make needle pricks for diabetics a thing of the past:

Patients with diabetes have to test their blood sugar levels several times a day to make sure they are not getting too high or too low. Studies have shown that more than half of patients don't test often enough, in part because of the pain and inconvenience of the needle prick.

One possible alternative is Raman spectroscopy, a noninvasive technique that reveals the chemical composition of tissue, such as skin, by shining near-infrared light on it. MIT scientists have now taken an important step toward making this technique practical for patient use: They have shown that they can use it to directly measure glucose concentrations through the skin. Until now, glucose levels had to be calculated indirectly, based on a comparison between Raman signals and a reference measurement of blood glucose levels.

While more work is needed to develop the technology into a user-friendly device, this advance shows that a Raman-based sensor for continuous glucose monitoring could be feasible, says Peter So, a professor of biological and mechanical engineering at MIT.

"Today, diabetes is a global epidemic," says So, who is one of the senior authors of the study and the director of MIT's Laser Biomedical Research Center. "If there were a good method for continuous glucose monitoring, one could potentially think about developing better management of the disease."

Sung Hyun Nam of the Samsung Advanced Institute of Technology in Seoul is also a senior author of the study, which appears today in Science Advances. Jeon Woong Kang, a research scientist at MIT, and Yun Sang Park, a research staff member at Samsung Advanced Institute of Technology, are the lead authors of the paper.


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  • (Score: 1, Interesting) by Anonymous Coward on Tuesday January 28 2020, @06:54PM (11 children)

    by Anonymous Coward on Tuesday January 28 2020, @06:54PM (#950177)

    As Dr. Richard K. Bernstein proved it over and over again, trans-cutaneous blood sugar monitoring is highly inaccurate compared to blood sampling. Moreover, he only recommends one brand usually as the most accurate. The last recommendation as far as I know is Abbott FreeStyle Freedom Lite (it used to be Accu-chek Aviva before). He is not on the payroll of these companies and he has actually unbeatable credentials as the first diabetic patient in the world to have monitored his own blood sugar in 1969. Read the Wikipedia entry on him for enlightenment on this.

    https://en.wikipedia.org/wiki/Richard_K._Bernstein [wikipedia.org]

    This posted in the hope that some diabetic or prediabetic people get to know him and his complete solution to diabetes (if I can venture to give it in a few words: diet, exercise, constant monitoring, minimal insulin injection all working synergistically to achieve a normal blood sugar of 83 mg/dl (4.6 mmol/l) throughout the day.

    If reading a book is beyond you, go check his teleseminars on YouTube since all the information in his book (and actually more) is given as he answer questions of the public.

    https://www.youtube.com/channel/UCuJ11OJynsvHMsN48LG18Ag [youtube.com]

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  • (Score: 2) by FatPhil on Tuesday January 28 2020, @07:04PM (10 children)

    by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Tuesday January 28 2020, @07:04PM (#950182) Homepage
    So there's a measurement mechanism already, and therefore we shouldn't work towards developing a more convenient measurement mechanism?

    Fuck, why are we still sending kids to colleges at all, if we can just settle for what's good enough already. Dayum, I've just solved the student debt problem, with your help of course, most of the credit goes to you.
    --
    Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
    • (Score: 2) by barbara hudson on Tuesday January 28 2020, @07:28PM (4 children)

      by barbara hudson (6443) <barbara.Jane.hudson@icloud.com> on Tuesday January 28 2020, @07:28PM (#950194) Journal
      Because the current measuring system that's been around for decades works better than anything we've come up with since? That the latest heavily advertised system, that uses subcutaneous monitoring, is neither all that accurate nor a replacement for actual blood sampling (you're supposed to still sample blood twice a day, but users are over-confident in the less accurate new tech so they don't, and are making dose decisions based on a machine that is 4x less accurate).

      Any new system is still going to require blood samples at least twice daily to confirm it's actually accurate. The proposed system is a proxy for actual blood tests, but not a replacement. I'm sticking with sampling every time I sit down at the table to eat - it's quick, easy, and not really painful. The same people with a reluctance to prick their finger for a blood sample skip insulin injections on a regular basis . They also boast about how when they do test, often the meter says HI because it's too high to measure. Then their kidneys fail and they die.

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      SoylentNews is social media. Says so right in the slogan. Soylentnews is people, not tech.
      • (Score: 2) by bd on Wednesday January 29 2020, @06:37AM (3 children)

        by bd (2773) on Wednesday January 29 2020, @06:37AM (#950533)

        I agree that blood tests are proven over decades. On the other hand, optical methods based on spectroscopy have the potential for being much more accurate than electrode based sensors... so it could potentially replace the test in hospitals and, depending on the technology used, also sample other interesting parameters. Depending on what else ends up working in terms of parameters, having an instant answer to stuff you normally have to wait for lab tests might be nice for emergency rooms.

        The biggest problem with optical systems is that many of them cannot distinguish between spectra of glucose in your blood vessels and signals from other tissues. This is a fundamental problem.

        Most likely a Raman system as in the article therefore won't be the solution that ends up being practical.

        What actually has the potential to work is optical coherence tomography, where you can actually image the blood vessels in depth, and only take signal from inside. Of course, that has other problems...

        But it would have its uses if it worked.

        • (Score: 2) by barbara hudson on Wednesday January 29 2020, @06:08PM (2 children)

          by barbara hudson (6443) <barbara.Jane.hudson@icloud.com> on Wednesday January 29 2020, @06:08PM (#950753) Journal

          The blood test strips are accurate to within 5%. The subcutaneous sample system is only accurate to within 20%. It should never have been approved.

          --
          SoylentNews is social media. Says so right in the slogan. Soylentnews is people, not tech.
          • (Score: 2) by bd on Wednesday January 29 2020, @10:25PM (1 child)

            by bd (2773) on Wednesday January 29 2020, @10:25PM (#950883)

            Maybe I'm mistaken, but for blood glucose meters, the FDA requirement is +/-15 mg/dl accuracy for blood glucose less than 100 mg/dl, and +/- 15% above 100 mg/dl.
            And a significant amount of points in your study may actually be outliers (something like 5%, though I didn't read through the statistics).
            Only the better blood test strips actually pass these requirements in real life: https://www.diabetestechnology.org/surveillance.shtml [diabetestechnology.org]

            Subcutaneous sample systems are a different beast from the technology described in the article. They measure glucose from sources other than capillary blood by definition, leading to impaired accuracy as you correctly describe.

            The scientific challenge for optical glucose meters (like the Raman system described in the article) is to differentiate the photons from inside the capillaries from other tissues. If they cannot differentiate, the accuracy will be unacceptible,
            which is why no such system has ever worked well enough so far.

            If this problem is solved, though, you could get instant continous measurements with Lab-reference accuracy. Such a system would be quite expensive, but you could put it on a patients finger just like the optical blood oxygenation sensors.

            • (Score: 2) by barbara hudson on Thursday January 30 2020, @12:23AM

              by barbara hudson (6443) <barbara.Jane.hudson@icloud.com> on Thursday January 30 2020, @12:23AM (#950918) Journal
              I came up with this idea more than 40 years ago and abandoned it immediately - there are too many obvious problems and it doesn't really bring anything to the table. My experience since with OCT pretty much affirms my original opinion.

              Current test strips are within 5%, are outside patent protection so the price hasn't gone up in decades, at least in Canada, and are far better than the old pee strips. An alternative would be to test breath for ketones, but just for rapid mass screening. By the time your breath smells of ketones you're pretty far and away out of control - but at least it would be a way to catch some of the 50% who have diabetes and don't know. But a blood test takes 15 seconds . What's the big deal of a finger prick anyway? Once a year at an annual checkup? Grow up. Several times a day? You'll get used to it.

              If you're afraid of a little pinprick, you're going to freak at regular insulin injections, even though they're less painful than a finger prick:

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              SoylentNews is social media. Says so right in the slogan. Soylentnews is people, not tech.
    • (Score: 3, Informative) by All Your Lawn Are Belong To Us on Tuesday January 28 2020, @09:50PM (4 children)

      by All Your Lawn Are Belong To Us (6553) on Tuesday January 28 2020, @09:50PM (#950257) Journal

      Also, as Heinlein said... most questions that start with, "Why?" end with, "Money," as the answer. For glucose monitors... each of the companies has sweetheart deals with certain insurances. Most insurances will reimburse for only one particular brand of test-strips or meters. It's a case of accepting good enough because it's free (to the end user).

      It's great that a newer method has been found. Now it has to be more economical than fingersticks. Or it will never see the consumer market.

      And there's also the HbA1C measure done as part of a Comprehensive Metabolic Panel, which gives a more long-term glucose situation. It has it's own questions about accuracy / reliability, but is generally accepted as the standard for knowing how a patient has been managing their glucose over the past 3 months or so.

      Bah, said enough already.

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      This sig for rent.
      • (Score: 2) by FatPhil on Wednesday January 29 2020, @08:04PM (1 child)

        by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Wednesday January 29 2020, @08:04PM (#950810) Homepage
        > each of the companies has sweetheart deals with certain insurances

        That's an answet that might satisfy <5% of the world, admittedly a noteably oblate sample, but what about the other 7.3 billion? (minus wuhantavirus adjustments)

        > KEEP AMERICA OPIATE AGAIN

        Nice sig! (did I misreade it?)

        Wait - Now I know whose payroll you're on!
        --
        Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
        • (Score: 2) by All Your Lawn Are Belong To Us on Wednesday January 29 2020, @10:46PM

          by All Your Lawn Are Belong To Us (6553) on Wednesday January 29 2020, @10:46PM (#950897) Journal

          That's an answet that might satisfy
          True, that's only the big driver where I live. Never looked up if diabetics elsewhere in the world are as monitor-happy as the United States is. (tongue in cheek. Monitoring does seem to help if one can afford it....) The rest of the world might also want to find the cheapest solution that works on a consistent basis. And if a non-invasive monitoring system works as-good-or-better (or even just well enough) and is more economical, I'd expect it to become popular there as well.

          Nice sig! (did I misreade it?)

          No. No, you did not. :P

          --
          This sig for rent.
      • (Score: 2) by pdfernhout on Thursday January 30 2020, @02:22PM (1 child)

        by pdfernhout (5984) on Thursday January 30 2020, @02:22PM (#951173) Homepage

        To twist your point. :-) Because otherwise more effort might be put by modern medicine (and modern urban planning) into nutritional and lifestyle changes like the "Blue Zones" project. Example:
        https://www.bluezones.com/2019/03/are-sitting-patterns-related-to-diabetes/ [bluezones.com]
        "Based on the findings from our study and those of the Dutch researchers, when viewed with the earlier epidemiologic data and findings from the laboratory experiments, it seems that sitting patterns may contribute to the growing international diabetes epidemic."

        And: https://www.bluezones.com/2017/12/diabetes-costs-u-s-employers-20-billion-annually-study-says/ [bluezones.com]
        "Researchers compared communities with the highest and lowest prevalence of diabetes. Communities with low diabetes rates are more likely to have community members who exercise, eat healthy, and don’t smoke, which often leads to overall higher well-being performance. ... Original blue zones areas have much lower rates of diabetes and other afflictions like heart disease, obesity, and cancer. Preventative care begins at the community level."

        An example from Cuban history:
        https://www.healthambition.com/how-to-prevent-diabetes/ [healthambition.com]
        "In recent news, a team of Cuban, US and Spanish researchers found that during the 1990s, the Cuban people, on a nation-wide level, had a significant reduction in overall deaths due to heart disease and diabetes. There was also an average weight loss of 5 kg per person in Cuba across the population during the period between 1991 and 1995. What could have caused this? The Caribbean nation isn’t known for its healthy eating habits, but during the early 1990s Cuba experienced a severe economic downturn due to the collapse of its ally the Soviet Union and an ongoing US embargo on imports. This led to a considerable drop in the number of calories Cuban people were consuming each day. At the same time, fuel for running cars was scarce and people took to walking or riding push bikes, thus increasing their daily exercise. Unfortunately, soon after the worst of the restrictions were lifted in 1995, weight gain increased dramatically. Followed, in the decade to come by a huge increase in heart disease and diabetes in Cuba. In fact, six years after the weight reduction period, diabetes mortality increased by nearly 50%. And by 2010, as fast food outlets and cheap processed food accessibility increased, around 53% of the population were estimated to be overweight or obese."

        Some similar examples can be found during WWII England.

        As that article also says: "The cost of treating diagnosed diabetes [in the USA?] has risen to $245 billion in 2012, from $174 billion in 2007. That’s an over 40% increase in just five years and diabetes now accounts for more than one in every five dollars spent in the massive US healthcare system."

        Meanwhile people complain about who will pay for installing the sidewalks Blue Zones has show to improve health:
        https://www.bluezones.com/2019/04/how-our-sidewalks-cars-trees-and-streets-affect-our-heart-health/ [bluezones.com]
        "How does your neighbourhood affect your risk for heart disease? Most of us can imagine that if we don’t have clean drinking water, heat, hydro or even garbage collection, our health might suffer. But what if we don’t have a sidewalk? Can that really affect our risk for heart disease? ..."

        See also to reverse most Type 2 diabetes and to improve the health of those with Type 1 diabetes:
        "The End of Diabetes: The Eat to Live Plan to Prevent and Reverse Diabetes"
        https://www.amazon.com/End-Diabetes-Live-Prevent-Reverse/dp/0062219987 [amazon.com]
        "At last, a breakthrough program to combat the rising diabetes epidemic and help millions of diabetics, as well as those suffering with high blood pressure and heart disease. Joel Fuhrman, M.D. Research director of the Nutritional Research Foundation, shows you how to live a long, healthy, and happy life—disease free. He offers a complete health transformation, starting with a diet with a high nutrient-per-calorie ratio that can be adapted for individual needs."

        While props are due to those who are making better blood sugar monitoring devices, we continue to ignore the low hanging fruit of reversing most diabetes through diet and lifestyle -- in part because there is little profit in that compared to selling someone a lifetime supply of insulin and other drugs and monitoring devices.

        See also the funny movie "Fat, Sick, and Nearly Dead" and its sequel by Joe Cross on the need for information on good nutrition as well as social support for the journey into wellness.
        https://en.wikipedia.org/wiki/Fat%2C_Sick_and_Nearly_Dead [wikipedia.org]
        "Fat, Sick and Nearly Dead is a 2010 American documentary film which follows the 60-day journey of Australian Joe Cross across the United States as he follows a juice fast to regain his health under the care of Joel Fuhrman, Nutrition Research Foundation's Director of Research. Cross and Robert Mac, co-creators of the film, both serve on the Nutrition Research Foundation's Advisory Board. Following his fast and the adoption of a plant-based diet, Cross states in a press release that he lost 100 pounds and discontinued all medications. During his road-trip Cross meets Phil Staples, a morbidly obese truck driver from Sheldon, Iowa, in a truck stop in Arizona and inspires him to try juice fasting. A sequel to the first film, Fat, Sick and Nearly Dead 2, was released in 2014."

        --
        The biggest challenge of the 21st century: the irony of technologies of abundance used by scarcity-minded people.
        • (Score: 3, Informative) by All Your Lawn Are Belong To Us on Thursday January 30 2020, @09:15PM

          by All Your Lawn Are Belong To Us (6553) on Thursday January 30 2020, @09:15PM (#951429) Journal

          I wouldn't disagree with much of anything you've said. Diet and exercise are unquestionably the best methods to use. They are the front line of medical advice for any person with diabetes, and a period of diet and exercise is the first prescription whenever possible which is the vast majority of the time. (You can gripe about requiring multiple doctor visits, then, as the only the practitioner has done in that first visit is get baseline readings and told you something which is public knowledge and free.) That's what is done first. The patient might also be recommended for dietary counseling. And it rarely works. It is also impossible to coerce compliance with a diet and exercise regimen - it is not something under medical control.

          So, if patient doesn't comply, then you do need medication. Insulin is rarely, if ever, a frontline prescription for Type II diabetes. Instead various drugs are tried which try and coax better glucose management. AFAIK you don't even really 'need' a monitor then. Your physician is going to be much more concerned with your A1C reading, really. The monitor is there for the patient's informational benefit and to hopefully inspire the patient to keep thinking about their diabetes as well. But if that works, then it does. (And you should still get recommendations for diet and exercise).

          As to WWII and Cuba.... sure, deprivation can indeed improve diabetic outlook when the food supply is restricted. It's almost like we evolved to be able to handle scarcity better than excess. (Actually more like reality....) OTOH, deprivation can also bring on a whole host of other nutritional related problems. Anemia and osteoporosis to name two.

          The only other thing I'd note is that if you're Type I diabetic, diet and exercise may still improve your outlook and cause less insulin usage. But that's a different picture - you will need insulin because your body just isn't making it.

          That said, I look forward to looking at your links.

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          This sig for rent.