Noninvasive blood glucose monitoring using the optical signal of pulsatile microcirculation: a pilot study in subjects with diabetes

Objective: The objective of this study was to determine the conditions for optimizing measurements obtained with a noninvasive blood glucose monitor using the optical signal of pulsatile microcirculation (OSPM) in both prediabetic and diabetic subjects receiving medication. Research Design and Methods: Eighteen subjects (3 prediabetic, 15 diabetic) aged 61.8 [15.9] years (mean [S.D.]) were studied. OSPM was the pulsatile component (P) of the signal obtained and analyzed by a blood glucose monitor. The measurement was calibrated to the fingerstick meter for each subject for personal calibration. Data were obtained from all subjects using both meters. Results: A total of 179 data pairs were measured and analyzed. The validity of the position of the tested finger was assessed using the position criterion, which resulted in the removal of 38 data pairs. The criterion for the intensity of the P signal was satisfied by 141 data pairs, with nonconforming data (with a much lower P signal) mainly occurring below 26 degrees C. A total of 113 data points passed both criteria, and 100% of them fell within Zones A and B of the Clarke error grid. Data in Zones A and B exhibited a linear relationship (r=.81; slope=0.82; intercept=28.0) between noninvasive and fingerstick measurements. Conclusions: Environmental temperature has the greatest influence on the capability of the OSPM technique to monitoring blood glucose concentration, which is subject dependent. The position of the tested finger is the second major factor, hence a carefully designed finger adaptor is essential. (C) 2008 Elsevier Inc. All rights reserved.