R&D Department, Solianis Monitoring AG, 8050 Zurich, Switzerland.
Diabetes Technol Ther. 2010 Jan;12(1):1-9. doi: 10.1089/dia.2009.0095.
It is widely accepted that noninvasive glucose monitoring (NIGM) has the potential to revolutionize diabetes therapy. However, current approaches to NIGM studied to date have not yet demonstrated a level of acceptable functionality to allow real-time use, beyond restricted fields of application. A number of reviews have been devoted to the subject of NIGM with different focuses related to challenges and a description of the respective underlying problems. This review is aimed at addressing a fundamental topic in the application of NIGM that seems to have received less attention, by describing the perturbations that result in a reduced functionality of NIGM in daily use. Here we provide a short general introduction to glucose monitoring and a basic illustration of the electromagnetic spectrum with a description of the respective physical mechanisms underlying the measurement techniques. This allows for a better understanding of how these perturbing factors affect the measured properties. Cutaneous blood perfusion is one of the major perturbing factors to NIGM, along with variations in temperature, migration of water, and the effect of attachment of the sensor to the skin. An understanding of the mechanisms underlying perfusion variation over time and within the measured human skin tissue matrix is required to enable a discrimination between glucose-induced effects within the tissue and various biophysical impacts to be made. It is suggested that a plurality of probing frequencies is required to discriminate glucose-related changes from the perturbations. A system designed to perform the measurements in different regions of the electromagnetic spectrum with dedicated sensors (multisensor approach) has the potential to more efficiently and reliably discriminate glucose-related information from perturbations. This can be achieved by combining signals related to measurements with different physical underlying mechanisms of the interaction between the probing field propagation and the tissue to help account for the different sources of perturbations.
人们普遍认为，无创血糖监测（NIGM）有可能彻底改变糖尿病治疗方法。然而，迄今为止，研究中的 NIGM 方法尚未表现出可接受的功能水平，无法实时使用，仅限于有限的应用领域。已经有许多评论专注于 NIGM 这一主题，涉及到不同的挑战和各自的基础问题描述。本篇综述旨在解决 NIGM 应用中一个似乎较少受到关注的基本问题，描述在日常使用中导致 NIGM 功能降低的各种干扰。本文简要介绍了血糖监测，并简要说明了电磁频谱，描述了测量技术背后的物理机制。这有助于更好地理解这些干扰因素如何影响测量的特性。皮肤血液灌注是 NIGM 的主要干扰因素之一，此外还有温度变化、水分迁移以及传感器与皮肤的附着效果。为了能够在组织内的葡萄糖诱导效应与各种生物物理影响之间进行区分，需要了解灌注随时间和在被测人体皮肤组织矩阵内的变化的机制。有人建议，需要多个探测频率来区分与葡萄糖相关的变化与干扰。设计用于在电磁频谱的不同区域使用专用传感器进行测量的系统（多传感器方法）有可能更有效地可靠地从干扰中区分与葡萄糖相关的信息。这可以通过结合与测量相关的信号以及探测场传播与组织之间相互作用的不同物理基础机制来实现，以帮助解释不同的干扰源。
