Analysis of Non-invasive Methods to Diagnose Blood Glucose Level-A Survey

 

J. Premalatha*, Dr. P. Grace Kanmani Prince

Sathyabama Institute of Science and Technology, Department of Electronics and Communication,

Rajiv Gandhi Road, Chennai 600118.

 

ABSTRACT:

Diabetes or otherwise known as blood glucose level among the people is a serious issue to be considered nowadays. There are three types of diabetes namely TYPE 1 which occurs due to destruction of beta cells, TYPE 2 which occurs due insufficient secretion of insulin into the cells by pancreas and the third one GESTATIONAL type which occurs during pregnancy. To detect blood glucose level at present there are device like glucometer which is handheld and can be detected by the people in home itself. The other one is the professional testing method in hospitals. The drawback in these two methods is that they are invasive type of detection which includes needle incision which may lead to pain among the patients, the patients may feel uncomfortable or they may get panic. This paper deals with the study of non-invasive methods of detecting diabetes which will be helpful to extend the work in future for both the patient and also to the country since the invasive methods are considered the costly one.

 

 

 

INTRODUCTION:

As for as human health is concerned diagnosis of health status of a person was serious issue in late 1940’s. The first blood test was invented in 1940 to diagnose anemia. It was an invasive method which is common nowadays. The main drawback with the invasive method is that the patient may get panic, they may experience pain, they may also face trauma and other problems too. Most importantly it was a time consuming method. To measure blood glucose level in diabetic patient to diagnose diabetes there are commonly two methods .one is the professional testing methods in the hospitals done by the experts. The other one is the household handheld glucometer. Even though the glucometer reading was an instant one its sensitivity and accuracy was not satisfactory. The main drawback with the two diagnostic methods is that they are invasive method of testing.

 

 

Thus non- invasive methods for monitoring blood glucose level, which is free from pain has become promising diagnostic methods in the field of medicine. since acute diabetes or high glucose level in blood leads to eye problem, cardiac disease, kidney failure, even premature death and so many other severe complications too. So it is necessary to find a way which is very simple and fast way to diagnose diabetes. There are four major ways to find Diabetes or diabetes mellitus which are oral glucose tolerance test (OGTT), and gene diagnosis, glycosylated hemoglobin diagnosis, VOC comprehensive diagnosis. Apart from this methods some more methods are also there which are electrical impedance, NIR spectroscopy, breath analysis, ultrasound and thermal spectroscopy^[1][2]. Figure 1 shows the high blood glucose level in blood capillary of humans. Also for high accuracy measurement of blood glucose artificial neural network is also been introduced in^[3].

 

 

Figure 1 Blood with glucose in blood capillary

 

Non invasive method to diagnose blood glucose level:

Blood in human body plays a major role which is the medium transportation of nutrients and glucose to the whole body. Blood contains of 55% of plasma and 45% of blood cell, including 99% is red blood cell (erythrocytes) and 1 % is a combination of white blood cell (leucocytes) and platelets^[4]. In 55% of plasma glucose other nutrients are also included, which will influence the impedance and blood resistivity. The resistivity can be measured from the glucose present in 55% of plasma from which blood glucose level can be measured. These blood components can be modelled by electrical properties as discussed in^[5]. In^[6] four tin lead alloy electrode is used measure the bio electrical signal output between fasting and non- fasting blood glucose level of patients.

 

 

Figure 2 Finger electrode [6]

 

In [6] four electrode is used where the two inner and outer electrode are designed such that the subject finger should touch the entire four electrode on the correct length and width for proper bio voltage output. Figure 2 shows the model of finger electrode. The measurement setup consists of the parts namely constant current source, placement of finger electrode and differential voltage circuit. The current source with 1.14mA current is applied to finger electrode (outer electrode). The voltage drop of the finger is  applied to the differential voltage electrode which measures the voltage drop of the finger, which is connected to data acquisition device for sampling the output, for reading and writing into the file. In^[6] 10 samples are taken whose fasting and non-fasting value are measured in terms of voltage. Here the samples are made to maintain fasting for 8 hours and at the end of 8 hours voltage is measured with finger electrode set up with a time duration of ten minutes. And non-fasting voltage value is measured with an intake of juice with 30- 50gms of glucose in it. The difference in fasting voltage and non-fasting voltage is noted. It was found that the glucose level for the range of 4-5 mol/liter has the voltage range of 0.005v to-1.800v for fasting and for non-fasting it is 0.100v for 5 to 11mol/liter. Rolamjaya et al. has proposed another method to measure the blood glucose level non-invasively by near infrared (NIR) spectroscopy since glucose has certain absorption range in NIR, from 850nm-1700nm of wavelength. To penetrate into the body surface LED is used as in coherent infrared source. This penetrated light is then detected using InGaAs photodiode, where the output in the form of current is converted to voltage using transimpedance amplifier circuit. The earlobe is chosen as the measurement site as it is thin compared to other organs. The idea behind the NIR spectroscopy is that each substance has its own absorption spectrum property. These property can be found with the help of light and glucose is one of the component which exhibit excellent light absorption property. In this paper^[7] transmittance is taken as measurement method rather than reflectance since transmittance measures the scattered light which pass the other side of the tissue. Here photodiode converts light into current whose produced current is proportional to optical power. This current is converted to voltage with the help of transimpedance amplifier. The photodiode voltage is proportional to near infrared light transmittance, and it is correlated with blood glucose and this correlation is used to find blood glucose concentration which is function of photodiode voltage. In^[8] instead of NIR, near infrared photoacoustic spectroscopy method is used which is a non-invasive method of measuring blood glucose level.

 

In^[9] photoacoustic spectroscopy PAS is used, where the sample is excited by intense optical source such as laser which produces acoustic waves. This optical energy is absorbed by sample molecules and it is released as heat which results in rise in temperature and the sample volume is expanded. This change in volume of the sample leads to generation of pressure waves and this pressure wave can be detected form the surface region which travels outward from the region. This generated pressure wave is dependent upon optical and physical properties of the sample. The advantage of PAS is unlike conventional optical method. The light which has travelled deeper into the tissue will get absorbed by the tissue which will result in acoustic pressure wave. Another advantage in this method is that it is non destructive method and before measurement it requires only minimal sample preparation and also for continuous glucose monitoring this method is considered safe and convenient to use in live tissue. These PAS vary linearly with sample glucose concentration. With the review of many experiments in the literature this PAS technique when compared to other non-invasive technique was the promising one^[10]-[14]. In^[15] it is given that biological molecules closely follow their optical spectra. With this property this method can be used for non-invasive blood glucose measurement.

 

Some of the non-invasive measurements of blood glucose level are thermal emission spectroscopy, bio-impedance spectroscopy, Raman spectroscopy, near-infrared spectroscopy^[16]. Thermal emission spectroscopy is the method of measuring IR signs when the glucose concentration changes in the body^[17]. Bio-impedance spectroscopy deals with electrical properties of organic tissues and liquids of the body. To this liquid and tissues when it is excited by low power, the changes in the blood glucose level are indicated by measurement changes. Raman spectroscopy is the method of measuring glucose level where the sample is subjected to radiation and when it is exposed to light the reflection depends on the frequency shifting which indicates the blood glucose level^[18]. As discussed earlier NIR uses infrared rays where the reflected light from body tissue is captured by it.

 

Volatile organic compounds when exhaled plays an important role in screening of diabetes in earlier days and also it helps in monitoring blood glucose level in the body^[19]. Thus, acetone concentration is based on h-hydroxy butyric acid and when acetone is released from skin it is a very useful method to diagnose diabetes. It is found that concentration of acetone in skin showed a significant difference in diabetic patient than in non-diabetic patient^[20]. ShyqyriHaxha et al introduced an experimental method where there is a relation between sensor output voltage level and glucose concentration level. Here^[21] the index finger of human is taken for test as it is easy when compared to earlobe.940nm is chosen as light operating wavelength since the same has been chosen by other researchers^[22][23]. In^[21] the sample thickness is placed between the NIR light source and detector, then the output from the sensor is collected and converted using analog to digital converter(ADC). To remove the noise the data from ADC is filtered and values of concentration and absorbance are collected using suitable data processing algorithm. To get the previous calculated value multiplier extraction function is implemented which is then used to compare the future datasets. The data which is extracted from multiplier is then displayed on a live chart using LabView Interface for Arduino (LIFA) module^[24]. In^[25] the fiber Bragg grating sensor (FBG) is placed on the radial artery and the pulse wave which is propagated from heartbeat is measured. Here the wavelength used is 1525-1575 nm which is a broadband near infrared light that propagates through optical fiber. Also, here two methods were used namely short time cut process and 1-s normalization process. The disadvantage in short time cut process is that above 200mg/dL it could not measure the blood glucose level accurately. But 1-s normalization process was able to measure the blood glucose level above 200mg/dL and it had good measurement accuracy. In^[25] the FBG sensor is placed on the radial artery of the person and the blood glucose level of the person is intentionally changed. With the help of the FBG sensor the blood glucose level is measured. Using ultrasonic tomographic imaging device blood flow and diameter of blood vessel is measured. For each blood glucose level the pulse wave detected by FBG sensor and the measurement of ultrasonic tomographic device is correlated.

 

CONCLUSION:

This paper deals with the study of various non-invasive method and techniques of measuring blood glucose level in human body. So many research works has been carried out in past years to measure the blood glucose level non-invasively since the invasive method of measuring glucose level in blood has so many disadvantages. Taking all this criteria into account we have analysed all the possible ways to measure the blood glucose level non-invasively. Still so many parameters have to be considered in measuring the blood glucose level since this sort of non-invasive measurement needs so many clinical and scientific evidences. The challenge in measuring the blood glucose level non-invasively in normal environment is the accuracy when compared to invasive measurement. All the above discussed techniques and methods for measuring and monitoring diabetes non –invasively has a problem of analysing the data in real time. More works have to be carried out in future which guarantees the accuracy and also it should be cost efficient. 

 

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Received on 18.01.2019          Modified on 01.03.2019

Accepted on 29.03.2019        © RJPT All right reserved