Glucose meter

Launch of the first personal glucose meter Medisense Inc. 

D. Matthews, R. Holman, E. Brown, J. Streemson, A. Watson, and S. Hughes, Pen-sized digital 30-second blood glucose meter. Lancet 2, 778-779 (1987). 

With the introduction of modern electronics, inexpensive computers, and new materials there is a resurgence of voltammetric techniques in various branches of science as evident in hundreds of new publications. Now, voltammetry can be performed with a nano-electrode for the detection of single molecular events [1], similar electrodes can be used to monitor the activity of neurotransmitter in a single living cell in subnanoliter volume electrochemical cell [2], measurement of fast electron transfer kinetics, trace metal analysis, etc. Voltammetric sensors are now commonplace in gas sensors (home CO sensor), biomedical sensors (blood glucose meter), and detectors for liquid chromatography. Voltammetric sensors appear to be an ideal candidate for miniaturization and mass production. This is evident in the development of lab-on-chip... 

Anonymous. Blood glucose meters-recalled because of error reading. WHO Newsletter 1998 9/10 16. 

Pecchio O, Maule S, Migliardi M, Trento M, Veglio M. Effects of exposure at an altitude of 3000 m on performance of glucose meters. Diabetes Care 2000 23(1) 129-31. 

Problems with the use of blood glucose measurement systems are reported from time to time. For example, it is easy to read glucose meters wrongly (SEDA-25, 508). Hypoglycemia was missed when a patient inadvertently switched the glucose meter from mmol/1 to mg/dl and read 266 mg/dl as 26.6 mmol/1 and 158 mg/dl as 15.8 mmol/1 (302). 

An 89-year-old man wrongly read the glucose concentrations in his home glucose meter (303). The meter read 561 mg/dl and 591 mg/dl but testing in the clinic 2 hours later showed concentrations of 175 mg/dl and 188 mg/dl. He had read the digital display upside down 591 instead of 165 and 561 instead of 195. 

Biosensors for the determination of blood glucose have enjoyed widespread commercial success since the introduction of the pen-sized 30 s blood glucose meter [10]. However, researchers have continued to devise novel approaches in the development of amperometric biosensors based on screen-printing technology Table 23.1 summarises some examples of these approaches together with their performance characteristics. 

Once the sensor is inserted, the user is instructed to wait 2 h before they are prompted to calibrate the sensor. The user must run duplicate blood glucose measurements using a specific brand of glucose meter and download the fingerstick data into the receiver. The calibrated sensor will transmit data from the transmitter to the receiver every 5 min. The data are stored inside the receiver and can be displayed... 

The system does not display a glucose result for the first 10 h of operation to allow the equilibration of the sensor inside the body. The user is instructed to calibrate the sensor at hours 10, 12, 24, and 72, after insertion, by a blood glucose measurement. The blood glucose meter is built into the receiver, so the calibration is done automatically when a blood glucose measurement is made. After 5 days the user is instmcted to remove and dispose of the sensor support mount. The transmitter is reusable and contains replaceable batteries. The transmitter and mount are water resistant and can be worn during showers. The receiver is not water resistant because the receiver contains the open port for insertion of a blood glucose test strip. 

Figure 15.12 Comparison of in vivo glucose measurement using SERS and the One Touch II blood glucose meter. The glucose concentration change is plotted over time. Glucose bolus was started at 60 min. Squares ( ) are measurements made using the SERS sensor and triangles (A) are measurements made using One Touch II blood glucose meter. — 785 nm, P — 50 mW, and t — 2 min.

Before Dr. Brouchard can begin providing these services, he wants to make sure that his program is financially feasible. To do this, he needs to explore ways to be compensated for his services. He is familiar with being compensated for durable medical equipment, so he knows the pharmacy can bill for blood glucose meters, but he has never tried to bill third-party payers or patients for other types of services. 

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