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Current methods of glucose detection
are typically based upon systematic self-monitoring of glycemia and
represented a cornerstone in intensified insulin therapy. In fact,
self-monitoring of blood glucose (SMBG) marks probably the most
important advance in diabetes care since the discovery of insulin.
However, at least two aspects make conventional SMBG difficult. Finger
pricking to obtain the droplet of blood is regarded by many patients as
even more daunting and painful than insulin injections.1 In
addition spot measurements of blood glucose, even if performed several
times daily, only provide an incomplete picture of the blood glucose
changes occurring over the whole day.
Non-invasive optical detection methods
have recently become viable alternatives to monitoring blood glucose
levels. Spectrophotometry is an established method for the
quantification of solutes in liquids. It is based on solute specific
absorption bands in the visible (VIS), near infra-red (NIR) or mid
infra-red (MIR) spectral range. Quantification of the solutes is
possible by determination of light attenuation caused by absorption at a
single wavelength when taking the light path length (i. e. the cuvette
thickness) into account. The solution has to be clear, as light
scattering would result in an additional attenuation of light.
Quantification of a single
solute in a complex mixture of substances is possible using various
wavelengths and requires complex mathematical procedures like
multivariate calibration. Today the ex vivo quantification of glucose in
complex matrices like plasma, serum or whole blood is feasible by using
high performance spectroscopic equipment in combination with
sophisticated mathematical calibration procedures. MIR radiation is
particularly appropriate for such measurements because glucose specific
absorption bands are prominent in this frequency range. Thus, it can be
expected that it is also possible to use spectrophotometric approaches
to measure glucose non-invasively in the skin. Water, however, as the
main tissue constituent and many other components of skin, absorb MIR
radiation very effectively. Hence, the in-vivo penetration depth of
MIR-light in skin is low [15]. In contrast, light in the NIR and VIS
region penetrates to deeper blood perfused skin layers potentially
allowing for glucose monitoring (ªoptical windowº) and glucose exhibits
no specific absorption properties in this frequency range. If tissue
thickness is low, transmission spectra can be recorded. Otherwise only
diffusely reflected light intensity has to be used. The current status
of blood glucose monitoring in human skin by near infra-red absorption
measurements using different spectrophotometric methods has been
reviewed recently.2
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