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When it comes to monitoring blood sugar levels in diabetics, scientists, technologists and designers are exploring everything from devices that use light to measure glucose levels through the skin to contact lenses equipped with miniature sensors and radio antennas.
However, one of the biggest advances took place some time ago.
“We’ve had the basic advantage of people being able to test their own glucose with a certain degree of accuracy for a number of years,” says Matt Petersen, managing director of medical information at the American Diabetes Association. “That was the important step.”
The catalyst for developments in diabetes monitoring came with two big trials in the 1990s. The trials – for both type 1 and type 2 diabetes – revealed that if patients maintained blood glucose at close to normal levels 24 hours a day, they experienced fewer complications. “There was no practical way that people could go to a clinic five times a day, so we needed these meters and they’ve revolutionised people’s ability to manage the disease.”
Since then, significant advances have been made. The technology has evolved from what Mr Petersen calls a “glorified dipstick that changed colour” to devices that generate enzymatic reactions creating an electrical current on a test strip that can be read by a meter.
Much effort has also been put into making devices more convenient for users – and not just when it comes to taking a blood sample. For example, when Ideo, the design consultancy, started working on a new device – the Contour USB – with Bayer, the German pharmaceutical group, the designers undertook an “empathy immersion”.
This process helped them understand where a range of improvements could be made to monitoring devices.
“We got glucose meters and we started measuring our blood sugar and carrying all the stuff around,” explains Amy Schwartz, a portfolio director at Ideo who worked on the Contour USB, which launched in 2009. What the team discovered was that many of the meters on the market required users to carry around several pieces of equipment. “You had to download special software on your computer and then find a special plug,” says Ms Schwartz. “There were a lot of barriers.”
As a result, the team designed a device with a USB that plugged into any computer and automatically downloaded the software. The meter was also designed to recharge automatically whenever plugged into a computer. Finally, the visual aspect of the device was important. Instead of producing something that resembled traditional medical equipment, the team designed a meter with a shiny black surface that looked more like a consumer gadget.
Today, the many meters on the market include backlit models and devices that wirelessly transmit data to mobile phones, to “talking” meters that announce the results for those with impaired vision.
Also in widespread use are continuous glucose monitors. People using these insert a small sensor under the skin. The sensor, which needs to be changed about once a week, sends data on glucose levels to a wireless monitor.
But, when it comes to helping control diabetes, blood sugar is not the only indicator of health. Managing things such as diet and exercise also contribute to the health of diabetics. And devices and apps are helping make this easier.
“Measuring blood glucose and insulin use are really important,” says Glenn Snyder, a principal at Deloitte Consulting. “But without also measuring patient-controllable things such as activity levels, calorie intake and body fat, you don’t have a complete enough picture to enable a clinician or patient to manage their health.”
What tend to attract notice are projects such as Google’s partnership with Novartis, the European pharmaceuticals company, to develop smart contact lens monitors. Mr Petersen believes such developments remain some way off.
But, he says: “If a device combined that significant improvement in usability with greater accuracy, that would be a game changer”.