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Noninvasive Device May Free Diabetics From Some Fingersticks

From the WebMD Archives

Oct. 12, 1999 (Baltimore) -- It's no surprise to people with diabetes that one of the worst aspects of managing the condition is the fingersticks associated with monitoring blood sugar levels. Now a less invasive method may be just around the corner, according to research that appears in this month's Diabetes Care, a journal published by the American Diabetes Association. A device called a GlucoWatch monitor is being tested in patients with type 1 diabetes, and researchers say the FDA should be evaluating it soon.

"Patients don't mind taking shots, even up to four times a day," says study author Satish K. Garg, MD, who is a professor of medicine and pediatrics at the University of Colorado Health Sciences Center in Denver. "It's the fingersticks they hate, and we may ask them to do that up to four times per day. Having a method to get more information on blood glucose without invasive or painful testing would be very advantageous." Diabetics who use fingersticks must prick their finger with a small need to draw a drop of blood.

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The study used GlucoWatch monitors on 28 patients with type 1 diabetes. Says Garg, "You apply the device to the skin on the forearm, a few inches above the wrist. It uses a small battery to create an electrical current that changes the characteristics of the pores in the skin and allows some fluid to come out. This fluid is collected by the device and a determination of the amount of glucose in it is made. This is actually interstitial fluid, but a very good correlation between glucose level in the blood and in the interstitial fluid exists."

The researchers compared the GlucoWatch monitor with other methods used in clinics and in homes and found a close correlation.

In an interview with WebMD seeking objective evaluation of the study, Angela Dobs, MD, an associate professor of endocrinology at Johns Hopkins Medical Institutions in Baltimore, says, "This is really very exciting. I don't think this device will replace [fingersticks] but it might be able to reduce some of the fingersticks necessary for some patients."

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Says Dobs, "Both patients with type 1 and type 2 diabetes may fail to sense drops in their blood sugar even when these [drops] are precipitous. This is called hypoglycemic unawareness, and it can be quite dangerous. This device may allow more accurate monitoring of this aspect of diabetes management."

Garg says there are a few aspects of the GlucoWatch monitor that may need some modification. For example, he'd like to see its size reduced. "Some patients also had trouble with a skin irritation at the site where the device was attached," he says. "I think for many patients that won't make a difference, but for some it will. But I see a place for the GlucoWatch when therapies are being changed for patients and close monitoring is needed."

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