An overview of minimally invasive technologies

Self-measurement of blood glucose is an integral part of diabetes mellitus therapy. As many as 65% of diabetic people (4-5 million people) perform some degree of self-monitoring and approximately 20-30% do so frequently. Most patients consider this the most onerous part of their diabetes therapy. It requires obtaining blood, frequently in public, and is usually the most painful part of therapy, being significantly more painful than insulin self-administration. Patients therefore are anxious for a less-invasive method for glucose measurement. Methods exist or are being developed for minimally invasive glucose monitoring, which use body fluids other than blood (e.g., sweat and saliva), subcutaneous tissue, or blood measured less invasively. Sweat and saliva are relatively easily obtained but their glucose concentration lags significantly behind blood glucose. Methods to increase sweating have been developed and seem to increase the timeliness of the sweat glucose measurement. Subcutaneous glucose measurement seems to lag only a few minutes behind blood glucose and may actually be a better measurement of the critical values of glucose concentrations in brain, muscle, and other tissue. Glucose can be measured by noninvasive or minimally invasive methods, such as those making skin or mucous membranes permeable to glucose or those placing a reporter molecule in the subcutaneous tissue. Needle-type sensors have been improved in accuracy, size, and stability and can be placed into the subcutaneous tissue or peripheral veins to monitor blood glucose with miniature instruments.