ABSTRACT
The availability of blood glucose monitoring devices for home use has significantly impacted the treatment of diabetes with the American Diabetes Association currently recommending that Type 1 insulindependent diabetic individuals perform blood glucose testing four times per day. Less than optimal outcomes are associated with high and low blood glucose levels. Injection of too much insulin without enough food lowers blood sugar into the hypoglycemic range, glucose below 60 mg/dL, resulting in mild confusion or in more severe cases loss of consciousness, seizure, and coma. On the other hand, long-term high blood sugar levels lead to diabetic complications such as eye, kidney, heart, nerve, or blood vessel disease [The Diabetes Control and Complications Trial Research Group, 1993]. Complications were tracked in a large clinical study showing that an additional 5 years of life, 8 years of sight, 6 years free from kidney disease, and 6 years free of amputations can be expected for a diabetic following tight glucose control vs. the standard regimen [The Diabetes Control and Complications Trial Research Group, 1996]. This compelling need for simple, accurate glucose measurements has lead to continuous improvements in sample test strips, electronic meters, and sample acquisition techniques. Some of the landmarks in glucose testing are shown in Table 66.1. Glucose monitoring systems are now available from a number of companies through pharmacy and mail-order outlets without a prescription. The remainder of the chapter comprises a history of technical developments with an explanation of the principles behind optical and electrochemical meters including examples of the chemical reactions used in commercial products.
