Page 8 - Glucose Monitoring Devices
P. 8
CHAPTER
1
Introduction to SMBG
Darja Smigoc Schweiger, MD, PhD, Tadej Battelino, MD, PhD
Department of Endocrinology, Diabetes and Metabolism, University children’s hospital University
Medical Centre Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana,
Ljubljana, Slovenia
Historical perspective and principles of blood glucose
control
As Benedict developed a copper reagent for urine glucose, urine glucose testing has
been the main method for diabetes monitoring for 50 years [1]. Later, a more conve-
nient and specific “dip-and-read” urine glucose oxidase-based reagent strip (Clini-
stix) was introduced [2]. However, urine tests had several well-recognized
limitations. High glucose levels were detected only when the renal threshold for
glucose was exceeded over a period of several hours and the results were affected
by fluid intake and urine concentration. Moreover, the test did not detect low glucose
levels [3]. In the 1960s, first blood glucose (BG) test strips (Dextrostix) were
developed. The exposure to blood resulted in a colorimetric reaction proportional
to blood glucose concentration. The color change that occurred was compared to
a color chart providing a semiquantitative assessment of blood glucose levels [4].
The first blood glucose meter, the Ames Reflectance Meter, was introduced in
1970. The meter exhibited quantitative blood glucose results based on Dextrostix
test strips and reflectance photometry, thus eliminating visual reading errors. The re-
sults were displayed by a moving pointer on three analog scales [5]. The device was
only available for testing in a doctor’s office and hospital emergency departments
[6]. Although the meter was heavy, expensive, and cumbersome to use, it ushered
the development in an era of blood glucose monitoring systems. In 1972, more
convenient Eyetone glucometer using Dextrostix test strips was developed, which
was more precise, lighter, and easier to operate [7]. In 1974, Boehringer Mannheim
launched Reflomat, a reflectance meter with modified reagent test strips (Reflotest),
equipped to accept smaller volumes of blood, which was removed more easily and
thus more suitable for at-home self-monitoring of blood glucose (SMBG) [6].
Dextrometer and Glucochek launched, in 1980, were the first glucometers with
digital display [8]. Technological advances during 1980s made glucometers smaller
and easier to use with built-in software to store and retrieve results [6]. The One
Touch meter introduced in 1987 was regarded as the first second-generation blood
glucose meter because it utilized an improved sampling procedure that eliminated
Glucose Monitoring Devices. https://doi.org/10.1016/B978-0-12-816714-4.00001-6 3
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