title: In vivo glucose monitoring: the clinical reality and the promise.
abstract: Glucose monitoring is an essential component of modern diabetes management. Three in vivo glucose sensors are now available for clinical use: a subcutaneously implanted amperometric enzyme electrode, a reverse iontophoresis system and a microdialysis-based device. Improvements in glucose-sensing technology continue to be sought, e.g. wired enzyme technology, viscometric affinity sensing and totally implanted glucose sensors. Non-invasive glucose sensing is the ultimate goal of glucose monitoring, but the most investigated approach, near-infrared (NIR) spectroscopy, is presently too imprecise for clinical application. Fluorescence-based glucose sensing offers several advantages and we are investigating strategies which include NIR-based fluorescence resonance energy transfer using concanavalin A/dextran; changes in the intrinsic fluorescence of hexokinase encapsulated in sol-gel; and non-invasive glucose monitoring of cells by measuring glucose-related changes in NADP(H).
authors.affiliation: Metabolic Unit, Guy's, King's and St Thomas's School of Medicine, Guy's Hospital, 5th Floor Thomas Guy House, London SE1 9RT, UK. john.pickup@kcl.ac.uk
authors.forename: John C
authors.initials: JC
authors.lastname: Pickup
authors.forename: Faeiza
authors.initials: F
authors.lastname: Hussain
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: Evans
authors.forename: Nabihah
authors.initials: N
authors.lastname: Sachedina
mesh_terms: D015374:Biosensing Techniques / Q000295:instrumentation* / Q000379:methods* / Q000639:trends; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation* / Q000379:methods* / Q000639:trends; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis*; D004867:Equipment Design; D006801:Humans; D017551:Microdialysis / Q000295:instrumentation / Q000379:methods / Q000639:trends; D008904:Miniaturization; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods / Q000639:trends; D013057:Spectrum Analysis / Q000295:instrumentation / Q000379:methods / Q000639:trends
chemical_list: D001786:Blood Glucose