A prototype of a new noninvasive device to detect nocturnal hypoglycemia in adolescents with type 1 diabetes--a pilot study.
BACKGROUND
Severe hypoglycemic events are a major consequence of tight diabetes control. Continuous glucose monitoring systems (CGMSs) were recently introduced in order to minimize the risk of hypoglycemia. However, the present CGMSs are invasive and costly and have been recently demonstrated to be intolerant for most children and adolescents. Hence there is a need for a simple, noninvasive, convenient, and inexpensive device to detect hypoglycemic events. The Gili Medical Hypoglycemia Non Invasive Monitoring System (GMHNIMS) (Gili Medical Ltd., Migdal HaEmek, Israel) has been currently developed for these purposes.


METHODS
Ten patients 14-18 years old with type 1 diabetes for at least 1 year participated in a pilot study that was held at the Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel. All patients were either treated by insulin pump or by multiple daily injections. The GMHNIMS was connected to the study subjects during three consecutive nights in an inpatient setting while they received their usual insulin regimen. The system is composed of four sensors (heart rate, perspiration, skin temperature, and tremor) that detect physiologic changes during hypoglycemia. In addition, each patient was connected to a real-time CGMS for 3 nights. When a hypoglycemic event was suspected clinically by the patient, a bedside capillary glucose was checked by a glucometer.


RESULTS
The system was found to be convenient without any disturbances to sleep quality. The sensitivity of the GMHNIMS for detection of true hypoglycemic events was 100% with specificity of 85.7%.


CONCLUSIONS
The new device showed high detection rates of nocturnal hypoglycemic events with an acceptable degree of false-positive readings. Being inexpensive and noninvasive, this device has the potential for routine use in insulin-treated patients.
Gili Medical Ltd., Migdal HaEmek, Israel.
Amir
A
Schechter
Ori
O
Eyal
Nehama
N
Zuckerman-Levin
Vered
V
Amihai-Ben-Yaacov
Naomi
N
Weintrob
Naim
N
Shehadeh
D000293:Adolescent; D000465:Algorithms; D015374:Biosensing Techniques; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D002940:Circadian Rhythm; D003362:Cost-Benefit Analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D004867:Equipment Design; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood* / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage* / Q000097:blood; D007557:Israel; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D010349:Patient Compliance; D010865:Pilot Projects; D012680:Sensitivity and Specificity
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin