The Current State of Non-Invasive Glucose Monitoring
By Andrew Briskin
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Researchers at ATTD 2023 discussed some of the latest advancements in non-invasive glucose monitoring, including two new approaches to tackling this challenge.
Many researchers and people with diabetes alike seem to have mixed emotions about the prospect of a non-invasive glucose monitor – a device that can measure glucose levels in the body without puncturing the skin, drawing blood or causing any pain.
On one hand, non-invasive glucose monitoring technology has advanced in recent years, with several devices in development and early clinical trials showing improved accuracy and convenience. On the other hand, the very long history of these devices has been marked by overpromises and underperformance, all while minimally invasive continuous glucose monitors (CGM) have become the standard of care for keeping track of glucose levels.
At the ATTD 2023 annual conference, researchers shared updates on two potential technologies for non-invasive monitoring – analyzing a person’s breath and measuring glucose levels using light with a technique called Raman spectroscopy.
The session started with a discussion about using breath to measure glucose levels, as well as ketones and other important molecules. Bruno Thuillier, founder and chief technology officer of BOYDSense, explained the company’s work on improving the accuracy and convenience of breath-based analysis.
BOYDSense’s prospective devices measure a group of compounds in the breath, called volatile organic compounds, or VOCs. VOCs are molecules that the body forms as byproducts from processes like using glucose for energy, breaking down fats, and many other processes that may be affected in someone with diabetes. By measuring the amount of some of these glucose byproducts, researchers hope to be able to consistently measure glucose levels in the body.
Thuillier explained that while it has been possible for decades to precisely measure these compounds, it requires a large, expensive lab instrument. However, the company’s device in development, called Lassie, hopes to deliver the technology in pocket-size. It is now being investigated in clinical trials in people with type 2 diabetes in France.
In the first trial, which included 112 people with type 2, researchers were able to pinpoint select VOCs that correlate with glucose levels, and established that those could be measured through breath. In an ongoing trial with 130 people, the company is developing an algorithm that can calculate glucose levels from these measures.
Thuillier said that the next steps are to analyze data and continue to research the device in clinical trials, but that he is optimistic about the data. “Based on the data and all the work that researchers have done, we think breath is a very realistic option [for measuring glucose],” he said.
One of the other techniques being studied for non-invasive glucose measurement is called Raman spectroscopy, which uses light to measure glucose simply by touching a button with your finger. The device, known as a touch glucose monitor (TGM), is in development by RSP systems.
Dr. Anders Weber, CEO of RSP Systems, said that the technology is being investigated in clinical trials and has published data on its current accuracy, but is still at a relatively early stage.
“We have academic research that establishes the practicality of non-invasive blood glucose monitoring, with intermittent accuracy [slightly lower than CGM] and improving. That has been a question for quite a while and we have answered it. It is possible,” he said.
Weber said that the next challenge to tackle is to make the device more convenient to wear, such as on a wristwatch, and to integrate the data with other devices. However, he emphasized that a significant obstacle – creating a working sensor and using the spectroscopic technology – has been overcome.
