Research into noninvasive devices for self-monitoring of blood glucose is mainly based on near-infrared spectroscopy. Such a device is particularly desirable in the intensive therapy of patients with diabetes mellitus to achieve optimal metabolic control through frequent glucose testing. The state of noninvasive assay technology is presented. Using diffuse reflectance spectra of mucous lip tissue has advantages and drawbacks compared with tissue transmittance experiments. Different approaches have been proposed in the patent literature; however, current technology requires further significant improvements, particularly within the lower normal and hypoglycemic glucose concentration ranges.

A spectral analysis of whole EDTA blood was undertaken by using attenuated total reflection and Fourier-transform infrared spectroscopy. The concentration of blood glucose was measured by an enzymatic method using glucose dehydrogenase and ranged between 40 and 290 mg/dL with an average concentration of 90.4 mg/dL. Multivariate calibration with the partial least-squares (PLS) algorithm was performed on spectral data between 1500 and 750 cm-1 showing a varying background from different unidentified interfering compounds. Cross validation was carried out for optimizing the PLS model. PRESS was 19.8 mg/dL, which was calculated on the basis of 127 standards, whereas the estimated standard deviation for the calibration fit was computed to be 11.9 mg/dL. Infrared spectroscopy can be used for monitoring glucose levels within the normal physiological range in a complex matrix like whole blood as an alternative to electrochemical sensors.

Near-infrared (NIR) spectra of the human inner lip were obtained by using a special optimized accessory for diffuse reflectance measurements. The partial-least squares (PLS) multivariate calibration algorithm was applied for linear regression of the spectral data between 9000 and 5500 cm−1 (Λ = 1.1–1.8 μm) against blood glucose concentrations determined by a standard clinical enzymatic method. Calibration experiments with a single person were carried out under varying conditions, as well as with a population of 133 different patients, with capillary and venous blood glucose concentration values provided. A genuine correlation between the blood glucose concentrations and the NIR-spectra can be proven. A time lag of about 10 min for the glucose concentration in the spectroscopically probed tissue volume vs. the capillary concentration can be estimated. Mean-square prediction errors obtained by cross-validation were in the range of 45 to 55 mg/dL. An analysis of different variance factors showed that the major contribution to the average prediction uncertainty was due to the reduced measurement reproducibility, i.e., variations in lip position and contact pressure. The results demonstrate the feasibility of using diffuse reflectance NIR-spectroscopy for the noninvasive measurement of blood glucose.

An analytical multicomponent method for the blood substrates total protein, glucose, total cholesterol, triglycerides, and urea in human EDTA plasma by FT-IR spectroscopy is described. The spectra were obtained with the use of the attenuated total reflection technique. Partial least-squares was applied for multivariate calibration over optimized spectral ranges. The mean-square prediction errors for the population of 126 plasma samples of different patients calculated by cross-validation are in the range of clinical acceptance. Within an error variance analysis, the contributions of the reference method and the spectrometric measurement to the average (root mean square) prediction error have been estimated for each substrate, giving evidence of the limitations of the spectrometric method. The problem of the biocompatibility of the plasma has been investigated, and the protein adsorption onto the ATR crystal can be reduced to a constant and tolerable level by appropriate cleaning and rinsing. The potential for further improvement is discussed.

Non-invasive assays for blood glucose can be based on near infrared spectrometry of skin tissue using the diffuse reflectance technique. Using a straightforward spectral variable selection based on choices from the optimum partial least-squares (PLS) regression vector yields better results than using PLS calibration models with full spectrum evaluation previously reported. The pairs of variables are selected from the maxima and minima of the regression weights, respectively, in decreasing order. Substantial improvements in the prediction performance of such calibration models, compared to previous calibrations based on full spectrum evaluation, are obtained. Another aspect is the reduced number of spectral variables needed for robust calibration modeling. In addition, evidence is provided for the physical effect, as manifested by the spectral glucose absorptivities, underlying the individual single-person calibration models. Their regression vector structure shows very similar features as calculated for a glucose calibration experiment based on random human plasma samples. Novel techniques are presented for probing the intravascular fluid space using time-resolved near infrared spectroscopy of oral mucosa. The pulsatile blood spectrum can be derived from these diffuse reflectance lip spectra by Fourier analysis. Future applications and prospects for non-invasive blood analysis are discussed.