We have developed a technology for continuous tear glucose monitoring, and therefore potentially blood glucose monitoring, using a daily use, disposable contact lens embedded with sugar-sensing boronic acid containing fluorophores. The novelty of our approach is two fold. Firstly, the notion of sensing extremely low glucose concentrations in tears by our approach, and secondly, the unique compatibility of our new probes with the internal environment of the disposable, off-theshelf, contact lenses, chosen because the physiological compatibility of disposable plastic contact lenses has already been assessed and optimized with regard to vision correction, size and oxygen / analyte permeability. Our findings show that our approach is indeed suitable for the continuous monitoring of tear glucose levels in the concentration range (50-500 µM), which track blood glucose levels which are ≈ 5-10 fold higher. We believe our approach offers unique opportunities for non-invasive continuous glucose monitoring for diabetics, especially since many have eye disorders and require vision correction by either contact lenses or glasses, which is thought to be due to glycation of protein in blood vessels.
IntroductionContinuous monitoring of blood glucose is essential to avoid the long-term consequences of elevated blood glucose, including neuropathies, blindness and sequella.1 , 2 These adverse health effects have resulted in worldwide efforts to develop non-or minimally-invasive methods to monitor blood glucose. 3 -13 A wide variety of methods have been proposed, including near infrared spectroscopy, 3 , 4 optical rotation, 5 , 6 colorimetric 7 , 8 and fluorescence detection. 9 -13 The most commonly used technology for blood glucose determination is an enzyme based method, which requires frequent blood sampling and therefore drawing. Although frequent "finger pricking" with a small needle to obtain the blood sample is a relatively painless process, this method does suffer from a few practical problems. The firstCorrespondence to: Chris D. Geddes, cfs@cfs.umbi.umd.edu.
HHS Public Access
Author ManuscriptAuthor Manuscript
Author ManuscriptAuthor Manuscript one is inconvenience and the required compliance by patients, which is often difficult for both the young and old, while the second is that this is not a continuous monitoring method. Despite intensive efforts, no method is presently available for the continuous non-invasive measurement of blood glucose.Elevated tear glucose during hyperglycemia was first demonstrated by Michail and coworkers in 1937, 14 , 15 as tear glucose levels track blood levels, in an analogous manner to the equilibrium that normally exists for glucose between blood and tissue fluid. 16 While it has been difficult to determine actual glucose concentrations in tears to-date, it is generally accepted that glucose levels are low and in the range 50-500 µM. 17 -21 For example, Giardini and Roberts have reported tear glucose concentrations to be ≈ 3 mg 100 ml −1 for subjects with a normal glucose met...