Historical perspectives in clinical pathology: a history of glucose measurement

Abstract

This is the second in the series of historical articles dealing with developments in clinical pathology. As one of the most commonly measured analytes in pathology, the assessment of glucose dates back to the time of the ancient Egyptians. It was only in the 19th century that advances in chemistry led to the identification of the sugar in urine being glucose. The following century witnessed the development of more chemical and enzymatic methods which became incorporated into the modern analysers and point-of-care instruments which are as ubiquitous as the modern day cellphones. Tracking the milestones in these developments shows the striking paradigms and the many parallels in the development of other clinical chemistry methods.

Electrochemical Glucose Biosensors for Diabetes Care

“…The vast majority of electrochemical SMBG systems rely on amperometric detection, with coulometric detection used in a small number of systems [52,61,66,71,131]. For both of these measurement methods, the general mechanism for signal detection is the same; the reduced mediator produced from the reaction of the reduced cofactor of the glucose-converting enzyme and oxidized mediator must diffuse to the test strip working electrode surface, where it is oxidized.…”

“…Home-use tests for PwDs have been available in some form since the late 1970s [52,131]. Early systems were based on testing of the user's urine, with the degree of color on the test strip indicating the glucose level.…”

Continuous glucose monitoring: review of promising technologies

“…Urine tests were the first method allowing controlling the glucose level. Later urine test strips have been used, but both had poor results in managing blood glucose level and led to early severe vascular complications (6).…”

Claimed effects, outcome variables and methods of measurement for health claims proposed under European Community Regulation 1924/2006 in the area of blood glucose and insulin concentrations

“…Different methods are available to measure glucose concentrations. They can be classified on the basis of the specific enzymatic reaction or the chemical reactivity of the sugar [16,17]. Chemical methods, although accurate and with good sensitivity, are poorly specific because hexoses [18].…”

“…The method of detection may be colorimetric or electrochemical, depending upon the nature of the enzymatic reaction. The reference method of measurement, which employs hexokinase, requires serum or plasma deproteination [17]. The value obtained can be an underestimation of the true glucose concentration in the presence of haemolysis, or an overestimation due to a positive interference of bilirubin and triglycerides.…”