Remote Blood Glucose Monitoring in mHealth Scenarios: A Review

Abstract

Glucose concentration in the blood stream is a critical vital parameter and an effective monitoring of this quantity is crucial for diabetes treatment and intensive care management. Effective bio-sensing technology and advanced signal processing are therefore of unquestioned importance for blood glucose monitoring. Nevertheless, collecting measurements only represents part of the process as another critical task involves delivering the collected measures to the treating specialists and caregivers. These include the clinical staff, the patient’s significant other, his/her family members, and many other actors helping with the patient treatment that may be located far away from him/her. In all of these cases, a remote monitoring system, in charge of delivering the relevant information to the right player, becomes an important part of the sensing architecture. In this paper, we review how the remote monitoring architectures have evolved over time, paralleling the progress in the Information and Communication Technologies, and describe our experiences with the design of telemedicine systems for blood glucose monitoring in three medical applications. The paper ends summarizing the lessons learned through the experiences of the authors and discussing the challenges arising from a large-scale integration of sensors and actuators.

Towards an ICT-Based Platform for Type 1 Diabetes Mellitus Management

“…As previously mentioned, a complete review of these systems has been presented recently in [8], offering an interesting overview of the current scenario and the previous attempts. Nonetheless, a complete approach for diabetes management that includes a complete characterization of the patient's state as well as knowledge discovery-in an ICT environment-is missed.…”

Medical Use of Sensor-Based Devices, the Debates Around and Implementation in Education

“…As solutions, already available security and encryption protocols can be used, but they require extensive memory and encryption capabilities. 24 An example on the side of implementing regulations is the introduction of cyber-security standard for securely interconnecting the medical devices by the Diabetes Technology Society. 24 Glucose monitoring to keep track of the diabetes patients is among the earliest applications of the sensor-based diagnostics.…”

“…24 An example on the side of implementing regulations is the introduction of cyber-security standard for securely interconnecting the medical devices by the Diabetes Technology Society. 24 Glucose monitoring to keep track of the diabetes patients is among the earliest applications of the sensor-based diagnostics. The commercialized complete system and advanced application examples in relation involve the remote monitoring system Acculink of Roche Diabetes Care GmbH (Mannheim, Germany) that allowed patients to \send data from their application to be installed on a server at the clinic for receiving and storing the patient's data"; DiaSend (Askim, Sweden) that o®ers \integration capabilities for all the major glucometers on the market in addition to many insulin pumps"; G5 mobile Continuous Glucose Monitoring (GCM) System of Dexcom Inc. (San Diego, CA, USA) with two smartphone applications, one of which is installed on the patient's smartphone and the other to those of the people who would (need to) be noti¯ed about the critical situations and the Nightscout Project that initially born as GCM in the Cloud and later turned into The Nightscout Foundation; and the Neokid project of the Neonatal Intensive Care Unit of the University Hospital in Padova that \helps in integrating CGM data of all patients on a single PC display," other than allowing for annotating events such as rest, acidosis, pneumothorax or pain and intravenous hemorrhage, and correlating the occurrences of these events with the CGM values ( Fig.…”

Propuesta y evaluación de un sistema de telemedicina y de ayuda a la decisión para el cuidado de pacientes con diabetes gestacional

“…A lo largo de las dos últimas décadas, los sistemas de telemedicina han evolucionado desde ser meros sistemas de recolección de datos hasta convertirse en sistemas proactivos con capacidades de gestión de conocimiento para la ayuda a la decisión clínica, ya que se detectó que esta evolución era necesaria para que la telemedicina fuera realmente efectiva (Klonoff and True, 2009;Lanzola et al, 2016). Las diferentes soluciones implementadas varían desde meros sistemas de transmisión vía modem hasta plataformas web y, más recientemente, aplicaciones móviles.…”

“…Las nuevas posibilidades que ofrecen los teléfonos de nueva generación ha posibilitado el desarrollo de numerosas aplicaciones para este tipo de plataformas (Wickramasinghe, 2015;Lanzola et al, 2016). La mayoría de ellas permite transferir los valores del medidor de glucosa al teléfono mediante Bluetooth (Bartholomew et al, 2015), etiquetarlas manualmente con la ingesta (DNO, CMDA o CNA) y momento (PRE o POS) correspondientes, y enviarlas a un servidor para su evaluación remota por parte del personal médico (Wickramasinghe, 2015).…”