This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. HYPOTHESIS: The landmark diabetes control and complications trial in type I diabetics and the Kumamato study in type II diabetics have demonstrated that intensive insulin therapy can dramatically reduce the long term tissue complications of diabetes. Data from the above two studies and from the Wisconsin epidemiologic study in type I and type II diabetics have demonstrated a direct relationship between average blood glucose control and diabetic complications. All available data indicates that average blood glucose levels in type I or II diabtics should be below 180 mg/dl. These data are so conclusive that the American Diabetes Association has issued a policy decision stating that acceptable diabetes control must include average daily blood glucose levels below 180 mg/dl. Clearly if the goal of good metabolic control is to be achieved, diabetic patients must be able to accurately monitor their blood glucose and adjust their medication accordingly. This is particularly important if intesive insulin therapy is practiced because the major side effect of this treatment is severe hypoglycemia. Thus it is universally recognized that it is a) not possible, and b) dangerous to attempt good blood glucose control int he absence of home blood glucose monitoring. Unfortunately, the majority of diabetics refuse to perfrom home blood glucose monitoring. The most recent data (1992) from the National Institutes of Health revela that 55% of type I and 84% of type II diabetics either never or only perform one home blood glucose test per week. The reason for this appalling statistic is that currently diabetic patients must prick a finger with a needle to obtain the blood necessary for glucose monitoring. Patients with daibetes state that this procedure is painful, inconvenient, and expensive. A blood glucose monitor can cost up to $100, and each blood glucose testing strip is about $1 each. Furthermore, if a diabetic patient wishes to follow their blood glucose excursion over a short time interval (e.g. exercise, acute illness, or a particular meal) they must repeatedly prick their fingers which involves considerable inconvenience and pain. The specifc aim of this proposal is to characterize a new non-invasive method for painlessly and precisely quantifying blood glucose levels on demand.
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