Analyte detection devices and methods with hematocrit/volume correction and feedback control

Information

  • Patent Grant
  • 10226208
  • Patent Number
    10,226,208
  • Date Filed
    Wednesday, June 8, 2016
    8 years ago
  • Date Issued
    Tuesday, March 12, 2019
    5 years ago
Abstract
Disclosed are devices, arrangements and methods for quantifying the concentration of an analyte present in bodily fluid, including: an assay pad having at least one chemical reagent capable of producing a detectable signal in the form of a reaction spot upon reaction with the analyte; a light source; a detector array; a processor; and a memory in communication with the processor, the memory comprising: (a) at least one value indicative of one or more of: (i) the level of hematocrit contained in the sample; (ii) the volume of the sample applied to the assay pad; or (iii) imperfections present in the reaction spot; and (b) at least one algorithm for calculating the concentration of the analyte contained in the sample.
Description
FIELD OF THE INVENTION

The present invention is directed to techniques and devices for detection of the presence and/or concentration of an analyte.


BACKGROUND OF THE INVENTION

In the following discussion certain articles and methods will be described for background and introductory purposes. Nothing contained herein is to be construed as an “admission” of prior art. Applicant expressly reserves the right to demonstrate, where appropriate, that the articles and methods referenced herein do not constitute prior art under the applicable statutory provisions.


According to the American Diabetes Association, diabetes is the fifth-deadliest disease in the United States and kills more than 213,000 people a year, the total economic cost of diabetes in 2002 was estimated at over $132 billion dollars, and the risk of developing type I juvenile diabetes is higher than virtually all other chronic childhood diseases.


A critical component in managing diabetes is frequent blood glucose monitoring. Currently, a number of systems exist for self-monitoring by the patient. One such system may be termed a photometric system or method. In such systems, the first step is to obtain the sample of aqueous fluid containing an analyte to be assayed, usually whole blood or fractions thereof. The sample of blood may be obtained by a finger stick or other means.


The fluid sample is then contacted with an assay pad or membrane. Contact is generally achieved by moving the assay pad or membrane into contact with the liquid sample on the surface of the patient's skin. Following application to the pad or membrane, the target analyte present in the sample passes through the assay pad or membrane by capillary, wicking, gravity flow and/or diffusion mechanisms. Chemical reagents present in the pad or membrane react with the target analyte producing a light absorbing reaction product, or color change.


The assay pad or membrane is then inserted into a monitor where an optical measurement is then made of this color change. In those embodiments where the optical measurement is a reflectance measurement, a surface of the assay pad or membrane is illuminated with a light source. Light is reflected from the surface of the assay pad or membrane as diffuse reflected light. This diffuse light is collected and measured, for example by the detector of a reflectance spectrophotometer. The amount of reflected light is then related to the amount of analyte in the sample; usually the amount of light reflected off the surface of the assay pad or membrane is an inverse function of the amount of analyte contained in the sample.


An algorithm is employed to determine analyte concentration contained in the sample based on the information provided by the detector. Representative algorithms that may be employed where the analyte of interest is glucose and the fluid sample is whole blood are disclosed, for example, in U.S. Pat. Nos. 5,049,487; 5,059,394; 5,843,692 and 5,968,760; the disclosures of which are incorporated herein by reference.


Glucose monitoring technology that relies on the photometric method of quantifying the glucose concentration in whole blood may be subject to errors associated with variations in hematocrit level, or concentration of red blood cells within the blood sample. Various methods have been employed to ensure the accuracy and repeatability of measured glucose concentration using the photometric method across a typical range of hematocrit levels. A normal hematocrit level is 42-54% for men and 36-48% for women. Overall, the normal range is from 36-54%, but for a variety of reasons, those who regularly test their glucose concentrations may have hematocrit levels even lower (anemia) or higher (polycythemia) than these normal ranges. This presents a challenge for the development of accurate glucose monitoring. This is because the meter is typically designed or calibrated assuming the sample will contain a hematocrit level somewhere in the normal range. Diabetics and clinicians make critical medical decisions in the management of their disease based on the readings provided by these meters. Thus, it would be advantageous to have a photometric quantification method that is more accurate across a broader range of hematocrit levels.


Additionally, glucose monitors typically require that the user supply a sufficient quantity of whole blood for an accurate reading. This volume has been around 10 microliters or more in the past, but with the development of newer quantification technologies, the minimum volume has been brought to as low as 1 microliter for photometric meters. This has reduced the burden on diabetics in their testing by reducing the depth of the lancing and the effort to milk a relatively large amount of blood from their lancing site. Again, the calibration of the meter is developed with the assumption that this minimum supply has been delivered to the test strip. If the user has not supplied a sufficient amount, then the meter generally displays an error code and the user must test again. Further, a user may supply more than the typical amount of blood to the test strip, which may lead to an inaccurate result if the calibration of the strip is volume sensitive. It would be advantageous for a photometric meter to have the ability to evaluate and adjust its internal calibration by detecting the amount of fluid supplied to the reagent strip, and applying an appropriate calibration parameter specifically chosen for that volume.


The development of a fully integrated glucose meter system requires incorporating the processes of skin lancing, transfer of blood to the reagent test strip, and quantification of whole blood glucose all in a single device. Such systems may not require any user intervention at all during the quantification process as long as sufficient sample volume is obtained. An automated catalyst, such as heat, vacuum, or pressure may be utilized to obtain a sample of body fluid, or whole blood.


One such device relies on the application of a specific magnitude and duration of a partial vacuum to the skin in order to facilitate the acquisition of a minimum required sample volume. For some individuals, this pre-programmed amount or duration of vacuum may be appropriate. For others, this pre-programmed catalyst may produce either an insufficient or excessive amount of blood, as well as other undesired outcomes, such as excessive bruising (for those with fragile capillary networks), an unnecessary delay in obtaining results (for fast bleeding individuals), as well as excessive residual blood left on the skin. Thus, it would be advantageous if the sample quantification detector could also determine in real-time whether or not a sufficient sample volume has been obtained for an accurate reading, and provide this information as feedback to control the magnitude and/or duration of a catalyst. This feedback driven control would be a significant advantage for integrated glucose monitoring technology.


Photometric assay pads or membranes for analyte concentration measurements typically produce a circular or linear spot when the chemical reagents contained therein react with a fluid containing a specific analyte, such as glucose, within whole blood. An ideal spot may be defined as one in which the color across the spot is uniform and indicative of the concentration of the analyte. A spot which is not ideal may be manifest in one or more of the following ways: non-uniformity of the primary color (e.g., variations in the intensity of blue); presence of non-primary color, such as red, which may be associated with the presence and/or lysis of blood cells, and the above color variations may be distributed randomly or non-uniformly across the spot.


For a variety of reasons, the quality of a spot developed as a result of an analyte reacting with the reagent membrane may not be ideal as described above. Such reasons may include one or more of: flaws or manufacturing variations in the membrane structure; variations in the concentration of the reagent enzyme; mishandling of the membrane during manufacturing; and unintended chemical reactions between the fluid and/or analyte and the reagent structure and/or membrane chemistry (such as another medical drug within the blood sample reacting with the reagent enzyme).


Most devices on the market cannot detect or correct for low quality spots. Their sensors, typically one or more photodiodes, do not have the ability to discretely analyze the flaws within a reagent spot. Thus, there exists a risk that these systems may not provide an accurate reading in circumstances of a non-ideal spot.


SUMMARY OF THE INVENTION

According to the present invention, the state of the art has been advanced through the provision of arrangements, devices and techniques such as those described further herein, for accurately, efficiently, and economically determining the presence and/or concentration of an analyte. According to the present invention, the state of the art has been advanced, especially, but not exclusively, within the context of personal glucose monitoring devices and techniques. Additionally, or alternatively, according to the present invention arrangements, devices and techniques are provided which may overcome one or more of the abovementioned shortcomings associated with conventional systems and methods.


Devices and methods are contemplated that may employ a detector comprising an array of detector elements or pixels to detect color change or intensity of reflected light associated with a photometric chemical reaction between the analyte and reagent chemistry. Optionally, the detector elements comprise CMOS-based detector elements. In particular, the CMOS detector elements help correct for differences in hematocrit levels and/or volumes associated with samples under analysis. An additional aspect of the present invention provides for CMOS-based detector elements that can provide feedback control for a connected device that performs automated whole blood sampling and detection of an analyte. In yet another aspect of the present invention, feedback from CMOS detection elements is used to compensate for non-ideal reaction spot characteristics.


According to one aspect, the present invention provides a device for monitoring the concentration of an analyte present in bodily fluid, the device comprising a detector, the detector comprising a detector element or pixel, the element or pixel comprising a CMOS sensor, a CCD sensor, a photodiode or an infrared sensor, including both near-field and mid-field infrared sensors. Other sensing systems also contemplated within the scope of the present invention include infrared, ultraviolet and fluorescent sensing systems and electrochemical sensing systems, including reagentless sensing approaches.


It is therefore to be understood that reference herein to the detector array of the present invention may include any suitable detector element(s). The present invention is thus not limited to embodiments of the invention including CMOS or CCD detector elements, photodiodes, infrared, fluorescent, ultraviolet or electrochemical detector elements.


It is to be understood that the detector array is not limited only to linear arrays. Non-linear arrays, such as polar or area arrays, are also contemplated by the present invention.


It is to be understood that reference herein to first, second, third and fourth components (etc.) does not limit the present invention to embodiments where each of these components is physically separable from one another. For example, a single physical element of the invention may perform the features of more than one of the claimed first, second, third or fourth components. Conversely, a plurality of separate physical elements working together may perform the claimed features of one of the claimed first, second, third or fourth components. Similarly, reference to first, second (etc.) method steps does not limit the invention to only separate steps. According to the invention, a single method-step may satisfy multiple steps described herein. Conversely, a plurality of method steps could, in combination, constitute a single method step recited herein.


According to an aspect of the present invention, there are provided devices, arrangements and methods for quantifying the concentration of an analyte present in bodily fluid, comprising: an assay pad comprising at least one chemical reagent capable of producing a detectable signal in the form of a reaction spot upon reaction with the analyte; a light source; a detector; a processor; and a memory in communication with the processor, the memory comprising: (a) at least one value indicative of one or more of: (i) the level of hematocrit contained in the sample; (ii) the volume of the sample applied to the assay pad; or (iii) imperfections present in the reaction spot; and (b) at least one algorithm for calculating the concentration of the analyte contained in the sample.


According to a further aspect of the present invention, there are provided devices, arrangements and methods for quantifying the concentration of an analyte present in bodily fluid, comprising: providing an assay pad comprising at least one chemical reagent; introducing a sample onto the assay pad; producing a detectable signal in the form of a reaction spot upon reaction of the at least one chemical reagent with the analyte; generating a signal based on light reflected off the assay pad; calculating at least one value indicative to one or more of: (i) the level of hematocrit contained in the sample; (ii) the volume of the sample applied to the assay pad; or (iii) imperfections present in the reaction spot; and calculating the concentration of analyte contained in the sample by factoring in the at least one value.


According to the above, the device may comprise a glucose meter integrating some or all of the above-described features. The integrated device may be configured to perform at least one such photometric analysis before reloading disposable components thereof becomes necessary. The integrated device may be handheld or wearable. The integrated device may be in the general form of a wristwatch.


According to the present invention, the detector elements may comprise CMOS-based detector elements. Moreover, the detector array may be in the form of a linear array of CMOS-based detector elements or pixels.


According to the present invention, an integrated device may include means for extracting a sample of bodily fluid and can comprise a skin piercing member and the application of one or more of: (i) vacuum; (ii) positive pressure; and (iii) heat.


According to the present invention, as described above, the device may further comprise a computer-readable medium, the medium comprising at least one of an algorithm and a look-up table. According to the present invention, the device may further comprise a microprocessor controller.


The above-described invention may further comprise at least one of a light source, one or more lenses, one or more light transmission elements (e.g. optical fibers), optical diffusers and optical filters.


In certain embodiments of the above-described invention, the assay pad may comprise at least one chemical reagent that produces a color change defining a reaction spot upon reaction with the analyte.





BRIEF DESCRIPTION OF THE DRAWINGS

The preferred embodiments are illustrated in the drawings in which like reference numerals refer to the like elements and in which:



FIG. 1 is a flow diagram of a mode of operation according to certain aspects of the present invention.



FIG. 2 is a schematic illustration of an arrangement formed according to the principles of the present invention.



FIG. 3 is a schematic diagram of a portion of the arrangement of FIG. 2.



FIG. 4 is a perspective view of a device formed according to an embodiment of the present invention.



FIG. 5 is a partial cutaway view of FIG. 4.





DETAILED DESCRIPTION OF THE INVENTION

Exemplary arrangements and methods for the detection and measurement of the presence and/or concentration of a target analyte, such as glucose, bilirubin, alcohol, controlled substances, toxins, hormones, proteins, etc., will now be described.


In broader aspects, the current invention provides the ability to correct for broad variations in sample hematocrit levels in the measurement of an analyte, such as glucose, during the course of the test. The invention takes advantage of an imaging array of detectors to perform this correction and does not require any additional hardware. In other words, no other distinct sensors or detectors, other than the imaging array, are required to calculate the correction. The very sensor that is used to quantify the analyte within the sample may also correct for hematocrit. Strategic algorithms that process the data from the imaging array provide real-time or near real-time information about the sample hematocrit level. Thus, more accurate results, regardless of the hematocrit level of the user, may be obtained via correction based on the hematocrit level of the sample.


The current invention may also use appropriate algorithms to permit real-time sensing of the amount of sample volume delivered to an assay pad. With this information, appropriate calibration parameters may be selected corresponding to the actual delivered volume. To correct for sample volume, algorithms similar to those used for hematocrit correction may be used, where volume is substituted for hematocrit and a unique formulation and corresponding constants are determined.


The present invention offers the flexibility to improve the accuracy of measured glucose for a broad range of sample volumes that are typically delivered to the assay pad of the meter system. In addition, sampling catalysts such as vacuum, heat, pressure, etc. may be implemented or provided automatically by the device to help ensure sufficient sample volume is collected and analyzed. The invention provides information to the meter system to know when and how much of the catalyst is sufficient. Since the invention can measure or estimate the volume of the sample delivered to the assay pad, it can also provide feedback to start, maintain or terminate the catalysts, as well as increase or decrease the magnitude of the catalyst, based on this measured volume. This offers the advantage of adapting the device function to the user's real-time skin physiology, minimizing the risks associated with the catalysts (bruising, scarring, excessive bleeding), reducing the energy consumed by the system, and reducing the chance of a wasted test operation (and the associated user's time, battery supply, and cost of test strip) by ensuring a minimum sample volume is obtained, as well as minimizing the overall time to get a result from the system.


According to additional broad aspects, the present invention can process data received from the detector array to compensate for irregularities or imperfections present in a reaction spot in order to improve accuracy of the analyte concentration method. The present invention includes devices, arrangements and methods that include any of the above referenced aspects individually, as well as combinations of some or all of these aspects.


The current invention may employ a linear CMOS imaging detector array. Contrary to other approaches that describe the use of 2-D CCD imaging detector arrays, the linear CMOS array detects light across a single row of optical detectors (pixels) whose output is proportional to the amount of light incident to the pixel. Linear detector arrays offer an advantage over 2-D imaging systems in simplicity and efficiency in processing the image information as long as the expected location of reagent chemistry reaction or reagent spot is known and the associated light, which may be supplied by an LED, is reflected from this area and is imaged appropriately by the CMOS array.


The CMOS detector array may have an overall size that is comparable to the size of the assay pad and the expected range of spot sizes that develop on the pad. According to one alternative, the detector can be larger than the size of the pad. This construction can allow wider tolerances in the relative position of the assay pad and the detector, and provide for additional in-process error detection and recovery (e.g., detecting or correcting for assay pad motion).


In addition to light sources such as LED's, various optical components such as lenses, diffusers, light pipes, etc. may be integrated into the system to optimize the image size and resolution. Such a system may utilize a commercially available linear CMOS detector array such as part # TSL1401R or TSL1401CS; from TAOS, Plano, Tex. This detector has 128 pixels across an array of ˜19 mm in length. Light reflected off of white surfaces, such as an unreacted reagent pad, and received by the CMOS detector results in a signal from each pixel that is conditioned to produce a near maximum response up to 5 volts. Darker surfaces, such as from a color change associated with a reagent spot, will produce lower voltage response for each pixel depending on the reagent chemistry, light source, optical path, and ultimately, the concentration of the analyte (e.g., glucose).


A number of different arrangements comprising a quantification member, such as an assay pad, a sensor or detector, and one or more additional components are contemplated by the present inventions. Additional exemplary arrangements are described in U.S. application Ser. No. 10/394,230, entitled ANALYTE CONCENTRATION DETECTION DEVICES AND METHODS, the entire content of which is incorporated by reference herein.


When coupled with an assay pad containing a photometric reagent, the sensor detects the change in color of the pad, and the output is processed as a change in voltage relative to that of the original reagent color. Typically, about 10-50% of the pixels across the array are sufficient to resolve a spot of color change, but this can depend on a variety of factors, including CMOS sensor design, sample volume size, reagent dynamics, and the optical path between the pad and sensor.


Since the arrangements and techniques of the present invention can perform the assay without all of the pixels in the sensor array being in optical registry with the reagent spot, it is contemplated by the present invention to utilize these free pixels in one or more possible ways. For example, a second assay may be performed at a different area of the same assay pad, or on separate assay pad, at a location corresponding to the aforementioned unused pixels. The unused pixels may be used for calibration or as a control. For instance, a control solution having a known concentration of analyte may be introduced in the area of the assay pad, or onto a separate pad, in the area of the unused pixels. The control solution reacts with the reagent and the signal produced by pixels can be calibrated in accordance with the known analyte concentration. According to another alternative, a means for calibrating the reagent for lot information may be provided in the area of the unused pixels, thereby eliminating the need for the user to set reagent lot calibration codes. A similar arrangement and technique would be to utilize a standard color in registry with the unused pixels that produces a known reflectance signal. Upon reading this known signal, the arrangement, via a microprocessor and associated software and electronic components, can verify whether or not the device is functioning properly.


According to certain embodiments, sensor data can be acquired with an analog-to-digital capture device, such as a PC board, and processed as a linear dimension data array whose size corresponds to the number of pixels in the imaging array, such as 128 or 256 pixels. This data array will change over time as the reaction between the analyte (glucose) and the reagent enzymes develops, reaches saturation and begins to dry out.


According to one embodiment, the current invention incorporates an algorithm for processing the information in the data array over time to detect and correct for the hematocrit in the blood sample. The rate of color change over time across the detector array, and thus rate of change in signal of the data array, is dependent upon the relative amount of plasma in the sample. A relatively high plasma content in a given sample size will cause the sample to react with the reagent chemistry faster and develop a change in color more quickly than a relatively smaller plasma content. Since hematocrit level is inversely proportional to plasma content, the rate of color change can be scaled inversely to hematocrit level.


The relation between rate of color change and hematocrit level will depend upon a variety of variables, including the volume of the sample delivered to the assay pad as well as the inherent reagent chemistry, optical path, light source and detector array. Consequently, a unique correlation calibration between color change rate as detected by the CMOS imager and blood hematocrit level can be empirically determined and programmed into a memory device as a lookup table, or calculation.


Exemplary, non-limiting algorithm formulations to accomplish the above include:

    • 1. Hct α δA(x,t)/δt; where Hct=hematocrit, α implies proportional to, δ/δt=is the partial derivative with respect to time (a measure of rate of change), and A(x,t) is a measure of the array signal strength in the sensor at position x at time t.
    • Proportionality may be linear and of the form Hct=m(δA(x,t)/δt)+C; where m and C are constants determined empirically. Hematocrit proportionality correction may also be better represented by polynomial, exponential, power or other functions.
    • 2. Hematocrit α δA(x,t)/δx; where Hct and α are as defined above, and δ/δx=is the partial derivative with respect to position x.
    • Again, proportionality may be linear and of the form Hct=m(δA(x,t)/δx)+C; where m and C are constants determined empirically. Proportionality may also be non-linear and represented by logarithmic, polynomial, exponential or other equations.
    • 3. Hematocrit α δA(x,t)/δxδt; where Hct and α are as defined above, and δ/δxδt=is the partial derivative with respect to position x and time t.
    • 4. Hematocrit α δ2A(x,t)/δ22t; where Hct and α are as defined above, and δ222t=is the second order partial derivative with respect to position x and time t.


Pixel position x ranges from the lower to upper limits and in the case of a 256 pixel array, would range from 1 to 256. For a variety of reasons, the algorithm may be limited to the evaluation of specific positions or ranges within the array, such as between x=x_lower and x=x_upper, where x_lower may be 40 and x_upper may be 80.


Time t as referred to in these algorithms can refer to the time elapsed between known events within the analyte quantification process. For example, t=0 may be defined at the point in which blood is first presented to the reagent membrane, or when the imaging array first detects a predetermined threshold change corresponding to the arrival of the analyte to the reagent membrane.


Array signal strength A(x,t) corresponds to a measure of the color of the reagent membrane. Typically, this signal is initially processed as a voltage or a current. Those skilled in the art of photometric reagent signal process will appreciate that subsequent transformation of this data into a measure of normalized reflectance R and/or to absorption via the well-known calculation of K/S may be represented by A(x,t). For example:


K/S (x,t)=(1−R)2/2R; where R=A(x,t)Reacted/A(x,t)Unreacted, where A(x,t)Unreacted refers to the array signal corresponding to the reagent membrane prior to any reaction with the analyte, and A(x,t)Reacted the array signal corresponding to the membrane as it reacts with the analyte at array position x at time t.


Those skilled in the art will appreciate that combinations of these and/or other similar algorithms would mathematically capture the relation between hematocrit and the rate of change of spot development in the membrane. Furthermore, the skilled reader would appreciate that the proportionality constants (m and C) are dependent upon the conditions of the reagent membrane (material, chemistry, lighting), the hardware and software specifications, and the nature and method in which the analyte is delivered to the membrane.


Thus, the appropriate calibration factor-relating reflected light to glucose concentration would then be chosen based on the hematocrit level. When the consumer uses the device, the meter detects color change and applies the correct calibration factor for the user's hematocrit level to the calculation of glucose content made by an algorithm also contained in the same, or a different memory device.


As an example of the above, if the glucose calibration curve is of the form:


R=m×[Glucose Concentration]+b; where R=the as-measured reflected light signal, and m and b are empirically determined constants.


A corrected signal Rc, could be derived from a look-up table of correction factors, Fh, as a function of hematocrit level:

Rc=Fh×R


This corrected signal would then be substituted into the above equation to calculate the hematocrit-adjusted glucose concentration.


Processing the data generated by the change in color caused by the reaction between the analyte and reagent chemistry in conjunction with the speed and capacity of today's microprocessors would not add to the required time to process the sample, yet would substantially increase the accuracy and reduce the variability for analyte concentration measurements associated with different whole blood hematocrit levels.


Various alternatives and modifications to the above-described embodiment related to detector data analysis to determine hematocrit levels are possible. For example, such alternatives and modifications include one or more of: evaluating the rate of pixel signal changes with respect to time; evaluating the rate of pixel change with respect to time and with respect to associated pixels that also are changing (i.e., spatial and temporal rate of change); evaluating the rate of pixel change with respect to time for an individual pixel; evaluating the rate of pixel change with respect to time for multiple pixels; evaluating the rate of pixel change with respect to time for the pixel that detects the largest change in color when enzymatic reaction and color change is complete; evaluating the rate of pixel change with respect to time for the pixel that detects the largest change in color during the ongoing enzymatic reaction; evaluating the rate of pixel change with respect to time for the pixel that detects the largest change in color after a lapse of a predetermined amount of time before any enzymatic reaction has actually occurred; and evaluating the resolved volume of the sample (as described earlier) at a specific time for which a fixed, prescribed amount of blood has been delivered to the reagent pad (since measured sample size is proportional to plasma volume, which is inversely proportional to hematocrit).


Using the aforementioned detector array, the invention also contemplates novel arrangements, devices and methods for quantifying, in real-time, the amount of sample delivered to an analyte quantification member, such as an assay pad. This method takes advantage of the discrete data provided by individual detector elements or pixels. As a reaction spot begins to develop in the assay pad, the system described earlier can resolve a particular dimension associated with the size of the spot, such as width. This invention does not require that the spot be of a particular shape, such as round, square, or rectangular, as long as the detector array is oriented to resolve at least one dimension of the spot that is proportional to sample volume. Assuming the assay pad and the method by which the blood is delivered to the pad has been optimized to reduce the variability in spot development, the spot size will be proportional to the volume of blood sample.


The imaging system can resolve the spot size by identifying how many pixels or detector elements have detected a color change. Although the color change associated with the chemical reaction between analyte and enzyme may not be completed or reached equilibrium, the quantification of the number of pixels that have detected a predetermined threshold change in color will be proportional to the spot size. Thus, a real-time assessment of the spot size and thus volume can be computed.


Accordingly, the effect on glucose concentration calculations associated with various sample volumes may be empirically determined, and a lookup table, equation, or calculation incorporated in a memory device which may then be used to select an appropriate predetermined calibration factor to provide a more accurate reading of the analyte concentration for a particular sample volume. Thus, an appropriate calibration factor based on the actual sample volume may be applied to an algorithm used to calculate glucose concentration.


As an example of the above, if the glucose calibration curve is of the form:


R=m×[Glucose Concentration]+b; where R=the as-measured reflected light signal, and m and b are empirically determined constants. A corrected signal Rc, could be derived from a look-up table of correction factors, Fv, as a function of sample volume:

Rc=Fv×R


This corrected signal would then be substituted into the above equation to calculate the volume-adjusted glucose concentration.


Various alternatives and modifications to the above-described embodiment related to detector array data analysis to determine sample size are possible, for example, such alternatives and modifications include one or more of: computing the number of pixels that have detected a change in color above a prescribed constant threshold at a particular point in time during the enzymatic reaction; computing the number of pixels that have detected a change in color above a prescribed constant threshold at multiple points in time during the enzymatic reaction; computing the number of pixels that have detected a change in color above a prescribed constant threshold at a time in which the enzymatic reaction is complete; computing the number of pixels that have detected a change in color above a variable threshold across the array; using above strategies to correlate output to actual sample volume at reagent pad; and using above strategies to predict sample volume to be delivered to assay pad after a predetermined amount of time.


Using the aforementioned detector array to detect the volume of the sample, the volume information can be used as feedback information, and utilized in devices such as an integrated meter. The definition of an integrated device or meter in this context includes one which includes the functions of acquiring a sample of body fluid or blood from the skin, transporting the body fluid or blood from the skin to a quantification area or assay pad, and quantifying the analyte (e.g.—glucose) in the sample via a photometric method.


In this embodiment, a catalyst such as vacuum, heat, pressure, vibration or similar action is preferably applied to the sampling site to facilitate the acquisition of sufficient sample volume of blood. Catalysts such as these can be effective in expressing sufficiently large volumes of blood even from alternative body sites that are less perfused than the fingertips. To ensure that the catalyst is applied with sufficient magnitude and duration, this invention provides a construction and method to control the catalyst such that it operates for exactly as long as necessary. By quantifying the sample volume delivered to the reagent pad in real-time, the detector array and associated on-board data processing within the integrated device can provide a feedback signal via a digital microprocessor controller or similar device which indicates either to increase, decrease, or keep constant the magnitude of the catalyst, as well as to either continue or stop the application of the catalyst. Those experienced in the art of controlling such catalyst mechanisms will appreciate that the control. signal may be either binary or analog and use this information accordingly to control a pump (for vacuum/pressure), a motor (for vibration), a heating element (for increasing skin temperature) or combinations thereof.


One such exemplary mode of operation is illustrated in FIG. 1. As illustrated therein, a suitable catalyst, such as a vacuum created by a suitable mechanism or pump is initiated. Shortly thereafter the signals from the detector array are analyzed and the sample volume estimated. This volume is compared with a target sample volume. If the volume is sufficient, the catalyst is turned off. If the volume is insufficient, the reading and calculating processes are repeated until such time as the target sample volume is reached. Once the target sample volume is reached, the analyte concentration determination may continue.


Various alternatives and modifications to the above-described embodiment related to detector array data analysis to provide feedback are possible. For example, such alternatives and modifications may include one or more of: providing a feedback signal corresponding to actual sample volume received at the assay pad; providing a feedback signal corresponding to predicted volume anticipated to be delivered to assay pad; providing an analog feedback signal that is proportional to the volume received at the assay pad; providing a digital feedback signal that indicates either sufficient or insufficient quantity of sample volume received; providing feedback signal based on imaging of an alternative location within the meter that is not necessarily the reagent pad, but can also be imaged by the detector array to detect whether a specific threshold of blood will be delivered to the reagent pad; and providing feedback signal based on imaging of an alternative location outside of the meter (such as on the skin) that can also be imaged by the detector array to detect whether a specific threshold of blood will be delivered to the assay pad.


The discrete nature of the detection elements or pixels also allows for detection of flaws and to distinguish them from regions of the reaction spot that are developing an appropriate or more ideal photometric reaction, even if they are randomly distributed.


For example, a detector array is arranged to scan the reaction spot, optionally coupled with appropriate optical magnification. An ideal spot will produce little or no variation in signal response across the array. In the case of a non-ideal spot, the response of the pixels will vary spatially and temporally. A quantification algorithm which has one or more of the following features could correct and/or ignore the reaction spot flaw(s) and have the potential to provide a more accurate measurement of the analyte concentration: identification and inclusion of data only from pixels which correspond to the appropriate and expected color (e.g., screen for data corresponding to various shades of blue only); identification and exclusion of data from pixels which do not correspond to the appropriate and expected color (e.g., screen out data corresponding to shades of red); inclusion/exclusion of pixel information which does not change at a rate with respect to time expected for the appropriate color (e.g., rate of change of blue is not the same as that of non-blue pixels); and inclusion/exclusion of pixel information which does not change at a rate with respect to time after a specific elapsed time or during a specific time window expected for the appropriate color (e.g., blue pixels change from time t1 to t2 by x %, whereas non-blue pixels do not change by x % between time t1 through t2).


Combinations of the above strategies or similar ones may allow the algorithm to successfully correct for non-ideal spots. It may even be the case that a relatively small percentage of the spot area actually is ideal, yet if the detector array can image this area, even 1 pixel could be sufficient to provide an accurate reading of the analyte.



FIGS. 2-3 are schematic illustrations of at least some of the aspects of arrangements, devices and methods of the present invention. As illustrated therein, an arrangement 10, such as an integrated device or meter may include a detector array 20, which can be provided in the form of a linear array of individual detection elements 30. Each detection element 30 is capable of producing a signal. The detection elements 30 may comprise one or more CMOS-based detection elements or pixels. The linear array 20 is generally in optical registry with an assay pad 40. The relative vertical position of the assay pad and detector array 20 may, of course, differ from the illustrated embodiment. In addition, the assay pad 40 and the detector array 20 may have a geometry that differs from that of the illustrated embodiment. The detector array 20 may be larger than the assay pad 40.


The assay pad 40 preferably contains at least one reagent. A mechanism may be provided to transport a sample of body fluid, such as blood, to the assay pad 40. According to the illustrated embodiment, a hollow member 60, such as a needle, having one end in fluid communication with the assay pad may provide a mechanism for transport. As a sample of body fluid is applied to the assay pad 40, a reaction between the reagent and the analyte of interest (e.g., glucose) results in a color change on a surface of the assay pad 40 forming a reaction spot 50 in optical registry with the array of detector elements 30. The detector array 20 corresponds in location to the spot 50 produces a signal in response to the color change that is indicative of the presence of the analyte of interest. The signal can be used to estimate the volume of the sample applied to the reagent pad, monitor the kinetics of the reaction between the reagent and the analyte, and ascertain irregularities in the reaction spot 50, as described above. This information can then be used to correct the output (e.g., concentration of analyte present in the sample) of the device to account for the hematocrit level, volume of sample presented to the assay pad 40, and/or irregularities in the reaction spot 50. The above-described arrangement 10 of features may all be contained or integrated within a single device or meter. Alternatively, one or a combination of any of the above-described features may be incorporated into such a device.


The detector array 20 forms part of an arrangement 70 present in the device 10 for carrying out the various operations described herein. As best illustrated in FIG. 3, the detector 20 may contain a plurality of detector elements in signal communication with a device 72 having timing and control logic. The timing and control logic may include internal as well external control signals. These signals typically include clock and frame start signals. External timing and control signals may be generated by a microprocessor/microcontroller or other external circuitry. The detector array 20 may have analog signal output. Alternatively, the detector 20 may have a digital data interface.


As illustrated, the detector may comprise an internal signal amplifier 74. Alternatively, the signal amplifier 74 may be external, as indicated by the amplifier 74 shown in broken line. According to another alternative, the amplifier 74 may be entirely omitted. According to yet another alternative, both an internal and external amplifiers 74 may be provided.


The signal from the detector 20 is outputted to an analog/digital converter 76 (where no digital data interface is provided by the detector). The converter 76 is connected to a bus 78, along with a memory 80 and an input/output device 82. The memory 80 may comprise one or more of RAM, ROM or EEPROM, as well as other conventional memory devices. Whatever its form, the memory 80 preferably contains at least one value indicative of hematocrit level, sample volume or reagent spot imperfections. In this regard the memory may contain one or more of the algorithms and look-up tables described herein.


The converter 76, the bus 78, the memory 80 and input/output device 82 may be components of a microprocessor/microcontroller 84. According to an alternative embodiment, the converter 76, memory 80 and input/output device 82 are external to the microprocessor/microcontroller 84.


The input/output device 82 is in signal communication with various output devices 86, 88, 90, 92, and can provide control signals thereto. These output devices may include a device providing a catalyst to facilitate sample acquisition, as described herein. For example, these devices may include one or more of a vacuum pump, an actuation trigger device, a light source, a heat source, a vibration motor, or combinations of any of the foregoing. Regardless of the form of these devices, they are configured and arranged such that they are in signal communication with input/output device 82 so as to be responsive to the control signals. These control signals may be based on sample volume calculations made with the assistance of the detector array, as described herein.


An integrated device formed according to the principles of the present invention may have a number of suitable configurations. According to certain embodiments the device is configured to perform testing by acquiring a sample of blood from the user, transfer the sample to an analysis site, and determine the concentration of a target analyte contained in the sample. These operations are all performed with little or no user input. For example, these operations may commence automatically according to a specified or predetermined schedule. Alternatively, these operations may commence at the command of the user via, for example, pressing a start button on the device.


The device may include disposable and reusable portions. The disposable portion may include at least one skin piercing element/transport member and analysis site (which may include an assay pad). The disposable portion may provide the capability to perform a single test. After testing is complete, the disposable portion is discarded and replaced with a new disposable portion before performing another test. Alternatively, the disposable portion includes a plurality of skin piercing elements/transport members and analysis sites. Such disposable units permit a plurality of tests to be performed before it is necessary to discard and replace the disposable unit. The device may be either wearable or handheld, or both.


A non-limiting exemplary integrated device 100 is illustrated in FIGS. 4-5. As illustrated therein the device 100 generally comprises a functional portion 102, and an optional attachment means or band 104. Thus according to the present invention, the integrated device 100 may be wearable. In addition, or alternatively, the integrated device may be operable as a hand-held device. For example, according to the illustrated embodiment, the band 104 can be separated and/or otherwise removed from the user, and the device 100 stored in a suitable case or in the user's pocket. The band can then be grasped and used to hold the device against the skin to perform a testing operation.


The device 100 preferably includes at least one arrangement for performing a measurement of the concentration of an analyte contained in a sample of blood. According to the illustrated embodiment, the device 100 comprises at least one skin-piercing element, at least one actuation member, such as a torsional spring element as described in further detail herein, and at least one analysis site 110, which may contain an assay pad. The at least one arrangement may form part of a disposable portion or unit. According to one embodiment, the disposable unit allows for at least one measurement of the concentration of an analyte contained in a sample of blood prior to being discarded and replaced. According to a further embodiment, the disposable unit allows for a plurality of measurements of the concentration of an analyte contained in a sample of blood prior to being discarded and replaced.


According to certain alternative embodiments, the device may additionally contain one or more of the features disclosed in U.S. Pat. No. 6,540,975, U.S. Patent Application Publications 2003/0153900, 2004/0191119, and published PCT Applications WO 04/085995 and WO 04/0191693, the entire contents of which are incorporated herein by reference.


While this invention is satisfied by embodiments in many different forms, as described in detail in connection with preferred embodiments of the invention, it is understood that the present disclosure is to be considered as exemplary of the principles of the invention and is not intended to limit the invention to the specific embodiments illustrated and described herein. Numerous variations may be made by persons skilled in the art without departure from the spirit of the invention. The abstract and the title are not to be construed as limiting the scope of the present invention, as their purpose is to enable the appropriate authorities, as well as the general public, to quickly determine the general nature of the invention. Unless the term “means” is expressly used, none of the features or elements recited herein should be construed as means-plus-function limitations pursuant to 35 U.S.C. § 112, ¶6.

Claims
  • 1. An arrangement for measuring a concentration of an analyte contained in a sample of body fluid, the arrangement comprising: an assay pad containing a single chemical reagent, wherein the chemical reagent produces a detectable signal in the form of a color change at a reaction spot formed upon reaction with the analyte, and wherein the concentration of the analyte is measured at the reaction spot;a light source;a detector array; anda processor configured to: derive a hematocrit level value from the color change at the reaction spot; andcalculate a hematocrit-adjusted analyte concentration using the hematocrit level value.
  • 2. The arrangement of claim 1, wherein the analyte comprises glucose and the body fluid comprises blood.
  • 3. The arrangement of claim 1, wherein the detector array is a linear array.
  • 4. The arrangement of claim 1, wherein the detector array comprises at least one of a linear array, a polar array, and an area array.
  • 5. The arrangement of claim 1, wherein the detector array comprises a plurality of detector elements, the detector elements comprising CMOS, CCD, photodiode, infrared, fluorescent, or ultraviolet elements.
  • 6. The arrangement of claim 1, further comprising at least one body fluid sampling catalyst device.
  • 7. The arrangement of claim 6, wherein the at least one catalyst device comprises at least one of a vacuum pump, a vibration motor, and a heating element.
  • 8. The arrangement of claim 7, wherein the at least one catalyst device is configured to be responsive to control signals, the control signals based on sample volume calculations.
  • 9. The arrangement of claim 5, wherein at least a portion of the plurality of detector elements are not in optical registry with the reaction spot and are configured to analyze one or more of a control solution having a known concentration of analyte introduced onto an area of the assay pad that is different from the area of the reaction spot, a standard color producing a known signal, and calibration information specific to the lot of the assay pad.
  • 10. The arrangement of claim 1 further comprising a memory, wherein the processor is further configured to look-up the hematocrit level value in a look-up table stored on the memory.
  • 11. The arrangement of claim 1, further comprising a needle having a first end configured to pierce skin, and a second end in fluid communication with the assay pad.
  • 12. An analyte monitoring device comprising the arrangement of claim 1, wherein the arrangement comprises a plurality of assay pads and a plurality of needles, thereby enabling the performance of a plurality of analyte concentration measurements.
  • 13. The analyte monitoring device of claim 12, further comprising a band for attaching the device to a body of a user.
  • 14. An integrated meter comprising: at least one piercing element;at least one actuation member; andthe arrangement of claim 1.
  • 15. An arrangement for measuring a concentration of an analyte contained in a sample of body fluid, the arrangement comprising: an assay pad comprising a chemical reagent configured to produce a detectable color change in a reaction with the analyte, wherein the detectable color change is indicative of an analyte level;a light source;a detector array; anda processor configured to: derive a calibration factor from the detectable color change of the same reaction, wherein the calibration factor is indicative of the level of hematocrit contained in the sample; andcalculate the concentration of the analyte using the analyte level and the calibration factor.
  • 16. The arrangement of claim 15, wherein the analyte comprises glucose and the body fluid comprises blood.
  • 17. The arrangement of claim 15, wherein the detector array is a linear array.
  • 18. The arrangement of claim 15, wherein the detector array comprises at least one of a linear array, a polar array, and an area array.
  • 19. The arrangement of claim 15, wherein the detector array comprises a plurality of detector elements, the detector elements comprising CMOS, CCD, photodiode, infrared, fluorescent, or ultraviolet elements.
  • 20. The arrangement of claim 15, further comprising at least one body fluid sampling catalyst device.
  • 21. The arrangement of claim 20, wherein the at least one catalyst device comprises at least one of a vacuum pump, a vibration motor, and a heating element.
  • 22. The arrangement of claim 21, wherein the at least one catalyst device is configured to be responsive to control signals, the control signals based on sample volume calculations.
  • 23. The arrangement of claim 19, wherein at least a portion of the plurality of detector elements are not in optical registry with a reaction spot formed by the reaction and are configured to analyze one or more of a control solution having a known concentration of analyte introduced onto an area of the assay pad that is different from the area of the reaction spot, a standard color producing a known signal, and calibration information specific to the lot of the assay pad.
  • 24. The arrangement of claim 15 further comprising a memory, wherein the processor is further configured to look-up the calibration factor in a look-up table stored on the memory.
  • 25. The arrangement of claim 15, further comprising a needle having a first end configured to pierce skin, and a second end in fluid communication with the assay pad.
  • 26. An analyte monitoring device comprising the arrangement of claim 15, wherein the arrangement comprises a plurality of assay pads and a plurality of needles, thereby enabling the performance of a plurality of analyte concentration measurements.
  • 27. The analyte monitoring device of claim 26, further comprising a band for attaching the device to a body of a user.
  • 28. An integrated meter comprising: at least one piercing element;at least one actuation member; andthe arrangement of claim 15.
CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent application Ser. No. 14/614,177, filed Feb. 4, 2015, which issued as U.S. Pat. No. 9,366,636 on Jun. 14, 2016, which is a continuation of U.S. patent application Ser. No. 13/037,089, filed Feb. 28, 2011, which issued as U.S. Pat. No. 8,969,097 on Mar. 3, 2015, and which is a continuation of U.S. patent application Ser. No. 11/239,122, filed Sep. 30, 2005, which claims priority pursuant to 35 U.S.C. § 119(e) to U.S. Patent Application No. 60/689,546 filed Jun. 13, 2005, the entire content of each of which is incorporated herein by reference.

US Referenced Citations (495)
Number Name Date Kind
842690 Oswalt Jan 1907 A
D137874 Partridge May 1944 S
2749797 Harks Mar 1950 A
3092465 Adams, Jr. Jun 1963 A
3310002 Wilburn Mar 1967 A
3620209 Kravitz Nov 1971 A
3623475 Sanz et al. Nov 1971 A
3626929 Sanz et al. Dec 1971 A
3630957 Rey Dec 1971 A
D223165 Komendat Mar 1972 S
3723064 Liotta Mar 1973 A
3741197 Sanz et al. Jun 1973 A
3961898 Neeley et al. Jun 1976 A
4014328 Cluff et al. Mar 1977 A
4042335 Clement Aug 1977 A
4057394 Genshaw Nov 1977 A
4109655 Chacomac Aug 1978 A
4250257 Lee et al. Feb 1981 A
4254083 Columbus Mar 1981 A
4258001 Pierce et al. Mar 1981 A
4260257 Neeley et al. Apr 1981 A
4289459 Neeley et al. Sep 1981 A
4321397 Nix et al. Mar 1982 A
4350762 DeLuca et al. Sep 1982 A
4394512 Batz Jul 1983 A
4414975 Ryder et al. Nov 1983 A
4416279 Lindner et al. Nov 1983 A
4418037 Katsuyama et al. Nov 1983 A
4422941 Vaughan, Jr. et al. Dec 1983 A
4429700 Thees et al. Feb 1984 A
4627445 Garcia et al. Dec 1986 A
4637403 Garcia et al. Jan 1987 A
4637406 Guinn et al. Jan 1987 A
4653513 Dombrowski Mar 1987 A
4661319 Lape Apr 1987 A
4702261 Cornell et al. Oct 1987 A
4711250 Gilbaugh, Jr. et al. Dec 1987 A
4737458 Batz et al. Apr 1988 A
4767415 Duffy Aug 1988 A
4774192 Terminiello et al. Sep 1988 A
4790979 Terminiello et al. Dec 1988 A
4794926 Munsch et al. Jan 1989 A
4815843 Tiefenthaler et al. Mar 1989 A
4829470 Wang May 1989 A
4846785 Cassou et al. Jul 1989 A
4887306 Hwang et al. Dec 1989 A
4920977 Haynes May 1990 A
4929426 Bodai et al. May 1990 A
4930525 Palestrant Jun 1990 A
4935346 Phillips Jun 1990 A
4953552 De Marzo Sep 1990 A
4966646 Zdeblick Oct 1990 A
4995402 Smith Feb 1991 A
5029583 Meserol Jul 1991 A
5049487 Phillips et al. Sep 1991 A
5050617 Columbus et al. Sep 1991 A
5059394 Phillips et al. Oct 1991 A
5077199 Basagni et al. Dec 1991 A
5094943 Siedel et al. Mar 1992 A
5110724 Hewett May 1992 A
5114350 Hewett May 1992 A
5116759 Klainer et al. May 1992 A
5131404 Neeley et al. Jul 1992 A
5141868 Shanks et al. Aug 1992 A
5145565 Kater et al. Sep 1992 A
5146437 Boucheron Sep 1992 A
5153416 Neeley Oct 1992 A
5164575 Neeley et al. Nov 1992 A
5166498 Neeley Nov 1992 A
5174291 Schoonen et al. Dec 1992 A
5176632 Bernardi Jan 1993 A
5179005 Phillips et al. Jan 1993 A
5183741 Arai et al. Feb 1993 A
5196302 Kidwell Mar 1993 A
5208163 Charlton et al. May 1993 A
5213966 Vuorinen et al. May 1993 A
5217480 Habar et al. Jun 1993 A
5218966 Yamasawa Jun 1993 A
5223219 Subramanian et al. Jun 1993 A
5228972 Osaka et al. Jul 1993 A
5234818 Zimmermann et al. Aug 1993 A
5241969 Carson et al. Sep 1993 A
5251126 Kahn et al. Oct 1993 A
D341848 Bigelow et al. Nov 1993 S
5275159 Griebel Jan 1994 A
5278079 Gubinski et al. Jan 1994 A
5288646 Lundsgaard et al. Feb 1994 A
5299571 Mastrototaro Apr 1994 A
5301686 Newman Apr 1994 A
5302513 Mike et al. Apr 1994 A
5304468 Phillips et al. Apr 1994 A
5306623 Kiser et al. Apr 1994 A
5308767 Terashima May 1994 A
5320607 Ishibashi Jun 1994 A
5354537 Moreno Oct 1994 A
5360595 Bell et al. Nov 1994 A
5368047 Suzuki et al. Nov 1994 A
5383512 Jarvis Jan 1995 A
5390671 Lord et al. Feb 1995 A
5399316 Yamada Mar 1995 A
5401110 Neeley Mar 1995 A
5402798 Swierczek et al. Apr 1995 A
5426032 Phillips et al. Jun 1995 A
5441513 Roth Aug 1995 A
5451350 Macho et al. Sep 1995 A
5458140 Eppstein et al. Oct 1995 A
5460777 Kitajima et al. Oct 1995 A
5460968 Yoshida et al. Oct 1995 A
5482473 Lord et al. Jan 1996 A
5506200 Hirschkoff et al. Apr 1996 A
5507288 Böcker et al. Apr 1996 A
5508200 Tiffany et al. Apr 1996 A
5510266 Bonner et al. Apr 1996 A
5514152 Smith May 1996 A
5527892 Borsotti et al. Jun 1996 A
5563042 Phillips et al. Oct 1996 A
5568806 Cheney, II et al. Oct 1996 A
5569287 Tezuka et al. Oct 1996 A
5575403 Charlton et al. Nov 1996 A
5577499 Teves Nov 1996 A
5582184 Erickson et al. Dec 1996 A
5586553 Halili et al. Dec 1996 A
5591139 Lin et al. Jan 1997 A
5611809 Marshall et al. Mar 1997 A
5624458 Lipscher Apr 1997 A
5630986 Charlton et al. May 1997 A
5632410 Moulton et al. May 1997 A
5636632 Bommannan et al. Jun 1997 A
5647851 Pokras Jul 1997 A
5658515 Lee et al. Aug 1997 A
5660791 Brenneman et al. Aug 1997 A
5670031 Hintsche et al. Sep 1997 A
5676850 Reed et al. Oct 1997 A
5680858 Hansen et al. Oct 1997 A
5681484 Zanzucchi et al. Oct 1997 A
5682233 Brinda Oct 1997 A
5697901 Eriksson Dec 1997 A
5701181 Boiarski et al. Dec 1997 A
5701910 Powles et al. Dec 1997 A
5705018 Hartley Jan 1998 A
5708247 McAleer Jan 1998 A
5708787 Nakano et al. Jan 1998 A
5715417 Gardien et al. Feb 1998 A
5730753 Morita Mar 1998 A
5735273 Kurnik et al. Apr 1998 A
5736103 Pugh Apr 1998 A
5741211 Renirie et al. Apr 1998 A
5746217 Erickson et al. May 1998 A
5746720 Stouder, Jr. May 1998 A
5757666 Schreiber et al. May 1998 A
5759364 Charlton et al. Jun 1998 A
5766066 Ranniger Jun 1998 A
5771890 Tamada Jun 1998 A
5797693 Jaeger Aug 1998 A
5801057 Smart et al. Sep 1998 A
5807375 Gross et al. Sep 1998 A
5820570 Erickson et al. Oct 1998 A
5827183 Kumik et al. Oct 1998 A
5840020 Heinonen et al. Nov 1998 A
5841126 Fossum et al. Nov 1998 A
5843692 Phillips et al. Dec 1998 A
5846837 Thym et al. Dec 1998 A
5854074 Charlton et al. Dec 1998 A
D403975 Douglas et al. Jan 1999 S
5855801 Lin et al. Jan 1999 A
5856195 Charlton et al. Jan 1999 A
5858194 Bell Jan 1999 A
5866281 Guckel et al. Feb 1999 A
5871494 Simons et al. Feb 1999 A
5879310 Sopp et al. Mar 1999 A
5879326 Godshall et al. Mar 1999 A
5879367 Latterell et al. Mar 1999 A
5885839 Lingane et al. Mar 1999 A
5891053 Sesekura Apr 1999 A
5893870 Talen et al. Apr 1999 A
5911711 Pelkey Jun 1999 A
5911737 Lee et al. Jun 1999 A
5912139 Iwata et al. Jun 1999 A
5925021 Castellano et al. Jul 1999 A
5928207 Pisano et al. Jul 1999 A
5930873 Wyser Aug 1999 A
5938679 Freeman et al. Aug 1999 A
5945678 Yanagisawa Aug 1999 A
5951492 Douglas et al. Sep 1999 A
5951493 Douglas et al. Sep 1999 A
5954685 Tierney Sep 1999 A
5962215 Douglas et al. Oct 1999 A
5968760 Phillips et al. Oct 1999 A
5968765 Grage et al. Oct 1999 A
5971941 Simons et al. Oct 1999 A
5972294 Smith et al. Oct 1999 A
5986754 Harding Nov 1999 A
5989409 Kurnik et al. Nov 1999 A
5993189 Mueller et al. Nov 1999 A
6001067 Shults et al. Dec 1999 A
6005545 Nishida et al. Dec 1999 A
6010463 Lauks et al. Jan 2000 A
6010519 Mawhirt et al. Jan 2000 A
6014135 Fernandes Jan 2000 A
6014577 Henning et al. Jan 2000 A
6023629 Tamada Feb 2000 A
6027459 Shain et al. Feb 2000 A
6030827 Davis et al. Feb 2000 A
6032059 Henning et al. Feb 2000 A
6036924 Simons et al. Mar 2000 A
6041253 Kost et al. Mar 2000 A
6050988 Zuck Apr 2000 A
6056701 Duchon et al. May 2000 A
6056734 Jacobsen et al. May 2000 A
6058321 Swayze et al. May 2000 A
6059815 Lee et al. May 2000 A
6061128 Zweig et al. May 2000 A
6063039 Cunningham et al. May 2000 A
6071294 Simons et al. Jun 2000 A
6077660 Wong et al. Jun 2000 A
6080116 Erickson et al. Jun 2000 A
6083196 Trautman et al. Jul 2000 A
6086544 Hibner et al. Jul 2000 A
6090790 Eriksson Jul 2000 A
6091975 Daddona et al. Jul 2000 A
6093156 Cunningham et al. Jul 2000 A
6097831 Wieck et al. Aug 2000 A
6099484 Douglas et al. Aug 2000 A
6100107 Lei et al. Aug 2000 A
6102933 Lee et al. Aug 2000 A
6103033 Say et al. Aug 2000 A
6103197 Werner Aug 2000 A
6106751 Talbot et al. Aug 2000 A
6118126 Zanzucchi Sep 2000 A
6120676 Heller et al. Sep 2000 A
6123861 Santini, Jr. et al. Sep 2000 A
6126899 Woudenberg et al. Oct 2000 A
6132449 Lum et al. Oct 2000 A
6139562 Mauze et al. Oct 2000 A
6142939 Eppstein et al. Nov 2000 A
6152942 Brenneman et al. Nov 2000 A
6162639 Douglas Dec 2000 A
6175752 Say et al. Jan 2001 B1
6176865 Mauze et al. Jan 2001 B1
6183434 Eppstein et al. Feb 2001 B1
6183489 Douglas et al. Feb 2001 B1
6187210 Lebouiz et al. Feb 2001 B1
6192891 Gravel et al. Feb 2001 B1
6200296 Dibiasi et al. Mar 2001 B1
6206841 Cunningham et al. Mar 2001 B1
6214626 Meller et al. Apr 2001 B1
6219574 Cormier et al. Apr 2001 B1
6228100 Schraga May 2001 B1
6230051 Cormier et al. May 2001 B1
6231531 Lum et al. May 2001 B1
6241862 McAleer et al. Jun 2001 B1
6242207 Douglas et al. Jun 2001 B1
6245215 Douglas et al. Jun 2001 B1
6251083 Yum et al. Jun 2001 B1
6251260 Heller et al. Jun 2001 B1
6254586 Mann et al. Jul 2001 B1
6255061 Mori et al. Jul 2001 B1
6256533 Yuzhakov et al. Jul 2001 B1
6268162 Phillips et al. Jul 2001 B1
6271045 Douglas et al. Aug 2001 B1
6272364 Kurnik Aug 2001 B1
6283926 Cunningham et al. Sep 2001 B1
6289230 Chaiken et al. Sep 2001 B1
6298254 Tamada Oct 2001 B2
6299578 Kurnik et al. Oct 2001 B1
6309351 Kurnik et al. Oct 2001 B1
D450711 Istvan et al. Nov 2001 S
6312612 Sherman et al. Nov 2001 B1
6312888 Wong et al. Nov 2001 B1
6322808 Trautman et al. Nov 2001 B1
6329161 Heller et al. Dec 2001 B1
6331266 Powell et al. Dec 2001 B1
6332871 Douglas et al. Dec 2001 B1
6334856 Allen et al. Jan 2002 B1
6350273 Minagawa et al. Feb 2002 B1
6352514 Douglas et al. Mar 2002 B1
6356776 Berner et al. Mar 2002 B1
6358265 Thorne, Jr. et al. Mar 2002 B1
6364890 Lum et al. Apr 2002 B1
6375626 Allen et al. Apr 2002 B1
6375627 Mauze et al. Apr 2002 B1
6379969 Mauze et al. Apr 2002 B1
6391005 Lum et al. May 2002 B1
6391645 Huang et al. May 2002 B1
6409679 Pyo Jun 2002 B2
6428664 BhulLar et al. Aug 2002 B1
6449608 Morita et al. Sep 2002 B1
6455324 Douglas Sep 2002 B1
6493069 Nagashimada et al. Dec 2002 B1
6500134 Cassone Dec 2002 B1
6520973 McGarry Feb 2003 B1
6530892 Kelly Mar 2003 B1
6537243 Henning et al. Mar 2003 B1
6540675 Aceti et al. Apr 2003 B2
6544475 Douglas et al. Apr 2003 B1
6555061 Leong et al. Apr 2003 B1
6558624 Lemmon et al. May 2003 B1
6579690 Bonnecaze et al. Jun 2003 B1
6602205 Erickson et al. Aug 2003 B1
6612111 Hodges et al. Sep 2003 B1
6616616 Fritz et al. Sep 2003 B2
6626874 Duchamp Sep 2003 B1
6656167 Numao et al. Dec 2003 B2
6679852 Schmelzeisen-Redeker et al. Jan 2004 B1
6706000 Perez et al. Mar 2004 B2
6706049 Moerman Mar 2004 B2
6706159 Moerman et al. Mar 2004 B2
6707554 Miltner et al. Mar 2004 B1
6740800 Cunningham May 2004 B1
6748275 Lattner et al. Jun 2004 B2
6753187 Cizdziel et al. Jun 2004 B2
6766817 da Silva Jul 2004 B2
6793633 Douglas et al. Sep 2004 B2
6830669 Miyazaki et al. Dec 2004 B2
6836678 Tu Dec 2004 B2
6837858 Cunningham et al. Jan 2005 B2
6847451 Pugh Jan 2005 B2
6918404 Da Silva Jul 2005 B2
6919960 Hansen et al. Jul 2005 B2
6923764 Aceti et al. Aug 2005 B2
6936476 Anderson et al. Aug 2005 B1
6988996 Roe et al. Jan 2006 B2
7004928 Aceti et al. Feb 2006 B2
7011630 Desai et al. Mar 2006 B2
7025774 Freeman et al. Apr 2006 B2
7052652 Zanzucchi et al. May 2006 B2
7066586 Da Silva Jun 2006 B2
7066890 Lam et al. Jun 2006 B1
7141058 Briggs et al. Nov 2006 B2
7156809 Quy Jan 2007 B2
7192061 Martin Mar 2007 B2
D540343 Cummins Apr 2007 S
7223365 Von Der Goltz May 2007 B2
7225008 Ward et al. May 2007 B1
7226461 Boecker et al. Jun 2007 B2
D551243 Young Sep 2007 S
7270970 Anderson et al. Sep 2007 B2
7297151 Boecker et al. Nov 2007 B2
7343188 Sohrab Mar 2008 B2
7344507 Briggs et al. Mar 2008 B2
7379167 Mawhirt et al. May 2008 B2
7427377 Zanzucchi et al. Sep 2008 B2
D599373 Kobayashi et al. Sep 2009 S
D601257 Berlinger et al. Sep 2009 S
7585278 Aceti et al. Sep 2009 B2
D601444 Jones et al. Oct 2009 S
D601578 Poulet et al. Oct 2009 S
7682318 Alden et al. Mar 2010 B2
D622393 Gatrall et al. Aug 2010 S
7803123 Perez et al. Sep 2010 B2
7850521 Briggs et al. Dec 2010 B2
7887494 Emery et al. Feb 2011 B2
D642191 Barnett et al. Jul 2011 S
8012103 Escutia et al. Sep 2011 B2
8012104 Escutia et al. Sep 2011 B2
D654926 Lipman et al. Feb 2012 S
8184273 Dosmann et al. May 2012 B2
8231832 Zanzucchi et al. Jul 2012 B2
8303518 Aceti et al. Nov 2012 B2
8360993 Escutia et al. Jan 2013 B2
8360994 Escutia et al. Jan 2013 B2
8372015 Escutia et al. Feb 2013 B2
8382681 Escutia et al. Feb 2013 B2
D691174 Lipman et al. Oct 2013 S
8795201 Escutia et al. Aug 2014 B2
8801631 Escutia et al. Aug 2014 B2
8919605 Lipman et al. Dec 2014 B2
8969097 Emery et al. Mar 2015 B2
9366636 Emery et al. Jun 2016 B2
9603562 Aceti et al. Mar 2017 B2
9636051 Emery et al. May 2017 B2
20010001034 Douglas May 2001 A1
20010027328 Lum et al. Oct 2001 A1
20010053891 Ackley Dec 2001 A1
20020002326 Causey, III et al. Jan 2002 A1
20020002344 Douglas et al. Jan 2002 A1
20020004640 Conn et al. Jan 2002 A1
20020006355 Whitson Jan 2002 A1
20020016568 Lebel et al. Feb 2002 A1
20020020688 Sherman et al. Feb 2002 A1
20020022934 Vogel et al. Feb 2002 A1
20020023852 Mcivor et al. Feb 2002 A1
20020042594 Lum et al. Apr 2002 A1
20020052618 Haar et al. May 2002 A1
20020087056 Aceti et al. Jul 2002 A1
20020136667 Subramanian et al. Sep 2002 A1
20020137998 Smart et al. Sep 2002 A1
20020160520 Orloff et al. Oct 2002 A1
20020168290 Yuzhakov et al. Nov 2002 A1
20020169394 Eppstein et al. Nov 2002 A1
20020169411 Sherman et al. Nov 2002 A1
20020177761 Orloff et al. Nov 2002 A1
20020183102 Withers et al. Dec 2002 A1
20020188223 Perez et al. Dec 2002 A1
20020198444 Uchigaki et al. Dec 2002 A1
20030012693 Otillar et al. Jan 2003 A1
20030028087 Yuzhakov et al. Feb 2003 A1
20030028125 Yuzhakov et al. Feb 2003 A1
20030039587 Niermann Feb 2003 A1
20030083685 Freeman et al. May 2003 A1
20030083686 Freeman et al. May 2003 A1
20030116596 Terasawa Jun 2003 A1
20030135166 Gonnelli Jul 2003 A1
20030135333 Aceti Jul 2003 A1
20030153844 Smith et al. Aug 2003 A1
20030153900 Aceti et al. Aug 2003 A1
20030175987 Verdonk et al. Sep 2003 A1
20030206302 Pugh Nov 2003 A1
20030207441 Eyster et al. Nov 2003 A1
20030208113 Mault et al. Nov 2003 A1
20030211619 Olson et al. Nov 2003 A1
20030212344 Yuzhakov et al. Nov 2003 A1
20030212347 Sohrab Nov 2003 A1
20040010207 Flaherty et al. Jan 2004 A1
20040030353 Schmelzeisen-redeker et al. Feb 2004 A1
20040049219 Briggs et al. Mar 2004 A1
20040059256 Perez Mar 2004 A1
20040073140 Douglas Apr 2004 A1
20040092842 Boecker et al. May 2004 A1
20040092995 Boecker et al. May 2004 A1
20040096959 Stiene et al. May 2004 A1
20040098009 Boecker et al. May 2004 A1
20040102803 Boecker et al. May 2004 A1
20040122339 Roe et al. Jun 2004 A1
20040132167 Rule et al. Jul 2004 A1
20040138588 Saikley et al. Jul 2004 A1
20040155084 Brown Aug 2004 A1
20040178218 Schomakers et al. Sep 2004 A1
20040186394 Roe et al. Sep 2004 A1
20040191119 Zanzucchi et al. Sep 2004 A1
20040202576 Aceti et al. Oct 2004 A1
20040236251 Roe et al. Nov 2004 A1
20040238675 Banaszkiewicz et al. Dec 2004 A1
20040259180 Burke et al. Dec 2004 A1
20050010134 Douglas et al. Jan 2005 A1
20050015020 LeVaughn et al. Jan 2005 A1
20050070819 Poux et al. Mar 2005 A1
20050096686 Allen May 2005 A1
20050106713 Phan et al. May 2005 A1
20050159678 Taniike et al. Jul 2005 A1
20050187532 Thurau et al. Aug 2005 A1
20050202567 Zanzucchi et al. Sep 2005 A1
20050202733 Yoshimura et al. Sep 2005 A1
20050215872 Berner et al. Sep 2005 A1
20050215923 Wiegel Sep 2005 A1
20050245844 Mace et al. Nov 2005 A1
20050255001 Padmaabhan et al. Nov 2005 A1
20050277972 Wong et al. Dec 2005 A1
20060008389 Sacherer et al. Jan 2006 A1
20060036134 Tarassenko et al. Feb 2006 A1
20060079809 Goldberger Apr 2006 A1
20060117616 Jones et al. Jun 2006 A1
20060122536 Haar et al. Jun 2006 A1
20060135873 Karo et al. Jun 2006 A1
20060155317 List Jul 2006 A1
20060178600 Kennedy et al. Aug 2006 A1
20060189908 Kennedy Aug 2006 A1
20060204399 Freeman et al. Sep 2006 A1
20060229533 Hoenes et al. Oct 2006 A1
20060241517 Fowler et al. Oct 2006 A1
20060257993 Mcdevitt et al. Nov 2006 A1
20060259102 Slatkine Nov 2006 A1
20060281187 Emery et al. Dec 2006 A1
20070017824 Rippeth et al. Jan 2007 A1
20070078313 Emery et al. Apr 2007 A1
20070078358 Escutia et al. Apr 2007 A1
20070083131 Escutia et al. Apr 2007 A1
20070179404 Escutia et al. Aug 2007 A1
20070255181 Alvarez-icaza et al. Nov 2007 A1
20070255302 Koeppel et al. Nov 2007 A1
20080046831 Imai et al. Feb 2008 A1
20080077048 Escutia et al. Mar 2008 A1
20080194934 Ray et al. Aug 2008 A1
20090156923 Power et al. Jun 2009 A1
20090292489 Burke et al. Nov 2009 A1
20090301899 Hodges et al. Dec 2009 A1
20100010374 Escutia et al. Jan 2010 A1
20100021947 Emery et al. Jan 2010 A1
20100021948 Lipman et al. Jan 2010 A1
20100095229 Dixon et al. Apr 2010 A1
20100174211 Frey et al. Jul 2010 A1
20100185120 Sacherer et al. Jul 2010 A1
20100217155 Poux et al. Aug 2010 A1
20110098599 Emery et al. Apr 2011 A1
20110201909 Emery et al. Aug 2011 A1
20120166090 Lipman et al. Jun 2012 A1
20120296179 Zanzucchi et al. Nov 2012 A1
20130158430 Aceti et al. Jun 2013 A1
20130158432 Escutia et al. Jun 2013 A1
20130172698 Reynolds et al. Jul 2013 A1
20130274568 Escutia et al. Oct 2013 A1
20140316301 Escutia et al. Oct 2014 A1
20140336480 Escutia et al. Nov 2014 A1
20140376762 Lipman et al. Dec 2014 A1
20150037898 Baldus et al. Feb 2015 A1
Foreign Referenced Citations (154)
Number Date Country
2 513 465 Aug 2004 CA
199 22 413 Nov 2000 DE
103 02-501 Aug 2004 DE
0103426 Mar 1984 EP
0 256 806 Feb 1988 EP
0 396-016 Nov 1990 EP
0 396-016 Nov 1990 EP
0 255-338 Feb 1998 EP
1 266-607 Dec 2002 EP
1 266-607 Dec 2002 EP
1 360-934 Nov 2003 EP
1 360-934 Nov 2003 EP
1 486-766 Dec 2004 EP
1 486-766 Dec 2004 EP
1 529-489 May 2005 EP
1 529-489 May 2005 EP
1 769-735 Apr 2007 EP
63-305841 Dec 1988 JP
3-63570 Mar 1991 JP
03093189 Apr 1991 JP
7-67861 Mar 1995 JP
7-213925 Aug 1995 JP
9-168530 Jun 1997 JP
9-313465 Sep 1997 JP
9-266889 Oct 1997 JP
9-294737 Nov 1997 JP
10-024028 Jan 1998 JP
10-318970 Dec 1998 JP
2000-116629 Apr 2000 JP
2000-126161 May 2000 JP
2000-168754 Jun 2000 JP
2000-254111 Sep 2000 JP
2001-159618 Jun 2001 JP
2001-515203 Sep 2001 JP
2001-305096 Oct 2001 JP
2001-330581 Nov 2001 JP
2002-502045 Jan 2002 JP
2002-514453 May 2002 JP
2002-168862 Jun 2002 JP
2003-180417 Jul 2003 JP
2004-000598 Jan 2004 JP
2004-500948 Jan 2004 JP
2004-117339 Apr 2004 JP
2004-522500 Jul 2004 JP
2004-528936 Sep 2004 JP
2005-503538 Feb 2005 JP
2005-087613 Apr 2005 JP
2006-512969 Apr 2005 JP
2005-525149 Aug 2005 JP
2005-237938 Sep 2005 JP
2005-525846 Sep 2005 JP
2005-527254 Sep 2005 JP
2006-512974 Apr 2006 JP
2006-516723 Jul 2006 JP
2006-521555 Sep 2006 JP
2006-527013 Nov 2006 JP
2007-067698 Mar 2007 JP
2007-521031 Aug 2007 JP
2007-311196 Nov 2007 JP
WO-8807666 Oct 1988 WO
WO-9114212 Sep 1991 WO
WO-9413203 Jun 1994 WO
WO-9510223 Apr 1995 WO
WO-9510223 Apr 1995 WO
WO-9604857 Feb 1996 WO
WO-9607907 Mar 1996 WO
WO-9614026 May 1996 WO
WO-9625088 Aug 1996 WO
WO-9715227 May 1997 WO
WO-9729847 Aug 1997 WO
WO-9730344 Aug 1997 WO
WO-9741421 Nov 1997 WO
WO-9831275 Jul 1998 WO
WO-9835225 Aug 1998 WO
WO-9912008 Mar 1999 WO
WO-9944508 Sep 1999 WO
WO-9958051 Nov 1999 WO
WO-0009184 Feb 2000 WO
WO-0013573 Mar 2000 WO
WO-0014269 Mar 2000 WO
WO-0014535 Mar 2000 WO
WO-0018449 Apr 2000 WO
WO-0018449 Apr 2000 WO
WO-0019185 Apr 2000 WO
WO-0036400 Jun 2000 WO
WO-0042422 Jul 2000 WO
WO-0074763 Dec 2000 WO
WO-0074763 Dec 2000 WO
WO-0078208 Dec 2000 WO
WO-0116575 Mar 2001 WO
WO-0152727 Jul 2001 WO
WO-0164105 Sep 2001 WO
WO-0164105 Sep 2001 WO
WO-0172220 Oct 2001 WO
WO-0180728 Nov 2001 WO
WO-0185233 Nov 2001 WO
WO-0185233 Nov 2001 WO
W0-0191634 Dec 2001 WO
WO-0191634 Dec 2001 WO
WO-0200101 Jan 2002 WO
WO-0200101 Jan 2002 WO
WO-0249507 Jun 2002 WO
WO-0249509 Jun 2002 WO
WO-0249509 Jun 2002 WO
WO-02082052 Oct 2002 WO
WO-02082052 Oct 2002 WO
WO-02093144 Nov 2002 WO
WO-02100251 Dec 2002 WO
WO-02100251 Dec 2002 WO
WO-02101359 Dec 2002 WO
WO-02101359 Dec 2002 WO
WO-2003030984 Apr 2003 WO
WO-2003066128 Aug 2003 WO
WO-2003066128 Aug 2003 WO
WO-2003070099 Aug 2003 WO
WO-2003071940 Sep 2003 WO
WO-2003071940 Sep 2003 WO
WO-2004062499 Jul 2004 WO
WO-2004062500 Jul 2004 WO
WO-2004062500 Jul 2004 WO
WO-2004064636 Aug 2004 WO
WO-2004085995 Oct 2004 WO
WO-2004085995 Oct 2004 WO
WO-2004091693 Oct 2004 WO
WO-2004091693 Oct 2004 WO
WO-2005006939 Jan 2005 WO
WO-2005006939 Jan 2005 WO
WO-2005009238 Feb 2005 WO
WO-2005018709 Mar 2005 WO
WO-2005018709 Mar 2005 WO
WO-2005084546 Sep 2005 WO
WO-2005084546 Sep 2005 WO
WO-2005085995 Sep 2005 WO
WO-2006138226 Dec 2006 WO
WO-2006138226 Dec 2006 WO
WO-2007041062 Apr 2007 WO
WO-2007041062 Apr 2007 WO
WO-2007041063 Apr 2007 WO
WO-2007041063 Apr 2007 WO
WO-2007041244 Apr 2007 WO
WO-2007041244 Apr 2007 WO
WO-2007041287 Apr 2007 WO
WO-2007041287 Apr 2007 WO
WO-2007041355 Apr 2007 WO
WO-2007041355 Apr 2007 WO
WO-2008027319 Mar 2008 WO
WO-2008027319 Mar 2008 WO
WO-2009145920 Dec 2009 WO
WO-2009148624 Dec 2009 WO
WO-2009148626 Dec 2009 WO
WO-2011065981 Jun 2011 WO
WO-2011162823 Dec 2011 WO
WO-2013020103 Feb 2013 WO
WO-2014205412 Dec 2014 WO
Non-Patent Literature Citations (52)
Entry
ADA Consensus Development Panel. (Jan.-Feb. 1987). “Consensus Statement on Self-Monitoring of Blood Glucose,” Diabetes Care 10(1):95-99.
ADA (Jan. 1994). “Self-Monitoring of Blood Glucose,” Consensus Statement Diabetes Care 17(1):81-86.
Anonymous. (Sep. 30, 1993). “The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus.” The New England Journal of Medicine 329(14):977-986.
Anonymous. (Jun. 23, 1998). Taking the “Ouch” Out of Needles: Arrays of “Microneedles” Offer New Techniques for Drug Delivery, Science Daily, located at <http:www.sciencedaily.com/releases/1998/06/980623045850.htm>, last visited Jan. 14, 2014, 3 pages.
Beregszàszi, M. et al. (Jul. 1997). “Nocturnal Hypoglycemia in Children and Adolescents with Insulin-Dependent Diabetes Mellitus: Prevalence and Risk Factors,” J. Pediatrics 131(1 Pt. 1):27-33.
Chase, H.P. et al. (Feb. 2001). “Continuous Subcutaneous Glucose Monitoring in Children with Type 1 Diabetes,” Pediatrics 107(2):222-226.
Clarke, W.L. et al. (Sep.-Oct. 1987). “Evaluating Clinical Accuracy of Systems for Self-Monitoring of Blood Glucose,” Diabetes Care 10(5):622-628.
Clarke, W.L. et al. (1981). “Evaluation of a New Reflectance Photometer for Use in Home Blood Glucose Monitoring,” Diabetes Care 4(5):547-550.
Collison, M.E. et al. (Sep. 1999). “Analytical Characterization of Electrochemical Biosensor Test Strips for Measurement of Glucose in Low-Volume Interstitial Fluid Samples,”Clinical Chemistry 45(9): 1665-1673.
Cox, D.J. et al. (Jun. 1997). “Understanding Error Grid Analysis,” Diabetes Care 20(6):911-912.
D'Arrigo, T.D. (Mar. 2000). “GlucoWatch Monitor Poised for Approval,” Diabetes Forecast, 53(3):43-44.
Extended European Search Report dated Jul. 18, 2013, for EP Application No. 06 772 943.4, filed on Jun. 13, 2006, 7 pages.
Extended European Search Report dated Aug. 27, 2012, for European Patent Application No. 09 758 789.3, filed on Jun. 8, 2009, 13 pages.
Final Office Action dated Oct. 15, 2009, for U.S. Appl. No. 11/239,122, filed on Sep. 30, 2005, 13 pages.
Final Office Action dated Aug. 14, 2012, for U.S. Appl. No. 13/037,089, filed on Feb. 28, 2011, 14 pages.
Final Office Action dated Sep. 23, 2013, for U.S. Appl. No. 13/037,089, filed on Feb. 28, 2011, 14 pages.
Feldman, B. et al. (2000). “FreeStyle™: A Small-Volume Electrochemical Glucose Sensor for Home Blood Glucose Testing,” Diabetes Technology and Therapeutics, 2(2):221-229.
International Search Report dated Jan. 16, 2008, for PCT Application No. PCT/US2006/022840, filed on Jun. 13, 2006, 1 page.
Johnson, R.N. et al. (Jan. 1998). “Accuracy of Devices Used for Self-Monitoring of Blood Glucose,” Annals of Clinical Biochemistry 35(1):68-74.
Johnson, R.N. et al. (Jan. 1999). “Analytical Error of Home Glucose Monitors: A Comparison of 18 Systems,” Annals of Clinical Biochemistry 36(1):72-79.
Johnson, R.N. et al. (2001). “Error Detection and Measurement in Glucose Monitors,” Clinica Chimica Acta 307:61-67.
Kumetrix, Inc. (Dec. 1999). “Painless Blood Glucose Monitoring, Courtesy of the Mosquito,” Start-Up pp. 27-28.
Lee, S-C. (Jun. 1999). “Light Scattering by Closely Spaced Parallel Cylinders Embedded in a Finite Dielectric Slab,” Journal of the Optical Society of America A 16(6):1350-1361.
McGarraugh, G. et al. (2001). “Physiological Influences on Off-Finger Glucose Testing,” Diabetes Technology & Therapeutics 3(3):367-376.
McNichols, R.J. et al. (Jan. 2000). “Optical Glucose Sensing in Biological Fluids: An Overview,” Journal of Biomedical Optics, 5(1):5-16.
Mahler, R.J. et al. (1999). “Clinical Review 102, Type 2 Diabetes Melitus: Update on Diagnosis Pathophysiology, and Treatment,” The Journal of Clinical Endocrinology and Metabolism 84(4): 1165-1171.
Medline Plus. (Jun. 17, 2008). , Medical Encyclopedia, Monitor Blood Glucose-Series: Part 1-4, 6 pages.
Neeley, W.E. et al. (1981). “An Instrument for Digital Matrix Photometry,” Clinical Chemistry 27(10):1665-1668.
Neeley, W.E. (1983). “Reflectance Digital Matrix Photometry,” Clinical Chemistry 29(6):1038-1041.
Neeley, W.E. (1983). “Multilayer Film Analysis for Glucose in 1- μL Samples of Plasma,” Clinical Chemistry 29(12):2103-2105.
Neeley, W.E. (1988). “A Reflectance Photometer with a Square Photodiode Array Detector for Use on Multilayer Dry-Film Slides,” Clinical Chemistry 34(11):2367-2370.
Non-Final Office Action dated Mar. 19, 2009, for U.S. Appl. No. 11/239,122, filed Sep. 30, 2005, 15 pages.
Non-Final Office Action dated Sep. 1, 2010, for U.S. Appl. No. 11/239,122, filed Sep. 30, 2005, 15 pages.
Non-Final Office Action dated Sep. 13, 2011, for U.S. Appl. No. 13/037,089, filed Feb. 28, 2011, 14 pages.
Non-Final Office Action dated Feb. 28, 2013, for U.S. Appl. No. 13/037,089, filed Feb. 28, 2011, 12 pages.
Non-Final Office Action dated Apr. 10, 2014, for U.S. Appl. No. 13/037,089, filed Feb. 28, 2011, 14 pages.
Non-Final Office Action dated May 29, 2015, for U.S. Appl. No. 14/614,177, filed Feb. 4, 2015, 13 pages.
Notice of Allowance dated Sep. 18, 2014, for U.S. Appl. No. 13/037,089, filed Feb. 28, 2011, 9 pages.
Notice of Allowance dated Feb. 16, 2016, for U.S. Appl. No. 14/614,177, filed Feb. 4, 2015, 7 pages.
Otto, E. et al. (2000). “An Intelligent Diabetes Software Prototype: Predicting Blood Glucose Levels and Recommending Regimen Changes,” Diabetes Technology and Therapeutics 2(4):569-576.
Pfohl, M. et al. (2000). “Spot Glucose Measurement in Epidermal Interstitial Fluid—An Alternative to Capillary Blood Glucose Estimation,” Experimental and Clinical Endocrinology & Diabetes 108(1):1-4.
Princen, H.M. (May 1969). “Capillary Phenomena in Assemblies of Parallel Cylinders, I. Capillary Rise Between Two Cylinders,” Journal of Colloid and Interface Science 30(1):69-75.
Princen, H.M. (Jul. 1969). “Capillary Phenomena in Assemblies of Parallel Cylinders, II. Capillary Rise in Systems with More Than Two Cylinders,” Journal of Colloid and Interface Science 30(3):359-371.
Rebrin, K. et al. (Sep. 1999). “Subcutaneous Glucose Predicts Plasma Glucose Independent of Insulin: Implications for Continuous Monitoring,” American Journal of Physiology 277(3):E561-E571.
Smart, W.H. et al. (2000). “The Use of Silicon Microfabrication Technology in Painless Glucose Monitoring,” Diabetes Technology & Therapeutics 2(4):549-559.
Svedman, C. et al. (Apr. 1999). “Skin Mini-Erosion Technique for Monitoring Metabolites in Interstitial Fluid: Its Feasibility Demonstrated by OGTT Results in Diabetic and Non-Diabetic Subjects,” Scand. J. Clin. Lab. Invest. 59(2):115-123.
Tietz, N.W. (1986).Textbook of Clinical Chemistry, W. B. Saunders Company, pp. 1533 and 1556.
Trinder, P. (1969). “Determination of Glucose in Blood Using Glucose Oxidase with an Alternate Oxygen Acceptor,” Annals of Clinical Biochemistry 6:24-28.
Written Opinion of the International Searching Authority dated Jan. 16, 2008, for PCT Application No. PCT/US2006/022840, filed on Jun. 13, 2006, 3 pages.
Yum, S. I. et al. (Nov. 1, 1999). “Capillary Blood Sampling for Self-Monitoring of Blood Glucose,” Diabetes Technology & Therapeutics, 1(1):29-37.
Non-Final Office Action dated Dec. 19, 2016, for U.S. Appl. No. 13/566,886, filed Aug. 3, 2012, 18 pages.
Extended European Search Report dated Nov. 8, 2016 by the European Patent Office for Application No. 16167087.2, filed Aug. 3, 2012, 7 pages.
Related Publications (1)
Number Date Country
20170095188 A1 Apr 2017 US
Provisional Applications (1)
Number Date Country
60689546 Jun 2005 US
Continuations (3)
Number Date Country
Parent 14614177 Feb 2015 US
Child 15177041 US
Parent 13037089 Feb 2011 US
Child 14614177 US
Parent 11239122 Sep 2005 US
Child 13037089 US