The present application claims priority from Japanese application serial No. 2009-171724, filed on Jul. 23, 2009, the contents of which are hereby incorporated by references into this application.
The present invention relates to a non-invasive glucose monitor that measures a glucose level in blood in a non-invasive manner.
For a diabetic to do an insulin injection properly, it is necessary to measure a glucose level in blood day by day correctly.
As a method of measuring the blood glucose level, there is known an invasive method of taking a small amount of blood sample from a patient and measuring a density of glucose contained in the blood. As to such an invasive method, it since needs to take the blood sample from a patient, it not only gives a physical pain to the patient but also increases cost of consumables such as exsanguination use needles, and further accompanies a possible danger of infectious disease via the needles.
For this reason, a non-invasive glucose monitor has been proposed as one which is able not to give a physical pain to the patient as well as to eliminate the cost increase of consumables and such danger of infectious disease.
For example, JP-B-3767449 indicated as patent document 1 proposes a non-invasive glucose monitor of irradiating light with a predetermined wavelength to a living body and sensing the reflection light thereof thereby to measure a density of glucose in the blood.
In order to enhance the measurement accuracy of the blood glucose level in comparison with the conventional art as disclosed in patent document 1, the present invention pays attention on a heat transfer rate from a body surface to outside thereof (a heat transfer rate per unit time) as a parameter relating to a blood flow rate.
Namely, the present invention uses a method in which, by contacting a member having a constant thermal resistance to a body surface, a temperature gradient caused within the member is measured to calculate a rate of heat transferring in the member, and the parameter relating to the blood flow rate is obtained from the heat transfer rate.
When adopting such a method to be used in the present invention, it since takes much time until an equilibrium temperature is reached, it is important to estimate the equilibrium temperature in a short measurement time.
The present invention is to provide a non-invasive glucose monitor capable of measuring the heat transfer rate from a human body in a short time to obtain a parameter relating to the blood flow rate and measuring the blood glucose level in high accuracy.
The present invention is basically constituted by as follows. It is comprised of:
a heat flux measurement device including a heat conductive member having a body surface contacting part for contacting a surface of a human body at its one end, a first temperature sensor with which the heat conductive member is provided adjacent to the body surface contacting part thereof, and a second temperature sensor with which the heat conductive member is provided adjacent to the other end apart from the body surface thereof;
an environmental temperature sensor that measures environmental temperature;
a radiation heat sensor that measures radiation heat from the body surface;
a light source that irradiates light having at least two different wavelengths toward the body surface contacting part;
a photo sensor that senses reflection light caused by reflecting the light at the body surface contacting part;
a computing device including a conversion part that converts respective outputs from the first temperature sensor, the second temperature sensor, the environmental temperature sensor, the radiation heat sensor and the photo sensor to respective parameters, and a processing part that stores a relationship between parameters and blood glucose levels and calculates a blood glucose level by applying the parameters converted from the respective outputs to the relationship, and a display part that displaying result outputted from the computing part.
For example, according to the present invention, after starting temperature measurement at the first temperature sensor and the second temperature sensor in the heat flux measuring device, a regression line is determined by making use of a least square method from temperature rise curves obtained at the first temperature sensor and the second temperature sensor with a predetermined time interval; relationships between the gradient of the regression line and equilibrium temperatures of the first temperature sensor and the second temperature sensor are respectively stored in advance as database; and the equilibrium temperature for a subject to be monitored is predicted from the database.
For example, a finger may be used as the body surface.
For example, preferably, the heat flux measuring device may be used while being cooled with a louver or a fan.
For example, the data base may be prepared in a form of grouping respectively with respect to items of at least room temperature, sex, age and anamnesis.
According to the present invention, it can provide a non-invasive monitor capable of measuring the heat transfer rate from a human body in short time to obtain a parameter relating to the blood flow rate and thereby measuring the blood glucose level in short time with high accuracy.
Herein below, embodiments of the present invention will be explained with reference to drawings.
At first, an amount of heat dissipated from a human body will be considered. Convective heat transfer that is a principal cause of the amount of heat dissipation relates to a temperature difference between the environment temperature (room temperature) and the temperature of body surface, and an amount of heat dissipation due to radiation that is another cause is proportional to the fourth power of absolute temperature of the body surface according to Stefan-Boltzmann law. Accordingly, it is understood that the amount of heat dissipation from a human body is related to the room temperature and the temperature of body surface.
On the other hand, an amount of oxygen supply that is a cause relating to an amount of heat generation is expressed by a product of hemoglobin density, oxygen saturation of hemoglobin and a blood flow rate.
Hemoglobin density can be measured from an absorbance at a wavelength (equal absorption wavelength) where mol absorption coefficients of oxygen coupling type hemoglobin and reduced (deoxidized) type hemoglobin become equal to each other.
The oxygen saturation of hemoglobin can be determined by measuring the above-mentioned absorbance at the equal absorption wavelength and at least another absorbance at the other wavelength in which ratio of mol absorption coefficients of oxygen coupling type hemoglobin and reduced (deoxidized) type hemoglobin is already known and by resolving simultaneous equations using the two wavelength (the equal absorption wavelength and the other wavelength).
Namely, the hemoglobin density and the oxygen saturation of hemoglobin can be obtained by measuring absorbances of at least two wavelengths. And remaining one is a flow rate of blood.
Although the blood flow rate can be measured with varieties of methods, an example of such measurement methods will be explained with reference to a drawing.
In
R1 is determined according to the following formula.
[MATHEMATICAL FORMULA 1]
R
1=(TC−T1)R2/(T1−T2) (1)
Herein, TC is a constant temperature at 37° C. as referred to above, therefore, when measuring T1 and T2 while fixing R2, R1 is determined, and the blood flow rate having correlation with R1 can be estimated.
Further, when also measuring the body surface temperature T3 with a radiation temperature meter, an amount of transferred radiation heat from the body surface can be estimated. A parameter suggesting the blood flow rate estimated from R1 is defined as X5.
According to our knowledge, we found that the measurement data necessary for determining the glucose density in blood with a mathematical model (described later of the present embodiments) is of room temperature (environmental temperature), temperature gradient inside the block contacting to the body surface, temperature due to radiation from the body surface and absorbances of at least two wavelengths.
In
In
In the non-invasive glucose monitor 100 according to the present embodiment, although the thick skin of a finger top is used as the body surface, other body surfaces can also be used.
In order to determine the thermal resistance R1, the equilibrium temperatures T1 and T2 are necessitated, however, in an actual measurement the following problems arise.
(1) When an amount of leakage heat transfer rate flow transferring from the finger to portions other than the block is large, a measurement error increases.
(2) It takes time until an equilibrium temperature for performing measurement is reached.
The present embodiment has a structure for solving such problems as follows.
In
A hollow part 25 is of a space for naturally air cooing the heat conductive member 20 to a room temperature via an outer frame 27 after finishing a body temperature measurement at the heat flux sensor part 17, and the end side of the heat conductive member 20 opposite to the finger contacting part is positioned within the hollow part 25. The thermister 26 is provided at the hollow part 25 to measure the room temperature. Further, an infrared lens 29 for optical measurement is disposed at a position inside the monitor 100 where the thick of the finger can be seen. A pyroelectricity sensor 31 is arranged below the infrared lens 29 via an infrared transmission window 30. Further, still another thermister 32 is disposed near the pyroelectricity sensor 31.
This infrared lens 29 is for focusing electromagnetic waves from the finger 21. The surface temperature of the finger 21 is sensed by the thermister 32 disposed near the pyroelectricity sensor 31 to which the electromagnetic waves are collected.
This optical measurement will be explained in connection with
Now, a method of predicting the equilibrium temperature will be explained.
In
[MATHEMATICAL FORMULA 2]
θ≡T−Ti (2)
[MATHEMATICAL FORMULA 3]
θmax=Tmax−Ti (3)
Herein, T is temperature in (° C.), suffix i: initial condition and suffix max: equilibrium condition
When classifying features of the temperature rise curves after contacting the finger to the temperature sensor with a constant pushing pressure, the initial portion thereof is considered that is affected by such as the surface temperature of the finger and the initial temperature of the temperature sensor, and reflects the heat transfer from the finger to the temperature sensor. On the other hand, after a certain time has passed, the portion thereof is considered to reflect heat transferred from the finger deep part to the surface due to biological reaction at the finger deep part. Accordingly, the present invention excluded the initial portion that contains large error, noted to a section obtained after a certain time has passed from the initial portion that contains a limited error and devised to estimate the equilibrium temperature by making use of the temperature rise curve of this section.
When explaining more specifically, in
[MATHEMATICAL FORMULA 4]
θ=αt+β (4)
[MATHEMATICAL FORMULA 5]
θmax=Aα (5)
β in the formula (4) is an intercept (which is not used in the prediction in the present invention) of the regression line. In
When a body temperature of another subject similar to the subjects A and B is measured at the same room temperature (an initial temperature), a correct equilibrium temperature Tmax is predicted in a measurement time of about 40s by making use of the formula (5) determined according to
An example of such database is shown in
With reference to
At the optical sensor portion 18, end portions of two optical fibers 60 and 61 are located. The optical fiber 60 is a light irradiation use optical fiber, and the optical fiber 61 is a light receiving use optical fiber. The optical fiber 60 is connected to branching optical fibers 60a and 60b. Further, the other end terminals of these fiber 60a and 60b are connected to the light sources 62 and 63 for the two wavelengths respectively. To the end terminal of the light receiving use optical fiber 61, the sensor 64 is arranged. The light source 62 emits light having wavelength of 810 nm, and the light emitting diode 63 emits light having wavelength of 950 nm. The wavelength of 810 nm is the equal absorption wavelength where the mol absorption coefficients of oxygen coupling type hemoglobin and reduced (deoxidized) type hemoglobin become equal, and the wavelength of 950 nm is a wavelength where the difference of the mol absorption coefficients of oxygen coupling type hemoglobin and reduced type hemoglobin becomes large.
The two light sources 62 and 63 emit light in time sharing, and the light emitted from the light sources 62 and 63 is irradiated to the finger 21 of the subject via the light irradiating use optical fiber 60. The light irradiated to the finger 21 is reflected by the skin of the finger 21, makes incident to the light receiving use optical fiber 61 and is sensed by the sensor 64. When the light irradiated to the finger is reflected by the skin of the finger, a part of the irradiated light enters into tissues through the skin and is absorbed by hemoglobin in blood flowing through capillaries. The measurement data by the sensor 64 is reflectance R and the absorbance is calculated approximately with log(1/R). Radiation is performed respectively with light having wavelengths 810 nm and 950 nm, respective reflectance Rs are measured and respective log(1/R)s are determined, thereby, absorbance A1 for wavelength 810 nm and absorbance A2 for wavelength 950 nm are obtained.
When assuming reduced type hemoglobin density as [Hb] and oxygen coupling type hemoglobin density as [HbO2], the absorbance A1 and absorbance A2 are expressed by the following formulas.
AHb(810 nm), AHbO2(810 nm), AHb(950 nm) and AHbO2(950 nm) are mol absorption coefficients at the respective wavelengths of reduced type hemoglobin and oxygen coupling type hemoglobin that are already known. “a” is a proportional coefficient. Hemoglobin density [Hb]+[HbO2] and hemoglobin oxygen saturation [HbO2]/([Hb]+[HbO2]) are determined as follows from the above formulas.
[MATHEMATICAL FORMULA 7]
[Hb]+[HbO2]=A1/a×AHbO2(810 nm)
[HbO2]/([Hb]+[HbO2])=(A2×AHbO2(810 nm)−A1×AHb(950 nm))/A1×(AHbO2(950 nm)−AHb(950 nm)) (7)
Herein, although an example where the hemoglobin density and hemoglobin oxygen saturation are measured through measurement of absorbances at two wavelengths, it is possible to reduce influences due to disturbing components and to enhance the measurement accuracy through measurement of the absorbances at not less than three wavelengths.
As seen from
Five kinds of analog signals are digital converted by analog/digital converters AD1˜AD5 via respective amplifiers A1˜A5. From the digital converted values, a conversion parts 111 and 112 calculate normalized parameters xi (i=1, 2, 3, 4, 5) in a computing device 110. xi can be expressed specifically in the following manner (a1˜a5 are proportional coefficients).
[MATHEMATICAL FORMULA 8]
Parameter proportional to radiation heat;
x
1
=a
1×(T3)4
Parameter proportional to heat convection;
x
2
=a
2×(T4−T3)
Parameter proportional to hemoglobin density;
x
3
=a
3×(A1/a×AHbO2(810 nm))
Parameter proportional to hemoglobin oxygen saturation;
x
4
=a
4×(A2×AHbO2(810 nm)−A1×AHb(950 nm))/(A1×AHbO2(950 nm)−AHb(950 nm))
Parameter proportional to blood flow rate;
x
5
=a
5
/R
1 (8)
Subsequently, normalized parameters Xi are calculated from an average value and a standard deviation of the parameters xi obtained from data of many actual healthy persons and diabetics. The normalized parameters Xi (i=1, 2, 3, 4, 5) are calculated from respective parameters xi according to the following formula.
[MATHEMATICAL FORMULA 9]
X
i=(xi×xa)/SD(xi) (9)
xi: parameters
xa: average value of parameters xi
SD(xi): standard deviation of parameters
With the above mentioned five normalized parameters Xi, a conversion calculation to the glucose density to be finally displayed is performed with a processing part 113. Programs necessary for the processing calculation are stored in a ROM built-in in a microprocessor incorporated in the monitor 100. Further, a memory region necessary for the processing calculation is likely secured in a RAM incorporated in the monitor. Results of the processing calculation are displayed on a liquid crystal display portion.
In the ROM, as program constitutional elements necessary for the processing calculation, particularly, a function for determining the glucose density C is stored. The function is defined in the following manner. At first, C is expressed by the following formula (10). ai (i=0, 1, 2, 3, 4, 5) are determined in advance from a plurality of measurement data. Steps of determining coefficient “ai” are as follows.
(1) To prepare multiple regression formula indicating a relationship between normalized parameters and glucose density C.
(2) To determine a normal equation (simultaneous equation) relating to the normalized parameters from a formula obtained through least square method.
(3) To determine values of ai (i=0, 1, 2, 3, 4, 5) from the normal equation and substitute the same in the multiple regression formula.
At first, the following regression formula (10) indicating a relationship between glucose density C and normalized parameters X1, X2, X3, X4, and X5.
Subsequently, in order to determine a multiple regression formula that minimizes an error from the glucose density measurement values through enzyme electrode method, least square method is used. When assuming the residual sum of squares as D, D is expressed by the following formula.
Since the residual sum of squares D will minimize when the formula (11) is partially differentiated by a0, a1, . . . a5 and the same assume zero, the following formulas are obtained.
[MATHEMATICAL FORMULA 12]
∂D/∂a0=−2Σ(Ci−(a0+a1Xi1+a2Xi2+a3Xi3+a4Xi4+a5Xi5))=0
∂D/∂a1=−2ΣXi1(Ci−(a0+a1Xi1+a2Xi2+a3Xi3+a4Xi4+a5Xi5))=0
∂D/∂a2=−2ΣXi2(Ci−(a0+a1Xi1+a2Xi2+a3Xi3+a4Xi4+a5Xi5))=0
∂D/∂a3=−2ΣXi3(Ci−(a0+a1Xi1+a2Xi2+a3Xi3+a4Xi4+a5Xi5))=0
∂D/∂a4=−2ΣXi4(Ci−(a0+a1Xi1+a2Xi2+a3Xi3+a4Xi4+a5Xi5))=0
∂D/∂a5=−2ΣXi5(Ci−(a0+a1Xi1+a2Xi2+a3Xi3+a4Xi4+a5Xi5))=0
(i=1˜n) (12)
When assuming that the average values of C and X1˜X5 are Cmwan and X1mean˜X5mean, since Ximean becomes zero (i=1˜5), the following formula (13) is obtained from formula (10).
Further, variation/covariation between the normalized parameters is expressed by the following formula (14), and covariation of the normalized parameters Xi (i=1˜5) and C is expressed by the following formula (15).
[MATHEMATICAL FORMULA 14]
S
ij=Σ(Xki−Ximean)(Xkj−Xjmean)=ΣXkiXkj(i,j=1˜5,k=1˜n) (14)
[MATHEMATICAL FORMULA 15]
S
iC=Σ(Xki−Ximean)(Ck−Cmean)=ΣXki(Ck−Cmean)(i,j=1˜5,k=1˜n) (15)
When substituting the formulas (13), (14), (15) into formula (12) and organizing the same, the following simultaneous equation (normal equations) is obtained, and when solving the same, a1˜a5 are obtained.
[MATHEMATICAL FORMULA 16]
a
1
S
11
+a
2
S
12
+a
3
S
13
+a
4
S
14
+a
5
S
15
=S
1C
a
1
S
21
+a
2
S
22
+a
3
S
23
+a
4
S
24
+a
5
S
25
=S
2C
a
1
S
31
+a
2
S
32
+a
3
S
33
+a
4
S
34
+a
5
S
35
=S
3C
a
1
S
41
+a
2
S
42
+a
3
S
43
+a
4
S
44
+a
5
S
45
=S
4C
a
1
S
51
+a
2
S
52
+a
3
S
53
+a
4
S
54
+a
5
S
55
=S
5C (16)
The constant term a0 is obtained by making use of the formula (13). ai (i=0, 1, 2, 3, 4, 5) as obtained as in the above manner are stored in the ROM at the time when the monitor is manufactured. During actual measurement by the monitor, the glucose density C is calculated by substituting normalized parameters X1˜X5 determined from the measurement values into the regression formula (10).
Subsequently, a specific example of calculation process of the glucose density will be shown. From many data measured in advance in connection with healthy persons and diabetics, the coefficients in formula (10) have been determined, and the following calculation formula of the glucose density is stored in the ROM in the microprocessor.
[MATHEMATICAL FORMULA 17]
C=105.0−20.0X1+38.5X2−78.9X3−15.2X4−41.1X5 (17)
X1˜X5 are ones obtained by normalizing the parameters x1˜x5. When assuming that the distribution of the parameters is a normal distribution, 95% of the normalized parameters takes values between −2˜+2.
As an example of measurement values of a healthy person, when substituting normalized parameters X1=+0.10, X2=−0.02, X3=+0.04, X4=−0.20, and X5=+0.20 into the above formula, C=94 mg/dl is obtained.
Further, as an example of measurement values of a diabetic, when substituting normalized parameters X1=−1.10, X2=+0.10, X3=−0.84, X4=−1.04, and X5=−0.20 into the above formula, C=221 mg/dl is obtained.
A measurement result according to an enzyme electrode method that is a conventional measurement method in which blood obtained by taking a blood sample is reacted with a reagent and an amount of blood glucose is measured by measuring amount of electrons generated by the reaction and a measurement result according to one embodiment of the present invention will be explained herein below. As an example of measurement values of a healthy person, at the time when the glucose density is determined as 89 mg/dl according to the enzyme electrode method, when the normalized parameters X1=+0.10, X2=−0.02, X3=+0.04, X4=−0.20, and X5=+0.20 that are obtained at the same time through measurement according to the present method are substituted into the above formula, C=94 mg/dl is obtained. Further, as an example of measurement values of a diabetic, at the time when the glucose density is determined as 238 mg/dl according to enzyme electrode method, when the normalized parameters X1=−1.10, X2=+0.10, X3=−0.84, X4=−1.04, and X5=−0.20 that are obtained at the same time through measurement according to the present method are substituted into the above formula, C=221 mg/dl is obtained. From the above results, it was confirmed that the glucose density is determined in high accuracy with the method according to the present invention.
In
At this moment, the displayed amount of blood glucose is stored in an IC card together with date and time. When the displayed amount of blood glucose is read out, a button in the manipulation portion is pushed. After about one minute, the monitor is rendered to a condition of waiting the subsequent measurement in which “place your finger” is displayed on the liquid crystal display.
As has been explained above, according to the present invention, it can be predicted in short time as well as in high accuracy.
Number | Date | Country | Kind |
---|---|---|---|
2009-171724 | Jul 2009 | JP | national |