Glucose Meter - History

History

In 1962, Leland Clark and Ann Lyons at the Cincinnati Children's Hospital developed the first glucose enzyme electrode. It relied on a thin layer of glucose oxidase on an oxygen of oxygen consumed by the enzyme.

Another early glucose meter was the Ames Reflectance Meter by Anton H. Clemens. It was used in American hospitals in the 1970s. A moving needle indicated the blood glucose after about a minute.

Home glucose monitoring was demonstrated to improve glycemic control of type 1 diabetes in the late 1970s, and the first meters were marketed for home use around 1981. The two models initially dominant in North America in the 1980s were the Glucometer, introduced on November 1981 whose trademark is owned by Bayer and the Accu-chek meter (by Roche). Consequently, these brand names have become synonymous with the generic product to many health care professionals. In Britain, a health care professional or a patient may refer to "taking a BM": "Mrs X's BM is 5", etc. BM stands for Boehringer Mannheim, now called Roche, who produced test strips called 'BM-test'.

Test strips that changed color and could be read visually, without a meter, were also widely used in the 1980s. They had the added advantage that they could be cut longitudinally to save money. As meter accuracy and insurance coverage improved, they lost popularity. However, a generic version of the BM is marketed under the brand name Glucoflex-R. There is a UK Pharmaceutical company (Ambe Medical Group) who have the executive rights for distribution within the United Kingdom.

On May 1, 2009, one manufacturer reduced the price of their test strip to the NHS, by approximately 50% (distributed in the UK by Ambe Medical Group and led by Patrick O'Neill-Ortiz). This should allow the NHS to save money on strips and perhaps loosen the restrictions on supply a little, but there is one catch - the test strip (Glucoflex-R) is read by eye, not by meter. Critics argue this is not as accurate or convenient as meter testing. The manufacturer cites studies that show the product is just as effective despite not giving an answer to one decimal place, something they argue is unnecessary for control of blood sugar. This debate has already happened in Germany where Glucoflex-R is an established strip for type 2 diabetes (test strips are not subsidized by the German government for people with Type 2 Diabetes). As a footnote, another low cost visually read strip is soon to be available on prescription according to sources at the NHS. How the other manufactures and the NHS react to these developments, remains to be seen.

Another visual strip is also marketed under the brand name Betachek.

At least in North America, hospitals resisted adoption of meter glucose measurements for inpatient diabetes care for over a decade. Managers of laboratories argued that the superior accuracy of a laboratory glucose measurement outweighed the advantage of immediate availability and made meter glucose measurements unacceptable for inpatient diabetes management. Patients with diabetes and their endocrinologists eventually persuaded acceptance. Some health care policymakers still resist the idea that the society would be well advised to pay the consumables (reagents, lancets, etc.) needed.

Home glucose testing was adopted for type 2 diabetes more slowly than for type 1, and a large proportion of people with type 2 diabetes have never been instructed in home glucose testing. This has mainly come about because health authorities are reluctant to bear the cost of the test strips and lancets.