Frikkin Lasers …

The expression that it is often the little things that matter most, holds true in medicine as well. While new technologies to treat brain cancer seem to make the news, what tends to be ignored are the day to day difficulties that patients face due to more common and “boring” diseases. When I was a Urology resident, one of the most difficult things for older women to deal with was urinary leakage. Otherwise vibrant and healthy women were frightened to leave their homes because of the fear that they would wet their own clothes. When we were able to help such patients, they literally cried in gratitude. Such moments are why I became a doctor – to truly help people live their lives.

I have discussed diabetes in a previous blog post and I spoke of a project that Google was working on, to have constant monitoring of blood sugar via a contact lens. I recently came across this article, where researchers are trying to tackle the same problem from a totally different angle. Whatever technology ultimately succeeds, it will be received with a blessing.

The life of a diabetic still depends on constant monitoring of blood sugar and then dosing of insulin as needed. For most people,.the constant monitoring requires mini-blood tests multiple times per day. It may seem trivial to some, but having to inflict upon yourself (via finger pinpricks to extract blood) even minimal pain multiple times per day, in order to test your sugar, is disheartening. And then of course, there is the injection of the insulin itself which is a further poke. I have spoken to many a diabetic who dream of a day when they could go on a vacation without having to think of stopping to check their sugar. I have met young people who are simply sick of the constant poking. To think that this will be your life for the rest of your days, legitimately weighs on many people. It is by no means trivial, and as a doctor, I also dream of a day when the needles can be thrown out.

The article I linked to above speaks of a technology that is being worked on at Princeton University. To quote the article, “the researchers describe how they measured blood sugar by directing their specialized laser at a person’s palm. The laser passes through the skin cells, without causing damage. The researchers use the amount of absorption to measure the level of blood sugar”. The key next step for this group is to shrink the apparatus to such a point that it can be carried around easily, or even better, become part of a totally implanted device that would constantly and painlessly measure blood sugar. 

There are other non-invasive measuring systems. I think this article presents another glucose measuring technology with the appropriate respect but also with a dose of reality mixed in. I have no personal preference for a given technology or product. I just want to see diabetics freed of the pinprick ritual.

I should point out that constant non-invasive monitoring of blood sugar is not just a matter of reducing pain and increasing convenience. One of the immediate killers of diabetics is severe hypoglycemia. This is when the diabetic’s blood sugar goes too low. There are a whole range of reasons for this (insufficient nutrition, too much insulin, other illness which changes the body’s requirements for sugar, etc.). Identifying such patients before they are severely hurt by the low blood sugar would be a huge benefit of any constant monitoring system. An alert (including in the middle of the night while everyone is sleeping) could be sent to the patient’s and/or patient’s caregiver’s phone and trigger a response that literally saves the patient’s life.

In time, researchers will develop a whole range of monitors that will allow for non-invasive measurements of all vital signs and blood factors. Combined, these devices will become the much dreamed-of tricorder that was introduced to the world by the TV show Star Trek , nearly 50 years ago. Whether at home, while walking outside or when interacting with a doctor, this tricorder will provide a tremendous amount of information about the health (or lack thereof) of the patient. As a child, this was science fiction. Today, I cannot wait for the reality.

Thanks for listening

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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