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Alfred Poor

The Light Touch: Solid State Healing With LEDs

Alfred Poor
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Alfred Poor
Alfred Poor
5/18/2013 12:17:00 PM
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Re: LED bili-lights
Thanks for this post, ddellario. Interesting details about the blue light therapy.

 

Alfred

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ddellario
ddellario
5/18/2013 12:08:41 AM
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Photon
LED bili-lights
I worked for Olympic Medical division of Natus Medical and designed many of their bili-lights and a radiometer to measure therapeutic output. Blue light therapy is more than 40 years old and there is no controversy about it. LEDs offer a more convenient vehicle to deliver monochromatic 450nm light that breaks down bilirubin transdermally and effectively. That said, fluorescent blue lamps or a sunny window are good therapy source. It's all well understood vanilla medicine that has helped millions of newborns. It is true that kids must be stuck with a needle repeatedly by protocol to assess serum bilirubin so it'll be a happy day when it can be done optically.

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alsoeric
alsoeric
5/16/2013 1:01:38 PM
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Re: The light fantastic
the upper limit for optical devices that I've seen is under 200 mg per deciliter. The optical device available on the market today are continuous glucose monitoring or cgm devices.  Google "optical cgm" and you will get a great set of references both industrial and research papers.

the last time I looked this particular device ran around $4000. It's cheaper than most of the CGM devices that use a probe stuck in the body for 3 to 5 days at a time. There's no cost advantage for the invasive cgm. The consumables cost about as much as test strips.

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kdawson
kdawson
5/16/2013 12:53:11 PM
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Re: The light fantastic
I'm with you, don't see why a range limited to 300 mg/dl would be a problem in practice.

How much do such devices cost, typically? Do insurance companies pay for them?

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alsoeric
alsoeric
5/16/2013 12:31:06 PM
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Re: The light fantastic
Drawback usually take the form of limited range of measurement. for example a finger stick meter may work from 30 to 500 mg/dl, optical meter range may be 60-180 mg/dl.  to me that is not a  problem.  if you go above or below those limits, the scale should read "screwed, really screwed, and call 911)  

my snarky opinion is based on the treatment guidelines of tight control, never above 135 and shoot for 95-95 as an average bg level. 

there is a belief in the D world that anything that that threatens the test strip revenue is bought up and hidden.   there seems to be some evidence for this as I have seen a couple if university announcements of optical measurement systems only to be followed by a test strip company buyout.

I suspect it is more likely that the techniques didn't work well in the real world.

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kdawson
kdawson
5/16/2013 10:01:36 AM
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Re: The light fantastic
@alsoeric, thanks for sharing your (first-person) expertise. A little judicious Googling finds experimental devices for non-invasive testing of blood glucose levels under development in India and israel. Here's an Israeli company in the business. One such device was patented in the US in 1991. I wonder what their drawbacks are such that they are not already in widespread use? Maybe it's that pushback you spoke of from the makers of finger-stick diagnostic supplies.

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alsoeric
alsoeric
5/16/2013 9:30:24 AM
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Photon
Re: The light fantastic
summary: read first paragraph, rest tl;dr

Noninvasive glucose measurement is a long sought-after dream. There are three models for LED-based measurements of glucose. Skin contact (like the oximetry and pulse measurements devices we have at the doctors office) either by hand-held sensor a momentarily applied to the skin or longer-term sensor glued to your side. Implanted optical sensor for long-duration measurements. The last is using polarization of light to measure sugar levels of secondary fluids such as tears, saliva, or the interior of the eyeball.

Measurement strategies for diabetes will change radically when the patient has a noninvasive technique for glucose measurement. Today, at a cost of roughly $.50-$.75 per measurement, doctors recommend measuring twice a meal, not because it's the right thing to do, but it's what insurance companies will pay for and, to be quite honest, usually the most that most diabetics will do when setting the fingers. Fanatical control diabetics like myself find the measuring 3 to 5 times a meal gives a much better information on how food affects the body. In the case of my girlfriend (T1.5), measuring the same rate gives her better understanding of the mismatch between insulin and carbohydrate absorption rates and how she needs to pace consumption of food to keep from going too high or too low.

Despite the benefits of frequent measuring, the pain, the cost, the reluctance of doctors to work with this information, the reluctance of insurance companies to pay for a good number of test strips is condemning a significant number of diabetics to invisible blood sugar levels and the subsequent side effects. Optical measurements of glucose levels could help diabetics by giving them more information to make better choices and, with science geeks like myself maybe even determine something new about diabetes. For example, I'm beginning to think that the rate of change of the slope of the glucose curve may be a predictor for high or low blood sugar numbers. I can't tell because I don't have the data, I can get it with the current measurement techniques. An optical device that can gather a lot of data points either as a one-shot measurement or a continuous glucose measurement would help immensely in determining whether or not my conjecture is true or false.

I expect there to be some kickback from the current makers of diabetic test strips. The market is huge for them. Each patient is at least five dollars a day worth of revenue. With 25 million diabetics, that amounts to $125 million every single day in test strips. Over the course of the year, that adds up to a significant amount of money.

One additional thing that just occurred to me as with this number of tests, the development of an optical system would spare us an enormous amount of biological hazard waste. In theory, we should be putting used test strips in a box and sending them to a medical disposal facility. I will admit that I just throw mine in the trash like most diabetics. With an optical system, no waste, no hazardous material, the little bits of plastic to further contaminate the environment.

As I said in the beginning, the holy grail for diabetics is noninvasive testing. There are environmental, economic, and health reasons driving the development of noninvasive or optical glucose from systems. So let me end this with this: I'm any great guinea pig, I would love to try out one of these systems.

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kdawson
kdawson
5/15/2013 11:39:35 AM
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Re: The light fantastic
Does anyone else here know about optical measurements of glucose concentrations?

I have a friend who is quite knowledgeable about the technicalities of the diabetes scene, I'll ask him.

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eafpres
eafpres
5/15/2013 11:24:34 AM
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Re: The light fantastic
Hi Keith--interestingly, today I got a note about a non-invasive technique (not light based) that has some promise for glucose measurements.  Not there yet but this is an active R&D area, in part because the market will be huge for such a device.

Measure glucose in saliva

I note that most spectrophotometric techniques I could find for glucose involve binding it, adsorbing it, or somehow interacting it with a substrate to generate something with a UV-VIS spectrum.  Needing a binding agent is problematic for non-invasive light-based measurements.

Does anyone else here know about optical measurements of glucose concentrations?

 

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kdawson
kdawson
5/15/2013 10:37:29 AM
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Re: The light fantastic
Great news. Maybe when medicine is able to assay bilirubin non-invasively, it will be possible to do the same for insulin. Millions of times more diabetics than Crigler-Najjar syndrome sufferers.

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