Read on to learn more about which types of blood sugar monitors do not involve finger sticks and how to talk with your doctor about whether these noninvasive options are right for you.
As such, many are looking for alternatives to make the process easier. In the last few years, there have been several new technologies to help in the development of blood sugar monitors without finger pricks.
Many things, such as stress, illness, and exercise, can also impact your blood sugar throughout the day.
Even so, it&#;s still extremely important for those with diabetes to keep tabs on their blood sugar readings . The number of times per day depends on your individual diagnosis and the treatment plan your doctor has prescribed.
While finger stick monitors have long been a mainstay in diabetes management, pricking your finger to obtain a blood sample several times a day can be painful and time-consuming.
You can also find a device that comes with time and date stamps for a better look at health patterns.
Certain features make a monitor easier and more fun to use, like Bluetooth connectivity or storage capacity. For example, if you prefer recording your readings on the device instead of writing them down, there are currently plenty of options.
For instance, if you&#;re on the go a lot, a compact model may be better suited for your needs. You don&#;t want to feel uncomfortable holding a device that&#;s too small, either, so it might be a good idea to test out the size before buying.
The more comfortable you are using your monitor, the better.
Since you&#;re likely going to be using your device several times per day, having a device that&#;s easy to use is helpful. If the device is too complicated (e.g., requires coding or is too long to read), you&#;re less likely to use it.
Some glucose monitors also come with a backlight display, which makes it easier to view the screen at night and in low-light settings.
Data display is essential as you need to be able to see the numbers on the screen. If you have vision problems, a larger screen or a monitor that comes equipped with audio capability to &#;say&#; the results out loud can be helpful.
This consistency should not waver outside of the lab meter difference of 15 percent higher or lower reading accepted by the Food and Drug Administration (FDA).
Accuracy is critical when choosing a glucose monitor. After all, your insulin dose and treatment options depend on what the results say.
A good first step is to check with your insurance company to see which monitors are covered in part or in full. Knowing your price range can make things easier by helping narrow your search. Since you&#;re likely to go through multiple test strips per day, this is also a good time to check whether your insurance plan covers test strips.
Whether you&#;re looking for a glucose monitor that uses a blood sample or a noninvasive monitor, there are several factors to consider before you choose a meter.
The FreeStyle Libre received FDA approval in for use in adults with diabetes. It does not require finger-prick blood samples. Instead, this meter reads glucose from interstitial fluids just underneath the skin.
The FreeStyle Libre works via a sensor you wear on the back of your upper arm, which you apply every 14 days. To read your glucose numbers, you wave the monitor in front of the sensor.
It&#;s recommended that you repeat the process several times per day. You can also use your (using an app that accompanies the Freestyle Libre) to scan as an alternative to the monitor.
The original Libre system does not come with alarms to alert you when your blood sugar is too low or too high. However, the Libre 2 system does have these features.
While the Libre is intended for adults, the Libre 2 may be suitable for children. Note that there is now a Libre 3 system, which is approved for use by people with diabetes in Europe.
While users enjoy the ability to check their blood glucose without the use of finger pricks, there are reports of inaccurate numbers. You may also experience skin irritation from applying the sensor.
Eversense, a subcutaneous implant device made by Senseonics, is another type of CGM on the market. It was FDA approved in for people with diabetes.
Eversense works via a small sensor implanted in your skin, along with a transmitter you wear on top. This is usually applied to your upper arm.
It measures your glucose in your interstitial fluids every 5 minutes and sends the data to your smartphone. The sensor works for up to 90 days at a time.
Unlike the FreeStyle Libre, you must get the Eversense set up at your doctor&#;s office, where they will insert the subcutaneous device for you. This could potentially be problematic if you aren&#;t able to see your doctor every 90 days.
One reported downside is the Eversense CGM&#;s sensitivity to direct sunlight. This is an important consideration to talk about with your doctor before determining the ideal insertion site.
The Dexcom G6 received FDA approval in . It&#;s intended to work with other diabetes devices, including insulin pumps, dosing meters, and more. This CGM is designed for people ages 2 years and older.
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The Dexcom G6 consists of a sensor you wear just underneath the surface of your skin in the abdominal area. It lasts for 10 days at a time and is also water resistant. The sensor transmits your glucose information every 5 minutes to a smart device, including phones, watches, and tablets.
Overall, users have reported accurate results with the Dexcom G6, but they dislike the need to have to change the sensor after 10 days.
Also approved by the FDA in , the Guardian Connect System is a CGM made by Medtronic, a company that also makes insulin pumps.
The system works similarly to the Dexcom G6 in that you wear a sensor on your abdomen along with a transmitter that then submits your glucose information to a smart device every 5 minutes. You can also wear this device on your arm, similar to the FreeStyle Libre.
Unlike other CGMs, the Guardian Connect focuses on &#;time in range&#; data to give users a better idea of how long they achieve ideal glucose ranges at a time. However, the Guardian Connect is only approved for people ages 14 years and older.
D-Base is a new form of CGM that uses heat to measure blood sugar levels. It was created by DiaMonTech, a German company.
The innovative technology uses an infrared laser that&#;s beamed through the skin, causing glucose in the skin to convert the light to heat. The results are then drawn from the amount of heat increase in the skin. In preclinical tests, it was found to be as accurate as test strips.
One major downside to the D-Base model is its size. It&#;s a stationary shoebox-size device, which makes it difficult to carry around. It&#;s also not yet ready for purchase. Development is still ongoing on this and several other glucose products made by the company, such as a D-Sensor that&#;s going to be embedded into watches or fitness bands.
Besides the above four CGMs, other meters are being developed that do not require blood samples. One such CGM is called GlucoTrack by Integrity Applications, which measures blood glucose via your earlobe. However, it hasn&#;t yet been FDA approved.
Other types of technologies may be seen soon to help improve diabetes management without the need for finger pricks. However, standalone smartwatches, contact lenses, and other buzzworthy devices haven&#;t yet proven to accurately measure blood glucose.
Introduction: Laser therapy has attracted experts&#; attention in medical sciences. Many benefits of laser therapy are presented besides some complications. In the present study, it is tried to present a new perspective of laser therapy in the various fields of medicine.
Methods: Laser therapy-related articles which are combined with regenerative medicine, cosmetic, dentistry, neurodegenerative diseases, kidney, bone fracture, and vaginal function in the English language were searched through the google scholar search engine in the range of -. After title screening, the abstracts were evaluated to access the full texts.
Results: Basic concepts and various kinds of lasers which are applied in medicine were explained. Applications of laser therapy in various fields of medicine such as pain reduction, wound healing, regenerative medicine, dentistry, and several other body organs were highlighted and some complications were pointed.
Conclusion: High potential of laser therapy for application in medicine implies a reconsideration of the laser properties and also styles of laser applications to improve the treatment and prevention of its side effects.
Keywords:
Laser therapy, Medicine, Complication, Application, Photobiomodulation therapy
Laser (light amplification by stimulated emission of radiation) as a new concept emerged from research by Einstein in on the physical principles of stimulated light emission.1 On the other hand, achieving a minimally invasive technique for the treatment of different pathologic processes was continually a challenge throughout the world. Recent advances have introduced laser therapy as an applicable treatment, which can be used in various kinds of medical sciences such as pain reduction, inflammation, as well as accelerating the process of tissue repairment.2,3 In addition to their practical usefulness in the operating room, lasers have a wide range of applications in ophthalmology, lithotripsy, the diagnosis and treatment of various cancers, as well as dermatologic and cosmetic procedures.4 The main part of laser therapy, known as low-level laser therapy (LLLT), through photoactivating cellular mechanisms, promotes a reduction in edema and the induction of analgesia as well as an acceleration of the tissue repair process. This mode of laser therapy has both inhibitory and excitatory effects.5,6 Nevertheless, the main effects of lasers on decreasing pain and repairing tissue have not been completely understood.7 In the present study, it is attempted to elucidate the benefits and possible disadvantages of laser therapy in the clinical fields.
A combination of laser therapy and regenerative medicine, cosmetic, dentistry, neurodegenerative diseases, kidney, bone fracture, and vaginal function in the English language in the range of - were searched through google scholar. After title screening, the abstracts were evaluated to access the related full texts. The appreciated articles were included in this review article.
Different types of laser light devices produce intense, coherent, monochromatic, and highly collimated beam of light.8 Recent studies have shown that the best wavelength in laser therapy involves visible red and near-infrared (NIR) portions of the electromagnetic spectrum (390&#; nm and &#; Hz) because these portions of the spectrum have been absorbed highly by the biological systems.9 Laser treatment induces low energy density, but it is high enough to stimulate the membrane or organelles of the targeted cell. Chromophores, which absorb photons, exist mainly in tissues like hemoglobin and melanin and their highest absorption band is during shorter waves. On the other hand, infrared photons with shorter waves can be absorbed by water. As a result, low-level lasers are known as suitable tools in medicine. Low-level lasers such as Krypton, Argon, He, Ne, and ruby are kinds of lasers affecting biological systems through non-thermal means.10 When the tissue chromophores are affected by laser energy, the cytochromes in the mitochondria absorb the laser radiation and convert them into energy by the cell (ATP), and produced energy causes protein synthesis and acceleration or stimulation of cell proliferation.1,11 Different parameters affect the interaction of light and biological tissues such as wavelength, laser dose, and the optical properties of the tissue. The tissue properties include its structure, water content, thermal conductivity, heat capacity, density, and ability to absorb, scatter, or reflect the emitted energy.12 The resolution list of further lasers which are used in medicine is presented in .11
It is reported that the mitochondrial respiratory chain is a suitable chromophore for red to near-infrared light. It can be concluded that mitochondria are appropriate targets in laser therapy (photo biomodulation therapy). It is a well-known fact that mitochondria are the important organelles of the cells which contain critical biomolecules such as reactive oxygen species (ROS), nitric oxide (NO), adenosine triphosphate (ATP), and cyclic adenosine monophosphate (cAMP). It is proposed that laser therapy affects the production of these biomolecules, which is accompanied by the initiation of cell proliferation. This, in turn, induces the signal cascade effects.13,14 Recently, researchers have published findings of the role of LLLT in the prevention of endothelial dysfunction development in COVID-19 patients. Based on these investigations, the clinical experience of the treatment and rehabilitation of COVID-19 patients is affected by LLLT.15
Cosmetic application of laser therapy is a well-known field of laser therapy which has attracted a great deal of attention in dermatology and related fields.16 Various parameters of an applied laser should be optimized to achieve a suitable therapeutic tool. Laser wavelength and pulse duration are the two important properties in laser therapy. It is reported that there are associated complications with laser therapy, such as burns, infections, dyspigmentation, ophthalmic injuries, Koebner phenomenon, scarring, prolonged erythema, acne, milia, and contact dermatitis. Therefore, it should be considered that the prevention of these effects need precautions to decrease long-term consequences.17
It should be mentioned that the popularity of laser applications in dentistry is tied to the s. it is known that a laser is a therapeutic or adjunct tool in dentistry.18 The application of laser irradiation in dentistry has established for various kinds of purposes. The effect of laser application in several aspects of dentistry such as root canal disinfections and pain reduction following orthodontic elastomeric separation has been investigated and confirmed by researchers.19,20 It is reported that the two popular uses of laser therapy are the stimulation of the healing process and pain relief.21 The potential of a laser as an alternative method to conventional methods in medicine, in detecting and removal of caries lesions, pulp therapy, dental hypersensitivity, surgery is emphasized by researchers.22
There are pieces of evidence that photo biomodulation has a positive effect on neurodegenerative diseases such as Parkinson&#;s disease, Alzheimer&#;s disease, and different types of epilepsy. The findings are characterized by excellent outcomes for animal researches, but they show poor outcomes in clinical studies. It seems that progress in this field requires more investigations.23 The cognitive effect of transcranial LLLT on mice is reported by Salehpour et al and Chang et al have investigated the role of transcranial LLLT in depression.24,25 It seems this field of investigation will experience more achievements in the near future.
Macagnan and colleagues&#; investigation indicates that PBMT improves maximal handgrip strength in chronic kidney disease patients who present muscle weakness, fatigue, and reduced functional performance. The samples of research were 15 chronic kidney disease patients who were under treatment for 6 ± 4 years. This finding indicates that PBMT can improve the kidney disease patients&#; life quality and ability.26 In another assessment, the importance of the thulium fiber laser in kidney stone treatment is investigated by Traxer and Keller.27 Oates et al evaluated the role of the acupuncture laser in pain reduction in pediatric kidney biopsies.28
Baek et al are reported that; posttraumatic edema is reduced in patients with facial bone fracture which were treated by light-emitting diode-based LLLT. Forty patients that had experienced facial bone fracture were included in this research.29
Gambacciani and Palacios showed that the fractional CO2 laser and also the non-ablative vaginal Er:YAG laser have an effective role in the morphological change in vaginal tissue. They proposed laser therapy as a treatment tool for stress urinary incontinence.30
It can be concluded that laser therapy has attracted experts&#; attention in nearly all fields of medicine. As it was mentioned above, there are some complications with laser therapy. Therefore, two important points should be considered to achieve an effective therapeutic method in laser therapy; the first point is the large capacity of a laser for its application in medicine, which implies more attempts to improve its physical and clinical parameters such as light wavelength, duration, fractionation and tissue targets, and the second one is the consideration of its complication to reduce the unfavorable side effects.
Not applicable.
There is no conflict of interest.
This project is supported by Shahid Beheshti University of Medical Sciences.
Please cite this article as follows: Arjmand B, Khodadost M, Jahani Sherafat S, Rezaei Tavirani M, Ahmadi N, Hamzeloo Moghadam M, et al. low-level laser therapy: potential and complications. J Lasers Med Sci. ;12:e42. doi:10./jlms..42
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