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Abstract: Type II diabetes is a chronic disease that characterized by insulin resistance and
deficiency. Over the past few decades, its prevalence has been increasing, making it likely to be
one of the world's main disablers and killers in the next few years [2]. The prevalence of diabetes
in Asian countries has experienced an exponential growth, presenting risks of many cases of
uncontrolled diabetes since the current technology and methods for treatment and monitoring
may not be able to keep up with the growing demand. Without the proper monitoring to control
diabetes, patients can develop many health complications that can increase the financial burden
on themselves [3]. The current monitoring method of using the blood-prick test is known to be
quick and accurate, however, it is invasive and presents sanitary issues, especially in less
developed areas. Therefore, we propose to develop a non-invasive, low cost, and easy to use
monitoring device for Type II diabetes. We investigated three monitoring methods (using saliva,
urine, and near-infrared spectroscopy (NIRS) samples) and compared it the conventionally used
finger-pricking blood sampling method. Using a Pugh chart to compare designs, we found that
the NIRS suits the purpose of our device the best with a weighted score of 4.25 out of five. Our
proposed device serves as a supplementary method to monitor traditional Chinese methods, uses
non-invasive methods, and appeals to a wide range of people from illiterates and blind and deaf
people since it uses audibly and visually easy to understand methods to report the results.
Therefore, we predict it to promote patient's willingness to monitor continuously and take the
correct proper actions in response to their blood glucose level, decreasing the risk of possible
health complications due to diabetes
Problem Statement and Description
Type II diabetes is a global public health crisis, affecting millions worldwide and
increasing especially in developing countries [15]. It is caused by insulin resistance and deficiency

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and accounts for 95% of the cases of diabetes globally. The World Health Organization
estimated that there were 366 million people living with diabetes in 2011, and the number is
expected to grow to 552 million by 2030 [13]. Due to its large prevalence, it is projected to
become one of the worlds main disablers and killers in the next few years [2].
Though diabetes began as a Western disease, it has been spreading worldwide. Due to
Asias large population and rapid economic development, it has become an epicenter of diabetes;
60% of the worlds diabetic population is Asian. Asians also have a specific normal-weight
metabolically obese phenotype that increases the tendency for insulin resistance, abdominal
obesity, and less muscle mass, which leads to many adults and children having diabetes with
normal BMI. Specifically, China has overtaken India as the global epicenter. In about thirty
years, China went from having less than 1% to about 10% of its population diagnosed with
diabetes, and there is a noticeable exponential rate of growth for the prevalence of diabetes in
China. Much of the increase is due to the high prevalence of smoking and heavy alcohol use,
high intake of refined carbohydrates such as rice, and dramatically decreased physical activity
levels [15]. Therefore, people would need to change their daily habits to decrease the risks of
diabetes. To track the progress, proper monitoring is necessary.
If left undiagnosed and uncontrolled, diabetes can lead to many health complications,
such as stroke, heart attack, kidney failure, foot ulcers (which can lead to amputations), and
blindness [13]. Proper monitoring can keep either hypoglycemia or hyperglycemia under control,
and thus adequate monitoring and treatment early on can slow down the progression of the
disease and minimize health complications caused by diabetes [3]. Therefore, it is important for
diabetic patients to monitor their blood glucose levels to track how well their diabetes is being
controlled and how well their plan of care is working.

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Currently, the golden standard for monitoring is an invasive method, requiring patients to
prick their fingers to obtain a blood sample. This method is accurate and gives results within
seconds. However, it is only reliable if it is correctly used and presents possible risks of infection
and spread of blood borne disease, especially in low resource settings. Since diabetes is a chronic
disease, the cost to maintain such a device that requires replacements for lancets and needles may
become a burden. In low-income families, as much as 25% of family income may be devoted to
diabetes care [15]. Thus, there is a need to mitigate the financial burden due to diabetes.
Furthermore, drawing blood can be uncomfortable as well as frightening to individuals in
developing countries. Because of the increasing threat diabetes presents and the pressing need for
improved diabetes management worldwide, we plan to develop a non-invasive, low cost, simple,
and intuitive blood sugar monitoring method.
Prior Art
Blood (finger-prick test): The most commonly used method for measuring blood glucose levels
is the finger-prick test. Patients draw blood with a needle and insert it into a device to test blood
sugar levels. One of the most commonly sold finger-prick tests is the OneTouch Ultra 2 Blood
Glucose Monitoring System, created by Lifescan, Inc. and patented in 2000 [14]. Some drawbacks
of this test are that it can be painful, requires adequate sanitation, and is not a simple process. It
requires patients to carry a kit with additional lancets, alcohol wipes, and the device. In
observing these limitations, we aimed to design a blood glucose monitoring device that is noninvasive, painless, and simple to use.
Saliva: Although it has not yet been patented, the iQuickIt Saliva Analyzer, developed by Quick,
LLC, measures blood sugar levels using saliva samples. In order to use this device, a draw wick
is placed inside the mouth for a few seconds then placed in the saliva analyzer for testing [1].

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Although this method painless, its accuracy is questionable because the recent presence of food
in someones mouth may greatly impact blood sugar test results. Since using additional materials
such as needles, test strips, or swabs present possible confusion and error in obtaining data, our
criteria and constrains include accuracy and simplicity.
Urine: Urine can also be used to measure blood glucose levels. During this process, a sample of
urine is collected and a test strip is dipped in it and after about two minutes the color pads on the
test strip show the results [6]. One major limitation of this method is that it only provides semiquantitative results. Furthermore, urine strips can only detect very high blood sugar because the
body does not generally get rid of access sugar in urine. This method of blood sugar monitoring
can also be a challenge in public settings and requires adequate hydration. In observing these
limitations we decided to make our device convenient for public settings and use quantitative
measures to present the amount of blood glucose.
NIRS: Recently, scientists have applied near-infrared spectroscopy (NIRS) to develop a noninvasive method of monitoring blood glucose levels in patients and to encourage regular use.
This method measures the absorption of near-infrared light due to glucose to determine blood
glucose levels [8]. In order for light measurements to be taken, a clip is placed on either the
thumb or earlobe before the results are processed. One limitation of the existing blood sugar
monitoring devices that use NIRS is that they are not single, hand-held devices. However,
because of the several advantages pertaining to the use of near-infrared light to measure blood
glucose levels, such as ease of use, cleanliness, and minimal waste, we decided to expand of this
existing technology during our design process for this project.

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Design Specification; and Solution Generation and Selection

Specifications: Considering the limitations from the devices currently available and described in
the Prior Art section, the needs and corresponding constraints and criteria were formed. The
design must be non-invasive to address the limitations---invasive nature and risk of infection---of
the current blood-pricking method. Therefore, some constraint of our design is safety and noninvasiveness. The procedure to obtain accurate glucose levels should be intuitive, and the data
must be presented in an understandable way. Thus, the device should be easy to use, accurate,
portable, and have access to data. The design must also be cost-effective and -efficient so that it
is accessible to many people, especially in the low-resource communities that we are targeting.
For it to meet these needs, the device must be affordable, durable, and efficient. Table 1
summarizes the needs and design constraints discussed.

Table 1. Description of needs synthesized from the limitations presented by the current diabetes
monitoring devices are listed with corresponding design constraints/criteria for the proposed
Type II diabetes monitoring device are presented in the table. Units of measures are described to
provide a measure to compare devices, if applicable.
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Explanation of units of measures (if applicable):

Cost: To follow the monitoring devices currently in market, the acceptable range of the
device has been set to be between twenty and twenty-five dollars. Ideally, the device would
be under twenty dollars, given that it provides accurate data and is durable.
Accuracy/sensitivity: The device must be able to accurately measure blood sugar levels so
patients can rely on results and act accordingly. However, device do not need to take precise
measurements for monitoring purposes. Therefore, a range of acceptable values---within
twenty milligrams of glucose per deciliter of blood (mg/dL)---is given for this constraint.
Portability: Diabetics will have to measure their blood glucose levels multiple times a day.
Thus, it is important for the device to be comfortable to carry. Otherwise, the users daily
tasks may be hindered by the use of the device. To ensure that it is portable, the maximum
mass has been established to about two hundred grams, matching closely to the mass of
current smart phones in the market.
Solution Generation: Our group met several times to brainstorm global health problems,
researching existing methods of blood glucose monitoring and their advantages and limitations,
identifying constraints and criteria for the Pugh chart and design, and developing the design.
Through discussions, we decided to focus on Type II diabetes and blood glucose monitoring
because of the increasing worldwide prevalence of the disease, especially in low resource
settings. We found four existing methods for measuring blood glucose levels---the standard
finger-prick test, a saliva analyzer, urine test strips, and near-infrared spectroscopy (NIRS). Each
member in our group was assigned to a method to research more in depth. In order to determine
which method of blood glucose detection would best suit the constraints and criteria, a Pugh
chart described in Table 2 was used to calculate which is best overall. In general, heavier weights

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were given to constraints, since it is a necessary quality, and lighter weights were given to
criteria, since it is a desirable quality. For comparing the four blood glucose monitoring method,
a rating system from 1 to 5 was used:
1: Does not meet the constraint/criteria
2: Rarely meets the constraint/criteria
3: Sometimes meets the constraint/criteria
4: Often meets the constraint/criteria
5: Almost always meets the constraint/criteria

Table 2. A numerical assessment of the blood glucose monitoring methods. The Pugh chart
organizes the constraints and criteria followed by the weights and ratings used. Final weighted
total shows that the use of near-infrared spectroscopy (NIRS) is the best overall method
considering the constraints and criteria with respect to their importance since it has the highest
weighted total (4.25 out of five).
Generation of Design Specifications: In generating these constraints and criteria used for the
device and the Pugh chart, we looked into what current diabetes monitoring products emphasize.
In the popular OneTouch blood sampling device, the company, LifeScan, Inc. advertises its large
display that clearly conveys the information the user needs. Glucose levels are accurate to one
mg/dL which allows the user to understand and act quickly. While it is not suitable for low-

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resource settings, LifeScan does emphasize the easiness in obtaining results by synchronizing the
device with smart phones. But inherent in this feature is the need for efficiency and even the
accessibility of data. It is also advertised how only a small drop of blood is necessary for analysis;
implied in this is the need for safety and the most non-invasiveness as possible. Diagrams of the
device also present its compact structure for portability and durability. In particular for lowresource settings, cost is automatically an important constraint as the most accurate devices (such
as OneTouch) may not be useful for mass distribution.
Ease of use: Findings of a patient study in 2011 suggest that device usability has a great impact
on patient acceptance, compliance, and their ultimate health [5]. In order for the design to be
effective, it needs to be simple to use and easy to understand, especially in low-resource settings
where unfamiliarity with medical devices is prominent. Since usability has a great impact on
patients' acceptance of the device, it is the most important constraint of the design. Due to these
factors, the most important constraint for the design is ease of use. Thus, it was given the
heaviest weighting of 20%.
Blood: This method requires patients to take samples of blood by pricking their fingers. It
requires patients to understand where and how to puncture their skin. With regards to
using the lancet, it may be difficult to understand how to use it. However, since it is a
commonly used and developed device, patients should be familiar with the methods.
Although many patients can already understand how to use the device, newer users may
not know the correct procedures. Therefore, it often meets the constraint. Grade: 4
Saliva: The patient must be aware of many precautions, such as when to take the test
since food in the mouth can disturb the data. This method also requires swabs that
requires disposal and the patient to be hydrated in order to provide a sufficient sample of

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saliva. Since this method takes a bit more concern and may become difficult to use if
patients forget when to take samples, it often meets the criteria. Grade: 4
Urine: The urine test requires adequate hydration of the patient, like the saliva test. The
patient also may not be able to use it in public spaces, therefore has to be aware of his or
her surroundings. Since it requires patients to be conscious of their water intake and
whether they can obtain samples, it sometimes meets the constraint. Grade: 3
NIRS: This is a new method, therefore, patients may not be used to where to place the
device and how to take measurements. However, the construction of the device implies a
certain angle for the thumb to be inserted into the device, therefore the former issue is not
of great concern. The device is also fairly easy to understand, and people would learn
quickly. Therefore, it almost always meets the constraint. Grade: 5
Cost: The devices must be affordable so that it is accessible to everyone, especially in less
developed countries where we are targeting the device, and satisfies the need for widespread use.
Low costs would also prevent discrimination of patients with regards to economic class
standings, avoiding some ethical conflicts that may arise with higher costs. Therefore, cost is
another necessary (therefore is considered a constraint) and important factor to consider. Thus, it
is also weighed as 20%.
Blood: A typical finger-prick blood glucose monitoring system costs around $20 and
satisfies the acceptable value for price. However, since there are so many parts to the
device (e.g. lancets, wipes, strips, etc.), it the actual price of the device over time may be
greater. Therefore, it often meets the criteria. Grade: 4
Saliva: A device using the saliva sample is not sold currently, therefore, we do not have a
price that we can consider. However, we predict it to cost about the same as the finger-

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pricking device since it uses many of the similar components of taking samples and
analyzing it. Likewise, it has additional material that has to be purchased over time.
Therefore, it also often meets the criteria. Grade: 4
Urine: The urine test strips costs about $20 for a packet of 100 strips, which would last
about a month, given that patients monitor their blood glucose levels about three to four
times a day. Since this cost can build over time, the method using urine sometimes meets
the constraint for cost. Grade: 3
NIRS: The use of this method requires not only additional development of the technology
as well as clinical trials to verify but also extensive calibration that may be costly.
However, many ideas and methods can be stemmed from already developed devices such
as pulse oximeters to lower the cost. Therefore, it often meets the constraint. Grade: 4
Safety: Following the do no harm principle, it is important for the benefits of the device to
outweigh its risks. Since the goal is to improve global health, the device must have low potential
contribution to illness or death. Therefore, it is a constraint and is one of our top priorities in
regards to our design. Thus, it is weight at 15%.
Blood: With the conventional method of blood sampling, there is a potential for the
spread of blood borne and could thus cause more harm than good. After pricking multiple
times, sensitivity of the area around the finger may be lost, and possible bruising and
calluses may form. Because drawing blood to measure blood sugar increases the risk for
infection and may cause desensitization and bruising, it sometimes meets the constraint.
Grade: 3
Saliva/Urine/NIRS: The other devices were designed to pose little or no health threat.
Therefore, they almost always meet the constraint. Grade: 5

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Non-invasiveness: In order to increase patient's willingness to use the device, the device must be
non-invasive, minimizing patient discomfort and angst while using the device. If it causes pain,
patients may be reluctant to use the device. Thus, non-invasiveness is one of the key aspects of
our design and reason for our proposal, therefore, is a constraint. However, all the products we
present are non-invasive (aside from the blood pricking test which we use as a comparison), this
factor would not be important in weight since designs would have the same rating. Therefore, it
is weighted as 10%
Blood: The blood test requires the patient to puncture their skin to draw blood, which can
be both uncomfortable and frightening. Therefore, it rarely meets the constraint. Grade:
Saliva/Urine/NIRS: The other three methods are not invasive in any way so they almost
always meet the constraint. Grade: 5
Durability: Diabetes is a life-long disease. Therefore, we want to have the device last as long as
their diseases will prevent extra costs and lessen the burden on patients. Replacing
malfunctioning/broken devices can be time-consuming, expensive, and inconvenient for patients
in need of the device. So, we want our device to be durable and minimize the number of times
patients have to repurchase the product or the parts to fix the device continuously in their lifetime.
Yet this is not as important as other factors such as safety, ease of use and cost as we want our
device to be safe and intuitive to use. So, this factor is considered a criteria, and we weigh it 10%,
which is third highest weights in the Pugh chart.
Blood/Saliva/NIRS: Currently, the blood glucose monitoring test has been developed to
last longer, but there may be many issues with having to replace the supplies (e.g. lancet,
alcohol wipe, swab, etc.). Also, because the blood, saliva, and NIRS tests both rely on
technology that can potentially break down, they often meet the criteria. Grade: 4

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Urine: Strips used for urine testing can become contaminated and cannot be used if it
touches other liquids. It is also not reusable, therefore requires changing the strips every
time. Therefore, it rarely meets the criteria and has the lowest rating. Grade: 2
Accuracy/sensitivity: The device should be accurate to give good enough data for the patient to
correctly assess and control their insulin level. Therefore, it needs to have a needs to have a
reliable level of accuracy and sensitivity and is considered a constraint. As a home-monitor
device, it does not have to be too accurate as this will increase the cost. The patients should gain
an approximately accurate idea of their blood glucose level so that they can control the diabetes
by proper diets and medication. It is less important than other factors such as cost and safety
because do not want to cause harm and our target population is low-income diabetics. Therefore,
we decided to give accuracy 10% of weighting, which is the third highest weights among the
constraints and criteria.
Blood: Measuring blood glucose level by pricking finger is the most conventional method
in this field and has been developed over the past decades. A study has shown that the
fasting blood glucose finger-prick values are not significantly different from venous
values 10. Thus, it almost always meets the constraint. Grade: 5
Saliva: This is still a patent-pending design. Although researchers claim it to be highly
accurate, it might not be able to measure the correct blood glucose value the value may
be affected by the liquid the patients have taken in. Overall, it seems to have a higher
accuracy than the urine test but lower accuracy than the NIRS test. Therefore, we
predicted it to sometimes meet the constraint. Grade: 4
Urine: This method provides semi-quantitative data, therefore has more room for
interpretation with the results. The determination of the value is also rather subjective

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since it depends on the ability of the patients to differentiate one color from another. Thus,
its accuracy and sensitivity is difficult to quantify and compare. It is also very easy to
cross contaminate the testing reagent (i.e. urine). Therefore, it rarely meets the constraint
and has the lowest rating. Grade: 2
NIRS: This method is proven to be within 95.5% error (an acceptable range) in the
Clarke Error Grid, a widely used method for assessing accuracy in glucose levels [9][17]
However, it is still under development and has room for improvement and testing.
Therefore, we project that it often meets the constraint and gave it the second most
accurate design in blood glucose measuring. Grade: 4
Portability: Since this is a home-monitor device, we want it to be relatively small and not taking
up too many spaces. Also, since diabetics need to monitor their blood glucose level for multiple
times a day, this factor is considered a constraint. We want our device to be portable enough for
them to carry around. However, it is as important as other factors such as safety and noninvasiveness as causing no harm is our top priority. Therefore, we give it 5% of weighting
along with efficiency and accessibility.
Blood: This device has been developed for decades and is very small. However, the
patients need to take other supplies (e.g. alcohol wipes, lancing device, etc.) in order to
use this device. So, it often meets the constraint. Grade: 4
Saliva: Like the blood test, the patient needs to carry many supplies (test strips, meter,
swab, etc.) in order to use this device. Therefore, it often meets the constraint. Grade: 4
Urine: For this method, the patient only need a test strip to dip into their urine sample, so
this design is high portable. Therefore, it almost always meets the constraint. Grade: 5

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NIRS: This device is still under development. So far it has been bulky and do not satisfy
this criterion. Therefore, we project it to rarely meet the criteria and rate it the lowest for
portability. Grade: 2
Efficiency: We want to develop a device which shows the results in a short period of time. If the
device takes too long to show the result, it will hinder the users from their daily activities.
However, it is not as important because the primary purpose of this device is to measure the
relatively accurate blood glucose level, therefore it is a criteria. As a result, we decided to give
this criterion the lowest weights. It is preferred that the device can measure and report data
within a reasonable amount of time (under a minute but ideally under thirty seconds) so that
patients can act quickly according to the results.
Blood: This device only takes less than a minute to get the result and falls within the
acceptable range. Therefore, it almost always meets the criteria. Grade: 5
Saliva: Although the researchers claimed it to be highly efficient, they do not have much
data provided. Therefore, we predicted it will sometimes meet the criteria and decided to
rate it to be lower than the blood test. Grade: 3
Urine: The color of the test strip changes instantaneously, so the results are presented
quickly. It almost always meets the criteria. Grade: 5
NIRs: So far this is the slowest test as research shows it takes up to 2.5 minutes to get the
results [9]. Since it falls outside the acceptable range of sixty seconds but does have room
for improvement and advancement, it rarely meets the criteria. Grade: 2
Accessibility of data: This criteria would only be useful for health care workers for further
assessing patients lifestyles and future actions they need to take. It may possibly be useful for
creating personalized artificial pancreas once this becomes an option for patients. Another useful,

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however not necessary or quite reliable, application of stored data would be for predicting when
one would need to take insulin from previous data. However, the cost will increase dramatically
if the accessibility of the device is too high. So we give this criterion the lowest weights of 5%.
The ability of a device to store and record blood glucose data may be useful for healthcare
workers in assessing a patients overall condition and further personalizing their care. However,
this criteria is only beneficial to an extent and it thus not vital for the device.
Blood: There is software such as OneTouch to help uploading patients data for future
management available currently available. Since there is an existing program, it meets the
criteria. Grade: 4
Saliva: So far there is no software for this design; however, it is expected to be relatively
easy to develop one, since it would most likely resemble the system for the blood sample
device. However, since it has not been developed yet, it receives lower rating that the
blood sample method, and we can only claim that it often meets the criteria. Grade: 3
Urine: This design makes it difficult to record the data because the results are color
shown on the test strips. No electronics are involved in this design and so all the data can
only be recorded manually. Even with this option, colors that people observe on the strip
can vary with time and is also very subjective. Therefore, the collected data would not be
useful when accessed by different people. Therefore, it rarely meets the criteria. Grade: 2
NIRS: This device is still under development; however, it is expected that it can be
connected to a cell phone which can record the results [8]. Therefore, it often meets the
criteria. Grade: 4
Solution Selection: The results in Table 2. showed that the method of using NIRS to measure
blood glucose levels had the highest weight total of 4.25 out of five. Even though all the methods,

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except for "Urine" had the same ratings before the weights were applied, NIRS stood out as the
strongest candidate to base our design off of because it had the highest combined ratings in
regards to our two most important criteria: ease of use and cost.
After determining what existing technology to base our design off of, we held a group
meeting dedicated to generating ideas on how to improve the existing designs using NIRS. One
drawback to these existing devices was that they were all fairly large and clunky, as illustrated in
the Pugh chart, since NIRS had a rating of two out of five on portability. To address this issue,
we brainstormed ways to minimize the components of our design to make it more portable and
decided that in order to do this, we would have to eliminate the cord on the existing models. We
ultimately decided that we would incorporate an adjustable opening into our device, which
patients would stick their thumb through for their blood glucose levels to be measured. This
eliminated the need for a cord as well as made our device handheld.
Another aspect we considered is how we would make our device more intuitive and easy
to use. Instead of interpreting numbers, we figured it would be easier for patients if their blood
sugar results were presented in a symbolic and more intuitive manner. We came up with different
audio and visual signals to indicate whether an individual's blood glucose levels are too high, too
low, or in a normal range. By doing this, we not only eliminated the need to educate users on
how to interpret a number scale but also made it possible for blind diabetics to use our device.
Because Type II diabetes often leads to blindness in low resource settings, this was a vital aspect
in the innovation of our device.

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Design Description

Figure 1. Diagram of the proposed NIRS device with labels.

The outer casing of the device and the sensors and receivers for the device would be
made out of aluminum because of its extreme abundance in the world. It is the third most
abundant element after oxygen and silicon, being 7.50% of the mass in Earths crust, oceans, and
atmosphere [18]. Aluminum is also a flexible and malleable material making it easy to shape and
still have a lightweight and durable structure. Its wide usage in phones, such as in Apples
iPhones, proves that it is able to conduct radiation (for our device, infrared radiation must not be
obstructed); phones must connect to satellites and various networks [7]. The LED display is a
common seven-segment display (the numbers are composed of seven trapezoidal pieces) which
is widely used in electronics. Its prevalence suggests that it is affordable and cost-effective. The
device would be powered with regular AA batteries which, similar to aluminum and LEDs, are
also commonly used.
We chose these materials because they are commonly used in electronics and other
products. They are not foreign to manufacturers so there would be little issues in constructing
these devices. The circuit boards within the device will have to be specifically made which

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would increase the cost of the device so it is thus critical to reduce the cost of the other parts of
the device as much as possible. Aluminum is a very abundant element so its cost would not be a
large factor. Moreover, as aluminum is being extracted from ores in bulk for thousands of other
products, there would be little issue in obtaining the aluminum for constructing these diabetes
monitoring devices. LED displays are also widely used and are composed of small light-emitting
diodes; given their size and prevalence, they should also be relatively easy to obtain from
manufacturers at a low cost. AA batteries may be more expensive that the previous two materials
because they may not be rechargeable. Further, given that the low-resource setting may not have
electricity, batteries will have to be constantly replaced. However, they are necessary because the
device may require more power than a solar panel may provide. Thus, AA batteries, a very
common form of the batteries, are preferred as they are manufactured on large scales.
Ideally, the device should be durable because diabetes is a life-long impairment that
needs continual monitoring. If the aluminum is thick enough, damage to the circuit boards can be
prevented if the device was dropped. The aluminum is merely a casing so it would not have to be
replaced unless it ruptured and started exposing the internal hardware to the outside elements.
The LEDs may burn out causing complications. However, it is estimated that LEDs have a useful
lifespan of 35,000 to 50,000 hours (4-5 years), triple the amount for other light sources [4]. As
they last for several years, the LEDs are not be a major issue. The battery is the main concern
because of its scarcity in low-resource settings. The device has to perform many calculations
with the data it receives in addition to sending out the infrared radiation. Thus, it would require a
decent amount of energy. Simply replacing the battery with a solar panel may not be sufficient
either. Therefore, a possible solution is for the device to use both a solar panel in addition to the
battery when necessary. This preserves the life of the battery and only uses it for more energy-

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intensive processes. Without the solar panel, the battery can be expected to last for a few months.
Another solution is to recharge batteries using a solar-powered charger. This would mean adding
to the overall cost but batteries would not have to be replaced as frequently.
Our device works by sending and detecting the infrared light in addition to amplifying the
data for analysis and conversion into a numerical value. Figure 2 outlines the schematic of the
internal hardware of the device. The finger is placed in between the light sources and the light
sensors. The glucose in the bloodstream absorbs near-infrared light and thus, the amount of
glucose present in the blood can be measured [11]. The data is amplified because the NIR signals
are fairly weak [8]. The glucose levels are then calculated and displayed on the LED display.

Figure 2. Schematic of the internal hardware: The infrared light from the light source passes
through the finger and the light sensors detect the amount of glucose absorbance. This is then
passed through the RC (resistor and capacitor) circuit filter then through the amplifier and
analog-to-digital converter (ADC) for display on the device. PWM stands for pulse-width
modulation and LC controller for liquid crystal modulators. PSoC 5LP is a low powered chip
used in the device. [8]

Figure 3. Raw data to numerical value process flow chart [8]

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However, not everyone in a low-resource setting can interpret this numerical value for
their blood glucose levels. It is therefore necessary to have an intuitive method for interpreting
the values for the user so they know how to react properly. For this, we have developed three
distinct signals that tell the user what their glucose levels mean.

Figure 4. Three Signals Diagram. The normal blood sugar level is half-way filled and
has a pleasant one time beep and thus does not call attention and action. High and low blood
sugar levels is either filled or empty and flashes quickly to call attention and action. There is a
fast, constant beep for high blood sugar levels to indicate that there's too much sugar in the
blood and there is a slower, regular beep for low blood sugar levels to indicate that there's too
little sugar in the blood.
Normal blood sugar levels results in a small rectangle that lights up before disappearing
within a few seconds. From the speaker on the device, a short beep will sound. For high blood
sugar levels, a larger rectangle will flash rapidly and quick, repeated beeps will sound from the
speaker. For low blood sugar levels, only the outline of the rectangle will flash and the beeps
from the speaker will have longer pauses between the repetition. We chose these signals because
the normal signal is neutral and does not call your attention whereas the high and low signals do;
they flash rapidly and emit sounds (primarily for blind diabetics). They want the user to react in a
certain way. But, they are also distinct enough to convey their own message; the high signal is
filled, meaning there is more sugar present. The low signal is empty, meaning there is little sugar
present. The users themselves do not need to know what diabetes is and how sugar is related but
they only need to know how to react to each signal. The signals are all very different so that the

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users will not misinterpret them. Moreover, by using symbols without any words, the
complicates of language barriers are reduced.
Major problems with this design is the devices physical durability and a more subtle issue
of the users knowing how to react to the data they are given. Concerning the durability, batteries
may need to be replaced every few months, something that is inevitable but can be reduced if
solar panels are integrated to preserve the battery for more intensive processes. Alternatively,
rechargeable batteries can be used in addition to a solar-powered charger, though this can be
expensive. Moreover, aluminum is not the strongest material and mixing it with other elements
to create stronger alloys may not be a cheaper alternative. As long as it protects the internal
hardware, it is satisfactory. A case for the device can also be provided as a solution for this
problem, reducing damage to the device. Another large issue is that the users must be told how to
react to each signal, that is, what they need to do if they have low, normal, or high blood sugar
levels. This is a major assumption as this means educating them prior to the usage of the device.
Education may not be readily available but this issue can be reduced if an information card can
be provided displaying the foods to eat, for example, given one of the three signals. This also
allows them to not have to memorize the proper reactions for each signal, making it easier for
them to react.
Ethical and Societal Considerations
In Chinese culture, seeing blood is thought to bring bad luck. Because of this, diabetics
may be reluctant to prick their fingers in order to measure blood glucose levels. This can be
dangerous for diabetics because unmonitored blood sugar levels can lead to dizziness, headaches,
fatigue and blurred vision [16]. Our device can solve this problem since it does not require blood
samples to be taken. This can encourage the diabetics to monitor their blood glucose levels in a

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constant manner, which is one of the most effective way to control diabetes and limit other
health complications [12].
The future development of our device would require the use of human subjects, because
the accuracy of the device needs to be confirmed. Yet, thanks to the non-invasiveness of this
device, it will hardly pose any health-related risks on the human subjects. Our human subjects
will be diabetics simply because they need to monitor their blood glucose level on a regular basis.
There are generally two ways of conducting this experiment the first one will be giving out the
devices to the diabetics who are monitoring their blood glucose level by finger pricking. Then we
will ask them to provide the data from both the finger pricking tests and from our devices on a
daily basis. Whereas the second one will be inviting the diabetics to our lab and using both finger
pricking test and our device to test their blood glucose level on a daily basis. We would prefer
the second method because it can make sure that the data we obtain are valid (subjects might
forget to use our device but make up the results). Further, no matter which method we finally use,
we will need to find another organization which does not have interest conflicts with us to record
and analyze the data so that biases can be avoided.
Conclusions
We have presented a new, innovative device for monitoring diabetes using the developing
technique of using near-infrared spectroscopy. We began by identifying the problem of the
growing prevalence of diabetes worldwide, and specifically in China, which allowed us focus
our problem statement and find a target audience. After exploring the current methods of blood
glucose level monitoring methods (using blood, saliva, urine, and NIRS samples), we
numerically compared the designs using a Pugh chart to find the design that satisfied the
constraints and criteria best overall. In the exploration process, we developed skills in looking for

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patents and finding, synthesizing, and understanding research papers. We found the NIRS to be
the most promising sample method, therefore developed a design using this technology to meet
the needs presented by the problem. Though we are not able to implement the design, we predict
that our design accomplished the major needs addressed by the problem: non-invasiveness, ease
of use, and low costs. We considered the possible cultural barriers and attempted to eliminate
them by incorporating an intuitive way to understand the data using sounds and symbols.
Therefore, we predict that people will be able to use the device easily. Also, since it serves as a
supplementary method to traditional Chinese treatment methods, our design does not criticize the
culture and thus would be received better by our targeted audience. The innovative additions to
our design (making it non-invasive, portable, and removing the language and cultural barriers)
will hopefully propel patients to monitor their blood glucose more frequently, thus allowing
patients to control their diabetes, eventually decreasing the risk of encountering the long-term
health complications due to diabetes.

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by Runyuan Chen; Philip Lee; Yunjung Kim; Tiffany Ohlsen