The impacts of the blood glucose meter, invented by Anton Clemens in 1970, can be felt throughout the medical field. Prior to the meter, urinalysis was the most popular way of diagnosing patients with any disease. The term “diabetes” can be traced all the way back to Ancient Egypt, but testing urine samples as a method of identifying medical conditions did not begin until the 19th century.[1] Medical practitioners noticed a strong sweetness from urine samples of patients with diabetes dating back beyond the 17th century.[2] Many of the procedures for testing urine before the mid-1800s relied on individual’s senses of sight, taste, and smell; making it a highly subjective form of diagnosis.[3] An English doctor by the name of George Oliver was one of the first to market test strips for urinalysis in 1883.[4] This was one of the first steps in legitimizing a method of urinalysis. Finally, in 1908 a copper reagent was invented that would enable urine to be tested for sugar levels without changing the composition of the glucose; which was the method prior to the 20th century.[5] Monitoring and managing sugar levels is the foundation to living with diabetes, so these new additions to the method of urinalysis greatly eased the management of individuals’ sugar levels. Urinalysis would remain the most popular and reliable method of managing diabetes, and other blood sugar related diseases, until the late 20th century when Anton Clemens would change the medical field forever.
In 1965, Ames released a paper based glucose testing strip called Dextrostix. This product worked similarly to a pH test strip. The patient would add a drop of blood to these paper strips, wait for the stip to change color, and then compare the color produced to a chart to determine blood glucose levels.[6] Though these testing strips were simple enough to read and would produce accurate results, comparing the strips to the color chart proved difficult for home users.[7] Then, in 1970, the Ames company released a new product known as the “Ames Reflectance Meter”. This battery operated device was able to accurately read the color results on Dextrostix by bouncing light off the test strip and reading the color value returned with a sensor. This sensor was able to translate the color value into a numerical value for the patient to read, thus eliminating much of the guessing associated with the older color chart comparison method[8] The inventor of the Ames Reflectance Meter was Anton Hubert Clemens, an Engineer that had been working for Ames since 1965.
Clemens invention of the Ames reflectance meter revolutionized the field of diabetes detection. Modern day engineers have improved upon the reflectance meter by making it smaller and more accurate, and companies such as Diramed LLC and RSP Systems are attempting to create a fully non-invasive method for detecting blood glucose levels.[9]
In order to showcase the accomplishments of Clemens and the advances in technology, the formatting for the blog will be like a timeline. By utilizing a program like JSTimeline, there will be an integrated timeline function showing the evolution of science that backed the technological advances. Diabetes is still an incurable disease with very little understanding of how it occurs; as the medical field progresses, they are looking into non-invasive forms of monitoring blood sugar levels.[10] The timeline will span from pre-Ames Reflectance Meter to the prototypes of non-invasive monitoring that are not commercialized towards individuals yet. For the documentary, it will follow the same idea of presenting the information in chronological order. A couple of tools that will be used to produce the documentary include software editing programs, voiceovers, and multiple primary source photos of the iterations of the blood glucose meter from the stationary hospital model to the modern day pocket-sized meter.
Diabetes is the seventh leading cause of death for Americans.[11] Those affected by diabetes know how important it is to constantly monitor their blood glucose levels. At one point in time the lives of those with diabetes revolved around diabetes, with Clemens invention the accessibility of blood glucose monitoring became much more flexible. At the time of Clemens invention those in the medical field were calling for more accessible at home monitors, and for this invention to give patients immediate results.[12] Following Clemens invention more at-home blood glucose monitors emerged with some improvements as time went on[13] with his invention the field of at-home glucose monitoring became a competitive field which benefited those with diabetes. Blood glucose monitoring is something that has significantly helped the lives of those with diabetes and has affected most Americans, directly or indirectly.
Annotated Bibliography
American Diabetes Association. American Diabetes Association Complete Guide to Diabetes. Virginia: American Diabetes Association, Inc., 2005. Published originally in 1999 and updated by 2005, the American Diabetes Association guide has an entire chapter dedicated to the benefits of self-monitoring glucose levels. After almost thirty years of testing, this guidebook not only encourages patients to utilize personal meters, but explains how and when to use them.
Baumer, J H, A D Edelsten, B C Howlett, C. Owens, C A Pennock, and D C Savage. “Impact of Home Blood Glucose Monitoring on Childhood Diabetes.” Archives of Disease in Childhood 57, no. 3 (1982): 195-99. This article, released one year after the Ames Reflectance meter began to be marketed for home use, summarizes the impact home glucose monitors have had on children with diabetes. According to the article, home monitors were found to be much more reliable, easier to use, and give a more dynamic representation of the patients blood glucose profile than older urine testing kits.
Bellenir, Karen. Diabetes Sourcebook. Michigan: Omnigraphics, Inc., 1999. This book is the only one that explains how self-monitoring may not be the best option for every patient and goes into the details behind the years it took to verify the accuracy and reliability of the blood glucose monitor.
Bruen, Danielle, Colm Delaney, Dermot Diamond, and Larisa Florea. “Glucose Sensing for Diabetes Monitoring: Recent Developments”. Sensors 17, no.8. (2017): 1866. The authors focus on the importance of the blood glucose monitor in helping predisposed diabetics and diagnosed patients in managing the symptoms of diabetes as it is still an incurable disease.
Clarke, S.F. and J.R. Foster. “A history of blood glucose meters and their role in self-monitoring of diabetes mellitus”. British Journal of Biomedical Science 69, no. 2 (2012): 83-93. This is one of the only scholarly pieces that focuses solely on the historical background of the blood glucose meter.
Clemens, Anton. Blood Glucose Monitor. US Patent 4151845A, filed November 25, 1977, and issued May 1, 1979. Through looking at the original patent for the Blood Glucose Monitor we can see how the original prototype worked and look at what Clemens envisioned for his invention. This can help us understand the need for this invention.
Feudtner, John Christopher. Bittersweet: Diabetes, Insulin, and the Transformation of Illness. University of North Carolina Press, 2003. By focusing on the history of diabetes (treatment, diagnoses, origins, individual patient histories), Feudtner argues that watching the shift from treating diabetes as an acute syndrome to an incurable disease has impacted how medical professionals and individuals view diabetes.
Geist, Harold. The Psychological Aspects of Diabetes or How to Live in Emotional Balance with Diabetes. Illinois: Charles C Thomas, 1964.While the book’s focus is on the mental impacts of diagnosis, it also predates the invention by Anton Clemens. This book gives a unique perspective on how diabetics were expected to regulate and control their blood sugar without the convenience of a blood glucose monitor. It even touches on how the inconvenience of urinalysis plays into the stigma surrounding diabetes.
Heron, Melonie. “Deaths: Leading Causes for 2017”. National Vital Statistics Reports 68, no. 6 (2019): 1-76. The statistics about diabetes being a leading cause of death in America helps stress the importance of the blood glucose monitor through quantifying how many people the invention impacts.
Hillson, Rowan. Practical Diabetes Care. New York: Oxford University Press, 1996. This book was written for medical practitioners, so it goes farther into the science behind testing methods than the American Diabetes Association guidebook does (as that what is marketed towards individual patients). It goes into depth about the differences between urinalysis and blood glucose monitoring.
Hirsch I.B., Battelino T., Peters AL, Chamberlain J.J., Aleppo G., Bergenstal RM. Role of Continuous Glucose Monitoring in Diabetes Treatment. Virginia: American Diabetes Association, 2018. This piece focuses more on the iterations that directly followed the first blood glucose monitored and how they adapted to the market.
Knight, A H. “Monitoring Blood Glucose.” British Medical Journal 280, no. 6209 (January 26, 1980): 253.This journal entry published in The British Medical Journal in 1980 discusses the importance of self-monitoring of blood glucose levels. This gives insight of the need for Clemens invention. Those affected by diabetes were looking for a reliable and at home blood glucose monitor.
Mendosa, Daivd. “History of Blood Glucose Meters: Transcripts of Interviews”. Mendosa.com. David Mendosa, February 15, 2006, http://www.mendosa.com/history.htm. These interviews are between David Mendosa, a renowned expert in the field of diabetes, and Anton Clemens, the inventor of the blood glucose monitor.
Nichols, James H. and Ksenia Tonyushkina. “Glucose Meters: A Review of Technical Challenges to Obtaining Accurate Results”. Journal of Diabetes Science and Technology 3, no. 4 (2009): 971-980. Accessed September 25, 2019 https://doi.org/10.1177/193229680900300446. Nichols and Tonyushkina argue that because blood glucose monitors are not very reliable because there are so many human factors that change results alongside the science proving that whole blood (which is the only form of blood that glucose monitors can analyze) creates unstable glucose. This is important as it argues directly against the Clemens invention and says that by introducing it to the individual, false positives may be given.
“Portable Meter To Aid Diabetics”, Pittsburgh Press, November 5, 1981, p. A-6. This article was one of the first public newspaper articles concerning the at-home blood glucose monitor. While we are still pending permission to the article through Quest we are hopeful that it will provide further insight regarding the initial reaction to this invention.
Schreider, E. “Some Statistical Aspects of Blood Sugar Regulation.” Nature 199 (1963): 388. This article precedes Clemens invention of the blood glucose monitor and discusses the relationship between testing blood glucose levels and the time that it takes for these to alter after meals to control blood glucose. This article will provide insight as to how those with diabetes controlled their levels before Clemens blood glucose monitor.
Soeldner, J. Stuart, Kuo Wei Chang, Sol Aisengerg, John M. Hiebert, and Richard H. Egdahl. “Diabetes Mellitus: A Bioengineering Approach — An Implantable Glucose Sensor”. In Diabetes Mellitus, edited by Stefan S. Fajans, 267-277. Maryland: National Institutes of Health, 1976. Written six years after the Clemen’s invention, it voices skepticism about the role of glucose levels in helping diabetic patients, but it also produces new research on extending beyond a portable monitoring and into an implantable one.
Tattersall, R B. “Home Blood Glucose Monitoring,” n.d., 4. This research article continues off of another source used in our research. We hope to use this article to look deeper into the blood glucose monitoring process preceding Clemens invention. This will allow us to determine the need for his invention and the impact it made on this process.
Tattersall, Robert. Diabetes: The Biography. England: Oxford University, 2009. This book contains a comparison image of the original 1970 Ames Reflectance Meter and a Accu-Check meter from the 2000s. This book focuses more on creating a timeline of diabetes than explaining the science behind the disease which makes it very different from other literature on the subject.
Webb, D J, J M Lovesay, A Ellis, and A H Knight. “Blood Glucose Monitors: A Laboratory and Patient Assessment.” British Medical Journal 280, no. 6211 (February 9, 1980): 362–64.This journal from the British Medical Journal looks at Clemens blood glucose monitor as compared to others. This offers insight as to how the process of glucose monitoring changed following Clemens invention.
[1] S.F. Clarke and J.R. Foster, “A history of blood glucose meters and their role in self-monitoring of diabetes mellitus”, British Journal of Biomedical Science 69, no.2 (2012): 84.
[2] John Christopher Feudtner, Bittersweet: Diabetes, Insulin and the Transformation of Illness, (University of North Carolina Press, 2003), 5.
[3] Clarke and Foster, 84.
[4] Ibid.
[5] Hirsch, 1.
[6] D. R. Harvey, L. V. Cooper, R. F. Fancourt, M. Levene, and T. Schoberg, “The use of dextrostix and dextrostix reflectance meters in the diagnosis of neonatal hypoglycemia”, J. Perinat Med. 4 no.106, (1976), 106. Accessed September 25, 2019, https://edoc.hu-berlin.de/bitstream/handle/18452/13353/jpme.1976.4.2.106.pdf;jsessionid=4DD4313F82A24500C24F7668F2A3F83A?sequence=1.
[7] W.L. Clarke and Associates. “Evaluating Clinical Accuracy of Systems for Self-Monitoring of Blood Glucose.” Diabetes Care, vol. 10, no. 5 (September 1987) 622-28. DOI: 10.2337/diacare.10.5.622.
[8] David Mendosa, “History of Blood Glucose Meters: Transcripts of Interviews”, Mendosa.com, David Mendosa, February 15, 2006, http://www.mendosa.com/history.htm.
[9] “Noninvasive Glucose Monitoring: Comprehensive Clinical Results.” JAMA 282, no. 19 (November 17, 1999): 1839.
[10] Ibid.
[11] Melonie Heron, “Deaths: Leading Causes for 2017”, National Vital Statistics Reports 68, no. 6 (2019): 1.
[12] Knight, A H. “Monitoring Blood Glucose.” British Medical Journal 280, no. 6209 (1980): 253.
[13] Webb, D J, J M Lovesay, A Ellis, and A H Knight. “Blood Glucose Monitors: A Laboratory and Patient Assessment.” British Medical Journal 280, no. 6211 (1980): 362–64
