Originally published February 1996
In focusing the cover story of this issue on medical electronics, I originally considered its value only from the point of view of our readers. Then I read the article produced by contributing editor Greg Freiherr, "Medical Electronics: Advanced Technologies Benefit Point-of-Care Devices," beginning on page 62. When I finished, I realized that his article concerned a topic vital to my own life.
One of the underlying trends in medical electronics that Greg covers is the continuing miniaturization and computerization of medical products. Most of us have heard the line from the computer industry about how the laptops people use today are more powerful than the computers of the 1960s that took up entire rooms. The same benefits of microelectronics have extended to the medical device industry. Thanks to advances in electronics, medical products have become significantly smaller, more versatile, and less expensive. This in turn drives continuing advances in diagnosis and treatment.
My best evidence for this is personal. Eight years ago, when my wife, Cheryl, was diagnosed as having insulin-dependent diabetes, I suddenly became aware of blood glucose meters. I did not initially appreciate their value or understand how critical they are to the treatment of this disease.
As Cheryl studied books and articles about her disease and took control of managing it, however, I began to see that her meter was a key tool. With its help, she stands an excellent chance of avoiding the neuropathy, retinopathy, kidney failure, circulatory disorders, and other complications that are almost inevitable with poorly controlled diabetes.
As demonstrated by the landmark Diabetes Control and Complications Trial, tight control of blood glucose levels yields dramatic benefits. Concluded in 1993, this 10-year study involved more than 1400 subjects with insulin-dependent diabetes. Half of the subjects used traditional "loose control," taking one or two shots of insulin a day. The other half used tight control, each day measuring their blood sugar levels at least four times, and correcting as necessary by using insulin pumps or by taking three or four shots. The risks of complications for the latter group were cut substantially.
The key to these benefits is frequent monitoring. Without convenient and accurate blood glucose tests, tight control would be virtually impossible to achieve. It is medical electronics that make these tests possible, and continuing advances in electronics technologies that make them ever more convenient. I've seen, for instance, how the biosensor-based, credit-card-sized meter that Cheryl carries in her purse makes it far more convenient for her to test in the car or in a restaurant. This, in turn, makes it that much easier to maintain tight control.
Coming advances will make the attainment of tight control even easier. The noninvasive blood glucose sensors now close to commercialization will relieve users of the need to prick their fingers for a drop of blood, allowing more-frequent monitoring. These units will probably start out relatively bulky, inconvenient, and costly, but as they are further developed, and the electronics are refined, they will undoubtedly shrink in size and price.
Continuous monitoring with a wristwatch-type device may one day be a reality. Conceivably, the right technology could be combined with insulin pumps to enable constant microadjustments of the insulin dose in response to blood sugar, mimicking the self-regulation of the body itself.
We may never see a true cure for diabetes. But if advances in electronics and related technologies continue at their current pace, we will likely see treatment regimens that are so accurate and convenient as to offer a virtual cure. I can hardly wait.