An estimated 463 million people already live with Diabetes. It is considered as a silent epidemic that claims 4.2 million lives worldwide every year. Fortunately, if self-monitoring of blood glucose levels is provided, patients enjoy a good quality of life. While technologies for disease management have evolved significantly (e.g. continuous glucose monitoring devices (CGM), insulin pumps) diabetes screening appears to be today an important hurdle. Almost one in two adults with diabetes are unaware of their condition (240 million). Its symptoms (frequent urination, thirst, weight loss, vision changes and fatigue) appear progressively and are often neglected. As a result, the disease may be diagnosed several years after its onset, once complications - like kidney and eye damage or an increased risk for heart disease or stroke - have arisen. For these reasons, some diabetes associations recommend screening people at risk of developing T2DM at least every third year and yearly after reaching 45 years. The availability of suitable tools in the primary health care (PHC) for early identification is one of the biggest challenges in promoting health and disease prevention. Generally, diabetes screening is prescribed by practitioners when patients visit primary care for other health issues. In these cases, fasting blood sugar and/or glycosylate haemoglobin (HbA1C) is checked. Alternatively, regular screening campaigns are organized at local pharmacies or primary care centres. In these campaigns, people get a capillary blood analysis and under an abnormal glucose level, are advised to look for confirmatory laboratory testing and given some guidance about health habits. However, these campaigns have very limited turnover, always limited to the number of available testing sites, glucometers and trained staff, that have no tools to follow-up or engage individuals under high-risk.
FAIRGLUCOSE presents a low cost and single use glucose sensing system to enable massive and ubiquitous diabetes screening. The key component consists of an enzymatic fuel cell that generates electrical power that is proportional to the glucose content of a sample. The self-powered sensor signal is managed with a proprietary minimalistic circuit and can be integrated in a card with near field communication that transfers glucose result to a cell phone. The device has several features that make it a promising candidate to enable distributed glucose testing: (1) It is affordable and has a minimal environmental impact due to its reduced electronic content and lack of battery. (2) Its card format together with its battery-less conditions enables massive distribution by regular mail to people’s homes for self-testing (3) test result is read in the cell phone, that becomes and IoT node with dual use: it provides glucose result and risk score to the individual under test but also stablishes connection with a healthcare provider. This connection with the patient cell phone can be used to inform the healthcare system and to enable patient’s follow-up by encouraging him/her to take a subsequent blood test, to reach a clinic for further assessment or to follow recommendations for a healthier lifestyle.
