See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/260945455

Design & Implementation of a Low Cost Blood Glucose Meter with High
Accuracy

Conference Paper · April 2014

DOI: 10.1109/ICEEICT.2014.6919050

CITATIONS READS

6 8,664

3 authors:

Shumit Saha Nayan Sarker

Toronto Rehabilitation Institute Bangladesh University of Business and Technology
29 PUBLICATIONS   110 CITATIONS    4 PUBLICATIONS   16 CITATIONS   

SEE PROFILE SEE PROFILE

Avijit Hira
Chittagong University of Engineering & Technology
12 PUBLICATIONS   58 CITATIONS   

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Car Anti-theft alarm with police notification View project

All content following this page was uploaded by Avijit Hira on 23 January 2019.

The user has requested enhancement of the downloaded file.

International Conference on Electrical Engineering and Information & Communication Technology (ICEEICT) 2014

Design & Implementation of a Low Cost Blood

Glucose Meter with High Accuracy
Shumit Saha, Nayan Sarker, Avijit Hira
Department of Electronics & Communication Engineering
Khulna University of Engineering & Technology, Khulna, Bangladesh
[email protected], [email protected], [email protected]

Abstract— Diabetes Mellitus mostly known as “Diabetes” is a In this paper, a glucometer is designed and implemented
worldwide common and serious health issue. Across the world with considering these two major drawbacks of commercial
approximately 175 million people at present are with diabetes glucometer. The proposed meter is much more low cost than
and this will increase to 366 million by the year 2030 according to available meters in market and it gives higher accuracy than
World Health Organization statistics. People suffering from
commercial one. The proposed blood glucose meter is built
diabetes are solely dependent on exact blood glucose
concentration information. Glucometer is a device which helps to with the ATMEGA8A AVR microcontroller. The software
detect blood sugar levels in human body. In developed countries part is done using the C programming in AVR studio. Hence,
people widely use this medical device. But in developing countries the cost remains low because this system use microcontroller.
like Bangladesh the usages of this helpful devices is limited to a Besides, to consider the accuracy as the cardinal priority, the
very few people; due to illiteracy, cost, publicity etc. In this proposed design introduces transcendental approach to relate
paper, a real time blood glucose meter is designed & the relationship between the glucose concentration and the
implemented which is very low in cost, targeting the poor people voltage from EGBT progresses which offer less deviation.
in developing and underdeveloped countries. This proposed Eventually, it is feasible to obtain much accurate result than
meter uses transcendental concentration equation over the linear
traditional linear approach.
equation used in existing commercial meters. Due to this, the
average deviation of result is much smaller than the commercial
one. Result shows that the proposed meter gives around 93% The theoretical background, design methodology,
accuracy with pathological data tested over 38 persons. Total implementation technique of the system, result & performance
cost of the proposed glucometer is only 5 USD so that poor people and meter specification will be discussed briefly in the
can have an easy access to this meter. following sections. This blood glucose meter provides many
features like low cost, high accuracy, higher sensitivity, lower
Keywords— Diabetes; Glucometry; Insuline; RBS; EGBTS; error rate, portability.
Embedded System; Low-Cost; High-Accuracy.
I. Introduction II. Theoretical Background
Blood Glucose Meter (BGM), much familiar as A. Diabetes – from biological view
‘Glucometer’, is a small, portable electronic device widely
used to measure the level of glucose concentration in blood. Normally, the body decomposes starch and transforms it
Depending on the glucose concentration level, drug might be to glucose as the body energy [7]. The amount of glucose
required for patient if necessary. A test strip is associated with (sugar) present in the blood of a human, to facilitate the
glucometer to interact with glucose presence patient’s blood quantitative analysis, is represented by the term of blood
drop. glucose concentration or level. Diabetes is characterized by
the body’s inability to produce enough insulin (Type-1) or by
There are several glucometers available in market. But, the the inability to properly metabolize the insulin hormone which
price range of these glucometer varies from 1200 to 2500 is produced in the pancreas (Type-2). Insulin is responsible
BDT. But, there is no glucometer available in market which for allowing cells to absorb glucose from food.
price is less than 1000 BDT. Moreover, the accuracy of the
B. Glucometry – in Helping Diabetes Patients
commercial glucometers varies between 85 and 90 percent.
This because the commercial glucometer offers Liner Glucometry is a technique of obtaining the values of
equations to relate the glucose concentration and the voltage concentration of glucose in peripheral or central blood. These
found from EBGTS. But, in practice, the relationship between values, expressed either in mg/dL or mM/L, have important
the glucose concentration and the voltage is taken from EGBT clinical value for metabolic disorders such as diabetes
progresses discretely. Hence, to accomplish the task of curve mellitus, denutrition, and some of their consequences like
fitting, a significant deviation will be occurred to linearize the hyperosmolar coma, malabsorption syndrome and the most
discrete function. This deviation results much inappropriate
glucose level.

978-1-4799-4819-2/14/$31.00 ©2014 IEEE

critical – hypoglycemia, lower than normal level of blood A. Electrochemical blood glucose test strips (EBGTS)
glucose[3]. At first the glucose of human blood is sensed by one kind
of transducer. The electrochemical blood glucose test strip, in
C. Expected Results for people without diabetes abbreviation EBGTS, is a very small volume disposable
electrochemical cell which is contacted with sample blood.
Glucose measurement system is calibrated in Plasma
Then it produces, in conjunction with a test meter, an
Blood Glucose Level. Plasma Blood Glucose test Result
electrical current which is proportional to the blood glucose
provides output like,
concentration [6]. Typical currents are a few μA.
Before eating < 110 mg/dL
Two hours after meals < 140 mg/dL
1) Low blood glucose (hypoglycemia) symptoms may include
trembling, sweating, intense hunger, nervousness, weakness or
trouble speaking.
2) High blood glucose (hyperglycemia) symptoms may
include intense thirst, a need to urinate too often, a dry mouth, Fig. 2. Schematic diagram of test strips.
vomiting, or headache.
The sensor is composed of various electrodes: a glucose
oxide membrane layer, a polyurethane film that is permeable
D. Different forms of Blood glucose measurement
by the glucose, oxygen, and hydrogen peroxide. Three
Glucose measurements, more specifically blood glucose electrode models are used such as working electrode (WE),
tests, are of various types according to medical science [6]. reference electrode (RE), and a counter electrode (CE). But in
Some blood glucose measurement types are mentioned practical way to explain ampereometry, a voltage is applied in
bellow- the WE and RE electrodes with a range of -400 millivolts to 8
volts. This is used to define the voltage at which the sensor is
• Plasma Glucose Fasting Blood Sugar Test
able to perform at the maximum current.
• Plasma Glucose Random Blood Sugar Test
• Plasma Glucose 1 Hour Post Parental Blood Sugar B. Electrochemical reaction of glucose using Enzymatic
Test (PPBST-1) method
• Plasma Glucose 2 Hour Post Parental Blood Sugar This electrical current is produced by the very selective
Test (PPBST-2) oxidation of glucose in the blood sample, which is catalyzed
• Plasma Glucose 75 gm Glucose Drink PPBS by two reagents which are pre-coated inside the test strip: (1)
Test(GTT) an enzyme and (2) a mediator molecule [4].
1) Enzyme: Four enzymes are commonly used in these strips
III. Design Methodology and these are Glucose Oxidase, PQQ-Glucose Dehydrogenase,
NAD-Glucose Dehydrogenase and FAD-Glucose
The design of an effective BGM device must incorporate
Dehydrogenase [6]. Enzyme reacts directly with the glucose
a wide range of functions such as sensing of the blood sample,
molecule to remove its two available electrons.
computation to determine the glucose level in the blood, user
interface to display results and control and store in memory. 2) Mediators: A few commonly used mediators are: (a)
ferricyanide, (b) 1, 10-phenanthroline Quinone, and (c)
osmium-based mediators. Their oxidation potentials are 500,
100, and -120 mV (against Ag/AgCl reference), respectively
[6], which takes two electrons from the enzyme, and transports
them to the working electrode. Some common features of
mediator are- rapid reactivity with enzyme and working
electrode, capable of being easily stabilized in oxidized rate,
high solubility in blood.
When a small sample of blood containing glucose is
deposited on the test strip, the electrodes and the presence of
the mediator, enzyme on the test strip prior to the blood
Fig. 1. Block diagram of blood glucose meter. reaching the electrodes, the enzyme will react with the blood
glucose to create free electrons. The free electrons can be
The block diagram of blood glucose meter is shown in moved through a circuit when a voltage is applied between the
Fig. 1. The measurement of glucose concentration using two electrodes. Each enzyme and mediator molecule can
electrochemical test strips is completed by the following repeat this transfer again and again, if necessary. The amount
procedure: of charge that moves through the circuit will be representative
of the blood glucose level in the sample. Although there are
many differences between the various commercially available Say, glucose concentration is represented by Y & voltage
test strips, they all rely on the fundamental mechanism of output is represented by X. So the two variable of
discussed above [5]. transcendental equation relates by
Among the wide variety of commercially available blood
glucose sensor, here, in this analysis, freestyle test strips are
used. In free freestyle test strips, glucose oxidase is used as
enzyme. Hence, the following electrochemical reaction will be
occurred in electrodes. lna =

Glucose + O2 D-glucono-1,5-lactone+H2O2 a= 66.896

Finally we get, Y=66.896 * X^1.223
This oxidation reaction produces a current flow. The This is a transcendental equation. For any value of X
amplitude of this current is directly related to the (voltage), Y (glucose level) can be determined. So, finally the
concentration of blood glucose. During the reaction, the equation instead of linear one, have developed:
concentration of glucose decreases with time due to the
oxidation reaction. This decreased concentration of glucose
Concentration=66.896 * (5*ADCvalue/1024) ^1.223
reduce amount of current as well as voltage in the input port of
MCU. Earlier, it is notable that it requires a few seconds to
start reaction. This reaction time varies with the types of test IV. Proposed Design & Circuit Details
strips available. When a sample is applied to the test strip, the Fig. 3 depicts the proposed design flow. The whole design
voltage jumps to a peak value and then stabilizes between 2 and circuit details are discussed in this section.
and 6 seconds.
A. Current to voltage converter
C. Relation of current & voltage with Glucose concentration The EBGTS sense the glucose concentration present in the
It has been formerly mentioned that the current due to blood sample, then produces a current proportional with the
oxidation reaction in EGBTS stabilizes after a few seconds. glucose concentration. This amount of current is converted to
This amount of current also varies with different test strips. In analog voltage using current-voltage converter [14].The output
this designed system, freestyle test strips are used for sensing voltage depends on the current from test strips. In
blood glucose. The discrete values of current and glucose mathematically,
concentration after 5 seconds in freestyle test strip are shown V1= - (input current* feedback resistance (RF1)).
in Table I [4], [6].
Here, V1 is negatively polarized. But microcontroller can’t
TABLE I: RELATION OF CURRENT AND VOLTAGE WITH GLUCOSE sense negative voltage. So voltage is inverted with unity gain.
CONCNTRATION
Glucose (mg/dL) Current (μA) Voltage (Volt)
46 7 .7
71 11 1.1
97 14 1.4
130 17 1.7
162 21 2.1
198 24 2.4
246 29 2.9
297 34 3.4
349 38 3.8
393 42 4.2

For this value of output voltage depend on both current-

voltage converter circuit & inverting amplifier. Using
transcendental equation of fitting a non-linear equation of two
variables [15], a relationship between concentration of blood
glucose and final voltage output after inverting amplifier are
set up.
Fig. 3. Proposed Design Flow Chart.
B. Inverting amplifier V. Result & Performance of Proposed Meter
Simple but reliable op-amp inverting amplifier is used in
The proposed glucometer has two main advantages over
proposed design. The gain of this scheme depends on-
commercial glucometer. These two are cost and accuracy.
Av = - RF1/R1.
A. Cost
Where RF1= feedback resistance and R1= input resistance.
The cost of the proposed meter is only 400 BDT i.e. only
Since, unity gain configuration is selected, so the input will be
$5. The comparison price between commercially available
the just invert in output.
meters and the proposed meter is shown in Table II. In the
C. Microcontroller unit table, it is shown that, the proposed meter cost is only BDT
Atmega8A as microcontroller unit is introduced. The 400 i.e. USD 5 whereas the available commercial glucometer
Atmel AVR ATmega8 is a low-power CMOS 8-bit price is not less than BDT 1250. So, it is clearly shown that,
microcontroller based on the AVR RISC Architecture. It has the proposed meter price is almost three times lesser than any
internal ADC & oscillator. So cost is reduced. ATmega8 can commercial meter. The production cost is depicted in Table
operate in both 8 MHz & 16 MHz clock signal. Earlier III.
TABLE II . PRICE-LIST OF COMMERCIAL GLUCOMETERS.
mentioned that, the small current produced by the test strip
rapidly changes. So the use of 16 MHz clock signal provides Glucometer Name Price (BDT) Price (USD)
(Approximate)
much accurate result [13]. E-valve 1250 15.5
The coding of designed meter is developed in C. Data Caresense-2 1900 24
type float is used. It requires four bytes of memory to store Clever check 1700 21
Safe touch 1000 12.5
each result. Atmega8A has 512 bytes of EEPROM. Though
Glucose sure star 1500 19
the results are displayed in both units, but stored only the
Glucose sure plus 2500 31
result of mg/dL for future access. So 128 result of glucose
Sense card 1800 22.5
testing can be stored.
True result 1500 19
Alcose 1400 17.5
Bionim 1300 16
Analog PROPOSED 400 5
voltage METER
input
TABLE III . TOTAL COST OF GLUCOMETER
SL. Names Quantity Per Unit Price
No price ($) ($)
Display 1 Microcontroller 1 1 1
2 LCD Display 1 1.88 1.88
4 Op-amp 2 .1 .2
5 Resistors 6 .01 .06
7 Variable resistors 1 .06 .06
8 Switch 1 .05 .05
Fig. 4. Interconnection with microcontroller and display in AVR studio.
9 Packaging, labor & 1.75
Fig. 4 shows the interconnection with microcontroller and others
display AVR. The microcontroller unit accepts analog voltage
Total Cost 5
as input. This analog voltage is then converted into digital by
the internal ADC of Atmega8A. Atmega8A has internal ADC
B. Accuracy
of 10 bit. So, it can digitize any voltage between its applied
reference voltages one of from 1024 level. Zero(0) volt as Most of the available glucometer usages linear equation to
lower limit & 5 volt as upper limit are selected. This ADC relate amount of voltage/charge generated from EBGTS
value is then used to compute the blood glucose concentration. depending on the glucose concentration [1], [3], [6], [7], [8],
Then the result is displayed in monitor. [11], [17,]. The use of linear equation increases the average
deviation which is shown in Fig. 5. In Fig. 5, it is seen that
most of the points are not in line and hence it increase
deviations. In Fig. 6, the glucose voltage relationship using
transcendental equation is shown and here it is seen that, most
of the point are in line and the average deviation is much
lesser than the commercial meters.
 For example sensitivities are 0.341, 0.398, 0.436 and 0.541
mg/dL for ADC values of 100, 200, 300 and 800.

C. Performance
Some sample tests are done over 38 persons (31 Male, 7
Female) to measure the accuracy of proposed meter. The
blood sample of a person is tested by designed meter and it is
compared with a commercial Accucheck Glucometer along
with pathological tests. Because of huge data complexity and
place constraint Table V has shown the best 5 results of the
test. In the table, it is seen that, the proposed meter deviation
from the pathological data is much lesser than the commercial
meter. The deviation of proposed meter from the pathological
Fig. 5. Glucose-Voltage relationship using linear equation [2]. data is not greater than 10 in any case. In Table VI, the final
specifications of the proposed meter are shown.

TABLE V. COMPARISON OF RESULTS

Deviation From
SL. No Results (mg/dL) Pathological Data
Proposed Accucheck Pathology Proposed Accucheck
meter meter test meter meter
Person-1 106.699 101 112 5.3 11
Person-2 95.502 92 104 8.5 12
Person-3 131.994 117 126 5.9 9
Person-4 121.670 126 117 4.6 9
Person-5 115.462 103 109 6.5 6

Fig. 6. Glucose-Voltage Relationship Using Transcendental Equation.

TABLE V I. PROPOSED METER SPECIFICATIONS
Parameters Values
According to the Parke’s error grid analysis [18], Result Range 52 - 480 mg/dL or 3.0-26.7 mM/L
minimum average deviations of different meter system are Sample Size 0.5 microliters (0.5 ȝL)
shown in Table IV. Sample Type Fresh capillary whole blood from the
finger or forearm
TABLE IV . ERROR ANALYSIS OF DIFFERENT EXISTING METER. Test Time As little as 5 seconds
Meter system Average deviation Result Value Plasma calibrated
(mg/dL) Assay Method Electrochemical
TRUEresult 9 Power Supply DC 5V
OneTouch Ultra 12 Shut-off Automatic after 30 seconds.
System Operating Range Relative Humidity: 10 - 90% (non-
Ascensia CONTOUR 15.7 condensing)
Freestyle Freedom Lite 11.7 Temperature 50° - 104°F
PROPOSED METER 7
The average deviation of designed meter is less than 7 V. CONCLUSION
mg/dL. This improvement is achieved due to the use of In this paper, the main goal is to design and implement a
transcendental equation to relate voltage and glucose very low cost with greater accuracy blood glucose meter than
concentration. the conventional one. The hardware and software features of a
To measure blood glucose level & the variable microcontroller based system for the measurement of blood
“concentration” is defined as float, so that it can hold up to six glucose are described. The necessary software is developed in
digits after decimal point but here displayed only three digits C programming, using AVR studio. The system is quite
after decimal point. So round off error can be avoided. Here successful for the measurement of blood glucose with an
1024 is due to 10 bit ADC & 5 is due to reference voltage accuracy of around 93% which is far better than conventional
difference. So the resolution of proposed meter is 0.341 meters. The cost is extremely low compared with other
mg/dL(ADC=100). This meter would be able to sense a glucometer so that it can be beneficiary for the developing
change in input voltage as little as 5 mV due to 10 bit A/D countries like Bangladesh. If the proposed meter is marketed
converter. by any industry, millions of people in developing and
As transcendental equation is used to relate voltage & underdeveloped country will be benefitted.
glucose concentration, So the sensitivity at lower level of
blood glucose concentration would be more than higher level.
 REFERENCES [10] H. Hasan, K. Kosko, T. Klarr, “Smartphone Blood Glucose Meter,”
SCIBD homage. Available:
[1] N. A. Latha, B. R. Murthy, U. Sunitha , “ Design And Development Of http://www.scribd.com/doc/145835445/Glucometer-Wireless-Design.
A Microcontroller Based System For The Measurement Of Blood [11] C.T.S. Ching and P. Connolly, “Reverse Iontophoresis: A New
Glucose,” International Journal of Engineering Research and Approach to Measure Blood Glucose Level,” Asian Journal of Health
Applications (IJERA), Vol. 2, No. 5, pp.1440-1444, Sep. 2012. and Information Sciences, Vol. 1, No. 4, pp. 393-410, 2007.
[2] M. Bularzik, D. Price, M. Rivera; “Accessible Blood Glucose [12] C. M. Rimoldi, “Achieving Efficiency in Blood Glucose Meter
Monitor,” University of Connecticut, Connecticut, Biomedical Design,” EE Times Magazine, 2012.
Engineering Senior Design, 2006. [13] The Atmel Website. Available: http:/www.atmel.com/avr.
[3] R. Suarez and C. Casillas, “Implementing a Glucometer and Blood [14] R. A. Gayakward, Op amps & linear integrated circuits, Pearson
Pressure Monitor Medical Devices,” Freescale Semiconductor Education, 2007.
Application Note, 2009. [15] E. Balaguruswami, Numerical Methods, Tata McGraw Hill Publishing
[4] B. Feldman, “Electrochemical Blood Glucose Test Strips for People Company, 2008.
with Diabetis,” Diabetes Technol. Ther., 2003. [16] Tran, Joseph, Rosanna Tran, and John R. White, Jr. "Smartphone-based
[5] “Renesas V850 MCU Improves BGM design,” Renesas Electronics glucose monitors and applications in the management of diabetes: an
Application Note, 2011. overview of 10 salient 'apps' and a novel smartphone-connected blood
[6] M. Gupta and H. Aggarwal, “Design and Implementation of PSoC glucose monitor," Clinical Diabetes, Vol. 30, No. 4, 2012.
based Cap Sense for Medical Touch system saliva Vs Blood Glucose [17] B.H. Ginsberg, “Factors Affecting Blood Glucose Monitoring: Sources
Meter,” International Journal of Advanced Research in Computer of Errors in Measurement,” J Diabetes Sci Technol., 3(4): 903–913,
Science and Software Engineering, Vol. 3, No. 5, May 2013. July 2009.
[7] “Glucose Meter Application Note,” Hycon Technology, 2008. [18] “Accuracy Study of Blood Glucose Monitoring System,” Nipro
[8] J. Jirka, M. Prauzek, M. Stankus, “Glucose Measuring Device with diagnostics Homepage. Available: http://prestigesmartsystem.com/
Advanced Data Processing and Improved Strip Detection,” Elektronika [19] V.M. Castro, B.R. Kaanta, S.R. Sideleau, “ Design of a Personal Health
Ir Elektrotechnika, Vol. 19, No. 1, 2013. Monitor Interface for Wireless, IP-based, Data Logging,” University of
[9] R. Graham, “Self-Monitoring of Blood Glucose: Considerations for Limerick, 2006.
IntensiveDiabetes Management,” A CME/CPE/CNE/CCM–Certified
Supplement Tech. Rep., 2005.

View publication stats