Patent Publication Number: US-2005137469-A1

Title: Single detector infrared ATR glucose measurement system

Description:
FIELD OF THE INVENTION  
      This invention involves a non-invasive glucose measurement device and a process for determining blood glucose level in the human body using the device. In typical operation, the glucose measurement device is self-normalizing in that it does not employ an independent reference sample in its operation. The inventive device uses attenuated total reflection (ATR) infrared spectroscopy. Preferably, the device is used on a fingertip or other part of the body. Although the inventive procedure preferably compares two specific regions of a measured mid-infrared spectrum to determine the blood glucose level of the user. Clearly, this device is especially suitable for monitoring glucose levels in the human body, and is especially beneficial to users having diabetes mellitus. The device and procedure may be used for other materials which exhibit unique mid-IR signatures of the type described below and that are found in appropriate regions of the outer skin. A cleaning kit and related procedure for preparation of the skin surface is also included.  
     BACKGROUND OF THE INVENTION  
      The American Diabetes Association reports that nearly 6% of the population in the United States, a group of 16 million people, has diabetes. The Association further reports that diabetes is the seventh leading cause of death in the United States, contributing to nearly 200,000 deaths per year. Diabetes is a chronic disease having no cure. The complications of the disease include blindness, kidney disease, nerve disease, and heart disease, perhaps with stroke. Diabetes is said to be the leading cause of new cases of blindness in individuals in the range of ages between 20 and 74; from 12,000-24,000 people per year lose their sight because of diabetes. Diabetes is the leading cause of end-stage renal disease, accounting for nearly 40% of new cases. Nearly 60-70% of people with diabetes have mild to severe forms of diabetic nerve damage which, in severe forms, can lead to lower limb amputations. People with diabetes are 2-4 times more likely to have heart disease and to suffer strokes.  
      Diabetes is a disease in which the body does not produce or properly use insulin, a hormone needed to convert sugar, starches, and the like into energy. Although the cause of diabetes is not completely understood, genetics, environmental factors, and viral causes have been partially identified.  
      There are two major types of diabetes: Type I and Type II. Type I diabetes (formerly known as juvenile diabetes) is an autoimmune disease in which the body does not produce any insulin and most often occurs in young adults and children. People with Type I diabetes must take daily insulin injections to stay alive.  
      Type II diabetes is a metabolic disorder resulting from the body&#39;s inability to make enough, or properly to use, insulin. Type II diabetes accounts for 90-95% of diabetes. In the United States, Type II diabetes is nearing epidemic proportions, principally due to an increased number of older Americans and a greater prevalence of obesity and a sedentary lifestyle.  
      Insulin, in simple terms, is the hormone that unlocks the cells of the body, allowing glucose to enter those cells and feed them. Since, in diabetics, glucose cannot enter the cells, the glucose builds up in the blood and the body&#39;s cells literally starve to death.  
      Diabetics having Type I diabetes typically are required to self-administer insulin using, e.g., a syringe or a pin with needle and cartridge. Continuous subcutaneous insulin infusion via implanted pumps is also available. Insulin itself is typically obtained from pork pancreas or is made chemically identical to human insulin by recombinant DNA technology or by chemical modification of pork insulin. Although there are a variety of different insulins for rapid-, short-, intermediate-, and long-acting forms that may be used variously, separately or mixed in the same syringe, use of insulin for treatment of diabetes is not to be ignored.  
      It is highly recommended by the medical profession that insulin-using patients practice self-monitoring of blood glucose (SMBG). Based upon the level of glucose in the blood, individuals may make insulin dosage adjustments before injection. Adjustments are necessary since blood glucose levels vary day to day for a variety of reasons, e.g., exercise, stress, rates of food absorption, types of food, hormonal changes (pregnancy, puberty, etc.) and the like. Despite the importance of SMBG, several studies have found that the proportion of individuals who self-monitor at least once a day significantly declines with age. This decrease is likely due simply to the fact that the typical, most widely used, method of SMBG involves obtaining blood from a finger stick. Many patients consider obtaining blood to be significantly more painful than the self-administration of insulin.  
      There is a desire for a less invasive method of glucose measurement. Methods exist or are being developed for a minimally invasive glucose monitoring, which use body fluids other than blood (e.g., sweat or saliva), subcutaneous tissue, or blood measured less invasively. Sweat and saliva are relatively easy to obtain, but their glucose concentration appears to lag in time significantly behind that of blood glucose. Measures to increase sweating have been developed and seem to increase the timeliness of the sweat glucose measurement, however.  
      Subcutaneous glucose measurements seem to lag only a few minutes behind directly measured blood glucose and may actually be a better measurement of the critical values of glucose concentrations in the brain, muscle, and in other tissue. Glucose may be measured by non-invasive or minimally-invasive techniques, such as those making the skin or mucous membranes permeable to glucose or those placing a reporter molecule in the subcutaneous tissue. Needle-type sensors have been improved in accuracy, size, and stability and may be placed in the subcutaneous tissue or peripheral veins to monitor blood glucose with small instruments. See, “An Overview of Minimally Invasive Technologies”, Clin. Chem. 1992 September; 38(9):1596-1600.  
      Truly simple, non-invasive methods of measuring glucose are not commercially available.  
      U.S. Pat. No. 4,169,676 to Kaiser, shows a method for the use of ATR glucose measurement by placing the ATR plate directly against the skin and especially against the tongue. The procedure and device shown there uses a laser and determines the content of glucose in a specific living tissue sample by comparing the IR absorption of the measured material against the absorption of IR in a control solution by use of a reference prism. See, column  5 , lines  31  et seq.  
      Swiss Patent No. 612,271, to Dr. Nils Kaiser, appears to be the Swiss patent corresponding to U.S. Pat. No. 4,169,676.  
      U.S. Pat. No. 4,655,255, to Dähne et al., describes an apparatus for non-invasively measuring the level of glucose in a blood stream or tissues of patients suspected to have diabetes. The method is photometric and uses light in the near-infrared region. Specifically, the procedure uses light in the 1,000 to 2,500 nm range. Dähne&#39;s device is jointly made up to two main sections, a light source and a detector section. They may be situated about a body part such as a finger. The desired near-infrared light is achieved by use of filters. The detector section is made up of a light-collecting integrating sphere or half-sphere leading to a means for detecting wavelengths in the near-infrared region. Dähne et al. goes to some lengths teaching away from the use of light in the infrared range having a wavelength greater than about 2.5 micrometers since those wavelengths are strongly absorbed by water and have very little penetration capability into living tissues containing glucose. That light is said not to be “readily useable to analyze body tissue volumes at depths exceeding a few microns or tens of microns.” Further, Dähne et al. specifically indicates that an ATR method which tries to circumvent the adverse consequences of the heat effect by using a total internal reflection technique is able only to investigate to tissue depths not exceeding about 10 micrometers, a depth which is considered by Dähne et al. to be “insufficient to obtain reliable glucose determination information.” 
      U.S. Pat. No. 5,028,787, to Rosenthal et al., describes a non-invasive glucose monitoring device using near-infrared light. The light is passed into the body in such a way that it passes through some blood-containing region. The so-transmitted or reflected light is then detected using an optical detector. The near-infrared light sources are preferably infrared emitting diodes (IRED). U.S. Pat. No. 5,086,229 is a continuation in part of U.S. Pat. No. 5,028,787.  
      U.S. Pat. No. 5,178,142, to Harjunmaa et al, teaches the use of a stabilized near-infrared radiation beam containing two alternating wavelengths in a device to determine a concentration of glucose or other constituents in a human or animal body. Interestingly, one of the transmitted IR signals is zeroed by variously tuning one of the wavelengths, changing the extracellular to intracellular fluid ratio of the tissue by varying the mechanical pressure on a tissue. Or, the ratio may be allowed to change as a result of natural pulsation, e.g., by heart rate. The alternating component of the transmitted beam is measured in the “change to fluid ratio” state. The amplitude of the varying alternating signal is detected and is said to represent glucose concentration or is taken to represent the difference in glucose concentration from a preset reference concentration.  
      U.S. Pat. No. 5,179,951 and its divisional, U.S. Pat. No. 5,115,133, to Knudson, show the application of infrared light for measuring the level of blood glucose in blood vessels in the tympanic membrane. The detected signal is detected, amplified, decoded, and, using a microprocessor, provided to a display device. The infrared detector (No. 30 in the drawings) is said simply to be a “photo diode and distance signal detector” which preferably includes “means for detecting the temperature of the volume in the ear between the detector and the ear&#39;s tympanic membrane.” Little else is said about the constituency of that detector.  
      U.S. Pat. No. 5,433,197, to Stark, describes a non-invasive glucose sensor. The sensor operates in the following fashion. A near-infrared radiation is passed into the eye through the cornea and the aqueous humor, reflected from the iris or the lens surface, and then passed out through the aqueous humor and cornea. The reflected radiation is collected and detected by a near-infrared sensor which measures the reflected energy in one or more specific wavelength bands. Comparison of the reflected energy with the source energy is said to provide a measure of the spectral absorption by the eye components. In particular, it is said that the level of glucose in the aqueous humor is a function of the level of glucose in the blood. It is said in Stark that the measured glucose concentration in the aqueous humor tracks that of the blood by a fairly short time, e.g., about 10 minutes. The detector used is preferably a photodiode detector of silicon or InGaAs. The infrared source is said preferably to be an LED, with a refraction grating so that the light of a narrow wavelength band, typically 10 to 20 nanometers wide, passes through the exit slit. The light is in the near-infrared range. The use of infrared regions below 1400 nanometers and in the region between 1550 and 1750 nanometers is suggested.  
      U.S. Pat. No. 5,267,152, to Yang et al., shows a non-invasive method and device for measuring glucose concentration. The method and apparatus uses near-infrared radiation, specifically with a wavelength of 1.3 micrometers to 1.8 micrometers from a semiconductor diode laser. The procedure is said to be that the light is then transmitted down through the skin to the blood vessel where light interacts with various components of the blood and is then diffusively reflected by the blood back through the skin for measurement.  
      Similarly, U.S. Pat. No. 5,313,941, to Braig et al., suggests a procedure and apparatus for monitoring glucose or ethanol and other blood constituents in a non-invasive fashion. The measurements are made by monitoring absorption of certain constituents in the longer infrared wavelength region. The long wavelength infrared energy is passed through the finger or other vascularized appendage. The infrared light passing through the finger is measured. The infrared source is pulsed to prevent burning or other patient discomfort. The bursts are also synchronized with the heartbeat so that only two pulses of infrared light are sent through the finger per heartbeat. The detected signals are then analyzed for glucose and other blood constituent information.  
      U.S. Pat. No. 5,398,681, to Kuperschmidt, shows a device which is said to be a pocket-type apparatus for measurement of blood glucose using a polarized-modulated laser beam. The laser light is introduced into a finger or ear lobe and the phase difference between a reference signal and the measurement signal is measured and processed to formulate and calculate a blood glucose concentration which is then displayed.  
      U.S. Pat. No. 6,001,067 shows an implantable device suitable for glucose monitoring. It utilizes a membrane which is in contact with a thin electrolyte phase, which in turn is covered by an enzyme-containing membrane, e.g., glucose oxidase in a polymer system. Sensors are positioned in such a way that they measure the electro-chemical reaction of the glucose within the membranes. That information is then passed to the desired source.  
      None of the cited prior art suggests the device and method of using this device described and claimed below.  
     BRIEF SUMMARY OF THE INVENTION  
      This invention is a glucose level measurement device utilizing IR-ATR spectroscopy and a method of using the device. The inventive device itself is preferably comprised of an IR source for emitting an IR beam into an ATR plate, the ATR plate against which the sampled human skin surface is pressed, and at least one IR sensor or detector for measuring absorbance of two specific regions of the IR spectrum, i.e., a “referencing wavelength” and a “measuring wavelength.” The IR source must emit IR radiation at least in the region of the referencing wavelength and the measuring wavelength. For glucose, the referencing wavelength is between about 8.25 micrometers and about 8.75 micrometers and the measuring wavelength is between about 9.50 micrometers and about 10.00 micrometers. The IR sources may be broadband IR sources, non-laser sources, or two or more selected wavelength lasers.  
      Other analyte materials which have both referencing wavelengths and measuring wavelengths as are described in more detail below and that preferably are found in the outer regions of the skin may be measured using the inventive devices and procedures described herein.  
      The ATR plate is configured to permit multiple internal reflections, perhaps 3-15 internal reflections or more, against the measurement surface prior to measurement by the IR sensors. Once the reflected IR beam is emitted from the ATR plate, it is filtered and then measured by the single IR sensor or detector, the resulting signals are then transformed using analog comparators or digital computers into readable or displayable values. The device also preferably has some accommodation for holding the body part against the ATR plate, for instance, at some value which is constant and above a selected minimum pressure.  
      The method for determining the blood glucose level, using the glucose measurement device, preferably comprises contacting a selected skin surface with the ATR plate, irradiating that human skin surface with an IR beam having components at least in the region of the referencing wavelength and the measuring wavelength, and detecting and quantifying those referencing and said measuring wavelength components in that reflected IR beam. The procedure ideally includes the further steps of maintaining the skin surface on said ATR plate at an adequate pressure which is both constant and above a selected minimum pressure and, desirably cleaning the skin surface before measurement. A step of actually measuring the pressure may also be included. A normalizing step practiced by detecting and quantifying the referencing and measuring wavelength components prior to contacting the skin surface is also desirable. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       FIGS. 1A, 1B ,  1 C, and  1 D show a side view of various ATR plates and their general operation.  
       FIG. 2  shows an IR spectrum of d-glucose.  
       FIG. 3A  shows a schematic layout of one variation of the optics of the inventive device.  
       FIG. 3B  shows a front view of a variation of an oscillating dual filter.  
       FIG. 4A  shows a schematic layout of another variation of the optics of the inventive device.  
       FIG. 4B  shows a front view of a variation of a rotating filter wheel.  
       FIG. 5  shows a graph with pulses of light which may be detected using, for example, an oscillating optical filter.  
       FIGS. 6A and 6B  show an example of pulses of light of multiple distinct wavelengths transmitted through, for example, a filter wheel.  
       FIG. 7  shows a packaged variation of the inventive glucose measuring device.  
       FIG. 8  shows a graph of pressure on the ATR crystal vs. IR value. 
    
    
     DETAILED DESCRIPTION OF THE INVENTION  
      The device in this invention uses infrared (“IR”) attenuated total reflectance (“ATR”) spectroscopy to detect and ultimately to determine the level of a selected analyte, preferably blood glucose, in the human body. Preferably, the inventive device uses an ATR procedure in which the size and configuration of the crystal permits a number of internal reflections before the beam is allowed to exit the crystal with its measured information. In general, as shown in  FIGS. 1A and 1B , when an infrared beam  102  is incident on the upper surface of the ATR crystal  104 —or ATR plate—at an angle which exceeds a critical angle θc, the beam  102  will be completely totally reflected within crystal  104 . Each reflection of the beam within the ATR plate, and specifically against the upper surface  114 , provides a bit more information about the composition of the sample  112  resting against that upper surface  114 . The more numerous the reflections, and the greater the penetration depth of the reflection, the higher is the quality of the information. The incident beam  102  becomes reflected beam  106  as it exits crystal  104  as shown in  FIG. 1A . Higher refractive index materials are typically chosen for the ATR crystal to minimize the critical angle. The critical angle is a function of the refractive indices of both the sample and the ATR crystal and is defined as:  
         Θ   c     =       sin     -   1       ⁡     (       n   2       n   1       )           
 
      Here, n 1  is the refractive index of the ATR crystal and n 2  is the refractive index of the sample.  
      Throughout this specification, we refer to wavelength measures as specific values. It should be understood that we intend those values to be bands or ranges of values, typically with a tolerance of, e.g., +/−0.20 micron, preferably +/−0.10 micron. For instance, a value of 8.25 microns would mean a band of 8.15 to 8.35 microns, and perhaps 8.05 to 8.45 microns depending upon the context.  
      As shown in  FIG. 1B , the internally reflected beam  108  includes an evanescent wave  110  which penetrates a short distance into sample  112  over a wide wavelength range. In those regions of the IR spectrum in which the sample absorbs IR, some portion of the light does not return to the sensor. It is these regions of IR absorbance which provide information, in this inventive device, for quantification of the glucose level.  
      We have found that the mid-IR spectrum does not penetrate into the skin to an appreciable level. Specifically, the skin is made up of a number of layers: the outermost—the stratum corneum—is a layer substantially free of cholesterol, water, gamma globulin, albumin, and blood. It is a shallow outer region covering the stratum granulosum, the stratum spinosum, and the basal layer. The area between the basal layer to the outside is not vascularized. It is unlikely that any layer other than the stratum corneum is traversed by the mid-IR light involved in this inventive device. Although we do not wish to be bound by theory, it is likely that the eccrine or sweat glands transport the glucose to the outer skin layers for measurement and analysis by our inventions.  
      We prefer the use of higher refractive index crystals such as zinc selenide, zinc sulfide, diamond, germanium, and silicon as the ATR plate. The index of refraction of the ATR plate  104  should be significantly higher than that of the sample  112 .  
      Further, the ATR crystal  104  shown in  FIG. 1A  is shown to be trapezoidal and having an upper surface  114  for contact with the sample, which sample, in this case, is skin from a living human body. However, this shape is only for the purposes of mechanical convenience and ease of application into a working commercial device. Other shapes, in particular, a parallelogram  111  such as shown in  FIG. 1C  and the reflective crystal  113  shown in  FIG. 1D  having mirrored end  115 , are also quite suitable for this inventive device should the designer so require. The mirrored reflective crystal  113  has the advantage of having both an IR source and the IR sensors at the same end of the crystal.  
      It is generally essential that the ATR crystal or plate  104  have a sample or upper surface  114  which is essentially parallel to the lower surface  116 . In general, the ATR plate  104  is preferably configured and utilized so that the product of the practical number of internal reflections of internal reflected beam  108  and the skin penetration per reflection of this product is maximized. When maximizing this product, called the effective pathlength (EPL), the information level in beam  106  as it leaves ATR plate  104  is significantly higher. Further, the higher the value of the index of refraction, n 2 , of the ATR plate  104 , the higher is the number of internal reflections. The sensitivity of the IR sensors also need not be as high when the EPL is maximized. We consider the number of total reflections within the crystal to be preferably from 3-15 or more for adequate results.  
      We have surprisingly found that a glucose measuring device made according to this invention is quite effective on the human skin of the hands and fingers. We have found that the glucose concentration as measured by the inventive devices correlates very closely with the glucose concentration determined by a direct determination from a blood sample. As will be discussed below, the glucose level as measured by the inventive device also is surprisingly found closely to track the glucose level of blood in time as well. This is surprising in that the IR beam likely passes into the skin, i.e., the stratum corneum, for only a few microns. It is unlikely in a fingertip that any blood is crossed by that light path. As discussed above, the stratum corneum is the outer layer of skin and is substantially unvascularized. The stratum corneum is the final outer product of epidermal differentiation or keratinization. It is made up of a number of closely packed layers of flattened polyhedral corneocytes (also known as squames). These cells overlap and interlock with neighboring cells by ridges and grooves. In the thin skin of the human body, this layer may be only a few cells deep, but in thicker skin, such as may be found on the toes and feet, it may be more than 50 cells deep. The plasma membrane of the corneocyte appears thickened compared with that of keratinocytes in the lower layers of the skin, but this apparent deposition of a dense marginal band formed by stabilization of a soluble precursor, involucrin, just below the stratum corneum.  
      Additionally, the inventive device can be highly simplified compared to other known devices in that the device can be “self-normalizing” due to the specifics of the IR signature of glucose.  FIG. 2  shows the IR absorbance spectra of d-glucose. The family of curves there shows that in certain regions of the IR spectrum, there is a correlation between absorbance and the concentration of glucose. Further, there is a region in which the absorbance is not at all dependent upon the concentration of glucose. Our device, in its preferable method of use, uses these two regions of the IR spectra. These regions are in the so-called mid-IR range, i.e., wavelengths between 2.5 and 14 micrometers. In particular, the “referencing wavelength” point is just above 8 micrometers  150 , e.g., 8.25 to 8.75 micrometers, and the pronounced peaks  152  at the region between about 9.50 and 10.00 micrometers is used as a “measuring wavelength”. The family of peaks  152  may be used to determine the desired glucose concentration.  
      Use of the two noted IR regions is also particularly suitable since other components typically found in the skin, e.g., water, cholesterol, etc., do not cause significant measurement error when using the method described herein.  
       FIG. 3A  shows an optical schematic of one variation of the inventive device. ATR crystal  104  with sample side  114  is shown and IR source  160  is provided. IR source  160  may be any of a variety of different kinds of sources. It may be a broadband IR source, one having radiant temperatures of 300° C. to 800° C., or a pair of IR lasers selected for the two regions of measurement discussed above, or other suitably emitted or filtered IR light sources. A single laser may not be a preferred light source in that a laser is a single wavelength source and the preferred operation of this device requires light sources simultaneously emitting two IR wavelengths. Lens  162 , for focusing light from IR source  160  into ATR plate  104 , is also shown. It may be desirable to include an optional additional mirror  163  to intercept a portion of the beam before it enters the ATR plate  104  and then to measure the strength of that beam in IR sensor  165 . Measurement of that incident light strength (during normalization and during the sample measurement) assures that any changes in that value can be compensated for.  
      The light then passes into ATR plate  104  for contact with body part  164 , shown in this instance to be the desired finger. The reflected beam  106  exits ATR plate  104  and then passes through lens  166 , which may be a collimating lens. Reflected beam  106  may then pass through optical filter  168 , which in this variation is configured as a dual optical filter connected via support arm  176  to, e.g., a piezo-electric crystal transducer  178 . Piezo-electric transducer  178  may in turn be connected to an oscillator  180  which causes the optical filter  168  to oscillate back and forth across the path of reflected beam  106 . The transducer  178  may be vibrated over a range of different frequencies, e.g., 100 Hz or higher, depending, for example, upon the desired sampling rate.  
      Generally, optical filter  168  may have several different sections separated by opaque regions. The dual optical filter  168  variation may comprise a first filter  220  configured to pass wavelengths in the region of the referencing wavelength and a second filter  222  configured to pass wavelengths in the region of the measuring wavelength, as shown in  FIG. 3B . Opaque section  224  may be interposed between the two filters  220 ,  222 . As filter  168  is oscillated back and forth in the indicated direction  226 , reflected beam  106  becomes pulsed as light having alternating wavelengths in the referencing wavelength region and the measuring wavelength region as it is passed through lens  170 , which may direct the light through an optional filter  172  and into a single sensor or detector  174 . An example of an oscillating filter may be seen in further detail in U.S. Pat. No. 3,694,086 (May), which is incorporated herein by reference in its entirety.  
      Turning back to  FIG. 3A , the reflected light detected by detector  174  may be electrically communicated to processor  182 , e.g., a computer. Processor  182  may also be in electrical communication with oscillator  180  and control the frequency of oscillation for filter  168 . Processor  182  may also contain an optional integrated lock-in amplifier for processing the signals received by detector  174 , in which case a driver or modulator  188  may be in electrical communication with IR source  160  for generating a reference signal to optionally modulate the IR optical beam. The optical signal may be modulated in a variety of patterns, e.g., sinusoidal, saw tooth, square wave, etc., so long as the signal is continuously and periodically modulated. Modulator  188  may be electrically connected to the optional lock-in amplifier within processor  182 . Having detector  174  in electrical communication with the lock-in amplifier may ensure that the reflected beam  106  and the signals detected by detector  174  are in a fixed phase relationship with the emitted beam due to the referenced signal provided by modulator  188 . An example of the use of lock-in amplifiers is discussed in greater detail in U.S. patent application Ser. No. 10/434,963 filed May 9, 2003, which is incorporated herein by reference in its entirety.  
      The processor  182  may be used to determine the measured glucose or analyte levels and display  186  may then be used to display the information in various forms, e.g., numerically, graphically, etc. An additional memory storage unit  184  may be used to store a history of measured data to enable the processing or viewing of data at a later time. Memory  184  may also enable a user to access the stored history of measurements at any point in time for display on either the display unit  186  or allow for the downloading of the data onto another medium.  
      Another variation of the device is shown in  FIG. 4A  which similarly utilizes a single detector  174 . Rather than the use of an oscillating optical filter  168 , a rotating chopper or filter wheel  190  may be used. Wheel filter  190  may be configured to rotate about a rotational pivot  192  and may also include an optical pickup  194  used to track a rotational position of filter wheel  190 . Optical pickup  194  may utilize a light source, e.g., one or several LEDs, along with a phototransistor for detecting the reflected light emitted by the LED. Optical pickup  194  may be in electrical communication with processor  182 , which may be used to keep track of the rotational position of the filters mounted on filter wheel  190  as well as to control a motor or actuator (not shown) for rotating wheel filter  190 .  FIG. 4B  shows an example of a front view of filter wheel  190 . A number of filters, as necessary or desired, may be positioned about rotational pivot  192  separated by opaque regions, as shown. These filters may each be configured to pass specific wavelengths in various combinations. For instance, first, second, third, and fourth filter  230 ,  232 ,  234 ,  236 , respectively, may each be configured to pass the same wavelength. Alternatively, first and third filter  230 ,  234  may be configured to pass a first wavelength, e.g., wavelengths in the region of the referencing wavelength, and second and fourth filter  232 ,  236  may be configured to pass a second wavelength, e.g., wavelengths in the region of the measuring wavelength. Although four filters are shown in this variation, any number of filters may be utilized as practicable. The reflected beam  106  may be passed through alternating filters as wheel filter  190  is rotated in either direction, as indicated by arrow  238 . Accordingly, the filtered light received by detector  174  will be received as a pulsed signal of alternating wavelengths. An example of a rotating wheel filter may be seen in U.S. Pat. No. 3,877,812 (Thompson), which is incorporated herein by reference in its entirety.  
       FIG. 5  is one example of a graph  240  showing pulses of light detected by single detector  174  over a period of time using, e.g., a dual-filter configuration such as oscillating optical filter  168 . As the filter  168  oscillates between the first filter  220  and the second filter  222 , the corresponding pulses will be detected sequentially over time. For instance, first detected pulse  242  may correspond to the wavelength of light, e.g., in the region of the referencing wavelength, passed through first filter  220  and second detected pulse  244  may correspond to the wavelength of light, e.g., in the region of the measuring wavelength, passed through second filter  222 . As the optical filter  168  oscillates, the detected pulses  242 ,  244  will alternate in pulses separated by the opaque region.  
       FIG. 6A  shows an example of another graph  250  in which light pulses may be detected for multiple wavelengths over a period of time using, e.g., a rotating chopper or filter wheel  190 . In this variation, pulses of multiple wavelengths  252 ,  254 ,  256 ,  258  may be detected depending upon the number of filters utilized in the filter wheel  190 . The filters may be configured to pass varying intensities of the light as it passes therethrough, as indicated by the varying detected intensities. Both  FIGS. 5 and 6 A show pulses having alternating intensities; the intensity of the detected light pulse may depend upon the type of filter used and the wavelength(s) of light to be filtered.  
      Alternatively, as the graph  260  in  FIG. 6B  shows, the filter wheel  190  (or dual-filter  168 ) may have its filters configured such that the alternating detected light pulses  262 ,  264  may have an equal intensity as they pass through to the detector  174 .  
       FIG. 7  shows perhaps a variation of this device  200  showing the finger of the user  202  over the ATR plate  204  with a display  206 . Further shown in this variation  200  is a pressure maintaining component  208 . We have found that may be desirable to maintain a minimum threshold pressure on the body part which is to be used as the area to be measured. Generally, a variation in the pressure does not shift the position of the detected IR spectra, but it may affect the sensitivity of the overall device. Although it is possible to teach the user to press hard enough on the device to reach the minimum threshold pressure, we have determined for each design of the device it is much more appropriate that the design of a particular variation of the inventive device be designed with a specific sample pressure in mind. The appropriate pressure will vary with, e.g., the size of the ATR plate and the like. A constant pressure above that minimum threshold value is most desired.  
      The variation shown in  FIG. 7  uses a simple component arm  208  to maintain pressure of the finger  202  on ATR plate  204 . Other variations within the scope of this invention may include clamps and the like. It should be apparent that once an appropriate pressure is determined for a specific design, the inventive device may include a pressure sensor, e.g.,  210  as is shown in  FIG. 7 , to measure adherence to that minimum pressure. Pressure sensor  210  may alternatively be placed beneath ATR plate  204 . It is envisioned that normally a pressure sensor such as  210  would provide an output signal which would provide a “no-go/go” type of signal to the user.  
      Further, as shown in  FIG. 8 , the appropriate pressure may be achieved when using our device simply by increasing the pressure of the body part on the ATR crystal surface until a selected, measured IR value becomes constant.  
      In general, the inventive device described above is used in the following manner: a skin surface on a human being, for instance, the skin of the finger, is placed on the ATR plate. The skin surface is radiated with an IR beam having components at least in the two IR regions we describe above as the “referencing wavelength” and the “measuring wavelength.” The beam which ultimately is reflected out of the ATR plate then contains information indicative of the blood glucose level in the user. As noted above, it is also desirable to maintain that skin surface on the ATR plate at a relatively constant pressure that is typically above a selected minimum pressure. This may be done manually or by measuring and maintaining the pressure or monitoring the constancy of a selected IR value.  
      The reflected beam may be passed through one or several alternating filters, as described above, and then focused onto the single IR detector. This is to say that, for instance, the IR detector may detect light only in the region of the referencing wavelength at time, t=1, and then detect light only in the region of the measuring wavelength at time, t=1+Δt, and so on. As noted above, for glucose, the referencing wavelength is typically in the range of about 8.25 to 8.75 micrometers. For glucose, the measuring wavelength is typically between about 9.5 and 10.0 micrometers. Variations on the device which utilize at least two IR detectors for simultaneously measuring wavelengths in the referencing wavelength and the measuring wavelength may be seen in U.S. Pat. No. 6,424,851, which is incorporated herein by reference in its entirety.  
      Other analyte materials which have both referencing wavelengths and measuring wavelengths in the mid-IR range and that are found in the outer regions of the skin may also be measured using the inventive devices and procedures described herein. Respective signals may be compared using analog or digital computer devices. The signals are then used to calculate analyte values such as blood glucose concentration using various stored calibration values, typically those which are discussed below. The resulting calculated values may then be displayed.  
      As noted above, it is also desirable both to clean the plate before use and to clean the exterior surface of the skin to be sampled. Reproducible and accurate glucose measurements may then be had in a period as short as ten minutes after cleaning the area of the skin to be measured. We also note that, depending upon the design of a specific variation of a device made according to the invention, periodic at least an initial calibration of the device, using typical blood sample glucose determinations, may be necessary or desirable.  
      Determination of blood glucose level from the information provided in the IR spectra is straightforward. A baseline is first determined by measuring the level of infrared absorbance at the measuring and referencing wavelengths, without a sample being present on the sample plate. The skin is then placed in contact with the ATR plate and the two specified absorbance values are again measured. Using these four values, the following calculation is then made.  
                     A   1     =       ⁢     ln   ⁡     (       T   01       T   1       )                   =       ⁢       A   g1     +     A   b1                     (     Absorbance   ⁢           ⁢   at   ⁢           ⁢   referencing   ⁢           ⁢   spectral   ⁢           ⁢     band   .       )                       A   2     =       ⁢     ln   ⁡     (       T   02       T   2       )                   =       ⁢       A   g2     +     A   b2                     (     Absorbance   ⁢           ⁢   at   ⁢           ⁢   measuring   ⁢           ⁢   spectral   ⁢           ⁢     band   .       )             
 
 where: 
      T 01 =measured value at reference spectral band without sample     T 02 =measured value at measuring spectral band without sample     T 1 =measured value at reference spectral band with sample     T 2 =measured value at measuring spectral band with sample     A g1 =absorbance of glucose at reference spectral band     A g2 =absorbance of glucose at measuring spectral band     A b1 =absorbance of background at reference spectral band     A b2 =absorbance of background at measuring spectral band     d=effective path length through the sample.     a 2 =specific absorptivity at measuring spectral band     k=calibration constant for the device     C g =measured concentration of glucose    

      Since the background base values are approximately equal (i.e., A b1 =A b2 ) and A g1 =0, then: 
 
 A   2   −A   1   =A   g2   =a   2   dC   g  
          and 
 
 C   g   =k ( A   2   −A   1 ) 
       

      The value of C g  is the desired result of this procedure.  
      This invention has been described and specific examples of the invention have been portrayed. The use of those specifics is not intended to limit the invention in any way. Additionally, to the extent there are variations of the invention with are within the spirit of the disclosure and yet are equivalent to the inventions found in the claims, it is our intent that this patent will cover those variations as well.