The CBmeter: designing innovative strategies for early diagnosis of metabolic diseases

Diabetes is a disease with high prevalence worldwide, however, about 44% of patients are asymptomatic, which leads to a later diagnosis of the disease and, consequently, increases the risk of developing complications. The development of new approaches for early diagnosis is imperative to allow proper adoption of preventive measures. From a motivational point of view, it is easier for patients to adopt healthy eating habits and lifestyles when there is an altered marker that indicates subclinical disease, particularly in a pathology that remains asymptomatic until advanced stages. Thus, timely diagnosis based on a measurable and monitorable indicator is extremely important so that such behaviors are implemented as early as possible, increasing effective health gains and reducing the costs related to this pathology. Pre-clinical studies in animal models have shown that the etiology of type 2 diabetes mellitus (T2DM) is related to alterations in the carotid bodies (CB), chemosensory organs located in the bifurcation of the carotid arteries. In animals with T2DM it has been observed that the CBs are overactivated causing an increased heart rate, respiratory rate, and blood glucose levels. In humans, this mechanism has been confirmed but is not yet well-characterized. This paper highlights the importance of developing a device that allows early detection of changes in CB activity correlating it with emerging diabetes. The design strategies to prototype the CBmeter were to model and characterize the features of interest for the diagnosis- respiratory rate, heart rate, peripheral oxygen saturation and glucose - in healthy people and people with diabetes using a combination of set commercial sensors pre-existent in the market that were integrated to collect real-time data. After determining health and disease patterns, the CBmeter development pipeline includes a co-design approach in which physiologists, endocrinologists, nurses, computer and electrical engineers, designers and patients are collaborating to develop an easy-to-use, portable, and minimally invasive medical device that associates CB function with endocrine dysregulation, with very small discomfort and risk for users. The definition and specification of the most appropriate architecture for the CBmeter, in order to allow its modularity, signal acquisition and consequently the communication between the sensor/device and the receiver/backend in the most efficient way is being allied to the selection of materials, tools and steps to create an innovative product, that will fill a technical gap in the market, designed for the early diagnosis of metabolic diseases, in a subclinical phase, with the potential to contribute with significant gains for public health in the medium/long term.