Determination of a Measure of a Glycation End-Product or Disease State Using Tissue Fluorescence of Various Sites

Abstract

Embodiments of the present invention provide an apparatus suitable for determining properties of in vivo tissue. An illumination system communicates light at a plurality of broadband ranges to an optical probe, which can comprise a flexible probe. Light homogenizers and mode scramblers can be employed in some embodiments. The optical probe can physically contact the tissue, or can be maintained separate from the tissue. The optical probe receives light from the illumination system and transmits it to tissue, and receives light diffusely reflected in response to the broadband light, emitted from the in vivo tissue by fluorescence thereof in response to the broadband light, or a combination thereof. The optical probe can communicate the light to a spectrograph which produces a signal representative of the spectral properties of the light. An analysis system determines a property of the in vivo tissue from the spectral properties.

1 . An apparatus for the determination of the presence of diabetes, the presence of pre-diabetes, or a combination thereof, from spectral information collected from in vivo tissue of an individual, comprising:
 (a) an illumination system configured to provide light at a plurality of broadband ranges;   (b) an optical probe mounted with the illumination system such that the optical probe receives light from the illumination system, wherein the optical probe is configured to transmit at least a portion of said received light to in vivo tissue of the individual, and to receive light (i) diffusely reflected in response to the transmitted light, (ii) emitted from the in vivo tissue by fluorescence thereof in response to the transmitted light, or (iii) a combination thereof;   (c) a spectrograph, mounted in optical communication with the optical probe, configured to produce a signal representative of the spectral properties of the light received by the optical probe;   (d) an analysis system configured to determine the presence of diabetes, the presence of pre-diabetes, or a combination thereof from the signal from the spectrograph.   
     
     
         2 . An apparatus as in  claim 1 , further comprising a calibration device mounted such that it is can be configured in and out of optical communication with the optical probe. 
     
     
         3 . An apparatus as in  claim 1 , wherein the optical probe comprises a flexible probe configured to be placed in contact with the tissue. 
     
     
         4 . An apparatus as in  claim 3 , wherein the flexible probe comprises a bundle of input and output fiber optic cables that are arranged in a pattern at a surface of the probe that is placed in contact with the tissue. 
     
     
         5 . An apparatus as in  claim 1 , wherein the optical probe comprises a probe configured to communicate light with the tissue without physical contact with the tissue. 
     
     
         6 . An apparatus as in  claim 1 , further comprising an input system configured to accept biologic information concerning the individual, wherein the biologic information comprises one or more of: gender of the individual, height of the individual, weight of the individual, waist circumference of the individual, history of disease in the individual's family, ethnicity, skin melanin content, and smoking history of the individual; and wherein the analysis system is configured to determine the presence of diabetes, the presence of pre-diabetes, or a combination thereof from the signal from the spectrograph in combination with the biologic information. 
     
     
         7 . A method of determining the presence of diabetes, the presence of pre-diabetes, or a combination thereof, from spectral information collected from in vivo tissue of an individual, comprising:
 (a) providing an apparatus as in  claim 1 ;   (b) using the illumination system and optical probe to communicate light with the tissue;   (c) using the spectrograph to generate a signal representative of the spectral properties of the light received by the optical probe;   (d) using the analysis system to determine the presence of diabetes, the presence of pre-diabetes, or a combination thereof from the signal from the spectrograph.   
     
     
         8 . A method as in  claim 7 , wherein the tissue comprises the tissue on an extremity of the individual. 
     
     
         9 . A method as in  claim 8 , wherein the tissue comprises the tissue on a leg of the individual. 
     
     
         10 . A method as in  claim 9 , wherein the tissue comprises skin on the foot of the individual. 
     
     
         11 . A method as in  claim 9 , wherein the tissue comprises skin on the upper leg of the individual. 
     
     
         12 . A method as in  claim 9 , wherein the tissue comprises skin on the lower leg of the individual. 
     
     
         13 . A method as in  claim 8 , wherein the tissue comprises the tissue on an arm of the individual. 
     
     
         14 . A method as in  claim 13 , wherein the tissue comprises skin on the hand of the individual. 
     
     
         15 . A method as in  claim 13 , wherein the tissue comprises skin on the upper arm of the individual. 
     
     
         16 . A method as in  claim 7 , wherein the tissue comprises the tissue on the torso of the individual. 
     
     
         17 . A method as in  claim 16 , wherein the tissue comprises skin on the neck of the individual. 
     
     
         18 . A method as in  claim 16 , wherein the tissue comprises skin on the buttocks of the individual. 
     
     
         19 . A method as in  claim 7 , wherein the tissue comprises the tissue on the head of the individual. 
     
     
         20 . A method as in  claim 19 , wherein the tissue comprises the sclera of the eye of the individual. 
     
     
         21 . A method as in  claim 19 , wherein the tissue comprises the oral mucosa of the individual. 
     
     
         22 . A method as in  claim 19 , wherein the tissue comprises the earlobe of the individual. 
     
     
         23 . A method as in  claim 19 , wherein the tissue comprises skin on the cheek of the individual. 
     
     
         24 . A method as in  claim 19 , wherein the tissue comprises skin on the forehead of the individual.