An IoT-Based Glucose Monitoring Algorithm to Prevent Diabetes Complications

Round 1

Reviewer 1 Report

The paper applsci-669133 reports the development of an algorithm based on an IoT architecture for the monitoring of glucose in diabetes patients. This work presents an interesting approach for controlling the prognosis of the diabetes disease. However, the manuscript provides insufficient results that support the relevance of the proposed method since it lacks consistent data referred to the application in real clinical settings with regard to the implications as a therapeutic approach. For these reasons, it is recommended the revision of the present manuscript version before publication.

 

Specific comments:

- Abstract: Please, include relevant information relying on the specific characteristics of the algorithm design.

The reference to elderly persons needs to be clarified since it is not conveniently addressed in the text. The supervision needed for elderly persons will require the measuring of glucose levels by the caregiver and subsequently further actions that could affect the suitability of the application.

Introduction: The different types of diabetes disease are normally referred in the literature as Diabetes type 1 and type 2, using numbers instead of letters.

Please, revise the adequacy of the sentence: ‘The main task of a person with diabetes is to control the blood glucose parameter’ and substitute for ‘concern’ or a more adequate term.

The correct term for measuring sugar levels is glucose, since it is the main carbohydrate present in body fluids and the only one which is measured by the mentioned devices.

The sensing mechanism for the detection of glucose by specific devices and the role of glycosylated haemoglobin in controlling diabetes needs to be more comprehensively described.

 

Related work: The following sentence requires revision to improve understanding: ‘In [9] diseases of the cardiac type are contemplated’.

The meaning of GSM and WSN acronyms should be included.

The sentence: ‘In [14] a design is proposed employing an ion-sensitive field-effect transistor connected to a 105 microcontroller’ should be revised considering the authors instead of the reference number, for better understanding.

The aim of the work should be mentioned.

 

System Architecture:

The acronym SQL needs to be defined.

Please, specify the sensing mechanism of the glucometer device employed for glucose detection.

 

Results:

The difference in alert notifications between increased glucose levels due to food intake and other physiological causes needs to be explained. More consistent results referred to the actions required after notification should be added in order to justify the clinical usefulness of the method, for example, insulin administration after hyperglucemia.

Discussion: this section needs further enhancement in order to show the strengths and limitations of the proposed method in comparison with other commercial available approaches. A conclusion section needs to be considered.

 

Additional comments:

The term prognosis is more adequate than forecast when referring to medicine outcomes for predicting the future course of a disease.

Figure 1: require revision in order to indicate more precisely the content of each phase. Figures 3, 4, 5 and 6: the quality and resolution need to be improved and their inclusion as a single figure may be considered. Figure 10: please improve the resolution.

Author Response

Dear reviewer thanks for your comments and suggestions.

We really believe that they will improve our work.

Here, we try to respond the comments. You will find them highlighted in yellow in the document

Specific comments:

We provided relevant information about the characteristics of the algorithm in the abstract. We strengthened the reference to elder persons. We take into consideration the suggestions of the international Diabetes Federation. We extended the analysis in the introduction section of the reference 5. We try to avoid redundancy due to the reference is very complete. We changed the sentence: “The main task of a person…..” We also changed the word sugar level by glucose, except in titles of the articles of reference. We evaluated different sources and after an extensive review, we found a good reference to analyze the role of the glycosylated hemoglobin. We added a description of the results obtained and the relevance of the use of information technologies. We added the reference. We changed the sentence “In [9] diseases ….” We include the meaning of the acronyms. We considered the authors in the sentence “In [14] a design…..” The aim of the work was included in the abstract and the discussion sections. The acronym SQL was also described.

System architecture

We provided the sensing mechanism used for the glucose detection. We propose a noninvasive wireless one. Our system is not depending of any type of sensor. It is possible to adapt it. However due to the non-availability of elder person to perform the tests, we used a traditional to obtain the readings.

Results:

We added a paragraph to notice the difference between false notifications. One of the advantages of our proposal is to avoid these notifications. The period before and after intake is considered avoiding false notifications. We provided more detail in the discussion for the strengths and limitation of our proposal. We analyzed a commercial product to make the comparisons. We considered that the product is more alike to our design.

Additional comments

We changed the word forecast for prognosis. You helped us to clarify the concept. We improved the description of the architecture in order to identify the content of each phase. We also added a numbering. We improved the resolution of the Figures 3, 4 5 and 6. We redesigned Figure 3. We changed the size for the Figure 4, 5 6 and 10 to improve the resolution. We don’t know if it is problem of the document. We consider that the figures 3, 4 and 5 help to support the system architecture. Figure 6 has the intention to show how the web page is used to visualize the profiles.

We look forward to hearing your views.   

Regards

Author Response File: Author Response.pdf

Reviewer 2 Report

Dear Authors,

Title of the paper is very interesting. However, you need to significant improvement before publication as a research work. The paper looks more project work than a research work. 

Minor comments:

a) Give full form of acronym while using first. 

b) Put follow IEEE referencing. Number should be in increasing order so that reader can follow. 

Major comments:

a) There is no clear explanation of the architecture and working principle. 

b) The paper is about algorithm but there is lack of clarity on algorithm how it works; what are the parameters and their definitions. You need to rewrite for clarity.

c) How the simulated patient data is generated? You mentioned that blood glucose values of a simulated patient. There is a lack of clarity.

d) In Fig. 7 and 8, there are three lines but I can see two legends in figure. What is the third one. Result discussion is also not clear and lack of technical details. You are focusing about web output or display.

Hope that when you incorporate these comments in revised paper, it will improve the quality of paper and able to publish. 

Regards,

 

Author Response

Dear reviewer thanks for your comments and suggestions.

We really believe that they will improve our work.

Here, we try to respond  the comments. You will find them highlighted in yellow in the document

Minor comments:

We provide the full form of the acronyms when we use first. All the references are ordered in ascending order. We follow the IEEE referencing

 

Major comments:

We extend the explanation of the architecture, clarifying the working principle and we identify the stages in the figure. We organize the algorithm in a better way and provide more details. More equations were added and descriptions of the variables are included. We describe how the patient data was generated. We propose a wireless sensor, however for the simulation, we considered a traditional one. The readings are for patient before and after intake. There were dotted lines in figures 7 y 8. We used as a reference to visualize the behavior our algorithm with relation to other tendencies. They were deleted to avoid misunderstandings. Additionally, we add a new reference to show the impact of the health information technologies on glycemic control [23]. We also modify the abstract and discussion to strength the algorithm operation and the discussion to reinforce the results obtained with the system.

 

We look forward to hearing your views.   

 

Regards

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

The clarity of the manuscript is much improved and most of the recommendations have been addressed satisfactorily. Only minor corrections are needed.

Page 10, Line 272. Consider the term hypoglycemia and hyperglycemia instead of ‘highs and lows in glucose levels’.

 

Page 10, Line 283. Please revise the grammar of the following sentence: ‘A complete assessment need to addressed for the specialist when is used in elder person following the guidelines mentioned in [5]’.

Author Response

Dear reviewer

Thanks for you comments and help to improve our paper.

 

We changed the termss ‘highs and lows for hypoglycemia and hyperglycemia 

 

We changed  the sentence: ‘A complete assessment need to addressed for the specialist when is used in elder person following the guidelines mentioned in [5]’

Author Response File: Author Response.pdf

Reviewer 2 Report

Dear Jamie,
The authors have done very good job incorporating the comments provided. I am happy with the authors work for publication. Sorry for late response as I was away during the break.
regards,

Comments for author File: Comments.pdf

Author Response

Dear reviewer.

thanks for you comments and help to improve our paper

Author Response File: Author Response.pdf