DE102010015094A1 - Portable apparatus i.e. blood glucose measuring device, for measuring blood glucose contents of patient in regular intervals for self therapy of diabetes, has injection unit for injecting dosed medicament into body location of patient - Google Patents

Abstract

The apparatus (1) has a puncture unit (PM) i.e. lancet, for puncturing a body location of a patient, and a measuring unit (GM) supplied with blood from the punctured body location to measure blood glucose contents in the blood. A dosing unit (ID) doses a medicament i.e. insulin, from a medicament reservoir (IR) and an injection unit (IM) injects the dosed medicament into the body location of the patient. A feeding mechanism supplies a hypodermic needle to the injection unit and a hypodermic needle disposal reservoir (NE).

Description

The invention relates to a portable device for measuring blood values of a patient, in particular the blood sugar content.

For the self-therapy of various diseases it is necessary that the patient checks his blood values at regular intervals and adjusts his medication according to the measured blood values. Especially in the field of diabetes therapy are known to be operated by the patient and portable devices with which the glucose content of the blood of the patient can be determined. For this purpose, the patient inserts a measuring strip into the measuring device and punctures with a separate puncturing mechanism, in order thereby to obtain a blood drop. This drop of blood is then positioned on the measuring strip in the meter, whereupon the meter measures the glucose level in the blood. Subsequently, the patient usually documents his glucose value by hand and uses a separate syringe or injection pen to administer an appropriate amount of medicament in the form of insulin.

The process of measuring blood levels with known gauges is cumbersome, and additional gadgets and materials in the form of syringes, lancets, gauges, and the like are needed in addition to the gage.

The object of the invention is therefore to simplify the process of self-therapy performed by a portable device for a patient.

This object is achieved by the device according to claim 1.

The device according to the invention is portable and serves to measure blood values of a patient. It comprises a measuring unit for measuring at least one blood value of the patient based on blood taken from a punctured body site. The device is characterized in that in addition to such a measuring unit further components are integrated in the device, which are needed in the context of self-therapy. In particular, a puncture unit for puncturing a body site of the patient is provided, wherein blood taken from the punctured body site can be supplied to the above-described measuring unit. Furthermore, a metering unit for metering a medicament is integrated in the device. About this metering unit z. B. a dose entered by the patient on the device or automatically determined by the device dose of the drug. In addition, the device includes an injection unit for injecting the previously dosed by the dosing drug into a body site of the patient.

The device according to the invention has the advantage that in addition to a known functionality of the measurement of blood values, it also assumes the functions of puncturing, dosing and injecting, so that no separate devices are required for these processes. In this way, the self-therapy by the patient is greatly simplified because he can perform the entire process of diagnosis and therapy using only a single device.

In a particularly preferred embodiment, the portable device is configured as a blood glucose meter, wherein the blood glucose content in the blood can be measured with the measuring unit and insulin can be metered with the metering unit and injected with the injection unit as medicament. The self-therapy of diabetes with portable gauges is very common, since in this disease, especially at regular intervals measurements of blood sugar must be performed.

In a particularly preferred embodiment, the device according to the invention comprises a first delivery mechanism for delivering a puncture means to the puncturing unit, wherein the puncturing means is preferably a lancet. Preferably, the first delivery mechanism interacts with a puncture agent reservoir within the device such that after puncture with a puncture agent, the puncture device may be supplied with a new puncture agent via the first delivery mechanism from the puncture agent reservoir. In this way, the storage of the puncture means is ensured within the device, without the need for separate containers. Preferably, the apparatus further comprises a puncture disposal reservoir to which a used puncture agent may be delivered after puncture via the first delivery mechanism.

In a further embodiment of the device according to the invention, a second feed mechanism is provided for feeding a measuring means, in particular a measuring strip, to the measuring unit in order to position the measuring means in a measuring position, wherein blood reaches the measuring means in the measuring position from the body point punctured by the puncturing unit and then with the measuring unit, the at least one blood value of the patient is determined. In this case, the measuring means can be conveyed, for example, in a suitable manner to the blood drawn by the puncturing, so that the blood runs on the measuring strip. Preferably, the second feed mechanism interacts with a measuring agent reservoir within the Device such that the measuring unit after the measurement with a measuring means, a new measuring means via the second feed mechanism can be supplied. As a result, the storage of the measuring means is realized within the device. Preferably, a measuring agent disposal reservoir is also provided, to which a used measuring means can be supplied after the measurement via the second feed mechanism.

In a further, particularly preferred variant, the device according to the invention also stores the medicament used for therapy in a corresponding medicament reservoir from which the dosage unit can appropriately remove and dose the medicament.

In a further preferred embodiment of the device, a third feed mechanism is provided for feeding an injection needle to the injection unit, wherein the third feed mechanism preferably interacts with an injection needle reservoir within the device such that the injection unit, after an injection with a hypodermic needle, disposes of a new injection needle can be supplied to the injection needle reservoir via the third feed mechanism. In this way, the storage of the injection needles is ensured within the device. If appropriate, an injection needle disposal reservoir can also be provided, to which a used injection needle can be supplied after the injection via the third supply mechanism.

In a further embodiment, the device includes a computing unit for controlling and / or performing the puncture by the puncture unit and / or the measurement by the measuring unit and / or the metering by the metering unit and / or the injection by the injection unit. The arithmetic unit can take on many different functions. If necessary, it can store the measured values obtained and issue appropriate instructions to the user during operation of the device. In a particularly preferred variant, the arithmetic unit determines from the at least one measured blood value a dose for the medicament and subsequently initiates an automatic dosage of the medicament based on the dose via the metering unit. In this case, the arithmetic unit preferably also causes the injection of the metered medicament after the dosage via the injection unit.

In a further, particularly preferred variant, the device further comprises a communication interface connected to the arithmetic unit for communication with other arithmetic units. For example, measured values or doses of medication stored via the communication interface can be read out. The read information can then be evaluated in a suitable manner by a doctor, who can then adjust the treatment plan. Likewise, if appropriate, the physician can also feed information via the communication interface into the device, for example an adapted therapy plan, which can then be called up by the operator or is carried out automatically by the device. The communication interface can be configured as desired. It can be wireless or wired. It can be z. B. to a USB interface, a Bluetooth interface or a wireless interface act.

In a further refinement, an output device, in particular a visual and / or a voice-based output device, is furthermore provided in the device according to the invention. By means of such an output device, a patient can be given information during the measurement and / or information can be transmitted, for example, the currently measured value can be output to the patient via the output device, so that the latter can adjust or adjust the dosage of medication on the device itself ,

In a further embodiment, a puncture opening is provided on the housing of the device according to the invention, on which a body site of the patient is to be set for puncturing by means of the puncture unit. This ensures a compact design of the device using an integral housing. Analog can be provided on the device housing and an injection port on which a body site of the patient is to be set for injecting the drug.

In a particularly preferred embodiment, the injection opening and the puncture opening are arranged on opposite sides of the device, wherein in the operating position of the device, d. H. in the process of puncturing and subsequent Injizierens, the injection port is preferably disposed on a lower side of the device housing and the puncture opening preferably on an upper side of the device housing. In this way, a particularly efficient measurement and therapy is achieved in that the puncture, the patient puts his finger on the top of the device and for injection, the bottom of the device to a corresponding body site, such. As his thigh, positioned.

In a further embodiment of the device according to the invention, a skin sensor is provided in the region of the puncture opening and / or the injection opening, wherein a puncture or an injection is only caused by the device, when skin contact is detected by the skin sensor. This avoids faulty or unwanted punctures and injections, which result in unnecessary waste of consumables.

In a further embodiment, the device according to the invention is designed such that it can be operated by the patient during the measurement by a single hand. Such an embodiment of a device will be explained later in the detailed description.

In a further embodiment, the operation of the device via a control button to trigger the process of puncture and / or measurement and / or dosage and / or injection. This control knob is preferably designed such that it can be operated with the thumb of the hand of the patient grasping the device. Preferably, the puncture opening is provided for the exit of the puncture means in the middle of the control knob. Thus, the operation of the control knob can be linked to the process of puncture in a simple manner.

In a further embodiment, the device according to the invention further includes a self-cleaning mechanism for cleaning the puncture unit and / or the measuring unit and / or the metering unit and / or the injection unit. In this way, the self-therapy is simplified again, since the patient before or after use of the device does not need to clean it. For this purpose, if appropriate, a reservoir for corresponding cleaning agents (eg cleaning pads) can be provided in the device, which are applied to the units to be cleaned via a suitable mechanism. Preferably, a suitable cleaning agent disposal reservoir is also provided in the device, to which a used cleaning agent is supplied after its use.

In a further variant, the device according to the invention can be configured such that the consumables used in the device, in particular the puncture means (preferably in the form of lancets) and the measuring means (preferably in the form of measuring strips) and optionally also the above-mentioned cleaning agents, in the required order are arranged on a suitable carrier tape. About this carrier tape consumables are retrieved from a common reservoir and conveyed into a common disposal reservoir after application.

Embodiments of the invention are described below in detail with reference to the accompanying drawings.

Show it:

1 a schematic representation of the integrated in one embodiment of the measuring device according to the invention components; and

2 to 5 different views of an embodiment of a measuring device according to the invention.

In 1 is schematically described the structure and the interaction of the integrated in one embodiment of the inventive device components. The device itself is identified by reference numbers 1 referred to and the individual components are indicated by functional blocks, their interaction with each other is represented by single or double arrows. This in 1 The device shown is a glucose meter for patients with blood sugar, who determine their blood sugar by self-diagnosis and administer insulin in a suitable dose. The device integrates all functionalities that have to be performed within the scope of a glucose determination and subsequent insulin injection. It must therefore no longer be performed separately by separate components, the corresponding functions of puncturing for blood sampling, the subsequent measurement and the subsequent dosage and injection.

The device according to 1 comprises an output device in the form of a display D, on which the patient can be given suitable information when using the device. In particular, the measured glucose values and the resulting dosage of insulin can be displayed on the display D. Likewise, the user can be given appropriate instructions in the context of performing the measurement. In addition or as an alternative to the display D, the device may also comprise a different output device, for example in the form of a voice-based output device via loudspeaker.

In the device 1 a puncture unit is integrated in the form of a puncturing mechanism PM, which interacts with a reservoir LR on lancets, with which blood can be removed by a puncture in the finger of the patient's finger. In this case, a first feed mechanism (not shown) is provided, via which a lancet can be supplied from the lancet reservoir LR to the puncturing unit PM. During puncturing, the tip of the lancet emerges from a corresponding puncture opening in the housing of the device and inflicts injury on the fingertip, whereupon a drop of blood BT enters the device via the puncture opening. The puncture mechanism PM it also interacts with a lancet disposal LE, in which a used lancet can be taken up after the use of the first feeding mechanism. In this case, corresponding devices are provided with which the lancet reservoir LR or the lancet disposal unit LE can be filled or emptied. The lancet reservoir or the lancet disposal can be designed, for example, as a magazine in which the new lancets or the used lancets are stored. In the same way, the consumables described below can also be stored in the form of unused or used measuring strips and injection needles in corresponding magazines.

The process of puncture is in the device of 1 triggered by a control knob B, which gives a corresponding command to a controller in the form of a computing unit RE. The arithmetic unit represents a central control for all processes in the device and also has access to the measuring unit or metering unit or injection unit described below. Furthermore, the arithmetic unit can also process data of corresponding sensors, which in 1 generally designated SE. An embodiment of a sensor in the form of a skin sensor will be described below. The control knob B triggers in the embodiment of the device described here not only the puncture, but also the subsequent measurement, dosage and injection, the operations are controlled by the computing unit RE.

As already mentioned, after the puncture, a drop of blood BT reaches the interior of the device via a puncture opening and then runs on a suitably arranged measuring strip MS, which is arranged in a measuring position. This measuring strip interacts with a measuring unit GM, which measures the glucose content in the blood drop BT in a manner known per se. The measuring strips MS are intended for single use and must be replaced after each glucose measurement. For this purpose, a second feed mechanism (not shown) is provided, via which a new measuring strip is fed to the measuring unit GM from a corresponding measuring strip reservoir MR, which contains a plurality of unused measuring strips, as soon as the measurement has been completed. The old measuring strip is deposited analogously to the lancet disposal described above via the second feeding mechanism in a suitable measuring strip disposal ME.

The blood sugar measured value determined via the measuring unit GM is subsequently transmitted to the arithmetic unit RE, which, based on methods known per se, computer-aided determines a suitable insulin dosage based on the determined blood sugar value. The computing unit RE comprises a memory in which the measurements carried out can be stored. In this case, a clock is preferably integrated, which stores the measurements with date and time in the memory. Furthermore, a suitable alarm clock can be provided which reminds the patient at predetermined intervals that he should measure his blood sugar level.

All data stored in the arithmetic unit can be removed from the device 1 be read out via a corresponding communication interface KS, the communication interface, for example, a USB interface or a wireless interface, for. B. based on Bluetooth or WLAN, can be. Optionally, several such communication interfaces may be provided. The data are preferably read by the attending physician via a suitable computer, so that the doctor has the opportunity during a patient visit to follow the course of therapy and to create appropriate diagnoses. If necessary, there is also the possibility that the doctor transmits suitable therapy plans to the arithmetic unit RE or tunes the device to the patient. In particular, for example, there may be the possibility that the automatic dosing is adapted individually to the patient based on the measured blood values.

After the computing unit RE has determined a suitable insulin dosage based on the measurement of the measuring unit GM, this dose is given to an insulin dosing unit ID, which then removes the amount of insulin according to the dose from an insulin reservoir IR by means of a suitable mechanism, for example by taking the injection needed Amount of a cannula, via which this amount can then be injected by means of a hypodermic needle into the skin of a patient. For injection, an injection unit in the form of an injection mechanism IM is provided, which in turn interacts with a third delivery unit (not shown) which removes hypodermic needles from an injection needle reservoir NR and positions them in a suitable manner on the cannula described above, via which then the Insulin can be pushed out through the injection needle.

For injection, the patient positions an injection port in the housing of the device on his skin. Subsequently, the injection needle is pierced into the skin via the injection mechanism IM and the insulin is injected subcutaneously. It may optionally be provided in the region of the injection port, a skin sensor which triggers an injection only if a contact with the patient's skin is detected. This ensures the correct positioning of the injection unit on the skin. After the injection has been carried out, the injection needle can in turn be dispensed via the third delivery mechanism to an injection needle disposal unit NE and thereafter a new injection needle can be supplied to the injection mechanism via the delivery mechanism.

In the foregoing was generically based on the schematic representation of 1 an integrated device for puncturing, measurement, dosage and injection in the context of insulin therapy described. The structure of the individual mechanisms integrated in the device was not explained in detail. Corresponding embodiments of these mechanisms, however, are known per se from the prior art or are within the scope of expert action.

A concrete embodiment of the external structure of a device according to the invention 1 is described below by means of 2 to 5 described. 2 shows a side view of a measuring device according to the invention 1 , It can be seen that the device consists of an integral housing 2 is formed, which is ergonomically shaped and can be easily grasped by an operator, in particular from that described below 5 becomes apparent. In the upper part of the device 1 the display D already mentioned above is integrated, and the operation of the device via a corresponding control knob B. The display D and the knob B are well in the front view of 3 recognizable. Within the device are based on 1 contain described components. The combined mechanism of puncturing, blood glucose measurement, dosing and injecting is thereby preferably triggered by depression and optionally holding the control knob B, wherein complementary messages or instructions on the display D can be output as needed.

In 4 which is a top view of the device 1 shows, you recognize the round control knob again 3 , Further, a puncture opening 3 apparent, which is located in the center of the control knob B. Through this opening depression of the control knob B by the thumb of the patient a depression of a lancet is achieved in the thumb. The subsequently exiting blood passes over the opening 3 in the interior of the device, in which then in a conventional manner, a glucose measurement is performed with appropriate gauges. Finally, the patient can inject the dosed in the dosing insulin, which in 5 is shown. It can be seen in this figure, in particular, how the patient with his hand H the device 1 grasps and touches the surface O of his skin. For example, he can position the device on his thigh. At the bottom of the device, an injection port (not shown) for exiting the injection needle of the injection mechanism is provided, wherein the placement of the device 1 on the skin surface O via a suitable skin sensor, eg. B. by means of a resistance measurement is detected. Only upon detection of the skin is the injection of the dosed insulin subsequently induced in the patient's body. This will ensure that you only inject when the device is properly positioned.

The following is another appropriate handling of the device 1 to 5 set forth by a patient. First, the patient puts the device on the skin, if according to the treatment plan, an injection can be expected. This can be displayed, for example, via the display D of the device and also announced via the loudspeaker. If no injection is expected, the device does not need to be placed on the skin. It is thus also possible to carry out the determination of the glucose content of the blood separately from an insulin injection.

In order to detect the blood sugar, the puncture is performed with the puncturing mechanism PM described above. For this purpose, the patient takes the device 1 with one hand and puts his thumb on the control knob B. When he presses this down, a fresh lancet from the lancet reservoir LR is placed in the puncturing mechanism PM and the finger by the lancet exit from the puncture opening 3 punctured. Optionally, in the area of the puncture opening 3 a sensor is provided which checks whether blood exits from the punctured area of the thumb. If not, the spent lancet is automatically transferred by the device to the lancet-disposal reservoir LE and the process of puncturing is aborted and restarted again.

If the leakage of blood could be detected by the sensor at the puncture opening, in a next step, a new glucose measuring strip MS is automatically taken out of the measuring strip reservoir MR by the device and inserted into the measuring unit GM. The measuring unit GM or the measuring strip MS is then brought to the blood drop located in the opening. Subsequently, the measuring unit GM measures the glucose content of the blood drop. If the measurement is complete, which can be determined with the arithmetic unit RE, the patient is signaled that he can remove the finger from the control knob. Finally, the glucose measuring strip MS is transferred to the strip strip disposal reservoir ME. The determined measured value is then transmitted to the arithmetic unit RE and stored with the date and time in the memory of the arithmetic unit. Finally, the arithmetic unit determines a dosage of insulin. Optionally, this step can also be skipped and the patient himself sets the dosage via appropriately provided controls on the device (not shown).

Subsequently, the automatically detected or adjusted dose is provided via the metering mechanism ID for injection by means of the injection mechanism IM. For injection, a fresh injection needle is retrieved from the injection needle reservoir NR and inserted into the injection mechanism IM. The skin sensor is used to check that the device is placed on the skin. If this is the case, the dose is injected and the spent injection needle is then transferred to the injection needle disposal NE. The end of the injection can then be signaled to the user again by the device. Then the patient disinfects the injection site and, if necessary, supplies it with a patch. Likewise, the patient disinfects the puncture of the fingertip and, if necessary, also supplies this patch with a patch. Finally, the patient wipes the control knob B clean and cleans the puncture opening with a cotton swab.

Optionally, the device can also be extended by a self-cleaning function, so that the cleaning of the device just described after its use is performed automatically by the device itself. In this case, another reservoir may be provided in the device, in which corresponding cleaning pads are provided with disinfectant. These pads are applied by suitable mechanisms in the area of the puncture opening or the injection opening. The cleaning pads can then be transferred to a disposal reservoir within the device. Suitable mechanisms for realizing the self-cleaning described above are within the scope of expert action and are therefore not described in detail.

The above-described embodiments of an apparatus according to the invention for integrated measurement of blood values and injection of medicaments have a number of advantages. In particular, all functional modules, which are required in the context of a measurement and injection, integrated in a single device. It can also be stored in accordance with the required consumables in the same device. Furthermore, a control of the entire process can be realized by a computing unit in a suitable manner. This results in a considerable relief and simplification in self-therapy by the patient. In particular, consumables are always present in the device or an imminent need for new consumable material can be suitably displayed on the display of the device, in which case corresponding sensors or counters are provided, via which the current level of consumable material can be determined.

The handling of the blood glucose measurement and insulin injection is considerably simplified for a patient, since all function modules are present in one device and do not have to be individually collected in the form of separate components. Optionally, the device may report at programmed time intervals for which a new measurement of blood glucose level is to be performed. The measurement results and therapeutic measures can be documented accurately and precisely in the device by means of the arithmetic unit. The patient and caregivers of the therapy (doctor, nurse, caregivers, and relatives) can easily retrieve the condition and the need for maintenance of the device via the corresponding display or via the communication interface. The person performing the therapy (patient or caregiver) is relieved of fine manipulation. Bad eyes, shaky hands and the like are no longer in the way of therapy. The course of the measured glucose values over time and the corresponding insulin administrations can also be electronically transferred to the patient file via the communication interface described above.

Claims (21)

A portable device for measuring blood levels of a patient, in particular the blood sugar content, comprising a measuring unit (GM) for measuring at least one blood value of the patient based on blood taken from a punctured body site; characterized in that in the device ( 1 ) is further integrated: - a puncture unit (PM) for puncturing a body site of the patient, wherein taken from the punctured body site blood of the measuring unit (GM) can be fed; - A dosing unit (ID) for dosing a drug; An injection unit (IM) for injecting the metered drug into a body site of the patient. Device according to claim 1, characterized in that the device ( 1 ) is a blood glucose meter, with the measuring unit (GM), the blood sugar content in the blood is measurable and insulin as the drug with the dosing unit (ID) can be dosed and injected with the injection unit (IM). Device according to claim 1 or 2, characterized in that the device ( 1 ) a first A delivery mechanism for delivering a puncture means, in particular a lancet, to the puncture unit (PM), the first delivery mechanism preferably having a puncture agent reservoir (LR) within the device (FIG. 1 ) interacts such that the puncturing unit (PM) after a puncture with a puncture means a new puncture means via the first delivery mechanism from the puncture means reservoir (LR) can be supplied. Device according to claim 3, characterized in that in the device ( 1 Further, a puncture-disposal reservoir (LE) is provided, to which a used puncture means can be supplied after the puncture via the first feeding mechanism. Device according to one of the preceding claims, characterized in that the device ( 1 ) comprises a second feed mechanism for feeding a measuring means (MS), in particular a measuring strip, to the measuring unit (GM) in order to position the measuring means (MS) in a measuring position, wherein in the measuring position blood is punctured by the puncturing unit (PM) Body site on the measuring means (MS) passes and then with the measuring unit (GM) of the at least one blood value of the patient is determined, the second feed mechanism preferably with a measuring agent reservoir (MR) within the device ( 1 ) interacts such that the measuring unit (GM) after the measurement with a measuring means (MS), a new measuring means (MS) can be supplied via the second feed mechanism. Device according to claim 5, characterized in that in the device ( 1 Further, a measuring agent disposal reservoir (ME) is provided, to which a used measuring means (ME) can be supplied after the measurement via the second feed mechanism. Device according to one of the preceding claims, characterized in that the device ( 1 ) comprises a drug reservoir (IR), from which the dosing unit (ID) can remove and dose the drug. Device according to one of the preceding claims, characterized in that the device ( 1 ) comprises a third delivery mechanism for delivering an injection needle to the injection unit (IM), the third delivery mechanism preferably having an injection needle reservoir (NR) within the device (FIG. 1 ) interacts such that the injection unit (IM) after injection with an injection needle, a new injection needle from the injection needle reservoir (IR) via the third feed mechanism can be supplied. Apparatus according to claim 8, characterized in that in the device ( 1 Further, an injection needle disposal reservoir (NE) is provided, which can be supplied to a used injection needle after the injection via the third feed mechanism. Device according to one of the preceding claims, characterized in that the device ( 1 ) a computing unit (RE) for controlling and / or performing the puncture by the puncture unit (PM) and / or the measurement by the measuring unit (GM) and / or the metering by the metering unit (ID) and / or the injection by the injection unit (IM). Apparatus according to claim 10, characterized in that during operation of the device ( 1 ) the arithmetic unit (RE) from the at least one measured blood value determines a dose for the drug and then causes an automatic dosage of the drug based on the dose via the dosing unit (ID), wherein the arithmetic unit (RE) preferably after the injection and injection of the metered drug via the injection unit (IM). Apparatus according to claim 10 or 11, characterized in that the device comprises a communication with the unit (RE) connected communication interface (KS) for communication with other computing units. Device according to one of the preceding claims, characterized in that the device ( 1 ) comprises an output device (D), in particular a visual and / or a voice-based output device (D), via which a patient during the operation of the device ( 1 ) Hints are given and / or information is transmitted. Device according to one of the preceding claims, characterized in that on the housing ( 2 ) of the device ( 1 ) a puncture opening ( 3 ) to which a body site of the patient is to be punctured by the puncture unit (PM). Device according to one of the preceding claims, characterized in that on the housing ( 2 ) of the device ( 1 ) an injection port is provided, to which a body site of the patient for injecting the medicament is to be set by means of the injection unit (IM). Apparatus according to claim 14 and 15, characterized in that the injection opening and puncture opening ( 3 ) on opposite sides of the housing ( 2 ) of the device ( 1 ), wherein in the operating position of the device the Injection opening preferably on a bottom side of the housing ( 2 ) and the puncture opening preferably at an upper side of the housing ( 1 ) is provided. Device according to one of claims 14 to 16, characterized in that in the region of the puncture opening ( 3 ) and / or the injection opening a skin sensor is provided, wherein a puncture or an injection through the device ( 1 ) is caused only when skin contact is detected by the skin sensor. Device according to one of the preceding claims, characterized in that the device ( 1 ) is configured such that it can be operated by the patient during the measurement by a hand. Device according to one of the preceding claims, characterized in that the device comprises a control knob (B) for triggering the process of puncture and / or dosage and / or measurement and / or injection, in particular a control knob (B) with the thumb of the the device ( 1 ) of the patient's palpable hand. Apparatus according to claim 19 when dependent on claim 14, characterized in that in the center of the control knob (B) the puncture opening ( 3 ) is provided. Device according to one of the preceding claims, characterized in that the device further comprises a self-cleaning mechanism for cleaning the puncture unit (PM) and / or the measuring unit (MS) and / or the dosing unit (ID) and / or the injection unit (IM).

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