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Apple has biomedical engineers developing sensors to monitor blood sugar

205 points by mayava 10y ago

leoh 10y ago
I don't understand how having ubiquitous sensors is the "holy grail for treating diabetes."
- ivanbakel 10y ago
  Seriously. You'd think genetic therapy, or even just a sensor-injector automatic combo (which to my knowledge already exist) might be more worthy of the title. But then, it's evident that the article is giving Apple too much credit already - even a life-saving sensor wouldn't be able to make a several-hundred-dollar gimmick worth buying.
  - MBCook 10y ago
    You don't think an Apple Watch (which starts at about $350) which could monitor your glucose more or less continuously would be far more preferable to a huge chunk of people then occasionally sticking themes with a lance and then trying to record the reading of a portable meter they have to carry around? Don't forget you have to buy the little strips. Let's ignore the idea of insurance paying for this or any other kind of help. I imagine the Apple Watch would end up paying for itself for a type one diabetic within what, a year or two? I know those little testing strips aren't cheap. But the Apple Watch would give you much better monitoring, no pain, no testing, far more data… Oh yeah and every feature that the people who already have an Apple Watch like. As others have mentioned in this thread, I'm sure it's INCREDIBLY easy to get small children to test their blood glucose when necessary. I imagine this would easily be worth it to a lot of parents as well.
    - ivanbakel 9y ago
      I think the technology would be better put to use on something other than the Apple Watch, unless an equivalent sensor minus Apple's other contributions also somehow starts at $350. You're conflating the sensor with an overpriced and rather useless piece of technology, which I say as the owner of one. I'm in full support of a non-invasive sensor for diabetics, but if we manage to come up with one, I would be against giving it an Apple price tag.
      - MBCook 9y ago
        Apple could invent this an then license the sensor to other people. They gave away health kit. And they could choose not to license it to their competitors, only medical companies. But surely they'd put it on their own devices as well. Seems like a weird attitude though: If company X can afford to (possibly waste) billions of dollars to make a medical breakthrough in Y, I don't want them to because then they'd use it themselves and charge money.
        ivanbakel 9y ago
        Where did I say that I don't want Apple to pursue this research? I just said that I don't want it to be solely available on Apple devices, and I certainly wouldn't support a company being congratulated for providing a medical service at an incredible cost.
  - jpttsn 9y ago
    > even a life-saving sensor wouldn't be able to make a several-hundred-dollar gimmick worth buying What a curious set of priorities.
  - tracker1 9y ago
    Not a gimmick at all... if I could track my blood sugar in even 5 minute intervals, it would be nice to know, and help a lot. As it is, I'm LADA, which has aspects of type 1 and 2, and my body is also very adept with gluconeogenesis... even if I have nearly no carbs (no refined sugars, no bread/pasta, minimal overall intake) for a few days, my blood sugar can start spinning out. It's about keeping things as level as possible. Also, genetic therapy could be amazing... but it's still, afaik a very long way off.
    - ivanbakel 9y ago
      I was referring to the Watch itself as a gimmick, which I think it currently is.
- semi-extrinsic 10y ago
  We already have automated continuous insulin injection pumps that work well. It's a big improvement over shots every few hours. But they still need manual setting of pump rate, based on manual periodic measurements. A noninvasive sensor that measures blood glucose accurately, even just once a minute, would give you the ability to close the feedback loop and remove all human input from the system. No "oh shit I forgot to measure and adjust". Especially for kids it would be a big breakthrough. In essence, you'd have an almost-perfect artificial pancreas.
  - jcims 10y ago
    Medtronic released the first closed loop pump this year.
    - zaroth 10y ago
      I'd say closed loop ish system. It uses the CGM data to make temp-basal adjustments. It's not like a full autopilot or anything. Since modern fast acting insulin still takes time to kick in, you need to dose to cover carbs about 15 minutes before eating. So there will always be some level of involvement of you want to avoid actually going high and then coming back down (proactive vs reactive). Don't get me wrong, it's great to know you're going to wake up at your target even if you screwed up your dinner-time bolus a bit. That is, assuming the CGM is functioning properly. My experience with the Dexcom G4 with my kids was much less than stellar. Lots of '???' readings or having it off by over 50 points, extremely painful insertions and being mostly useless the first 24 hours and then sensors failing long before 7 days was the norm and ultimately we abandoned it. Anxiously waiting for the auto-inserting CGM to come out of trials.
      - coldpie 9y ago
        That's too bad. I got my Dexcom about 18 months ago and while it's not perfect and very expensive, I really do miss it if I have to go a week without it. I can imagine having to use it on children would be pretty nasty, though. Putting the sensor in is not a fun time for a grown adult. You have multiple kids with T1D? That's a stroke of bad luck :(
- llccbb 10y ago
  I am certainly not defending the article, but here is my take from living and being very close with a type-1 diabetic. The holy grail of __treating__ diabetes is technology that helps maintain excellent blood glucose control. Diabetes Mellitus (T1) is not a curable disease right now except through pancreas transplants. Diabetes is therefore a disease that has to be treated. The treatment for diabetes is personal, non-uniform, active, and adaptive. Every ingestion of food or liquid affects your body and needs to be considered. Diabetes is a disease that needs its symptoms to be monitored and managed at a high granularity. Both monitoring and managing blood glucose can be really invasive though, with needles and finger-sticks causing extensive scar tissue development. Minimally invasive glucose monitoring technology that generates high-resolution time series data (such as Dexcom systems) literally transforms the way that people can manage their disease. Going from glucose reading every 6 hours (test strips) to every 5 minutes (CGM) is life changing. Monitoring that is non-invasive is the next technological step. The holy grail for treating diabetes should actually be stabilized monomeric human insulin. Afrezza[0] is exactly that, and inhalable no less. The company that makes it just can't break through the insulin cartels and insurance-pharma exclusivity, so they are having a hard time. They did what was unachievable for 100 years though, and they are amazing chemists. [0] https://www.afrezza.com/hcp/afrezza-action-profile/ https://www.afrezza.com/hcp/afrezza-action-profile/
  - zaroth 10y ago
    I'm not sure inhalable is a feature. Insulin pumps/pods micro-dose fast acting insulin throughout the day to cover your basal dose, you can't do that with fast-acting insulin via inhaler. You can't close loop your inhaler with a CGM to adjust your basal based on your current BG and automatically control for overnight highs/lows. You can't dose your kid from across the room from your smartphone. Also there seems to be a a notable incidence of lung cancer which raises a bit of a yellow flag there...
    - llccbb 10y ago
      I think alternative delivery mechanisms to injection are a feature. Ask any diabetic if they would like less needles in their bodies. There is work and patents on adjustable dose inhaler systems, but its never going to be a basal insulin that is being delivered. It's prandial. The lung cancer concerns come from the only previous inhaled insulin Exhubra, which was literally vaporized insulin solution and offered no pharmacological benefit over injected insulin. The two instances of lung cancer in the 12(?) years of Afrezza testing occurred with patients who were smokers. I'm not saying that Afrezza is the greatest invention ever, but it is a substantial step up from other mealtime insulins in my opinion.
- jk2323 9y ago
  It is not about "ubiquitous sensors", it is about non-invasive. A good starting point would be: http://www.mendosa.com/The%20Pursuit%20of%20Noninvsive%20Glucose,%20Fourth%20Edition.pdf http://www.mendosa.com/The%20Pursuit%20of%20Noninvsive%20Glu... Would be very interested in the email of Johny Srouji.
- vfuse 9y ago
  Research by doctors such as Bart Roep at the City of Hope is the holy grail. Sensors like this already exists like the Freestyle Libre by Abbott.
- abarringer 9y ago
  Clearly you don't have diabetes. Everyone responds differently to the same inputs. My BG spikes hundreds of points if I eat a banana. It drops 50pts an hour when sitting in intense sun. Make sense? No.. is it repeatable, for me, yes. Would ubiquitous sensors help me identify more of these patterns? Absolutely.
differentView 10y ago
That's great, but why not make them round?
patrickmn 10y ago
A low-carb diet? (Tongue-in-cheek, but not really.)
- philip1209 10y ago
  A low-carb diet app for treating type 2 diabetes already launched (with $37M in funding): http://virtahealth.com http://virtahealth.com
  - amalag 10y ago
    This is great, we need more lifestyle approaches to disease. Not just people hoping a magic pill will fix it without them having to change their behavior.
    - andyfleming 10y ago
      Type 1 and Type 2 diabetes are completely different conversations, but regardless everyone should try to take lifestyle approaches to improving their health (in addition to whatever is medically necessary).
      - patrickmn 9y ago
        Yes, this is very important: Diet can be a complement to medical treatment, not a replacement. Don't make Steve Jobs' mistake!
    - tracker1 9y ago
      Even going very low carb, gluconeogenesis paths can still cause a diabetic to have very elevated blood sugar... It's about keeping things as level as possible and a non-invasive monitoring path can help a lot... I was very low carb (fewer than 30g/day) for over a year, and was still hospitalized for ketoacidosis.
- DiabloD3 10y ago
  Yeah, I've been saying for years now we've cured most modern diseases, including diabetes: follow a strict low carb variant of the Paleo diet. No grains, no refined sugars (that means no fruit juices as well), no legumes, no garbage oils (canola, corn, soy, etc); moderate protein, high (quality) fat (meat itself, olive oil and coconut oil), low carbs (and only healthy sources from whole actual foods). Every diabetic, no matter how severe, who has successfully adopted this diet has gone on to not only managing their diabetes, but frequently moving on to no longer needing any medicine, and sometimes even healing at least some of the damage (something modern medicine claims is impossible). Don't believe the hype that a cure is coming soon: it already came, and it isn't something you can shove into a pill, market, and sell for high prices.
jshevek 10y ago
Amazing the lengths our society will go to cling to our hedonism, even when it's killing us. We should be doing more with dietary solutions, not this.
- erikpukinskis 10y ago
  Our society values economic growth above everything. That means you get rewarded more for creating a problem and then making it go away than for solving the problem completely. This is everywhere. Feeling lonely? You could just hang out in your yard with your neighbors and cousins, put some ice in the cooler and see what people bring over to eat. Or you could stop talking to them entirely, get dressed up in expensive clothes, and come to our exclusive lounge with other people who are up on the latest fashions as well, drink a fancy cocktail, and look down at the people who are drinking cheap beers out of a cooler. Guess which of these does more for the economy? And which one gets the crap advertised out of it?
  - consz 10y ago
    What if nobody comes over to your cooler?
- jermops 10y ago
  That helps some forms of type-2, but not type-1. This would be a godsend for people if they can make it work reliably.
  - yourapostasy 10y ago
    Judging by some posts I gleaned from /r/diabetes with a quick skim just now, even Type 1's who regulate their net carb intake benefit by being able to reduce their required insulin. In the US, that is a very significant personal financial factor with our broken healthcare system. That forum is littered with Type 1's sharing prices of their insulin medications. From what I read, there are many different kinds of insulin, and even the generic kind that WalMart sells without a prescription (in some states) is not cheap for middle-income households. And unless you have gold-plated medical insurance, the really nice insulin can run into low thousands per month, depending upon your required dosage. Type 2 takes up a disproportionate amount of healthcare funds because for most patients diet and moderate exercise can mitigate it according to enough researchers that Sweden's national health system switched to advocating low-carb for Type 2 diabetics. Karl Denninger at Market Ticker is a vociferous advocate of low carb for Type 2's, based upon his first-hand experience, and has written a lot about the financial aspects. EDIT: I'm guessing downvotes are from Type 2 patients here who get pissed off when told diet and moderate exercise can help them. I don't think folks in /r/diabetes, /r/fasting, /r/keto, Karl Denninger, Dr. Fung, etc. are saying you'll be cured; it sounds more like better control leading to fewer late-life complications (which is where the real healthcare expenses get out of control). I'm coming in at this from the life extension and the terrible US healthcare financial picture angle; I keep seeing interesting caloric restriction research intersecting with low-carb findings and keep running across diabetics fiddling around with the same protocols that caloric restriction life extension folks like me are experimenting with. As always, YMMV, but I keep seeing enough diabetics dabbling with low-carb and caloric restriction that it raises my eyebrow, and that Sweden thought it was enough to switch their recommendations should be given some consideration when putting together your own health plan.
wishinghand 10y ago
I'm a type 1 diabetic and I've been waiting for this. I'm not a big fan of watches but having a wrist mounted snippet of the email/Slack/text that I just received has been enticing, but not worth the 1 day charge time of the iWatch. But even if the glucose testing function is somewhat above mediocre AND integrates well with a journal app of my ups and downs, I'm sold. No questions, line me up for a too-expensive band, the charging station, etc.
- mayava 10y ago
  Appreciate you sharing your perspective on this. Interesting to listen to the debate re: the merits of various technical approaches, but ultimately what matters is whether people will actually USE the product and derive health benefits.
- BlakePetersen 10y ago
  Are you currently using a CGM? I use the Dexcom G5 which has an iOS app and watch integration. I also have it set up to feed into a night scout instance and am working on a browser extension so I don't need to rely on the web interface so much (plus much more low key). I've found that I keep my watch on all night and really only charge it when in the shower and getting ready and it never seems to come close to dying. I literally just look at my watch and get my glucose. It's a game changer for sure.
  - wishinghand 9y ago
    I do have an integrated CGM but they're so goddamn itchy after the 3rd day, and they're designed to last 6 days. The cost of these things is too much to just use them for 3 days and change anyway.
- antirez 9y ago
  If you like the ability to get notifications without having to charge often, try the Garmin VivoActive HR. You charge it once every week and receive the notifications snippet of the apps you want. Moreover it is a very programmable device with an SDK and so forth. I never used a watch before in my life, but to avoid looking at the phone so often is a great life improvement for me. The watch is also water resistant, so for instance, I can shower while there is some call I need to receive or something like that, and if I get it I just drop out: before I would not even adventure since I could not check the phone to see who was texting/calling and so forth.
HillaryBriss 10y ago
to treat diabetes, the holy grail should only contain water or another low-glycemic beverage.
- brational 10y ago
  wrong diabetes type.
  - coldpie 9y ago
    I really hate that two totally separate diseases have the same name.
    - richie5um 9y ago
      Me too.
pizza 10y ago
Best of luck to them, noninvasive glucose monitoring is not something that has had a lack of attempts: https://en.wikipedia.org/wiki/Noninvasive_glucose_monitor https://en.wikipedia.org/wiki/Noninvasive_glucose_monitor But just because it might be a tough nut to crack, it isn't necessarily impossible. Interested to see how it develops.
- MBCook 10y ago
  The article mentions that too. But if one company had the money and wanted to do the pseudo-altruistic thinking of getting it working by just throwing money at it until someone came up with a breakthrough, Apple has the money to do that. The article is right, they could make a fortune in sales after doing it, and since I'm sure there would be a patent chances are no other smart watch company would be able to make such a thing. I'm not sure that would make up for $2 billion in research (just to make up a number); but Apple can afford it.
  - jlebrech 9y ago
    370 million diabetics in the world, it's also a disease of affluence [1] so they'll have money to buy an iphone and watch combo. 1. https://en.wikipedia.org/wiki/Diseases_of_affluence https://en.wikipedia.org/wiki/Diseases_of_affluence
    - whostolemyhat 9y ago
      Type 2 diabetes may be, but I don't think my wallet caused my pancreas to pack in
      - jlebrech 9y ago
        http://www.foxnews.com/health/2014/04/15/too-much-animal-protein-linked-to-increased-diabetes-risk.html http://www.foxnews.com/health/2014/04/15/too-much-animal-pro...
        9y ago
burntrelish1273 10y ago
Grew up in a household with an adult-onset type-1 diabetic whom had little remaining biological control, either high or low: Interstitial monitoring has been "around the corner" for 30 years. Let's hope some shop can deliver a reasonably-priced, accurate-enough interstitial or tiny implantable device that can replace daily/routine blood sampling.
Mz 10y ago
One would hope this would also lead to better data on things like diabetes. From what I have read, we really don't understand it as well as a lot of people seem to think. It would be nice to have more comprehensive data sets so we can figure out better treatment modalities.
scentoni 9y ago
I saw a presentation at Stanford around 2000 of the science and engineering behind a watch-like device that would measure glucose levels in the interstitial fluid extracted from the skin with an electric zap. I think it is the GlucoWatch, which seems not to have worked out well in practice. http://www.mendosa.com/glucowatch.htm http://www.mendosa.com/glucowatch.htm https://en.wikipedia.org/wiki/Cygnus_Inc https://en.wikipedia.org/wiki/Cygnus_Inc
cperciva 9y ago
The holy grail for treating diabetes is not a continuous glucose monitor -- not even a noninvasive one. The holy grail for treating diabetes is regulating the immune system so that it doesn't attack beta cells.
jk2323 9y ago
Anyone has the contact information of Johny Srouji? (Speak Email). I would like to send him some of our research about non-invasive blood glucose measurement. Don't think anything comparable exists.
du_bing 9y ago
This is great, I have been waiting for this to monitor my body state. But is there already any good device or sensor that can monitor my heartbeat?
reacweb 9y ago
Most of the scientific breakthrough were preceded by improvement of measure instruments. IMHO a constant monitoring of some health indicators of many people good give invaluable data for researchers.
- amelius 9y ago
  > a constant monitoring of some health indicators of many people good give invaluable data for researchers. Yes, Apple's researchers ...
  - HappyTypist 9y ago
    Have you heard of ResearchKit?
iamgopal 9y ago
Stupid me thinks that if they can measure data that is even indirectly related to blood glucose with sufficient quantity they can actually infer glucose level with quite accuracy. I.e. only with measuring heart beat, oxygen and co2 level at the skin, temperature and time of the day, and sufficient data crunching they can actually know the glucose levels.
- BjoernKW 9y ago
  For hyperglycaemia at least ketones would be a significant marker. In sufficient concentration they even have a characteristic smell detectable by humans. So, creating a sensor that measures ketone concentration shouldn't be too difficult. Hypoglycaemia is more difficult to diagnose because apart from the actual blood glucose level there's no definite symptom that doesn't occur with other conditions as well (typical symptoms include headaches, dizziness, confusion, high pulse rate).
- jpttsn 9y ago
  Careful there. In this domain, you need the measurement to be accurate every time, and especially on atypical days: that one time you run a marathon or get stuck in the elevator with no food. I get scared thinking of training a glucose predictor on big data. It could reach treacherously high accuracy scores, by secretly assuming every day is an average day.
sambe 9y ago
Is anyone else doing good quality home-testing/monitoring devices for other metrics? I occasionally look around for e.g. cholesterol and find that home kits are not thoroughly reviewed or unreliable if reviewed more thoroughly. In addition, they often miss important values or are considered painful/awkward to use. You could think of a few other metrics you might want to collect at home (say, kidney/liver function), and urine sticks seem the best option right now. For blood glucose the problem seems more-or-less solved at a basic level (I've tried an Aviva Nano, seems pretty good) due to diabetic demand. I'm sure integration and further improvements are possible but I personally would like to see more frequent monitoring of more metrics.
fsiefken 9y ago
Yesterday my Healbe GoBe 2 healthband arrived, it has an array of non-invasive sensors which values can be used to take a good guess at how much calories are burned from carbohydrates, proteins and fats. Each time you eat you have to push a button. https://www.techwalla.com/12049437/healbe-gobe-2-is-a-fitness-band-that-knows-what-youve-eaten-review https://www.techwalla.com/12049437/healbe-gobe-2-is-a-fitnes...
- mtw 9y ago
  Quite an interesting device. But sounds a little too good to be true for $179? It'd be great to have clinical trials and also qualified people (doctors, diabetic users etc.) to review it and compare with other devices
  - bigtimeidiot 9y ago
    >It'd be great to have clinical trials and also qualified people (doctors, diabetic users etc.) to review it and compare with other devices If there is no potential for harm (like with medications), throw it out there and see what happens. The market will validate the technology, one way or another.
    - gedrap 9y ago
      There is some potential for harm: people making decisions based on incorrect information. Yes, you shouldn't trust such a device completely. But if you can't trust it... What's the point, other than an expensive cool toy?
      - fsiefken 9y ago
        Hi gedrap, even if the calorie-intake tracker doesn't work, it has a gsr, heartrate, sleep, steps and hydration tracker which work for certain (i'm using it now).
  - dmix 9y ago
    This seems like a simple thing to disprove. Anyone with access to high quality sensors could compare results. Any professional with a bit of spare time... I'm sure if it was inaccurate that it would come out pretty quickly on review sites. Edit: the article the person above linked to includes exactly that > When the first GoBe band was released in 2014, it was the target of some harsh criticism. The medical blog The Doctor Weighs In, for example, made this call based on Healbe's marketing pitch [...]
JulianRaphael 9y ago
These guys from Israel have a very promising approach: https://www.osapublishing.org/boe/fulltext.cfm?uri=boe-5-6-1926&id=286417 https://www.osapublishing.org/boe/fulltext.cfm?uri=boe-5-6-1... Is someone else in here besides me working on self-made tracking tools for logging your metrics beyond glucose? Would love to chat!
surfrider 9y ago
Whatever. HN may appreciate that there is a small force of nature callled #WeAreNotWaiting comprised of diabetic engineers and more that is tired of waiting for innovation to help manage the EVERYDAY in the life with out a pancreas.
- arafa 9y ago
  Some of those folks have even automated blood sugar detection and insulin management, creating basically an artificial pancreas. It's pretty cool (open source) software if people want to learn more, called Nightwatch.
- dmix 9y ago
  Can you expand on what you mean by this? Is it an open source project or community?
- BlakePetersen 9y ago
  Come on now. This shouldn't be dismissed as trivial. The most critical component of Nightscout (#WeAreNotWaiting's OSS) is continuous glucose monitoring. THIS provides THAT. And all by (what sounds like) wearing an Apple Watch 3 or 4. Right now I have to drive a 1.5 inch needle into my gut every time I need to swap out my subcutaneous sensor, which is 1/week. These sensors are made of platinum and other precious metals and are expensive, especially without insurance. Plus, you have a lil nub sticking off your body, not the worse thing but it can get caught in door frames and what not. I'm wearing an Apple Watch right now that shows my glucose readings (217 --> for the other T1Ds ;]). If I could remove the sensor from the equation, maybe even be liberated from my iPhone every now and again, it would ease dealing with my condition a good amount. Simply put, one needs to monitor glucose passively to allow for the closed loop artificial pancreas these guys are working towards. This technology would make that monitoring so much easier, cheaper, more efficient and less wasteful.
CodeSheikh 9y ago
If Apple nail this one then their Apple Watch sales are going to sky rocket. I have a failing they can, especially with the type of money they have.
- adamfarmer 9y ago
  CodeSheikh, This is fantastic. The Helo LX is a device already ahead of Apple's Engineers. You can find the Helo LX at http://Farmer.Helo.Life http://Farmer.Helo.Life look into who Antonio De Rosa is. In short, he is our chief designer and he was on that Apple iWatch team in 2010. We are ahead of Apple on this one. Those sensors exist today and guess who has them?! But this is great, Apple has a much bigger marketing budget than we do.
adamfarmer 9y ago
This is fantastic. The Helo LX is a device already ahead of Apple's Engineers. You can find the Helo LX at http://Farmer.Helo.Life http://Farmer.Helo.Life look into who Antonio De Rosa is. In short, he is our chief designer and he was on that Apple iWatch team in 2010. We are ahead of Apple on this one. Those sensors exist today and guess who has them?! But this is great, Apple has a much bigger marketing budget than we do.
- faitswulff 9y ago
  I can't tell whether you're being sarcastic when you say "this is fantastic/this is great."
- jonwachob91 9y ago
  Not only do they have a much bigger marketing budget, but they seem to have a more experienced marketing team. Why is your site requiring me to send you personal information before I can watch a two minute clip that Fox did on you? Not only will I not send you that information, but I won't be able to watch your video and share with others what may or may not be some cool tech. You are shooting yourself in the foot using these "worst-practices".
msrupnik 9y ago
Measuring glucose makes little sense, no matter how precisely and non-invasively it is done. Physiologically speaking is glucose part of the solution in people with impaired insulin function, not the problem.

205 points by mayava 10y ago

leoh 10y ago

I don't understand how having ubiquitous sensors is the "holy grail for treating diabetes."

ivanbakel 10y ago
Seriously. You'd think genetic therapy, or even just a sensor-injector automatic combo (which to my knowledge already exist) might be more worthy of the title. But then, it's evident that the article is giving Apple too much credit already - even a life-saving sensor wouldn't be able to make a several-hundred-dollar gimmick worth buying.
- MBCook 10y ago
  You don't think an Apple Watch (which starts at about $350) which could monitor your glucose more or less continuously would be far more preferable to a huge chunk of people then occasionally sticking themes with a lance and then trying to record the reading of a portable meter they have to carry around? Don't forget you have to buy the little strips. Let's ignore the idea of insurance paying for this or any other kind of help. I imagine the Apple Watch would end up paying for itself for a type one diabetic within what, a year or two? I know those little testing strips aren't cheap. But the Apple Watch would give you much better monitoring, no pain, no testing, far more data… Oh yeah and every feature that the people who already have an Apple Watch like. As others have mentioned in this thread, I'm sure it's INCREDIBLY easy to get small children to test their blood glucose when necessary. I imagine this would easily be worth it to a lot of parents as well.
  - ivanbakel 9y ago
    I think the technology would be better put to use on something other than the Apple Watch, unless an equivalent sensor minus Apple's other contributions also somehow starts at $350. You're conflating the sensor with an overpriced and rather useless piece of technology, which I say as the owner of one. I'm in full support of a non-invasive sensor for diabetics, but if we manage to come up with one, I would be against giving it an Apple price tag.
    - MBCook 9y ago
      Apple could invent this an then license the sensor to other people. They gave away health kit. And they could choose not to license it to their competitors, only medical companies. But surely they'd put it on their own devices as well. Seems like a weird attitude though: If company X can afford to (possibly waste) billions of dollars to make a medical breakthrough in Y, I don't want them to because then they'd use it themselves and charge money.
      - ivanbakel 9y ago
        Where did I say that I don't want Apple to pursue this research? I just said that I don't want it to be solely available on Apple devices, and I certainly wouldn't support a company being congratulated for providing a medical service at an incredible cost.
- jpttsn 9y ago
  > even a life-saving sensor wouldn't be able to make a several-hundred-dollar gimmick worth buying What a curious set of priorities.
- tracker1 9y ago
  Not a gimmick at all... if I could track my blood sugar in even 5 minute intervals, it would be nice to know, and help a lot. As it is, I'm LADA, which has aspects of type 1 and 2, and my body is also very adept with gluconeogenesis... even if I have nearly no carbs (no refined sugars, no bread/pasta, minimal overall intake) for a few days, my blood sugar can start spinning out. It's about keeping things as level as possible. Also, genetic therapy could be amazing... but it's still, afaik a very long way off.
  - ivanbakel 9y ago
    I was referring to the Watch itself as a gimmick, which I think it currently is.
semi-extrinsic 10y ago
We already have automated continuous insulin injection pumps that work well. It's a big improvement over shots every few hours. But they still need manual setting of pump rate, based on manual periodic measurements. A noninvasive sensor that measures blood glucose accurately, even just once a minute, would give you the ability to close the feedback loop and remove all human input from the system. No "oh shit I forgot to measure and adjust". Especially for kids it would be a big breakthrough. In essence, you'd have an almost-perfect artificial pancreas.
- jcims 10y ago
  Medtronic released the first closed loop pump this year.
  - zaroth 10y ago
    I'd say closed loop ish system. It uses the CGM data to make temp-basal adjustments. It's not like a full autopilot or anything. Since modern fast acting insulin still takes time to kick in, you need to dose to cover carbs about 15 minutes before eating. So there will always be some level of involvement of you want to avoid actually going high and then coming back down (proactive vs reactive). Don't get me wrong, it's great to know you're going to wake up at your target even if you screwed up your dinner-time bolus a bit. That is, assuming the CGM is functioning properly. My experience with the Dexcom G4 with my kids was much less than stellar. Lots of '???' readings or having it off by over 50 points, extremely painful insertions and being mostly useless the first 24 hours and then sensors failing long before 7 days was the norm and ultimately we abandoned it. Anxiously waiting for the auto-inserting CGM to come out of trials.
    - coldpie 9y ago
      That's too bad. I got my Dexcom about 18 months ago and while it's not perfect and very expensive, I really do miss it if I have to go a week without it. I can imagine having to use it on children would be pretty nasty, though. Putting the sensor in is not a fun time for a grown adult. You have multiple kids with T1D? That's a stroke of bad luck :(
llccbb 10y ago
I am certainly not defending the article, but here is my take from living and being very close with a type-1 diabetic. The holy grail of __treating__ diabetes is technology that helps maintain excellent blood glucose control. Diabetes Mellitus (T1) is not a curable disease right now except through pancreas transplants. Diabetes is therefore a disease that has to be treated. The treatment for diabetes is personal, non-uniform, active, and adaptive. Every ingestion of food or liquid affects your body and needs to be considered. Diabetes is a disease that needs its symptoms to be monitored and managed at a high granularity. Both monitoring and managing blood glucose can be really invasive though, with needles and finger-sticks causing extensive scar tissue development. Minimally invasive glucose monitoring technology that generates high-resolution time series data (such as Dexcom systems) literally transforms the way that people can manage their disease. Going from glucose reading every 6 hours (test strips) to every 5 minutes (CGM) is life changing. Monitoring that is non-invasive is the next technological step. The holy grail for treating diabetes should actually be stabilized monomeric human insulin. Afrezza[0] is exactly that, and inhalable no less. The company that makes it just can't break through the insulin cartels and insurance-pharma exclusivity, so they are having a hard time. They did what was unachievable for 100 years though, and they are amazing chemists. [0] https://www.afrezza.com/hcp/afrezza-action-profile/ https://www.afrezza.com/hcp/afrezza-action-profile/
- zaroth 10y ago
  I'm not sure inhalable is a feature. Insulin pumps/pods micro-dose fast acting insulin throughout the day to cover your basal dose, you can't do that with fast-acting insulin via inhaler. You can't close loop your inhaler with a CGM to adjust your basal based on your current BG and automatically control for overnight highs/lows. You can't dose your kid from across the room from your smartphone. Also there seems to be a a notable incidence of lung cancer which raises a bit of a yellow flag there...
  - llccbb 10y ago
    I think alternative delivery mechanisms to injection are a feature. Ask any diabetic if they would like less needles in their bodies. There is work and patents on adjustable dose inhaler systems, but its never going to be a basal insulin that is being delivered. It's prandial. The lung cancer concerns come from the only previous inhaled insulin Exhubra, which was literally vaporized insulin solution and offered no pharmacological benefit over injected insulin. The two instances of lung cancer in the 12(?) years of Afrezza testing occurred with patients who were smokers. I'm not saying that Afrezza is the greatest invention ever, but it is a substantial step up from other mealtime insulins in my opinion.
jk2323 9y ago
It is not about "ubiquitous sensors", it is about non-invasive. A good starting point would be: http://www.mendosa.com/The%20Pursuit%20of%20Noninvsive%20Glucose,%20Fourth%20Edition.pdf http://www.mendosa.com/The%20Pursuit%20of%20Noninvsive%20Glu... Would be very interested in the email of Johny Srouji.
vfuse 9y ago
Research by doctors such as Bart Roep at the City of Hope is the holy grail. Sensors like this already exists like the Freestyle Libre by Abbott.
abarringer 9y ago
Clearly you don't have diabetes. Everyone responds differently to the same inputs. My BG spikes hundreds of points if I eat a banana. It drops 50pts an hour when sitting in intense sun. Make sense? No.. is it repeatable, for me, yes. Would ubiquitous sensors help me identify more of these patterns? Absolutely.

differentView 10y ago

That's great, but why not make them round?

patrickmn 10y ago

A low-carb diet? (Tongue-in-cheek, but not really.)

philip1209 10y ago
A low-carb diet app for treating type 2 diabetes already launched (with $37M in funding): http://virtahealth.com http://virtahealth.com
- amalag 10y ago
  This is great, we need more lifestyle approaches to disease. Not just people hoping a magic pill will fix it without them having to change their behavior.
  - andyfleming 10y ago
    Type 1 and Type 2 diabetes are completely different conversations, but regardless everyone should try to take lifestyle approaches to improving their health (in addition to whatever is medically necessary).
    - patrickmn 9y ago
      Yes, this is very important: Diet can be a complement to medical treatment, not a replacement. Don't make Steve Jobs' mistake!
  - tracker1 9y ago
    Even going very low carb, gluconeogenesis paths can still cause a diabetic to have very elevated blood sugar... It's about keeping things as level as possible and a non-invasive monitoring path can help a lot... I was very low carb (fewer than 30g/day) for over a year, and was still hospitalized for ketoacidosis.
DiabloD3 10y ago
Yeah, I've been saying for years now we've cured most modern diseases, including diabetes: follow a strict low carb variant of the Paleo diet. No grains, no refined sugars (that means no fruit juices as well), no legumes, no garbage oils (canola, corn, soy, etc); moderate protein, high (quality) fat (meat itself, olive oil and coconut oil), low carbs (and only healthy sources from whole actual foods). Every diabetic, no matter how severe, who has successfully adopted this diet has gone on to not only managing their diabetes, but frequently moving on to no longer needing any medicine, and sometimes even healing at least some of the damage (something modern medicine claims is impossible). Don't believe the hype that a cure is coming soon: it already came, and it isn't something you can shove into a pill, market, and sell for high prices.

jshevek 10y ago

Amazing the lengths our society will go to cling to our hedonism, even when it's killing us. We should be doing more with dietary solutions, not this.

erikpukinskis 10y ago
Our society values economic growth above everything. That means you get rewarded more for creating a problem and then making it go away than for solving the problem completely. This is everywhere. Feeling lonely? You could just hang out in your yard with your neighbors and cousins, put some ice in the cooler and see what people bring over to eat. Or you could stop talking to them entirely, get dressed up in expensive clothes, and come to our exclusive lounge with other people who are up on the latest fashions as well, drink a fancy cocktail, and look down at the people who are drinking cheap beers out of a cooler. Guess which of these does more for the economy? And which one gets the crap advertised out of it?
- consz 10y ago
  What if nobody comes over to your cooler?
jermops 10y ago
That helps some forms of type-2, but not type-1. This would be a godsend for people if they can make it work reliably.
- yourapostasy 10y ago
  Judging by some posts I gleaned from /r/diabetes with a quick skim just now, even Type 1's who regulate their net carb intake benefit by being able to reduce their required insulin. In the US, that is a very significant personal financial factor with our broken healthcare system. That forum is littered with Type 1's sharing prices of their insulin medications. From what I read, there are many different kinds of insulin, and even the generic kind that WalMart sells without a prescription (in some states) is not cheap for middle-income households. And unless you have gold-plated medical insurance, the really nice insulin can run into low thousands per month, depending upon your required dosage. Type 2 takes up a disproportionate amount of healthcare funds because for most patients diet and moderate exercise can mitigate it according to enough researchers that Sweden's national health system switched to advocating low-carb for Type 2 diabetics. Karl Denninger at Market Ticker is a vociferous advocate of low carb for Type 2's, based upon his first-hand experience, and has written a lot about the financial aspects. EDIT: I'm guessing downvotes are from Type 2 patients here who get pissed off when told diet and moderate exercise can help them. I don't think folks in /r/diabetes, /r/fasting, /r/keto, Karl Denninger, Dr. Fung, etc. are saying you'll be cured; it sounds more like better control leading to fewer late-life complications (which is where the real healthcare expenses get out of control). I'm coming in at this from the life extension and the terrible US healthcare financial picture angle; I keep seeing interesting caloric restriction research intersecting with low-carb findings and keep running across diabetics fiddling around with the same protocols that caloric restriction life extension folks like me are experimenting with. As always, YMMV, but I keep seeing enough diabetics dabbling with low-carb and caloric restriction that it raises my eyebrow, and that Sweden thought it was enough to switch their recommendations should be given some consideration when putting together your own health plan.

wishinghand 10y ago

I'm a type 1 diabetic and I've been waiting for this. I'm not a big fan of watches but having a wrist mounted snippet of the email/Slack/text that I just received has been enticing, but not worth the 1 day charge time of the iWatch. But even if the glucose testing function is somewhat above mediocre AND integrates well with a journal app of my ups and downs, I'm sold. No questions, line me up for a too-expensive band, the charging station, etc.

mayava 10y ago
Appreciate you sharing your perspective on this. Interesting to listen to the debate re: the merits of various technical approaches, but ultimately what matters is whether people will actually USE the product and derive health benefits.
BlakePetersen 10y ago
Are you currently using a CGM? I use the Dexcom G5 which has an iOS app and watch integration. I also have it set up to feed into a night scout instance and am working on a browser extension so I don't need to rely on the web interface so much (plus much more low key). I've found that I keep my watch on all night and really only charge it when in the shower and getting ready and it never seems to come close to dying. I literally just look at my watch and get my glucose. It's a game changer for sure.
- wishinghand 9y ago
  I do have an integrated CGM but they're so goddamn itchy after the 3rd day, and they're designed to last 6 days. The cost of these things is too much to just use them for 3 days and change anyway.
antirez 9y ago
If you like the ability to get notifications without having to charge often, try the Garmin VivoActive HR. You charge it once every week and receive the notifications snippet of the apps you want. Moreover it is a very programmable device with an SDK and so forth. I never used a watch before in my life, but to avoid looking at the phone so often is a great life improvement for me. The watch is also water resistant, so for instance, I can shower while there is some call I need to receive or something like that, and if I get it I just drop out: before I would not even adventure since I could not check the phone to see who was texting/calling and so forth.

HillaryBriss 10y ago

to treat diabetes, the holy grail should only contain water or another low-glycemic beverage.

brational 10y ago
wrong diabetes type.
- coldpie 9y ago
  I really hate that two totally separate diseases have the same name.
  - richie5um 9y ago
    Me too.

pizza 10y ago

Best of luck to them, noninvasive glucose monitoring is not something that has had a lack of attempts: https://en.wikipedia.org/wiki/Noninvasive_glucose_monitor https://en.wikipedia.org/wiki/Noninvasive_glucose_monitor But just because it might be a tough nut to crack, it isn't necessarily impossible. Interested to see how it develops.

MBCook 10y ago
The article mentions that too. But if one company had the money and wanted to do the pseudo-altruistic thinking of getting it working by just throwing money at it until someone came up with a breakthrough, Apple has the money to do that. The article is right, they could make a fortune in sales after doing it, and since I'm sure there would be a patent chances are no other smart watch company would be able to make such a thing. I'm not sure that would make up for $2 billion in research (just to make up a number); but Apple can afford it.
- jlebrech 9y ago
  370 million diabetics in the world, it's also a disease of affluence [1] so they'll have money to buy an iphone and watch combo. 1. https://en.wikipedia.org/wiki/Diseases_of_affluence https://en.wikipedia.org/wiki/Diseases_of_affluence
  - whostolemyhat 9y ago
    Type 2 diabetes may be, but I don't think my wallet caused my pancreas to pack in
    - jlebrech 9y ago
      http://www.foxnews.com/health/2014/04/15/too-much-animal-protein-linked-to-increased-diabetes-risk.html http://www.foxnews.com/health/2014/04/15/too-much-animal-pro...
      - 9y ago

burntrelish1273 10y ago

Grew up in a household with an adult-onset type-1 diabetic whom had little remaining biological control, either high or low: Interstitial monitoring has been "around the corner" for 30 years. Let's hope some shop can deliver a reasonably-priced, accurate-enough interstitial or tiny implantable device that can replace daily/routine blood sampling.

Mz 10y ago

One would hope this would also lead to better data on things like diabetes. From what I have read, we really don't understand it as well as a lot of people seem to think. It would be nice to have more comprehensive data sets so we can figure out better treatment modalities.

scentoni 9y ago

I saw a presentation at Stanford around 2000 of the science and engineering behind a watch-like device that would measure glucose levels in the interstitial fluid extracted from the skin with an electric zap. I think it is the GlucoWatch, which seems not to have worked out well in practice. http://www.mendosa.com/glucowatch.htm http://www.mendosa.com/glucowatch.htm https://en.wikipedia.org/wiki/Cygnus_Inc https://en.wikipedia.org/wiki/Cygnus_Inc

cperciva 9y ago

The holy grail for treating diabetes is not a continuous glucose monitor -- not even a noninvasive one. The holy grail for treating diabetes is regulating the immune system so that it doesn't attack beta cells.

jk2323 9y ago

Anyone has the contact information of Johny Srouji? (Speak Email). I would like to send him some of our research about non-invasive blood glucose measurement. Don't think anything comparable exists.

du_bing 9y ago

This is great, I have been waiting for this to monitor my body state. But is there already any good device or sensor that can monitor my heartbeat?

reacweb 9y ago

Most of the scientific breakthrough were preceded by improvement of measure instruments. IMHO a constant monitoring of some health indicators of many people good give invaluable data for researchers.

amelius 9y ago
> a constant monitoring of some health indicators of many people good give invaluable data for researchers. Yes, Apple's researchers ...
- HappyTypist 9y ago
  Have you heard of ResearchKit?

iamgopal 9y ago

Stupid me thinks that if they can measure data that is even indirectly related to blood glucose with sufficient quantity they can actually infer glucose level with quite accuracy. I.e. only with measuring heart beat, oxygen and co2 level at the skin, temperature and time of the day, and sufficient data crunching they can actually know the glucose levels.

BjoernKW 9y ago
For hyperglycaemia at least ketones would be a significant marker. In sufficient concentration they even have a characteristic smell detectable by humans. So, creating a sensor that measures ketone concentration shouldn't be too difficult. Hypoglycaemia is more difficult to diagnose because apart from the actual blood glucose level there's no definite symptom that doesn't occur with other conditions as well (typical symptoms include headaches, dizziness, confusion, high pulse rate).
jpttsn 9y ago
Careful there. In this domain, you need the measurement to be accurate every time, and especially on atypical days: that one time you run a marathon or get stuck in the elevator with no food. I get scared thinking of training a glucose predictor on big data. It could reach treacherously high accuracy scores, by secretly assuming every day is an average day.

sambe 9y ago

Is anyone else doing good quality home-testing/monitoring devices for other metrics? I occasionally look around for e.g. cholesterol and find that home kits are not thoroughly reviewed or unreliable if reviewed more thoroughly. In addition, they often miss important values or are considered painful/awkward to use. You could think of a few other metrics you might want to collect at home (say, kidney/liver function), and urine sticks seem the best option right now. For blood glucose the problem seems more-or-less solved at a basic level (I've tried an Aviva Nano, seems pretty good) due to diabetic demand. I'm sure integration and further improvements are possible but I personally would like to see more frequent monitoring of more metrics.

fsiefken 9y ago

Yesterday my Healbe GoBe 2 healthband arrived, it has an array of non-invasive sensors which values can be used to take a good guess at how much calories are burned from carbohydrates, proteins and fats. Each time you eat you have to push a button. https://www.techwalla.com/12049437/healbe-gobe-2-is-a-fitness-band-that-knows-what-youve-eaten-review https://www.techwalla.com/12049437/healbe-gobe-2-is-a-fitnes...

mtw 9y ago
Quite an interesting device. But sounds a little too good to be true for $179? It'd be great to have clinical trials and also qualified people (doctors, diabetic users etc.) to review it and compare with other devices
- bigtimeidiot 9y ago
  >It'd be great to have clinical trials and also qualified people (doctors, diabetic users etc.) to review it and compare with other devices If there is no potential for harm (like with medications), throw it out there and see what happens. The market will validate the technology, one way or another.
  - gedrap 9y ago
    There is some potential for harm: people making decisions based on incorrect information. Yes, you shouldn't trust such a device completely. But if you can't trust it... What's the point, other than an expensive cool toy?
    - fsiefken 9y ago
      Hi gedrap, even if the calorie-intake tracker doesn't work, it has a gsr, heartrate, sleep, steps and hydration tracker which work for certain (i'm using it now).
- dmix 9y ago
  This seems like a simple thing to disprove. Anyone with access to high quality sensors could compare results. Any professional with a bit of spare time... I'm sure if it was inaccurate that it would come out pretty quickly on review sites. Edit: the article the person above linked to includes exactly that > When the first GoBe band was released in 2014, it was the target of some harsh criticism. The medical blog The Doctor Weighs In, for example, made this call based on Healbe's marketing pitch [...]

JulianRaphael 9y ago

These guys from Israel have a very promising approach: https://www.osapublishing.org/boe/fulltext.cfm?uri=boe-5-6-1926&id=286417 https://www.osapublishing.org/boe/fulltext.cfm?uri=boe-5-6-1... Is someone else in here besides me working on self-made tracking tools for logging your metrics beyond glucose? Would love to chat!

surfrider 9y ago

Whatever. HN may appreciate that there is a small force of nature callled #WeAreNotWaiting comprised of diabetic engineers and more that is tired of waiting for innovation to help manage the EVERYDAY in the life with out a pancreas.

arafa 9y ago
Some of those folks have even automated blood sugar detection and insulin management, creating basically an artificial pancreas. It's pretty cool (open source) software if people want to learn more, called Nightwatch.
dmix 9y ago
Can you expand on what you mean by this? Is it an open source project or community?
BlakePetersen 9y ago
Come on now. This shouldn't be dismissed as trivial. The most critical component of Nightscout (#WeAreNotWaiting's OSS) is continuous glucose monitoring. THIS provides THAT. And all by (what sounds like) wearing an Apple Watch 3 or 4. Right now I have to drive a 1.5 inch needle into my gut every time I need to swap out my subcutaneous sensor, which is 1/week. These sensors are made of platinum and other precious metals and are expensive, especially without insurance. Plus, you have a lil nub sticking off your body, not the worse thing but it can get caught in door frames and what not. I'm wearing an Apple Watch right now that shows my glucose readings (217 --> for the other T1Ds ;]). If I could remove the sensor from the equation, maybe even be liberated from my iPhone every now and again, it would ease dealing with my condition a good amount. Simply put, one needs to monitor glucose passively to allow for the closed loop artificial pancreas these guys are working towards. This technology would make that monitoring so much easier, cheaper, more efficient and less wasteful.

CodeSheikh 9y ago

If Apple nail this one then their Apple Watch sales are going to sky rocket. I have a failing they can, especially with the type of money they have.

adamfarmer 9y ago
CodeSheikh, This is fantastic. The Helo LX is a device already ahead of Apple's Engineers. You can find the Helo LX at http://Farmer.Helo.Life http://Farmer.Helo.Life look into who Antonio De Rosa is. In short, he is our chief designer and he was on that Apple iWatch team in 2010. We are ahead of Apple on this one. Those sensors exist today and guess who has them?! But this is great, Apple has a much bigger marketing budget than we do.

adamfarmer 9y ago

This is fantastic. The Helo LX is a device already ahead of Apple's Engineers. You can find the Helo LX at http://Farmer.Helo.Life http://Farmer.Helo.Life look into who Antonio De Rosa is. In short, he is our chief designer and he was on that Apple iWatch team in 2010. We are ahead of Apple on this one. Those sensors exist today and guess who has them?! But this is great, Apple has a much bigger marketing budget than we do.

faitswulff 9y ago
I can't tell whether you're being sarcastic when you say "this is fantastic/this is great."
jonwachob91 9y ago
Not only do they have a much bigger marketing budget, but they seem to have a more experienced marketing team. Why is your site requiring me to send you personal information before I can watch a two minute clip that Fox did on you? Not only will I not send you that information, but I won't be able to watch your video and share with others what may or may not be some cool tech. You are shooting yourself in the foot using these "worst-practices".

msrupnik 9y ago

Measuring glucose makes little sense, no matter how precisely and non-invasively it is done. Physiologically speaking is glucose part of the solution in people with impaired insulin function, not the problem.