4 ms·

The device claims to have 97% of reading within 15% of the Freestyle Libre, which itself is then not as accurate as blood glucose. Put another way, it’s less a

The device claims to have 97% of reading within 15% of the Freestyle Libre, which itself is then not as accurate as blood glucose. Put another way, it’s less accurate than a device that’s already less accurate than finger sticks. Given this info, I’m not sure this version is practically useful yet in terms of accuracy.

paxys 5y ago
A completely non-invasive device even getting close to the accuracy of finger stick or implanted devices is a big deal.
- guywhocodes 5y ago
  Agreed, as a diabetic and climber I've used a lot of the libre pucks but honestly, there is no spot on my body I wont use while practicing my sport. Still the libre was miles better than always pricking my fingers and arms. I've been thinking about what kind of EM-signal could be used for this for a long time, IR-spectroscopy never seemed possible. But this has real potential.
  - john_yaya 5y ago
    I worked on the Freestyle Libre, I’m thrilled to hear it’s at least a workable solution for you. When I was working at Abbott, I often volunteered for testing finger-stick devices, which made me appreciate a small part of what people with diabetes have to endure.
    - rstupek 5y ago
      I've used them and they're great just pricey
      - inetsee 5y ago
        I use a Freestyle Libre sensor and I like it better than finger sticks. When I was doing finger sticks I was averaging 4 tests a day; before each meal and at bedtime. With the Freestyle Libre I'm checking my glucose an average of 20 times a day. But the Freestyle Libre sensors are quite expensive. I have insurance so my out of pocket expenses are very low, but my provider bills $1074 for 2 sensors, which last for 4 weeks. I have read comments from other posts that buyers without insurance can get sensors for substantially less, but they are still quite expensive. When I was doing finger sticks I could get enough test strips for a month for about $30.
        guywhocodes 5y ago
        Your provider is being ripped off, I'm pretty sure my doctor is not selling them subsidized and I'm paying roughly US$62 each. I still find it quite expensive but it's acceptable with my income and taxation where I live.
        hellbannedguy 5y ago
        What country?
        inetsee 5y ago
        The provider bills for $1074, but their actual reimbursement is only $208 for 2 sensors.
    - ninjin 5y ago
      I am deeply grateful for your work and that of Abbott. The Libre has been life changing for me, possibly ever more so than getting a pump as it gave me a much clearer picture how my body reacts to different foods, exercise, lack of sleep, etc. After about two years of usage I have encountered very few issues at all. My only complaint was that I would like to scold whoever crippled the sensors and readers somewhat by making them region specific for what I can only assume are purely market control reasons (not to mention that this is not obvious from the packaging or instructions from what I can tell and I only found out when talking to an Abbott representative that cautioned me that readers and sensors were not compatible between regions).
1123581321 5y ago
Patients averse to finger sticks are going to use this much more often. It's going to provide more useful data to them. Much of the time the exact number isn't as important as knowing the trend or the general range. Whether this makes more sense than a Libre for someone just depends on price and how insurance treats it.
- wincy 5y ago
  I tested my blood sugar when my wife was pregnant and she was testing hers. I was amazed at how just from the small blood stick, and even if I had my wife do it and didn’t see any blood, I’d get sick to my stomach every time I did a blood stick. I’m glad I don’t have diabetes or I’d have a terrible time of it.
  - 1123581321 5y ago
    Yes, it's not fun. On top of that, for a permanent diabetic, finger sticks over a long period of time are an infection risk, especially if the patient isn't good at using all of their fingers (I got comfortable with it and there were still at 4-5 finger locations that I dreaded pricking.)
  - gremloni 5y ago
    Then do it till you get over it. You’re just so comfortable being a pansy, it disgusts me.
idealmedtech 5y ago
Hi, this is actually my field of expertise! IdealMedTech is a clinical glucose control startup targeting inpatient glucose control. Having an MARD (mean absolute relative difference, or in math terms, E[|g-r|/r], g is measured glucose, r is reference glucose) of below 15% is actually considered very good for glucose monitoring. We did a study that involved modelling different levels of sensor error, and you actually start to see diminishing returns on control once your MARD passes below 10%, with 15% being a good target. Most sensors on the market that are considered best in class (eg Dexcom G6) have guaranteed MARD below 15%, usually sitting right at 10%. Getting lower than that is very difficult for interstitial glucose, especially using the classical glucose oxidase sensing mechanism. There are other ways to sense glucose using, for example, Raman spectroscopy, and there have been companies successful in employing these techniques (OptiScan comes to mind), but I'm not yet convinced by the capacity of spectroscopy to deliver accurate results in the presence of interference from drugs and perfusion issues.
- a9h74j 5y ago
  In addition, I imagine confounds which are patient/location specific can be calibrated out to some extent, by comparing against finger-stick while fasting, and longer-term A1C. Following a chain of references from the OP: study of wearable: https://cb195ec0-5419-4138-91fc-7288f69116ec.filesusr.com/ugd/23f159_f935920175134c9d8c85c34ebbd21693.pdf https://cb195ec0-5419-4138-91fc-7288f69116ec.filesusr.com/ug... whitepaper announcement: https://medium.com/know-labs/know-labs-releases-white-paper-detailing-experimental-results-of-their-bio-rfid-technology-a7c6ced6dc84 https://medium.com/know-labs/know-labs-releases-white-paper-... whitepaper: https://docs.google.com/document/d/e/2PACX-1vQXqlmKwPzhZIn9tFi3tFHHYFla9ciX8ljZL638JH9AUKjX7-DGKB1Qk4cProTbOp27ZLAhriFfOAVT/pub https://docs.google.com/document/d/e/2PACX-1vQXqlmKwPzhZIn9t... The whitepaper gives actual prep methods for tissue phantoms. It shows a clean correlation of ca 1.72GHz transmission to glucose. Presumably altered parameters in tissue phantoms could help roughly characterize confounds.
- rrrrrrrrrrrryan 5y ago
  > Most sensors on the market that are considered best in class (eg Dexcom G6) have guaranteed MARD Disclaimer: I work for Dexcom. A few times every year, there's a ton of hype about some new noninvasive device, and the newbies get a bit worried, but the old timers just shrug it off. We (humanity) will literally be able to regrow new pancreases with stem cells before we have accurate noninvasive blood glucose devices. Even Tim Cook with unlimited resources at his disposal admitted it's a much harder than they thought. That said, I think there's a large market for people without diabetes who are interested in their blood glucose and who may not need super-accurate readings. For example, as a long distance runner, it'd be super helpful to know if my blood sugar is trending down before I bottom out, so I can know when to eat a gel pack, etc. It would also be useful for people trying to lose weight to learn how their eating habits and exercise affect their blood sugar levels. Noninvasive devices may be better for this group of people who don't need the devices to be accurate enough to make decisions about insulin-dosing.

paxys 5y ago

A completely non-invasive device even getting close to the accuracy of finger stick or implanted devices is a big deal.

guywhocodes 5y ago
Agreed, as a diabetic and climber I've used a lot of the libre pucks but honestly, there is no spot on my body I wont use while practicing my sport. Still the libre was miles better than always pricking my fingers and arms. I've been thinking about what kind of EM-signal could be used for this for a long time, IR-spectroscopy never seemed possible. But this has real potential.
- john_yaya 5y ago
  I worked on the Freestyle Libre, I’m thrilled to hear it’s at least a workable solution for you. When I was working at Abbott, I often volunteered for testing finger-stick devices, which made me appreciate a small part of what people with diabetes have to endure.
  - rstupek 5y ago
    I've used them and they're great just pricey
    - inetsee 5y ago
      I use a Freestyle Libre sensor and I like it better than finger sticks. When I was doing finger sticks I was averaging 4 tests a day; before each meal and at bedtime. With the Freestyle Libre I'm checking my glucose an average of 20 times a day. But the Freestyle Libre sensors are quite expensive. I have insurance so my out of pocket expenses are very low, but my provider bills $1074 for 2 sensors, which last for 4 weeks. I have read comments from other posts that buyers without insurance can get sensors for substantially less, but they are still quite expensive. When I was doing finger sticks I could get enough test strips for a month for about $30.
      - guywhocodes 5y ago
        Your provider is being ripped off, I'm pretty sure my doctor is not selling them subsidized and I'm paying roughly US$62 each. I still find it quite expensive but it's acceptable with my income and taxation where I live.
        hellbannedguy 5y ago
        What country?
        inetsee 5y ago
        The provider bills for $1074, but their actual reimbursement is only $208 for 2 sensors.
  - ninjin 5y ago
    I am deeply grateful for your work and that of Abbott. The Libre has been life changing for me, possibly ever more so than getting a pump as it gave me a much clearer picture how my body reacts to different foods, exercise, lack of sleep, etc. After about two years of usage I have encountered very few issues at all. My only complaint was that I would like to scold whoever crippled the sensors and readers somewhat by making them region specific for what I can only assume are purely market control reasons (not to mention that this is not obvious from the packaging or instructions from what I can tell and I only found out when talking to an Abbott representative that cautioned me that readers and sensors were not compatible between regions).

1123581321 5y ago

Patients averse to finger sticks are going to use this much more often. It's going to provide more useful data to them. Much of the time the exact number isn't as important as knowing the trend or the general range. Whether this makes more sense than a Libre for someone just depends on price and how insurance treats it.

wincy 5y ago
I tested my blood sugar when my wife was pregnant and she was testing hers. I was amazed at how just from the small blood stick, and even if I had my wife do it and didn’t see any blood, I’d get sick to my stomach every time I did a blood stick. I’m glad I don’t have diabetes or I’d have a terrible time of it.
- 1123581321 5y ago
  Yes, it's not fun. On top of that, for a permanent diabetic, finger sticks over a long period of time are an infection risk, especially if the patient isn't good at using all of their fingers (I got comfortable with it and there were still at 4-5 finger locations that I dreaded pricking.)
- gremloni 5y ago
  Then do it till you get over it. You’re just so comfortable being a pansy, it disgusts me.

idealmedtech 5y ago

Hi, this is actually my field of expertise! IdealMedTech is a clinical glucose control startup targeting inpatient glucose control. Having an MARD (mean absolute relative difference, or in math terms, E[|g-r|/r], g is measured glucose, r is reference glucose) of below 15% is actually considered very good for glucose monitoring. We did a study that involved modelling different levels of sensor error, and you actually start to see diminishing returns on control once your MARD passes below 10%, with 15% being a good target. Most sensors on the market that are considered best in class (eg Dexcom G6) have guaranteed MARD below 15%, usually sitting right at 10%. Getting lower than that is very difficult for interstitial glucose, especially using the classical glucose oxidase sensing mechanism. There are other ways to sense glucose using, for example, Raman spectroscopy, and there have been companies successful in employing these techniques (OptiScan comes to mind), but I'm not yet convinced by the capacity of spectroscopy to deliver accurate results in the presence of interference from drugs and perfusion issues.

a9h74j 5y ago
In addition, I imagine confounds which are patient/location specific can be calibrated out to some extent, by comparing against finger-stick while fasting, and longer-term A1C. Following a chain of references from the OP: study of wearable: https://cb195ec0-5419-4138-91fc-7288f69116ec.filesusr.com/ugd/23f159_f935920175134c9d8c85c34ebbd21693.pdf https://cb195ec0-5419-4138-91fc-7288f69116ec.filesusr.com/ug... whitepaper announcement: https://medium.com/know-labs/know-labs-releases-white-paper-detailing-experimental-results-of-their-bio-rfid-technology-a7c6ced6dc84 https://medium.com/know-labs/know-labs-releases-white-paper-... whitepaper: https://docs.google.com/document/d/e/2PACX-1vQXqlmKwPzhZIn9tFi3tFHHYFla9ciX8ljZL638JH9AUKjX7-DGKB1Qk4cProTbOp27ZLAhriFfOAVT/pub https://docs.google.com/document/d/e/2PACX-1vQXqlmKwPzhZIn9t... The whitepaper gives actual prep methods for tissue phantoms. It shows a clean correlation of ca 1.72GHz transmission to glucose. Presumably altered parameters in tissue phantoms could help roughly characterize confounds.
rrrrrrrrrrrryan 5y ago
> Most sensors on the market that are considered best in class (eg Dexcom G6) have guaranteed MARD Disclaimer: I work for Dexcom. A few times every year, there's a ton of hype about some new noninvasive device, and the newbies get a bit worried, but the old timers just shrug it off. We (humanity) will literally be able to regrow new pancreases with stem cells before we have accurate noninvasive blood glucose devices. Even Tim Cook with unlimited resources at his disposal admitted it's a much harder than they thought. That said, I think there's a large market for people without diabetes who are interested in their blood glucose and who may not need super-accurate readings. For example, as a long distance runner, it'd be super helpful to know if my blood sugar is trending down before I bottom out, so I can know when to eat a gel pack, etc. It would also be useful for people trying to lose weight to learn how their eating habits and exercise affect their blood sugar levels. Noninvasive devices may be better for this group of people who don't need the devices to be accurate enough to make decisions about insulin-dosing.