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Headline aside, it sounds like the real news is just how difficult this problem is - even for Apple. Back in 2020-2021, the rumor was that a Watch might include

Headline aside, it sounds like the real news is just how difficult this problem is - even for Apple. Back in 2020-2021, the rumor was that a Watch might include Rockley glucose monitoring[1], possibly in 2022-2024. If this article is correct, Apple is nowhere near that: > Apple’s system — more than 12 years in the making — is now considered to be at a proof-of-concept stage, said the people, who asked not to be identified because the project is confidential. The company believes the technology is viable but needs to be shrunk down to a more practical size. > Engineers are working to develop a prototype device about the size of an iPhone that can be strapped to a person’s bicep. That would be a significant reduction from an early version of the system that sat atop a table. … > Before shifting to TSMC, Apple had worked with Rockley Photonics Holdings Ltd. to develop the sensors and chip for the technology. In 2021, Rockley publicly disclosed its work with Apple, stoking interest in the supplier. Apple later ended the partnership, and Rockley filed for bankruptcy last month. [1]: Related conversations: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&query=rockley%20glucose&sort=byPopularity&type=comment https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...

onepointsixC 4y ago
I don't think anyone who is in the know would be surprised about that. Noninvasive blood glucose monitoring is a multi billion dollar product, should anyone be able to figure it out at all. It's fiendishly difficult, and quite possibly impossible to do it sufficiently accurately, even more so over long periods of time. C8 MediSensors was trying to do it 10 years ago, but ultimately went under. Even with Apple's budget, it's a herculean task.
- akiselev 4y ago
  You’re underselling it. Measuring blood at millimoles per liter precision through skin on a watch sized device is Theranos-esque physically impossible product-market fit. Tricoder level of science fiction.
  - copperx 4y ago
    I wonder whether there are any shortcuts like ingesting a substance to make the glucose visible by the sensor.
    - Cshelton 4y ago
      Bingo. Noninvasive, with any sort of accuracy that can be used for anything, is most likely impossible. So back to "invasive"... what can we do... embedding a device under your skin, right around where your watch goes, that can be powered and communicate with the watch. While also making sure the device is not rejected by the body and stays in place.. AND has no other adverse side-effects. I think this is where it'll ultimately end up for the people who want it. sub 10 min procedure to put it in and should last for quite some time (maybe dissolves after 5 years for upgrades?)
      - blendo 4y ago
        Add heart rate, blood pressure, and blood oxygen level. Have the Apple Watch call 911 if things go pear-shaped. Profit.
        Nekhrimah 4y ago
        > Profit. Well yes, but also substantial life saving interventions become possible.
        Spooky23 4y ago
        They should profit. That will save millions of lives.
      - MengerSponge 4y ago
        Eversense sells something similar to this already: https://www.ascensiadiabetes.com/eversense/ https://www.ascensiadiabetes.com/eversense/ I'd get a tattoo, but I'm not interested in anything that has to be removed
      - yazaddaruvala 4y ago
- pavlov 4y ago
  There’s a startup named Movano Health trying to build a glucose monitor sensor chip that uses RF energy: https://www.wareable.com/wearable-tech/movano-ceo-on-its-rf-glucose-sensor-8895 https://www.wareable.com/wearable-tech/movano-ceo-on-its-rf-... Movano plans to ship an Oura-style smart ring this year, but it won’t have the glucose monitor. (One might suspect the “moonshot” glucose RF chip story is meant to keep investors excited through the zero-revenue stage until hopefully the more ordinary smart ring takes off.)
  - onepointsixC 4y ago
    The chance that a ring form factor wearable will be the first to reliably, non invasively measure glucose is zero. Yes they got SpO2 and HR, those are easy and well established technologies. But blood glucose? Forget it. A ring form factor is too aggressive and difficult of a target.
tpoacher 4y ago
on the contrary, I wouldn't be too surprised to find that this burst of innovation is happening to coincide with a bunch of patents held and buried by big pharma coming near their expiration period. up until now there has been zero financial incentive for stakeholders to promote a method of blood glucose measurement which bypasses the need for consumables, and every incentive to prevent such a solution.
- joezydeco 4y ago
  It's interesting you mention that because Abbott (maker of the Freestyle sensor) is trying to hire like crazy for a project named Lingo. It's pretty much the same technology that will be offered to non-diabetics to offer health monitoring via blood chemistry. https://www.fiercebiotech.com/medtech/abbott-ceo-ford-unveils-lingo-line-sports-biosensors-based-diabetes-monitoring-tech https://www.fiercebiotech.com/medtech/abbott-ceo-ford-unveil...
  - rrrrrrrrrrrryan 4y ago
    This is still an invasive consumable.
- MengerSponge 4y ago
  This isn't a 3d-printing type problem where the problem was basically solved twenty years ago but locked behind patent protection. It's really an incredibly hard problem. C8 sold a battery-powered miniaturized Raman spectrometer that strapped to your belly about a decade ago. It was a technological tour de force, but it went under. Battery tech is better, but we're just waiting for some particularly clever team to figure out a different optical stack that is small enough to wear comfortably, delivers enough power to be effective, and is robust enough to wear 24 hours a day.
- snowwrestler 4y ago
  You can’t bury patents, a patent is a public record. That’s the whole point of patents: an incentive to disclose your invention. If we knew how to do this, but valid patents blocked the broader commercialization of it, then we would not be reading stories about breakthroughs in basic implementations. We’d be reading stories about how companies have products ready to go once the countdown timer hits zero.
caycep 4y ago
Granted, at least they make progress and have actually health products. I had a colleague who left UCSF to work for Verily....we were all quite impressed at the time. But now, I realize I haven't heard heads or tails from him for 4-5 years now...
- refurb 4y ago
  Google made the mistake of “we’re really smart about tech, how hard could biology be?”
rrrrrrrrrrrryan 4y ago
> it sounds like the real news is just how difficult this problem is - even for Apple I've worked in this space for 5 years now, and this is not news to any of us. Today, a tiny, noninvasive device, that is accurate enough to make insulin dosing decisions, is pure science fiction. It's probably not impossible, but we'll literally be able to use stem cells to regrow human pancreases and straight-up cure people of diabetes before this tech becomes a reality. (We're much further along that path.) What is interesting about this though is the possibility of using this device for non-diabetics who don't need extremely accurate glucose readings. A rough approximation of someone's blood glucose levels is enough to learn how your body reacts to different types of foods and exercise, and would be helpful for amateur athletes who can't afford to purchase real continuous glucose monitors, as well as pre-diabetics for whom CGMs aren't covered by insurance.
- deleted 4y ago
  [deleted]
- crazygringo 4y ago
  I'm fascinated by the fact that this seems incredibly hard, yet not so impossible that Apple is trying. Is there an ELI5 of the basic principle of how it would work (or at least the direction being pursued), and what the main obstacle is, and why we think we'll be able to overcome it to some degree? Besides athletes, I can't help but think it could be a huge step forwards for weight loss as well. I'm aware of the concept (for non-diabetics) of only eating once your blood sugar is below a certain level, and never eating so much that it goes over a certain higher level.
  - kamens 4y ago
    Important nuance here is the difference b/w the parent poster's "accurate enough to make insulin dosing decisions" criteria (extremely difficult+risky) vs "useful enough signal for general population / those at risk of type 2 diabetes / those with diabetes who don't require insulin treatment / etc" (much larger market for Apple w/ greatly reduced requirements)
wkat4242 4y ago
I'm sure if it were easy the medical world would have done it ages ago. There's a huge market for this kind of device and medical markups are even more royal than Apple's.

onepointsixC 4y ago

I don't think anyone who is in the know would be surprised about that. Noninvasive blood glucose monitoring is a multi billion dollar product, should anyone be able to figure it out at all. It's fiendishly difficult, and quite possibly impossible to do it sufficiently accurately, even more so over long periods of time. C8 MediSensors was trying to do it 10 years ago, but ultimately went under. Even with Apple's budget, it's a herculean task.

akiselev 4y ago
You’re underselling it. Measuring blood at millimoles per liter precision through skin on a watch sized device is Theranos-esque physically impossible product-market fit. Tricoder level of science fiction.
- copperx 4y ago
  I wonder whether there are any shortcuts like ingesting a substance to make the glucose visible by the sensor.
  - Cshelton 4y ago
    Bingo. Noninvasive, with any sort of accuracy that can be used for anything, is most likely impossible. So back to "invasive"... what can we do... embedding a device under your skin, right around where your watch goes, that can be powered and communicate with the watch. While also making sure the device is not rejected by the body and stays in place.. AND has no other adverse side-effects. I think this is where it'll ultimately end up for the people who want it. sub 10 min procedure to put it in and should last for quite some time (maybe dissolves after 5 years for upgrades?)
    - blendo 4y ago
      Add heart rate, blood pressure, and blood oxygen level. Have the Apple Watch call 911 if things go pear-shaped. Profit.
      - Nekhrimah 4y ago
        > Profit. Well yes, but also substantial life saving interventions become possible.
      - Spooky23 4y ago
        They should profit. That will save millions of lives.
    - MengerSponge 4y ago
      Eversense sells something similar to this already: https://www.ascensiadiabetes.com/eversense/ https://www.ascensiadiabetes.com/eversense/ I'd get a tattoo, but I'm not interested in anything that has to be removed
    - yazaddaruvala 4y ago
pavlov 4y ago
There’s a startup named Movano Health trying to build a glucose monitor sensor chip that uses RF energy: https://www.wareable.com/wearable-tech/movano-ceo-on-its-rf-glucose-sensor-8895 https://www.wareable.com/wearable-tech/movano-ceo-on-its-rf-... Movano plans to ship an Oura-style smart ring this year, but it won’t have the glucose monitor. (One might suspect the “moonshot” glucose RF chip story is meant to keep investors excited through the zero-revenue stage until hopefully the more ordinary smart ring takes off.)
- onepointsixC 4y ago
  The chance that a ring form factor wearable will be the first to reliably, non invasively measure glucose is zero. Yes they got SpO2 and HR, those are easy and well established technologies. But blood glucose? Forget it. A ring form factor is too aggressive and difficult of a target.

tpoacher 4y ago

on the contrary, I wouldn't be too surprised to find that this burst of innovation is happening to coincide with a bunch of patents held and buried by big pharma coming near their expiration period. up until now there has been zero financial incentive for stakeholders to promote a method of blood glucose measurement which bypasses the need for consumables, and every incentive to prevent such a solution.

joezydeco 4y ago
It's interesting you mention that because Abbott (maker of the Freestyle sensor) is trying to hire like crazy for a project named Lingo. It's pretty much the same technology that will be offered to non-diabetics to offer health monitoring via blood chemistry. https://www.fiercebiotech.com/medtech/abbott-ceo-ford-unveils-lingo-line-sports-biosensors-based-diabetes-monitoring-tech https://www.fiercebiotech.com/medtech/abbott-ceo-ford-unveil...
- rrrrrrrrrrrryan 4y ago
  This is still an invasive consumable.
MengerSponge 4y ago
This isn't a 3d-printing type problem where the problem was basically solved twenty years ago but locked behind patent protection. It's really an incredibly hard problem. C8 sold a battery-powered miniaturized Raman spectrometer that strapped to your belly about a decade ago. It was a technological tour de force, but it went under. Battery tech is better, but we're just waiting for some particularly clever team to figure out a different optical stack that is small enough to wear comfortably, delivers enough power to be effective, and is robust enough to wear 24 hours a day.
snowwrestler 4y ago
You can’t bury patents, a patent is a public record. That’s the whole point of patents: an incentive to disclose your invention. If we knew how to do this, but valid patents blocked the broader commercialization of it, then we would not be reading stories about breakthroughs in basic implementations. We’d be reading stories about how companies have products ready to go once the countdown timer hits zero.

caycep 4y ago

Granted, at least they make progress and have actually health products. I had a colleague who left UCSF to work for Verily....we were all quite impressed at the time. But now, I realize I haven't heard heads or tails from him for 4-5 years now...

refurb 4y ago
Google made the mistake of “we’re really smart about tech, how hard could biology be?”

rrrrrrrrrrrryan 4y ago

> it sounds like the real news is just how difficult this problem is - even for Apple I've worked in this space for 5 years now, and this is not news to any of us. Today, a tiny, noninvasive device, that is accurate enough to make insulin dosing decisions, is pure science fiction. It's probably not impossible, but we'll literally be able to use stem cells to regrow human pancreases and straight-up cure people of diabetes before this tech becomes a reality. (We're much further along that path.) What is interesting about this though is the possibility of using this device for non-diabetics who don't need extremely accurate glucose readings. A rough approximation of someone's blood glucose levels is enough to learn how your body reacts to different types of foods and exercise, and would be helpful for amateur athletes who can't afford to purchase real continuous glucose monitors, as well as pre-diabetics for whom CGMs aren't covered by insurance.

deleted 4y ago
[deleted]
crazygringo 4y ago
I'm fascinated by the fact that this seems incredibly hard, yet not so impossible that Apple is trying. Is there an ELI5 of the basic principle of how it would work (or at least the direction being pursued), and what the main obstacle is, and why we think we'll be able to overcome it to some degree? Besides athletes, I can't help but think it could be a huge step forwards for weight loss as well. I'm aware of the concept (for non-diabetics) of only eating once your blood sugar is below a certain level, and never eating so much that it goes over a certain higher level.
- kamens 4y ago
  Important nuance here is the difference b/w the parent poster's "accurate enough to make insulin dosing decisions" criteria (extremely difficult+risky) vs "useful enough signal for general population / those at risk of type 2 diabetes / those with diabetes who don't require insulin treatment / etc" (much larger market for Apple w/ greatly reduced requirements)

wkat4242 4y ago

I'm sure if it were easy the medical world would have done it ages ago. There's a huge market for this kind of device and medical markups are even more royal than Apple's.