
Apple has biomedical engineers developing sensors to monitor blood sugar - mayava
http://www.cnbc.com/2017/04/12/apple-working-on-glucose-sensors-diabetes-treatment.html
======
wishinghand
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.

~~~
sametmax
Do you REALLY want apple to have a recording of all your health data though ?
I got a bad feeling about letting the GAFAs getting even more invasive.

~~~
monkmartinez
I suspect if you are a diabetic that actually cares about his/her blood sugar,
you wouldn't give two hoots as to the company that made it easier to monitor.
You would simply want the device.

~~~
sametmax
Until insurances use the data to make your life miserable. Until companies buy
black market database and your resume is rejected everywhere and you can't get
a loan.

It's always the same with democracy. You have to make those decisions before
something actually happens. After it's too late.

~~~
wishinghand
I work at companies that pay 100% of my insurance, with no pre-existing clause
BS. So do all of my job prospects.

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pizza
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
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
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)

~~~
013a
Also consider that tech like this has applications beyond just diabetics.
Glucose could be correlated with caloric intake. Tech like this could be a
step toward the Apple Watch actually monitoring how much you are eating
passively.

I would put money on that being the reason why Apple is developing it; not to
directly help diabetics, but to add fitness features to the Apple Watch.

~~~
wmeredith
> Apple Watch actually monitoring how much you are eating passively

This is a technology grail for me. I'm for calorie counting and there's no
doubt that it's integral part of weight loss. But entering all my meals in
forms. Blerg. I only ever do it for a few months at a time before throwing in
the towel.

~~~
adamfarmer
wmeredith,

Have you ever heard of the HELO LX? You would find this an extremely
interesting device. Wearable Technology with Life Sensing Sensors. Check out
our 2 minute video at [http://Farmer.Helo.Life](http://Farmer.Helo.Life)

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

~~~
llccbb
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/)

~~~
perfmode
What do you mean by "insurance-pharma exclusivity"?

~~~
llccbb
I don't have a link available, but I will try to describe it.

Insurance company A needs to help with a wide variety of prescription needs --
cholesterol management, heart disease, kidney disease, cancers, MS, diabetes.
Insurance company A negotiates with pharmaceutical companies B, C, and D for
how much A will pay for any drug and what copay A will charge to the insured
patient.

Pharma B makes a deal to ensure that their diabetes drugs are on tier 1 or
preferred status (most likely to be approved/used/paid) in exchange for a very
good deal to the insurance companies on the price for each prescription and a
lower tier for their cholesterol drug. The agreement also states that all
other diabetes drugs (insulin, let's say) will be tier 3 or need prior
authorization. This is a contract that might last a year or 5 and is not
public.

Company C makes a deal to get their MS drug as the only reasonably priced
option in exchange for basically giving away their foot fungus drug. The
insurance company is happy because every foot fungus prescription is pure
profit. Company C is happy because they are they only game in town for MS
treatments on that insurance provider.

Pharma D wants to get their insulin at a higher tier so that patients can
afford it and not buy out of pocket. But Pharma B already has an agreement
that all other insulins will be tier 3 or lower, so Pharma D is locked out of
that insurance company.

The current health insurance and prescription system in the US __heavily__
favors large pharma companies that can negotiate on multiple grounds and
leverage competing health interests. Small pharmas that offer a singular
stellar product have a tremendous fight to even get past prior authorization.

------
fsiefken
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-
fitnes...](https://www.techwalla.com/12049437/healbe-gobe-2-is-a-fitness-band-
that-knows-what-youve-eaten-review)

~~~
iplaw
I've investigated every device that claims to be able to accurately track
calories expended and/or calories ingested.

On the calories expended side, the clear winner is a power meter on a bicycle.
The power meter measures actual power output and energy expenditure, which is
easily and accurately converted to kCal.

For the indirect devices, it's a massive mixed bag with some very unexpected
observations. Measuring galvanic skin response ended up being quite
inaccurate. Garmin devices without a heart rate strap were insanely
inaccurate, sometimes reporting 300% higher-than-actual calories expended. The
best device has actually been the Apple Watch paired with an iPhone. The
calories reported are usually within 5% of actual.

As for the devices claiming to track calories ingested, every device has been
either outright fraudulent or, at best, vaporware.

~~~
anu7df
I am sorry but I cannot see how the power meter on a bicycle is "accurate" in
this context. I am not trying to measure the part of the energy expended to
run the cycle (which the power meter accurately measures) but the total energy
expended by me while biking.An example; what if I put on some ankle weights
while biking. How does the power meter know that? To explain with an almost
farcical extreme example, if I attach a power meter to a step/chair while
doing a step up step down exercise, it will register zero calories burned
always. But I would most certainly be burning calories doing the exercise.

~~~
iplaw
You're not understanding how the power meter works. Nor did I say that a power
meter can be applied to every possible workout or piece of equipment.

In your ankle weight scenario, the added weight would, in effect, cancel out.
You'd get a free boost to power output for 50% of a pedal stroke, and added
resistance to the other 50% of the pedal stroke. These forces are being
applied simultaneously on either side of the cranks. While one side is
combating the added weight, the other side is feeling the boost of the
additional weight.

And sure, there are additional caloric expenditures while cycling - increased
heart and respiration rate, utilization of muscles in your arms and torso,
etc. - but they are marginal compared to the generation of 300-400W using,
primarily, the muscles in your lower body.

Further, these differences are factored into the athlete's efficiency in
turning calories into mechanical output. A trained cyclist is 25% efficient.

You seem to be attempting to be deliberately obtuse.

------
reacweb
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
> a constant monitoring of some health indicators of many people good give
> invaluable data for researchers.

Yes, Apple's researchers ...

~~~
HappyTypist
Have you heard of ResearchKit?

------
burntrelish1273
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.

------
sambe
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.

------
surfrider
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.

~~~
BlakePetersen
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.

------
scentoni
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)

------
Mz
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.

------
cperciva
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.

------
JulianRaphael
These guys from Israel have a very promising approach:
[https://www.osapublishing.org/boe/fulltext.cfm?uri=boe-5-6-1...](https://www.osapublishing.org/boe/fulltext.cfm?uri=boe-5-6-1926&id=286417)

Is someone else in here besides me working on self-made tracking tools for
logging your metrics beyond glucose? Would love to chat!

------
iamgopal
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.

~~~
jpttsn
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.

------
msrupnik
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.

------
CodeSheikh
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
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.

------
du_bing
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?

------
adamfarmer
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.

~~~
jonwachob91
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".

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

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

~~~
srssays
The average person eats a diet primarily of carbohydrates, particularly rice.
Humans have been high carb diets for the entirety of recorded history.

It would be quite the failure of natural selection if eating a normal human
diet caused type 2 diabetes.

~~~
drjesusphd
"Recorded history" is too short for natural selection to occur. You don't get
significant carbohydrates without agriculture, which is about as young.
Besides, type 2 diabetes doesn't seem to have an impact on ability to pass on
ones genes, so natural selection would be blind to it.

~~~
kennywinker
Agree up to "type 2 diabetes doesn't seem to have an impact on ability to pass
on ones genes, so natural selection would be blind to it."

Individuals who have extensive family support do better than ones who do not.
That's why we don't die the moment we stop being able to produce offspring.
Grandparents care for grandchildren, and help pass on knowledge that is very
helpful for survival.

So not blind to it. Reduced impact, yes, but not blind.

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

~~~
brational
wrong diabetes type.

~~~
coldpie
I really hate that two totally separate diseases have the same name.

~~~
richie5um
Me too.

------
jshevek
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.

~~~
jermops
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
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.

~~~
imcrs
For type 1 and type 2, the more insulin you take per day, the lower your blood
sugar will be. If you a1c is too high, you unquestionably must take more
insulin. Simple as.

Should you exercise more? Yeah. Should you eat better? Yeah. Should you cut
refined carbs? Yes, you probably should. None of these are unique to
diabetics, but they get levied on us when we talk about insulin prices or
complications with our condition.

Also, you owe it to yourself to be extremely skeptical when looking at any
"diet doctor" selling a book. Most stretch the cure factor of lifestyle far
beyond its limit.

The advice to someone with a high a1c is the same in every case: take more
insulin.

