
Alphabet unit halts glucose-detecting contact lens project - sonabinu
https://www.reuters.com/article/us-alphabet-verily/alphabet-unit-halts-glucose-detecting-contact-lens-project-idUSKCN1NL2B5
======
pm90
The actual blog post is much more informative:
[https://blog.verily.com/2018/11/update-on-our-smart-lens-
pro...](https://blog.verily.com/2018/11/update-on-our-smart-lens-program-
with.html?m=1)

Sounds like they couldn’t, with today’s technology, measure glucose levels to
the accuracy required for medical devices. But will continue work on measuring
other things with those lenses.

I don’t know why the negative tone of the article. Sounds like they tried
something and demonstrated their specific solution didn’t work. Most research
experiments generally don’t.

~~~
aaavl2821
A lot of people in the scientific community had suggested for a while that
glucose levels in eye fluid were not sufficiently correlated to blood glucose
levels for glucose measured in tear fluid to be clinically useful. So even if
you could detect glucose in eye fluid, it wouldn't help you manage disease. In
the eyes of some this was an obvious limitation that the company brushed
aside, and there was a fair amount of hype around it, so there were some ppl
calling it vaporware

Although some of the core tech around engineering all the sensors, battery,
Bluetooth etc into a contact lens is pretty cool. There are a lot of patents
from the inventor, brian Otis (who wrote the blog post), if you want to take a
look.

But based on the blog post it seems like they were having trouble measuring
glucose in tear fluid, which is one step upstream from the aforementioned
issue around lack of correlation btw eye and blood glucose. If you can't
accurately measure the analyte it doesn't really matter if it's correlated w
disease

~~~
thomasfedb
The technology is definately more than cool, hopefully some of that tech can
be repurposed into something that can make it clinically.

Worth noting, tear glucose wouldn't need to be correlated in a linear fashion
with BGL, as long as there was a way to derive BGL from tear glucose data.

~~~
leemailll
I think the opposite is true. To achieve medical usage the correlation should
be linear. If this is not the case, a small variation of glucose could lead to
big jump in the reading, which would decrease the accuracy. In real life, most
of the biological system or test exist in a buffered environment, which often
show a range of linear relationship for substrates, and tests are often
performed by adjusting into such linear range.

~~~
whatshisface
If a small variation in glucose led to a big jump in the reading, then the
glucose calculation would end up with _greater_ precision.

------
bunnycorn
Doesn't matter, what matters is that they published the story with a picture
(a stupid picture, that there's no way it would work without alien technology)
in hundreds of websites, generating buzz and a rise in their stock value due
to investors goodwill.

This is why I dislike Google. If you read the news, you would think they have
the future in their hands, but after 10 years of Android, many more of YouTube
and Gmail, and only one thing works, only one thing brings them 90% of their
revenue: advertising.

And boy do they sell advertising, but they also know how to advertise
themselves...

Google is like a children whose parents give free access to chocolate (ad
business money). Why would a child eat anything else besides chocolate? It's
tasty, it's sweet, it's easy to eat. And it turns out that engineering
something is not as easy as turning up ads on YouTube.

~~~
notatoad
So you don't like Google because all their revenue comes from advertising, but
you're also angry that they're trying to branch out into things other than
advertising?

~~~
ModernMech
I think what the parent is saying is that if you listen to the hype, you would
perceive Google as bringing a lot of innovative tech into the world. But the
reality is many of these hyped projects that provide this perception are
quietly shut down, and at the end of the day after more than a decade Google
is still just an ad machine. The parent is upset about the difference between
what Google sells itself as doing versus what they actually do.

~~~
notatoad
yeah, i understand what the parent is saying, and i think it's stupid. how are
they supposed to diversify if they don't try? or are they supposed to do all
their R&D in secret, just to avoid any perception that they might not be
entirely evil?

yes, their PR people hype up their R&D efforts. But the point is that they're
doing R&D, and why shouldn't they get a PR win out of that?

~~~
ModernMech
Well the point is it's been over a decade. They've done a lot of trying with
little return.

~~~
saulrh
The projects they're attempting take decades. Period. Loon, for example: Two
years for a handful of prototypes, two years for LTE functionality and a
"real" trial run, two more years for a mesh network so they aren't
bottlenecked by satellites, another year for a large-scale real-world trial
run (Puerto Rico), and now we're at the present day. Their job _now_ is to
demonstrate that they can keep a balloon fleet up long enough and at
sufficiently low cost that it's safe to transition an entire country's economy
over to the system. That's probably going to take another ten or fifteen years
simply because that's how long it _takes_ to show that your system is reliable
enough to be core, critical infrastructure. And Loon is just an easy example.
Waymo, Brain. Anything to do with healthcare. Etc. There's a _reason_ these
things are called "moonshots".

~~~
shaklee3
I thought loon was also considered a failure, although not shut down yet. It's
an interesting idea on its own, but it's somewhat dated in that there are
better technologies now that don't cost as much to run.

~~~
saulrh
Last I heard it was declared economically viable and spun out. Wikipedia says
Loon is currently contracted to provide internet service to a few particularly
inaccessible chunks of Kenya, and its performance during the hurricanes last
year is probably enough to guarantee its continued existence regardless.

------
ipsum2
Good on Alphabet for 1) releasing their findings and 2) not continuing the
experiment for publicity purposes.

I'm wondering though, even if this were a success, how many people would it
help? How big is the intersection of people who use contact lens (i.e. can
afford them and don't find them annoying) & have diabetes?

In the US, there are 45 million people who wear contacts [0] and 30 million
with diabetes [1]. Naively assuming independence, that means potentially 4
million people would benefit from this. Seems like small potatoes to Alphabet,
even if they could capture 50% of the market.

0: [https://www.cdc.gov/contactlenses/fast-
facts.html](https://www.cdc.gov/contactlenses/fast-facts.html) 1:
[https://www.cdc.gov/media/releases/2017/p0718-diabetes-
repor...](https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html)

~~~
westoncb
I suspect the number would be quite a bit larger. You have to consider how
many _with diabetes_ would be willing to wear contact lenses, and if you
consider what the tradeoffs involved are, I think you'd find it's a rather
large proportion.

Managing blood sugar how we do it now is a far larger bother than wearing
contact lenses. I would guess that most diabetics who could afford them and
did not have some physical aversion would use the lens monitors.

The alternative is primarily: draw blood from your finger every time you want
to know where your blood sugar is. (There are other 'continuous' glucose
monitors, but you have to keep a needle in you all day, and my understanding
is they are inaccurate enough that you still often need to check sugar by
drawing blood.)

~~~
modin
> The alternative is primarily: draw blood from your finger every time you
> want to know where your blood sugar is. (There are other 'continuous'
> glucose monitors, but you have to keep a needle in you all day, and my
> understanding is they are inaccurate enough that you still often need to
> check sugar by drawing blood.)

I have been using Freestyle Libre for the last two years and only picked my
fingers a handful of times in that period. It’s very accurate for me, perhaps
a few (10-ish) minutes delay at most compared to fingers and toes, on par with
measuring in the arm. And it’s a small fibre, not a needle that’s in the arm
for two weeks at a time, doesn’t hurt at all.

The development in diabetes treatment have been tremendous the last years,
which might be another reason as of why Alphabet is discontinuing this
project.

~~~
westoncb
Hmm, maybe time for me to look into CGMs again :) Any recommendation for how
to go about getting the Freestyle Libre? I don't have insurance, so I'm
guessing it's gonna be prohibitively expensive...

~~~
inetsee
I'd have to double check, but my recollection the last I looked into the
Freestyle Libre monitor was that the Reader cost about $150, and the monitors
(the things that attach to your arm) cost somewhere around $100 to $150 a
month. Not cheap, but significantly less expensive than the older style
monitors, and reports are that the Freestyle Libre is much less uncomfortable
then the old style monitors.

------
londons_explore
> Verily cited insufficient consistency in the correlation between tear
> glucose and blood glucose

For a research project, they should have measured that in week one, and canned
the project just 3 weeks in after a bunch of test results on swabs from
peoples eyes couldn't be closely correlated with blood glucose after
controlling for temperature and humidity in an excel spreadsheet.

How did it take years for them to figure this out? Smells of bad management to
me - the engineers saying 'It's so nearly working!!' for years just to keep
their jobs, and management believing them.

~~~
bitpush
Wow. I knew that HN commentators were over their head, but this is probably
the most outrageous one I've seen.

I sure hope none of the companies, startups included, dont give up after a
week (or three) of testing on the projects they are working on.

~~~
wild_preference
These types of people confuse the ease of pooping on something with the
viability and worthwhileness of that thing.

------
raverbashing
I see this in a positive light. They tested, it didn't work as well as they
expected and hence they're abandoning it.

Sounds like what Theranos should have done

~~~
umichguy
Theranos should be a case study of how not to, for a long time to come in tech
firms - especially, those dealing with real-life humans in the healthcare
arena.

~~~
atq2119
Even more, Theranos should be a case study for investors. People in the
industry were calling out Theranos' nonsense for _many_ years before the whole
thing finally collapsed.

I'd really like to know if investors were just oblivious or if they genuinely
believed that Holmes could fake it until she made it.

~~~
zaidf
_People in the industry were calling out Theranos ' nonsense for many years_

People in the industry enabled Theranos. You don’t make deals with Walgreens
and Safeway without people in the industry backing you.

Of course, there were fair number of doubters. But when the likes of Mayo
Clinic lend their name to anything from Theranos, it’s safe to say an
important part of the industry backed it.

------
cycrutchfield
>Our clinical work on the glucose-sensing lens demonstrated that there was
insufficient consistency in our measurements of the correlation between tear
glucose and blood glucose concentrations to support the requirements of a
medical device. In part, this was associated with the challenges of obtaining
reliable tear glucose readings in the complex on-eye environment. For example,
we found that interference from biomolecules in tears resulted in challenges
in obtaining accurate glucose readings from the small quantities of glucose in
the tear film. In addition, our clinical studies have demonstrated challenges
in achieving the steady state conditions necessary for reliable tear glucose
readings.

Why wasn't this clinical work done prior to any work on "smart lenses"? This
is like Theranos trying to build all this equipment to support fingerprick
blood tests only to find out that venous blood is superior for a lot of things
that you want to measure.

~~~
azurezyq
It seems that it may work somehow in controlled environment but hit hard rocks
when applied to more real patients. It never reached the stage of mass
deployment, which is different from Thernos.

Well, medical research is always difficult.

------
tlubinski
With DiaMonTech (www.diamontech.com) we are also working on a non-invasive
blood sugar monitor. Google lens was always a discussion with the interested
parties (e.g. investors). Our take was that it is hard to detect the small
concentration of glucose in tear fluids but even if you manage to do that, the
real problem would be that there is always a delay (between 30 and 100
minutes) until changes in the blood sugar level are seen in tear fluid. So for
people with fast changing blood sugar levels (i.e. diabetics) the needed
information comes too late.

------
joshstrange
Honestly I think it wasn't a great tech idea/application in the first place. A
lower profile Dexcom [0] would be the better option. My boyfriend has one of
these and he can leave it on for 10 days. I take my contacts out at night and
normally if I don't leave the house I just use glasses (so does he). His
dexcom can monitor 24/7 where as contacts don't work that way. Also before you
say "they have contacts you can sleep in and leave in your eyes for a month" I
know, but some people's eyes are more prone to infection or have other issues
that don't allow for this.

[1]
[http://www.annualreports.com/HostedData/CompanyHeader/header...](http://www.annualreports.com/HostedData/CompanyHeader/headerdxcm.png)

------
gwern
> In a blog update, Verily cited here insufficient consistency in the
> correlation between tear glucose and blood glucose concentrations to support
> the requirements of a medical device.

Continuing the extremely long and varied history of failures in non-invasive
glucose testing, especially those attempting to measure proxies rather than
the blood itself: See John Smith's _The Pursuit of Noninvasive Glucose Blood
Tests: "Hunting the Deceitful Turkey"_
[http://www.mendosa.com/noninvasive_glucose.pdf](http://www.mendosa.com/noninvasive_glucose.pdf)

------
trhway
while glucose-detecting lens are cooler and would be very convenient, there
seems to be breath analyzing devices development which does show very good
promise - i.e. the acetone in breath seems to be an established correlate and
the work seems mostly about building convenient device (for people who don't
already have a dog performing such a service :) and for that work the product
development power of Google money i think would help very much.

------
swedish_mafia
Was rapid evaluation team getting neck massages for positive rapid
evaluations?

