Apple has biomedical engineers developing sensors to monitor blood sugar
cnbc.com
cnbc.com
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.
You can't trust corporations to do the right things here. They will be tempted. Eventually one will give in.
Not only can they steal it in ways you won't notice, but they don't even need to. They can just do an update in the CLUA that people must accept or loose their 3 years of accumulated data, giving access to "anonimized health data".
The only way to be sure it's almost safe is to either:
- design en open source system so that you know it does no evil and you can control it
- avoid putting the data in the system in the first place
It's always the same with democracy. You have to make those decisions before something actually happens. After it's too late.
Are you familiar with the Helo? The Helo LX is a device already ahead of Apple's Engineers. You can find the Helo LX at 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.
Here's the thing about Type 1 diabetics- we'll take what we can get. No one caters to us because we're such a small subset of diabetics we may as well be a rounding error. Every treatment/study/drug you see in the media is aimed at Type 2 diabetics. Glucose meters are about the only thing we both benefit from.
Even with doing finger prick blood tests 5 times a day, for years, I feel mostly clueless. And rely heavily on how I feel. Given how much time this condition (?) costs healthcare, this seems a poor way to manage it.
I'm desperate to learn more about my body's glucose trends. A watch that could do that would be awesome.
But just because it might be a tough nut to crack, it isn't necessarily impossible. Interested to see how it develops.
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.
doesn't take long to make google searches.
No amount of diet change is going to reverse the damage to the pancreas in Type 1 - it is not a "disease of affluence"
I give up, and suggest you learn to Google something more than just source to try to confirm (poorly!) your own biases about what diabetes is or isn't.
Maybe I shouldn't care, but it is upsetting to have to explain to people all the time. Even more so when they close their ears to the response.
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.
Not sure whatever became of that project...
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.
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
With automatic periodical measurements, data logs and trends, food intake recommendations, alerts and notifications, and so on, management of the disease would be quite effortless.
I assume that the problem is that there is a lot of other stuff underneath our skin that interferes with the measurement.
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.
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.
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.
What a curious set of priorities.
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.
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.
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.
You have multiple kids with T1D? That's a stroke of bad luck :(
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.
Also there seems to be a a notable incidence of lung cancer which raises a bit of a yellow flag there...
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.
My father was involved in some of the early long-term diabetes control trials which began at the University of Washington in the '80s. One group was randomly selected and told to keep doing what they were doing. The other group was to keep as tight of control over their blood sugar and insulin administration as humanly possible, and was continually given state of the art tools to do so. He was in the later group.
Despite having excellent leading-edge advice, and being one of the most disciplined people I've ever known - marathon runner / Mormon* / literal boy scout (master) - it was a constant battle to keep things under control. It's a myth that diabetics can't have sugar; rather, it's easier avoid it because it ends up being such a pain in the ass.
I wasn't really paying attention, but still knew what a basal rate was as a kid.
* I never realized how much more difficult Diabetes could be until college, when a roommate was relieved to hear I knew what a glucagon shot was, and how to administer it. Alcohol & everything else was something my dad never had to deal with.
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.
You know, it's funny. I've had Type 1 Diabetes since I was 13, more than 15 years ago. I just can't imagine what it's like to not think about everything you eat. I have to do several math equations every time I eat just to survive. At this point it's just a part of eating, there is no alternative. The idea of eating a donut and not worrying about feeling like shit for the next two hours is totally foreign to me.
I always say, if you want to monitor your food intake, just become a Type 1 Diabetic. You will consider everything you eat :)
¯\_(ツ)_/¯
A good starting point would be: http://www.mendosa.com/The%20Pursuit%20of%20Noninvsive%20Glu...
Would be very interested in the email of Johny Srouji.
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.
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.
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?
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 [...]
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.
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.
Unless of course you are machine running at 100% efficiency. (The only 24% efficiency factor for humans is based on so many assumptions)
Only real way to measure energy expenditure accurately is using breathing measurements. VCO2/VO2
Sure, the power meter under reports total expenditure. For example, it doesn't exactly account for BMR, increased expenditure due to elevated heart and respiration rate, utilization of muscles in your arms and torso, etc.
However, it is extremely accurate compared to the alternatives.
https://www.theatlantic.com/health/archive/2014/06/can-you-s...
Also the reviews on Amazon are pretty bad.
If they do claim that it works based on noninvasive blood glucose monitoring that's also a red flag; many have tried to solve that problem, and the obvious application would be a monitoring device for diabetics.
and supposedly they have improved the device in generation 2 which I'm currently testing. Sleep, step, hydration status and heart rate tracking work well, based on these reviews, a science article on bioimpedance and non-invasive glucose monitoring https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500977/ I have hope I can confirm that calorie tracking works.
Tech like this is a major breakthrough. It's just not something you see come from a crowd funding campaign. I'm extremely skeptical.
Be interested to know what your personal experience with it is though. Best of luck.
Yes, Apple's researchers ...
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.
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.
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.
Is someone else in here besides me working on self-made tracking tools for logging your metrics beyond glucose? Would love to chat!
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).
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.
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.
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.
I was very low carb (fewer than 30g/day) for over a year, and was still hospitalized for ketoacidosis.
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.
It also is the main market for improved glucose monitoring.
And it isn't particularly well established that Type 2 diabetes is reversible.
As an aside, the story of how insulin was discovered is super interesting. Diabetes used to be an incredibly lethal disease (part of why there were so many nobel prizes given out for insulin research)
It would be quite the failure of natural selection if eating a normal human diet caused type 2 diabetes.
At the same time, tribes in Papua New Guinea who eat almost exclusively carbohydrates have been shown to be virtually free of heart disease.
Zooko and Amber Wilcox-O'Hearn maintain a fascinating blog on the science of ketogenic (very low carb) diets that I can highly recommend: http://www.ketotic.org/
> https://www.iifym.com/iifym-calculator/
It's alleged but unknown if the metabolism can be (cumulatively or not) damaged over the long term if the diet is unbalanced to our needs.
And in the human history no population has had a lifestyle as sedentary as we have now. The natural selection adapted to something else.
The mutation of ApoA1 in ApoA1-AS [http://jamanetwork.com/journals/jama/fullarticle/197579 - https://www.ncbi.nlm.nih.gov/snp/28931573] is an example of how the body is adapting to our new diet-lifestyle.
I joke. But really, access to high carb, low fibre diets is pretty new. Too new for much natural selection, anyway. We've been eating rice for a long time, but brown rice. I can't find a definite source, but at least in Japan white rice only came into production in the 17th or 18th century.
> According to the New York Times, a 2010 Harvard study showed that people who consume white rice at least five times a week “are almost 20 percent more likely to develop Type 2 diabetes than those who eat it less than once a month.”
http://www.yesmagazine.org/blogs/john-cavanagh-and-robin-bro...
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.
low carb is merely retarding the disease, you reduce your blood sugar, but this also provides energy but doesn't treat the cause.
high blood sugar is the symptom of lipids locking up the insulin receptors [1]
so unless you eat just the carbs you need an exercise, you'll just go down a downward spiral.
1. http://www.diabetesincontrol.com/insulin-resistance-a-viciou...
Now, that's mostly anecdotal. There are very few studies on diet in general. As far as type 2 diabetes is concerned, though, low-carb diets have empirically been shown to reduce the need for insulin injections, slow progression of disease, and prevent the disease in the first place.
Low carb means the range of readings the patient has to control is generally narrower. Lows are the result of too much insulin. Trying to get to 100 from 300 without going below 70 is riskier than from 150. Low carb/low insulin intake makes exercise safer.
Operating in a narrower potential range of readings means less development of insulin resistance and easier exercising safely.
It's challenging to start a low carb diet while taking insulin, so please be careful and talk to your doctor. For me, reducing my insulin "too much" while starting the diet made the transition nearly free of lows at the acceptable expense of fasting too high for a few days until the new situation became stable, but I realize not everyone can do that.
From memory entire counties were removed that didn't fit, one I recall ate more animal protein than whats found in Western Diets, yet had lowest incidence of heart disease, and some statistical correlations of higher significance were removed, because they didn't fit the narrative.
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?
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.
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.
Well, at least you're being honest.
You're replying to some people who have been fighting this disease for close to their entire life and you're trying to tell them they're doing it wrong after skimming a few subreddit posts?
I'm sure you mean well but come on...
and the lack of any discussion about how mood disorders is a low level significant effect of chronic blood sugar chaos still annoys me as well. They are only really investigating that now, based on some study I glanced at. They should have emphasized that when I was younger, really emphasized it. But instead all I got was talk about effects that would be a long way off, when I was 50 and old and etc - so they were not really real. And high fat diets were used back in the 30s before they developed insulin, but zip was said about low carb diets. To hell with the ADA.
It is my fault for not developing good habits when I was younger, but also a lot of what I was told was BS. When I moved to the UK, I learned of a protocol that'd developed in Germany in the 70s that made more sense than the nth level of detail carb counting yadda yadda they taught in the States (don't know what it's like in America now, though I'm sure there is a lot more gadgets and etc available)
But insulin is free here and I have saved 60k in personal costs over the years. The US is ridiculous.
And no, insulin isn't the sole solution (replying to someone else). First you look at your behavior. Stop eating so much carbs. Carbs are basically poison to a diabetic (a loaded word, perhaps toxic is better). If you can't, then still adjust your diet and behavior as best you can. If you find you need lots of insulin because of insulin resistance or you are one of the small percentage who need 10x more insulin than normal, then do take it. Otherwise, get more exercise and lose weight if necessary. Blindly using more insulin only makes you get fatter and that should be a big concern, because the effects of that cascade into other problems. And caffeine... I have to cut that out, but ...I'm in IT dammit.
Treating diabetes first and foremost involves behavioral changes, not fancy insulin or more gadgets. But behavioral change is so hard. I can manage a low carb diet for so long and it works great, then stress and it all falls apart because of various personal failings, not because low carb is a bad idea. It is not a cure, but I really believe it could help so many people.
I have had Type 1 since I was in grade school and have had to deal with countless teachers, friends, and relatives who have admonished me to just cut out sweets to treat my disease. Most of them never realize that if I stopped controlling my blood sugar with finger pricks, my insulin pump, and extreme attention to food and drink for even a day or two I would become so ill as to require hospitalization, and shortly after that, if not corrected, be in a condition which could be life-threatening (DKA).
Even a person with well-controlled diabetes faces long-term complications, and it is a disease that requires constant vigilance. Multiple glucose tests per day (even with a continuous glucose monitor, you need to calibrate it with a meter test), finely tuned insulin delivery rates, insulin sensitivity calculation, insulin to carb ratio calculation, how carbohydrates of different complexity or mixing a fat or protein into your meal might affect how much insulin you need or when you need it to avoid hyper- or hypoglycemia.
Minimed is coming out with an (almost) closed loop CGM/pump system, which will do continuous monitoring and also insulin delivery adjustment--I am hoping to get one, but it may be too expensive even with insurance.
The fact that any company with the brains and pockets of Apple is even approaching improvements for people with Type 1 is great news...