Apple Has 'Secret' Team of Biomedical Engineers Developing Sensors for Non-Invasively Monitoring Blood Glucose

[BrighterShades]

For those interested in the clinical aspects, what gets measured is glucose in the subcutaneous interstitial fluid (ISF). As others have stated, measuring ISF glucose has been around for awhile, but not in the form of a mainstream product for a variety of reasons, including consistency and reliability because ISF glucose levels lag behind blood glucose levels and can vary between different parts of the body. The lag/latency of ISF glucose is due to the time it takes for glucose to travel through capillaries into tissues, so the lag time can vary from 10-20 minutes.

For more, see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769894/ and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903977/

My opinion:

• this could be very useful for early detection and management of Type 2 Diabetes (T2D), much less useful for Type 1 Diabetes (T1D);
• The US Centers for Disease Control (CDC) calls T2D an "epidemic" (https://www.cdc.gov/chronicdisease/resources/publications/aag/diabetes.htm) that will eventually affect 100 million Americans, so a watch that could help that population could be very, very popular

Something else to consider: with the ongoing healthcare debate in the USA, what are the implications for a third of the US population to develop a pre-existing condition called diabetes? Are "risk pools" a viable approach with that many people in them?

 

[nitramluap]

And you need an actual horse to move a cart.
And you need actual telephone lines to make a call.
And you need a room sized mainframe computer to calculate the square root of Pi.

Seriously? Ever heard of progress?

You obviously aren't up to speed on physiology & biochemistry. It's not possible... but it's amazing how much people think just throwing 'smart' and lots of money at a problem will somehow magically fix it. It's bordering on religious fanaticism.
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For those interested in the clinical aspects, what gets measured is glucose in the subcutaneous interstitial fluid (ISF). As others have stated, measuring ISF glucose has been around for awhile, but not in the form of a mainstream product for a variety of reasons, including consistency and reliability because ISF glucose levels lag behind blood glucose levels and can vary between different parts of the body. The lag/latency of ISF glucose is due to the time it takes for glucose to travel through capillaries into tissues, so the lag time can vary from 10-20 minutes.

Yes, and to measure that (inaccurate) level requires breaking the skin - ie. *invasive*.

I don't know... maybe Apple will link a little needle stab to the 'Stand Up!' warning at 10 minutes to the hour? :eyeroll:

 

[IJ Reilly]

Sign me up!

(Type 1 Diabetic for 45 years)
(And before you go there, I was 3 when I got it. T1D is when your pancreas stops producing insulin)
(Oh yeah, I have a Class 3 Medical from the FAA too...)
[doublepost=1492042124][/doublepost]
or Dexcom... as well as Tandem Diabetic Care...

Special Issuance?

 

[smorrissey]

mmmm i like a SODA!!

 

[DUIduckSAUCE]

I wish this type of information didn't get leaked. Samsung and Microsoft are now going to rush crappy imitations to market and say they did it first.

Why would you care ?

 

[jbernie]

Better...

Add a caloric intake sensor that alerts the wearer: "It's time to stop eating."

Stop diabetes before it begins.

Except that for type 1 the causes are more environmental, stress events, genetics (normally skips generations), other medical events, etc, basically you are going to get it, just a matter of when. I was sick a few weeks prior to my diagnosis, a bad sunburn followed by hives and then jackpot. I know of one person who was diagnosed with type 1 quite late (mid 30s) after a sudden death of a parent.

Type 2 diabetes is definitely more associated with diet which is why some people can get by with diet changes only, but even then it isn't always a direct cause. Some type 2s occasionally need insulin to help them.

One of the big issues treatment wise is how unique each person is in their treatment needs, so if you took all the type 1s who are on here, there is a pretty good chance that none of us have equal reactions to insulin & food intake and even then just ourselves we can have different reactions to the exact same food at the exact same time every day. My insulin pump allows you to set a basal rate (small insulin doses delivered through out the day) and bolus rates (with meals) and I have multiple levels set for both for various times throughout the day.

My weekday routine is pretty consistent, I have the same breakfast at basically the same time every day and walk the same distance to the train and then to the office at you guessed it the same time every day and I can't guarantee getting the same reaction to the food/insulin combination even though it's the same thing every day.

 

[swingerofbirch]

As someone who studies diabetes, especially among tech-savvy millennial, I can tell you that this tech exists, but is in the clinical stages. Apple would have to follow the same procedures if they want FDA approval. Thus, I suspect they are working as 'blind' tech developers in conjunction with clinical researchers.

This would, indeed, be exceptional tech, if it came to market.

Is there a way you can make the same product and market it as a non-medical device?

For example, Nonin and Masimo make pulse oximeters that they sell to the public without a prescription, and they sell those exact same models with a prescription, as well. It depends on how they market it, I think.

Apple could say something like, "It's for monitoring carbohydrate transport in healthy individuals," so that they don't indicate it's for monitoring a particular disease.

 

[Sonmi451]

I'd rather they work on a Touch ID sensor and multitouch screen that will work with wet fingers & underwater.

Can't tell if serious or trolling. Bloodless Glucose monitoring which would affect millions of people, or some underwater gimmick nobody cares about. Tough choice.

 

[Xirian]

Do you use the Dexcom insulin pump with it? I used to have the Medtronic insulin pump but it was more of a pain to use. It wasn't very accurate so I also had to carry around an extra glucose tester. Eventually I just went back to syringe and tester.

There is no "dexcom insulin pump", though there is at least one that will show the value from a dexcom sensor on the screen. The dexcom g5 sensor (the current one) is being used on all of the automated insulin pumps that are being trialed except the medtronic one. I had a medtronic one before and it was always off and a lot of sensors had to be tossed because inserting them made me bled. I've been happy with dexcom, I've been using them through 3 generations of their products.

The current dexcom g5 works on its own, sending the blood sugar to your iPhone and then to your apple watch if you have one. It pairs to your phone via bluetooth. After you change the sensor you attach the transmitter to it and hit a button in the app, after 2 hours it asks you to calibrate it with 2 blood sugars. After that it needs to be calibrated twice per day. The sensor needs to be replaced every 7 days though they can be restarted. Lots of people have luck going 2-3 weeks with the same one but I haven't gotten more than 10 days out of one before it went wonky.

Their software can generate reports which also suggest some patterns that need adjustment. I would never go back to syringes but it would work just fine without a pump. Insurance companies don't like to cover it but medicare just approved coverage of it and usually the insurance companies will follow medicare's lead.

 

[AlexH]

I applaud Apple for doing this. They make amazing tech we love to use. No one would blame them for not doing this kind of work, but that they are makes me happy. I hope they keep exploring this fusion of consumer tech and medical.

 

[FreeAngel]

I have had problems in the past being a borderline diabetic but I can control it with diet. either a Mediterranean dietof low fat fish and veggies. no sugar. or being entirely VEGAN. no processed foods.

But I really think having these capabilities in a phone is going to FREAK a lot of people out and send them running to emergency rooms all over. People FREAK OUT easily over high blood pressures and high blood sugars

So my vote is to keep this off phones and have an on body Glucose monitor and injector that can automatically treat and cure the situation.
iPhone can't do this and it will freak a lot of people out knowing their blood sugar is HIGH and send them running to the hospital. especially if they don't have medicine available to treat themselves

If your going to offer this feature in a phone build it as an ADD ON to the phone for those that really want it and need it

I would Rather see the iPhone and the iPad become a Digital Nomad that can become a fully functional portable computer to replace a standard desktop computer. Powerful ARM Processor. 16 to 32GB of built in RAM. I high END GPU so it can connect to a 4k monitor. A cool docking station with external ports for HDMI and USB 3.0. Blue Tooth 5.0. maybe even Thunderbolt 3 ports for external storage.

 

[5105973]

You mis-spelled hypochondriacs.

I know what you mean and the kind of person you are referring to, like the people who claim they could not eat gluten, despite not having celiac disease or other conditions aggravated by gluten consumption. But with diabetes, it's not necessarily hypochondria that impels some healthy people to monitor their blood sugar. A lot of women like me, who had diabetes during pregnancy, rebound to normal after the baby is born, but some of us are warned we are at elevated risk to develop type 2 permanently for various reasons. My friend Beth even ended up going straight to type 1 by the time her baby was a toddler, even after rebounding to normal when they tested her after her daughter was born.

I don't necessarily like that I periodically have to monitor my blood sugar with the finger poke and the meter, but it's necessary to keep an eye on it from time to time, especially since I have other manifestations of auto immune disease and both of my parents are type 2 diabetics and my paternal great grandmother was type 1. I also am tested by my doctor at regular intervals due to my risk factors. However, as far as I know at the moment, I'm not diabetic. Yet I would be interested in this technology if it is good. No hypochondria involved.

 

[bollman]

Going into the medical business is a tad bit different than electronic gadgets for fun.
The next time Apple gets sued it will be due to people dying.
Monitoring heart is one thing, noone will die if there's an error in the measurement, just annoying. If they start measuring blood sugar, I'm pretty sure the lawyers at Apple will have to ramp up their work.

 

[laudern]

Tim, if you manage to pull this off, I'll take back every negative thing I've ever said about apple. You'll have one less troll in the world.

 

[bmac89]

I'm not sure how they can have an FDA approved app running on a device which is not FDA approved?

If Apple doesn't want to go through the FDA process due to slowness and holding back innovation, then maybe they could have a consumer Apple Watch which follows the normal upgrade cycle and then a medical watch.

This would also solve the issue some have raised who say they do not want more sensors which they won't use as it may impact on the battery life. It would also avoid a higher priced product for those who don't need this feature.

This is definitely very interesting. I think non-invasive medical monitoring is definitely the future - both in medical practise and the opportunity for non-invasive research, but ONLY if it is scientifically accurate and reliable with independent medical proof.

However I'm not sure whether Apple would be willing to open there product to this sort of process.

 

[MH01]

"Secret" why? It's just engineers working on functionality.

Though best of luck to them , worthwhile project

 

[StyxMaker]

Well how secret could it be if it's on here?

That's why they wrote 'secret'.

 

[BuddyTronic]

Non invasive? You need the actual blood to get accurate blood measurement.

No, if you take blood out of the patient it is obviously "invasive"

The way to do it is by using light shining through the skin and using special "camera" "light sensor" "transducer" type sensors to make a "guess" about blood glucose. Photo Spectrometry type of thing. I didn't read the article, but I'm sure that's what it's about. If you "guess' close enough to actual, it can be good enough.

 

[Soccertess]

This would SKYROCKET the market for wearables and the applewatch. With diabetes being so prevalent, and having an apple designed solution to monitoring it, it would be huge. Genius idea, that I'm sure they have been considering for some time.

See, I was shocked that the first two Apple watches didn't have more health sensors. The lack of additional sensors really makes the current Apple watches only a nice to have item. It wasn't revolutionary as Timmy O'tool claimed.

However, if Apple ever puts in additional health sensors that are useful, and positions the watch as a health companion, THEN it will be revolutionary and rock the market (until everyone copies and catches up).

 

[charlituna]

See, I was shocked that the first two Apple watches didn't have more health sensors.

yeah lets have 12 sensors that are still in major need of adjustment rather than just 4.

 

[randian]

Keep in mind if there were easy fixes we would have them by now, the short and then long term success rates of the various "cures" are pretty bad, islet cell or pancreas transplants can work short term but then the body starts to reject them & back to square one.

Islet cell transplants? I didn't know they did those. That would be killer for a Type 2, who unlike a Type 1 doesn't have an autoimmune condition ready and waiting to destroy the newly implanted cells.

 

[ellsworth]

Secret team? Not any more.

 

[hellosil]

TimQuote: "I wouldn't mind putting something adjacent to the watch through it, but not the watch, because it would hold us back from innovating too much, the cycles are too long."

Something adjacent as a Watch band?

 

[G4DPII]

Not necessarily. You can check blood oxygen levels non-invasively; blood glucose levels are the next step.

And they have a 5% - 10% variation in accuracy. It varies from each machine, let alone from finger to finger.

 

[BuddyTronic]

And they have a 5% - 10% variation in accuracy. It varies from each machine, let alone from finger to finger.

Yes, but what is your point on this? - I am curious. You are suggesting that they should give up on it or what are you getting at?

Perhaps they will overcome all the challenges with interesting hardware and software. I think they will!


I can think of a semi-non-invasive way to do it:

Get the patient to take a pill every day. The pill has some sort of colour indicator for "blood glucose". Fancy hardware in the Apple Watch using light (that can also be used to measure your heart rate etc), does some measurements and estimates of actual blood glucose levels.

Maybe it is not accurate, but maybe being accurate does not matter. Maybe it's the delta that is important - what direction and how much blood glucose has changed. If you measure that, maybe that represents 80% of the usefulness, and since it is nearly a non-invasive measurement, maybe it's worth it.