As a type 1 diabetic I can say this would be a huge improvement over current continuous glucose monitoring systems. No expensive disposable parts. No needing to inject a new sensor each week. No strange, uncomfortable, and (often) painful bulge stuck to your abdomen.
>We’re in discussions with the FDA, but there’s still a lot more work to do to turn this technology into a system that people can use
I'm chomping at the bit. Anyone familiar with process know how soon this could possibly be available?
As a fellow type 1 diabetic, I'm thrilled with any new projects - especially a project like this which would benefit not only type 1, and is not only targeted for type 2.
> how soon this could possibly be available?
I've been following various type 1 research for as long as I can remember (runs in the family, myself etc.), and I remember a similar enthusiasm back when glucose watches were first in production. I recall it taking years before they had an actual product (this was before the Panic Room featured watch, which wasn't a glucose measurement, but anyway.. to give you a time reference), and sadly, even when they were available from more than one manufacturer, they were still not widely available to patients (i.e. wanting to get one).
None the less, I will be following this eagerly.
On a personal note, awolf: how do you like your current monitoring system (apart from the mentioned downsides)? I've considered needle monitoring many times, but never gone for it (for idle office work I wouldn't mind, but I see it as a hinder in my personal life re: flexibility)
PS: Accuracy is not even a factor until the technology is further along, and that was one of the main issues with the watches back in the day: measuring glucose levels through human skin was not accurate or reliable enough. So I'd add years of testing at least, and maybe tweaking aswel (as the watch project did).
The movie in which a child has a severe low blood sugar, on the edge of death, and her mother administers here a large shot of... insulin! I could not believe it when I saw it. The treatment given in the movie would have killed her in no time.
For future reference, in case anyone comes across a diabetic experiencing a seizure. Do not give insulin in this case. This will lower blood sugar further. What they need is to consume anything with sugar, if conscious. If not, they need a glucagon injection. These typically come in a clunky red container, containing a large needle filled with saline and a vile containing a white powder. Shoot the saline into the vile, shake up the vile, extract the solution, then shoot the solution into the affected person's leg ASAP. Do not give anyone insulin under any circumstances. If you give someone glucagon with a high blood sugar, they will probably be ok. If you give someone insulin with a low blood sugar, they will likely be dead. /PSA
This has always been one of my biggest fears. People always assume diabetics need insulin, when in most cases of unconsciousness, insulin could be deadly.
I carry a note in my diabetes-bag with me (next to that glucagon-injection) saying: "Don't give me insulin. Ever!" I translate that to other languages when I travel abroad.
My biggest fear is to go out because of low sugar, then someone with good intentions killing me, for wanting to help me.
For diabetics, you are usually injecting insulin, which should be rotated around parts of the body (any fatty area) to avoid scar tissue build up.
In this case, however, I was talking about glucagon, which is only given in emergencies (to messed up to ingest sugar). Glucagon needles are much larger than insulin needles, and can be shot straight into the leg through jeans. The arm would work too, but might be more likely to leave soreness. The main thing is to administer it as quickly as possible.
I think it is just easier for people to slam a needle into a leg anywhere than think about how to inject a needle into someones arm. As above it was stated you don't even need expose skin but can do it through clothes.
they have to prove that the monitoring it provides is accurate, measures what they think it does (I.e. no false positives or negatives), and doesn't v endanger the users lives (I.e. doesn't blind them I see the proposed led being an issue here since it can go off at night, and likely that it doesn't have a severe lag time that would reduce the likelihood of a life saving response because the user isn't checking blood sugar otherwise). I think all of these are definitely solvable issues so I would be surprised if it doesn't get anywhere. the specialized nature of the contact is likely not going to be an issue since the market is desperate for something better (every diabetic I know would switch to this in a blink). what I wonder is what the communication with the device is going to be like, smartphone would be nice but some of the smart watches I think would be better, and how is it powered too.
I'm sure it will be expensive, but doubt it would need to be disposable: current CGMs rely on injecting a metal sensor into subcutaneous fat. After about a week your body starts to heal around it and the sensor becomes ineffective. Do to the nature of the application process, there is no way to re-inject a sensor once used. The sensors are on the order of $50 each, so $50/week.
Expensive hardly matters to me. As long as it is less than ~$30k per 10 years, I would pay. Insulin pumps already cost $10k+, and do not provide as much value. This kind of tech is life extending for those of us who need it, so price kind of moot (up to a point). How much would you pay per year to get an extra decade of life?
All my praise to these Google engineers and scientists. Another completely crazy idea that will really help millions of people every day. Thanks Google!
We have discovered a lot of Google X technologies in the last months. It seems that Google X is really working. We may have to stop having fun of Google+.
You've discovered a lot of Google X technologies because it is a deliberate strategy by Google to publicize these projects regardless if they will ever reach a commercial stage.
They are attempting to stay relevant and perceived to be an innovative company in the eyes of their various stakeholders (employees, potential employees, shareholders, tech press, the general public, regulators, etc.) while transitioning to today's Microsoft.
... and when they stop, we can swoon over the tech advances of the new player. The fact that Bell Labs no longer puts out tech hardly detracts from their contributions.
Microsoft was working on similar technology 3 years ago [1]
It looks like Google poached MSFT's engineers to work on this -- Babak Parviz was working on this at Microsoft 3 years ago, and is now cofounder of the smart contact lens team at Google.
This has very little to do with MSFT research. Microsoft collaborated with Parviz's research at University of Washington. He wasn't a MSFT engineer. He was a Professor at UW before he left for Google. His affiliation with Microsoft, and Microsoft's contribution, seems minimal.
Do you work for Google? You're unwarranted support aside, Microsoft does deserve some kudos for investing in his research. In fact, much more so than Google just because they were the initial partners/investors.
>Tan and Microsoft Research Connections have been great supporters of the project, Parviz said. Their willingness to explore and invest in the project was critical to advancing research and development of the functional lens. “A lot of people considered it science fiction,” Parviz says. “Desney and Microsoft Research were actually, very early on, convinced that this is perhaps a worthy cause. And they were willing to work with us, and support us. And I’m very grateful they did.”
Type I diabetic here. Assuming current tech stays where it is (not saying it will), this could easily tack 10 years on to my lifespan. For many who watch their diabetes less closely (something I cannot fault anyone for), this could add 20-30 years.
For anyone who does not know, type I diabetes is not something you can just follow a doctor's direction on and be ok. Even if you follow your doctor perfectly, there can still be serious complications, and type I diabetics with the best control are actually more likely to die from severe low blood sugars.
The reason for this is that the optimum blood glucose level is around 100. <70 and you start to be severely mentally impaired, making it difficult at times to seek treatment (finding and eating sugar, in a nutshell). On the flip side, if you are lax on insulin, your blood sugar might hover around 250 for months, and you will feel close to normal. Having a blood glucose this high on a long term basis will have long term effects that are what kill most diabetics in the long run. A low blood sugar, however, can be fatal within minutes to hours.
Either way, a continuous feedback mechanism would help tight control diabetics, and diabetics who do the minimum. Tight controllers could get faster feedback about when they are going into the serious danger zone without having to initiate any action (checking blood sugar), and lax diabetics would get a constant reminder of how they are letting there life slip away (which they normally would rarely see, since they hardly ever check their blood sugar anyway).
I have to say though, I am still a bit skeptical for a few reasons:
- One, I have been told about this sort of miracle technology ever since I was diagnosed 15 years ago.
- Two, the medical complex locks down their tech and extracts the maximum value out. There is not a single glucose device on the market that lets you extract the data out of your glucose monitor and crunch the data how you want. I have worked on hacking these devices to extract data and the legal verbiage around these activities has strongly discouraged me from releasing anything. Previous continuous glucose monitoring systems. These companies would prefer you rot in the dark, than to lose one bit of profit.
- Three, if one of these devices is not 100% perfect, it gets shot down and banned from the market. This is probably a combination of profit-motivated industry and caution-motivated government. A great example of this is a continuous glucose monitoring, non-invasive watch that came out ~ a decade ago. It was on the market for several years, before being banned. I, like just about every person in the thread I linked, would pay $10k+ for one of these, despite the reduced accuracy over traditional devices. Entrepreneurs in the health industry take note.
>type I diabetics with the best control are actually more likely to die from severe low blood sugars.
I'm very much in this crowd. Type 1, AIC of 6.3, LDL cholesterol around 100, BP of 110/72-75. This is with completely manual testing and subcutaneous insulin injections.
The problem of keeping your blood sugar towards an A1C of 6 is you have insulin reactions. Quite often, as you're being rather aggressive in keeping on top of your blood sugar. Worse, is I don't show or feel any real physiological symptoms until I'm at 60 mg/dL or below, which is getting fairly dangerous. I can be as low as 25-30 mg/dL and still be conscious and functioning. My tipoff is realizing that I either feel tired or that I can't think straight. It's hard to realize you're not thinking straight when you can't think straight, and have the cognizance to then test and get some carbs in you.
I've had a few close calls. One where I was driving a supercar north on Route 24 in Boston rush-hour traffic. I subconsciously took an exit and drove 5 miles into a suburb, and managed to not hit anything and the police officer told me I mostly obeyed traffic laws, aside from weaving about (but was completely incoherent) -- I was at 21 mg/dL when the EMTs tested me.
I once didn't compensate for alcohol, passed out on my couch, and when I finally came to in a pool of my own sweat, it took me 3 hours to traverse 30 feet to the kitchen to attempt to drink (and wear at least half) of a half-gallon of orange juice. When I finally tested 30 minutes after consuming an entire carton of OJ, I was barely in the 40s -- I have no idea how low I was, and I was lucky I ever regained consciousness.
Just curious, how old are you and how long have you had it? I've had it for 11 years this February, and while my A1C is pretty terrible (high), the idea that I might not be able to detect lows eventually is pretty terrifying.
About 13 years. My big tipoff is feeling tired. I'm a night owl and stream on Twitch after a long day of consulting -- I'm NEVER tired before 1 or 2AM.
The most severe problems were the result of a new doctor in their residency changing my long-acting insulin to an intermediate that was also a 30% mix of fast acting, in an attempt to drive my A1C to under 6. This created a serious problem of wanting to give myself insulin for a meal, my blood sugar only being around 90-100 mg/dL, and then being unable to decouple the fast-acting from the intermediate since it was pre-mixed. I hemmed and hawed, but the attending stood by the decision to change to 70/30. I had to change 10 years of regimen instantly, which was fraught with peril.
Two serious episodes later, and a waiting room at a prestigious teaching hospital hearing someone scream, "Your stupid decision has nearly killed me twice", and I'm now back on the long-acting with insulin reactions being rather infrequent (twice a month), and nowhere as severe (catching it around 65-70 mg/dL). My A1C has trended up slightly (6.1-6.2 to 6.3-6.4), but I'd rather that than death by overdose.
Not speaking for the parent, but I'm a 35 year old T1D who has been diagnosed for only about 7 years and I am already nearly asymptomatic when I have low blood sugars. The risk of becoming asymptomatic for low blood sugars increases over time, but it is completely inconsistent. Some diabetics have always been asymptomatic for low blood sugars, others will go their whole lives and always have easy to detect symptoms. I have a friend who is in his mid forties and is also a T1D; he was diagnosed about 30 years ago and he still consistently gets the shakes when he is any lower than 70.
I was diagnosed when I was 12, about 13 years ago, and I can usually still detect when I'm under 60 or 70. I'm one of the tight-control types that the OP mentioned (6.4 A1c), so this happens a few times a week. I usually notice it when I can't think, and instead wander over the same two thoughts back and forth. Suddenly I realize I'm thinking in the tiniest of circles and go have some yogurt or something.
The first thing my endocrinologist asks when I see him (literally, before he even asks how I'm doing today) is if I can still feel lows. I think he'd get me on a CGM pretty quick if I reported I couldn't.
I'm super interested in this contact lense solution.
In my experience (Type 1 partner), it's repeated and severe lows, say like 4 or 5 in a week, that will give you hypo-unawareness. It's definitely possible to experience that and still have a high A1C, but I don't see it causing hypo-unawareness. I'd highly recommend a pump to get more control.
That is simply misinformation. The problem is you can not extrapolate your personal experience out to the rest of the population. I'm virtually hypo-unaware and I have low blood sugars maybe 2 or 3 times in a month.
Do you just check LDL or do you also check trigs and hdl?
Weird that you don't see any symptoms at such a low level. My vision would completely black out except for maybe half a centimeter blurry hole... everyday. It took hours to recover. I was always munching on snacks to prevent low blood sugar but it never helped. Thankfully I'm alright now.
It is not weird not feeling it until such low levels at all. Some diabetics never feel low blood sugars; the longer you have diabetes the more common it is to experience this phenomena. Additionally how you "feel" a low blood sugar varies over your lifetime so the "tells" change. This means we may be feeling different, but have no idea that it is because of a low blood sugar since we haven't felt this new warning symptom before.
When I first was diagnosed with diabetes I could tell quite early if my blood sugar was low. If my blood sugar dipped to just 70 I would start shaking like a leaf. Now I don't have any warning signs at least until I hit around 55 and sometimes not until the low 30s; when I have symptoms at all. I have twice had incidents where I fell because my blood sugar had dipped so low with no physical warning signs. Both times my vision went black for a second and I fell over. I don't know if this was me actually "passing out", but in both instances I recovered almost immediately and immediately consumed large quantities of juice to get my bgl back to normal as quick as possible.
When I do have a tell it is difficult to even notice now; the best way I can even describe it is that I have a very sudden sense of dread as a feel my mind sort of shifting away from me. By this point I'm so low as to be in serious danger zone. I try like crazy to stay out as far away from that as possible by testing as frequently as possible, but your fingers can only take so much; and even if they could take some more the insurance carriers won't cover more test strips anyway.
I think this Google product is a great idea and I would love to see something like this actually work, but like the parent of this thread; I'll believe it when I see it. I've been reading about all sorts of wonderful continual monitoring solutions for BGLs for years and have seen nothing come of it.
Your last point listed here is such a big deal too. It shouldn't matter if these things are 100% effective; they need to be released and patients need to be informed that manual testing still needs to be done. If for no other reason than to help reduce the number of type 1 diabetics who die in their sleep from low blood sugars.
For anyone here not familiar with this phenomenon; it is referred to as "Dead in Bed Syndrome" This is where your blood sugar suddenly drops while you are sleeping and you don't notice the drop because you are sleeping; you then progress into a coma and then die.
To this day I almost never am able to sleep straight through the night because of the sheer dread I have that this will happen to me (In fact I'm posting this at about 3:30am where I am at, because once again I'm up in the middle of the night).
In well controlled diabetics about 55% of all severe low blood sugars occur while you are sleeping. And in type 1 diabetics about 6% of us will die in our sleep by age 40.
"It appears that such deaths occur in 6% of all deaths in diabetic patients below age 40 years."
So, it's not that 6% of diabetics will die in their sleep before they are 40, but of those that die before they are 40, 6% die I their sleep.
That makes the risk per hour of dying in your sleep about a tenth of that of dying while awake. I would guess that is relatively large compared to non-diabetics, but probably nowhere as freaky as you portray it it be.
Further evidence: http://www.ncbi.nlm.nih.gov/pubmed/8542738 shows 16 such deaths in Norway in a ten year period, with 224 other deaths (during the day, or at night, but not matching the criteria for death in bed syndrome)
Thanks for the link. I've seen the statistic listed several other places and it was shown as 6% of type 1 diabetics under age 40.
The importance of someway to reliably provide continuous monitoring of BGLs is still critical and could help prevent a lot of deaths as well as contribute to the overall well being of diabetics.
Yep. I actually have two alarms on my phone, one for wakeup, and one for 2 hours after I go to sleep. I've been doing this for years. Most nights I just solve the math problems unconsciously and go back to sleep. But some nights, I can't solve the math problems or otherwise feel low and I know it's time to check the BG.
Almost all meters allow you to extract data over USB, but the data usually comes out in an obfuscated proprietary format. Do you know which format this exports to? Scott Hanselman had a blog post about this a few years ago (can't seem to find the link).
IMO, every meter should be required to export to CSV at a bare minimum. I will look into the one you linked, but for most users, they really need something that can be easily converted to an xls. The current state of things is that they only export to some supremely terrible proprietary program that is really only meant for an endocrinologist to use with the help of an IT team.
I should be able to easily view my health data and crunch it how I see fit. Decent analytics around my glucose data would be extremely valuable, but the current state of affairs is abysmal.
I really feel your pain. The reason why I love this meter so much is that it doesn't require a £50 USB cable (The usb is built into the meter) the proprietry software is a standalone jar on the USB device which is amazingly quite good. But best of all when you plug the USB device in it mounts as removable storage with a db.sqlite file which is easily accessible and a simple .dump reveals the sensible DB schema. It's really refreshing to be able to get my data and do what I want with it.
Thanks for the tip. I will buy this and try it out, open sourcing any scripts I can write that will assist in the extraction. Do you know of any existing tools?
If it's a sqlite database with a reasonable schema, you can probably get a surprising amount of mileage out of a few simple SQL queries and this command-line tool:
Seconding the recommendation. I have this meter for the same reason.
You need to use the Bayer software to talk to it (I'd recommend actually installing the software rather than using the copy from the meter itself). But then the readings are stored in a standard sqlite database without any obfuscation etc.
It uses some sort of hash so you can't actually modify things, but for just getting the raw numbers I didn't have any trouble.
Decent analytics exist (disclosure: I am web lead for a company [1] in precisely this device space) but some problems we are facing are situations like the following:
Device manufacturers hiding the ability to decrypt their (proprietary binary blob) file format in the same DLL as their driver, forcing us to install it on the end user's machine, and refusing to release the source code to us either so we could verify it was thread safe and run it on the server or possibly use Emscripten/asm.js on it to be able to package it cross platform in the browser.
In addition a plurality of our userbase is on IE 8 and below. I don't even want to think about their XP situation.
That being said, we have a good start at excellent analytics capability. Feel free to shoot me an email (HN handle at gmail) if you're a device manufacturer, clinician, patient, Scott Hanselman (we're in Portland too! And we use .NET!), or just plain doggone interested in the space or just working on the problem.
[1] http://www.diabetespartner.com. Any feedback on the design is of course welcome. We do in fact support the Bayer Contour mentioned above.
The blog post you are talking about can be found here[0]. Despite an active push by Scott for a standardized data format and communication protocol, little has been done in almost 5 years.
As a person with diabetes for 14 years, I feel frustrated about the roadblocks to accessing my data. I am currently investigating reverse engineering the one touch verioiq.
My mother has been full on diabetic for thirty plus years. She uses a pump now as it does offer some convenience over just using needles. It still is not easy.
The problem I see with this technology is that her biggest threat is at night. She can go to bed with perfectly fine blood sugar levels, just like any other night, and wake up with a level in the forties. What worked good for her? Besides an attentive spouse a dog works wonders too.
Still I haven't seen an accurate blood sugar monitor, there are variances depending on where they are placed on the body and even at times the same place may not yield similar numbers each week. The same goes for where her pump connects, some weeks its a great spot, another week a similar spot isn't quite the same.
Top it off with, her comment about asking three doctors in day and getting four opinions. The flip side of low blood sugar is silly high numbers. Going to the hospital with 300, or worse 600 plus, and having to debate the emergency room staff that you know whats happening isn't fun. Having to have your level tested three or four times because they cannot believe your functional at those levels is a sign of how much even much of the medical world has problems with this disease.
I am all for new technologies but I believe your chances lie in first not ignoring the diagnoses, second making sure to take the medicine assigned; especially your insulin; third, enlisting your family and even friends in emergency treatment aids, fourth being purely your genetics, and finally knowing when to doubt a medical professional and how to engage them intelligently.
I'm going to go ahead and down vote you here as well. I'm a type one diabetic on a ketogenic diet. Continuous glucose monitoring is still extremely valuable to my health.
I am type 1 on ketogenic diet as well and my sugars are virtually always in healthy person's range (or actually always if the healthy person eats candy or white bread :P).
So I am curious why you consider it extremely valuable with such stable sugars in the first place? I mean I can see it could be nice to have for the stats but that's not worth the obtrusiveness at all.
How does this help type I diabetes? I see nothing about this diet that does anything beneficial over alternatives. Type II maybe, but please try to research a bit more before throwing in a dictate.
It really comes down to phrasing. If they had said "Have you tried a ketogenic diet?" Or "Some people have found a ketogenic diet to be helpful with type 1 diabetes." it would be fine. Instead it came off as an order or command: "Switch to a ketogenic diet."
One of the things about written communication is we only have your phrasing and word choice to inform us of your tone and meaning. It is vitally important to use proper phrasing to avoid being misunderstood. It is entirely possible that their comment was innocuous but it came off as rude.
The next level up we start to see responses to the writing, rather than the writer. The lowest form of these is to disagree with the author's tone. E.g.
I can't believe the author dismisses intelligent design in such a cavalier fashion.
Though better than attacking the author, this is still a weak form of disagreement. It matters much more whether the author is wrong or right than what his tone is. Especially since tone is so hard to judge. Someone who has a chip on their shoulder about some topic might be offended by a tone that to other readers seemed neutral.
So if the worst thing you can say about something is to criticize its tone, you're not saying much. Is the author flippant, but correct? Better that than grave and wrong. And if the author is incorrect somewhere, say where.
I wasn't disagreeing with the statement about the ketogenic diet, I was disagreeing with this statement:
"Sometimes statements are statements. People needlessly attach emotion to the written word when there is no need."
In my disagreement I explained how the author has an imperative to make sure they are understood and, since we only have the words that they posted to go on, it is important that they are clear in their wording.
Secondly, I am not responding to their tone but the clarity of their statement. It is a completely different argument.
I was just trying to explain how the comment could have been misunderstood. You seemed to put the burden of understanding upon the audience and I felt compelled to elucidate the source of many commentators 'needless emotions'.
I'm expecting sensor tech to explode in the coming years, including noninvasive cgm. Imagine high level endurance athletes on a full biometrics panel during a race, including glycose and blood pressure (among other things).
If pro athletes are where the demand lies, I am fine with that. Unfortunately, most education around diabetes has conflated type I with type II, which has caused and overemphasis on high blood sugar control, rather than low blood sugar management. Pro athletes might have the same problem as type I diabetics, which could lead to a converging need.
What scale is that glucose level measured in? I ask because my partner is diabetic but and those levels are supposed to be between 6 and 12 mmol / L. Clearly 100 is not expressed as mmol/L.
I think what he's saying is that an accuracy of, say, 10 mg/dL on a continuous basis is better than an effortful (requires you to test — and, perhaps more importantly for Type 1 diabetics, to be able to test) accuracy of 1 mg/dL. That's still going to tell you with enough accuracy whether you need to get some carbs into your system, or whether you've put too many in already.
I think that would depend on the type of errors the device makes. If every 1s measurement is of by independent errors, you can simply do a running average and improve accuracy that way. If the error is fixed, you can determine it and compensate.
If, on he other hand, errors between close in time measurements are correlated, that won't work. You might get "things look fine" measurements for an hour while your glucose level is dangerously low or vice versa.
Given that the first two kinds of errors can be worked around, I would guess this device to produce the third kind of error. You don't need 1s intervals in glucose reading to improve the life of diabetics; 10 minutes or even an hour would be fine, too.
I guess most meters have a display accurracy of 1 mg/dL, but that's just on display. If you check your blood twice in a row, you're likely to get at least a 5 mg/dL difference. I'm not even sure this is your meter's problem, but rather your blood having not 0.01 mg/dL-consistent sugar across all of your body.
Nevertheless 10 mg/dL is just the right accuracy needed to control type I diabetes. I don't tend to attach much importance to the last digit anyway.
Reduced accuracy would be offset by frequency of feedback. The current model requires active input; you have to go and prick your finger. With a passive input, you could get a general idea all the time, which is especially important considering that a low blood sugar can sometimes affect your mental capacity.
Did you acknowledge my explanation further down that this is Babak's research and that Microsoft only contributed/funded his research, and then post this up higher for some sort of MSFT brownie points?
Have you tried to control your diabetes with a ketogenic diet? Dr. Bernstein, a type 1 diabetic since 1946, is successfully managing his condition with it, and wrote a book about it.
I was going to say this! Ketogenic diet is the best and most stable way of eating for pretty much anyone. Fat is a much better source of energy than glucose.
Continuous glucose monitors have been around for a while. I'm not sure who this would help.
The fundamental problem is that glucose levels in non-blood fluids do not exactly match blood glucose. The current monitor solutions use interstitial fluid in the skin. They still require the user to test themselves several times a day and recalibrate the monitor based on blood glucose, and they can't alert the user if their blood sugar is low until it's already a serious situation. They also frequently give false positives.
This is a new (but very clever!) way to do something that has been around for a while, not a revolution, unless tears track blood glucose much closer than interstitial fluid does. Simply based on first principles, that seems unlikely.
And there are basic hygiene problems wearing contacts while you're asleep, which is when monitoring would be most useful. If google has the technology to make contact lenses that you can wear 24*7 without getting ulcerative keratitis, that's more revolutionary than another way to monitor blood sugar.
> And there are basic hygiene problems wearing contacts while you're asleep, which is when monitoring would be most useful. If google has the technology to make contact lenses that you can wear 24/7 without getting ulcerative keratitis, that's more revolutionary than another way to monitor blood sugar
overnight and extended-wear contacts (for up to a month, I believe) have been available for many years now.
There are severe drawbacks to CGM like scarring, infection and most importantly the expense. In the UK CGMs and even insulin pumps are almost impossible to get most places on the NHS.
This seems like a prototype of what Google Glass will evolve into. The medical device will offer a first generation of solutions to several major problems for augmented reality contact lenses: fitting "an antenna for wireless data communications, a chip to process data, and tiny battery onto a tiny, thin, curved surface..."[1]
Then, a later version will need to solve the problem of projecting crisp images from the contact lens onto the user's retina. Google's experience with Glass seems like it could inform that effort. Perhaps we'll see this product on the market with significant usage within 10 years.
Augmented reality contact lenses have other implications. For example: what does it mean for privacy and advertising to not being able to shut one's eyes?
I've experimented with multiple CGMs and have been plagued with severe accuracy issues. I know this isn't the case for all people, but I found myself constantly recalibrating the CGM only to be given readings that were — no joke — 100% different than the "normal" meter's. I'm talking CGMs giving "30" or "300" when my trusted tester claimed "150."
I was careful w/ calibrations, tried for months, spoke w/ people at the company, etc etc...it just wasn't worth the effort for me. Maybe they're better now, haven't tried in about 3 years.
That was the final straw for me, but the effort around these CGMs is also not to be understated. Calibrations, extra items to lug around attached to your body, extra pieces that can break / not work, etc etc. Anything that helps with this is huge.
When I think of the big picture I realize that Type I Diabetes is nothing compared to the health issues many people deal with, and I consider myself _extremely_ lucky. That being said, it's a daily battle that you never, ever get a break from. Personally, the CGMs didn't make the battle (or my results) much better.
Who knows if this technology would be any better, but I can cross my fingers. I would gladly pay almost all spare money I have for a CGM guaranteed to be both accurate (keep me healthy) and reliable/simple (keep me sane).
Doing keto for a T1 diabetic is hard and it doesn't change that much. Sure, you don't use as much insulin but there's also no effective way of getting your glucose level up without going out of ketosis. There's also the ketoacidosis problem, which is even harder to avoid while being on keto and being a T1 diabetic.
It's a great diet for T2. And I would dare to say that paleo is even better, you keto guys (going by what I see on /r/keto) need to eat more vegetables.
The current solutions I am aware of are invasive (put a big needle into your gut and redo it again every few days), and do not allow for real time feedback. Useful in that you can analyze the data later, but hardly helps when you are currently experiencing an issue (which could be life threatening).
I'm just speculating, but the physical presence of the device itself has been a dealbreaker for me, and I've heard of similar issues from a couple of athletes (with diabetes).
I am encouraged by the fact that Google is working in this area. If any company can overcome the obstacles to this technology becoming available soon and at a reasonable price, it would probably be Google.
I am discouraged by the fact that the underlying technology (measuring glucose from tears) was first reported more than two years ago. There is another (sort of) non-invasive glucose measuring technology that involves injecting a biofluorescent dye under the skin, then using a device that measures the fluorescence that varies with the blood glucoe levels. This technology was also first reported years ago, and is also apparently nowhere near being available.
I'm amazed at how many people on HN are diabetic !
Could be an interesting study on cause/effect - is all this sitting at screens contributing to an epidemic or are there other factors ? Perhaps respondents are just self-selecting because of the subject matter ?
It's also interesting how anyone who needs to track their blood sugars likes the idea of an easier and more convenient method - typical finger prick readings up to 4 times a day can leave your fingers in a real mess and pretty painful so even sticking something to your eyeballs sounds attractive !
Type II is caused by external influences, such as unhealty life-style, old age, or other medical conditions (which include genetic defects or other genetic variations).
Type I is genetic. If you have the faulty genes, you get it. Regardless of lifestyle, health, country and whatnot.
Another thing many people are confused with, is "severety of Diabetes". You can have "very severe Type II" or "just a little Type II", but you cannot have "severe Type I", Type I is binary: you have it or you don't.
As a Type I, I'd love to see the medical world and then the rest of us, using a different term for Type I Diabetics, because the deseases are entirely different: the cause is different, the effect is similar.
As a Type I, people often blame me for my desease. Often people think it is because of unhealty lifestyle. "Ah you are a diabetic, many programmers have Diabetes, guess its because they sit around all day, haha". This is infuriating. No matter how healthy I am, whether I am a programmer or bycicle-courier, I'd have gotten my Diabetes anyway. Type I is one of these deseases that you can do absolutely nothing against, other then not passing on your faulty genes to children.
Edit: clarified the sentence where I am blamed for having Type I.
Edit2: As pointed out below, Type II can be influenced by genetics too, made that more clear.
That said, there will be a correlation between Type I and amount of people in a certain branch of work.
First, because there are a lot of professions one is not allowed to (this is different per country, obviously), but in general professions where you operate machines (pilot, truckdriver, sawmills etc) or which are physical (police, army, firefighters) and many more.
Which means that other, "Type I-friendly" professions get more Type I diabetics, obviously.
Sitting around all day in an office, is not particularly good for your Type I, but it's not dangerous either.
So, yes, there might be a correlation between certain professions and the amount of Type I diabetics they attract, but that is cause-and-effect turned around: not the profession causing the desease, but the desease preferring certain professions.
> As a Type I, I'd love to see the medical world and then the rest of us, using a different term for Type I Diabetics
> As a Type I, people often blame me for my desease. Often people think it is because of unhealty lifestyle. "Ah you are a diabetic, many programmers have Diabetes, guess its because they sit around all day, haha". This is infuriating.
I've experienced the same thing. We really do need a new name for Type 1. There's some small amount of agitation for this, but it largely doesn't seem to have caught on. I usually just tell people the full name: "I'm a Type 1 diabetic." Usually they've never heard of the "type" system before, and ask for clarification.
I'd like to add that there isn't always a clear cut delineation between the types. For example, MODY is highly penetrant, heritable diabetes that fits neither classification. The idea that type 1 == genetic and type 2 == external is really no longer the prevailing view. The better description is the production of insulin where in type 1, there is a lack of insulin production and typically in type 2 insulin resistance (and possibly deficient insulin). The causative factors are complex and a combination of genetics and environmental factors. I'm a type 2 diabetic with none of the traditional risk factors (typical diet, and underweight), from a family with a high diabetes frequency (sister and father).
I agree with you 99%, but would like to make a couple clarifications:
> Type I is genetic. If you have the faulty genes, you get it. Regardless of lifestyle, health, country and whatnot.
It is not entirely genetic. It is an auto-immune disease that has a complex, and not fully understood trigger mechanism. That said, type I diabetics still do not have any control over it.
> Type I is binary: you have it or you don't.
Generally true, with the exception of the "Honeymoon Phase" in which new diabetics will still produce small amounts of insulin for a year or two after onset.
That said, I agree with the sentiment all the way.
"Type I is genetic. If you have the faulty genes, you get it. Regardless of lifestyle, health, country and whatnot."
Also, this statement is not correct. From OMIM on type 1:
"IDDM exhibits 30 to 50% concordance in monozygotic twins, suggesting that the disorder is dependent on environmental factors as well as genes. The average risk to sibs is 6% (Todd, 1990)."
There are other studies with similar conclusions. Having the "faulty" genes does not guarantee disease manifestation because the disease is multi-factorial.
I understand what you mean about terminology and different names. My wife has auto-immune hepatitis. I mention that to people, and too often they then ask me, "So hep-A or hep-C?" It's like the first words AUTO-IMMUNE just fly right past because all they've ever heard of is a virus causing it.
... and completely ignoring the fact that "hepatitis" simply means liver inflammation, regardless of cause. So auto-immune hepatitis is totally accurate, and still, people think "virus" when they hear it.
Yes, By no means did I mean to say that getting Type II is always "the person's own fault". Not at all!
I included "other medical conditions" which includes "genetics" too. But I guess that was not entirely clear. I've edited my comment to point that out more clearly.
Indeed, I've spent the last few years trying to significantly improve my lifestyle to decrease the chance my maternal line's 100% record of Type II diabetes ends before it gets to me.
This is why I still love Google. Between this, self-driving cars and other world-changing projects, I say take my data if you need it. You're one of the few companies in this world that seems to bring a big, direct net benefit to humanity.
One major concern I would have is that, in diabetic patients their eyes experience more dryness than non-diabetic patients. This might lead to more scratches on the cornea and prone to further infections and ulcers. As diabetics care 101, diabetics patients have mucher high risk of systematic infections. And this is all way before any diabetic retinopathy develops in those patients. So why Google[x] thinks it's a good idea to have diabetics patients wear contact lens?
AS a Type I, my doctor advised me strongly to start wearing glasses and stop wearing lenses. Because they would apparently increase the risk of early blindness even more.
I'm not sure whether you or my wife need a new eye doctor. Hers knows she is diabetic and is doing extra screening watching for any possible damage from the disease but has never said anything about her contact lenses being a problem. Other than while sleeping she always wears her contacts.
There's a whole story to this, but that is a little too private to share on the web :)
The larger story is, that lenses can damage the eye (tiny scratches, little infections); regardless of Diabetes. Diabetics have increased risk of badly healing damage, especially wrt fragile nerves (toes, eyes, hearing). The increased risk that anyone has for infections and problems when wearing lenses, is only so more dangerous to Diabetics.
I know there are sprays available for people with dry eyes who are prone to infection. Would those help in this situation or is it more complex than that?
Where's all the FUD about collecting user data and doing evil things with it that we've been seeing in the Google+Nest stories lately?
"But what about when google sells your data to insurance companies, who then penalize diabetics for not maintaining specific glucose levels?'
"Do you really want google to know every single thing you put into your body?"
"Can we trust google to not put advertisements in the contact lens, making you watch a 15 second commercial before being able to read your gluose levels?"
I think this is one of many such implementations which we will see in the next few months. Not long ago, the FDA posted their guidelines on mobile health, which will most likely be part of the system, finally establishing a hint of what they will require to give an approval to a mobile system in the medical field. I have some experience in this, and can tell you it is very exciting. No blatant ad here, sorry!
Since the risks for ventures in this field have dropped significantly, devices such as this lens now have a much higher probability to actually see the light of day and not just be hidden in the archives, on thrown away napkins and spreadsheets.
Yes, Microsoft worked on it a few years back – yet seem to have dropped the ball or shifted their focus, I have also heard of such a project at Sanofi and research institutes around the world – yet a google X project may potentially be what this concept needs to make progress and actually have an impact. My sincere gratefulness to you guys at X for going at it!
Forgot to mention, like many others in this thread I am a type 1 diabetic since 30 years, so my gratitude goes a tad further than only thinking it's cool.
Type 1 also, and I fully admit that part of what prevents me from using pump therapy is the CGM technology and how invasive and frustrating it is. The lens project gives me hope, but as others in the thread have mentioned - I've gotten my hopes up on several occasions about potential technologies and agree that it seems like a lot of it comes down to profit. Full disclosure, I'm the COO of a tech company and I love data - so a constant frustration is lack of consistent data that can be manipulated in usable ways. (Also mentioned by others in the thread.)
I don't at all want to downplay the honest importance of this project — this is the true sort of real "tangibly improving people's lives" technology that not enough people are aspiring to these days — but the timing of this announcement is very strategic on Google's part. Days after people get VERY upset at Google for buying Nest, and moaning about Google's evil surveillance state, Google turns around and announces something that's a legitimate force for good in the world. Very clever.
Please. Like this project was just sitting there, waiting for a media shitstorm to pop up. The knee-jerk cynicism on these threads is truly getting stupid.
The timing is almost certainly because the project's secrecy had been recently compromised by the FDA revealing a meeting with the engineering team on its public calendar.
At first, I thought this could be quite intrusive. I mean, you're putting something in your eye! It's the same discussion as the biometry authentication systems (retina scanning, saliva, etc).
But then I realized: the alternative is to put a piece of hardware under your skin! It will be embeded in you "forever" and can only be removed via surgical procedures...
These contact lens, if ever available, will in fact revolutionize the diabetes scene and may open precedent to new "wearable" technologies targeting health.
Maybe. You need to understand that diabetes equipment is a lot like a Segway - it's interesting and solves a problem but it's expensive and somewhat infeasible.
Many things could contribute to this not being as revolutionary as it sounds. Everything from cost down to accuracy is a concern. Diabetics do like to have hope that this will be the game-changer but they've heard that many times before.
Few years ago I saw a feature in IEEE spectrum about contact lens displays/computers. Apparently, because they're so small and have such low power requirements, they can power themselves off of the ambient radio / wifi / cell / etc signals
I'm wondering this too. Could it pick up on an electrical potential from the eye itself? Or could the reading be gathered with only as much of a signal as an RFID tag gets?
This is the most interesting question. And failsafe. You couldn't rely on this, unless there was a way to ensure it is working or had a fixed lifespan.
I believe the thermoelectric converter works by exploiting a temperature gradient, which I suspect would not be sufficient at this scale and location.
Anyone else have a problem where if they read an interesting story like this about potential future technology, they are virtually incapacitated and unproductive for the rest of the day thinking about the potential?
Obviously, a Google Glass or Oculus Rift equivalent but with contact lenses has to be one thing everyone's long thought of. But what about activating a contextual display by closing one eye briefly (a map or information about a person you're meeting), or seeing a definition of a word spoken in conversation by closing the other eye, or watching a movie with both eyes closed, reading a book the same way, getting song recognition data at any point, etc.
Could we see high-res displays worked into lenses so that they worked, were eventually cheap enough and able to operate in a "pass through" mode so they didn't other interrupt regular vision?
Are any companies working on it? Is it possible? What would be the key challenges?
Building a VR contact lens is orders of magnitude harder than this. Key challenges would be:
1. Component size.
2. Power. The glucose monitor is similar to an RFID that can be powered by radio waves. Driving a screen or laser would require much more power. So you'd probably need some sort of inductive coil matched to regular eyewear.
3. Focus. You can't at that distance. So you'd probably have to beam an image directly onto the retina with a laser.
4. Occlusion of the pupil. Really hard to avoid this one. You might have to pair with a camera to add sight back as a feed. However there could be benefits with this too - eg. night vision
5. Health. Beaming power could be a cancer risk. Also contact lenses need to breath to prevent corneal neovascularization and other nasty effects of hypoxia. Modern contacts are gas permeable but adding electronics would hinder the flow.
This is really awesome, and sounds like a great thing for people with diabetes (if the accuracy issues are solved).
Further down the line, technologies like this could be a great thing for the rest of us too. We all experience peaks and troughs in our blood glucose and in those troughs we often feel tired, without really knowing why. It would be great to be able to have continuous feedback like "your blood glucose spiked and now is low after you drank that bottle of lemonade an hour ago". Something like this would really help people to make better decisions and would be a great boon for general public health.
Am I the only one that thinks Google[x] is just the arm of google that looks for far future intellectual property to patent and never really produces usable tech?
You are wrong. They spin off the tech that they do want to commercialize. E.g., Brain use to be part of X, but now it's its own group. Same with Glass.
You have a point. But I think Google's vision and mission and intention is to move forward the technology in every area. Financially possible, not necessarily intelligently possible. The acquisition of Nest shows they may not have the gene for building hardware systems, devices are ok, but it's not a long-terms solution without a system in place.
Being diabetic, I would be quite happy to receive an image saying, hey your blood sugar is low, why not get some sugary snacks right across the road at Acme Candy Store - get 10% off during the next 10 minutes.
To take this to a purely business/tech place - this is an interesting market for prototyping contact-lense electronics; maybe in 10 or 20 years the new Glass will just be a contact, but for now this looks like one of the few applications where a sensor and two LEDs (high and low) can provide a lot of user value.
I think it would be just like RFIDs and NFCs: you send power to the antenna, the chip uses it to make a measurement, and to send it back.
Maybe it can take enough energy from the ambient RFs. Maybe we will see a lot of people bringing their phones close to their faces from time to time, and people would be confused. "What are you doing with your phone, do you have an ear in your eye?"
We have developed a non-invasive system for measuring blood glucose (patent protected, many publications in peer reviewed magazines, working prototype).
If someone has contacts in the VC scene or is working in the VC scene and is interested please let me know.
Sooner or later a competitor technology will come out to lines of Google Glass for contacts; ultimately the 3rd episode of Black Mirror, where you can record 24-hours of your life via your eye contacts.
>We’re in discussions with the FDA, but there’s still a lot more work to do to turn this technology into a system that people can use
I'm chomping at the bit. Anyone familiar with process know how soon this could possibly be available?