Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Apple Monitoring Blood Glucose

mondaynote.com

Post reply on HN
Print view View original

11–20 of 142 posts

Re: Apple Monitoring Blood Glucose

#11

Post by TeMPOraL »

sillysaurus3 wrote: post #9
Xoros wrote: post #2

I think the term "consumer base" is not heartless but in fact pretty accurate. Why not spending the probably huge amount of money in a cure instead of monitoring devices ? Well, because why kill the Golden Egg Goose ? Millions of people who have to take pills every day are good recurent money. If you cure them, no more cash. (Well it's the middle of the night, I can't sleep and fill a little bit bitter...) One more t…

I think this idea is pretty odd. If someone had a cure for diabetes, you'd bet they'd charge an arm and a leg for it. The patents alone would be incredibly valuable. From a non-monetary standpoint, dehumanizing companies is always a bit frustrating. They consist of people, like you and me. Most people aren't sociopaths and the idea that business leaders are entirely sociopathic is worth challenging. I don't think mos…

Also, withholding cure for a big disease is not necessarily a stable equilibrium on the market - the first company to release such a cure would mop the floor with their competitors.

Re: Apple Monitoring Blood Glucose

#12

Post by cperciva »

Apple appears to be working on blood glucose monitoring as a way to address Type 2 Diabetes.

Either the article is very wrong, or Apple is doing something very cute here.

Type 2 diabetics do check their blood glucose -- occasionally. For non-insulin-using diabetics (aka. most type 2s) medical plans typically cover less than one test per day, because the evidence is that testing more frequently doesn't accomplish anything. (Blood glucose testing in T2D basically answers the question "is the treatment working, or do I need to talk to my endocrinologist", while blood glucose testing in T1D is essential for answering the question "how much insulin should I inject right now".)

So the idea of a continuous glucose monitoring system for type 2 diabetics is pretty much nonsense from a medical perspective; sure, they'll get pretty graphs, but those graphs won't provide any medically actionable information. So my first instinct was to think that the article was very wrong.

But maybe Apple is being very cute. The reason we don't have any non-invasive blood glucose tests is that nobody has managed to make them accurate enough to meet FDA requirements for tests to be used for diagnostic and treatment purposes. But if Apple markets this as being for type 2 diabetics... well, they can perfectly reasonably put a sticker on the box saying "for entertainment purposes only", since that's the only thing type 2 diabetics would be using a continuous glucose monitor for anyway! FDA requirements circumvented -- and once Apple gets a large installed used base, they get a huge pile of data which they can use to help them develop a later version which is accurate enough.

Re: Apple Monitoring Blood Glucose

#13

Post by ekianjo »

Xoros wrote: post #2

I think the term "consumer base" is not heartless but in fact pretty accurate. Why not spending the probably huge amount of money in a cure instead of monitoring devices ? Well, because why kill the Golden Egg Goose ? Millions of people who have to take pills every day are good recurent money. If you cure them, no more cash. (Well it's the middle of the night, I can't sleep and fill a little bit bitter...) One more t…

> If you cure them, no more cash

This is pretty shortsighted. Because:

- it's not like you would cure everyone at once anyway

- there are always people who will develop the disease eventually so you can always make money in the long run

- if you are the only effective treatment you can pretty much make the price you want, and collect massive profits that can be invested in the develop of other drugs or solutions.

Never heard of vaccine companies going bankrupt, for example.

Re: Apple Monitoring Blood Glucose

#14

Post by cperciva »

sillysaurus3 wrote: post #10
harigov wrote: post #4

Earlier quoted context omitted.

I think machine learning coupled with increase in sensitivity of the signals could make a difference.

Why would machine learning be able to overcome a lack of statistical power?

It's not clear whether there's actually a lack of statistical power, or simply a lack of sufficient modelling of the noise.

Re: Apple Monitoring Blood Glucose

#15

Post by TeMPOraL »

sillysaurus3 wrote: post #10
harigov wrote: post #4

Earlier quoted context omitted.

I think machine learning coupled with increase in sensitivity of the signals could make a difference.

Why would machine learning be able to overcome a lack of statistical power?

It wouldn't, but maybe there is enough statistical power, but it's just tricky to process?

Re: Apple Monitoring Blood Glucose

#16

Post by TheOtherHobbes »

TeMPOraL wrote: post #11
sillysaurus3 wrote: post #9

Earlier quoted context omitted.

I think this idea is pretty odd. If someone had a cure for diabetes, you'd bet they'd charge an arm and a leg for it. The patents alone would be incredibly valuable. From a non-monetary standpoint, dehumanizing companies is always a bit frustrating. They consist of people, like you and me. Most people aren't sociopaths and the idea that business leaders are entirely sociopathic is worth challenging. I don't think mos…

Also, withholding cure for a big disease is not necessarily a stable equilibrium on the market - the first company to release such a cure would mop the floor with their competitors.

This is only true if a one-off sale of the cure is significantly more profitable than a reliable income stream from products that help manage the disease without curing it.

For that to be true the cure would have to be more expensive than management by at least an order of magnitude - assuming monthly refills for management and an annual reporting cycle - but still not so expensive that it became unaffordable.

Re: Apple Monitoring Blood Glucose

#17

Post by weego »

harigov wrote: post #4
highd wrote: post #3

Research labs have been trying this for years with every spectroscopy known to man - the signal is just too weak. I don't see any reason to think Apple has figured something out that labs of optics experts can't do on the benchtop.

I think machine learning coupled with increase in sensitivity of the signals could make a difference.

Yeah let's get some AI in there to help out, maybe building the front end in react native will solve some problems no one though of. We could get the data with graphql to solve some issues.

Re: Apple Monitoring Blood Glucose

#18

Post by sillysaurus3 »

TheOtherHobbes wrote: post #16
TeMPOraL wrote: post #11

Earlier quoted context omitted.

Also, withholding cure for a big disease is not necessarily a stable equilibrium on the market - the first company to release such a cure would mop the floor with their competitors.

This is only true if a one-off sale of the cure is significantly more profitable than a reliable income stream from products that help manage the disease without curing it. For that to be true the cure would have to be more expensive than management by at least an order of magnitude - assuming monthly refills for management and an annual reporting cycle - but still not so expensive that it became unaffordable.

Can someone provide links to examples of companies withholding cures in exchange for profit? If not, the idea of this is nothing but conspiratorial.

If it's true, though, it's worth knowing.

Re: Apple Monitoring Blood Glucose

#19

Post by _ph_ »

Xoros wrote: post #2

I think the term "consumer base" is not heartless but in fact pretty accurate. Why not spending the probably huge amount of money in a cure instead of monitoring devices ? Well, because why kill the Golden Egg Goose ? Millions of people who have to take pills every day are good recurent money. If you cure them, no more cash. (Well it's the middle of the night, I can't sleep and fill a little bit bitter...) One more t…

First, these things are not easily exchangeable. Yes, it is important researching for cures as well as for treatments in the absence of "cures". But with diseases, which are caused by bad habits mainly, a device like the Apple Watch can be part of the cure, if it helps preventing the disease. And, of course, as long as we don't know how to cure, we should at least optimize the treatments.

Re: Apple Monitoring Blood Glucose

#20

Post by pimeys »

templaedhel wrote: post #6

As a type 1 diabetic I'm super excited to see apple working in this space, even if they're focusing it on type 2 to start (a logical move, considering there is something like 30x more type 2 diabetics in the US). I think making it easier to track glucose levels in real time is the number one thing that can be done to improve quality of life for both types of diabetics. The "CGM" (continuous glucose monitor) has reall…

Here in Germany the Dexcom G4 system with Animas Vibe insulin pump became fully covered by the health insurance last November and a couple of weeks ago I got my system working. It is a pretty amazing improvement to my life: both the pump and CGM.

The G4 transmitter has a 2.4 GHz radio and I built an extra device with Wixel and Bluetooth to transfer the data so my Android phone so xDrip+ and my Android watch can display the glucose values real time. It works so great that my A1c levels been going down from over 7% to 5-6%.

If you are in Europe and have a Type 1 Diabetes, you should ask your doctor about your options.

Post reply on HN