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Apple Monitoring Blood Glucose

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Re: Apple Monitoring Blood Glucose

#21
post #17
post #4

Earlier quoted context omitted.

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.

[deleted]

Re: Apple Monitoring Blood Glucose

#22
post #13
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. Nev…

I've never heard of successful vaccine companies going bankrupt.

But vaccines are an exception in medicine. Serious conditions rarely have magic bullet cures.

E.g. "cancer" isn't one condition, it's a set of loosely related problems. It's very unlikely indeed there will ever be "a cure for cancer", but not at all unlikely that specific cancers will become much more treatable.

That doesn't stop companies promising to develop magic bullet cures - or magic bullet anything - and getting huge interest from investors. (See also Theranos, etc.)

Re: Apple Monitoring Blood Glucose

#23
post #20

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 displ…

If you have an insulin pump (best if it's an older one, since newer ones are harder to hack) you should look into OpenAPS (open artificial pancreas system) https://openaps.org/. People have code/schematics available to build a closed loop system between CGMinsulin pump which automatically adjusts the dosage based on glucose levels and keeps you in range better than even the best attempts at manual dosages. Seems like you've already done half the work, which is connecting the CGM to a device you can run custom code on.

Medtronic just came out with their first closed loop system (https://www.medtronicdiabetes.com/products/minimed-670g-insu...), but OpenAPS has been around for years, and not sure how Medtronic will go about getting the 670 approved in Germany.

Re: Apple Monitoring Blood Glucose

#24

Earlier quoted context omitted.

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.

I wasn't being conspiratorial, so much as adding some detail to a market-based model.

As in the other post below, I don't believe magic bullet cures are possible for most diseases.

Following that economic logic further, it's much cheaper and easier to produce a not-very-effective but marketable palliative than it is to aim for a Nobel-winning medical moonshot.

I don't know of any suppressed super-cures, but evidence confirming the limited effectiveness of (e.g.) SSRIs is easy to find and hard to argue with.

Similarly questionable outcomes have been noted in other fields. E.g. novel anticoagulants:

https://en.wikipedia.org/wiki/Dabigatran

Re: Apple Monitoring Blood Glucose

#25
post #20

Earlier quoted context omitted.

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 displ…

If you have an insulin pump (best if it's an older one, since newer ones are harder to hack) you should look into OpenAPS (open artificial pancreas system) https://openaps.org/ . People have code/schematics available to build a closed loop system between CGM insulin pump which automatically adjusts the dosage based on glucose levels and keeps you in range better than even the best attempts at manual dosages. Seems li…

The Medtronic 670g was my other option, but I took the Animas Vibe + Dexcom G4 just because it's easier to hack, lots of German Diabetes hackers use it, its CGM seems to be more accurate and you can use the G4 sensors way longer than the 670g.

670g is a closed loop system, but what it does is it stops giving you the basal insulin when it thinks you are getting a hypoglycemia soon. What it doesn't do is to give you correct amount of insulin automatically when you've been eating carbs or doing exercise to keep your glucose level in the 5.5 mmol/l target. And with the new Fiasp insulin automatic adjustments would be possible.

To be able to build the OpenAPS, you must have an older Medtronic pump which are not covered by German insurance anymore. My Animas doesn't allow to tweak the insulins remotely.

Re: Apple Monitoring Blood Glucose

#26

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 anyt…

maybe this could be a qualitative way of understanding the body's insulin response to a meal, and to adjust one's diet accordingly (more meals, lower GI foods, etc)?

Re: Apple Monitoring Blood Glucose

#27

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 anyt…

I think your use of the word "cute" is a bit disingenuous and at odds with the conclusion you draw. "Cute" implies misleading, whereas the scenario you outline isn't misleading at all.

It makes total sense to start where they are starting; they'll get teams of data in a very short space of time (from diabetics and non-diabetics alike) and be able to iterate quite quickly from there.

As a non-diabetic, I want this so much. The impact of sugar and insulin on health is finally getting the attention it needs and I think this could be the innovation that makes health trackers actually useful.

Re: Apple Monitoring Blood Glucose

#28
post #20

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 displ…

Unfortunately I can't get this in the UK. I asked, but they only give out to kids or people who poorly manage their T1. :(

Re: Apple Monitoring Blood Glucose

#29

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 anyt…

I think your use of the word "cute" is a bit disingenuous and at odds with the conclusion you draw. "Cute" implies misleading, whereas the scenario you outline isn't misleading at all. It makes total sense to start where they are starting; they'll get teams of data in a very short space of time (from diabetics and non-diabetics alike) and be able to iterate quite quickly from there. As a non-diabetic, I want this so…

Well, I think it is cute, in that I'm sure every type 1 diabetic who can afford it will immediately buy one of these -- whether they're FDA approved or not.

Re: Apple Monitoring Blood Glucose

#30
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.

Maybe Apple will tell their users with t2 diabetes they are eating wrong, roll out a new streamlined diet, and everyone gets better.
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