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Know Labs unveils glucose monitor that swaps fingersticks for RF sensors

fiercebiotech.com

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Re: Know Labs unveils glucose monitor that swaps fingersticks for RF sensors

#21

Post by tempdiabetic »

RHSeeger wrote: post #18
tempdiabetic wrote: post #6

Earlier quoted context omitted.

The Dexcom G6 is the best CGM on the market, but its sensor filtering (Kalman or particle?) has smoothness and/or continuity priors that cause persistent inaccuracies. I observe these persistent inaccurate states on the fifth or sixth day using a sensor. Calibration doesn't help. The reading goes wrong and stays wrong. It probably happens to you, too, but anyone who doesn't test with a glucometer will likely not noti…

I can't say enough good things about my G6. It literally changed my life as far as how I interact with my diabetes. - I feel safer when I go to bed, because it's there to wake me up if my blood gets low (or too high). - I feel safer in general because I don't need to worry that my blood is low but I haven't noticed it; and that I'm going to just fall down face first while walking across the room. - Testing my blood i…

If I may ask, what's your HbA1c, and please be honest?

Re: Know Labs unveils glucose monitor that swaps fingersticks for RF sensors

#22

Post by idealmedtech »

georgebarnett wrote: post #4

The device claims to have 97% of reading within 15% of the Freestyle Libre, which itself is then not as accurate as blood glucose. Put another way, it’s less accurate than a device that’s already less accurate than finger sticks. Given this info, I’m not sure this version is practically useful yet in terms of accuracy.

Hi, this is actually my field of expertise! IdealMedTech is a clinical glucose control startup targeting inpatient glucose control.

Having an MARD (mean absolute relative difference, or in math terms, E[|g-r|/r], g is measured glucose, r is reference glucose) of below 15% is actually considered very good for glucose monitoring.

We did a study that involved modelling different levels of sensor error, and you actually start to see diminishing returns on control once your MARD passes below 10%, with 15% being a good target.

Most sensors on the market that are considered best in class (eg Dexcom G6) have guaranteed MARD below 15%, usually sitting right at 10%. Getting lower than that is very difficult for interstitial glucose, especially using the classical glucose oxidase sensing mechanism.

There are other ways to sense glucose using, for example, Raman spectroscopy, and there have been companies successful in employing these techniques (OptiScan comes to mind), but I'm not yet convinced by the capacity of spectroscopy to deliver accurate results in the presence of interference from drugs and perfusion issues.

Re: Know Labs unveils glucose monitor that swaps fingersticks for RF sensors

#23

Post by idealmedtech »

tempdiabetic wrote: post #6
tronicdude wrote: post #2

“We know that not all people with diabetes are looking for a wearable continuous glucose monitoring device to manage their diabetes." Okay that's pretty bogus. Some people can't afford it, but everyone with diabetes would benefit from a CGM. There's much more to be gained from trends in CGM data than singular data points. (I was diagnosed with Type 1 at 16, been on a CGM for most of that time).

The Dexcom G6 is the best CGM on the market, but its sensor filtering (Kalman or particle?) has smoothness and/or continuity priors that cause persistent inaccuracies. I observe these persistent inaccurate states on the fifth or sixth day using a sensor. Calibration doesn't help. The reading goes wrong and stays wrong. It probably happens to you, too, but anyone who doesn't test with a glucometer will likely not noti…

I've done accuracy studies of the G6 for a submission to the FDA, and while it's true they do filter out spikes, they're never more than 5mg/dL off from the measured value (which itself is usually within 10% of the real value). Interstitial lags are closer to 5 minutes when you're not experiencing severe perfusion issues, which is more than close enough for making dosing decision, especially considering subcutaneous insulin has similar or longer lag times (depending on lots of things of course, and subject to an individual's own body).

Re: Know Labs unveils glucose monitor that swaps fingersticks for RF sensors

#24

Post by rstupek »

john_yaya wrote: post #19
guywhocodes wrote: post #15

Earlier quoted context omitted.

Agreed, as a diabetic and climber I've used a lot of the libre pucks but honestly, there is no spot on my body I wont use while practicing my sport. Still the libre was miles better than always pricking my fingers and arms. I've been thinking about what kind of EM-signal could be used for this for a long time, IR-spectroscopy never seemed possible. But this has real potential.

I worked on the Freestyle Libre, I’m thrilled to hear it’s at least a workable solution for you. When I was working at Abbott, I often volunteered for testing finger-stick devices, which made me appreciate a small part of what people with diabetes have to endure.

I've used them and they're great just pricey

Re: Know Labs unveils glucose monitor that swaps fingersticks for RF sensors

#25

Post by 1123581321 »

wincy wrote: post #12
1123581321 wrote: post #11

Earlier quoted context omitted.

Patients averse to finger sticks are going to use this much more often. It's going to provide more useful data to them. Much of the time the exact number isn't as important as knowing the trend or the general range. Whether this makes more sense than a Libre for someone just depends on price and how insurance treats it.

I tested my blood sugar when my wife was pregnant and she was testing hers. I was amazed at how just from the small blood stick, and even if I had my wife do it and didn’t see any blood, I’d get sick to my stomach every time I did a blood stick. I’m glad I don’t have diabetes or I’d have a terrible time of it.

Yes, it's not fun. On top of that, for a permanent diabetic, finger sticks over a long period of time are an infection risk, especially if the patient isn't good at using all of their fingers (I got comfortable with it and there were still at 4-5 finger locations that I dreaded pricking.)

Re: Know Labs unveils glucose monitor that swaps fingersticks for RF sensors

#27

Post by DougWebb »

jcims wrote: post #8
tempdiabetic wrote: post #6

Earlier quoted context omitted.

The Dexcom G6 is the best CGM on the market, but its sensor filtering (Kalman or particle?) has smoothness and/or continuity priors that cause persistent inaccuracies. I observe these persistent inaccurate states on the fifth or sixth day using a sensor. Calibration doesn't help. The reading goes wrong and stays wrong. It probably happens to you, too, but anyone who doesn't test with a glucometer will likely not noti…

Is there a good source for info on ketogenic diets for type 1 diabetics? My youngest has been on pump therapy for the past 5 years and is completely burnt out from all of the alerts and scares (some of it is self inflicted). She was on a medtronic closed loop system for 4 years and that was the source of most of her frustration. She's on g6+tslim now which has been much better, but she still falls off the wagon regul…

I'd recommend watching Dr Sten Eckberg's videos, like this one: https://youtu.be/XTmUnIrmAe8

I'm on a keto diet for chronic insulin resistance and obesity, caused by 50 years of high carb eating. (Every meal a sandwich, or including potatoes or rice, and lots of sugar.)

I got a CGM a few months ago to help me directly see the impact of the foods I'm eating. It has allowed me to fine tune my diet and get rid of everything that causes a noticable rise in my glucose. My daily graph now shows little more than than the natural daily cycle of glucose produced by my liver: starts rising before dawn, peaks around 10am, drops to my average by 6pm, and drops to daily low around 3am.

If I were a type 2 diabetic (I was headed there), I wouldn't need supplemental insulin because I'm not eating anything that increases my glucose. The only glucose in my blood is the small amount my liver puts there because I need it.

If I were type 1, I'd need to take insulin because my body wouldn't be making any at all. With my natural, consistent, and small-range daily pattern, it would be easy to predict my needs and take the right amount at the right time.

CGMs are life changing.

Re: Know Labs unveils glucose monitor that swaps fingersticks for RF sensors

#28

Post by KMnO4 »

monkey88 wrote: post #26

Can't wait until it is bought by an existing company and then discarded, like its previous competitors.

Test strips are $1 x 5 times per day x 30M diabetic Americans.

How can this even compete? You can’t sell RF “per-use”.

Re: Know Labs unveils glucose monitor that swaps fingersticks for RF sensors

#29

Post by a9h74j »

idealmedtech wrote: post #22
georgebarnett wrote: post #4

The device claims to have 97% of reading within 15% of the Freestyle Libre, which itself is then not as accurate as blood glucose. Put another way, it’s less accurate than a device that’s already less accurate than finger sticks. Given this info, I’m not sure this version is practically useful yet in terms of accuracy.

Hi, this is actually my field of expertise! IdealMedTech is a clinical glucose control startup targeting inpatient glucose control. Having an MARD (mean absolute relative difference, or in math terms, E[|g-r|/r], g is measured glucose, r is reference glucose) of below 15% is actually considered very good for glucose monitoring. We did a study that involved modelling different levels of sensor error, and you actually…

In addition, I imagine confounds which are patient/location specific can be calibrated out to some extent, by comparing against finger-stick while fasting, and longer-term A1C.

Following a chain of references from the OP:

study of wearable: https://cb195ec0-5419-4138-91fc-7288f69116ec.filesusr.com/ug... whitepaper announcement: https://medium.com/know-labs/know-labs-releases-white-paper-... whitepaper: https://docs.google.com/document/d/e/2PACX-1vQXqlmKwPzhZIn9t...

The whitepaper gives actual prep methods for tissue phantoms. It shows a clean correlation of ca 1.72GHz transmission to glucose. Presumably altered parameters in tissue phantoms could help roughly characterize confounds.

Re: Know Labs unveils glucose monitor that swaps fingersticks for RF sensors

#30

Post by KMnO4 »

jcims wrote: post #8
tempdiabetic wrote: post #6

Earlier quoted context omitted.

The Dexcom G6 is the best CGM on the market, but its sensor filtering (Kalman or particle?) has smoothness and/or continuity priors that cause persistent inaccuracies. I observe these persistent inaccurate states on the fifth or sixth day using a sensor. Calibration doesn't help. The reading goes wrong and stays wrong. It probably happens to you, too, but anyone who doesn't test with a glucometer will likely not noti…

Is there a good source for info on ketogenic diets for type 1 diabetics? My youngest has been on pump therapy for the past 5 years and is completely burnt out from all of the alerts and scares (some of it is self inflicted). She was on a medtronic closed loop system for 4 years and that was the source of most of her frustration. She's on g6+tslim now which has been much better, but she still falls off the wagon regul…

Anecdotal, but a Keto diet has completely flatlined my BG — in a very good way. I’m talking about being in the range of 4.8 to 5.8 for weeks on end. My endocrinologist thinks I’m a wizard and has never seen anyone with 100% in range.

I also love that I never have to bolus with food. It’s the closest I can get to pretending I’m not a T1D. I just eat. If I’m full, I stop and don’t have to worry that I accidentally took too much insulin. To reiterate, I take zero boluses when I’m on the keto diet.

Doctors are against it because they’re dealing with ketoacidosis on a regular basis. Ketosis also means your body is producing ketones (which I believe is the source of confusion for doctors), but that’s fine because your BG is in a normal range. Technically you’re at higher risk for ketoacidosis when on the keto diet because of those ketones, but realistically your BG is not going to reach >15mmol/L so you don’t have to worry too much.

By the way, you may be interested in Loop[0] if you wanted to look at a more advanced closed loop system. It can handle both auto basal and auto bolusing.

[0]: https://loopkit.github.io/loopdocs/

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