Automated glucose control will be the next frontier in so many areas of healthcare. I'm still skeptical that anyone will be able to noninvasively and accurately sense blood sugar, but I'm glad people (especially kids with T1) will have one more tool to help them. I hope they can figure out the reimbursement side to get it into the most hands possible!
Invasive CGMs (Continuous Glucose Monitor) and minimally invasive CGMs exist. It's the non-invasive CGMs which are being worked on because managing an implant or having something always poking through you is a big annoyance and risk compared to wearing a watch, ring, or patch.
The problems so far have been these non-invasive options so far either too easily fail to work, are bulky/expensive, give very ballpark accuracies, or some combination of the above.
Does anyone know if something like this is required to be approved by the FDA? Like if someone were to make one for the hobbyist/weight loss market, would that even be legal?
The difference is that these only measure blood sugar, while the new system also measures ketones, of keto diet fame, which are leading indicators of a really dangerous situation called diabetic ketoacidosis. It's treatable with a hospitalized IV insulin drip, but can be avoided if you have some advance notice.
These are the same CGM technologies (Dexcom = Stelo and Lingo = Libre), just aimed at the over the counter "health and fitness" market.
This is not verified info, but I would assume these are either A) the exact same device, just with different marketing B) "binned" production runs that did not meet the accuracy threshold for clinical/prescribed use, but are otherwise "good enough" for someone looking to healthmaxx.
I t
Looked into the OTC ones and it does seem they’re binned versions. The failure rate appears to be higher too, which is more acceptable in a non life threatening device.
It also probably gives the companies really valuable data.
I thought this was going to be a non-invasive sugar-level device, but it looks like in fact the innovation here is that a popular CGM line can now do ketones?
non-invasive continuous blood sugar measurement is mired in patents and technical challenges. Turns out it's really difficult to disambiguate the absorption lines of glucose from other similarly shaped molecules when you're also dealing with untangling skin conductivity, transmissivity, sweat, inflammation etc.
I also think there's no financial incentive from incumbents to develop something like this. Why would abbott develop something that works "forever" if they can milk people buying new sensors every 10~14 days.
There is a major IP holder in the space who is asserting their ownership, so even if they could solve the technical challenges, they might not be able to come to market.
There has been talk, but as one who hangs around those circles I've not heard of anyone actually doing it. But I'm sure someone is. At the same time, what I'm reading is that CGM won't give a non-diabetic any actionable information.
a regulated blood sugar level aids massively in cellular repair, inflammation reduction, and immune response. These are well studied and established. I could absolutely see a top athlete using AID in the future as part of a recovery routine, but I can also understand reluctance to adopt anything new or weird.
A few years back, there were a number of startups that essentially resold prescriptions of the ABT/DXCM CGM and provided personalized meal/exercise-response analytics on top. Seems like traction has been tough going, though. Dialing back from "anyone with potential metabolic issues" -- what's a realistic market? Something like high-level athletes and/or bio-hacker enthusiasts are the only folks who seem to care. On the low end, the OTC options are eating away as well.. they are less accurate, but probably solve the use case better for a pre-diabetic "once-a-year/occasional" wear use case.
Talking to ultramarathoners and cyclists, I think lactate is a biomarker that is tracked (POC blood samples) and would be more immediately useful for training/performance. AID might be construed as a form of doping, IMO.
I am aware of the "eating wins races" strategy for endurance sports.
Glucose and ketone monitoring seems a natural, more precise extension of that strategy. Isn't the point of carb-cramming to get more glucose into your blood stream, where your muscles can convert that into forward motion?
Monitoring glucose and ketones can help you develop metabolic flexibility and let you grok how easily your body cuts over to ketones. Knowing your personal realtime glucose and ketone levels helps you understand just how much carbs will kick you out of ketosis or keep you in it. Glucose monitoring will help you avoid large crashes that can lead to low energy. Among other things!
My understanding is that essentially all high-level endurance athletes are just maximizing their simple sugar intake at all times (during exercise) and knowing blood glucose/ketone levels wouldn't change anything about that intake, nor would it have any impact on crashes.
As someone who has to deal with type 1 diabetes every day, this is marketing nonsense. No one needs ketones in the sensor - we need high-quality sensors, and Abbott's are only mediocre at best. They are not as bad as Dexcom, which is appalling, but they are still far from the superior quality of Medtronic/MiniMed which measure glucose exceptionally well.
Ketones are rare. They can kill you, but before that happens, your blood sugar usually rises enough for you to realise you may have ketones and start using test strips to measure them. Instead of this marketing gimmick, Abbott should have focused on improving the quality of their glucose sensors which is far more important.
Looked after my son who has T1D for now 5 years, checked keytones maybe 20 times.
Compared to blood glucose which we check look at every 5 minutes.
Maybe this is more for Type 2 or other diabetes, or for people prone to DKA.
Or it is for people with a working pancreas who think looking at their blood sugars (and now keytones) tells them something like soothsayers reading tea leaves
Mate they won't understand. People are often exceptionally ignorant and eager to fall for marketing gimmicks like this one. They have no idea what type 1 diabetes is.
For anyone who doesn't get it: glucose is checked every *five* minutes. It's a nightmare. It's 1000 times more important than ketones which are almost never a problem. Before ketones become an issue, glucose has to stay high for hours. Abbott is using marketing tricks instead of improving the quality of its sensors. Libre 2 is absolute crap. Libre 3 is somewhat okay and sometimes even mediocre - which is still a pretty bad situation. Bad glucose sensor is a nightmare and it can kill a person or a child much likely than ketoacidosis.
No one asked them for ketones, except maybe their marketing department. People want higher quality glucose sensors that fail less often and are more accurate. Glucose sensors, not ketones!
Automated glucose control will be the next frontier in so many areas of healthcare. I'm still skeptical that anyone will be able to noninvasively and accurately sense blood sugar, but I'm glad people (especially kids with T1) will have one more tool to help them. I hope they can figure out the reimbursement side to get it into the most hands possible!
> Automated glucose control will be the next frontier in so many areas of healthcare.
What areas do you have in mind outside of diabetes management?
I wonder if there are any legs in an internal sensor that pushes out its reading every x? That seems pretty plausible.
Invasive CGMs (Continuous Glucose Monitor) and minimally invasive CGMs exist. It's the non-invasive CGMs which are being worked on because managing an implant or having something always poking through you is a big annoyance and risk compared to wearing a watch, ring, or patch.
The problems so far have been these non-invasive options so far either too easily fail to work, are bulky/expensive, give very ballpark accuracies, or some combination of the above.
A good read on this topic is The Pursuit of Noninvasive Glucose: 'Hunting the Deceitful Turkey'.
Internal as in swimming in the bloodstream?
I have to imagine Apple was pushing for similar functionality but probably got distracted over the last few years due to the lawsuits.
Does anyone know if something like this is required to be approved by the FDA? Like if someone were to make one for the hobbyist/weight loss market, would that even be legal?
Basically yes, take a look at the not for human consumption drug, sorry medicine market.
Was analogs in the 2010s, Obama had to pass the analog act low… now it’s back with peptides and glp 1 which aren’t scheduled but..
Yeah I guess make enough money and then lobby for the benefit of your audience base or for future proscuation
What about all the other wearable sensors like
https://www.stelo.com
https://www.hellolingo.com
The difference is that these only measure blood sugar, while the new system also measures ketones, of keto diet fame, which are leading indicators of a really dangerous situation called diabetic ketoacidosis. It's treatable with a hospitalized IV insulin drip, but can be avoided if you have some advance notice.
Those ‘only’ measure glucose levels. As the article says, this is the first approved device that monitors both ketone and glucose levels.
These are the same CGM technologies (Dexcom = Stelo and Lingo = Libre), just aimed at the over the counter "health and fitness" market.
This is not verified info, but I would assume these are either A) the exact same device, just with different marketing B) "binned" production runs that did not meet the accuracy threshold for clinical/prescribed use, but are otherwise "good enough" for someone looking to healthmaxx.
I can all but guarantee you they are the same device. IDK if they are even binned differently. The software is the main difference.
The "real" device gives you what it measures as your real highs and lows while the OTC devices won't report high highs or low lows.
I have a Stelo (I was curious and diabetes runs in my family) while my wife has the Dexcom.
I t Looked into the OTC ones and it does seem they’re binned versions. The failure rate appears to be higher too, which is more acceptable in a non life threatening device.
It also probably gives the companies really valuable data.
You can read the Stelo out into XDrip with some settings adjustments, last I checked, so it is just some “light” software tweaks between sensors.
https://navid200.github.io/xDrip/docs/Dexcom/G7.html
No FDA authorization I guess
Nope that was two years ago.
https://www.fda.gov/news-events/press-announcements/fda-clea...
I thought this was going to be a non-invasive sugar-level device, but it looks like in fact the innovation here is that a popular CGM line can now do ketones?
non-invasive continuous blood sugar measurement is mired in patents and technical challenges. Turns out it's really difficult to disambiguate the absorption lines of glucose from other similarly shaped molecules when you're also dealing with untangling skin conductivity, transmissivity, sweat, inflammation etc.
I also think there's no financial incentive from incumbents to develop something like this. Why would abbott develop something that works "forever" if they can milk people buying new sensors every 10~14 days.
For abbott, no. But what about for Garmin, Apple, Samsung, or Google?
Diabetics would snap up a smart watch which does accurate glucose monitoring in a heartbeat.
There is a major IP holder in the space who is asserting their ownership, so even if they could solve the technical challenges, they might not be able to come to market.
> There is a major IP holder in the space who is asserting their ownership,
Is it a secret? Why not name them?
As a T1 diabetic, can confirm.
Seems to be the case, yeah
bet marathoners and ultra runners will start using this to improve performance
(don't have a problem with that, but it's predictable)
too bad it's not "wearable" like a watch but that might be coming eventually too since Garmin has a patent on it
* https://the5krunner.com/2026/02/06/garmin-non-invasive-blood...
(btw Fenix 9 launched today but it's same hardware as Fenix 8 and no glucose feature)
There has been talk, but as one who hangs around those circles I've not heard of anyone actually doing it. But I'm sure someone is. At the same time, what I'm reading is that CGM won't give a non-diabetic any actionable information.
a regulated blood sugar level aids massively in cellular repair, inflammation reduction, and immune response. These are well studied and established. I could absolutely see a top athlete using AID in the future as part of a recovery routine, but I can also understand reluctance to adopt anything new or weird.
A few years back, there were a number of startups that essentially resold prescriptions of the ABT/DXCM CGM and provided personalized meal/exercise-response analytics on top. Seems like traction has been tough going, though. Dialing back from "anyone with potential metabolic issues" -- what's a realistic market? Something like high-level athletes and/or bio-hacker enthusiasts are the only folks who seem to care. On the low end, the OTC options are eating away as well.. they are less accurate, but probably solve the use case better for a pre-diabetic "once-a-year/occasional" wear use case.
Talking to ultramarathoners and cyclists, I think lactate is a biomarker that is tracked (POC blood samples) and would be more immediately useful for training/performance. AID might be construed as a form of doping, IMO.
I am curious how this will help. During training? During the actual race, the strategy is to eat a much as you can without puking.
I am aware of the "eating wins races" strategy for endurance sports.
Glucose and ketone monitoring seems a natural, more precise extension of that strategy. Isn't the point of carb-cramming to get more glucose into your blood stream, where your muscles can convert that into forward motion?
> to improve performance
How? Like, what is the mechanism where this is useful?
Monitoring glucose and ketones can help you develop metabolic flexibility and let you grok how easily your body cuts over to ketones. Knowing your personal realtime glucose and ketone levels helps you understand just how much carbs will kick you out of ketosis or keep you in it. Glucose monitoring will help you avoid large crashes that can lead to low energy. Among other things!
More on metabolic flexibility: https://www.levels.com/blog/what-is-metabolic-flexibility-an...
My understanding is that essentially all high-level endurance athletes are just maximizing their simple sugar intake at all times (during exercise) and knowing blood glucose/ketone levels wouldn't change anything about that intake, nor would it have any impact on crashes.
As someone who has to deal with type 1 diabetes every day, this is marketing nonsense. No one needs ketones in the sensor - we need high-quality sensors, and Abbott's are only mediocre at best. They are not as bad as Dexcom, which is appalling, but they are still far from the superior quality of Medtronic/MiniMed which measure glucose exceptionally well.
Ketones are rare. They can kill you, but before that happens, your blood sugar usually rises enough for you to realise you may have ketones and start using test strips to measure them. Instead of this marketing gimmick, Abbott should have focused on improving the quality of their glucose sensors which is far more important.
So she was merely ahead of her time.
The use case was never the problem. The problem was that it did not work.
Who?
Theranos lady.
Huh, makes 0 sense to me, blood tests w/o much blood isn’t same as glucose checking, we’ve been able to do that w/o much blood for…a long long time.
That silly patch idea?
Looked after my son who has T1D for now 5 years, checked keytones maybe 20 times. Compared to blood glucose which we check look at every 5 minutes.
Maybe this is more for Type 2 or other diabetes, or for people prone to DKA. Or it is for people with a working pancreas who think looking at their blood sugars (and now keytones) tells them something like soothsayers reading tea leaves
Considering that DKA accounts for 160k hospital admissions a year, your lived experience translates poorly to such a flippant dismissal.
[0] https://www.cdc.gov/diabetes/about/diabetic-ketoacidosis.htm...
I agree, but there are a lot of factors going on to contribute to that number.
For example, about 20% of that number is because someone is finding out for the first time they have T1D [1].
Insulin costs and monitoring costs are also going to be a pretty big contributing factor. CGMs and finger sticks aren't cheap.
IDK how often it happens that ketoacidosis happens when glucose appears to be fine, I assume it's pretty rare.
[1] https://www.sciencedirect.com/science/article/pii/S016882272...
DKA is what killed the legendary Dan Kaminsky.
Mate they won't understand. People are often exceptionally ignorant and eager to fall for marketing gimmicks like this one. They have no idea what type 1 diabetes is.
For anyone who doesn't get it: glucose is checked every *five* minutes. It's a nightmare. It's 1000 times more important than ketones which are almost never a problem. Before ketones become an issue, glucose has to stay high for hours. Abbott is using marketing tricks instead of improving the quality of its sensors. Libre 2 is absolute crap. Libre 3 is somewhat okay and sometimes even mediocre - which is still a pretty bad situation. Bad glucose sensor is a nightmare and it can kill a person or a child much likely than ketoacidosis.
No one asked them for ketones, except maybe their marketing department. People want higher quality glucose sensors that fail less often and are more accurate. Glucose sensors, not ketones!