Please make this a reality Apple. This will change my life. I'm tired of pricking my finger several times a day and the difficulty of managing my diet.
I'm nervous about anything that is pitched to the general public and not provided or monitored via a doctor. Gathering lots of data is one thing. Properly interpreting it and knowing what to do with it is another. I think Apple should go slow, maybe partner with an insurance company or medical facility to do trials. Once you start talking about health that's a whole other ball game with next to no room for error.
Anyway I don't believe for one second that Tim Cook would wear a prototype device around campus where any employee could see it, nor do I believe he would out said product to students at a university.
I'm nervous about anything that is pitched to the general public and not provided or monitored via a doctor. Gathering lots of data is one thing. Properly interpreting it and knowing what to do with it is another. I think Apple should go slow, maybe partner with an insurance company or medical facility to do trials. Once you start talking about health that's a whole other ball game with next to no room for error.
I think Apple will go slow because it's in their nature and this could come with severe liability cases (even if the lawsuits are silly). We already heard that they didn't include many features two years ago because they wanted them to be more accurate. I've seen several reports that show Apple's step tracking and pulse rate are the most accurate for a consumer-level device. As for a doctor, I think we're good with a pulse without needing a doctor, and people with diabetes record their levels already. Plus, CareKit can have that data sent to doctors so there's already a path for that.
Soli said: If it comes to that, that's a solution, but couldn't it infer that you are eating when your blood sugar spikes between measurements?
Probably. The blood sugar increase after eating doesn't exactly spike. It hits its peak around two hours after a meal. Blood sugar can spike pretty quickly though with high doses of sugary drinks. I suppose the Watch app could ask if you ate recently or drank a sugary beverage.
Soli said: If it comes to that, that's a solution, but couldn't it infer that you are eating when your blood sugar spikes between measurements?
Probably. The blood sugar increase after eating doesn't exactly spike. It hits its peak around two hours after a meal. Blood sugar can spike pretty quickly though with high doses of sugary drinks. I suppose the Watch app could ask if you ate recently or drank a sugary beverage,
Or check your Apple Pay receipts, GPS location, and any Instagram pictures of food you may have uploaded.
I'm nervous about anything that is pitched to the general public and not provided or monitored via a doctor. Gathering lots of data is one thing. Properly interpreting it and knowing what to do with it is another. I think Apple should go slow, maybe partner with an insurance company or medical facility to do trials. Once you start talking about health that's a whole other ball game with next to no room for error.
Unlike all those other products that Apple rushes to market without foresight?
Soli said: If it comes to that, that's a solution, but couldn't it infer that you are eating when your blood sugar spikes between measurements?
Probably. The blood sugar increase after eating doesn't exactly spike. It hits its peak around two hours after a meal. Blood sugar can spike pretty quickly though with high doses of sugary drinks. I suppose the Watch app could ask if you ate recently or drank a sugary beverage.
Lost me at "selling it as a separate band"
ONE WATCH TO RULE THEM ALL! Keep packing in the features!
Putting features in a band is part of packing in the features. There's a large area that can be utilized by sensors in the band… or are you wanting to use it as a pocket watch?
This angle has legs...
Visiting an Apple Store to buy 2 watches in 2020:
"I'm not diabetic, but my wife is, so I'd like to buy her a 38 Stainless with the diabetic feature band. I have hypertension, so for me, I'd like a 42 Liquid Metal with the blood pressure feature band."
He could also be wearing an Apple prototype sensor along with a traditional invasive glucose monitor so they could compare the accuracy between the devices.
That would be the only way to test the Apple sensor properly. Test both sensors on many Apple employees concurrently for month at a time and only when truly confident you've got a very accurate sensor do you go near the FCC for approval. I suspect they are a few years away still from reaching the required non-invasive glucose sensor accuracy. I'd be surprised it this is announced for Apple Watch before 2020. My guess would be 2023 or something like this. The bar is very high considering how dangerous an innacurate reading would be and how much bad PR you'd get for a reading that isn't reliable—you only get one chance to be a great non-invasive reader, without which you'd take years to recover from the bad PR regarding medical sensors.
People are obsessed with FDA approval of glucose monitoring...
The FDA approves medical devices. In this case, it would be for monitoring the glucose levels of diabetics. But, there are many uses for monitoring glucose beyond just the diabetic world.
Whether or not Apple needs FDA approval depends mostly on their marketing claims more than their technology. As for the band, a functional band greatly expands the functionality of the watch -- additional battery life, additional sensors, even blood pressure measurement. None of which inherently need FDA approval.
FDA approval ONLY comes into play IF Apple markets it as a medical device.
People are obsessed with FDA approval of glucose monitoring...
The FDA approves medical devices. In this case, it would be for monitoring the glucose levels of diabetics. But, there are many uses for monitoring glucose beyond just the diabetic world.
Whether or not Apple needs FDA approval depends mostly on their marketing claims more than their technology. As for the band, a functional band greatly expands the functionality of the watch -- additional battery life, additional sensors, even blood pressure measurement. None of which inherently need FDA approval.
FDA approval ONLY comes into play IF Apple markets it as a medical device.
I don't think Apple can get away with this. They can market a Watch that can measure blood glucose or blood pressure, presumably through smart bands, as a not for medical use type thing, but their customer base won't see it that way. The small print disclaimers, or even big print disclaimers, won't let them get away with it either. If the measurements are reliable, they end up selling a few units (let alone millions of units), they will have no choice. The FDA will intervene. 23andme didn't get away with. Apple won't get away with it.
Lost me at "selling it as a separate band"
ONE WATCH TO RULE THEM ALL! Keep packing in the features!
Putting features in a band is part of packing in the features. There's a large area that can be utilized by sensors in the band… or are you wanting to use it as a pocket watch?
This angle has legs...
Visiting an Apple Store to buy 2 watches in 2020:
"I'm not diabetic, but my wife is, so I'd like to buy her a 38 Stainless with the diabetic feature band. I have hypertension, so for me, I'd like a 42 Liquid Metal with the blood pressure feature band."
Apple Store Associate: "No worries! Coming up!"
I bet a blood pressure smart band is setting in Apple's lab right now. Wrist blood pressure cuffs are like, ugly. Cheap. It is definitely a device that is ripe for miniaturization and beatification.
The idea of a truly non-invasive continuously glucose monitor is always the holy grail of diabetes research. I am skeptical Apple has come up with a way to do it. It is just extremely complex and difficult to find a way to measure glucose without pricking a skin or putting a sensor under the skin (like Dexcom). If Apple managed to come up with that, it will definitely change the whole game.
There is just no way that Apple Watch itself will be able to do glucose monitoring. It's likely an accessory device if it exists. And it will be likely expensive but it will likely be cost effective in the long run.
It is just extremely complex and difficult to find a way to measure glucose without pricking a skin or putting a sensor under the skin
Sensor readings that are from just below the skin are not the same as blood readings. Sensor readings are taken from your interstitial fluid, and not from your blood. Interstitial fluid is the fluid that surrounds the cells of your tissue below your skin, and usually glucose moves from your blood vessels and capillaries first and then into your interstitial fluid which takes time and is probably why Dexcom only reads the glucose level every five minutes instead of continuously (CGM). And the readings from the interstitial fluid are almost always going to be lower than actual blood readings which is why you need to periodically calibrate the receiver app with an actual blood reading.
As a side bar, readings taken from a finger stick are also considered more accurate than with blood drawn from a vein because it is coming from a much smaller blood vessel.
Since interstitial fluid readings every five minutes will not show an accurate reading when the level of glucose is changing quickly in the blood, such as after eating or using insulin, it is best to look at trends rather than being overly concerned with a single reading.
As I mentioned in an earlier post, I expect Apple to use some RF or light emitting technology to calculate the glucose in the capillaries by detecting some physical property like refraction or rotation of the signal. This way you would have continuous readings that would be more accurate, because you would be measuring the blood in the capillary, not the Interstitial fluid, and also you would not need a sensor under your skin.
In either case, sensor or actual blood sample, using insulin to control glucose levels is really just treating the symptom. Normal bodies create their own insulin that aids cells in absorbing sugar which they need to live. Diabetes is actually an immune disorder that prevents the body from producing insulin. In the future I would hope we can find a way to treat the underlying immune disorder instead of relying on insulin injections to maintain normal glucose levels.
It is just extremely complex and difficult to find a way to measure glucose without pricking a skin or putting a sensor under the skin
Sensor readings that are from just below the skin are not the same as blood readings. Sensor readings are taken from your interstitial fluid, and not from your blood. Interstitial fluid is the fluid that surrounds the cells of your tissue below your skin, and usually glucose moves from your blood vessels and capillaries first and then into your interstitial fluid which takes time and is probably why Dexcom only reads the glucose level every five minutes instead of continuously (CGM). And the readings from the interstitial fluid are almost always going to be lower than actual blood readings which is why you need to periodically calibrate the receiver app with an actual blood reading.
As a side bar, readings taken from a finger stick are also considered more accurate than with blood drawn from a vein because it is coming from a much smaller blood vessel.
Since interstitial fluid readings every five minutes will not show an accurate reading when the level of glucose is changing quickly in the blood, such as after eating or using insulin, it is best to look at trends rather than being overly concerned with a single reading.
As I mentioned in an earlier post, I expect Apple to use some RF or light emitting technology to calculate the glucose in the capillaries by detecting some physical property like refraction or rotation of the signal. This way you would have continuous readings that would be more accurate, because you would be measuring the blood in the capillary, not the Interstitial fluid, and also you would not need a sensor under your skin.
In either case, sensor or actual blood sample, using insulin to control glucose levels is really just treating the symptom. Normal bodies create their own insulin that aids cells in absorbing sugar which they need to live. Diabetes is actually an immune disorder that prevents the body from producing insulin. In the future I would hope we can find a way to treat the underlying immune disorder instead of relying on insulin injections to maintain normal glucose levels.
"Diabetes is actually an immune disorder that prevents the body from producing insulin" That's Type 1 diabetes. It doesn't stop the beta cells of the pancreas from producing insulin. Instead, antibodies attack and kill those cells. It used to be called "IDDM" (Insulin Dependent Diabetes Mellitus)
But the epidemic is Type II Diabetes - which is caused by insulin resistance blocking the muscles and fat from absorbing glucose -- so it remains in the blood stream. People say: "I have sugar" -- but actually that is just a symptom (a deadly symptom, but a symptom). Actually, they have insulin resistance. For a while, the pancreas pumps out increasing amounts of insulin to counteract the rising sugar levels. But, eventually, in some cases, that same process may also kills off the beta cells in the pancreas -- but that's still not the Type I diabetes. (Some nickname it "type one and a half".
True but 95% of type 2 diabetes cases are the patient's own damn fault for being obese, poor diet and lack of exercise or activity. That can only be corrected with self discipline.
True but 95% of type 2 diabetes cases are the patient's own damn fault for being obese, poor diet and lack of exercise or activity. That can only be corrected with self discipline.
True... That's also true of most of our chronic diseases such as: heart disease, many of the most common cancers, as well as some dementias... But, our food industry makes huge profits making them sick while our diseasecare industry makes huge profits treating the symptoms and effects of those diseases...
What would happen to our economy if people actually lived healthy lifestyles? ... We don't make steel anymore -- instead we make people sick and then treat the effects...
tht said: ... I bet a blood pressure smart band is setting in Apple's lab right now. Wrist blood pressure cuffs are like, ugly. Cheap. It is definitely a device that is ripe for miniaturization and beatification.
I have considerable admiration for Apple the company but only the pope is in charge of 'beatification'. Apple excels at beautification.
@GeorgeBMac you are a smart guy. You should be involved with shaping our nation's healthcare policies. I hope you can run for office.
Thank you.... I am a nurse and care deeply about health - and I am discouraged and frustrated with our DiseaseCare system. It does what it does pretty well -- admittedly it costs far too much, but it does get pretty good results where it focuses its efforts. But we very much need to shift to a HealthCare system.
Right now, our DiseaseCare system admits that although healthy lifestyles (diet, exercise, stress reduction, etc.) are the only way to health, it also tells us that it cannot help us and we are on our own. While I agree that a healthy lifestyle is a personal responsibility, I also believe that we need a health care system that promotes and supports those healthy lifestyles -- rather than simply pushing pills and procedures when it fails.
Comments
Anyway I don't believe for one second that Tim Cook would wear a prototype device around campus where any employee could see it, nor do I believe he would out said product to students at a university.
(This is joke)
Visiting an Apple Store to buy 2 watches in 2020:
"I'm not diabetic, but my wife is, so I'd like to buy her a 38 Stainless with the diabetic feature band. I have hypertension, so for me, I'd like a 42 Liquid Metal with the blood pressure feature band."
Apple Store Associate: "No worries! Coming up!"
The FDA approves medical devices. In this case, it would be for monitoring the glucose levels of diabetics. But, there are many uses for monitoring glucose beyond just the diabetic world.
Whether or not Apple needs FDA approval depends mostly on their marketing claims more than their technology. As for the band, a functional band greatly expands the functionality of the watch -- additional battery life, additional sensors, even blood pressure measurement. None of which inherently need FDA approval.
FDA approval ONLY comes into play IF Apple markets it as a medical device.
There is just no way that Apple Watch itself will be able to do glucose monitoring. It's likely an accessory device if it exists. And it will be likely expensive but it will likely be cost effective in the long run.
As a side bar, readings taken from a finger stick are also considered more accurate than with blood drawn from a vein because it is coming from a much smaller blood vessel.
Since interstitial fluid readings every five minutes will not show an accurate reading when the level of glucose is changing quickly in the blood, such as after eating or using insulin, it is best to look at trends rather than being overly concerned with a single reading.
As I mentioned in an earlier post, I expect Apple to use some RF or light emitting technology to calculate the glucose in the capillaries by detecting some physical property like refraction or rotation of the signal. This way you would have continuous readings that would be more accurate, because you would be measuring the blood in the capillary, not the Interstitial fluid, and also you would not need a sensor under your skin.
In either case, sensor or actual blood sample, using insulin to control glucose levels is really just treating the symptom. Normal bodies create their own insulin that aids cells in absorbing sugar which they need to live. Diabetes is actually an immune disorder that prevents the body from producing insulin. In the future I would hope we can find a way to treat the underlying immune disorder instead of relying on insulin injections to maintain normal glucose levels.
That's Type 1 diabetes. It doesn't stop the beta cells of the pancreas from producing insulin. Instead, antibodies attack and kill those cells. It used to be called "IDDM" (Insulin Dependent Diabetes Mellitus)
But the epidemic is Type II Diabetes - which is caused by insulin resistance blocking the muscles and fat from absorbing glucose -- so it remains in the blood stream. People say: "I have sugar" -- but actually that is just a symptom (a deadly symptom, but a symptom). Actually, they have insulin resistance. For a while, the pancreas pumps out increasing amounts of insulin to counteract the rising sugar levels. But, eventually, in some cases, that same process may also kills off the beta cells in the pancreas -- but that's still not the Type I diabetes. (Some nickname it "type one and a half".
That's also true of most of our chronic diseases such as: heart disease, many of the most common cancers, as well as some dementias... But, our food industry makes huge profits making them sick while our diseasecare industry makes huge profits treating the symptoms and effects of those diseases...
What would happen to our economy if people actually lived healthy lifestyles?
... We don't make steel anymore -- instead we make people sick and then treat the effects...
Right now, our DiseaseCare system admits that although healthy lifestyles (diet, exercise, stress reduction, etc.) are the only way to health, it also tells us that it cannot help us and we are on our own. While I agree that a healthy lifestyle is a personal responsibility, I also believe that we need a health care system that promotes and supports those healthy lifestyles -- rather than simply pushing pills and procedures when it fails.