If they can it'll be huge. Maybe even Ozempic-huge. There's a theory of weight loss that you can objectively manage your weight by never allowing your blood sugar to go over a certain level.
That doesn't work, even if it were true. You can also manage your weight by never allowing the weight on the scale to go over a certain level.
And no -- your weight on the scale varies drastically with water levels and food in the gut. By up to five pounds. It is useless for figuring out if you can eat another bite of rice.
While glucose levels are literally minute-by-minute. They're fine-grained enough to actually tell you when to eat more and when to not.
Losing weight is simple in theory, you can just eat less. In practice, eating less is very hard for some people. Having real time glucose information isn't going to help those people.
Losing weight is hard because it can be incredibly difficult to "just eat less" by the right amount.
If you "eat less" too little, you won't lose weight. While if you "eat less" too much, your health suffers and willpower becomes too difficult.
And counting calories doesn't work well if your calorie needs vary per-day, which nearly everyone's does -- how much did you walk, what temperature were the rooms you were in, etc.
The idea is that real time glucose information will allow you to "eat just right" -- never eating so little that willpower becomes an issue, but never so much that you gain weight (or fail to lose weight).
You shouldn't be so dismissive of the idea.
We're not talking about people with underlying health conditions. Exceptions don't invalidate a general principle.
> You’re suggesting 20 calories can make you obese because it raises blood glucose lol!
Nothing "lol" about it. An extra 20 calories, 20 times a day, every day for months and years, above your caloric needs, is yes quite likely to make you obese. How else do you think most people get obese?
> fat... will not spike your blood glucose until 5-12 hours later
And you can become aware of those patterns. You will know, for example, not to eat anything else during that window. Or learn to eat fat in gradual amounts, rather than large amounts in a single sitting.
> Blood glucose is VERY important but not predictive of weight.
You seem quite confident about that. You're also quite possibly wrong. The underlying logic is pretty sound: we gain weight when our blood sugar goes up and therefore our insulin goes up to remove the sugar from the bloodstream and, eventually, store it as fat.
I like this post because it assumes that humans don’t use sugar for energy. It is all stored as fat because the human body is a closed system that does not burn calories.
Also I like “I see you said 20, obviously you mean 20 times that”
I’d be hard-pressed to believe that someone trying the newest Dexcom G7 CGM would find it more discomforting than a mosquito bite. And for that literal pain you get 10 days of constant readings on your phone.
> I think demand would be high enough, even if they have to raise prices, that it would easily be worth it.
This is probably correct but I don’t think many non-diabetic people would see an actual benefit from CGM data. It’s the kind of thing people love to think is useful but in reality it’ll be just one more thing to ignore.
Right now, I’m on glipizide which manages (along with a low-carb diet) the situation, but I need the GCM so I know when this “honeymoon” period (before I start needing insulin) starts to end.
Unfortunately I have an extreme needle phobia too. My insurance doesn’t cover the G7, just the G6, so I don’t know if it’s different, but if I try to apply the G6, my heart rate will massively speed up, I will start to hyperventilate, and typically pass out when I click the button on the applicator. I’m out for only a few minutes, but it’s not a pleasant experience… I have to make sure I’m lying on a bed to do it now, after learning the hard way that it’s possible to fall when just sitting down, and head wounds don’t stop bleeding when you’re unconscious.
I would dearly love the ability to measure glucose non-invasively. It’s actually nowhere near as bad for me if I don’t have to click it myself, but my wife wouldn’t understand what to do, and my son is too young for me to feel comfortable asking. Theres no-one else around to help, so sometimes I make a dr appt, for a 10-second “click”. Most of the time I just put up with it. The hope is that the phobia starts to diminish, but so far it hasn’t, and yes I’ve tried psychologists.
Every 10 days, and [sigh] as I write, I recall that today is the day. Again.
But obviously they all have a needle because they need to get something under your skin. Which is I guess what triggers you.
So G6 it is. And yeah, the difference between the non-invasive and invasive is what causes the problem. It's weird, I don't have any other phobias, but I found out about this one when we all stabbed our fingers to test our blood-groups in school. Fell off the stool in the lab, 14 stitches in my scalp. Not the last time, either.
Hopefully you get access to it soon.
Isn't that the key point and means Dexcom/Libre would cost you (or your insurance company) several thousands of dollars/pounds/euros/etc every single year. For many people they already have an iphone and just need an Apple watch which could last for several years.
Yes, obviously if Apple could figure out how to get accurate BG numbers on an iPhone it would be better than the currently available CGMs.
My point is that CGM data is very very very unlikely to change behavior in the overwhelming majority of people.
I would have probably quit drinking alcohol a lot earlier if I had seen the hell it plays with sugars in your blood iirc.
Sometimes a notification that you did something unhealthy might be enough? Like my watch buzzes if it detects less than X steps in the last hour, tells me to get up. The app tells me I get to sleep too late most days.
If it told me that food I just ate is something I'll have to be careful with...
Not diabetic, but I've tried a set of two of these out of curiosity. The insertion pain is nothing, but having something bonded to your skin with adhesive constantly is kind of a pain.
I also got some irritation at the insertion sites around the 1-week mark, though that might have been because I don't have much fat on that area of my arm.
The CGM that wins is the one that doesnt stop working when batteries die. Or piercing the skin.
- skin conductivity changes over time
- the ways in which skin tone changes signal absorption (which itself changes over time)
- the ways in which different levels of fitness affect blood flow, material density etc.
You also can't use it in a hospital setting, due to how your skin and bloodflow changes during serious conditions like sepsis (though I'm guessing they're not thinking about that market).
Really smart people have been trying to use Raman spectroscopy to solve this problem for decades at this point (early patents go to early 2000s). Apple is an extremely strong hardware vendor, and I wish them luck, but I would not hold my breath for this. Plus, I'm guessing they will not open the signal up for looping, which would really leave the T*DM community out to dry.
It would be super helpful to know (relative to other foods) how my body reacts to claimed low-carb foods. Is there a large spike (don't need to know the number) or is it a much more flat curve? How long in general does it take for the line to return to pre-meal levels? What does that trend look like over many months? Heck, I could even run a rudimentary and simple test to do comparative insulin response to a known amount of carbs to see if my insulin response is improving over time (using the period of the curve). I would love to get an alert that hey, we think your glucose level shot up a lot (don't care how much) so that I can remediate it through exercise then and there and avoid that food or timing going forward.
Really hoping the people in Medtech don't make perfect the enemy of good in this case. Although maybe what you listed would still be blockers for even getting general glucose curves. I've been planning on getting a CGM for at least a few months to achieve all of this, but it would be great to just have it in a watch or other simple wearable.
The issue with spectroscopic approaches is the amount of noise can be really hard to disentangle, to the point that you might get really unreliable trend information, to the point of it even being dangerous if you're making dosing decisions off it. And even if you aren't, getting incorrect trend information doesn't really help you any more than just not knowing it.
Unfortunately T1 diabetics and insulin dependant T2 diabetics will get killed by a machine that tosses out numbers that can be considerably off to the point no manufacturer is going to make the risky product.
For oxygen sensing there are numerous readily available inexpensive stand-alone sensors available at any drug store or online. They are non-invasive and painless. Yes, a continuously wearable sensor would be better for some people but most people don't need that. Accordingly it is something that while nice wouldn't really sell a lot of watches, and so something that might not be worth licensing if it is under patent.
Glucose sensing on the other hand is a literal pain to test and has ongoing costs due to consumables used for the testing. Non-invasive painless glucose sensing on a watch is a feature that would sell a lot of watches. I think demand would be high enough, even if they have to raise prices, that it would easily be worth it.