[rkagerer]

Sounds exciting, but the fact their prototype is in a wristwatch form factor makes me wonder if it's aiming to be more of a media showpiece to hype investment valuation from those industry partners. Forward looking statements like "maybe we'll make it monitor blood pressure too" don't help.

Even at the size of a brick, or without conveniently hiding the power supply off-camera, forgoing needles would still be a huge boon to diabetics. Why not get the concept working and demo some hard stats, then miniaturize?

[hn_throwaway_99]

That's because it's bullshit.

To clarify, the actual science they did is interesting (to me at least, as someone not in the field). The paper is linked here: https://www.nature.com/articles/s44172-024-00194-4

What is bullshit is the completely unwarranted conclusions in the title or in the quotes in the article. This is classic "science by press release".

If you notice in the paper, they didn't do any testing, at all, with actual humans (or animals) and their blood sugar levels. The paper is mainly about the design of this "metasurface" which they claim allows higher resolution and sensitivity of a millimeter-wave radar system. The leap from what they've done to "no more needles for diabetics" is about 100x of "draw the rest of the owl".

Again, to emphasize, I'm not denigrating the science they've done. I'm denigrating the hyping of it.

[raphman]

Thanks for calling this out. That was also my impression after having skimmed their paper: the only link to glucose monitoring is that the authors mention a few papers on the topic to motivate their research. And looking at the papers they cite, I see little evidence that this approach could work in practice in the near future. Most of the citations [2, 15, 16] are to their own work, which did not look at glucose monitoring in the human body.

This is not my field of expertise, and maybe I am misunderstanding the papers. But it seems that there is little evidence that non-invasive glucose monitoring via measuring dielectric properties works reliably in practice. No in-the-wild studies, no investigation of potentially confounding factors.

Take for example citation 22 from the paper. A study where the authors propose a new antenna design. They seem to measure how the pancreas changes size during insulin production by monitoring its dielectric properties. IIUC, they look for a dip in the frequency spectrum caused by absorption of a certain frequency band.

But their measurements show an even larger effect when measuring on the thumb instead of the pancreas. This effect is not explained at all. (My guess: after having patients fast for 8-10 hours, giving them glucose will have an effect on the whole metabolism, resulting in higher blood flow, and that's what they measured).

Also, while they operate the antenna in the GHz range, they use a cheap USB soundcard (sampling rate 44.1 kHz) for capturing the signal. I did not understand this at all. They also repeatedly use the term "dielectric radiation". Seems to be a rather uncommon term?

The "machine learning algorithms" mentioned in the title seem to be a simple linear regression? They claim an accuracy of ~90% and show some sample results. The complete study data is only available upon request, however.

[22] S.J. Jebasingh Kirubakaran, M. Anto Bennet, N.R. Shanker, Non-Invasive antenna sensor based continuous glucose monitoring using pancreas dielectric radiation signal energy levels and machine learning algorithms, Biomedical Signal Processing and Control, Volume 85, 2023, 105072, https://doi.org/10.1016/j.bspc.2023.105072

[bobmcnamara]

I assume there's an RF mixer somewhere in there.

Edit: read the paper, now more confused

[amluto]

I don’t have access to the full text, but I loved this part:

> Commercial CGM devices have certain drawbacks in diabetic measurement during daily activities such as food intake, sleeping, exercise and driving. The drawbacks are continuous radiations from devices

So they think a drawback of CGM is the (Bluetooth) radiation, and their alternative is to zap the pancreas with, um, magic dielectric radiation? Or magic radiation that results in “dielectric” backscatter?

I do find myself wondering whether a watch- or patch-sized object could get a usable NMR signal from glucose. Maybe a neodymium magnet and a very carefully shaped probe antenna to compensate for the horribly nonuniform magnetic field? Maybe an AC field with no permanent magnet at all? I found a reference suggesting that measuring glucose in blood outside the body by 1T NMR is doable but marginal, so this may be a lost cause.

[Projectiboga]

The paper is full text, fyi. You won't get any extra info about actual glucose measurements. The paper is all about their device idea engineering. The press release dose purport to show a pic of a supposed sensor and a vague claim of clinical trials.

[amluto]

I meant this reference that was being discussed a bit:

https://doi.org/10.1016/j.bspc.2023.105072

The OP paper is a bit lacking in any actual details of how glucose is being detected…

[raphman]

Thanks :)

[sheepscreek]

> they didn't do any testing, at all, with actual humans (or animals)

They did mention in the article that clinical trials are on-going.

[hn_throwaway_99]

Correct, but I'm extremely skeptical, and that sentence had my bullshit detector alarms screaming even louder:

> “We have a minimum viable product that’s already being used in clinical trials, and while there’s more work to be done, we’re much closer to a full marketable device,” Shaker said.

Absolutely no information about what this "clinical trial" entails, or what phase it was. Most importantly, to get an initial assessment of the accuracy of the device, no clinical trials are necessary - you simply need to do a test that compares the blood sugar reading from the device against the current gold standard, most likely first in some animal model.

If their device was really as far along as the title and quotes are implying, they would be showered with so much money it would make the Theranos peak valuation look small. The only evidence they've provided (which, again, I'm not saying is insignificant) is that the "metasurface" they have developed enhances the resolution and sensitivity of a radar system against a beaker of water.

[sheepscreek]

It’s fair to be skeptical. Personally, I’ll believe it when I see it in action. There’s likely an unexplained catch or they wouldn’t have shared any hard data in the paper.

One possibility is that they want to sell this technology to a big company without publicly disclosing all their trade secrets. However, this research could have been sponsored by a public grant, which would have compelled them to share some information. Therefore, they published a paper that appears more like a patent application than a research paper with solid data. It’s still noteworthy that it was published in Nature.

[raphman]

> It’s still noteworthy that it was published in Nature.

FWIW, it was not published in 'Nature' but in 'Communications Engineering', a journal by Nature Portfolio (formerly known as Nature Publishing Group, part of Springer Nature). It is a new Open Access journal, established only in 2022. Given the track record of their 'Scientific Reports' journal [1], I would be rather cautious regarding the quality of the works published at 'Communications Engineering'.

IMHO, Nature Portfolio is doing their 'Nature' journal a disservice by hosting all of their journals at nature.com. I guess this is intentional, letting their less prestigious journals profit from Nature's prominence.

[1] https://en.wikipedia.org/wiki/Scientific_Reports#Controversi...

[sheepscreek]

Ah, very interesting. Thanks for pointing out.

[azinman2]

But they have a minimal viable product! It’s viable! /s

[caseyy]

Well… yes. Looking at the article, it satisfies the MVP requirements for getting grant funding. A bar GlucoWatch cleared more than two decades ago, though it could never quite clear the bar of clinical viability.

Theranos also had an MVP in this sense :)

[cb321]

I have probably seen "viable" overinterpreted 100s of times by now. Perhaps we need to re-interpret the 'V' in "MVP" as "VC-investable" or perhaps replace it with 'I' to be I)nvestible which gets you a more pronounceable "MIP" (and maybe, just maybe highlights uncertainty since all investment carries risk)? Happens to also abbreviate "Multum In Parvo" (Latin for "many/much in little") which is not even that far off from the semantic. ;-)

[m463]

I thought apple was trying to get glucose monitoring approved

https://en.wikipedia.org/wiki/Noninvasive_glucose_monitor#Ne...

(different technique)

[theendisney4]

If it fits in a watch a lot of nondiabetics will also buy it. It can be much cheaper that way.

[adaml_623]

I think this is a really important point. Making it a feature in millions of watches will drive the cost of implementation down

[lukan]

Why would I as a nondiabetic buy it? Out of general curiosity for my blood sugar levels?

[crazygringo]

Not general curiosity -- but for healthier eating.

There's a theory that says you basically won't ever gain weight if you prevent your blood sugar from going above a certain level. So it's an objective way of knowing how much to eat and when.

Also, to warn when blood sugar is too low. Some people (myself included) often get so into work (or whatever) that we forget to eat, with adverse consequences. An alert is very helpful.

[doxick]

My garmin watch measures blood oxygen, heart-rare, breathing patterns, sleep patterns, stress-levels, etc

Usefull? It is if you use it. I do triathlons and knowing exactly where my blood-sugar level is at would allow me to focus better on the type of nutrition and the impact of it while working out. It would also tell me if i was a bit down before a race, so i can take some food.

Basically: this is a game-changer for amateur athletes, which would create a tremendous market for it. People i know already use the patches to measure as well, or lactate measurements, ketone measurements, etc. and that's just at the casual amateur level.

Another application that springs to mind is knowing when to eat instead of just having lunch and sugar-crashing 2 hours later in the office.

[stevage]

I also wonder if monitoring your blood sugar is a potential way to avoid becoming a Type 2 diabetic.

[fragmede]

That's what HelloLingo is selling. A wearable blood glucose monitor for 2 weeks, like diabetics wear, so non-diabetics can get a better feel for their blood sugar level and how what they do affects it. https://www.hellolingo.com

[mzhaase]

Would be a real game changer for endurance sports. There is "bonking" - depletion of muscle glycogen. When that happens your race is over. Sometimes it happens even to high level athletes what feels like out of the blue. If you knew ahead of time your blood sugar is getting low you could prevent it.

[lukan]

"If you knew ahead of time your blood sugar is getting low you could prevent it."

If I am connected to my body, I can also feel it by own biological sensors. But I do see the use case, to get another data input, for those cases where I am distracted and don't pay too much attention on myself.

[promiseofbeans]

Because it's built-in as an extra feature to a watch that you were already gonna buy. Garmin watches can measure blood oxygen, but not many people use the feature because it drains the battery quickly. Samsung watches can do a single lead EKGs. Does that sell you the watch? Probably not. Is it yet another thing a company can add to the spec sheet and use to justify a price increase? Yes.

[e40]

Because many of us have high blood sugar but are not diabetic and knowing the impact of diet on blood sugar would be a boon to controlling the issue.

[DoctorOetker]

I believe GP assumes the reader of their comment to understand that one of the types of diabetes is acquired during ones lifetime, by over-consumption of certain types of nutrition.

Preventing non-hereditary diabetes could be much cheaper from a societal perspective.

[theendisney4]

There is a whole spectrum from trying to reach ultimate form to trying not to die and everyone in between.

I measure my heart rate one time for fun. It was insanely high at rest. I felt perfect, full of energy but it was completely obvious i needed to introduce rest days. I conviscated the heart rate monitor and everything was back to normal 3 days later.

[stabbles]

Endurance athletes already monitor this to figure out how to fuel best.

[hombre_fatal]

To fuel their “low carb” low carb eating disorder.

[nradov]

Type-2 diabetes is commonly comorbid with hypertension (similar root causes) so combining both sensors in a single wrist device would be useful for many patients. There are existing wrist blood pressure monitors such as Aktiia. Not as accurate as an arm cuff, but good enough for routine monitoring.

https://aktiia.com/

[froil]

Where can i buy?