Where’s the limit to the ‘superpowers’ of the latest fitness bracelets? Making sense of the memes

Many terms, which have passed into everyday speech from professional speech, seem to change their meaning, become close to us and are not scary at all. Here’s an example: “If you eat too many sweets, you’ll get diabetes!” – they used to say. Diabetes mellitus – a kind of babaika, which scare sweet-toothed people of different ages, as soon as the threat of sticking buttocks becomes irrelevant.

Diabetes is not just an under-the-bed monster waiting for you after a date with an eclair. According to the World Health Organization, the disease is the ninth leading cause of death in the world. In November 2021, the International Diabetes Federation (IDF) released new figures: 537 million adults worldwide are now living with the diagnosis – an increase of 16% (74 million) from the IDF’s 2019 estimates. And beyond that, like Chernyshevsky, we are only interested in one question: “What to do?”

Even if you don’t observe any of the major complaints of diabetic patients in yourself, it doesn’t save you from being predisposed to the disease or its latent course. How do you know if you need specialist help? Measure your sugar! The most reliable sign of disturbed metabolism is an increase in blood sugar – on an empty stomach more than 6.1 mmol / l, and two hours after eating – more than 11.1 mmol / l.

And here lies the most interesting thing: how to measure sugar? Of course, if in your environment there is an acquaintance with diabetes, you can rub in the confidence of his glucometer. Or immediately seek advice in a medical center. But if you have to monitor your sugar on a regular basis, not just once?

The most reliable glucometers are invasive. That is, a small amount of blood is used for analysis, which is “extracted” with the help of a puncture on the finger. The thing is not very pleasant and not very convenient. Let’s deal with the specialist, whether we can monitor sugar levels bloodlessly and what promising projects exist in this direction.

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There have been so many attempts to create a non-invasive glucometer that it is impossible to recount them all. There is a lot being invested in this. Companies appear and disappear, and inventions do not often reach clinical trials. Everything has been tried to be created. The most common case is, of course, watches and bracelets. But whichever company you take, they promise a lot, postpone or fail to pass EC and FDA inspections, then disappear or remain hanging websites that no one even edits for a long time.

Look, but don’t touch

Bloodless and reliably determine the presence of diabetes mellitus learned a long time ago. Nothing complicated: you just had to taste the urine. If the bouquet revealed a sensual honey note – bingo, colleagues! Unfortunately, with the quantitative determination of glucose can not cope with any, even the most experienced, “sommelier”, so the research continues.

Why are non-invasive diagnostic methods relevant? Apart from the fact that it is trivially painless, blood sampling – especially in mass and frequent examinations – carries the risk of contracting a number of blood-borne diseases.

Conventional glucose monitoring devices use an electrochemical method. It requires a small amount of blood: it is obtained either by injection or with a lancet implanted under the skin (a special surgical device). The difference is that the first type of device gives an indicator only at a certain point in time and does not require professional assistance. It is therefore suitable for self-measurement of blood glucose levels (SMBG). The second type of device provides continuous access to data and is called a continuous glucose monitoring (CGM) device.

Non-invasive methods of glucose monitoring may use tissue fluid, eye fluid, saliva, and sweat in addition to blood as a test sample.

St. George: The Dutch startup NovioSense is working on a glucose sensor that fits under the lower eyelid. From there, it can wirelessly transmit glucose measurements directly to a smartphone.

Georgi: A non-invasive glucometer would be a great assistive way to monitor. You will be aware of what is happening with your body at any given second, no matter where you are or what you are doing: work, sports or whatever. This will definitely increase adherence to treatment, reduce hyper- and hypoglycemia, and therefore improve quality and longevity of life. But the margin of error of such devices will still be high due to the complexity of the technology. Invasive monitoring, albeit much less frequently, will be necessary. The world is well on the way to progress, and in my opinion, the market will be dominated by products that are simply “less invasive” and smaller than what we have now. And invasive glucometers with test strips are slowly becoming a thing of the past.

There are many universities and small companies currently working on non-invasive glucose monitoring technology. You can familiarize yourself with some of them here.

In 2002, the FDA approved the much coveted GlucoWatch Biographer. However, within months of its release, the GlucoWatch ceased to be all so pretty in a white coat worthwhile invention. Patients reported painful rashes where the watch was worn, and the three-hour calibration of the device was impractical. On top of that, the data couldn’t be called reliable either. A 2004 study showed that the device often missed real dips in glucose levels.

George: The accuracy of these glucose monitoring sensors is usually described by a metric called MARD, or mean absolute relative difference. The MARD is stated as a percentage and describes how much the sensor reading can differ from the actual blood glucose level. This generally means that the smaller the percentage, the more accurate the sensor. All the announced devices so far are very far from the desired numbers.

For example, KnowU is a pocket-sized device that measures glucose levels by simply placing the palm of your hand against the device. Know Labs is conducting external clinical trials of its Bio-RFID technology pending FDA clearance, the last step before the FDA approval process. Although the trials are just beginning, the data from the initial studies is very promising.

Cnoga is a digital health startup based in Israel that has developed a hybrid non-invasive monitor called the TensorTip Combo Glucometer, or CoG. The device is called “hybrid” because for the first three days of use, it needs to be calibrated with both invasive and non-invasive measurements. After that, the device becomes completely non-invasive.

Like the aforementioned devices, the CoG directs a small amount of light through your finger – it needs to be inserted into the device. When the glucose absorbs and reflects the signal, it is projected onto another camera. And it, in turn, processes the received data with the help of artificial intelligence and gives a value of glucose level.