There are Many Challenges to Noninvasive Glucose Monitoring

-Craig Idlebrook

A recent feature in Nature Biotechnology provides a strong overview of the challenging technological landscape of noninvasive glucose monitoring.

According to diabetes technology insiders quoted in the article, while truly noninvasive monitoring remains elusive, the outlook looks more promising for a continuing trend toward less invasive glucose monitoring.

Here are 5 takeaways from that article:

CGMs have become a gold standard in the glucose monitoring marketplace.

Author Emily Waltz cites T1D Exchange Clinic Registry data which shows that 38 percent of registry participants with type 1 diabetes use a CGM. Over the years, as CGMs have gotten smaller and more accurate, they have gained in popularity over traditional blood sugar meters.

Truly noninvasive glucose monitoring is hard.

How do you get a sensor to distinguish between old sweat and new sweat? Can a sensor accurately tell the difference between tears of joy and tears to keep the eye moist? Could that garlic bread you had for lunch be interfering with glucose levels in your mouth?

All good questions.

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It’s proven incredibly difficult to get accurate glucose readings without piercing the skin, despite advances in medical technology. Measuring glucose through tears, sweat, and saliva means fighting against the body’s ever-changing physiology. A small study may show a tiny eyelid sensor can be as accurate as a CGM in the lab, but replicating those results in the real world may prove impossible to replicate in the real world, according to the article.

Investors are sometimes wary of noninvasive startups.

The article quotes the chief technology officer of a noninvasive startup who pitched her idea to 86 venture capital firms before giving up and switching to competing for grants.

Investors have seen too many noninvasive ideas not pan out. It doesn’t help that Google’s much-touted foray into creating a glucose-sensing contact lens seems to have fizzled out after a lot of breathless headlines.

Whither the implantable?

While the well-researched overview discusses the promise of microneedles and smaller CGMs, it does leave out one new innovation in glucose care: implantables. The article fails to mention the Eversense CGM, a small, implantable CGM that is approved to stay in the skin for up to 90 days.

While still considered a niche member of the CGM marketplace, Eversense was the first to bring implantable diabetes technology to market. It remains to be seen if other companies will follow suit.

Dexcom and Abbott are staying the course.

Perhaps the most telling passage in the article on the future of noninvasive glucose monitoring is how little the power players in diabetes technology are investing in it. In the article, representatives from Dexcom and Abbott both shared that their companies were not bullish on the technology.

Of the three major CGM makers, only Medtronic is earmarking research and development money toward noninvasive glucose monitoring; how much the company did not say.

To read the full Nature Biotechnology article, click here.

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