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A few years back, there were a number of startups that essentially resold prescriptions of the ABT/DXCM CGM and provided personalized meal/exercise-response analytics on top. Seems like traction has been tough going, though. Dialing back from "anyone with potential metabolic issues" -- what's a realistic market? Something like high-level athletes and/or bio-hacker enthusiasts are the only folks who seem to care. On the low end, the OTC options are eating away as well.. they are less accurate, but probably solve the use case better for a pre-diabetic "once-a-year/occasional" wear use case.

Talking to ultramarathoners and cyclists, I think lactate is a biomarker that is tracked (POC blood samples) and would be more immediately useful for training/performance. AID might be construed as a form of doping, IMO.

by ijustlovemath7 hours ago|

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Lactate actually comes for free with blood glucose when you measure it with a chemical sensor, it's just not something that's usually asked for. I definitely think it would be considered a form of doping to use it in competition, but I think recovery is where it would make more impact anyways. You also wouldn't want to use it before a race, as you'd run the risk of reduced pancreatic function.

AGC will find its main application in surgical and inpatient uses, eg in cardiac, neuro, burn, ICU, and people with diabetes in any hospital setting.

by mikestew7 hours ago|

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I definitely think it would be considered a form of doping to use it in competition

Already banned:

https://www.bikeradar.com/news/uci-bans-supersapiens

by eoamk7 hours ago|

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There doesn't seem to be a continuous lactate sensor on the market. Lactic acid production and/or clearance are definitely useful data w.r.t. exercise (many training regimens talk about lactate thresholds) and also useful in in-patient settings.

No disagreement about AGC in the hospital -- there is a lot of lab/titration work in current clinical workflows for monitoring patient glucose levels.

by ijustlovemath7 hours ago|

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Lactate's available in the internal engineering data of these sensors, just not something that anyone has wanted to spend the time or money to qualify with the FDA. It essentially comes "for free" due to the chemical reaction the sensor uses.

by eoamk6 hours ago|

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I think you are misinformed: the electrochemical reaction used by continuous glucose sensors relies on a glucose-specific enzyme and it doesn't have anything to do with lactate. Lactic acid strips use a completely separate enzyme/reaction.

Hat tip to you and sibling comment about continouous lactate sensors (seem like they are microneedle/patch based?). Quick review shows minimal clinical evidence, but maybe that's sufficient for the consumer wearable market.

by ijustlovemath5 hours ago|

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I've had the fortune to work with several CGM OEMs behind the scenes as part of our work developing an artificial pancreas, they all have a secret lactate signal!

by mikestew7 hours ago|

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There doesn't seem to be a continuous lactate sensor on the market.

They exist, a simple search will turn up a variety (how well they work is a different question). But see my sibling comment, they're banned from cycling competition.