Earlier this month, Gizmodo published a story about Sano Intelligence, a healthcare startup that is making a continuous glucose tracker that sticks to a user’s skin and monitors blood sugar elevations through a mobile app. The news Gizmodo wanted to make a point of is that Sano plans to market the product to people without diabetes. If you’re wondering what the tech publication thought of it, their headline says it all: Nobody Needs This Silicon Valley-Made Blood Sugar Tracker.
My first instinct was also that it sounded ridiculous and in my head I poked fun: ‘Ooh, look what this slice of pizza does to my blood sugar. Cool!’ I couldn’t imagine why anyone with normal body functions would want to be privy to their short-term spikes and dips. It appeared that Sano was taking short cuts. Instead of focusing on changing the lives of people with diabetes, the company was looking to make a quick buck. (Quick in medical-device land is still far from quick.)
After my initial reactionary response, I spent time thinking about why anyone would want to be tethered to physical updates like those of us with diabetes (myself included). Are people without diabetes curious to learn more about their deeper metabolic functions? And, is it worth it to those of us with diabetes to keep an eye on new product launches like the one from Sano Intelligence?
But first, what is it? The Sano tracker is a small stick-on sensor that feels like a piece of Velcro. It’s covered in “hundreds of tiny microstructures that are less than half a mm in length,” says Ashwin Pushpala, CEO of Sano Intelligence. The daily-use patch goes into the skin with the help of an applicator and is far less invasive than the Libre or other CGMs currently on the market. Pushpala hopes to have it available later this year.
Going this route, as a lifestyle-enhancement tool versus a diagnostic one used to make insulin-dosing decisions, allows the startup to get to market quicker and instead of a rigorous FDA approval, it can apply for a simpler form of regulatory sign off for what the FDA considers to be a “low-risk device.” This category refers to technology that’s intended “to promote, track, and/or encourage choice(s) which, as part of a healthy lifestyle, may help living well with certain chronic diseases or conditions.”
“Currently, there are no solutions on the market that provide a painless, discreet, or affordable way for people with pre-diabetes to monitor their glucose levels to make more informed diet and exercise choices. We feel very strongly that we want to build a product that fits their needs,” says Pushpala.
With type 2 diabetes on the rise––undiagnosed and diagnosed––and vast numbers categorized with pre-diabetes (some say 50% of Americans), it’s reason enough to view what Sano is planning as potentially good for everyone. This population needs a simpler tech solution that they can adopt with minor inconveniences. The once-a-day patch from Sano could be the answer, and even if it isn’t, who are we to say it shouldn’t be attempted? Sano gets a return on years of research, a larger pool of consumers to sell to and it avoids lengthy clinical trials and years of red tape.
While I was considering this idea of a world of people wearing glucose trackers, I reached out to Geoffrey Woo, CEO and co-founder of Nootrobox, a nootropics-based startup located in the San Francisco Bay Area. Woo started his company with a desire to improve cognition. His goal: to grow more neurons in the brain. “There was a misperception that you couldn’t grow new ones,” says Woo.
Much like vitamins, nootropics—smart drugs or cognitive enhancers––has both believers and naysayers. Early adopters that have warmed to this field call themselves biohackers and they’re looking to re-engineer their bodies to be smarter, more creative and more alert. One of the ways they do this is by obsessively watching their intake of food.
How do we watch our body’s reaction to food? By wearing a CGM. Woo wears an Abbott FreeStyle Libre and loves it. “You’re more thoughtful in your biometrics,” says Woo. Woo’s goal is to track his mental clarity––where he is at a normal state and how he can get to an enhanced state. “Why do you crash after a big meal?” asks Woo. By tracking his meals Woo feels that he can refer back to the “truth,” which will enforce good behavior.
“We all know a Coke, fries and hamburger aren’t good for us, but seeing my blood sugar spike to 13.4 (241) is like, ‘That’s an insane jump!’” says Woo. For help in understanding his body’s mechanics, Woo has Dr. Manual Lam, Nootrobox’ science and clinical lead. Lam also works at a hospital in Palo Alto, and is a believer in many of the things that Woo holds dear, namely our ability to re-boot our bodies at a cellular level.
“A lot of chronic diseases are due to nutrition and diet. It’s funny that doctors are the ones teaching it and we’ve only gotten four weeks of nutrition or one semester of biochemistry,” says Lam. As a hospitalist at a government funded hospital, Lam sees a wide range of sick patients, including those with type 2 diabetes. “I think there are some fundamental principles that have been propagated,” says Lam. “If we’re all doing the right thing, why is there an increase in obesity and diabetes?”
While Nootrobox, which currently doesn’t market anything for people with diabetes, wasn’t able to get funding on a recent episode of “Shark Tank,” the company is growing. It might take time for nootropics to go mainstream, but its believers, those who want to gain valuable insights into their bodies, could be the first wave in diabetes tools gaining traction—even with those of us with diabetes.
Sano Intelligence is committed to casting a wide net with its technology. “Our beta release that we are targeting for later this year is step one,” says Pushpala. “As we continue to test and conduct clinical trials, we are absolutely taking all the steps necessary for FDA approval of future device designs that will target the diabetic market.”
If the increased attraction in specialty diets like Whole30, Ketogenic and Paleo are any example, it won’t be long before more people are embracing what were previously considered to be tools for people with diabetes. “I use [the Libre] all the time, it’s important to have a visual reminder. Everyone is going to be diabetic or obese and we need more tools to help us. A CGM is a good alarm clock to pull us back,” says Woo.
I could benefit from this device because I am hypoglycemic. I have to keep a close watch on my blood sugar level to make sure it does not get too low.