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A New Shot at Glucose Monitoring in the Eye
Non-invasive glucose monitoring simply by scanning your eye? What a dream! But we’ve heard it all before, and it ain’t lookin’ too promising to become a reality any time soon, right? I mean, we were all watching both Fovi Optics and Oculir closely before both companies folded due to optical scanning technology that simply didn’t work.
Well, now there’s some new hope, in the form of Freedom Meditech, a San Diego-based company that’s developing an entirely new approach to non-invasive ocular glucose measurement technology for people with diabetes. In February, the company announced an agreement with Battelle life sciences labs and is 
raising capital to kick off human clinical trials on its proprietary little device, which looks like a kaleidoscope you hold up to your eye for a few seconds to get a reading.
“This is fundamentally different technology than Oculir was using,” Meditech’s CEO Craig Misrach explained to me in a briefing at last week’s ADA conference. Their approach is so different and so promising, Misrach says, that former Oculir CEO John Burd has joined the Board of Meditech, convinced that there’s hope for optical glucose scanning after all.
“We licensed this new technology from the University of Toledo, OH. It uses polar imagery and the relation of light to specific to glucose, so you experience no delay like you do when testing interstitial fluid. In fact, our scan takes less than one second.”
Whereas Oculir’s method for shining light on the back of the eye, at the retina, turned out to be an insurmountable R&D challenge, Meditech is “shifting the paradigm” of ocular monitoring by scanning the front portion of the eye only. Did you know glucose resides in your Aqueous humor? (see illustration)
This technique should have a major impact on reducing laser exposure, i.e. any potential long-term safety hazards, Misrach tells me. And it’s even safe and effective for patients who’ve already developed diabetic eye disease. The only possible obstacle is corneal scarring, Misrach adds.
If and when Meditech’s product is mature and ready for market, one huge advantage would be early screenings for diabetes: there are 65,000 eye exams conducted every year in this country, and this would be a perfect point of access to check for early signs of diabetes.
“Right now, 21% of people diagnosed with diabetes already have early retinopathy,” says Keith Ignotz, CEO of DiaKine Therapeutics, who happens to be another Meditech board member and sat in on last week’s briefing. (DiaKine itself is a very interesting company — post for another day.)
“Glucose is a very small molecule, so you have to create an algorithm that can sort out the ’signal’ from the all the ‘noise.’ That’s what makes this alternate site, or non-invasive testing such a challenge. That and you’re trying to get the time delays into an acceptable range,” Ignotz explained. “What Freedom Meditech is doing is extremely promising.”
We’ll see about that… Misrach nods affirmingly. “Our team is not out to create any false sense of hope. We are realistic of where we are at and the obstacles that lay ahead of us,” he concedes.
Still, as usual, it’s fascinating technology to know about and we’re crossing our fingers that the eyes shall eventually have it.
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For what it’s worth, Battelle is the company who also developed Eli Lilly and Company’s fairly new Humapen Memoir, which has a memory of previous dosages with the time and date all contained in a convenient pen dosage device. Whether they’ll be successful remains to be seen, but innovation is always a good thing.
Posted by: Scott | June 19th, 2008 at 7:43 amThis might be good to avoid fingersticks. But the key to BG management is knowing status all the time as well as trends, direction and speed of change. And the CGMS devices out now (Dexcom, Abbott, Minimed) are excellent in that in spite of some accuracy problems and in spite of being first generation. Knowing how to use them and understanding how to react or in fact pre-act to an indication should be properly trained, because it is perhaps the single most important limiting factor (apart from reimbursement). Combined with ultra-fast acting insulin (biodel, generex etc) they will be the state of the art of BG management over the next couple of years and with these tools it should be possible to consistently achieve A1c’s of 6.5 or less with considerably less hypoglycemic attacks over long periods of time.
Posted by: Titos | June 19th, 2008 at 9:24 amI think (apart from the squeemish issue) that if it can get people to test more often without worry of test strips, then that’s a good thing. I’d test my son 20 times a day to get a better picture if I didn’t have to poke him or spend money on 20 test strips.
But I just wonder how safe it would be to stick this into your eye 20 times a day, or even 10 times a day. I agree with Titos. The future will be the continuous monitors that show trends. We all know now that it’s not good enough to know that at 4pm my son’s bg was 98. What’s more important is knowing which direction is it heading. Unfortunately, this won’t help. This only solves the problem of sore fingers.
Posted by: Michelle | June 19th, 2008 at 2:40 pmThe best things about this device seems to be the fact that it is reusable – no need for strips, but for how long? Will there be any calibration issues? This kind of system could be very valuable in showing trends, just as CBGM. Another problem could be the time that it takes for the aqueous humor to equilibrate with blood glucose. If, for instance, if your blood sugar is rapidly dropping, will the ocular monitor gives a value of 80 while a fingerstick shows 60? The abstract referenced mentioned a lag in the changes in the aqueous humor relative to blood glucose, so the user would have to be educated about the lag and then apply the knowledge. This might be tough if one is going hypoglycemic.
And, I think you mean 65 million eye exams per year, not 65 thousand.
Posted by: wschaf | June 19th, 2008 at 6:39 pmI’d be interested to know where the statistic “21% of people diagnosed with diabetes already have early retinopathy” comes from. Are we talking about type 2 or type 1? I’d be very surprised if a few months or weeks of high BGs prior to type 1 dx could achieve retinopathy.
As for the comment above about the Humapen Memoir, I have had plenty of trouble with that device as well as the Humapen Luxura. I’m on my third Luxura in less than a year, the plunger broke on the other two. As for the Memoir, it was so cumbersome I downgraded to the memory-less Luxura. I’m all for diabetes technology, but I don’t intend to try these things until I actually have the time to endlessly calibrate, fiddle with, and troubleshoot them.
Posted by: Lauren | June 19th, 2008 at 6:45 pmThis is interesting invention, but even if they manage to make a working prototype in next few months, I don’t know if this is the future… I would bet it would be CGMs, but not in the way we know them today… Since current sensors have “lag” time (15-30 minutes) and they are very expensive, this must evolve too… I am still vaiting for implantable sensors, that will last for some time. I hope Verichip and DigitalAngel are on track with their project… if yes we could have some prototype of that in 2-3 years. Who comes out with this kind of technology first, will be the winner… It would be great step towards better diabetes control and to making closed circle tehnology, that pump companies are aiming for.
Posted by: Andy Rozman | June 26th, 2008 at 4:50 pmAndy
TKL Research is currently seeking qualified Investigators and centers to participate in an exciting study for Diabetes Type 1 for Newly Diagnosed Subjects, age 16-20. Please contact Patti Mierzwa at 201-587-0500 x 3389 or email: pmierzwa@tklresearch.com for details.
Please post in highly visible area if possible.
Posted by: Patti Mierzwa | July 11th, 2008 at 6:55 amWith the rate at which this technology is advancing, I challenge everyone who reads this message to donate to a good cause in 2009, and get at least 2 others to do the same. Please pass this on.
Posted by: AC | January 18th, 2009 at 5:36 am