For 4 weeks throughout 2021, this TechCrunch reporter took the plunge and examined a “metabolic health” service from Bangalore-based startup Ultrahuman. The tracker program, branded Cyborg, makes use of arm-mounted medical grade {hardware} to get a real-time read-out of your blood glucose — utilizing that dynamic data-point to energy a quantified well being service that scores what you eat and the way you progress, nudging you to make more healthy way of life selections all through the day.
Analysis has linked continual metabolic irritation, from components similar to poor food regimen and bodily inactivity, to the chance of growing quite a lot of illnesses — from diabetes to heart problems, continual kidney illness and even most cancers. So the speculation behind the product is that a number of incremental way of life selections can stack as much as a more healthy long run outlook — in the event you’re in a position to ‘optimize’ these choices to keep away from triggers for irritation and oxidative stress.
Right here follows my lengthy learn on the curious expertise of residing with a skin-perforating wearable and a dynamically updating digital window onto your organic course of, in addition to wider dialogue of the worth of steady glucose monitoring (CGM) for a common well being/health goal, and — lastly — some notes on the aggressive panorama bobbing up round productizing one of these sensing {hardware}.
As that is loosely a assessment of Ultrahuman’s (nonetheless personal beta) product/service, I’ve additionally included a ‘Verdict & Value’ part too. Skip forward if you wish to dive into the operational particulars. However first some context…
Preamble & Caveats
Changing into a cyborg is not as sci-fi as that sounds. For years the ‘quantified self’ development has spawned all types of sensors and providers for measuring bodily exercise and nudging you to trace and ‘optimize’ your outputs — from step counters and heart rate screens, to stress and sleep sensors, lung capacity scorers, and, extra just lately, freakier stuff: Blood glucose screens and saliva or pee/poop analyzers — the latter for delving into hormonal and/or microbiome/metabolic well being in the event you’re so inclined.
Serving the anxious nicely with wrist-mounted, strapped on or in any other case self-administered sensing expertise plus a subscription service to play pocket oracle — through an app-delivered interpretation of what all this private knowledge means (and ofc learn how to enhance your metrics) — is booming enterprise. Shut your (train) rings. Breathe extra deeply. Attempt to get to mattress earlier, and so forth.
A few of this quantified well being tech can come throughout as a bit superficial or frivolous; an try to ‘gizmoify’ day by day life and push a gadget when you might simply go for a stroll or get to mattress earlier. The extra fundamental merchandise work by promoting the motivation-challenged a name to get off the couch or a alternative for misplaced childhood construction. Or, nicely, data-fication as proof of existence.
However it may be horses for programs, too; when you have a sleep problem or undergo from stress and nervousness then monitoring your sleep — and getting little nudges and recommendations on how get extra shut-eye — could be simply what it is advisable lock in high quality Zzzs.
Obtainable tech has been getting extra refined, too. Though, when business trackers put a suggestive deal with organ-function (coronary heart; lung and so on), the quantification might sound spectacular however can undergo from questionable accuracy — given a variety of these items is consumer-grade, somewhat than (regulated) medical units.
Even step tracker knowledge might be lots inexact.
However in a newer improvement, a rising variety of startups are making use of medical grade sensing {hardware} to supply self-administered metabolic evaluation through monitoring (close to) real-time adjustments in blood glucose by the usage of a sensor that you simply ‘put on’ on (and, nicely, in) the pores and skin.
It is a fascinating and rising however nonetheless novel space of focus for quantified well being startups. One that appears promising, when it comes to with the ability to serve individually helpful well being insights and which — given sufficient knowledge — could possibly scale in utility and assist empower many others to make more healthy particular person way of life selections.
However the actually large caveat is that scientific understanding of metabolic health isn’t but as full and holistic as we’d hope.
A lot will not be understood — similar to why there might be a lot variation between people’ metabolic responses (totally different folks consuming the very same food regimen can have very totally different responses, for instance); or the precise position of irritation within the threat of growing illnesses like diabetes or most cancers.
So the power of startups to play oracle right here is bounded by the necessity for extra analysis. (Albeit, grabbing knowledge to advance analysis and understanding is a key a part of the chance entrepreneurs are spying.)
Neither is the sensing {hardware} in query regulated for the ‘common wellness’ use-case most of those startups are pursuing.
Which implies these providers stay novel — aka, experimental — even when the {hardware} they’re repurposing is legit, within the sense of being manufactured by established medical units companies, and controlled for narrower use (i.e. diabetes administration).
Sometimes these sensors have regulatory clearance for folks with diabetes to trace their blood glucose — as an alternative of getting to do fixed finger prick assessments. That will lend credibility to startups hooking into the identical gadget makers’ APIs to seize the identical knowledge stream. However the interpretative spin such providers placed on the information is simply that: A spin.
Any wider evaluation — together with way of life suggestions — are positively not FDA accredited.
The debates which have continued to rage forwards and backwards for years round vitamin — all of the fad diets, bestselling books and rehashed discussions of what’s good or unhealthy for us to eat, and even what’s efficient train — is a long-running symptom of a nonetheless flawed understanding of the interaction between our biology and what we routinely expose it to.
It’s clear that measuring advanced programs with no full understanding of how all of the constituent elements can work together and interaction means you’re not going to get the total image. At greatest it’s a snapshot — possibly one which helps improved understanding. Nevertheless it’s by no means going to have all of the solutions. So, one other phrase of warning, the chance of misinterpretation is actual.
There may be additionally the query of how precisely do you go about measuring ‘metabolic health’? As a label it’s a little bit of a fuzzy umbrella — arching over advanced organic interactions linked to chemical reactions which generate vitality in our our bodies which will (or might not) imply we’re simply in a position to keep a wholesome weight; or which might in any other case assist or work towards us reaching a excessive stage of bodily health.
What you eat; how; when; and the way lively and nicely rested (vs careworn) you had been on the time are only a few of the dynamically various components that may have an effect on metabolic operate. (One illustrative instance: What you ate the day earlier than might have an effect on how your physique metabolizes a selected foodstuff in the present day.) Whereas the biomarker (or biomarkers) a product chooses to zero in on and observe may even, clearly, affect what that “metabolic health” service can see — and is ready to deduce.
Startups focusing on metabolic well being are exploring a spread of choices — from monitoring blood glucose, to analyzing the intestine microbiome or different bodily excretions (like urine), or taking a look at a mixture of outputs/alerts (possibly additionally factoring in coronary heart price). Over time extra bodily alerts are more likely to be added to the combo to attempt to flesh out a fuller understanding — however a variety of the present gen metabolic monitoring is greatest considered a chunk of the puzzle; a sketch or a tough guess, with extra blanks than shading traces.
Learn how to perceive — or, nicely, greatest interpret — knowledge from a mixture of metabolic alerts presents no scarcity of questions and challenges for these making an attempt to productize the slicing fringe of determining all this bodily chemistry. As Ultrahuman’s founder acknowledges — telling TechCrunch: “Fixing for accuracy of insights that we generate from glucose biomarkers is on the very core of our mission.”
The corporate’s web site additionally comprises a textual content disclaimer that the Cyborg service gives “common info for athletes to know their glucose ranges and athletic efficiency”; and doesn’t substitute for an expert medical opinion or include healthcare/therapy for particular situations or medical issues.
Whereas an entrepreneurial mission to demystify the metabolism — and commercialize the idea of metabolic health — stays very a lot ongoing, a few issues are clear: 1) Demand to raised perceive organic operate exists (loads of folks, not simply elite athletes, are curious about what’s happening with their our bodies typically and their metabolism particularly) — and: 2) large however as but unverifiable claims are being made for what one of these ‘well being’ monitoring tech may present a person person as a long run profit.
So — one other caveat! — anybody eager to get entangled with metabolic biohacking must be clear in regards to the limitations.
Getting a bit of knowledge will not be the identical as getting a analysis — or perhaps a correct understanding. Extra knowledge on this context can imply extra noise and confusion, not essentially a transparent sign. It might additionally make you anxious about stuff you shouldn’t.
One other remark: The patron increase in digital well being/wellness monitoring over the previous decade has been understandably slower on the replace relating to invasive/semi-invasive wearables. Aka, sensing units that work by being put in (at the very least a little bit bit) contained in the physique.
Even partially — dipping below the pores and skin so it could stick a sensing filament into the interstitial fluid within the case of Ultrahuman’s Cyborg — the ‘wearable’ metabolic monitoring service that’s the primary focus of this assessment. This semi-invasive-sensor-plus-app combo screens (close to) real-time glucose ranges as a proxy for understanding and scoring metabolic well being — offering the patch-wearer with blood sugar-triggered nudges and alerts to encourage helpful way of life tweaks.
The aim is to assist the sensor-wearer to stabilize their glucose ranges as they go about their day — avoiding excessive highs or lows — with the overarching mission of lowering irritation and oxidative stress, which is linked to damaging well being outcomes.
The suggestion is that, by taking note of “metabolic health” — Ultrahuman’s phrase of selection to explain its mission — and taking little actions associated to what you eat and when, and the way and whenever you train and sleep — you’ll be able to keep away from and even reverse continual irritation which may, over time, result in growing a metabolic dysfunction like diabetes, or non-alcoholic fatty liver illness or heart problems.
Whereas the notion of weight-reduction plan isn’t at all times overtly promoted by startups productizing CGM expertise, blood sugar spikes are additionally after all related to the consumption of sugary meals (and with the next quantity of consumption) — each of which might result in weight acquire. So supporting metabolic health implies assist to acquire and keep a wholesome weight too.
With such headline-grabbing potential positive aspects — from lowering the chance of continual illnesses to assist for weight administration and a sensible digital sidekick to spice up athletic efficiency — it’s simple to see why there’s been a serious startup scramble to demystify (and monetize) the metabolism.
And relating to startup alternative, a actually ‘wired in’ shopper well being tracker is certainly loads much less mainstream than wrist-mounted monitoring gear just like the Apple Watch — which immediately shrinks competitors from shopper tech giants, offering daring entrepreneurs with an opportunity to shine.
Secure to say, if Apple’s wearable got here with a retractable metallic fang embedded within the backplate, the tech big wouldn’t have shipped wherever close to as many watches, regardless of how fancy-looking its glucose-sensing filament. (Apple will certainly wish to incorporate a needle-free model of glucose monitoring into its Watch, as rumors have suggested, and if the tech works out.)
Piercing the pores and skin simply sounds messy (even when it isn’t actually). And ofc a number of folks hate the thought of needles. Which means there may be merely more room and alternative — right here at biohacking’s innovative (ha!) — for quantified well being startups to blaze a path that appears to go deeper than mainstream shopper tech corporations. Quantified self tech that’s not afraid to cross the needle-phobia line actually feels extra severe as a result of it’s actually nearer to the organic course of that’s being tracked.
That stated, whether or not putting a tracker into the pores and skin makes a significant distinction vs a much less intimate sensor placement — when it comes to the standard of the information being captured; the evaluation of that knowledge; and any ensuing suggestions supplied to the person — is a tricky-to-answer query. (Certainly, it’s an entire sequence of questions, relying on context and the execution of the service/s.)
Within the case of Ultrahuman’s Cyborg, the startup is cautious to not overpromise; its advertising places the duty on customers to “work on bettering your well being with real-time visibility of how meals and train affect your physique, and a rating that motivates you to enhance daily”, because the minimalist directions which arrived within the field with the beta product put it.
The metabolic “rating” Cyborg provides is personalised, sure, Nevertheless it’s an abstraction and interpretation of organic processes that also maintain loads of questions for science. So, once more, that is actually extra about being a part of a seek for solutions vs getting a single ‘organic reality’ handed to you on a plate. (Briefly, there isn’t a plate; there’s simply a variety of suggestive knowledge to feast your curiosity on.)
Whereas a little bit information could be a harmful factor — possibly much more so when the information in query is hooked up to your individual biology — a glimpse of 1’s interior workings is undoubtedly catnip for the curious. And in our digital age, with a lot well being analysis info out there on-line on the stroke of a key, who isn’t a little bit curious on issues of non-public biology?
The hazard, maybe, is {that a} extra invasive/intimate sensor placement might lead folks to robotically assume one of these tracker is giving increased high quality intel (and extra personally related insights) than the calibre of the information processing — and our wider scientific understanding of metabolic processes — is ready to ship.
Ultrahuman isn’t afraid to push that sci-fi notion as a promoting level, although. Therefore its overt selection of ‘Cyborg’ branding — which intentionally emphasizes the intradermal sensor placement — the direct interface between the tech and your physique — implying that’s the particular sauce powering a quantified well being service which guarantees to “nudge you in direction of higher well being, one small step at a time”, and with out the necessity for “drastic food regimen adjustments” or the tedium/frustration of “generic train plans”.
Given what number of different startups are additionally leveraging the identical (or related) CGM {hardware}, the automagic of acquiring the information is already vulnerable to being commoditized; it’s how this info will get visualized, analyzed and contextualized for every person that actually counts.
Once more, although, given all of the aforementioned uncertainty across the science, that appears inherently onerous to quantify.
In fact cynics may say that makes for an ideal startup alternative…
Ultrahuman Cyborg: The way it works
Monitoring dynamic adjustments in blood glucose is Ultrahuman’s proxy of selection for assessing metabolic well being.
Why glucose? Ultrahuman’s CEO and co-founder, Mohit Kumar, says it was one of the best match for what they needed the product to attain — being “a real-time biomarker that’s delicate to meals, stress, sleep and exercise”.
“We had been searching for biomarkers and strategies to personalize the health journey for folks once we began as nicely but it surely took us a yr lengthy of experimentation to determine which biomarker actually works for the sort of affect we had been taking a look at. We checked out varied biomarkers like HRV [heart rate variability], sleep and respiratory price however glucose appeared actually fascinating out of your entire lot due to the suggestions it gives on our meals side of the life-style,” he tells TechCrunch.
“Which means that we’d have the ability to get prompt suggestions for these way of life components and what we’ve seen is that prompt suggestions results in higher actionability. For e.g. a nudge that pushes you to stroll after a meal that provides you a spike will result in higher actionability vs a report that will get despatched after a day.
“Secondly, there are such a lot of health wearables and markers that aid you enhance your exercise efficiency however there’s nothing that helps you optimize what you eat. Diet is mostly a blackbox and is far more complicated (given lots of of food regimen sorts and private choice) however it’s most likely crucial way of life issue given how damaged our meals ecosystem is.
“Because of this we felt entering into with glucose makes a ton of sense from a ROI perspective though it’s a semi-invasive biomarker. The personal beta helps us perceive what nudges and data helps folks make way of life adjustments simply. We’ve seen large engagement on the platform with app opens / person being round 21 per day and most of the people seeing real-improvements of their well being across the forty fifth day of utilization.”
Monitoring blood sugar swings virtually as they’re taking place — due to CGM expertise — is straight away a serious step up on the patience-challenging enterprise of (conventional) weight-reduction plan trial and error over a multi-week/month interval: Aka, change what you eat/the way you train and wait and see if it really strikes the scales, weeks and even months later.
Steady blood glucose monitoring (vs repeated finger pricks) has been enabled by the event of CGM {hardware} in recent times — initially for folks with a proper analysis of diabetes. However now a rising variety of startups are productizing this expertise for a extra common health-concerned or fitness-focused shopper.
The tech itself has led to some fascinating science. See for instance this 2018 research paper which confirmed that glucose dysregulation (i.e. highs or lows outdoors what’s thought of the traditional vary) had been really fairly frequent in ‘wholesome’ folks; i.e. these with no analysis of diabetes or pre-diabetes — which wasn’t what the researchers had been anticipating to seek out.
At a fundamental stage, Ultrahuman’s service consists of arm-mounted sensing {hardware} (a disc-shaped sensor) — which have to be changed each two weeks — plus an app to visualise your blood glucose knowledge and ship alerts and nudges. You pair every new sensor with the app to proceed the monitoring.
The sensor {hardware} is made by one other firm: US medical units agency, Abbott. The particular sensor that shipped with the Ultrahuman product on the time of writing was Abbott’s FreeStyle Libre 2 flash glucose monitoring system.
Self administering the CGM sensor is a little bit nerve wracking however primarily since you solely get one shot at (right) placement. And with solely two sensors within the beta field delivered to TechCrunch I didn’t wish to waste any {hardware}.
On the time of software, Ultrahuman had produced a few (amusingly robot-voiced) movies to instruct on sensor placement and arrange. These had been useful — and solely barely disturbing (owing to the reference to not press too onerous to keep away from “few drops of blood splatter”).
Abbott’s {hardware} comes with its personal set of directions and a spring-loaded applicator which you prime manually earlier than positioning the plastic cup in your raised higher arm and, trepidatiously, urgent down to fireside the filament into your flesh. The motion is fast sufficient to make you flinch. It might not assist to recall one other phrase in Ultrahuman’s instruction video (“hole needle”). However the needle is simply the supply mechanism for the filament; you’re not going to be left with that little bit of seen steel in your arm.
Was there any blood splatter? Not that I observed. Nevertheless the second sensor I put in/placed on appeared to have fired right into a nerve or one thing because it was fairly painful for a number of days. After which it type of settled down/bedded in. Or, nicely, I bought used to it.
The primary sensor was not painful, per se, to put on but it surely positively takes a little bit of getting used to to sleep with a chunk of plastic hooked up to your arm. I discovered sure yoga poses required further contortions to keep away from uncomfortably urgent down on the sensor, for instance. And I swear I may hear a really excessive pitched whine in my head at night time whereas sporting the CGM — however possibly I used to be simply dreaming of electrical sheep.
Sure you’ll be able to bathe/bathe with the sensor in place. Ultrahuman’s field contained a couple of disc-shaped material tape patches to assist shield the {hardware} (and add its branding to your arm). These can begin peeling off after a couple of days relying in your way of life however the sensor itself remained firmly lodged for each my two-week stints. (You possibly can take away a dogeared patch and substitute it with a recent one (when you have sufficient spare). Though that was additionally nerve wracking as you don’t need early patch removing to prematurely rip out the sensor. So mainly it’s about as a lot enjoyable as making use of an entire Macbook decal.)
If you happen to’re curious in regards to the sensing filament itself it appears like a chunk of not that wonderful wire. You get to see it for the primary time on extraction out of your arm. At which level I noticed it seemed as if it was coated in some sort of black paint. Which was — I used to be not too happy to watch — flaking barely… However by that point you’ve been residing with it in your pores and skin for 2 weeks so Cyborg acceptance has already taken place. Sensible.
Was there a mark left? Yeah, a small crimson bump the place the filament had perforated the pores and skin. It pale after some time. The tape itself — together with the sensor’s inbuilt fixing (which stayed much more firmly hooked up) — by no means bothered me.
The sensor pairs with Ultrahuman’s app through Bluetooth. This implies it could lose connection in case your telephone is out of some meters’ proximity along with your arm/individual — at which level the information circulation (and real-time alerts) will cease. So now you may have the proper excuse in your telephone by no means to go away your facet!
If that does occur, the app will notify you and request you to faucet the telephone again on the sensor when you’ll be able to to add any lacking readings. (NB: On arrange, the sensor additionally wants a little bit time to “heat up” — earlier than knowledge begins flowing. So you could end up pacing the room as you anticipate it to be able to log your first exercise/meal and so on.)
The app itself was a piece in progress throughout TechCrunch’s interval of testing which was cut up over greater than a month (as I took a break between making use of sensor 1 and sensor 2) — and the software program went by quite a lot of adjustments, together with one main visible tweak.
This modified the glucose plot line’s gradient from a too simplistic view (the place low-to-high glucose was at all times displayed as green-to-red) to having a central “goal zone” the place the plot shows in frosty ‘good to go’ inexperienced however as/if charges drop too low or too excessive they’ll bleed in a gradient from yellow to orange to crimson — which means you’ll be able to have crimson highs and lows in the event you’re out of the optimum glucose vary (which is between 70mg/dL and 110mg/dL).
This replace was an enormous enchancment as the sooner model had been visually suggesting {that a} decrease glucose was at all times higher — even when the extent was already beneath goal (aka, hypoglycemia) — which it only a small illustration of among the design/UX pitfalls for one of these quantified well being product.
In addition to plotting the ups and downs of your blood glucose all through the day (or at the very least the approximation which Abbott’s {hardware} pulls out of your interstitial fluid; as any diabetic could tell you, these ranges don’t at all times precisely match blood glucose readings; and in case your glucose is rising or falling there could be a quick time lag earlier than that exhibits up in a flash glucose monitor), the app shows what Ultrahuman refers to as a “metabolic rating” — which is a quantity from ‘0’ to ‘100’.
That is the primary ‘metric’ mechanic the app makes use of to attempt to nudge and gamify wholesome way of life tweaks.
Ultrahuman describes this rating as an indicator of your “general metabolic well being” and says it’s calculated primarily based on glucose variability, common glucose and time in goal metrics. The quantity resets to 100 daily at midnight and reduces or will increase “primarily based in your day by day way of life actions and physique’s response”.
The gamification mission sounds quite simple: “Your aim is to maximise this rating every day,” because the app places it.
In observe, getting a ‘good’ (i.e. excessive) rating will rely in your particular person biology and way of life. And, depressingly, you’ll be able to get up with a rating that’s already down within the 80s (or, I assume, worse) — relying on what you probably did/ate earlier.
NB: Stress also can affect blood sugar so occasions outdoors your management can impinge in your metrics.
Logging of meals — and/or exercise or the opposite varieties of occasions which had been progressively added to the app in the course of the testing interval — is completed manually.
Initially this was by customized typing your meal descriptions (or exercise). A later replace added a meals and exercise index that allows you to search and choose from a structured listing and their portions or instances somewhat than manually typing the whole lot.
Ultimately, I a lot most well-liked customized typing to log meals because the listing was far too particular and tedious to really feel helpful. (Kind: “Cheese” and it’ll recommend a variety of several types of cheeses — however not essentially the precise one you’re consuming, nor the quantity you even have in your plate, which you’ll not know in any case; and that’s only one meal ingredient to log; repeating that for a full plate rapidly will get previous quick… Plus the listing additionally appeared fairly US-centric, which wasn’t very helpful for logging a European food regimen.)
Whereas sort in your individual favourite cheese — or certainly a customized description of your entire meal — and you may rapidly log it subsequent time you eat it because the app will keep in mind your customized label.
Likely Ultrahuman is eager to get the highest quality structured knowledge that it could — to construct the broader utility hunted for from predictive AI fashions. However, if logging feels an excessive amount of like work, few customers will carry out the duty completely without spending a dime. So it could have its work minimize out to get correct and structured (vs customized however cryptic) food-to-glucose-response knowledge from its beta user-base.
(Certainly, it could have to depend on asking customers to snap a picture of their meal and making use of laptop imaginative and prescient expertise to make knowledgeable deductions, say, though which will additionally introduce loads of errors. Long run — if the tech goes actually mainstream — you might think about eating places printing a QR code per meal on their menus which might be scanned so all the right nutrient knowledge is immediately logged to cut back enter friction.)
Exercise logging was much more easy than meals. Not least as a result of, except you’re an Olympic athlete, you’re going to wish to log loads much less of it than meals.
After neighborhood suggestions from beta customers, Ultrahuman additionally added “stress” occasions as a logging choice, in addition to fasting — which might after all play havoc with blood glucose however — per some analysis — might have its personal set of well being advantages. So giving customers extra granular choices to assist higher construction the CGM knowledge is smart.
Sooner or later, automated logging through integration with different varieties of shopper wearables appears seemingly. For instance, it’s simple to think about that your health band or good watch detects a selected exercise and passes that knowledge to the Ultrahuman app — which may simply immediate the person to verify the small print of the detected exercise.
For now, although, beta customers stay answerable for inputting and structuring the information so knowledge high quality is more likely to be an actual smorgasbord.
What I learnt
Ultrahuman’s ideas warning that in early use of the product you most likely received’t be rewarded with steady, excessive scores.
It is because studying what it is advisable do to stabilize your blood glucose sometimes takes a little bit of time — since you must strive totally different stuff (meals pairings, train timings and so on) to see what works for you. Though that is nonetheless a a lot accelerated course of vs the tedious enterprise of old skool weight-reduction plan and health regime evaluation. (Ofc in the event you’re blessed with a naturally extra steady (i.e. low variation) glucotype you could discover it is advisable do loads much less guide ‘steering’, because it had been.)
I’ll nonetheless unprepared for the early horror, although. And spent just about the entire first week — jaw on the ground — watching the app lowball rating the stuff I normally eat.
Humus salad pita bread sandwich lunch adopted by a couple of walnuts, half an apple and low (white, no sugar)? Doesn’t that sound moderately wholesome? Um, apparently not, in my case. It stays one of many all time “backside zone” lunches throughout my 4 weeks as a Cyborg (scoring a giant fats ‘0’). 😬
The all time worst lunch meals in the course of the check interval (purely when it comes to how excessive my glucose peaked after consuming) was at the very least not a dish I had ready myself however a quick meals meal — albeit, from a model that markets its fare as a “pure” and extra wholesome selection than conventional McBurgers n chips.
The meal in query — Leon’s lentil masala with brown rice adopted by a “common” coconut milk latte (model of plant milk: Impolite Well being); one other ‘0’ scorer — produced such an epically massive spike that I made a decision I wanted to do an emergency HIIT session simply to carry my elevated ranges again down once more.
The train did do the trick. Nevertheless, if I’d recognized earlier than lunch that I would want to do do a bunch of burpees and squats proper after lunch to metabolise the meals spike I’d nicely have revised my meals selections.
How steady glucose monitoring, and mass entry to real-time metabolic knowledge, will have an effect on the quick meals business is actually an fascinating query to ponder…
I hadn’t checked the components small print previous to consuming the Leon meal — however eyeing the label suspiciously afterwards, within the crimson glow of the app’s condemnation, I used to be unimpressed to seek out “caster sugar” in an extended listing of additives.
Though, realizing what I do know now, it was most likely the coconut milk (an ingredient in each the stew and the espresso) that was particularly triggering for me.
Sadly, the post-meal espresso most likely didn’t assist both.
My least favourite Cyborg studying was that espresso appears to lift my blood sugar. Inexperienced tea? Completely wonderful. Black espresso, decaf, white? All trigger me some uplift. And since I wish to drink espresso within the afternoon, after consuming lunch, meaning a increase atop a (meals) increase — which could be simply sufficient to tip me into the crimson.
I nonetheless refuse to be a morning espresso individual, although.
Rice can be a spiker for many individuals — actually white rice which is extra rapidly metabolized by the physique vs the extra fiber-rich wholegrain. Though I’m now extra cautious of the crash that may come after consuming a primarily white rice-based night meal because it appears to work towards maintaining blood sugar steady and sustained within the goal zone in a single day.
Blood sugar lows are simply as vital to keep away from as highs, because it seems. At the least, that’s my sense after 4 weeks hooked to a CGM. Though my early utilization of the app was totally preoccupied with making an attempt to keep away from the large crimson spikes, they did get simpler to handle over time — with some artistic biohacks and some strategic dietary edits.
For instance, I’ve all however eliminated plant-based milks from my food regimen (save for a touch of oat milk in espresso; no I’ve not — is not going to! — hand over espresso totally. However I do are likely to nurse a cup for longer now). The spikes these alt milks served up had been simply too constantly crimson flag-ish to disregard and I got here to consider them as akin to fruit juice and greatest prevented. Which — once more — is fairly fascinating contemplating how typically the advertising of those extremely processed drinks makes loud noises about how they provide a ‘wholesome selection’.
Curiously, different Cyborg customers appear to have reported an identical difficulty — per one of many firm’s electronic mail publication round-ups of shared learnings, the place it wrote that: “Almond milk and breakfast cereal may really trigger a much bigger spike than a resort breakfast buffet!”
Possibly it is a related mechanism as may cause a glass of orange juice to spike whereas consuming an entire orange (sometimes) received’t. Or possibly it’s right down to one thing extra particular in how these drinks are manufactured — the kind of processing they endure and particular additions. Many have added sugar for example (though those I used to be pouring on my cereal positively didn’t — but they nonetheless spiked me). Sadly I didn’t have an opportunity to make a do-it-yourself model of oat milk to do a direct comparability with business manufacturers to see if it was any much less spikey.
For breakfast I do nonetheless normally eat a bowl of oats — which actually additionally has spike potential (being carbs, albeit fiber-rich carbs) — however I make certain they’re jumbo oats (not oatmeal). Most significantly, I liberally mud the bowl with cinnamon (which I found helps cut back glucose spikes). And I eat them with water (not any sort of milk), plus a blob of pure yogurt (for taste and a few important nutritional vitamins), plus the same old mixture of berries and seeds.
This isn’t a large change on my pre-CGM breakfast of selection (oats, berries, seeds and so on however washed down with, er, oat milk). However the distinction in metabolic rating phrases? Big! It switches from a meal that sometimes scores a ‘2’ to a ‘9’. Loopy however true (or, nicely, true per Ultrahuman’s studying of my fluctuating interstitial fluids).
I additionally discovered artistic methods to adapt how I eat bread to restrict how a lot of a spike it generates.
Consuming much less and even no bread is one strategy to shrink glycemic load and handle down any related blood sugar rise. Nevertheless like oats, wholegrain bread is a posh carb that has dietary advantages so I didn’t wish to take away it (or, certainly, stop carbs totally) from my food regimen. So, with the good thing about the app’s real-time glucose view, I experimented with consuming a slice of wholemeal bread in direction of the tip of lunch, after different fiber, protein and fats wealthy foodstuffs — which take the physique longer to interrupt down — and that appeared useful.
I then discovered one other particular biohack — involving apple cider vinegar — that labored a deal with.
As with cinnamon, I discovered one of these fermented vinegar has properties that assist to cut back glucose spikes. So I experimented with pouring the vinegar (stick with me) on a slice of sourdough bread earlier than consuming it — sure this sounds odd however really tastes wonderful! Utilizing this technique, plus consuming the bread in a while within the meal (after the salad, nuts and so on), I may flip a lunch that spiked into one which remained within the wholesome zone. There’s merely no method I’d have found out one thing as particular as that with out with the ability to see real-time shifts in my blood sugar.
The issue is the lunches that spiked didn’t make me really feel any totally different/much less wholesome vs the lunches that didn’t. Not with out seeing the metabolic response within the app. So it simply wouldn’t have been doable to differentiate between them with out the sensor knowledge.
Plus, after all, one other individual, with totally different metabolic responses, could possibly eat 5 slices of bread with none spikes in any respect. So there actually is not any intelligent strategy to generalize — past setting fundamental strictures similar to management your carb consumption and punctiliously construct the steadiness of foodstuffs in your plate. And generic, broad-brush methods that may be very demotivating within the absence of speedy suggestions — which is precisely what makes the CGM so doubtlessly, individually transformative as a life-style software. Instantly you’ll be able to strive stuff and see if it really works for you or not.
That stated, whether or not managing comparatively small blood sugar spikes is as vital for an individual’s long run well being as metabolic tracker startups wish to recommend is a wider query.
Dr Matthew Campbell, a scientist who does analysis into organic programs that affect the human metabolism on the College of Sunderland within the UK, was sceptical about the advantages of in any other case ‘wholesome’ folks placing a lot effort into managing their blood glucose once we requested for his views on this common use of CGM expertise.
“Glucose normally fluctuates all through the day anyway — it’s not a sort of static variable, it is vitally dynamic. Nevertheless it ought to, on common, keep inside a standard vary. There are minimize off factors for individuals who could be characterised as excessive threat. For instance, in case your glucose doesn’t come down beneath a sure stage after a meal or within the morning time if it’s chronically elevated. And that’s the place the sort of minimize factors are for diagnosing diabetes and even pre-diabetes, the people who find themselves vulnerable to growing diabetes,” he tells TechCrunch.
“The difficulty that we’ve got [with ‘healthy’ people tracking their glucose] is simply these arbitrary values — if it’s taking place that’s okay, if it’s going up that’s not so good — [but] in the event you sit inside the regular vary I don’t know what the medical utility and the usefulness or the well being benefit is of, for instance, lowering your glucose by 1mmol if it’s already within the wholesome vary.
“So I assume in the event you already sit — 95% of the time — inside a wholesome vary making an attempt to flatten that line or aggressively handle it even decrease, I don’t assume that confers any further well being profit since you are already in a wholesome vary.”
Campbell additionally pointed to the problem of appropriately linking the blood glucose knowledge that comes from the CGM to the whole lot happening within the person’s physique which could be influencing glucose ranges, noting too that in addition to a time lag the precise place of the sensor on the person’s arm can have an effect on the readings, for instance.
“So sure conditions, is it your weight, your intercourse, your ethnicity, particular person genetic make-up — all of these various factors affect glucose ranges — sleep impacts it, vitamin impacts it,” he says. “And I feel if this tech simply [tracks] the glucose hint and it doesn’t tie in these different components then it’s fairly tough to make an knowledgeable resolution on what’s influencing your glucose ranges.”
He was extra constructive in regards to the potential of CGM for athletes, although.
“I feel what it may be helpful for — you talked about elite athletes — in the event you’re exercising at notably excessive ranges or for an extended period of time — even in the event you don’t have diabetes, might be vulnerable to having low blood sugar ranges and a variety of this tech tends to return with alerts,” he provides.
Campbell additionally raised an fascinating comparability — suggesting out of vary glucose might not at all times be an issue if the person’s metabolism is ready to aggressively handle it again down once more.
“The best way to consider it’s a little bit like coronary heart price throughout train,” he says. “If you happen to’re exercising any individual may need a a lot increased coronary heart price on the similar train depth as any individual else and also you may assume they’re exercising loads tougher due to this fact they could be much less match.
“However really if the variability inside the coronary heart price is loads better then that’s extra indicative of extra cardiovascular flexibility. Which is just about related to excellent train tolerance and excellent ranges of health — and I don’t actually see the way it’s any totally different with glucose response.
“So it’s not essentially the truth that the glucose stage goes outdoors of vary as a result of that occurs for a big proportion of individuals and they are often metabolically wholesome — I feel what’s vital is trying on the general image.”
Provided that, Campbell prompt the true utility of those providers might be in augmenting the CGM knowledge with algorithms and machine studying — that may “search for patterns within the knowledge” and “piece issues collectively somewhat than simply cherry selecting ‘nicely your glucose stage went excessive after you probably did this’; nicely it doesn’t actually matter if it got here down pretty aggressively, possibly that’s really a superb factor.”
Returning to blood sugar lows, I had an fascinating private expertise in that I used to be ready to determine — by utilization of the app (together with by chatting to Ultrahuman’s in-app coaches to get their guide evaluation of my CGM knowledge) — {that a} sequence of glucose lows I had skilled in a single day correlated with waking up in the midst of the night time in a chilly sweat and even with cramps.
I additionally observed that such in a single day lows typically adopted a meal that had concerned consuming alcohol (which, seems, performs its personal devilish recreation of interference with regular metabolic processes). So maintaining a cautious eye on the ratio of meals to alcohol — and maybe consuming a protein-rich snack earlier than mattress after a night meal after I had drunk wine with a much less nutrient dense dinner (white rice, say) — was one other little hack I used to be in a position to work in to shrink the chance of going hypo/crampy within the night time with out having to forgo wine with a meal.
In that case the private profit seems to be tangible: Not having my sleep unpleasantly disturbed.
I used to be additionally in a position to extrapolate this discovering to recommend an identical night time time snack hack for an aged relative — who had been struggling continual night time cramps for months. After she’d tailored her regime to incorporate a strategic bedtime snack she quickly reported being virtually totally cramp free in a single day.
These are after all simply a few anecdotal examples — however they’re illustrative of the potential for people to experiment, make connections and be a part of the dots between the distinctive quirks of their way of life and the CGM knowledge.
Dr Michael Snyder, a Stanford professor and co-author of the aforementioned pioneering research paper — who can also be a co-founder of a (rival) US startup, referred to as January AI, which sells its personal metabolic well being monitoring service that’s productizing CGM — is, as you’d anticipate, evangelic about the advantages of the expertise to ship worthwhile revelations to particular person customers.
He really has Kind 2 diabetes — and has worn a CGM to assist handle the situation for round a decade at this level — so is nicely positioned to touch upon the tech’s utility.
Albeit his private use, for a selected medical situation, could be very totally different to the overall health/well being use Ultrahuman, January AI and different startups on this house are focusing on. However he means that broader use of CGM expertise may assist handle and even reverse the chance of individuals changing into pre-diabetic or diabetic.
“Instantly you study what meals spike you and what doesn’t — and that simply differs from one individual to the following,” he tells TechCrunch. “You possibly can really see individuals who have glucose dysregulation who won’t in any other case realize it and it is a large deal as a result of 90% of pre-diabetics don’t realize it and 70% of these will go on to develop into diabetic so one may argue it’s actually actually worthwhile to get their glucose below management so at the very least they will push off changing into diabetic hopefully for quite a lot of years.”
“There’s these sort of hidden secrets and techniques in your meals — at the very least they’re secrets and techniques to you, they’re most likely apparent to any individual,” he provides. “However even individuals who assume they knew the whole lot study stuff, from what I can inform, that they didn’t understand. And, yeah, there’s simply sugar in all places.
“It most likely traces as much as the idea that I feel now — in comparison with proper after World Battle 2 — folks eat one thing like 40,000x extra sugar than they used to. It’s simply in all places.”
“I personally assume — from my standpoint — the entire world must be getting measured on this at the very least on some remedies,” he additionally tells us. “In case your glucose is below management possibly you get measured a little bit bit much less, get measured periodically. However in the event you’re pre-diabetic or diabetic I feel this info must be life-saving on some stage.”
Snyder additionally predicts the tech will get much more highly effective — due to the addition of AI and predictive modelling round meals responses primarily based on all of the empirical knowledge that’s now being ingested after being fed in by early adopters.
“That’s why you want AI,” he notes. “To begin with you’ve bought to know which meals spike you — which of them don’t. It’s very empirical except you simply do it you don’t know entering into — so we’re discovering some folks spike to grapes, different folks to pasta. All people spikes to white rice.
“However totally different folks do spike to various things and sooner or later we’ll get predictive about what’s doing that however proper now it’s simply empirical. And in order that’s what these units do — they educate you.”
“For January AI we’ve got meals recommender system as a result of we will say nicely right here’s what you’re consuming that spikes you and we all know the composition of those different meals and with cheap predictive accuracy we will say nicely this meals didn’t spike you, eat that one, don’t eat that one,” he provides.
“It sounds loopy — however it’s a large knowledge drawback. It is advisable have a variety of knowledge and a variety of understanding to have the ability to do this.”
January AI equally components within the person’s exercise stage — given it additionally impacts glucose stage. And Snyder argues that even simply monitoring these two parts is sufficient for such a service to be helpful.
“I feel that’s basically at the very least two of the components — however you’re proper there are a variety of components and that’s why it’s an information drawback,” he provides. “Usher in sufficient knowledge round you personally and we’ve bought the information to determine what formulation are working for you.”
Personally, I can say one factor for positive: I’ve by no means recognized a gadget to be so participating. Simply on the pure info stage.
The Ultrahuman app’s pretty formulaic alerts — which could pop as much as warn you that your glucose is rising and recommend you “get movin’” to carry the extent down; or nudge you to eat earlier within the night for “higher sleep high quality and metabolic response”; or supply some motivation by trumpeting an “epic/insane begin to the day” primarily based on minimal spikes/crashes — had been most likely the least personally helpful component of the product for me. As a result of, nicely, in the event you’re taking note of the information you’ll quickly understand that type of stuff your self.
I used to be in a short time method down the rabbit gap of testing food regimen/train tweaks to see whether or not I may establish hacks and techniques to maintain issues frosty inexperienced.
It’s completely fascinating/terrifying to observe how your physique offers with the stuff you throw at it. However, be warned: Your S.O. will hate you as you inexorably whip out your telephone at lunch/dinner to first log your meal after which vicariously observe because the app scores your physique’s response to no matter you’re consuming. It’s a double whammy for display time. And the stickiest app I’ve used since ceaselessly. (Typically actually given you’re logging what you’re consuming.)
However after all it’s not excellent.
One notable performance difficulty I discovered is that the app wasn’t at all times in a position to distinguish between an exercise-related spike (sure intense train can increase blood sugar out of the goal vary!) and a meals associated spike (even in the event you’re doing cautious logging) — so it may find yourself scoring your day badly when it shouldn’t.
Train spikes are “nothing to fret about”, per Ultrahuman’s coaches — who I quizzed about this through the app’s chat operate. “The explanation for spikes throughout energy and HIIT exercises is because of a rise in adrenaline and cortisol which stimulates the liver to interrupt down glycogen into glucose,” was the reason I bought from one of many coaches, together with the reassurance that that is: “Nothing to be anxious about. It’s pure phenomenon.”
Now an individual with diabetes might have to fret about going out of goal even when train is the trigger — as their physique may have hassle bringing the elevated blood glucose again down once more. However an individual with out that analysis — the extra common shopper that Ultrahuman is focusing on for Cyborg — shouldn’t, in concept, be anxious.
Nevertheless the app, in its present type, ended up inflicting me some concern after I did some intense train after which proper afterwards ate a meal. Excessive glucose charges brought on by the HIIT — which the app will usually notify as “a superb spike” — appeared to get co-mingled with the food-related enhance and that mixture conspired to dent my metabolic rating.
Precisely distinguishing a “good spike” from a foul one is evidently a piece in progress.
Right here’s what Kumar informed TechCrunch once we requested about this: “Fixing for accuracy of insights that we generate from glucose biomarkers is on the very core of our mission. If we have a look at medical grade parameters that decide how one’s physique responds to one thing like meals, we get to know that it’s a mixture of: ‘X ( macro+micro constituent of meals ) + Y ( the state of restoration i.e stress, sleep deficit, microbiome variety and so on ).’
“The platform presently seems to be at X carefully and therefore you’ll see that there are lots of exceptions to how glucose responds to meals. With our customized {hardware} that’s going dwell in early 2022, we’re altering the best way we have a look at this by capturing the remainder of the Y components i.e HRV, sleep and so on. We really feel this may utterly change how we have a look at the meals and exercise response and the ensuing accuracy.
“For e.g.: The platform will have the ability to clearly determine the attribution of exercise and meals inside a spike. It is because we may determine your approximate glycogen launch thresholds primarily based on a mixture of glucose with different components that we’ll seize through our customized {hardware} wearable.”
Kumar additionally stated the startup is beginning medical trials for a research that relates glucose, insulin and different bodily parameters (“Triglycerides and hormone steadiness”) to ascertain what he described as “a correct correlation between glucose monitoring predictions (‘metabolic rating’) and the precise state of metabolic well being”.
“This has additionally been tried up to now with lesser instruments and non-continuous glucose at disposal however the v2 right here can have far more validation,” he predicts.
So, as soon as once more, extra analysis is required to attempt to enhance the decision of the ‘personalised’ snapshot of knowledge the CGM is pulling out of your arm. Which additionally signifies that these innovative quantified well being providers should be making a comparatively crude evaluation of what’s happening in your physique at any given second.
There’s an identical complication with meals too after all, except you’re somebody who eats a single foodstuff per meal.
Since most of us eat meals together (bundling totally different components), it’s the combo you’re consuming that counts — and, certainly, the order by which you eat totally different components in your plate can have an effect on the way you metabolise them. So the identical meal eaten otherwise (or at a special time of day) may go down (or up) in a different way.
Beginning with fiber wealthy meals (salad, greens and so on), transferring by proteins and fat and ending with (any) carbs — a deconstructed humus salad pita lunch, say — would most likely have been much less of a low scoring lunch for me than wrapping the identical meals in bread and consuming it the short and handy method.
One other clear takeaway from my 4 weeks as a Cyborg is that quick, ‘handy’ meals — scoffed at a tempo — will, inexorably, trigger large, unhealthy-looking glucose spikes.
I additionally discovered that extra processed the meals (i.e. ready meals with added sugars, preservatives, oils and so on), had been extra more likely to spike vs consuming complete meals, freshly ready.
This was not stunning to me — I’ve lengthy sought to keep away from consuming closely processed meals in favor of stuff I put together myself utilizing recent/minimally processed components — but it surely did underscore how a lot of a problematic meals tradition the Western world has developed, with its time-is-money emphasis on pace which inspires liberal use of synthetic sweeteners and different components as a way to flip an edible comfort meals right into a worthwhile product with an extended shelf life.
My expertise of utilizing a CGM means that consuming in a method that’s more healthy for you — as a result of it generates much less irritation and oxidative stress — requires each extra time to organize meals and extra time to eat meals.
More healthy components might also be dearer to purchase and assemble your self vs shopping for a product that comes prepackaged and ‘able to eat’. So well being can actually value extra, in money and time. So there are big socioeconomic concerns whenever you begin to dig into metabolic well being.
Cracking open this Pandora’s (lunch)field has implications that scale past our damaged meals system too — referring to wider structural inequalities baked into our societies.
Poor well being and poverty are sometimes intertwined. And it stays to be seen whether or not large knowledge and AI will have the ability to break that hyperlink by democratizing entry to worthwhile well being insights — scaling broad utility off of sufficient individual-level learnings — or whether or not tech’s wealth divide will simply serve to additional speed up inequalities as well being tech will get smarter too.
The idea of a cyborg immediately implies a brand new elite tier of humanity. However what about all those that can’t afford to be wired in?
Verdict & Value
Whereas I stay (healthily) sceptical of the dimensions of the potential positive aspects being claimed for metabolic monitoring, 4 weeks as an Ultrahuman Cyborg was lengthy sufficient to persuade me that is the beginning of one thing large. And I didn’t have an apparent want going into testing the product — similar to eager to shed extra pounds or needing to get match. I’m simply curious about staying wholesome.
Nor am I a giant fan of health wearables, typically. However this felt like a special stage of self quantification.
The way forward for healthcare will definitely be about shifting in direction of preventative interventions by leveraging knowledge accessibility to tell and increase our concepts about what’s good and wholesome for us — even when, the place metabolic well being is anxious, there’s no scarcity of studying and analysis nonetheless to do.
The info from particular person sensors (Ultrahuman’s service alone has some 400x cyborgs on the time of writing) may even feed analysis that may proceed to deepen our understanding of advanced metabolic processes. Though there’s a diploma of threat that business pursuits will search for outcomes which assist and underscore their viewpoint, the potential scale of use — as extra of those providers launch — ought to assist drive transparency and preserve the science clear.
On the similar time there may be lots to be cautious about.
Essentially the most engaged and scientifically literate customers are more likely to get essentially the most out of this type of monitoring as they will carry wider information/sources to bear to assist them interpret their knowledge — whereas a much less knowledgeable person may take an excessively simplistic learn of what the knowledge means.
There may be additionally the chance that linking large daring stress triggers to meals and different way of life occasions may result in (or exacerbate) issues like consuming problems. The service wrapper and assist are due to this fact a extremely key piece of benefiting from what CGM tech can supply.
Briefly, poor UX choices may have severe ramifications. And a variety of care and due diligence is required over service design and supply.
Long run, having a snapshot view of blood glucose might — by itself — change into far too limiting.
A extra absolutely built-in monitoring platform is more likely to be wanted to ship one of the best understanding of a person’s metabolism, drawing in a wide range of alerts and biomarkers. Though, proper now, monitoring glucose appears like a begin; one which presents the possibility to experiment with way of life tweaks that would accrue vital advantages over time — in a method that’s way more motivating than making an attempt to determine wholesome particular person dietary selections with none sort of real-time suggestions.
Even simply 4 weeks utilizing the product yielded so many fascinating tidbits and a lot meals for thought — avocado and egg is a brilliant stable breakfast selection!; beer is a horrible spiker however pure cider seems to be (er) virtually medicinal!; olives and nuts are actually the meals of the Gods! — and the expertise has led me to make some small however sustained way of life adjustments.
The jury remains to be out on whether or not these tweaks are genuinely worthwhile from a long-term well being viewpoint. However given the adjustments weren’t particularly radical, even when there’s solely a tiny probability they’ve a profit then, actually, the place’s the hurt in that?
That stated, one other qualification: I do wonder if (additional) lowering the quantity of carbs I eat — on account of seeing how a lot they will spike me — won’t have capped how a lot vitality I’ve out there for coaching functions.
I already had a reasonably low consumption of carbs and it’s vital to keep in mind that meals can also be gasoline — and vitality wants differ. So a ‘spikes are unhealthy, stability is greatest’ view on blood glucose could also be too simplistic for an above common sporty way of life.
There’s a actual have to plug this knowledge into related specialisms. A private coach would seemingly have the ability to make way more clever use of my outcomes for me — primarily based on realizing my particular person gasoline for coaching wants. Such an individual might even have the ability to advise on dietary tweaks that would let me have my bread and eat it, so to talk.
However after all a private coach — or nutritionist — isn’t one thing everybody can afford or in any other case justify primarily based on their (non-Olympic athlete) way of life. So on that entrance the product seems to be good worth. (Even in the event you’re largely getting uncooked knowledge and have to do a lot of the broader interpretation your self.)
How a lot does Ultrahuman’s Cyborg value? The beta program is priced at ~$80 for 2 weeks (or $470 for 12 weeks). If you happen to had been paying a human private coach to be in your case and analyzing your knowledge 24/7 it could be a lot dearer than that — so it seems to be like fairly good worth. (An honest private coach may cost $80 an hour.)
It’s vital to emphasise that the app isn’t actively making an attempt to be a full-time private coach. However it could do some staple items like supply train nudges in case your blood glucose will get too excessive and — retrospectively — establish your “greatest exercise zones”, aka optimum time home windows to take train over the course every week primarily based on how your physique was fuelled. (“Do you see a development? Use these instances to your benefit to crush your subsequent exercise” was one suggestion it emailed me, though this nudge appeared extra random than helpful tbh.)
There are additionally a couple of (human) coaches available within the app to take questions and aid you analyze your knowledge. Plus you’ll be able to at all times ask for assist from different customers through the invite-only Cyborg Slack channels. (Albeit, that’s crowdsourced knowledge, not devoted skilled assist.) So the ‘relative worth’ price-tag comes with the caveat that more often than not you’re by yourself relating to drilling in and distilling extra nuanced insights.
Yet one more thought to ponder: As with each data-driven and ambitiously predictive AI product the Cyborg isn’t simply coaching you; your knowledge is coaching the Cyborg… So how a lot do you assume 24/7 entry to your biology is price?
The worth being derived out of your extremely intimate private knowledge flows two methods — and that upside isn’t essentially being distributed equally. If you happen to really feel you’re getting sufficient worth from the service that will not trouble you. However privateness concerns are unattainable to disregard.
Even in the event you’re comfy sharing such intimate knowledge with a business firm so as to have the ability to entry the service, Ultrahuman’s privacy policy for Cyborg notes some circumstances the place your info might find yourself elsewhere — similar to if it receives a subpoena it’s legally sure to answer.
The coverage additionally specifies that: “Anonymized, aggregated knowledge could also be shared with advertisers, analysis companies and different companions.” And robustly anonymizing well being knowledge has been shown to be notoriously difficult to do, even because the adtech business has proven a rapacious urge for food for triangulating and “sharing” knowledge to raised profile people for focusing on — up to and including applying labels like “diabetes”. So your extremely private knowledge leeching from a CGM into the trendy internet’s manipulative microtargeting advert matrix will not be, sadly, unattainable to think about.
However let’s finish on a private observe: What has Kumar himself discovered from utilizing CGM to trace his glucose?
“For me the most important studying has been round increasing my meals spectrum and incorporating extra of the meals that I like. Previous to this I just about adopted a disciplined food regimen however couldn’t maintain it for lengthy given it could have an effect on social consuming and so on. With Cyborg, I’m in a position to perceive how I can steadiness meals with my exercise. On the times I raise weights or am typically extra lively, I do know that I’ve a little bit bit of additional flexibility round consuming what I wish to,” he tells TechCrunch.
“The opposite large studying — which is a piece in progress — is round sustaining steady vitality ranges all through the day. For me, steady glucose ranges are broadly correlated to steady vitality ranges and that is what I’ve been making an attempt to keep up throughout a selected week the place I’ve a variety of studying work to do.”
Innovative competitors
Right here, previous the quantified self development’s needle-phobia line, is actually a wild(er) west — a lesser trodden area of experimental startup alternative. Naturally, it’s much more fascinating than boring previous step/sleep monitoring, precisely as a result of it’s a lot much less acquainted.
There’s a real sense of discovery as you hearth the spring-loaded CGM sensor into your arm; feeling like a little bit of a pioneer, concerned in a sort of citizen science collective — with the fascinating alternative to design and run experiments that interrogate the well being of your individual way of life.
On high of that, is the overarching risk that what you study personally could be helpful to others — inspired by Ultrahuman’s community-building efforts round Cyborg (similar to its Slack channels, the place early adopters are inspired to share their learnings; in addition to digital and in individual meet ups) — so there’s a ‘philanthropic mission’ really feel as nicely.
Startups which are daring sufficient to get entangled in skin-puncturing machine-human interactions do have an opportunity to face out. In spite of everything, mainstream tech giants merely can’t be that freaky. And it units them aside from the broader wellness quantification crowd that’s plumped for a extra quotidian biomarker to trace.
That in flip means these startups have an opportunity to seize some very intimate organic knowledge to feed their product dev, knowledge science, AI fashions and algorithmic predictions; and — doubtlessly — jockey themselves into place to race forward as shopper urge for food for personalised well being providers steps up.
On the blood glucose monitoring entrance — an exercise that has historically been related to individuals who have situations like diabetes (or pre-diabetes) — numerous startups at the moment are taking the plunge into keen recipients’ interstitial fluids.
In addition to (India’s) Ultrahuman, with its nonetheless beta Cyborg service, there’s January AI, which does glucose monitoring mixed with coronary heart price monitor knowledge to supply personalised meals predictions and train ‘recipes’ that will help you burn off any indulgent extra; Levels Heath, which has bagged backing from a16z; Signos, which is utilizing CGMs to supply real-time weight reduction recommendation; the athletic-performance centered Supersapiens; and NutriSense, which presents large image soundbites round “optimizing” your “day by day well being efficiency”, to call a couple of of Ultrahuman’s US CGM-leveraging rivals.
There are extra rivals in Europe — together with (UK-based) Zoe, which is utilizing knowledge from large-scale microbiome research to generate AI fashions to foretell particular person meals responses. So in addition to getting customers to put on a blood glucose monitor, it additionally asks them to ship in stool samples for lab evaluation.
Additionally focusing on glucose monitoring within the area is Germany’s Perfood (“personalised food regimen” for weight administration); and Holland’s Clear Nutrition (“study your distinctive responses to meals” and “construct your individual vitamin plan”). On the time of writing, one other European firm on this nascent house, Finland’s Veristable — or Veri for brief — was noticed promoting its 24/7 glucose monitor service on photo-sharing social community Instagram.
The advert pictured a really hipster look mannequin sporting the identical disc-shaped wearable which Ultrahuman’s service makes use of (and certainly many others do), taped over with a classy gray patch vs the previous’s black and white disk emblazoned with its tipped ‘Okay’ image. “Finish the Guessing Recreation of “What Ought to I Eat?” Veristable’s advert proclaimed, pointing Europeans towards a €159pm service.
Each Veri, which raised a seed spherical in June (per Crunchbase), and Ultrahuman — and quite a lot of others — are utilizing a CGM made by Abbott (the aforementioned FreeStyle Libre). This disc-shaped data-collecting gadget comes with a spring-loaded applicator that’s armed with a hole needle. As soon as positioned in place you press down (firmly however not too firmly) and it fires the filament instantly into your flesh.
The novelty right here isn’t the tech itself — CGMs have been round for some years (Abbott’s FreeStyle Libre was launched in 2016 for instance, whereas Dexcom, one other maker, bought FDA approval for a completely interoperable CGM that may very well be used with different digital diabetes administration units again in 2018) — it’s what they’re doing with it that’s experimental.
So whereas CGM tech has already been a transformative expertise for folks with diabetes and pre-diabetes, it’s solely comparatively just lately there have been strikes to commercialize it for a extra common person who simply desires to get to know their very own physique higher.
Final summer, Dexcon gained FDA clearance for its real-time APIs for third occasion builders and units. Health {hardware} maker Garmin was among the many first wave of corporations signed as much as work with it to broaden customers’ entry to their glucose knowledge, albeit nonetheless with a deal with boosting utility for folks with diabetes.
However traders have been fast to identify broader shopper potential — and are more and more injecting funds to speed up developments and get CGMs into many extra arms.
Early final yr, for instance, January AI topped up with a further $8.8M; whereas Zoe bagged a $53M Sequence B in May 2021 (recently expanded once they added Balderton as an investor). Ultrahuman additionally introduced a $17.5M in Sequence B (in August 2021); whereas Signos raised a $13M Sequence A in November.
As extra knowledge flows, it’s a protected wager that rather more VC money will observe.
Ultrahuman’s PR factors to the dimensions of the addressable potential market — speaking about an rising “metabolic well being disaster”, and claiming that some 88%+ of Individuals (and virtually 80% of the worldwide inhabitants) are “coping with a metabolic dysfunction”; and thus may doubtlessly profit from becoming a member of its “Cyborg military”, because it manufacturers early adopters.
So the potential addressable market is big. Though any such wider onboarding seems to be like it should entail a steep studying curve — as startups search to push past the low friction pond of early adopters and efficiency lovers and step outdoors the quantified self and biohacking communities the place this tech will naturally thrive.
A giant a part of Ultrahuman’s community-building efforts deal with encouraging customers to share particular person experiences and ideas through invite-only Cyborg Slack channels and Townhalls, in addition to signing up sporty influencers to evangelise the advantages of “efficiency fuelling” and different biohacking strategies that feed the aim of sporting a CGM.
“The world presently has over 500M+ people who find themselves diabetic however in the event you have a look at the issue holistically, you’d discover that there are virtually 600M+ pre-diabetic folks,” its PR goes on to say, earlier than suggesting the treatment: CGM expertise mixed with “well being rating algorithms” and “prompt well being nudges” — which it argues “may assist tens of millions enhance and assist management / reverse this disaster”.
Whether or not tens of millions of individuals might be offered on sporting a sensor in their pores and skin stays to be seen.
However the expertise might nicely evolve so it may be much less invasive — and extra mainstream-friendly — with out shedding an excessive amount of accuracy. At which level there’s no cause to assume it wouldn’t develop into an ordinary little bit of health equipment.
Whether or not a metabolic tracker subscription service is one thing tens of millions of individuals will shell out for each month is one other query. However when you’ve had a taster of this type of knowledge entry it may be addictive. Even when you might also really feel a bit ‘watched’ and judged because the sensor feeds again knowledge in your way of life selections and the software program scores how healthily you reside.
It’s humorous to think about that the world’s unhealthy pursuit of one thing candy to eat might, over time, get commercially rerouted into monitoring and biohacking the rollercoaster trip of blood sugar — which ought to at the very least be a more healthy fixation than blindly chasing the following sugar excessive.