In the Hearconomy Podcast: 8.5 million people in Germany have the metabolic disease diabetes. They have to measure their blood sugar several times a day. Until now, this has been done with test strips for blood samples and a prick in the finger. But the health-i Award winner DiaMonTech now makes it possible to measure without pricking.

Click here for the podcast in German and the transcript in English:

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Intro HostMatthias Ruttkowski: A little prick like can be quite annoying and often hurts,whether it's a mosquito bite in summer or you've accidentally grabbed somethingsharp in the kitchen.

Diabetes isa widespread disease and for many people this little prick on the finger ispart of their daily routine. There is a startup from Berlin that has developeda solution that really has completely revolutionized blood glucose monitoringand it is precisely this startup that won first place in this year's health-iAward, which is presented by Techniker Krankenkasse and Handelsblatt. The shortversion of their idea is: non-invasive measurement. I talked to ThorstenLubinski about how this works, what the solution looks like and what thestartup's next steps are. Thorsten is co-founder and CEO of DiaMonTech. HelloThorsten!

TL: Hello,nice to be here!

Host:Thorsten, I've set the bar very high for you. In a nutshell: what is yoursolution?

TL: Oursolution is non-invasive, which means you no longer need a needle to measureyour blood sugar. From the user's point of view, it works a bit like thefingerprint sensor on a cell phone: you put your finger on our sensor, you waita few seconds and then you see the blood glucose value on the display - withoutblood, without pricking or unpleasant circumstances.

Host: Reallyno minimal prick?

TL: Noprick, no nothing. We use a new type of laser called a quantum cascade laser.We use it to send invisible light into the skin and stimulate the glucosemolecules. You can imagine it like this: There are a lot of people in a discoand a few of them like rock music. How do you find them now? Quite simply: youplay rock music and then count the people who start dancing. That's what we dowith the laser. We send light into the finger, the glucose molecules move,generate a little bit of heat, just as the rock musicians start to sweat whenthey dance, and then we measure the temperature difference on the outside ofthe skin. So we can tell how much glucose you have in your body.

Host: Whyis that so difficult? The idea sounds simple as you presented it with the rockmusicians. Why hasn't this been around for much longer?

TL: Bloodsugar is present in the body in a very low concentration, so very few rockmusicians in the disco. They are transparent in visible light, the skin is alsovery different for you and me and today is different from tomorrow. So thereare a lot of side issues to work on in order to actually find the glucose. Thespecial feature of our laser, and it hasn't been around for very long, is thatwe can stimulate the glucose very specifically. We talk about the glucosefingerprint region in this area. This is what we are doing in a new and uniqueway, which no one else has done before us.

Host:Thorsten, how did you as the DiaMonTech team come up with the idea ofnon-invasively measuring blood glucose? What was the impetus, how can I imagineit?

TL: Theinvention came from the mind of my co-founder Prof. Dr. Werner Mäntele and hehad one of the very first of these lasers in his laboratory, 25 years ago, totest what he could actually do with them. A few members of his working grouplive with diabetes and they had an idea: let's see if we can see glucose in theskin. As a result, and this took a few more years of research, they then createda proof of principle. A refrigerator-sized device in the laboratory that wasthen used to measure sugar in the skin for the first time. I was in the USA atthe time, I had a different start there and had a few extra kilos on my ribsdue to the good Californian cuisine. I then wanted to know, ok, what do I needto do now to get back into shape a bit better. Then you find out very quickly,ok, you have to see how your glucose develops. Glucose is a very good biomarkerfor all your metabolic functions in the body. Then I was very surprised that Ihad to prick myself to find out my blood glucose level. I then researched whatother options there were and found a publication by Prof. Mäntele. I wrote himan email at one in the morning saying that I would like to measure bloodglucose non-invasively. And ten minutes later he wrote back that it was still alaboratory device and that he would like to commercialize it. I don't think I'mstepping on anyone's toes when I say a German university is not the beststarting point for a start-up and that's how we met. We discussed back andforth and then founded DiaMonTech in 2015 and have been working on turning thislarge device into a consumer-grade device ever since.

Host: Howcan I imagine going from this refrigerator-sized device to this small box? Youhad it with you at the health-i Award, which we presented in Hamburg. You couldreally see how it works and what dimensions it has. How did you get there? Didyou occasionally think: maybe it wasn't such a good idea after all, I'm goingto give it up and move on to another idea, or did it feel more like a runawaysuccess?

TL: Acertain degree of frustration tolerance is required, especially in the hardwarebusiness and in medical technology. In our case, we built thisrefrigerator-sized device with laboratory equipment that is very large becauseit has to be easy to assemble and disassemble. We then developed a device thesize of a shoebox with components that can be bought easily, so to speak, butwhich are not optimized for glucose detection. And then we learned what weneeded in order to develop our own components ourselves, which we were then ofcourse able to make a little smaller. So we have a very nice path fromrefrigerator-sized to shoebox-sized to now cell phone-sized and hopefully atsome point it will also be in the watch.

Host: I'm lookingdown at my wrist, I've got a smartwatch. Is there a chance that one day peoplemight no longer need one of your boxes, but that your laser technology mightalso be built into a smartwatch?

TL:Absolutely, that's the big goal for the future. Every step of the downsizingprocess, as we learned in the first two downsizing steps, always takes a littletime and you also learn a lot in the process, to put it positively. You fallinto a lot of traps that weren't so clear before. The integration of the sensoron a chip that is then smaller than my fingernail is something we have planned,something we will tackle and at some point the sensor will also be available inthe watch. But that's still a bit up in the air.

Host: Andhow far along are you now?

TL: We'venow reached the stage where we have concepts. We have a good idea of what weneed to do to achieve this. But the actual implementation will come after theapproval of the handheld device

Host: Havebig players like Apple, Google or whatever you call them already called?

TL: Yes, weactually already have Samsung, a very well-known tech player, on board as aninvestor. But we also have other very interesting investors such asInvestitionsbank Berlin here from Germany and other German healthcare orinternational healthcare investors. Diabetes is a global topic, many people areinterested in it. A system like this is also very interesting becausenon-invasive measurement is much easier for the user. With frequentmeasurements, I know my blood sugar better and can adjust myself better, managemy diabetes better and have far fewer long-term problems.

Host:You've just mentioned that a German university might not have the bestreputation in the start-up environment. Nevertheless, the German market is alsoa great springboard. I've met a few medical start-ups who have said that onceyou have this certification, these approvals in Germany, even with the EUstandard, then it's a springboard into the world.

TL: We arestill in the development phase, but we see it similarly. On the one hand,research is simply very, very strong in Germany and Europe in general.Commercialization is perhaps better developed in the USA or China, so it'sfaster and you get better financial support. We are already very strong inresearch here, especially when it comes to new technologies such as this newlaser technology.

Host: Whatkind of feedback do you get, on the one hand from patients with whom you arealready testing it and what kind of feedback do you get from the healthcaresystem?

TL:Patients love the fact that they no longer have to be pricked. That's whateveryone wants. Especially because it's not just the prick itself, but alsoeverything that goes with it: taking out the drop of blood and putting it onthe test strip. You have waste afterwards and you have to dispose of it. If youimagine going out for a nice dinner somewhere in the evening, it's not pleasantfor the person who then wants to measure their blood sugar. Getting our systemout, putting your finger on it, is much, much easier.

Host: Thisnon-invasive measurement makes everything much easier, much quicker and ofcourse more flexible, if I may summarize it like that.

TL:Absolutely, that's exactly right. Plus, we don't produce the waste either. It'salways waste smeared with blood and each test strip is actually its own biolab.I need it every time I take a measurement and we no longer have any of that.

Host: Whatare your experiences in the healthcare system? Are you welcomed with open armsor are there other people who produce these test strips, for example, who say:let's keep them down so that our business model doesn't shake so quickly?

TL: I don'tknow whether, as a start-up, we are immediately seen as competition for abillion-dollar company that sells test strips. We talk a lot to diabetologists,we talk to health insurance companies, we talk a lot to pharmacies and they allthink it's a good idea. But of course we need an approved device and that isnow one of our next milestones: that we get our device approved so that it canthen go onto the market. And I actually believe that the test stripmanufacturers are now also looking at what will happen in 5 years' time?

Host: Youwon the health-i Award 2024 from Techniker Krankenkasse and Handelsblatt withyour blood glucose monitoring system. There were lots of people from thehealthcare sector at the event, other start-ups, but also investors, businessangels and, of course, a specialist audience such as journalists. What do youtake away from this award?

TL: Firstof all, it's a very prestigious award from Techniker and Handelsblatt, whichare big names, very well-known names. That has already attracted a lot ofattention. I've been getting lots of inquiries from all sorts of differentpeople over the last few days and that's super exciting. We now have to sortthrough them and see in which order we work through everything. But I'm reallylooking forward to it! I really enjoyed the evening, I really enjoyedexchanging ideas with other startups. The quality of the start-ups is simplyvery, very high, and the quality of the jury was also very high. It was areally great evening and we are delighted to have been part of it. The prize isalso nice and has found its place here in our office. It just looks differentwhen you walk through the lobby, look at an award like this and can say: wecame first here.

Host: Youhave to continue to develop, just like any other company. Otherwise you will beovertaken at some point. What's next, what else can we look forward to?

TL: Nowwe're diving into the depths of approval, which is great. We're really lookingforward to that. We've just completed a clinical trial where we've shown thatour technology measures at a similar level to minimally invasive or invasivedevices. Now it's time to take the data, put it all together and then gothrough the approval process. Here in Germany for the CE mark as a medicaldevice, but also in the USA for FDA approval. That will certainly keep us busyfor a year and a half until we get to the point where we can say, ok, now wehave an approved device with which we can enter the market.

Host: Now,of course, your sensor can also collect data and data is the foundation of ourdigital economy and, of course, in healthcare. Without data, you don't need tocome up with the idea of developing this further. How can you perhaps usemodern technologies, such as artificial intelligence, to work on your idea evenfurther and offer additional solutions?

TL: Weactually already use artificial intelligence. What we do is record atemperature spectrum and then have to translate it. Artificial intelligence andmachine learning are already being used for this. But you're right, from theuser's point of view, your measured value remains on your device for the timebeing. You can also forward your data to your phone and connect it to GoogleFit or Apple Health to see what effect 110 minutes of walking or an ice creamin between has on your blood sugar levels. If you want, you can also donate thedata to us, so that we can perhaps do an evaluation at some point: is Hamburghealthier than Berlin or is the area around a fast food restaurant less healthythan the area where all the organic supermarkets are. We also need to find outhow diabetes can develop, both positively and negatively. Our idea is that youlearn something about how you move, what kind of eating habits you have. Andwhether it might be worth skipping the cake snack in the afternoon. Thenhopefully you will see an improvement in your diabetes over time. But it canalso be valuable information for healthy people who simply want to eat a littlehealthier and lose weight. Maybe we can help prevent diabetes from developingin the first place.

Host: Nowyou've said that you work from the user's point of view. Now we have to behonest: you won't get very far in life with Love, Peace and Harmony. Let's takea quick look at the whole thing from an economic perspective. How do you earnmoney now?

TL: We earnmoney by selling our device to the health insurance companies and the healthinsurance companies pass this on to their users. So for the end user in abilling system, our system will hopefully be free of charge. That's what we'reworking towards and why we're also in discussions with the health insurancecompanies. We are currently in discussions with the health insurance companiesand I think it will end up with us renting out our device for €150 a month. Ifa user no longer wants it, they can return it. And then someone else gets it orwe take it back, so it's a very simple exchange of the device.

Host: Andwe're keeping our fingers crossed that this happens as quickly as possible andthat you can help lots of diabetes patients to be able to measure their bloodglucose levels non-invasively. Thorsten, thank you very much for talking to us!

TL: Thankyou very much!

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