eoamk

To follow-up, "commercially available" products from a simple search appear to all be vaporware. I did see that cyclists have been estimating lactate thresholds through breathing rate/expiration volume measurements

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

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

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

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

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

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