The diabetes world is abuzz with reports that the new Apple Watch will include a non-invasive blood sugar sensor.
Non-invasive glucose monitoring technology is considered a holy grail of the industry, and the report has prompted some skepticism that Apple has got it right before any of the other many tech firms working on the same problem. If the reports seem a bit unreliable, it didn’t dampen enthusiasm in the world of tech blogs, where they were widely covered and discussed.
As this is still just an unconfirmed rumor, we naturally lack details, but that hasn’t stopped many from speculating on its nature. A writer at 9to5Mac, for example, has guessed that Apple may employ infrared sensing or a tag sensor that could be taped to the skin under the watch.
The source of the rumor appears to be a Korean information technology site named ETnews. The original article, which was published in Korean, indicates that the new Samsung Galaxy Watch 4 will also be equipped with glucose measuring. The Samsung device reportedly will employ Raman spectroscopy technology to measure blood glucose.
The Apple Watch is already a lynchpin of glucose management for many tech savvy people with (and without) diabetes. The device neatly syncs with the Dexcom G6 continuous glucose monitor, and can be “hacked” to display glucose information from the Freestyle Libre through the use of third-party software, making glucose checks about as easy as a brief glance at the wrist. Apple also has a relationship with OneDrop, a smart traditional glucose meter—the tech behemoth even sells OneDrop glucose monitoring kits in its own Apple stores, perhaps an indication of how seriously Apple takes the idea of glucose measurement.
Whether or not Apple has truly cracked non-invasive glucose monitoring, the news is just the latest and perhaps most dramatic indication of the extent to which glucose monitoring has been adopted by the mainstream.
Glucose monitoring fever goes far beyond Apple and Samsung: a New York Times article this week covered the proliferation of glucose monitoring subscription services. These companies, which include Levels, Nutrisense and January (among others), provide users with off-the-shelf continuous glucose monitors (typically the Freestyle Libre II) and access to mobile apps and experts that try to help make sense of the data. These businesses are not typically marketed to people with diabetes or even pre-diabetes, but rather to health-conscious individuals.
While people with diabetes are not as likely to take advantage of these sorts of subscription services—none of which are covered by insurance—their spread can only be good news for the diabetes community. The more people interested in glucose monitoring technology, the more businesses will be motivated to innovate and compete on price. If CGM technology goes truly mainstream, it should only accelerate progress to the day when nearly everyone with diabetes will have access to affordable CGM technology.
One might also hope that mainstream CGM use could actually curb the growth of Type 2 diabetes. Many early non-diabetic CGM users are already concerned with developing diabetes and other metabolic issues, and use the CGM primarily to help inform better eating decisions. Imagine some day in the near future, when an entire generation has automatic blood glucose data on its smart devices. Will people begin to take the negative metabolic impact of offending foods more seriously?
The rise of glucose monitoring among people without diabetes has been pushed by a perfect storm of health and technology trends. To begin with, there’s been a general explosion in biometric tracking (and biohacking): with smart phones, step counters, sleep and heart rate monitors and so on, more people than ever are analyzing their own health data on a daily basis and using it to inform their lifestyle decisions. At the same time, there’s been a rising chorus crying outrage over the health effects of the highly-processed modern diet: sugar is widely referred to as “the next cigarettes,” and keto and related diets have skyrocketed in interest, among people both with and without diabetes. Additionally, glucose monitoring offers one of the very best opportunities to practice personalized healthcare—one of the dominant fads in medicine today—by tracking one’s unique individual responses to different foods and types of exercise.
Combine all of these trends, and you get a market of affluent, tech-savvy, health-conscious, and highly motivated people that see glucose monitoring not just as preventive medicine but actually as one of the best ways to unlock the body’s potential. Check out this recent article in Wired, which proclaims that the Supersapiens CGM program could be “the secret to” optimized athletic performance.
There are now a dizzying number of companies, many of them startups, racing to put the first reliable non-invasive continuous glucose monitor on the market. This race has prompted a great deal of excitement and speculation among people with diabetes, fans of technology, and investors. For a more sober assessment, read this very comprehensive review, which enumerates in professional detail the pros and cons of the different technologies that have shown potential.
Even if the Apple and Samsung rumors are true, it’s my guess that a 2021 smart watch will not yet be accurate enough to replace the CGM or fingersticks for people with insulin-treated diabetes. Dexcom, for example, had to meet very high standards to get its system approved by the FDA for treatment decisions, and even today the system comes with several caveats. It seems unlikely that a watch manufacturer would be able to match that level of accuracy on its first try with an ancillary feature. Nevertheless, it’s clear that many businesses and investors across the world are betting big on widespread adoption of continuous glucose monitoring, a development that people with diabetes can celebrate.