Apple Watch for Diabetes: The Latest on Apple's Plans for Non-Invasive Blood Sugar Monitoring

[MacRumors]

For many years now, it has been rumored that the Apple Watch will eventually gain non-invasive blood sugar monitoring capabilities, which would enable millions of people with diabetes to track their blood glucose levels without needing to prick their skin with a needle or wear a dedicated continuous glucose monitor.

According to Bloomberg's Mark Gurman, Apple recently shifted oversight of the project from its platform architecture chief Tim Millet to Zongjian Chen, a senior engineer overseeing advanced technologies within the company.

He framed this change as positive news for the project, which has apparently been in development for more than 15 years.

"Some view the transition as a sign the work may finally be progressing to a point where Chen, known as someone who delivers, can ramp up development of the technology into an eventual consumer-grade offering," he said.

In 2023, Gurman reported that Apple's system would rely on a laser that would emit light under the skin to determine a person's blood glucose level.

"The system uses lasers to emit specific wavelengths of light into an area below the skin where there is interstitial fluid — substances that leak out of capillaries — that can be absorbed by glucose," he said. "The light is then reflected back to the sensor in a way that indicates the concentration of glucose."

An algorithm would ultimately determine a person's blood glucose level, and the feature could also alert users to potential signs of prediabetes.

While the project has new leadership, the Apple Watch is still unlikely to gain non-invasive blood sugar monitoring for several more years, if ever. But if Apple eventually achieves this moonshot, the Apple Watch would provide diabetic people with a more comfortable and convenient solution for keeping track of their blood sugar.

Article Link: Apple Watch for Diabetes: The Latest on Apple's Plans for Non-Invasive Blood Sugar Monitoring

 

[DocMultimedia]

This would be a superb addition. I really hope in becomes feasible in a year or two.

 

[Mega ST]

I think health monitoring is the breakthrough on the mass market. Aging boomers and blood sugar monitoring = deal.

 

[brett_x]

My wife and I have a rule that we won't discuss things around dinner time... because "hangry" really is a thing.

Now I see our future:
Me: "Honey, how's your glucose, because I have a question or two about our credit card bill."
Wife: Looks at watch. "Not great. Lets talk later."
Me: "Okay.. grab a snickers or something... it's gonna be a doozy."

 

[Slix]

As a type 1 diabetic for most of my life, this would be a game changer and I would buy one immediately if it was added to the Apple Watch.

 

[wonderings]

This would be absolutely massive if they could make an accurate glucose monitor without puncturing the skin. I am very skeptical that they could do this though would love it if they did as a T1 Diabetic. Accuracy of the read is paramount here, if it cannot be trusted completely then it is not a solution for diabetics. Now IF they can do this then they have disrupted a multi billion dollar industry with something that costs far less than what is paid for a year just with glucose monitoring alone. This would truly make an Apple Watch a must have for ALL diabetics and I would never question whether I want to switch to another watch.

 

[Shalev Lazarof]

The holy grail feature of the Apple Watch.

 

[IIGS User]

Not just a watch feature, but a medical breakthrough in general.

The application isn't only limited to a wearable. During recent hospitalizations I was put on high dose intravenous steroids that massively mess with your blood sugar. At least 4 times a day they're sticking your fingers checking it. That, and the anti clot medication they jab you with are totally not fun.

Being in the hospital in general is totally not fun. But making technology that could accurately check blood sugar without piercing the skin would be revolutionary.

 

[Radeon85]

If they can do non-invasive testing, then sales for a new watch would be insane.

 

[Wrylachlan2]

I’d bet any amount of money that well before we get blood glucose monitoring accurate enough for diabetes monitoring we’ll get a less accurate at a point in time but acceptably accurate over time glucose test that can tell you whether you have pre-diabetes. The kind of accuracy needed for diabetes monitoring is a tight tolerance. But a broader measure could still be very very useful and technologically more feasible.

 

[mrgraff]

This would be absolutely massive if they could make an accurate glucose monitor without puncturing the skin. I am very skeptical that they could do this though would love it if they did as a T1 Diabetic. Accuracy of the read is paramount here, if it cannot be trusted completely then it is not a solution for diabetics. Now IF they can do this then they have disrupted a multi billion dollar industry with something that costs far less than what is paid for a year just with glucose monitoring alone. This would truly make an Apple Watch a must have for ALL diabetics and I would never question whether I want to switch to another watch.

Absolutely massive. I hated finger sticks, even changing my CGM biweekly is mildly annoying, and I don't wear watches. But this could totally change my mind.

 

[b.williams]

Won’t happen. Certainly not in the watch first.

 

[Boil]

As someone who recently lost a foot to Type 2 diabetes, this would be a godsend...!

 

[weckart]

This would be a superb addition. I really hope in becomes feasible in a year or two.

Per the article:

While the project has new leadership, the Apple Watch is still unlikely to gain non-invasive blood sugar monitoring for several more years, if ever.

So, I wouldn't hold my breath. Even the current monitors using interstitial fluids aren't all that accurate, so I just wonder how less accurate a laser would be.

 

[mlayer]

I don't see much in this that leads me to believe anything on blood glucose monitoring is happening soon. Shifting the project from Millet to Chen may be merely a matter of getting something off Millet's plate. The industry as a whole appears to be running into limits in terms of the accuracy and efficacy of their solutions. There was an illuminating article at The Verge from April about the healthy, non-diabetic author using a CGM and how it bewildered everyone from users to medical professionals. Apple will have to be even more careful about how they pitch this feature since users will be likely to gear their lives around it despite it being basically a single data source that is sure to be less accurate than more invasive options. As a Type 2 diabetic I am looking forward to this myself, though I am less sanguine about the initial versions of it.

 

[Macaholic868]

Judging by “Smart Siri” this feature will debut in WatchOS 99.

 

[one more]

“While the project has new leadership, the Apple Watch is still unlikely to gain non-invasive blood sugar monitoring for several more years, if ever.”

This is a tough one and the sentence above gives a good summary on the topic. So far neither Google nor Apple managed to deliver, despite their virtually unlimited resources.

Currently nothing beats the accuracy of the old good finger prick test. The most advanced (invasive) CGM systems on the market (Dexcom & Abbott) are close, with their MARD values at about 8, but even they lag behind.

 

[HaHaRich!]

This would be a superb addition. I really hope in becomes feasible in a year or two.

Eh. I use a continuous glucose meter already, it’s ok. The laser tech isn’t new; interstitial glucose levels are already imprecise and the laser methods are less accurate than the physical needle sensors. But the big hurdle is going be on the legal front from Libre and Dexcom, they will be doing what they can to protect their market, and get their non-invasive options out before Apple does

 

[AL2TEACH]

This would be absolutely massive if they could make an accurate glucose monitor without puncturing the skin.

Apple would not be able to keep up with demand for the watch.

Accuracy of the read is paramount here, if it cannot be trusted completely then it is not a solution for diabetics.

Get this wrong and the lawsuits would bankrupt Apple.

 

[I7guy]

Apple would not be able to keep up with demand for the watch.

Get this wrong and the lawsuits would bankrupt Apple.

The watch won’t be classified as a medical device. IMO, making lawsuits much more difficult.

 

[jbernie]

Medical device, and it would need to be one = FDA (etc.) approval and likely also = review of all future devices if the device changes. I would think this is more likely a separate distinct model as opposed to being included in the standard watch. Also, being realistic, most of the population doesn't need this data, but for those who do *really really* need it and need it to be good they need to be really careful on the promises. For most people it would be similar to doing your blood pressure on a free machine in the pharmacy area of your grocery store. It could definitely have potential to help catch things, but many times you will know because type 1 diagnose is pretty sudden.

The technology isn't really measuring "blood glucose", it is really non-invasive CGM "sensor glucose" which actually measures interstitial fluid and very different. A blood glucose test (finger prick) is real time data (with margin of error), sensor glucose is typical shows what you were 15 or so minutes ago, though they can be identical if you don't have food, exercise, bolus insulin or other influences in play.

The Mean Absolute Relative Difference (MARD) will be critical, you need to be below 10% to be a more proper device. When you think about what diabetics live with, a 10% MARD even if your blood glucose is at 100 is still a pretty big difference, but it gets way worse as you deal with much higher levels. My CGM and glucometer are both around 8% which means putting numbers side by side is nowhere near an exact science, but hopefully there is an overlap and that is likely where you really are.

I know of non-invasive blood glucose discussions happening back in the very early 90s (get off my lawn etc.), so while I would really love to see something like this happen, I am still waiting 35 years and endless promises later, so my excitement levels haven't really moved the needle (diabetic pun) with all this talk.

 

[andiwm2003]

All of the big players in diabetes have tried to do this for the last 40 years. Nobody was successful. The physics has not changes and lasers for all wavelength were available for decades. It's more than unlikely that apple can solve this in a watch when ev everybody else couldn't even make it work with a dedicated larger device. In addition the precision required for diabetics is also hard to achieve. We will wait for this for another 15 years.

 

[LlamaLarry]

As a current Dexcom G7 user, this is an interesting goal and would be an instant buy for both my wife and I. Red Cross now uses a non invasive hemoglobin test which takes longer, has a bulky reader, and a finicky, cable connected, thumb holder to get the job done. Since there is not a hospital version of this for glucometry leads me to believe we are a loooooong way from it appearing in a consumer device on my wrist.

 

[mannyvel]

All of the big players in diabetes have tried to do this for the last 40 years. Nobody was successful. The physics has not changes and lasers for all wavelength were available for decades. It's more than unlikely that apple can solve this in a watch when ev everybody else couldn't even make it work with a dedicated larger device. In addition the precision required for diabetics is also hard to achieve. We will wait for this for another 15 years.

Device manufacturers aren't crazy like Apple is.

When a device manufacturer asks its people "how do we do this," they see the cost, the development time, the current options and they say "what we have is good enough. Why blow tens of millions on R&D?"

Dexcom et al are already making millions off of devices that are clunky, but functional. Do they really want to spend $50 million to get a watch form factor with lasers when a plastic applicator, a plastic disc, and a fancy needle are all they need?

I think we all know the answer to that.

If it can be done it'll be Apple that does it.

 

[jz0309]

Technology is evolving and at some point in the future this will be available as a true CGM.

As for AW, it'll likely be similar to the current hypertension functionality, it'll give you a trend but not absolute numbers. Cause to do the matter, it'll have to be a medical device and I just do not see Apple turning the regular AW into a medical device.
If Apple have the technology "solved" they could release a "Apple Watch Health" that could be a medical device at 5x the cost, but I doubt that Apple will enter the tough regulated device space