Glucose Sensing Likely Too Challenging to Include in First-Generation iWatch

Discussion in ' News Discussion' started by MacRumors, Feb 26, 2014.

  1. MacRumors macrumors bot


    Apr 12, 2001

    Apple's iWatch has been rumored to include a glucose monitoring feature, but how that feature would be implemented is still unknown. One report from earlier this month indicated that a "Healthbook" app under development for iOS 8 will be able "to read glucose-related data," while another report has warned not to expect glucose sensing built directly into the initial iWatch. The two reports are not necessarily conflicting given the possibility of Healthbook interfacing somehow with third-party glucose-monitoring devices, but a new report from Network World argues that the technology is indeed too early in its development to be incorporated into a mainstream consumer device such as the iWatch.

    Heisler points to C8 Mediasensors and its non-invasive continuous glucose monitoring (CGM) device, the HG1-c, as an example of how this technology is still in its infancy. It's a relevant example as Apple has hired several research scientists and engineers from the now defunct company and is presumably using their knowledge to explore bringing CGM to the iWatch.

    The HG1-c device relied on Raman spectroscopy to indirectly measure a person's blood glucose level. This technique shines light through the skin in order to excite blood glucose molecules and cause them to vibrate. An optic sensor then analyzes the amount of light reflected off these vibrating molecules and returns a reading that is used to calculate an approximate glucose level.

    Though innovative, the technology has flaws that make it impractical for a wrist-worn device. The sensor unit was attached to a belt that was worn around the waist and required a large battery pack to operate. It also needed a gel to accurately measure light levels, which were influenced by ambient sunlight. This sunlight sensitivity was highlighted by former C8 employee Charles Martin, who spoke to Network World.
    Apple likely can overcome many of these limitations, but it will take time to transform the technology to the point where it is reliable enough to be used as a diagnostic or monitoring device. Once Apple improves the technology, it will need to receive FDA approval, which is a painstaking process with extensive clinical trials and documentation.

    If Apple goes down this route, it could take up to 18 months just to receive approval necessary to sell the device. Given this lengthy approval process and the fact that evidence of Apple earnestly assembling its iWatch biometric research team only started surfacing around early 2013, Heisler believes "the notion that this feature will appear in the first iteration of the device is highly improbable."

    Instead of measuring glucose levels, the iWatch may allow users to monitor glucose levels by importing them from a glucose monitoring device or by manually entering them into the accompanying Healthbook app for iOS. Apple is rumored to be working on the health and fitness app, which uses a card-based interface to track vital health statistics such as heart rate, weight and step count.

    Article Link: Glucose Sensing Likely Too Challenging to Include in First-Generation iWatch
  2. chrmjenkins macrumors 603


    Oct 29, 2007
    Interesting territory as it would potentially open them up to medical liability. Tread lightly.
  3. DZakDad macrumors newbie

    Feb 26, 2014
    Lots of hurdles

    Any device that measured glucose levels would have to get government approvals in any country that it was sold in. There are also different units of measurement used, depending on the country you're in. Think metric vs. non-metric. Recent law changes required that glucometers must be hard coded to the units used in the selling country. This would mean different SKU's.

    You're in an entirely new world when you've got a device that could make a person take potentially fatal actions - taking insulin or not. Potentially a huge, huge liability for Apple should somebody die.

    Non-invasive glucose monitoring has a lot of hurdles to get through before it'd be reliable.

    As a diabetic myself, this could be useful but I'm not holding my breath.
  4. taptic macrumors 65816


    Dec 5, 2012
  5. IJ Reilly macrumors P6

    IJ Reilly

    Jul 16, 2002
    Yet again we see the problem of being obsessed with the "watch" concept, especially when all the evidence points towards Apple being interested in the much broader category of wearable tech. This would likely take the form of a family of products, of which a "watch" is the least likely and certainly the least interesting.
  6. Rocketman macrumors 603


    The whole thing with iWatch is an accessory to your iPhone. One would obviously think someone with a Glucose monitoring (or other) requirement could wear yet another "sidecar" accessory clipped over the pant line inside against the skin. No problem.

  7. Old Muley macrumors 6502a

    Old Muley

    Jan 6, 2009
    Titletown USA
    They should just invent some kind of implantable iDevice and be done with it.
  8. Robert.Walter macrumors 65816

    Jul 10, 2012
    While I'm really happy this technology exists, I really feel sorry for the folks that have to deal with such issues (even more so for those w/o the tech to help them.)

    Hopefully one day, all this monitoring will lead to a breakthrough in prevention or cure!
  9. RoccoFan, Feb 26, 2014
    Last edited: Feb 26, 2014

    RoccoFan macrumors regular

    Aug 12, 2008

    This thing is beginning to sound more and more like the Galaxy S 4. All I'm reading about are a bunch of functions that maybe 5% of the population will actually care to use on a regular basis.

    This whole iWatch thing is BS. Just make a wider iPhone and put out an iOS version that doesn't crash my iPad and let's move on.
  10. JimmyMac macrumors newbie

    May 19, 2002
    St. Louis
    Dexcom could talk to the iWatch?

    Dexcom is a CGM company and is already partnering with insulin pump companies to develop pumps to read BG readings from the Dexcom transmitter / sensor. It would be slick and very easy for a watch device to talk to the Dexcom sensor / transmitter like an insulin pump can.

    I would leave the CGM research and development to the CGM experts. And the Dexcom sensor is so accurate and stupid easy, it can only be explained as magic, BTW. It would be awesome if Apple worked with them to develop the iWatch to talk to the Dexcom transmitter / sensor. I'd buy that in a heartbeat!
  11. OS X Dude macrumors 6502a

    OS X Dude

    Jun 30, 2007
    My grandad was a Type-1 diabetic, so this was interesting to read.

    As I understand it, clinical trials on dogs (wrong, but that's another story) for a series of injections to 'cure' the disease and all associated symptoms for around four years were well underway. Whether I've got parts of that muddled, I don't know, but I remember telling my grandad about it a few months ago.

    Funny to think there'd potentially be a 'cure' of sorts released before this was both feasible and certified. Great if they could get it working, however.

    EDIT: The animals were themselves diabetic, I think they'd done tests on some other animal and were planning on treating dogs next.
  12. Piggie macrumors 604


    Feb 23, 2010
    I may be wrong but the whole health aspect of the so called iPhone I can see as a dead end.

    Whilst health is all good, in reality it's not the mass market that's needed, unless it's just another toy for Apple to play with like the Apple TV.

    Whilst there are groups of people into this, it's not the vast country wide majority who are turned on by the whole health concept.

    By all means have these features as a bonus, but it's not going to be mass market in the same way a phone is, it's is total focus is health
  13. DZakDad macrumors newbie

    Feb 26, 2014
    There are devices like this already. A continual glucose monitoring system is often used with an insulin pump. The sensor is inserted under the skin and measures the glucose in the bodily fluid - not in the blood. Blood monitoring is much more accurate - hence finger prick testing. The sensors are generally good for 3-7 days and then must be changed. They are also quite expensive. The one I use costs about $70/sensor. The sensor transmits to my insulin pump and allows me to see the trend of my blood sugar levels.

    Non-invasive monitoring would be a blessing. Between glucose sensors and insulin pump devices I'm heading towards Borg status. While giving me better monitoring of my innards it's not a "no problem" scenario yet.
  14. OAK77uk macrumors newbie

    Mar 17, 2012
    Glucose Sensing Likely Too Challenging to Include in First-Generation iWatch

    Looks like the first rung on the ladder to total control & robotism!
    Sure it's what the world's looking for but not me I'm afraid.
  15. Rogifan macrumors P6


    Nov 14, 2011
    But Samsung has a watch and rumors are Google is doing one so of course Apple has to do one too. /s
  16. currentinterest macrumors 6502

    Aug 22, 2007
    If I recall, a few months ago Apple applied for a patent for a wrist glucose monitoring device. The market is not people with diabetes who need very accurate glucose levels, but people who want to avoid becoming diabetic. For the later, simple glucose range indicators is enough. One would primarily eat less sugar containing foods to change it.
  17. Rogifan macrumors P6


    Nov 14, 2011
    What is mass market that's needed? Certainly not the current crop of so-called "smart watches". I'd love to see Apple go in a different direction.
  18. charlituna macrumors G3


    Jun 11, 2008
    Los Angeles, CA
    I rather agree with this. I suspect that Apple's talks with the FDA were more about what is required for a health device to actually release, in order to know what paperwork to ask for before allowing such a device to be MFi. After all Apple wouldn't want to put their endorsement on a a device that wasn't an authorized health device.

    I like the idea of the healthbook even if just connecting to outside devices.


    But which came first the chicken or

    oh sorry wrong joke. i mean the rumors of the watch or the watch.
  19. vsighi macrumors 6502


    Jun 22, 2010
    San Diego, CA
    WOOW dude this is a grate innovation but If I was Apple I think I will invent a bigger screen iPhone :cool:
  20. unplugme71 macrumors 68030

    May 20, 2011
    I'm all up for a healthbook app that integrates with iCloud, iDevices, Apple TV w/ potential for camera and fitness apps, iWatch and activity trackers, a meal/nutrition integration, etc.
  21. T-Will macrumors 6502a


    Sep 8, 2008
    If only Apple had experience shrinking down bulky technology...


  22. theOtherGeoff, Feb 26, 2014
    Last edited: Feb 26, 2014

    theOtherGeoff macrumors regular

    Jun 18, 2010
    Even if not diagnostically accurate, if the 'false negatives' are within clinical norms (It may overreact, but rarely under react), it may be a good first step for early warning.... (read: all use procedures will read "prior to action, confirm your BGL with your FDA approved and MD prescribed device").

    But in general, it will take at least one generation of 'wearable' BGM (noninvasive) with FDA approval to drive this down into the 'general computing platform' (which the iWatch is).

    Until then, if Apple can deliver an App platform for analysis/communications (reliable BT and notifications, and alerting), then I see them building the framework for that, and inviting 3rd Party Med device makers build the device and the app for the iOS platform. And stay out of the FDA fray, and just design the iWatch for 'non-diagnostic, advisory' purposes.'

    Why is that? Because if insurance pays for the monitoring, and the payment of the monitoring is through your AppleID, That's like printing money without the risk (a $19.99 app and then say $5/month to remotely monitor equals 25 bucks the first year, and 18 bucks a year after that... multiply by... a couple billion people who either have chronic HyT, Cardiac, or endocrine issues that would reduce net costs if monitored properly continually).

    That's why the device is less important ,and the transport (which from an FDA/HIPAA perspective is a lot simpler to standardize,even across regulatory geographies), is easier to build out.

    This all goes to the end game model of Apple building the appliance that you have, and building the infrastructure for others to ride on (AppleID, App Store, TouchID/security, Passbook (think HSA cards or Insurance accounts as payment for this)).

    Whether it be a picture of a skin lesion on your leg you want to send to your Derm MD (saving a 1/2 day drive and part of $130 office visit to be told it's a benign keratosi), or an upload of your sleep pattern to your sleep apnea tech to verify adjustments to your CPAP, or your week's history of BP to your Cardiologist for checking the dosing of a new med, all of this will require a secure data transport.

    Apple is in the lead on this, as they control the hardware and the encryption/transport (hence the TLS bug being so bad)... few others have that, and none at the scale. And Apple's model of 1 to 4 new devices a year, makes FDA validation of applications a lot easier (Validated systems are a pain. validating on 300 android devices would be impossible... 2 iPad and 2 iPhone devices and 1 new major OS, Not so much), makes them an early leader in 'consumer grade' diagnostic apps.

    And Apple, like BioTechs and Pharma, are comfortable with the long view. Let the technology mature... and any promising great tech can be acquired-bought-into early (BioTech is almost all based on M&A cashouts), and implemented when the medical world is ready. Remember, your MD has to accept both the technology, and the new diagnostic paradigm of continuous outpatient monitoring - most MDs can't handle 'big data' - it will take a generation of research, follow-up, and then med school curriculum upgrades adopting these as 'promising new technologies' before MDs (and more imporantly in the US, Insurance companies) start modifying their practice to encorporate them into their diagnostic/pricing model.
  23. Apple Key macrumors 6502a

    Apple Key

    Jan 4, 2012
    I think it really depends on the features. I have no idea what they have planned, but if they could theoretically have the following features (which would be extremely difficult and even more difficult to be accurate enough to be useful), I would buy one in a second:

    24-hour heart rate monitoring
    Blood pressure monitoring
    Oxygen level
    calories burned
    calorie intake

    Why not throw in temperature too. It could tell you right away if your temperature was lower or higher than typically is normal for you.
  24. sransari macrumors 6502

    Feb 11, 2005
    I like the idea of importing glucose level information from a stand-alone glucose meter. CGM technology is really inaccurate and unreliable at this stage, and I don't see the value in importing inaccurate and unreliable data, via CGM device, in to a healthbook app. crap in is crap out, thats what i always say!
  25. theOtherGeoff macrumors regular

    Jun 18, 2010
    Well 'The Collective' already tracks where you are, what you buy for food, when you sleep, when you wake up (smart grid electrical), when you talk to people, which direction you're moving, what roads your car is driving.

    Resistance is futile... you are being assimiliated;-).


    until fuzzy logic cleans up the mess. your cameras now focus based on years of looking at how cameras 'jiggle' (and really that's how the Hubble was refocused).
    If the hardware is 'consistently' inaccurate, progress can be made.

    As I stated, once the innaccuracies can be quantified and potentially adjusted and sighted in, then these become reasonable consumer grade advisories, and will likely provide good trend analysis, and drive for better 2nd generation devices.

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