The holy grail: What you need to know about wearables and glucose monitoring

It's what everyone is shooting for, but is it possible?
Glucose monitoring state of play
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After taking care of our heart and attempting to tackle sleep disorders, what will be the next big health monitoring challenge wearable companies will try to tackle? There's growing evidence that non-invasive glucose monitoring is next on the agenda.

Traditionally, it's a process that involves drawing blood to take a measurement. The first company that is able to build a smartwatch or a fitness tracker that reveals your blood sugar levels in real time, will have something truly groundbreaking on its hands.

Read this: What I learned wearing a real-time blood glucose monitor

But what progress has been made so far – and who is trying to make our wearables a better fit for diabetics? We take a look at the current state of play in building those glucose monitoring devices.

Glucose monitoring: Why it's a big deal

The holy grail: What you need to know about wearables and glucose monitoring

Let's dream for a bit, shall we? Imagine you're wearing the fancy new Fitbit and you're pretty thirsty. So you get yourself a Coke and start drinking. All of a sudden, your Fitbit sends you a notification.

It's detected a massive intake of sugar, and you all of a sudden see your glucose levels in real time, soaring after inhaling 39g of the sweet stuff. That's the big sell with glucose monitoring: once you can see what sugary foods do to your body in real time maybe you'll be less likely to reach for a soda, or even a donut or cookie, the next time you want a delicious snack.

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More specifically, that's the big sell with non-invasive continuous glucose monitoring. It would essentially track your glucose levels like wearables track your heart rate now. You'd have a daily, minute-by-minute break down throughout your day.

You could then better and more instantly tweak your diet. And since diet is half of maintaining a healthy lifestyle, it could completely change people's lives. There are different levels of glucose monitoring, however.

Non-invasive continuous glucose monitoring would more likely impact everybody, largely because you'd get that near-instant feedback loop between what you eat and how your glucose is affected.

The level below that is just non-invasive glucose monitoring. This would allow something like a fitness tracker to track your glucose, but not all the time. Perhaps at hourly intervals. It would be nice, but it's not as groundbreaking as continuous glucose monitoring.

Let's also not forget that there are around 100 million Americans living with diabetes. Non-invasive glucose monitoring would be a major quality-of-life upgrade, saving them a prick on the finger.

Glucose monitoring: Who are the big wearable players?

The holy grail: What you need to know about wearables and glucose monitoring

Who isn't a player? Every company that makes wearable technology has at least half an eye on the possibility of non-invasive continuous glucose monitoring for its products.

The biggest player in the game is obviously Apple, which has been rumoured to be interested in glucose monitoring since before the Apple Watch was even a thing. In fact, CEO Tim Cook was rumoured to be testing out a continuous glucose monitoring device before the Series 3 arrived on our wrists.

We've seen Apple granted a patent for technology that sounds a lot like potential non-invasive glucose monitoring. It uses a light-based optical monitor that measures substance in blood and then sees how it changes. Basically, checking your blood for glucose.

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The other big player is Fitbit, who has been making gains – and allies – with companies like Dexcom, one of the biggest names in glucose tracking… but we'll get back to them in a bit. Fitbit partnered up with One Drop to bring diabetes management to Fitbit smartwatch owners. Then there's the UnitedHealthcare partnership, which is a pilot program that'll see a whole bunch of people get a Fitbit and Dexcom monitor to see how activity impacts their diabetes.

Fitbit's biggest stake in diabetes, however, is its $6 million investment in Sano. This is a company that's working on a painless, coin-sized patch that can track your glucose. The way it works is that it reads the interstitial fluid just under your skin, which doesn't involve any pain to get a reading.

The thing about that is Dexcom has a new device called the G6, which essentially does what Sano wants to do. That device has FDA approval and is adding the ability to transfer glucose monitoring data directly to the Apple Watch soon, according to Dexcom's CEO.

Finally, there's Alphabet's Verily. Verily and Dexcom are working on its G7 device together that will track glucose, and Dexcom president Kevin Sayer told Wareable that the same tech that powers the G6 will also power this new joint product. It promises to be smaller than the current tracker too.

There's also the curious case of LifePlus, which claims to be the first wearable company to crack non-invasive continuous glucose monitoring. It's currently undergoing clinical tests in five cities, but we're dubious. If they have pulled it off, then we wonder if the crew is drawing enough data to advise on dosage.

That is a good question for all the players.

Glucose monitoring: What's possible?

The holy grail: What you need to know about wearables and glucose monitoring

It's one thing to be able to do non-invasive continuous glucose monitoring, it's another thing to be able to do it so well it can help advise on insulin dosage for those with diabetes.

While the first bit could be possible, it would have to be able to advise on dosage to be used as a reliable medical device for people with diabetes. Valencell CEO Steven LeBoeuf told Wareable that that's pretty much impossible.

"There will literally be stem cell regenerated pancreas cells in the body before there is ever anything that can be a truly noninvasive glucose monitor for dosing insulin," he said.

The problem? The laws of physics. You just can't draw that much data from things like interstitial fluid and need a real drop of blood, which requires a pricked finger.

However, LeBoeuf also says that other methods – for non-diagnosing reasons – are actually working well. In fact, research by big companies like Apple may help others advance the technology.

While it's not the true holy grail, continuous non-invasive glucose monitoring seems to actually be possible. Even better, some of the biggest players in wearables are working toward it, so it doesn't look like anyone is going to lose out when we can all finally see how a can of Coke affects our sugar.