With the release of Apple Watch, Apple has become more interested in health issues and has begun to invest significant resources in researching various functionalities that they could implement in their product. Among other studies, the company is interested in controlling blood sugar levels for people with Diabetes. This idea has already been in development since the days of Steve Jobs, who did not like the puncture of the finger necessary to measure the level of glucose. In 2018, a patent from Apple was published, which many people equated to the glucose meter in iWatch. Is everything ready for release?
Relevance of Problem
The problem of diabetes, both the first and second type is now at a high level. According to the World Health Organization, as of 2014, 8.5% of people over 18 have diabetes. In 2016, 1.6 million people died from this disease or from its complications.
For those who do not know, Diabetes – is a chronic disease that, due to a lack of control over it, leads to an increase in blood glucose levels. It can be caused mainly by two factors: reduced production of insulin (type 1) – a hormone that is responsible for the transport of glucose into the cell; or insulin receptor cell immunity (type 2). In one case, after eating candy, there is not enough insulin to seize the glucose from the sweetness and deliver it to the cell. And in the other insulin is enough, but the cells themselves do not use it.
For people who have already been diagnosed with Diabetes, it is a question of monitoring their condition and blood sugar. Dosed physical exertion, a healthy diet, control of body weight and quitting tobacco smoking can significantly reduce the risks of developing type 2 diabetes and monitor the existing types 1 and 2. Modern technologies, in the form of wearable electronics, make it easier to control weight and exercise.
Blood Sugar Monitoring
In many countries, glycemia levels are monitored at the doctor’s office by taking blood from a finger or a vein. Also, for a more thorough measurement can be used home blood glucose meters. In the case of them, the measurement technique is as follows: a disposable test strip is inserted into the device and the skin on the finger is pricked with a small syringe pen. The resulting drop of blood is placed in the window on the test strip and after a few seconds (or more) the person receives the result of blood sugar. It is worth noting that when using glucometers, the results do not have high accuracy and are used to make it clear whether you should eat or take a drug that lowers sugar (medications or insulin injection). It is also required for regular monitoring and adjustment of the dosage of medications.
All of these options are invasive, that is, those that require direct puncture of the skin and taking a blood sample for examination. So what did Apple decide to bring in innovation? On August 23, the company registered the patent “Reference switch architectures for non-contact sensing of substances“, which describes a sensor capable of determining the concentration of a substance in a sample. If we put this statement on the problem of diabetes, then we get the determination of the concentration of glucose (substance) in the blood sample. But is everything so simple?
The patent is based on an optical system, which is based on absorption spectroscopy technology. When exposed to light on a sample with a known wavelength, energy and other properties, the substance absorbs energy. At the output, the parameters of the incoming light change, which allows us to differentiate various changes in the substance.
The patent also states that the sensor will be able to be continuously calibrated, which will reduce the measurement error.
The company itself declares that at this stage there are problems that have yet to be resolved. The presence of artifacts, multiple other substances, the uneven distribution can affect the measurement error. All these moments affect the final figures of the desired substance. Measurement accuracy is especially important for people with diabetes, as low or very high sugar levels require immediate action by the patient and doctor. Until these problems are resolved, clinical trials are conducted, FDA approval, we will not see this sensor at Apple Watch.
Breathe in the Watch
At the end of 2018, Apple published another patent, but this time it is not based on blood. In particularly severe conditions in the exhaled air of diabetic patients, acetone can be smelled. The sensors described in the patent are able to pick up the sweet particles that a person with an elevated glucose level exhales. One sensor will use photodetectors to literally see particles in the air, while the other, gas, will directly analyze substances in the air. All this will be complemented by machine learning and neural networks.
In addition to determining the level of glucose, new detectors will help people with respiratory diseases, as well as to determine air pollution and the level of harmful gases. The sensors are so compact that they can be built into almost any device like a phone or tablet.
Existing Solutions for Glucose Analysis
Patented Apple absorption spectroscopy still needs some work. In the market of smart blood glucose meters (BGM), among others, Raman spectroscopy is now used, which is based on the reflection and measurement of light from a sample. Already working on various technology devices: GlucoTrack, Combo Glucometer, Dexcom, One Drop, and several others. Some of them already support synchronization with iOS and watchOS devices. So, you can control your sugar level through Apple Watch.
An invasive device that allows you to control your glucose levels throughout the day (CGM – Continuous Glucose Monitoring), allowing you to accurately determine the critical drop or rise in blood sugar.
First, you need to install the app on your phone or watch. Next is the process of creating an account, installing the upper and lower sugar levels for you, entering serial numbers.
With the help of the applicator, you install the sensor on the surface of the skin of the abdomen or waist and then install the transmitter on top. Next, the application connects the transmitter and the phone/watch/transmitter and the subsequent calibration.
Sensor installation, according to statistics from Dexcom, is 84% painless and 100% convenient. Within 2 hours after implantation, you can get your first data on the level of sugar in the blood. One sensor can be used up to 10 days, then it must be replaced with a new one.
Studies have been conducted regarding the G4 model and published in the Journal of Diabetes Science and Technology, which indicate the high accuracy of the Dexcom system as CGM.
One Drop – traditional BGM using finger pricking and which is capable of transmitting measurement data by Bluetooth to Apple Watch / iPhone. Officially sold in Apple Store. The package includes One Drop, lancet, test strips and carrying case. Approved by FDA, CE, Health Canada. It also has its own application for tracking blood sugar levels and tips on glycemic control.
Non-invasive meter without connecting to a smartphone. The sensor is attached to the earlobe and connected to the analyzer. The stated sensor life is up to 6 months. Memory for 1000 measurements. You can upload the measurement history via USB. The promised accuracy, according to the company’s clinical studies, is 97.3%. The boundaries of measurement are 70-500 mg / dl (3.9-27.8 mmol / L). Recommended only for people with type 2 diabetes and pre-diabetes. Related studies have been made by Tamar Link, Yuliya Mazel etc. in the Journal of Drug Assessment 2018; 7(1).