Live Glucose Monitoring With The Apple Watch

There has been a rumor that Apple is working on a glucose monitoring solution for the Apple watch. [Harley] decided not to wait and managed to interface an Abbot FreeStyle Libre sensor with the Apple watch. The sensor doesn’t directly read glucose continuously, but it does allow for more frequent reading which can help diabetic patients manage their blood sugar levels. However, as part of the hack, [Harley] effectively converts the meter to a continuous-reading device, another bonus.

The trick is to add a Bluetooth transmitter to the NFC sensor. Using a device called a MiaoMiao, the task seems pretty simple. The MiaoMaio is small, waterproof, and lasts two weeks on a charge, which is longer than the sensor’s life. Honestly, this is the hack since once you have the data flowing over Bluetooth, you can process it in any number of ways including using an app on the Apple watch.

It isn’t perfect. There’s a slight lag with readings due to the way the sensor works. However, you usually don’t care as much about the absolute value of your glucose (unless it is very high or very low). You are usually more interested in the slope of the change. This data is more than good enough for that.

In fact, the most complex part of this seems to be the watch app. It might be less work to feed the data to a machine learning model and let AI guide your insulin injections. Something to think about.

We have a keen interest in glucose monitoring around here and we know why it is so darn hard. Honestly, the idea of pushing glucose meter data to a watch isn’t new, but this is a well-done implementation with a lot of possibilities.

27 thoughts on “Live Glucose Monitoring With The Apple Watch

        1. By going through a “back door” the individual hack into other programs such as Apple Pay to retrieve your information putting not only you but, the entire network at risk.

        2. >>> who really cares if a hacker knows your blood sugar level?

          Forget “hackers,” insurance companies (if you’re in the USA) would *love* to have live glucose monitoring, so they could deny claims (or silently raise your premiums) if the number deviated from their specification.

    1. @Hirudinea said: “Maybe Abbott should talk to Harley about putting this into all their sensors?”

      Exactly. Glucose Monitoring is deadly serious business. The Apple Watch is an ideal user interface device for Abbott’s FreeStyle Libre stick-on sensors. Quoting [Harley], “If there’s one device that’s stuck to your body more than a phone, it’s a watch.” So why did [Harley] have to hack his own Apple Watch FreeStyle Libre Continuous Glucose Monitoring (CGM) app? I mean c’mon Abott, you ALREADY provide CGM smart phone apps for both iOS and Android.[1][2][3] Is it really that much harder to provide an app for Apple’s watchOS? Evidently not, as [Harley] shows us. Abbott, you should $BUY [Harley]’s app!

      * References:

      1. FreeStyle Libre systems apps @ Abbot Labs

      2. FreeStyle Libre 2 – US for iOS

      3. FreeStyle Libre 2 – US for Android

    2. Dexcom already can be displayed on the Apple Watch but via the app on the phone, it can be included in a number of watch faces! Before Google shut out watch apps from users, they had a constant watch face that displayed too. And I do agree if the sensor already transmits to the phone and the Tandem T-slim ( which automatically raises and lowers basal rate plus bolus one per hour as needed) why don’t we have stand alone watch connectivity? Is the FDA really blocking this?

  1. Dexcom G6 has a great system, but oh my GOD the cost of the sensor/transmitter is insane. Helping a school nurse and her patient, I found out that it was like $300 for an extra one if purchased outside the insurance schedule. And they only last for ten days.

    1. I live in Italy and we have all from our national health service (a bit bureaucratic process but of an excellent level. We can also choose which device and / or pump. my doctor remotely monitors, tune and contacts me. Continuous visits etc).).
      The 24/7 assistance service and replacements for problem or sensor detachment are also included.
      However, it happens that the supplied equipment is not enough. Here who wants to buy here:

      Libre 1 fantastic (precise, simple) but closed like a fortress.
      Dexcom G6 much less accurate (and for some people problematic) but open and practical. Excellent his app. Excellent the possibility of monitoring via the web and the fact that the data are “reachable”.

  2. Those sensors do not measure blood glucose levels, they measure interstitial glucose levels, which can be misleading if you have an active life style, use with caution.

  3. I see the stick-on Omnipod 5 [1] insulin delivery technology is (or will be?) closed loop compatible with both Abbott’s and Dexcom’s existing transcutaneous Continuous Glucose Monitoring (CGM) systems.[2] So we’re close to seeing a stick-on Bionic Pancreas?!

    I wonder how they close the control loop with Omnipod + CGM? AI/ML seems like a bad choice to me, it’s hard to train and makes mistakes. Plus when AI/ML learns a mistake, it’s almost impossible to truly unlearn it. I think something that is less rigid and more adaptive would work better. Maybe something like a rules constrained predictive Extended/Ensemble Kalman filter?[3][4][5]

    * References:

    1. Omnipod 5 Insulin Delivery System

    2. Omnipod Closed Loop Technology to be Compatible with Both Abbott and Dexcom CGMs

    3. Kalman filter

    4. Extended Kalman filter

    5. Ensemble Kalman filter

  4. this is old technology, I did this 5 years ago with a NFC to BT transmitter for Liber 1. MiaoMiao just copied the open source code and sold the transmitter for over $100.
    Now you don’t need it, Liber 2 has BT, you get the BG data with xDrip on Android. Same goes for Libre 3, already works, but still under development.

  5. Change your diet if you are Type 2 diabetic. It’s much cheaper to reduce or eliminate refined carbohydrates than it is to monitor and treat problems caused by overconsumption. You’ll have more energy, clearer thinking, and get sick far less often when you stop punishing your pancreas with sugar bombs.

    Glucose monitoring shouldn’t be this popular. It’s a terrible reflection on society that so many people are addicted to junk food, and expect that a wristwatch will show them the way to live healthier. It’s not interesting, it’s just plain sad.

    1. When you think about it, though, those who do this to themselves drive innovation and lower costs for those who can’t fix thing with lifestyle changes or self control. In the long run, it helps those who really need it.
      When I was a kid, I had a weird issue with my blood sugar- it was all over the place. Could be really high or really low, didn’t matter what I did or ate- it was discovered when I passed out after drinking an energy drink on an empty stomach. The equipment cost over $1,000 up front, and dozens a month in strips/needles (thankfully I had insurance). It went away after a short while, but recently came back. My 13 year old monitor and strips were long outdated, so I had to buy new ones. Insurance wouldn’t cover it, since I didn’t yet have proof (only a suspicion based on symptoms) that my blood sugar was causing the problems. It cost me $20 for a monitor that supports alternative tests sites and a few months worth of strips and needles. My blood sugar is indeed on a nonsensical roller coaster, again.

    2. In europe we are really more healthy that average US (Mediterranean diet and so on) BUT I often attend the diabetic departments in hospital and I guarantee you that there are alarming numbers of T1 / T2 patients. I agree on the healthy lifestyle but the (worldwide) problem is serious. And without continuous monitoring and insulin pump you will die badly. Very very badly and soon.
      I’m not critical of the American system but (for my survival) I could never live in a
      country where I am not treated and (so as not to feel a burden for the community) that does not manage the problem systemically by controlling prices to guarantee everyone the necessary treatment.
      With or without a correct lifestyle.

    3. Not everyone has their blood sugar under control YET and it’s not always 100% because of diet. Glad you are so perfect you don’t need to monitor your sugars, others struggle like 2 family members of mine that look like they are in great shape, eat proper well balanced diets and exercise but due to family genetics and other medical conditions and medications it affects their insulin production. If technology can make it easier and quicker to get a baseline and know which foods or times of days affect you the most than what is the problem. If you don’t need it move along and maybe try and be a tad sympathetic to those struggling for something that may not be 100% within their immediate control.

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