The Apple Watch keeps you company as you navigate to manage this data driven disease

Anyone who is diabetic will remember the day they came face to face with the truth of that impossibly high blood sugar reading. No matter how common the condition is — and it’s more common than ever in India, as we know — diabetes is always something that happens to someone else; like to an annoying aunt. Until it happens to you.

The shock of knowing you have it too takes a long while to wear off, if it does at all. All of a sudden, the prospect of life being completely different from that day on looms large in front of you, making you feel intensely vulnerable. I remember the exact date and time that I found my carelessness and my inheritance had come together in a sugar reading I won’t even mention. I felt so fragile; I found I was even sitting down and standing up with extreme care — with a permanently embedded awareness of my condition.

And then there are always those who don’t miss a beat and with a devil-may-care attitude, dig straight into that tub of ice cream anyway. Jeff Dachis wasn’t one of them. After the initial shock and a singularly unhelpful visit to the doctor, he decided it was all about self-care. “About three years ago, I was diagnosed with Type 1 diabetes,” he said. “And I was given an insulin pen, a prescription and a pat on the back and I was out the door in about six minutes.” Deeply annoyed with the healthcare market, Dachis wanted to do something to empower himself and others to take charge of their own health because “Diabetes health happens outside of the doctor’s clinic, not in it.”

In India, diabetes specialists are among the busiest of healthcare professionals, but despite the diet charts and dire warnings, it’s the diabetics themselves who will have to work out and maintain the balance between diet, activity, exercise and medication that is the essence of managing the condition.

One drop, one glance

And interestingly, all of this comes together on the Apple Watch, where the data can be seen and acted upon all in one place via the health app. Lately, there have been a number of rumours and reports linking the Apple Watch (or rather, a future version of it) to continuous needle-less glucose monitoring. But Apple, as is typical for the company, is silent on the subject. What it is not silent on is the company’s interest in making the iPhone and Apple Watch a hub for better health. That’s where Jeff Dachis came into the picture. As the Cupertino giant began to encourage developers to create health products for the Apple Watch, Dachis set up One Drop, an app plus glucose meter that adds up to a whole community of diabetics and experts. As I watched, Dachis flicked out a neat looking gadget from his pocket and before we knew it, had given himself a little finger-prick and was examining the reading — on his Apple Watch. The One Drop Chrome gadget is connected via Bluetooth to the phone and watch. While it works on Android as well, it’s on iOS that all the data gathers inside the native health app.

Coaching and community

But the One Drop solution isn’t just to collect diabetes related data such as blood glucose, calories, or activity. It’s to put all that together and be part of a community — anonymously or as an ambassador — that one can compare notes with. The experience also includes coaching from enrolled experts, complete with alerts and advice. The experts feature is based on a subscription model of ₹250 a month but the price is being tinkered with to make it more pocket friendly in India.

The glucose meter component is not yet available in India, but it’s on the cards because Dachis says that India is the second largest market for One Drop after the US, the home country for the company. One third of all One Drop app users actually already are from India. Even though the reading is entered manually, it’s very fast through the watch from where you can also enter information on your medication, food and activity. It’s particularly nice for those who are insulin-dependent and need more support than those who test occasionally and use tablets. Happily, the One Drop app is open to taking in data from other devices and apps.

Going continuous

The holy grail being sought, however, is continuous glucose monitoring and rumours on a solution that does this painlessly through the watch are always doing the rounds. It isn’t easy at all to measure glucose without pricking the skin and drawing blood. There are other fluids that can reflect sugar, but monitoring them is difficult and is interfered with by many other factors. Meanwhile this year, Apple announced at WWDC 2017 that the Apple Watch is running Core Bluetooth, meaning that it will be able to communicate more easily with low energy Bluetooth devices. Taking advantage of this, Dexcom’s Continuous Glucose Monitoring System or G5 is able to send glucose readings every five minutes to the Apple Watch. But this still means invasive implanting of a sensor and transmitter under the skin, so obviously it’s done only when absolutely called for, and by prescription and under a doctor’s supervision. Nor is it a solution that’s left in place for a diabetic person’s lifetime.

Clearly, the ideal solution is yet to be arrived at if the life of diabetics is to be made easier by allowing them much better management of their condition. But big tech taking up the fight against diabetes — no matter what their reasons — it’s beginning to look really hopeful.

This writer was in West Hollywood, California, US, at the invitation of Apple Inc to see live demonstrations of the Apple Watch and health solutions

(This article was published on August 9, 2017)
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