Apple Makes Major Progress on No-Prick Blood Glucose Tracking for Its Watch
bloomberg.com
bloomberg.com
> Apple’s system — more than 12 years in the making — is now considered to be at a proof-of-concept stage, said the people, who asked not to be identified because the project is confidential. The company believes the technology is viable but needs to be shrunk down to a more practical size.
> Engineers are working to develop a prototype device about the size of an iPhone that can be strapped to a person’s bicep. That would be a significant reduction from an early version of the system that sat atop a table.
…
> Before shifting to TSMC, Apple had worked with Rockley Photonics Holdings Ltd. to develop the sensors and chip for the technology. In 2021, Rockley publicly disclosed its work with Apple, stoking interest in the supplier. Apple later ended the partnership, and Rockley filed for bankruptcy last month.
[1]: Related conversations: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...
Noninvasive, with any sort of accuracy that can be used for anything, is most likely impossible.
So back to "invasive"... what can we do... embedding a device under your skin, right around where your watch goes, that can be powered and communicate with the watch. While also making sure the device is not rejected by the body and stays in place.. AND has no other adverse side-effects. I think this is where it'll ultimately end up for the people who want it. sub 10 min procedure to put it in and should last for quite some time (maybe dissolves after 5 years for upgrades?)
Profit.
Well yes, but also substantial life saving interventions become possible.
I'd get a tattoo, but I'm not interested in anything that has to be removed
We need significantly better power sources that are either have lots of energy capacity, xor some energy capacity and able to charge while inside the body.
Either version they need to be small enough that the procedure is cheap and the body doesn't reject the device. Additionally, anything like this would need to go through regulatory bodies for medical devices, and would not be approved for "healthy people" (i.e. significantly reduced adoption).
Roughly putting us back to non-invasive.
We do it with pulse ox pretty well, but +\- 2-3% O2 sat and repositioning isnt a big deal.
Having the watch move and misreadibg blood sugar can have serious consequences.
A can of worms.
But I do applaud the team for working on the technology nonetheless.
Biasing low would be the move if scared of risky downsides.
It’s not enough of a difference to be deadly, as the sibling comment suggests, and the clinician guidance is to always eat something if you are feeling hypo, and at or near that level.
The upshot is that I set my CGM-linked pump to target 1 mmol/L higher to compensate.
And the Libre3 is so much better than anything else I've tried before.
Another T1D here with 2 decades direct experience with Medtronic, Tandem, Dexcom, and Abbott. I'm an outlier, but that doesn't make this story less empirical. I've got many years of data to prove it and while I can't match real autonomy's millions-of-points-per-second firehose, I do have years of hundreds of point-per-day.
It's n-of-1 for sure, but one way of looking at that is just that there's a lot of latency on the data gathering, particularly in emerging stories in healthcare where the entire system is weaponized against the truth reaching wide audiences, but I digress. Back to the objective facts vs. the subjective reality.
I'd just like to confirm the findings here in that it's a wicked problem, just like T1D:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529400/
The fact that CGM or non-invasive requirements follow suit should be of little surprise to anyone.
It's challenging enough that I wore 2 CGM's concurrently over the past year: Dexcom G6 and Freestyle Libre 2. They both have poor data veracity, particularly at the times that I need them most - when fasting; that would be sleep and exercise. Both critical periods for any diabetic. I should know because the former put my T1D brother-in-law in an early grave.
I realize that some people have great success with these devices and that's something we should celebrate. However, we should not celebrate the fact that there are legitimate lawsuits against these companies. I've been outspoken about the risks given my family history, exercise, and experience working in medical devices that have a history of injuring patients:
https://en.wikipedia.org/wiki/Therac-25#Problem_description
https://www.11alive.com/article/news/investigations/the-reve...
The amount of time that I spent on the phone with Dexcom support was excessive and frequently at all hours of the night since the problem would present with alarms that cannot be disabled and are able to disable do-not-disturb mode on the smart phone and sound like an alarm system from the Austin Powers series.
That leaves the patient with two choices: tolerance (which is unrealistic at 3 AM) and powering the phone completely off, which silences it while having the side effect that alarms can't save the patient from potentially life-threatening hypoglycemia given that alarms emanating from the Tandem t:slim X2 alone are not sufficiently intense to wake me.
Dexcom has responded to this crisis by following the letter of the law: since I first reported the problem, they have replaced 2-3 dozen sensors under warranty while following the typical corporate communication playbook of not admitting design flaws or any legal culpability while not admitting the rather serious problem of the fact that, when the G6 is used in concert with a hybrid closed loop system such as the Tandem t:slim X2, inaccurate sensor readings on the low side have the potential to underdose the patient, and inaccurate sensor readings on the high side have the potential to overdose the patient. This is because near-autonomous, near-realtime basal rate adjustment is responding to sensor measurement that can often be at odds with reality and not closely monitored at times like sleep and exercise.
This isn't just theory!
I've seen both of these scenarios play out while exercising and sleeping - two events that cannot be precluded, are frighteningly difficult to handle given failures in the aforementioned design of the alarm system, and no one at either Tandem or Dexcom seems to admit, document, or address which is distressing given that these are FDA-regulated devices in markets that aren't Therac 25 but have the potential to end badly in large populations.
I've tried to alleviate the problem by wearing two different CGM sensors concurrently. I wore an Abbott Freestyle Libre 2 from spring through fall 2022 in addition to my Dexcom G6 where I have little choice given the joint venture design chosen by Tandem. That has done little to alleviate the problem since both sensors tend to move in parallel showing the same inaccurate readings in fasted states around sleep and exercise.
Worse, the only evidence I've seen that anyone in the mobile software design side of equation understands the problem is xDrip and the various people working in OpenAPS:
https://scholar.google.com/citations?user=rt1_gOgAAAAJ&hl=en...
I don't believe they are getting the attention, credit, or remuneration they deserve.
I hope that the situation does not turn out like American insulin pricing, where the first person to perish not being able to afford insulin was documented several years ago:
https://www.snopes.com/fact-check/alex-smith-died-couldnt-af...
If we think social media needs regulated, I'm pretty sure what we call healthcare in the United States qualifies for better regulation than that given FDA's lack of oversight.
In contrast, the Libre3 transmits via Bluetooth, and does so once per minute, without me having to do anything else. The non-insurance retail cost is about $70 per sensor. With insurance, it can be much lower.
For me, the size difference is a real game changer. This thing is so much easier to wear and live with.
For me, the automatic update once per minute is also a real game changer. I don't need to tap the sensor with my phone to get a reading, I just open the app on my phone and the data is already there.
By all accounts, the Dexcom G7 is about the same size, and because Dexcom plays nicer with other devices, that's the way you want to go if you're trying to close the loop on the CGM plus automatic insulin dosing.
For now, I'm super happy to have the Libre3. The app needs some improvement, but this is already a World Series + Super Bowl winner.
https://www.wareable.com/wearable-tech/movano-ceo-on-its-rf-...
Movano plans to ship an Oura-style smart ring this year, but it won’t have the glucose monitor. (One might suspect the “moonshot” glucose RF chip story is meant to keep investors excited through the zero-revenue stage until hopefully the more ordinary smart ring takes off.)
A ring form factor is too aggressive and difficult of a target.
up until now there has been zero financial incentive for stakeholders to promote a method of blood glucose measurement which bypasses the need for consumables, and every incentive to prevent such a solution.
https://www.fiercebiotech.com/medtech/abbott-ceo-ford-unveil...
If we knew how to do this, but valid patents blocked the broader commercialization of it, then we would not be reading stories about breakthroughs in basic implementations. We’d be reading stories about how companies have products ready to go once the countdown timer hits zero.
There are some exceptions to that, at least in the US:
https://slate.com/technology/2018/05/the-thousands-of-secret...
So, pharma companies trying to obtain "non-invasive glucose monitoring" patents like crazy, to stop other companies from creating such things, because they want to keep selling pinpricks which rely on a consumable model.
Having said that, now that everyone's into "bullshit subscription models", perhaps the era of "bullshit consumables" may be coming to an end.
I've worked in this space for 5 years now, and this is not news to any of us. Today, a tiny, noninvasive device, that is accurate enough to make insulin dosing decisions, is pure science fiction. It's probably not impossible, but we'll literally be able to use stem cells to regrow human pancreases and straight-up cure people of diabetes before this tech becomes a reality. (We're much further along that path.)
What is interesting about this though is the possibility of using this device for non-diabetics who don't need extremely accurate glucose readings. A rough approximation of someone's blood glucose levels is enough to learn how your body reacts to different types of foods and exercise, and would be helpful for amateur athletes who can't afford to purchase real continuous glucose monitors, as well as pre-diabetics for whom CGMs aren't covered by insurance.
Is there an ELI5 of the basic principle of how it would work (or at least the direction being pursued), and what the main obstacle is, and why we think we'll be able to overcome it to some degree?
Besides athletes, I can't help but think it could be a huge step forwards for weight loss as well. I'm aware of the concept (for non-diabetics) of only eating once your blood sugar is below a certain level, and never eating so much that it goes over a certain higher level.
vs
"useful enough signal for general population / those at risk of type 2 diabetes / those with diabetes who don't require insulin treatment / etc" (much larger market for Apple w/ greatly reduced requirements)
And I didn't just check the bog standard 98% measurement but also tried to hold my breath etc.
On the contrary, the Apple Watch ECG is quite accurate, not quite enough to replace the system the doctor makes me wear, but enough that apple can get a general idea of any defects and tell you to go to the doctor. The "regular" hear rate sensor isn't anywhere near good enough to be taken seriously, but its leaps ahead my previous samsung.
I dream of the day where my Apple Watch can replace the myriad of annoying wires and sensors I have to wear to monitor myself. Even then, the Apple Watch has greatly helped me out when I've fallen and need assistance, and I've gifted several to my family just in case.
I'm using a $70 Amazfit right now but previously I had a Samsung, neither is very good.
https://en.wikipedia.org/wiki/Google_Contact_Lens
For something that has to be monitored very closely, nothing beats an actual blood sample. And to get a blood sample, it can't be non-invasive.
To be fair, the Verily folks did design the algorithm that predicts where your blood sugar will be in X minutes in Dexcom CGMs, which lives on. Dexcom now owns the patent.
> nothing beats an actual blood sample
Technically, interstitial fluid can get you pretty dang close, which is considered minimally invasive.
https://iopscience.iop.org/article/10.1088/2516-1091/abe6f8#...
Seems like spectroscopy seems particularly promising, and according to the article, that's the approach Apple is taking. (Makes sense for a watch.)
And from the paper, the challenges with spectroscopy are signal interference -- scattering, water absorption, and distinguishing between glucose and other sugar components. So it ultimately sounds like a fiendishly complex signal processing problem. Which is exactly the kind of problem that is very very hard yet maybe not impossible.
We - at DiaMonTech - working on a solution with mid-infrared spectroscopy and showed good accuracy in a published paper in the "Journal of Diabetes Science and Technology". We plan another clinical trial this year, but yes, this took some time. We started in 2015 and still have some work to do.
The reason it's your comment I'm replying to is because you indicate you actually worked in this field.
Whenever these discussions surrounding noninvasive monitoring of blood solute concentrations come up I keep wondering why anyone is surprised taking a hard route is hard, and why there seems little attention to seeking easier routes of noninvasive optical sensing.
Please do shoot my comment if it is nonsensical, so that I can stop caring next time I read such a discussion, but I would like a mechanistic explanation why the lips wouldn't be easier.
From an a priori perspective, it would certainly be desirable to have any type of noninvasive monitoring in the form factor of a watch. There is nothing wrong with dreams or hope. Yet to me it sounds like a dream was interpreted too literally: starting from some hypothetical dreamer exclaiming "imagine testing concentration X or Y, but noninvasively! sure wearing a device would may come with some inconveniences, but if the advantages outweigh the inconveniences, it would find a niche" and "after all people have been wearing watches too".
An idea that started as an analogy: just like a personal wearable watch had advantages compared to an immobile pendulum clock, perhaps we can devise the analogous personal wearable device that performs the duties of some large inconvenient measuring setup, workflow, discipline,....
I can't shake the feeling that the analogy has been taken too literally, as if the original dream insists the blood glucose meter has to be integrated into the watch and located on the same or similar place on the body...
Blood is red.
Lips are red.
The color of the lips is the color of the blood.
Acknowledging the inconvenience of mounting a device or perhaps an optical fiber to your lips, it may constitute a more tractable milestone.
What is the reason all the 'failed' startups avoid the lips and make life hard on themselves by choosing to do spectroscopy (in the widest sense: plain, Raman, ...) through the highly variable noisy medium of skin (different pigmentations by genetics, different pigmentations by varying exposure to sun within an identical individual, different states of skin like sweating, the intinsic noise incurred by imaging through a robustly thick layer of skin, scattering like mist, ...).
It almost looks like attempting an artificially troubling tour de fource, akin to painting a masterpiece... with your toes. I think its possible eventually, fundamentally speaking, but it doesn't sound like a wise choice to make, at least not initially.
(I wrote failed in quotes, because in reality after bankruptcy IP is transferred, experience was gained by employees, some of which end up at different companies in the same space, others end up in new disciplines where they gain a new applicable insight that nobody previously connected to blood glucose monitoring, etc...)
Then there's the social issue of the first iterations of the tools potentially working better for less pigmented skin...
> It's probably not impossible, but we'll literally be able to use stem cells to regrow human pancreases ...
I have some serious question marks surrounding the near-term viability of stem cell regrown organs.
As an unethical thought experiment consider freshly born twins, and removing their pancreas and putting each in a chamber where you would otherwise grow the artificial pancreas. How fast would you notice harmful levels of sugar purely from observation of the kept-alive pancreas? (without cheating and using knowledge of healthy blood sugar levels). If it would take many many experiments or very long durations to detect these problems (for glucose or otherwise), then one doesn't really have the engineering confidence of how long it would last, what the side effects are, ... i.e. blanket statements that stem cell derived organs will arrive earlier than affordable democratized noninvasive sensing could be true, could be false, but isn't proven by a blanket statement. The burden of proof doesn't lay with the reader.
> ... and straight-up cure people of diabetes before this tech becomes a reality. (We're much further along that path.)
Which type of diabetes?
Type 1:
The root of the problem is an unsuitable autoimmune response, during V(D)J the immune system rolls the dice to construct a generator of randomly chosen but from then on specific antibody. Due to natural selection library of segments for V(D)J recombination has a strong bias for resulting in antibodies that match foreign pathogens and potentially endogenous cancers while simultaneously also having a strong bias for not matching normal endogenous or symbiotic features. So usually nothing goes wrong.
We all carry a different but similar library of segments for V(D)J, so our immune systems display slightly different statistics for expressing antibodies.
Imagine an individual has the flu and its immune system ramps up the production rate of new generators of antibodies, each generator corresponding with a randomly chosen but from then on fixed type of antibody, usually safe but not guaranteed. Perhaps this individual has bad luck and besides generating suitable antibodes for the flu, it has also generated a low probability antibody that happens to attack the pancreas. Over time the pancreas starts to degrade and fail. The person now has type 1 diabetes. The pancreas damage is a symptom, not the cause.
Even if you grow a new pancreas, and replace the damaged one with the freshly grown one, the immune system cells generating the regrettably bad antibodies are not filtered out of the body, so after a while the type 1 diabetes will recur! Your proposal does not straight-up cure diabetes type 1
(how hard or easy does it sound to locate and filter the specific immune system cells that result in the autoimmune disease without also removing those that represent your acquired immunity of diseases the individual was exposed to throughout life? if such a thing were easy, curing HIV would be easy by simple filtration of every last HIV genome from a human body, so it does not sound that easy at all)
There are decades of research with all kinds of wild wearable devices in all kinds of form factors that can do amazing things. They have gone over like a lead balloon with the consumer.
Socially, it is acceptable to wear exactly one piece of technology on one wrist. People with very dangerous medical conditions might be convinced to wear a well hidden device under their clothes but it's a big ask and compliance won't be as high as you'd expect.
That's just how people are, so as engineers we have to make products to fit that.
It just can't look too unusual.
It makes it very hard for a business when, for instance, very few men are willing to wear your bangle or people can't wear your glucose monitoring hat inside nice restaurants.
It's likely that different wearable forms will become more common and accepted, but that is one of those predictions you hear every year for the last thirty years and it's true to an extent but also there is a long way to go.
Maybe one day it will be common for men to wear bangles on each arm, or for hat wearing to be common indoors via their actions.
For example, no one carried around headphones out-and-about before the Walkman.
"You are currently already by necessity accepting the monitoring of blood glucose invasively with device X, here is a less invasive device Y that sits under your lip, or perhaps has a fiberoptic cable running up to your lip. Would you switch to this lip-oriented device today? Or would you rather profusely refuse to use this device Y until some more distant unspecified future date where the technology Z finally robustly works through thicker layers of skin while continuing to use the more invasive device X?"
I don't claim but tend to believe they would take improvement Y over X while waiting for Z.
You actually claim they wouldn't.
I say let the patients speak for themselves.
Perhaps your claim is correct and no suitably large niche of patients would switch to the lip-oriented device.
Perhaps you are wrong and you have confirmed my suspicion of the miscommunication between patients and engineers.
Your rebuttal does not prove compliance of a less invasive lip oriented device would be lower than current invasive devices.
I can't prove it, but I think it actually makes a lot of sense. The interstitial CGMs like Libre/Dexcom are invasive (brief pinch on application) but they last up to 2 weeks and you can set and forget. I'd think any other non-invasive device that requires carrying it around, running wires, and being even a little pro-active would lose on convenience alone.
You could get some traction I'm sure, but the majority of people are going to gravitate towards the easiest solution, and applying a patch once every 10-14 days is pretty darn easy. Even if Apple could check glucose I'd still prefer a CGM patch so I don't have worry about always wearing the watch.
There is a lot (a lot) of history here that I think would help you test your assumptions on this.
A 2017 survey found only 32% of the US population wears a watch daily, so for a large fraction wearing a glucose monitor in the form of a watch would also constitute a change, and correlate with diabetes patients. Under the lip or monitoring the inside of the cheeks, etc may be even less conspicuous than wearing a watch. Perhaps you might wish to test your assumptions too, and again, neither me nor you should be the arbiters in this matter: the patients ought to be the ultimate arbiters.
https://www.jckonline.com/editorial-article/most-consumers-d...
I don't understand why a person would contort themselves into less defensible or self-contradictory stances. It would seem engineers or others involved in the field would welcome the suggestion that perhaps there is a more tractable way, that might simultaneously be more acceptable by the patients themselves.
Observe I don't accuse you of causing the miscommunication. Everyone is prone to following the herd, including me.
While it isn't proven the patients would prefer a miniaturized device under the lips (or somehow reversibly attached to a teeth in a way that it doesn't interfere with eating, kissing, etc..) let us suppose for a moment that it actually turned out to be the case, after a survey or after actual trials.
In this case it's not the fault of the average employee or engineer in the field that they were designing thick-skin CGM devices before the survey or trials were done.
The real question in that case is: who was or wasn't aware before the survey that the red mucous membranes were easier? If not why not? It's obvious these tissues are redder due to better visibility of blood. Those that were aware before the eventual survey: did they yes or no tell their superiors? why not? if they did, they are absolved, but the line of questioning now transfers to the superior. Why didn't they order a survey asking for patients concerns about the idea, and if they would consider switching to such a product if properly executed? Why didn't they consult the patients?
One potential solve is watch-only for non-diabetics and a more invasive watch + patch solution for those that need high accuracy.
They don't currently send data directly to Apple watches (it goes through the iPhone first), but that's largely a regulatory approval issue, not a technical one.
I did a proof of concept with a Bluetooth scales so this should work. I'll add a README after work:
While the manufacturer-provided ecosystems function okay, they give you limited data mobility in case you switched to a different diabetes-related product like a CGM or insulin pump. They also introduce a dependency on on a cloud SaaS platform managed by said manufacturer, which can impose limitations, such as not allowing for real-time access to your data (Dexcom requires an approval process to get real-time data from their API: https://www.dexcom.com/webapi) and can have uncertain reliability (Dexcom had a notable outage in 2019, for instance: https://www.wsj.com/articles/diabetes-blood-sugar-data-outag...).
Conversely, you can run a Nightscout server on a Raspberry Pi in your home, or on a cloud server, for yourself and have full access to your data.
It is categorically untrue that you have to enable the cloud option to store/create logs and reports with the G6/G7. The app creates fantastic and easily digestible logs/reports on your phone, without any cloud processing.
Apple Maps has been working entirely fine for me.
For this glucose monitoring the early product that Apple ships will almost certainly be grossly inferior to the product 10-20 years later.
I don't understand why this is a problem.
If glucose monitoring gives you bad information, you could easily lose body parts, die, or other bad outcomes (In the last 10 years, one of my friends died, after apparently having lost several toes in an earlier episode. Another friend was rescued by the police after driving on the highway for several hours in a disoriented state. Both of them were medical professionals and presumably using best practices in their monitoring).
How much more slow and careful do you want them to be?
Today, I find that while Waze does the best driving navigation and Google Maps is unbeatable as a modern yellow pages, Apple Maps is equal to or superior in nearly every other way. It’s walking and public transport modes are, in my experience, consistently superior to anything else.
I find the reviews in Google Maps to be (like Yelp, TripAdvisor etc) to be thoroughly useless. Tourism-driven companies are loaded up with manipulated reviews; cafes and restaurants get ratings that often bear no resemblance to reality. The sad fact is, even where reviews are genuine, the people who leave reviews on a mainstream site like Google Maps are not a representative sampling.
Yes, you can build a wearable device that mostly gets your blood pressure right, most of the time. What are you supposed to do with that? It's not a useful product (and the FDA won't let you sell it, for that reason).
If you can't depend on the results, you can't quantify in exactly what way the results are erroneous, and you don't have an enormous volume of clinical data and outcome studies, etc. with your device that allows you to draw clinical conclusions about your results regardless of their errors, you have nothing actually useful.
At the moment every 10days we have to pay $100 for a Dexcom sensor. That is like buying a couple new iPhones a year and just throwing them away.
A non disposable glucose sensor would change the world for all diabetics.
Even step counting with them is not accurate at all. Can't imagine that Blood Glucose tracking will work anytime soon for a large population.
I've considered implantable monitoring like Eversense CGM but it's costly and the implants only last for 90 days and requires doctor's visit to "install" it. At the moment - I resort to finger testing whenever I feel off or want to know the measurement.
I would be willing to do an implant (chip?) if it can last for say a year+ with Apple Watch, for example, tracking the data and sending me alerts as needed.
That's where I need a CGM, preferably like the Freestyle Libre3.
Question - do you eat meals in regular schedule or just once a day?
I'm trying to get better about that. Lots of snacking isn't good.
Additionally every morning before my alarm went off, I could see my glucose increasing, most likely preparing for wakeup, all by itself. Amazing!
It gave me a new-found respect for these otherwise invisible processes happening in this fleshy vessel on autopilot with closed cockpit doors. I only got to peek through a small window during 2 weeks.
The nighttime fluctuations could be legit changes in glucose level, but could also be weird sensor issues. The sensor will often give low readings when lying on it in your sleep. These are referred to as 'compression lows'.
The morning glucose spike you noticed is called the 'dawn phenomenon'. I inject a little insulin every morning to counteract it.
Now that I know how little the sensor costs, I would say that's definitely the better option...
In general you'll be able to basically see in real time the glycemic impact of all the foods you eat. Which would probably be helpful to a lot of people - you can find all the info online, but having the physical real time stats in front of you makes a difference.
But mostly its what you'd expect. High carb, fast digesting meal -> blood sugar spikes, then drops in accordance with you feeling tired afterwards. Eat keto -> blood sugar is mostly stable.
Could be wrong on the above but that's been my understanding/experience.
…so far, I’m finding it wildly inaccurate. It shows trends well enough, but blood glucose is anywhere from 0-40 mg/dL off from a finger prick test depending on the day. I couldn’t imagine relying on this thing as a diabetic.
As another poster mentioned, it won't happen either invasively or non-invasively any time soon. Insulin levels aren't even part of a standard blood test in most places due to the cost.
I'm not convinced this is really going to matter. I'd love to be able to measure how much different foods affect my blood sugar. But because I don't have diabetes and am not at high risk for diabetes (based on my A1C), the Dexcom is absurdly expensive as just a toy to satisfy my curiosity. But if I could buy a $19 thigh strap for my iPhone to do this then I'd jump on that in a heart beat.
My understanding is that it’s a “safety” concern (read: liability). Because it would be providing “medical” advice the requirements around design are skewed to ensure that it doesn’t kill people rather than being permissive about the user experience [1]. Out of context, this seems sensible (therac anyone?) In practice this means that sensors like the Dexcom or Medtronic have “features” like alerts that cannot be silenced until the device is calibrated with blood. This makes sense from a safety perspective but is not particularly forgivable at 3am when the thing refuses to stop beeping until you feed it blood. I would guess that Apple will try, but they may find that their desired UX may not be compatible with the requirements imposed by the FDA process.
[1] This personal anecdote is old. I hope things have improved.
Closest is when I’m trying to do a workout circuit and I don’t have my phone I use Seconds. https://apps.apple.com/us/app/seconds-pro-interval-timer/id3...
However I prefer to use Seconds on the phone so I can see the timer without looking at my wrist.
I love what apple has built around it - health and fitness monitoring primarily but also siri integration (setting reminders, alarms, timers etc).
Generally on the health and fitness aspects the only accessories I find useful are a connected scale and connected blood pressure monitor (both from withings). The data is shared from the withings app to the health app (and I don't let the withings app read any data from health) so I can see that info along with everything else.
I do wish either the health or fitness apps on iPhone had better analytics, data visualization, and comparison tools or made them easier to find. They do have some good ones but it takes more taps than I'd like and I wish there were more breakdowns.
Makes it very easy to track this data over the longterm automatically - especially BP which I can then show my doctor at my annual physical of how I'm doing especially since white coat syndrome can affect readings they take.
I find having this data very motivating and I can use it to calibrate my days and weeks.
What do you think is preventing more development for the watch?
Ping authentication is really nice.. I can leave my phone anywhere in the house and still validate VPN authentication requests.
Wallet -- wrist tap to pay.
These alone would keep the watch on my wrist.
That Google doesn't let me authenticate Gmail app 2FA by phone seems.. silly (does it? have I missed that?).
Do you mean by watch? From what I'm aware google prompt only works in the google/gmail applications for iOS.
I've written Watch apps (It's a pain in the ass). I haven't really found a compelling driver for it, though.
That might change, as the hardware improves.
- SmartGym for tracking reps without my phone.
- Paprika with my grocery list. Much easier to flip over my wrist while pushing a cart than pull a phone out.
- Pocket Casts for selecting podcasts on a dog walk.
Honestly, none are worth buying an Apple Watch for but the notifications & built-in fitness tracking are really the selling points anyway.
I don't deeply trust many of the metrics but anecdotally it's very accurate for the amount I'm sleeping, which is mainly what I'm concerned with
“Sleep sufferers” as in insomniacs and sleep-apnea folks. I’m lucky to be both. :/
* Stocard - gym / loyalty cards.
Speaking of messaging, I monitored several whatsapp groups, but I don't need to answer all messages. I did that on my PC; if I received a notification in my PC, but didn't interact with it, my phone would ding a few second later, and if I ignored that too, my watch would ding/vibrate a few seconds later. This is probably Meta's implementation, but getting triple notifications made day-to-day a bit more annoying.
I also tried to use it to track exercise, which I usually do at home. I saw no advantages compared to regular timing and counting, and didn't find the gamification of exercise engaging, because I was already doing it.
I got the watch during the pandemic, primarily for the oxymeter and ECG in case I had COVID (which I had). The oxymeter worked well, but the ECG wasn't enabled in my country until late 2022.
Maybe it's become better now, but I sold mine before it became too old. Except for the automatic health monitoring, it made things a bit more of a hassle instead of making them simpler.
Do you want to get those notifications in all three places in case you only have one of the devices with you? I’d just turn WhatsApp notifications off everywhere but my computer if I were you (if I were me I’d just turn them ALL off ;)
Also, mine would automatically go into “Sleep Focus” (previously “Do Not Disturb”) during sleep time, which muted notifications. Not sure why yours wouldn’t do that.
But also nice to allow the watch to act as a wifi hub so that I can if needed carry an iPad if I need to look at things.
I thought the thread was what would be the killer feature that you wanted.
Which is not what this part is about.
But it is a killer feature that makes the watch a must have, and since I'm on the iOS stack, it might as well be an apple watch.
(Not really "can't live without" but that, to me, justify the cost of buying and the routine of wearing.)
I do sometimes want to track or do some things in a certain way that the default apps don't... but I can ever seem to find an existing app to do it either. The apps exist but don't work the way I want any better than the built-in ones.
(Since I'm a developer, I sometimes whip up a prototype watch app myself, though I have to admit that while some have proved useful for a while, none have become a killer app for me, no matter how much I thought I wanted it originally. I do like my couch to 5K app.)
I can also use the watch to pay for stuff anywhere. I can go on a jog and reward myself with ice cream half way (stupid: yes, fun: also yes) without needing to carry my phone or wallet with me.
That combined with a list of curated apps that can notify me on the watch help me not check my phone as often. If my watch vibrates it's something I actually need to take action on, and it's easier to quickly glance at it compared to a phone.
I like that the watch provides some benefits like sleep tracking + vibrating alarm for a calmer wakeup, and buzzing on my wrist while using maps on silent to remind me a turn is coming.
I can live without the benefits the watch provides. Sometimes I take it off for days because I find wearing watches hurts/annoys my wrists (I had pocket watches until cellphones/PDA's took over for this reason). Although I am amazed that it's more comfortable than other smart watches/fitness bands I've tried to wear in the past.
I've turned off all other features/notifications on my Apple Watch, it just does this, and it's the most valuable product I use (since I no longer have to pull out an insulin pump in a meeting, look at some other screen to see glucose values, etc etc etc).