By Devon Hess, MBA, PharmD Candidate 2024 and Rachel Long, PharmD, BCPS, CPP, CDCES
Advancements in technology have revolutionized current patient care. Now, healthcare providers can monitor patients’ blood pressure, heart rate, glucose levels, and more remotely. Pharmacists play a large role in the ambulatory care space due to chronic ongoing medication and disease management, which is an area of pharmacy practice that smartwatches may be able to assist in expanding. Smartwatches are expected to grow 8.2% in compounded annual growth rate (CAGR) by 2030.(1) The surge in interest in using smartwatches for healthcare purposes is growing and could be the next generation of patient monitoring systems.
Advancement
Many patients prefer not to use finger stick glucose monitoring, as pricking their fingers over and over can be painful and uncomfortable. There have been advances in continuous glucose monitoring (CGM) devices, which have been a game-changer for monitoring patients and guiding therapeutic changes in their care plans. However, some patients are not comfortable having a CGM attached due to concern about skin irritants, needle used for application, having a flexible tip embedded in their arm or stomach, or bringing attention to their diabetes. There is also the concern of recurring cost for CGMs, whether patients are paying copays or purchasing out of pocket. Now, companies have made a non-invasive form of glucose monitoring by the way of a transdermal patch within a smartwatch or on the wristband, which has been shown to have 84.3% clinical accuracy in a trial of 23 participants.(2) This could improve the patient’s quality of life and provide glucose levels without finger sticks.
Using a smartwatch with a transdermal patch would offer a less invasive option for patients that are opposed to the traditional finger pricks and CGMs. There are also smartwatches for hypoglycemia detection, which monitor for physiological signs like heart rate, variability in heart rate and more to alert patients.(3) A small prospective study by the American Diabetes Association suggests there is a space for this form of smartwatch for patients that do not use continuous glucose monitoring devices and need alerts for lows.(3) In the study, Garmin vivoactive 4S and Empatica E4 smartwatches were used, but there are also other similar smartwatches available from multiple manufacturers.(3) Patient safety is a high priority within healthcare, and this technology could assist in preventing the risks of hypoglycemia from progressing. The convenience of a wearable, non-invasive option may be a more efficient method to control patients with diabetes and open doors for wearable devices.
There are other alternatives to fingerstick glucose monitoring other than smartwatches and CGMs currently on the market or forthcoming. In Europe, GlucoTrack is a non-invasive option that the patient clips onto their ear lobe.(4) Small studies have demonstrated 92-98% of the measurements from GlucoTrack were in clinically acceptable zones when compared to a more invasive blood glucose reference method.(4,5) However, it is important to note that GlucoTrack is inferior to that of current SMBG and CGMs on the market and is not indicated to base treatment decisions due to lag time which can be impacted.(5) The developers continue to upgrade the algorithm, device, and accuracy. An upcoming advancement is glucoWISE, which is in the development stages. The plan is to have “pain free” way to test blood sugars. All patients would have to do is hold it in between their thumb and pointer finger.(6)
While this is opening the doors for non-invasive options for glucose monitoring, it can be expensive for patients. Currently, there are no FDA-approved medical smartwatch devices for glucose monitoring. This means that it will not be covered under insurance until approved. This limitation is not the only one that pharmacists will need to assess. It is unclear how long the transdermal patch will last if a patient wears it continuously for the best accuracy.
Conclusion
Advancements in healthcare technology can change how we monitor and care for patients in the future. At-home monitoring will give a full landscape of what the patient is experiencing or what their body is doing throughout the day. The hope is that patients could have non-invasive forms of glucose monitoring systems that do not include needles or changing the device consistently.
1. Smartwatches Market Size, Share & Growth Report, 2030. Grand View Research.
2. Chang T, Li H, Zhang N, et al. Highly integrated watch for noninvasive continual glucose monitoring. Microsyst Nanoeng. 2022;8:25. Published 2022 Feb 23. doi:10.1038/s41378-022-00355-5.
3. Lehmann V, Föll S, Maritsch M, et al. Noninvasive Hypoglycemia Detection in People With Diabetes Using Smartwatch Data. Diabetes Care. 2023;46(5):993-997. doi:10.2337/dc22-2290.
4. Harman-Boehm I, Gal A, Raykhman AM, et al.. Noninvasive glucose monitoring: a novel approach. J Diabetes Sci Technol. 2009;3:253–260.
5. Lin T, Mayzel Y, Bahartan K. The accuracy of a non-invasive glucose monitoring device does not depend on clinical characteristics of people with type 2 diabetes mellitus. J Drug Assess. 2018;7(1):1-7. Published 2018 Jan 11. doi:10.1080/21556660.2018.1423987.
6. GlucoWISE®: Meet the new non-invasive glucose monitor that helps you take control of your life. glucoWISE®. https://gluco-wise.com/.
Devon Hess, MBA
PharmD Candidate 2024
High Point University
Fred Wilson School of Pharmacy
High Point, NC
Rachel Long, PharmD, BCPS, CPP, CDCES
Ambulatory Care Clinical Pharmacist
Chronic Care Medication Management
Atrium Health
Concord, NC
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