How Apple technology is transforming the future of diabetes

The new Apple features help patients and doctors take charge of diabetes management

Brand new Apple Watches are displayed during an Apple event on September 12, 2023 in Cupertino, California. Getty Images via AFP

Apple has added features to its iPhones and Apple Watches that can help those suffering from diabetes, and those who have not yet had it diagnosed but are vulnerable to it.

Around the world an estimated 537 million adults are living with diabetes, a chronic condition caused by elevated blood sugar or glucose.

The inability of the pancreas to produce enough insulin or to properly use it results in an increased concentration of glucose in the blood.

Type 1 diabetes results from a lack of insulin production, while Type 2 diabetes is caused by the body’s inefficient use of insulin, mainly occurring through physical inactivity and obesity.

The number of people with diabetes worldwide is expected to reach 643 million by 2030.

According to the World Health Organisation, every five seconds one person develops diabetes, every 10 seconds one person dies of it and every 30 seconds a limb is lost because of the illness.

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Apple's five features on the iPhone and Apple Watch that can help those with diabetes are the Activity, Cycle Tracking, Sleep, Medical ID and third-party apps.

"This is really the best time in the history of humankind to be able to better our lives with technology and to be able to learn about it, but also through social media or the internet," Khulood Al Ahmadi, a Saudi doctor in Riyadh, told The National.

"Years ago, my grandmother bought a machine to test her sugar at home and our family rejoiced over it. She still uses it.

"And now with features available to you on your wrist with the new apps, I think it is going to help a lot of people suffering from diabetes but also those who are prone to it yet have not yet discovered it.

"You have to remember genetics play a very strong role in the development of diabetes."

Early detection of diabetes and intensive glucose management can reduce the risk and severity of many complications.

Over time, diabetes can damage blood vessels in the eyes, kidneys, heart and nerves.

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Research such as the Apple Heart and Movement Study and the Apple Women’s Health Study launched in 2019 shared new findings that reinforce the benefits of physical activity on glucose, including maintaining a target range throughout a menstrual cycle.

Findings from the research at Harvard University's Brigham and Women’s Hospital revealed that as participants increased the average duration of exercise or number of steps, there was a corresponding increase in the average percentage of time glucose fell within the target range of 70 to 180 milligrams a decilitre.

Activity levels will help with glucose management. Through the Activity app you can set targets and receive reminders to keep up with them.

The link between menstrual cycle, hormones and glucose levels

The menstrual cycle is regulated by many hormones prone to changes in glucose and insulin.

New studies highlight the connection between one's menstrual cycle, glucose levels and insulin sensitivity, influenced by hormones such as oestrogen and progesterone.

“In a preliminary analysis, our research team has identified an intriguing pattern in continuous glucose measurements across the menstrual cycle among people with regular cycles," said Calum MacRae, a cardiologist, professor of medicine at Harvard and principal investigator for the Apple Heart and Movement Study.

"During the follicular phase, which is characterised by higher oestrogen levels and low progesterone levels, we've observed a slight increase in the time spent within the target glucose range."

Active lifestyle – a core component in diabetes management

Physical activity can decrease blood glucose levels, increase glucose uptake by cells, improve insulin sensitivity, increase fatty acid oxidation, fat mobilisation and lipolysis, and lead to better mental health.

The Apple Watch monitors physical activity levels, heart rate and sleep patterns, giving users a holistic view of their well-being, and allowing physicians such as Dr Aarti Javeri-Mehta, an internal medicine specialist in Dubai, to receive objective data for analysis.

Blood glucose monitoring is a cornerstone for diabetes management and is recognised as one of the seven self-care gems in diabetes self-management.

Dr Javeri-Mehta said blood glucose monitoring is a highly empowering process for a patient that enables self-management, encourages understanding of patterns and allows for more informed treatment decisions in a doctor’s office.

Through third party apps, glucose meters including continuous monitoring is now possible to view on Apple Watch.

The Apple Heart and Movement Study showed participants who exercised more than 30 minutes a day spent 78.8 per cent of the day within the target blood glucose range, demonstrating the potential for the Activity App to be a powerful motivator in positive movement behaviour.

Prof MacRae said that empowering users to move in the right direction is a fundamental foundation of precision health and medicine.

The Apple Watch enables users to determine how best to improve their cardiometabolic risk.

"I got my wife and parents Apple Watches to get them to look after their health," said Hasan Jamal, a Saudi entrepreneur in Jeddah.

"While there was opposition before, they agreed to it because they can use it as their phones, for entertainment and now, honestly, they are addicted.

"I look forward to using the data especially for my ageing parents, both diabetic, to see how it can also help the doctors as it is so much easier to have the data recordings, such as your movement and physical activity, than having to remember it."

In the Health app, people can update their Medical ID to include information about diabetes and medications, which can be used to help in an emergency.

Third party iOS apps affiliated with meters, including CGMs, can help users to track glucose, with some giving an option to view your levels directly on the Apple Watch.