Biowearables: Evolution and potential

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Marc Taub, PhD, divisional vice president of technical operations for Abbott's diabetes care business, shares his thoughts on the use and potential of biowearables, the latest evolution of health technology.

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Wearables – smart devices like watches, bracelets and rings - have become ubiquitous, with almost a third (31%) of all UK consumers owning and using a wearable device daily, according to research from YouGov. Wearables typically sit on top of the skin, and measure what health data they can, but we’re now moving into the latest evolution of healthtech, known as biowearables. Biowearables go a step further, continuously measuring biomarkers inside the body in real-time.

By tracking the body’s internal biomarkers – things like glucose, ketones, or lactate – a person can get an ongoing and precise window into their body. And this enhanced data and insights could help them make more informed decisions about their health and wellness.

Biowearables have been life-changing for people with diabetes for more than a decade, and now we’re starting to understand the positive effects of biowearables for general consumers who are interested in improving their overall health and wellness or preventing future disease.

Biowearables for people with diabetes

One of the first biowearables I helped develop was Abbott’s FreeStyle Libre continuous glucose monitoring technology for people living with diabetes – arguably the most successful biowearable to date, now used by more than five million people globally. This small sensor sits on the back of an arm and measures data directly from the body, sharing it in real-time with people via their smartphone app. In this case, the biomarker the sensor measures is glucose. When a person with diabetes knows their glucose levels throughout the day, they know how to change their behaviour – maybe get something to eat, inject insulin, go for a walk – based on what is happening in their body right then.

Before technology like this, people with diabetes relied on painful, point-in-time, finger pricks – sometimes up to 10 times a day – to check glucose levels in their blood.

Now, after years of clinical studies and real-world data from millions of users, we know that this medical biowearable helps people with diabetes improve their glucose control, lower their HbA1Cs, decrease diabetes-related hospital admissions, and improve their quality of life.

As we better understand the power of this technology, we know it can also help more people – beyond those with diabetes – get enhanced visibility into their bodies too.

Monitoring glucose for athletic performance

A cohort we knew could benefit from biowearables was elite athletes. Professional athletes are constantly looking at ways to fine-tune their bodies to maximise their training and performance. If biowearable technology provides a window into our bodies to help manage diabetes, could it also help athletes better understand how their bodies respond to nutrition and training?

World record marathon runner, Eliud Kipchoge, says yes. He is just one of many professional athletes using and advocating the benefits of this technology. “I am learning how my glucose levels relate to my running performance and have already started to see how quickly small adjustments can make a big difference," Kipchoge said.

Bodies store glucose as fuel ready to be burned as needed. Once exercising, glucose will rise for a time, but later — and especially so in endurance exercise like marathoning and as glycogen stores are depleted — glucose will begin to lower. How and when that's happening is key to helping achieve our best performance. And biowearables are key to knowing the how and the when.

Seeing the impact that monitoring glucose levels had on professional athletes offered a glimpse into the promise of monitoring glucose for the general population.

Consumer biowearables, and beyond

Metabolism is important to our overall health and one key element to managing our metabolism is understanding our bodies’ glucose. We know that keeping our glucose from spiking and dipping – or flattening our glucose curve – leads to improved energy, mood, focus, sleep, and reduces unpredictable cravings. But most people have no clue where their glucose levels are or if they are heading up or down.

That’s where biowearables can come in. This tech provides a continuous real-time data stream to inform people how their activities, food, stress, or other behaviors affect glucose levels in their body.

And while glucose is a good place to start, there are also many other biomarkers that can be tracked in a similar fashion. In the case of ketones, many people are trying the keto diet, an extremely low-carb, high-fat diet, which is supposed to put the body into ketosis, where the body burns fat for fuel. The problem is: people have no idea when they are in ketosis, and because they usually are not in ketosis, they are frustrated when they don’t see results.

A biowearable that can continuously measure ketone levels could show exactly when a person’s ketone levels are high enough to be in ketosis – allowing them to make changes to what they’re eating to reach their goals.

Measuring ketones is something we’re looking at for use in medical biowearables as well. For example, for people with diabetes, rising ketone levels that accompany diabetic ketoacidosis can be fatal, which is why we’re developing a first-of-its-kind dual monitoring system that will enable people with diabetes to continuously monitor both glucose and ketone levels in one sensor.

Unlocking the future of health

Biowearables are already helping people manage chronic disease and better understand their bodies to reach their personal health and wellness goals. And the future potential is even greater. Biowearables may one day help doctors make more accurate diagnoses, help people recover at home instead of the hospital and drive down the cost of healthcare.

Put simply, biowearables offer a window into our body like never before – and they are unlocking the future of health.

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