Apple’s Most Secretive Team Is About to Spark a New Health Era

The next generations of wearables will introduce a new approach to health care, improving prevention and treatment of chronic diseases.

Eugenio De Lucchi
Predict
7 min readMar 29, 2023

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Photo by Carles Rabada on Unsplash

Few companies have stricter secrecy standards than Apple. Inside the tech giant, a group named New Product Security team –consisting of former National Security Agency (NSA), FBI, and Secret Service– educates employees through product secrecy training and investigates those responsible for Apple leaks worldwide.

Employees’ knowledge about internal projects is limited to what they are working on. And a sort of “SWAT team” prevents and deals with accidental leaks between employees via email.

Workers assigned to top-secret projects must pass through a maze of security doors and show their badges multiple times to access their offices. Workspaces are generally monitored by security cameras and even trash bins are checked.

Over the years, however, this paranoia over secrecy has not prevented leaks about secret projects from filtering outside the company.

Just in the past few days, the progress of one of these projects has become public knowledge. For more than twelve years, a task force of a few hundred of the best engineers and scientists at Cupertino’s disposal has been pursuing the project at the initiative of Steve Jobs.

The team, known inside the company as Exploratory Design Group, works on the most sophisticated technologies, has vast financial resources, and is instructed to explore ideas to the point of ascertained unfeasibility.

After years of development, the project in question has reached a significant turning point and is poised to introduce a massive medical and health revolution.

Steve Jobs’s last vision

Steve Jobs ordered the start of the project in the last years of his life when diabetes joined cancer.

His hatred of repeated blood glucose injections led the Apple co-founder to authorize a research team to work on a noninvasive glucose reading sensor that could be contained in a wristwatch.

Jobs aspired to create wearable devices for monitoring vital parameters such as oxygen levels, heart rate, and blood sugar.

The project began in 2009 with the acquisition of RareLight, a startup pioneering an exploratory approach to noninvasive blood glucose monitoring.

According to reports, the team initially operated as Avolonte Health LLC, an actual startup established not too far from Apple’s headquarters, in order to appear with no connection to Cupertino.

Recently, Apple partnered with Rockley Photonics to create glucose monitoring sensors and chips, funding $70 million in research.

In 2021, Rockley Photonics unveiled a digital sensor system that could monitor body temperature, blood pressure, glucose, alcohol, lactate, and more. Then last year, Cupertino ended the relationship.

According to Patently Apple, also in 2021, Apple obtained a license for an integrated silicon photonics device. Recent updates confirm that Apple is secretly working on a sensor on a sensor for its future smartwatch models and is working closely with Taiwan Semiconductor Manufacturing to produce the main chip.

The team assigned to the project is reportedly working on a Silicon Photonics chip that would rely on optical absorption spectroscopy to perform noninvasive blood glucose monitoring.

In other words, the technology would involve light or laser sensors that can read the concentration of light in the skin by going back to how much glucose is in the blood.

As things stand, the technology is in a “proof-of-concept” state and needs to be “scaled up to fit a wearable.” The prototype is about the size of an iPhone and can be attached to the arm.

Its eventual release will not occur for a few years, a time frame needed for Apple to continue research and obtain the necessary approvals for commercialization.

A big thing, even for not-diabetic people

A continuous glucose monitoring sensor on the wrist would be a breakthrough, even for non-diabetics.

Death rates from diabetes have been rising steadily since the 1990s. Approximately seven million people died from the disease in 2021 alone. About one in ten people have it, and between 2019 and 2021 alone, the number of cases rose from 463 million adults to 537 million.

The number of cases has more than doubled in recent decades, with a significant increase in the rise of onset in the younger age group. About 9% of the population is diabetic, and about 25% do not even know they are affected.

For six million people in the U.S. alone unaware of having the disease, there are another 96 million in a state of pre-diabetes, the antechamber to 2 diabetes.

By 2045, estimates predict that there will be more than 780 million diabetics. In other words, over the same period in which the global population is expected to grow by 20%, cases of diabetes would increase at more than double the rate of 46%.

Type 2 diabetes is the most prevalent but also is the most preventable form of the disease. About 80 percent of diabetes cases can be prevented if people intervene in their lifestyle early. Wearable devices can induce these changes by suggesting workouts, nutritional plans, and sleep routines.

As early as 2017, researchers at Stanford argued that wearables could help people at risk of getting diabetes in advance by distinguishing those with insulin resistance, a precursor to type 2 diabetes.

Simply put, smartwatches with the noninvasive glucose sensor could play an important preventive function against type 2 diabetes, suggesting early on those lifestyle changes that, in one of the largest studies for diabetes prevention, led to a 58% reduction in diabetes development.

A new gold standard

Last summer, CNET diabetic video producer Justin Eastzer shared how his Apple Watch and continuous glucose monitor saved his life.

His Apple Watch woke him up with an alert in the middle of the night after his continuous glucose monitor detected critical blood sugar levels.

For a diabetic person, when blood levels fall below a certain threshold, the scenarios he or she faces are fainting or diabetic coma.

The alarm signal instead allowed Eastzer to wake up just in time to run to the refrigerator and drink some orange juice before passing out.

A few minutes later, once his sugar levels returned to normal, the video producer regained consciousness.

Unlike shots and glucose measurements at scheduled intervals, a continuous glucose meter measures glucose levels consistently, providing better control over glucose and a lower risk of developing debilitating consequences.

These devices attached to patients’ bodies constantly monitor blood sugar through a small tube that measures glucose levels in the interstitial fluid. And thanks to recent integrations with smartphones and smartwatches, they can send notifications and trigger an alarm if sugar levels reach too high or too low.

The problem with these devices is the cost. A 2021 study found that cost is the principal barrier of entry to the widespread adoption of these CGM devices.

Without insurance, CGM systems can cost between $160 and $500 monthly, Healthline reports. And even with insurance, these devices that have become the new standard in diabetes treatment are too expensive for most people to maintain.

If Apple could incorporate a sensor capable of reading glucose without deviating too much from the current Apple Watch price, the devices would result in a new standard for monitoring diabetes.

Compared to modern CGM devices, it would have even tighter hardware and software integration offering noninvasive wrist-worn monitoring at a fraction of the price.

A new scenario of possibilities

When the Apple Watch debuted in 2015, many health-related features were dropped as a compromise to size and battery life. Apple focused the smartwatch on notifications and tracking functions, although it had a heart rate sensor.

Now years later, every smartwatch on the market is a more or less accurate health tracker with heart and sleep monitoring functions.

Specifically, the Apple Watch has a heart rate sensor and offers functions for electrocardiogram, body temperature sensing, and calculation of blood oxygen levels.

Cupertino’s next generations of smartwatches prospect to move even closer to Jobs’ latest vision and raise the open-ended question of how far smartwatches –or wearables in general– can go in the future.

Part of this question concerns what part wearables will play in diagnosing and monitoring other major diseases.

A team of engineers at Stanford, for instance, has developed a flexible electronic strip with the appearance of a band-aid that can measure the change in the size of a tumor down to a hundredth of a millimeter in real time.

The sensor, positively received by the oncology community, transmits size changes to a smartphone app documenting the progress of the tumor in real time.

Its measurements are precise, noninvasive, and can detect 3D shape changes that would otherwise be difficult to capture in real time with conventional technologies.

In addition, with an assembly cost of about $60, the device, dubbed FAST, could significantly speed up and shorten the screening process for cancer therapies.

To date, FAST works only with subcutaneous tumors and is awaiting testing in people. But it certainly represents a bright beginning proving how much potential wearable devices have in improving human health.

Bottom line

Soon, small wearable devices with noninvasive diagnostic sensors will flood the technology market, introducing a healthcare revolution.

Already wearables, from wristbands to watches, trackers, and patches, can measure more than 7500 behavioral and physiological variables. These devices, aided by artificial intelligence, prefigure the beginning of a new era of health through early detection and real-time monitoring of chronic diseases.

Wearable devices can enable early diagnosis, ensuring earlier treatment and a softer disease course. For example, they can predict Parkinson’s in its early state from arm gait. Or they can recognize if an elder’s balance is beginning to weaken or diagnose atrial fibrillation in time and thus save hundreds of thousands of lives at a negligible cost.

In addition to what they already do, in a matter of years, smartwatches could measure a wide range of parameters-glycemia, alcohol, hydration, markers of inflammation, and kidney and liver function.

With the help of AI, future sensors could quickly find patterns and potentially anticipate knotty health issues.

Real-time monitoring also would enable doctors to administer better treatments. And with algorithms analyzing thousands of data suggesting diagnoses, prescriptions would become more accurate, effective, and personalized.

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