Wearable Technologies

By, Dr Amit M. Joshi,

 What is Wearable Technology in Healthcare?

• Wearable technology incentivizes behavior that reduces hospital visits and

readmissions due to poorly managed personal health—75% of users agree
that wearables help them keep track of their health.
• When consumers started spending more time at home during the pandemic,
many started using wearable devices as a means to monitor their health and
seek medical treatment.
• According to Insider Intelligence, US consumers’ use of wearables increased
from 9% to 33% in just four years.
Trends of Wearable Technologies
Market of Wearable Technologies
 Consumer Market

• The first forms of wearable fitness trackers were wristbands equipped with sensors to
track a user’s physical activity and heart rate.
• Some of the earliest models, such as the FitBit Flex, were favored for their sleek look,
their ability to track steps with five indicator lights, and their capacity to sync with a
number of smartphone apps.
• Fast forward a few years and more wearable fitness trackers have entered the market,
thanks in large part to big tech players entering the space.
• According to IDC, Apple shipped 34.1% of wearables worldwide in 2020, far ahead of
Samsung (9%) and Fitbit (2.9%).
• Google appears to be investing in the wearable technology space as well, as they
recently acquired Fitbit.
 Smart Watches
• Smart health watches are similar to standard wearable fitness trackers in that they offer
exercise and health tracking benefits.
• But, smartwatches also offer features that one would normally have on their mobile device,
including notifications, messages, and phone calls.
• While smart health watches were first known for more simple fitness uses like counting daily
steps, recent advancements have made them more viable healthcare tools.
• The Apple Heart Study app gained popularity in 2017 for its capacity to monitor heart rhythm
and alert users if they experience atrial fibrillation.
• Apple’s Series 7 model released in 2021 came packed with a blood oxygen saturation
monitor, native sleep-tracking capabilities, a faster FDA-approved electrocardiogram (ECG)
sensor, upgraded heart health monitoring, and fall detection that will automatically call 911 if
it detects the wearer is not moving.
• According to Insider Intelligence’s Smartwatch Users forecast shown below, the number of
US smartwatch users grew from 42 million to 45.2 million users from 2020 to 2021, and this
is expected to continue to grow to 51.9 million smartwatch users by 2024.
Smart Watch Users
Wearable monitoring Systems
 Glucose Measurement : Need
• Diabetic patients have doubled , 422 million diabetic people in 2019

• Design the solution for the glucose measurement

• People would be more aware of their diet control

• No smart healthcare solution for glucose measurement

Jain, Prateek, Amit M. Joshi, Navneet Agrawal, and Saraju Mohanty. "iGLU 2.0: A new non-invasive, accurate serum
glucometer for smart healthcare." arXiv preprint arXiv:2001.09182 (2020).
Diseases in human body due to diabetes
 Diabetes Effects
Symptoms

Excretion of Consistently Unexpected weight Heart disease,

urine within hungriness and loss, tiredness and nerve damages
short durations Thirsty vision changes and blindness

Kidney disease

❖After being these problems, probability of death with diabetes has become 50% higher
than without diabetes in adults.
❖In 2019, 69.2 millions Indians of the population had type 2 diabetes. Approximately 2.35
million adults have Type 1 diabetes.

David R. Whiting, Leonor Guariguata, Clara Weil, and Jonathan Shaw. Idf diabetes atlas: Global estimates
of the prevalence of diabetes for 2011 and 2030. Diabetes Research and Clinical Practice, 94(3):311 -321,
Types of Diabetes
Need of Continuous Glucose Monitoring
 Detection of Glucose Molecule
• The reflectance and absorption of light using
specific wavelength cause respective glucose
molecular vibration which can be observed in
glucose spectra.
• Molecular vibration depends upon bond vibration
like wagging, bending, rocking, stretching and
twisting.
• It has been analyzed that multiple bonds stretch
and wag at different resonant frequencies.
• With the absorption, the glucose molecule gains
energy and start vibrating and the mode of
vibration
• It is also examined that absorption of light will depend on the molecular
concentration of the medium.
M Ries Robinson, R Philip Eaton, David M Haaland, Gary W Koepp, Edward V Thomas, Brian R
Stallard, and Paul L Robinson. Noninvasive glucose monitoring in diabetic patients: a preliminary
evaluation. Clinical chemistry, 38(9):1618-1622, 1992.
Glucose Characterization using NIR Spectrometer
• Perkin Elmer Lambda 750 UV-VIS-NIR spectrometer has been used in

analyzing the absorption spectra of different samples of interest.

• Following this, hydrated glucose samples were prepared by dissolving

varying quantities of commercially available refined glucose powder

whose spectra were analyzed.

• Hydrated glucose solutions comprised of 5 g, 10 g and 15g glucose

powder uniformly dissolved in DI water.

• In this work, 940 nm and 1300 nm have been chosen to ensure

reliable detection.
Jain, Prateek, Ravi Maddila, and Amit M. Joshi. "A precise non-invasive blood glucose measurement
system using NIR spectroscopy and Huber’s regression model." Optical and Quantum Electronics 51,
no. 2 (2019): 51.
 iGLU 1.0 PROCESS FLOW
iGLU 1.0:

Jain, Prateek, Amit M. Joshi, and Saraju P. Mohanty. "iGLU: An Intelligent Device for Accurate Noninvasive Blood
Glucose-Level Monitoring in Smart Healthcare." IEEE Consumer Electronics Magazine 9, no. 1 (2019): 35-42.
Glucose Characterization using NIR Spectrometer
• Perkin Elmer Lambda 750 UV-VIS-NIR
spectrometer has been used in
analyzing the spectra
• Initially, DI water spectra were
extracted
• Following this, hydrated glucose
samples were prepared by dissolving
varying quantities of commercially
available refined glucose powder
• Peaks obersved in range of 900 nm to
980 nm and 1300 nm to 1320 nm.
• In this work, 940 nm and 1300 nm have
been chosen to ensure reliable
detection.

Jain, Prateek, Ravi Maddila, and Amit M. Joshi. "A precise non-invasive blood glucose measurement
system using NIR spectroscopy and Huber’s regression model." Optical and Quantum Electronics 51,
no. 2 (2019): 51.
Experimental Setup
• Dual wave NIR spectroscopy based non-invasive blood glucose system is proposed.
• For precise measurement of blood glucose concentration, absorption and
reflectance spectroscopy techniques are implemented at 940nm and 1300nm
wavelengths using three channels.

• At channel 1, the absorption technique is implemented using the 1300 nm

wavelength.
• Absorption and reflectance techniques are used using 940 nm wavelength at
channel 2 and channel 3 respectively.
• Infra-red emitters and detectors are embedded on 2-layer PCB.

P. Jain, Sidharth Pancholi and A. M. Joshi, “An IoMT Based Non-Invasive Precise Blood Glucose
Measurement System,” IEEE-iSES, 16-18 Apr. 2019.
Invasive vs Non -invasive
 Self Glucose Measurement
❖The continuous monitoring and telemedicine for the control
❖The people needs to put conscious efforts using various self-care device to
control them in daily life
❖Non-invasive approach is useful to eliminate the process of pricking in the
body which helps for continuous health monitoring
❖In order to mitigate the issues, we present a non-invasive iGLU device with
Internet of Medical Things (IoMT) framework to provide the state of art
solution for smart healthcare.

Noninvasive Approach – Processing of Light

Invasive Approach – Processing of Blood/Serum
 Novel Contribution for iGLU

A. M. Joshi, P. Jain, and S. P. Mohanty, “iGLU: Non-Invasive Device for Continuous Glucose Measurement
with IoMT Framework”, International Symposium on VLSI (ISVLSI), 6-8 July, 2020, Cyprus
 Serum Glucometer iGLU2.0
• This section represents the first-ever non-invasive glucometer that takes into account serum
glucose for high accuracy.
• In the case of blood glucose measurement, serum glucose value has always been considered
precise blood glucose value during prandial modes.
• Serum glucose can be measured in the laboratory and more stable glucose level compare to
capillary glucose.
• We have proposed a novel IoMT-enabled glucometer for non-invasive precise serum glucose
measurement.
• An optimal multiple polynomial regression model and other regression models have been
presented to analyze the precise measurement.
• We have developed the device which can measure the serum glucose without puncturing the
finger instantly.

Jain, Prateek, Amit M. Joshi, Navneet Agrawal, and Saraju Mohanty. "iGLU 2.0: A new non-invasive, accurate serum
glucometer for smart healthcare." arXiv preprint arXiv:2001.09182 (2020).
 Baseline Characteristics of Collected Samples

Joshi, Amit M., Prateek Jain, Saraju P. Mohanty, and Navneet Agrawal. "iGLU 2.0: A New Wearable for
Accurate Non-Invasive Continuous Serum Glucose Measurement in IoMT Framework." IEEE Transactions
on Consumer Electronics (2020).
 Clarke error grid analysis
• The Clarke Error Grid Analysis (EGA) was developed in 1987 to quantify
clinical accuracy of patient estimates of their current blood glucose as
compared to the blood glucose value obtained in their meter.
• It was then used to quantify the clinical accuracy of blood glucose
estimates generated by meters as compared to a reference value.

W. Clarke, "The Original Clarke Error Grid Analysis (EGA)", Diabetes Technology & Therapeutics, vol. 7,
no. 5, pp. 776-779, 2005.
 Comparison with Previous Non-invasive Works

Jain, Prateek, Amit M. Joshi, Navneet Agrawal, and Saraju Mohanty. "iGLU 2.0: A new non-invasive,
accurate serum glucometer for smart healthcare." arXiv preprint arXiv:2001.09182 (2020).
Automatic Insulin Drug Deliver model with
IoMT framework

Jain, Prateek, Amit M. Joshi, Saraju Mohanty iGLU 1.1: Towards a Glucose‐Insulin Model-Based
Closed-Loop IoMT Framework for Automatic Insulin Control" . World Forum of IoT 2020, May, USA
 Glucose Control For Diabetes
• A novel glucose-insulin model is proposed which represents an
artificial pancreas system (APS) with continuous glucose
monitoring.

• Different cases have been considered to validate the proposed

glucose-insulin model. In this modeling, glucose consumption
parameters have also been determined.

• Proposed model (APS) are integrated with IoMT framework for

remote located diabetic patients to provide prescribed insulin
plan with the help of diabetologist.
Framework of Diabetes Control System
•The unbalanced diet is one of the main
factors for the occurrence of diabetes
Mellitus.
•Therefore, diagnosis and treatment of
diabetes Mellitus are attracting points of
research in smart healthcare.
•Time to time, the glucose values have
been monitored by a diabetologist and
insulin secretion has been recommended
accordingly
 Glucose Insulin Control Closed Loop System

Jain, Prateek, Amit M. Joshi, Saraju Mohanty , “iGLU 1.1: Towards a Glucose‐Insulin Model-Based Closed-
Loop IoMT Framework for Automatic Insulin Control" . WF IoT (World Forum of IoT) 2020, May, USA
 Works of Diabetes Control

• The first glucose-insulin mathematical model has been explored to

estimate the coefficients of normal blood regulation.

• An FDA approved Uva/Padova Simulator was represented for

glucose-insulin control system.

• A lot of models have been presented with different parameters in

terms of meal detection and glucose-insulin concentration
measurement.
 Limitations of Existing Approaches for
Diabetes Control
• Various parameters such as glucose absorption rate, net hepatic
glucose balance, peripheral glucose utilization and renal excretion rate
are required to determine the glucose consumption in the body.

• Parameters are necessary to determine the blood glucose level

regulation with scheduled diet and necessary insulin secretion plan.

• A glucose-insulin mathematical model is required to control the blood

glucose level of type 1 diabetic patients with prescribed diet and insulin
secretion plan.
 iGLU 1.1: Automatic Glucose Control in IoMT
Framework

•The proposed work is integrate with IoMT

framework for a consultancy from diabetologist.
•This proposed model analyze the controlling of net
glucose level, plasma insulin level and glucose
excretion.
•APS system determines the various parameters of
glucose consumptions along with plasma insulin and
glucose level for precise treatment of remote located
diabetic patients.
Proposed APS model with IoMT
framework
Comparison with Previous Work

• The proposed work represents glucose-insulin mathematical

model.

• Glucose consumption parameters are estimated using

MATLAB simulation with four possible cases of diabetic
patients recommended by diabetologist.

• In this work, glucose profiles are simulated with respect to

the scheduled diet and insulin secretion for multiple cases.
 Secure– iGLU (Intelligent Noninvasive
Monitoring and Control)

Continuous
Privacy-Assured
Glucose Health Data Storage Hospital
Monitoring

Security-
Assured System
Insulin Cloud Storage
Display Secretion Doctor
of Artificial Pancreases
Parameters System (APS)

A. M. Joshi, P. Jain, and S. P. Mohanty, “Secure-iGLU: A Secure Device for Noninvasive Glucose
Measurement and Automatic Insulin Delivery in IoMT Framework”, Proceedings of the 19th IEEE
Computer Society Annual Symposium on VLSI (ISVLSI), 2020.
Wearable technologies Pros & Cons
• to monitor our fitness levels, track our location with GPS,
and view text messages more quickly
• devices that allow us to do this are hands free and portable,
eliminating the need to take our devices out of our pockets.
• Wearables are connected to our smart devices, transmitting this
information to them and allowing us to view it at later times, as
well as in the moment. This can help you with setting
goals and tracking your progress toward them.
Wearable technologies Pros & Cons
• Wearables tend to have a fairly short battery life. Some devices,
like the simpler Fitbit trackers, can last for several days. But some
of the more advanced wearables, like the Apple Watch, will only
last for a day or so.
• Some wearables have been reported to measure data
inaccurately on occasion. This can be especially dangerous when
measuring data like heart rates. For individuals with heart
conditions, this false reading could lead to overexertion and further
health issues.
 Will they help improve our health?
• Many wearables provide the ability to track your physical activity and store it
to view at a later time. This can be a great resource, allowing us to set short-
term and long-term goals and track our progress toward them. By receiving
real-time notifications on our activity, like reminders to stand or walk,
wearables can also serve as a source of encouragement and motivation.

• On the other hand, there's no guarantee that people will continue using
wearables over time. At first, they're pretty novel and exciting, but a study has
shown that around 30 percent of people stopped using them because they
didn't find them useful or simply grew tired of them.
 Will they help improve our health?
• Many wearables provide the ability to track your physical activity and store it
to view at a later time. This can be a great resource, allowing us to set short-
term and long-term goals and track our progress toward them. By receiving
real-time notifications on our activity, like reminders to stand or walk,
wearables can also serve as a source of encouragement and motivation.

• On the other hand, there's no guarantee that people will continue using
wearables over time. At first, they're pretty novel and exciting, but a study has
shown that around 30 percent of people stopped using them because they
didn't find them useful or simply grew tired of them.
 The security of your information
• Many wearables tend to have little to no security measures keeping their
data safe. The fact that much of the data is unencrypted and that most of
these devices use Wi-Fi or Bluetooth connections to transmit data means
cybercriminals can get their hands on it pretty easily.
• It's important to consider how this information becomes big data to be
collected and used by companies and governments. This means, whether you
like it or not, that your tracked information could be used for marketing or
health purposes. There are positive ways this information could be used, but
as with all big data there's also a chance it could be misused.
• At the moment, most of the data that's available via wearables isn't valuable
enough for hackers to pursue. But as wearables and their capabilities continue
to evolve, they may become higher-priority targets.
 The future of wearable technology
• Smartwatches, fitness trackers, and VR/AR headsets have become more
and more prevalent in our society over the past several years. It's
predicted that wearables will only continue to grow in popularity, so
naturally companies are finding new and innovative ways to apply them
to our everyday lives

• Lower visibility
• Longer battery life
• Medical wearables
• Authentication
References
• Wearable technology trends that will shape healthcare in 2022
(insiderintelligence.com)
• Wearable Tech in Healthcare: Possibilities and Pitfalls | HealthTech
Magazine
• The Future of Wearable Technology in Healthcare | SCAND
• All You Need To Know About Wearable Technology in Healthcare
(intellectsoft.net)
• Wearables: The Future of Wearable Technology (gcfglobal.org)