Review: Monitor your glucose wirelessly with iHealth Smart and Align
Diabetes is a lifelong condition that causes a person’s blood sugar level to become too high. It is one of the fastest growing health threats of our times and an urgent public health issue. According to US government statistics, some 9.3% of Americans or 29.1 million people are diagnosed with the condition. A further 8.1 million people are undiagnosed. Worldwide, an estimated 371 million people have the disease.
We’ve heard recent rumours of Apple working on developing sensors that non-invasively and continuously monitor blood sugar levels. CNBC reports that the efforts have been going on for over five years and that the tech giant is looking at finding ways to navigate regulatory pathways. Whether or not these efforts actually pan out and we see a commercial product remains to be seen.
Essential reading: Top fitness trackers and health gadgets for 2017
Non-invasive glucose monitoring is considered to be the holy grail of diabetes treatment. Many companies have tried and failed and diabetes patients still have no accurate alternatives to tracking glucose by piercing the skin. Diabetics usually do this several times daily in order to make decisions on diet, exercise and medication. Many diabetics still resort to logging their results using pen and paper.
While we are waiting for someone to come up with non-invasive glucose monitoring system, there are more high tech solutions for tracking a person’s blood sugar levels. This is where iHealth comes in.
Founded in 2010, iHealth is a company based in Mountain View, California. It is a subsidiary of the Tianjin-based, Chinese manufacturing company Andon Health, one of the largest OEM health technology manufacturers in that country. The company is known for its wireless devices that can measure vital signs such as blood pressure, weight, heart rate, and more recently blood sugar levels.
For glucose monitoring iHealth offers two solutions – iHealth Align and iHealth Smart. Both take readings like you’re used to with a traditional glucometer, but add a digital twist. The devices add the convenience of automatically interpreting your readings, and transferring them to the accompanying app. You essentially get a digital logbook that presents your data in simple and easy to understand ways such as color-coded charts and graphs.
Align is the less expensive version which directly attaches to your smartphone or tablet via the headphone jack. Smart is its big brother – a wireless version that uses Bluetooth to transmit your readings over the air to the cloud.
| Design Features and software Overview |
Design
Align arrives in a packaging containing the small tear shaped glucose meter, a lancing device, ten lancets, four colored cases, and a clear cap for alternate site testing. About the size of an American quarter, this portable glucometer fits easily into your pocket.
A small 3.0V (CR1620) battery powers the whole thing. Rather conveniently, I found that the box contained two more replacement batteries. There is also a travel patch where you can squeeze everything in, and a couple of instruction booklets.
The more sophisticated Smart arrives in a much larger box to accommodate the Gluco-monitoring device, lancing device, ten lancets, a clear cap, USB charging cable, travel case and instruction booklets. The oval shaped measuring unit is Bluetooth enabled so apart from the charging cable, there are no wires and you don’t need to plug it into your smartphone.
Holding the power button for 3 seconds will turn Smart on. Further presses of the button display previous blood sugar level readings. On the other side of the meter you will find a micro USB port that is used to recharge the device’s batteries. It takes up to 2 hours to recharge meter and it last for up 200 tests. There is also a test strip eject button on the back of the main unit.
You also need to purchase measuring strips and control solution which are sold separately. 100 test strips retail for $25 which works out a reasonable 25¢ per test strip. The measuring strips are “coded” meaning you need to scan the bottle and they will expire in 90 days. The app tracks both expiration and quantity of test strips, and warns you if you are running low. Both devices use the same type of strips and the exact same lancing device.
Features and software
iHealth’s iGluco smartphone app works with both Apple’s devices and Android phones. You can use it as a standalone app to manually log results from your traditional glucometer, or use it to sync readings from Align and Smart.
When you first use Smart, you need to pair it with your smartphone. Once connected, the Bluetooth symbol will flash and remain lighted on the meter. The app will then register the device and connect with it.
The process for setting up Align is simpler – just add the unit as a new device on the smartphone app. There is no Bluetooth pairing in this case as the tear shaped tracker plugs directlyinto the headphone jack.
You need three items to test your blood sugar level: the iHealth Smart or Align device, the lancing device, and test strips.
To start off, insert the test strip into the Align’s or Smart’s strip port with the contact bars facing toward you. The top end of the lancing device comes off to load a lancet while the opposite end twists to prime the lancer. Prepare the lancing device by adjusting the lancing level and cocking the handle until it clicks.
You then need to use the lancing device to obtain a blood sample. Its important to wipe away the first blood drop and squeeze until a second small blood drop forms. This increases accuracy. Then apply the blood sample to the absorbent hole of the test strip. If you are using Smart and are in Bluetooth range, the iHealth app walks you through the test process.
I must to admit I wasted about 3-4 test strips before learning the correct technique. But once I did, I found that even the smallest droplet of blood was enough when applied correctly to the testing strip.
Each time you take a test, the app will look at the time and tag the reading automatically (before/after breakfast/lunch etc…). You can edit the automated info about each test if it is incorrect. You can also enter other information such as medications, activities, record an audio note and more.
Each test will show as red, green or yellow on the smartphone app. Red means a high blood sugar level, green is a normal level and yellow is low. This is based on glucose recommendations issued by the World Health Organisation. If you prefer, you can edit the levels through the smartphone app and define your own target range levels.
If you don’t have the mobile device with you, you can sync later on as Smart stores up to 500 test readings on its internal memory. I would suggest though using the app because it provides a much easier way to view results and trends.
A lot of effort has clearly been put into designing the app and for me, this was perhaps the best part of the system. The software keeps all your readings in one place, colour codes everything showing if you are in a low, normal, high or very high range. It also keeps tabs on your highest and lowest reading and has further charts which separate your results depending on meal-times.
You can view trends by date, time of day, before meal trends, after meal trends – and all this can be segregated into daily, weekly, 2 weekly, monthly and 3 monthly data presentations. You can share the reports and the app will export PDF, CSV or Microsoft Excel files with your results in table or graphic form, or even post them to social networks.
You can also set reminders. Furthermore, the app plays nicely with Apple Health, and you will find that all your readings will find their way into the Apple Health app.
Accuracy of glucose meters is, of course, a common topic of concern. Commenting on the accuracy of readings and comparing them to clinical settings is, however, beyond the scope of this article. But blood glucose meters must meet accuracy standards set by the International Organization for Standardization (ISO). iHealth says its Smart glucometre is both FDA Approved and CE Certified.
 | iHealth Align Glucometer |  |
I did find that the readings tended to fluctuate somewhat. Reading through Amazon reviews, it is clear that most people have praised the hardware and software side, but there is a division of opinion on accuracy. I would suggest reading through Amazon reviews and making your own judgement. I would also suggest purchasing a control solution test. It contains a known amount of glucose that reacts with test strips and is used to check that your meter and test strips are working together properly.
Overview
Summary
All in all, I found that both Align and Smart look and handle very nicely. In the time that I’ve tested them, I had no problems pairing or measuring readings. If you are looking to purchase one of the two, the price for both is very low so I would suggest paying $15 more and opting for the more expensive Bluetooth version.
Outside of accuracy which is beyond the scope of this article, I can say that the system is simple to use once you get the hang of it. It comes with a comprehensive iHealth Gluco-Smart app which serves as a great visualization tool. The app automatically collects and analyzes your readings, and gives you a host of simple to read and understand history and trends charts.
 | iHealth Smart Glucometer | |
Progress has been slow in advancing glucose monitoring systems. You still need to prick your finger to get drops of blood and both systems use disposable test strips – just like your traditional glucometer. Its fair to say that these and other similar high-tech devices, are middle-of-the-road solutions to integrating technology with diabetes care. For use until one day someone finally comes up with a non-invasive glucose monitoring solution.
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