The Alert app, from the team behind the popular Diabetes Helper support network, uses blood sugar readings recorded by a patient’s smartphone to alert friends & family when a dangerously high or low level is detected.

During my internal medicine training, it was all too common to admit diabetic patients to the hospital with hypo or hyperglycemia for any number of reasons – an innocent medication error, an infection causing blood glucose derangement, dehydration affecting insulin metabolism, and so on. And for some patients, it would turn out that, for whatever reason, their presentation was a surprisingly long time after a “red” blood glucose level was measured.

Alert reads blood glucose measurements through HealthKit integration and watches for high or low measurements; those thresholds can be set by the user. It then creates a push notification for the user to tap and initiate a conference call with up to three trusted family members or friends. The app is also integrated with Apple Watch so the patient can tap on a big red alert button on the Watch to start the process as well.

These individuals also get a text message with the GPS location of the user. These individuals can then help troubleshoot, come check on their loved one, or help escalate the alert including through 911 activation.

Alert App Apple WatchAn important limitation of Alert is that the actual alert still has to be sent by the user. So if there is a blood glucose measurement of 30 mg/dL, if the user doesn’t tap on the push notification, no alert is sent. While that does help avert false alarms, it could also mean real misses particularly if the patient has already become altered or somnolent.

Dexcom’s G5 continuous glucose monitoring (CGM) system includes a similar alert feature and I’m sure other CGMs and glucometers will incorporate those into their associated apps over time. An advantage here though is that by using HealthKit, it doesn’t matter what the patient is using – they could be manually entering data into the app, using a connected glucometer, or a CGM system. So long as it’s HealthKit compatible, this core alert function can operate in the background.

It’s definitely an interesting and timely resource given demographic trends in the United States – as the baby boomer generation ages, they are often dealing with multiple chronic medical conditions with increasingly complex medication regimens. And with the growing focus on helping elderly individuals “age in place,” development of resources to both help them manage their health on a day to day basis, as well as quickly trigger alerts about potential dangers before they materialize, are important.

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