Smartwatches and AAPS

Various smartwatches can be used to display some of the information available in AAPS or perform remote actions.

Having a smartwatch directly control AAPS (pump and sensor) is achieved using full Android watches (that are considered like small smartphones).

Some smartwatches can allow you to enter treatments, or more, but with the phone itself still managing AAPS.

Smartwatches are becoming increasingly used with AAPS both for adults with diabetes and carers/parents of children with diabetes.

General advantages of using smartwatches with AAPS

Smartwatches - depending on the model - can be used in many different ways with AAPS. They can be used to fully or partly control AAPS, or simply to remotely check glucose levels, insulin-on-board, and other parameters.

Integrating a smartwatch with AAPS can be useful in many situations, including driving a car or (motor) bike and during exercise. Some people feel that looking at a watch (in a meeting, party, dinner table etc.) is more discreet than looking on a phone. From a security perspective, a smartwatch can also be beneficial while on the move, enabling user to have their AAPS phone stored out of sight (like inside a bag), but with the aid of the smartwatch for remote control use.

Specific advantages for parents/carers using AAPS

For a child - if their AAPS phone is nearby - a caregiver can use a smartwatch to monitor or make modifications without needing to use the AAPS phone. This can be useful, for example, if the AAPS phone is hidden away in a pump belt.

A smartwatch can be used either in addition to, or as an alternative to the PHONE-based options for remote control or following only.

Additionally, unlike parent/caregiver follower phones (which rely on the mobile network or Wi-Fi connection), Bluetooth connected smartwatches can be useful in remote locations, like a cave, in a boat, or half-way up a mountain. If both devices (AAPS phone and smartwatch) are on the same wifi network, they can also use wifi.

Different types of Smartwatch-AAPS interactions

There are currently five main ways in which smartwatches are used in conjunction with AAPS. These are shown in the table below:

Watch Setup	Features	Requirements
Standalone	AAPS without a phone	Full Android smartwatch (check min Android) Running app-fullRelease
Full remote control	Most AAPS functions	Android Wear OS watch (check Android/API) Running wear-fullRelease
Remote control	AAPSClient functions	Android Wear OS watch (check Android/API) Running wear-aapsclientRelease
Remote control	Some AAPSClient functions	Some Samsung, Fitbit and Garmin watches See below.
Display	Display some AAPSClient indications	Many smartwatches (see here) xDrip+ and WatchDrip+

Before you buy a smartwatch…

The exact model of smartwatch you buy depends on the desired function(s). You may find useful information on the Phones page, including a list a tested phones that also contains some smartwatches.

Popular watch brands include Samsung Galaxy, Garmin, Fossil, Mi band and Fitbit. The different options summarized in the Table above are explained in more detail below, to help you decide which smartwatch is right for your situation.

If you are integrating a smartwatch with AAPS on a phone with the intention to remotely interact with AAPS, you also need to consider if the two devices are compatible with each other, particularly if you have an older, or an unusual phone.

In general, if you only want to follow glucose numbers and not interact with AAPS, there are a wider range of affordable and simpler watches you can use.

The best way to choose a smartwatch is to search for “watch” posts on either Discord or Facebook AAPS groups. Have a read of others experiences, and post any specific questions, if your query isn’t answered by older posts.

Full Android

It sounds like an attractive option, right? However, at present, only a few enthusiasts are experimenting with AAPS on a stand-alone watch. There are a limited number of smartwatches with a reasonable interface which also which work well with standalone use of AAPS and your CGM app. Popular models include the LEMFO LEM 14, 15 and 16. You will need to load the watch with the AAPS “full” apk (the apk which is usually installed on a smartphone) rather than the AAPS “wear” apk.

While there is no clear specification which helps you to know if a watch will work well for standalone AAPS use, the following parameters will help:

1. Android 10 or newer.

2. Being able to take the watchface off “square” mode to make text larger and easier to read.

3. Very good battery life.

4. Good Bluetooth range.

Most of the frustrations of standalone AAPS watches come from interacting with a tiny screen, and the fact that the current AAPS full app interface has not been designed for a watch. You may prefer to use a stylus to edit AAPS settings on the watch, due to the restricted screen size, and some AAPS buttons may not be visible on the watch screen.

Additional challenges are that it is hard to get sufficient battery life, and watches with sufficient battery are often bulky and thick. Users report fighting with the OS and power-saving settings, difficulty in starting sensors on the watch, poor Bluetooth range (for maintaining connection with both the sensor and pump) and questionable water resistance. Examples are shown in the photos below.

If you are interested in setting up a standalone watch, read the posts and comments on the AAPS Facebook group (good search options are “standalone” and “Lemfo”) and Discord for more information.

Wear OS

AAPS code contains an app extension that can be installed on Wear OS smartwatches.

Verify your smartwatch satisfies AAPS prerequisites.

What is Wear OS?

The first three smartwatch options require the smartwatch to have Wear OS installed.

Wear OS is the operating system which runs on some modern Android smartwatches. In 2018, Google rebranded Android Wear 1.x to Wear OS from version 2.x. So, if a device is labelled “Android Wear” rather than Wear OS it may indicate an older version. If the description of the smartwatch indicates only compatibility with Android and iOS - it does not mean it is running Wear OS. It may be some other sort of Vendor specific operating system which is not compatible with AAPS. To support installation and use of any version of AAPS or AAPSClient, a smartwatch will need to be running Wear OS, and ideally be Android 10 or newer. As a guide, as of October 2023, the latest release of Wear OS is version 4.0 (based on Android 13).

If you install AAPS wear.apk on a Wear OS watch, there are a range of different custom AAPS watchfaces which can be selected. Alternatively, you can use a standard smartphone watchface, with your AAPS information included in small tiles known as “complications” on the face. A complication is any feature that is displayed on a watchface in addition to the time. Features like complications require Wear OS version 2.0 or newer to work.

What could my smartwatch look like?

After installing AAPS onto your watch, you will automatically be able to select your preferred watchface from these AAPS-dedicated watchfaces. On most watches, you simply long-press on the home screen until the screen shrinks and swipe right to select an alternative screen:

These are the basic screens embedded in AAPS, there are more watchfaces and you can also use complications.

How would I operate a Wear OS watch from day-to-day?

Further details about the watchfaces, and day-to-day use, including how to make (and share) your own customized watchface, can be found in the section Operation of Wear AAPS on a Smartwatch.

Samsung Tizen

AAPS supports sending data to the G-Watch app.

Please check the dedicated Facebook group for latest news.

Garmin

There are a some watch faces for Garmin that integrate with AAPS, on the Garmin ConnectIQ store.

AAPS Glucose Watch integrates directly with AAPS. It shows loop status data (insulin on board, temporary basal) in addition to glucose readings and sends heart rate readings to AAPS. It is available in the ConnectIQ store, the necessary AAPS plugin is only available from AAPS 3.2.

Fitbit

Warning

Google is phasing out Fitbit products. Custom watchfaces are not available in Europe anymore (you need to use a VPN). Purchasing a Fitbit now is not recommended.

AAPS supports sending data to the Sentinel watchface.

“Sentinel” is a clockface developed by Ryan Chen for his family and shared for free for the Fitbit smart watches: Sense1/2, Versa 2/3/4. it is not compatible with the FitBit Luxe since this is only a fitness tracker. Sentinel can be downloaded from the FitBit mobile app.

It allows the monitoring of 1, 2, or 3 individual’s blood glucose numbers using either Dexcom Share, Nightscout, or a combination of the two as data sources.

You can also use xDrip+ or SpikeApp if used with local web server mode. Users can set custom alarms and submit events using Nightscout’s careportal functionality directly from the watch to help track insulin-on-board (IOB), carbs-on-board (COB), enter meal information (carb count and bolus amount), and BG check values.

All will appear on the Nightscout timeline-graph, and as updated values in the IOB and COB fields. Community support can be found at the dedicated Facebook group, Sentinel.

There are additional options for FitBit watches which appear to be for monitoring only. This includes Glance. These additional options are described in the Nightscout webpages.

Following only

These smartwatches will reflect some AAPS information, some will require other apps.

There are a wide range of affordable smartwatches which can provide display only. If you are using Nightscout, then a good overview of all the options is here

Here below some of the follow-only watch options popular with AAPS users:

Xiaomi and Amazfit watches

Artem has created an xDrip+ integration app WatchDrip+ for various smartwatch models, mostly for Xiaomi (e.g. Mi band) and Amazfit brands:

You can read more about them, including how to set up at his website here. The advantage of these watches is that they are small and relatively affordable. They are a popular option especially for kids and those with smaller wrists to wear.

Pebble watch

Pebble watches (now discontinued) were on general sale from 2013 to 2016, and may still be available second-hand. Fitbit took over Pebble’s assets. Pebble users can use the Urchin watchface to view Nightscout data. Displayed data options include IOB, currently active temp basal rate and predictions. If open looping you can use IFTTT to create an applet that says if a Notification has been received from AAPS then send either an SMS or pushover notification.

Bluejay watches

These are unique pieces of technology which can receive glucose data directly from the Dexcom transmitter. It is not widely known that Dexcom G6/G7 transmitters actually broadcasts the current glucose data on two separate channels, a phone channel and a medical channel. The Bluejay watches can be set to receive glucose data on either channel, so if **AAPS ** is using the phone channel, then the Bluejay watches can use the medical channel.

The key advantage is that it is currently the only watch which is completely independent of both the phone and the looping system. So, for example, if you disconnect the pump and the AAPS phone at the beach or flume park, and are out of range of the AAPS phone, you can still get readings from your Dexcom directly to the Bluejay watch.

Reported disadvantages are that it doesn’t always pick up a reading every 5 min, and the battery is not replaceable. The Bluejay GTS watch runs a modified version of xDrip+ software whilst the Bluejay U1 runs full xDrip+.

Apple watch

Check Nightscout on your watch.

The Apple watch now supports G7 direct connection and can be used simultaneously with AAPS.