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Google’s “Health Guardian” feature set is rolling out to Pixel Watches 3, 4, and 5 this week, and to Fitbit Air users “later this year.” Google says the new features will include reports on your blood pressure trends and on insulin resistance, which is a big claim for a wearable. Here’s what we know about Health Guardian, including how to set it up and what to expect.
Can you really measure insulin resistance with a wearable?
Insulin resistance is associated with type 2 diabetes, and can be an early sign that you are heading toward pre-diabetes or diabetes. When your body’s insulin receptors stop responding as strongly to insulin, you’re more likely to have higher blood glucose.
Insulin resistance is normally measured with bloodwork. For example, your fasting glucose levels and fasting insulin are combined into a score called HOMA-IR. If you’re concerned about insulin resistance or pre-diabetes, it’s best to talk to an actual healthcare professional to find out what tests they recommend, and what to do with the results.
The insulin resistance feature coming to Google Health is, Google notes, “not intended for medical purposes” and “not a pre-screener for diabetes.”
Google published a paper describing some of the testing that went into developing its insulin resistance algorithm. In the study, the researchers had people use their own Fitbits or Pixel Watches to record a variety of metrics, including heart rate, HRV, and activity. It’s not clear from this paper exactly how the algorithm works or whether it’s likely to be useful in a general population, but apparently Google is betting on it being an interesting factor to track in your Google Health app.
Is Health Guardian free?
Google said in a press release that Health Guardian is available for free for people who use a Pixel Watch 3, 4, or 5. Fitbit Air users will get blood pressure and insulin resistance trends “with a Google Health Premium subscription later this year.” So it’s free if you have a Pixel Watch, but not if you only have the Fitbit Air. Google Health Premium is $9.99/month.
It’s unclear what happens if you own both devices; presumably having a Pixel Watch will get you free access. In any case, other devices, including older Fitbits, do not seem to be included.
How to get Health Guardian’s blood pressure trends and insulin resistance estimates
The new features are built into the 5.09 release of the Google Health app for Android, which is rolling out this week. (It seems iOS will be getting the features later. This makes sense, since iOS users wouldn’t have a Pixel Watch paired, anyway.)
According to Google, you can “set up” your blood pressure and insulin resistance tracking as soon as you get the new version of the Google Health app. A Reddit user who has gotten the update says that you can set up these features by going to the Health tab and then tapping Metabolic to set up insulin resistance tracking, Heart to set up blood pressure tracking, and Respiratory to set up sleep breathing quality.
Google says that you’ll receive your first monthly reports for these metrics on Oct. 1, and that afterwards you’ll be able to view this data in the Health tab.
To get the blood pressure report on Oct. 1, Google says you’ll need to wear the watch for five consecutive days in September. For insulin resistance, you’ll need to wear the watch for seven or more “days and nights” in September. I notice that doesn’t say consecutive days.
I haven’t gotten the new version of the app yet myself, and nobody has gotten their monthly report yet, so I’m looking forward to it as much as you are. I’ll update when I’ve had a chance to try out the new features.
