Garmin’s Race for On-Wrist Glucose Tracking

While Apple’s secretive “E5” project often gets the headlines for all-things related to glucose tracking, recent breakthroughs like the isaac by PreEvnt—a non-invasive breath analyser—signal that the era of needle-free glucose monitoring draws ever closer.

For Garmin, a device like this would be a key justification for customers to choose the brand as their smartwatch of choice, rather than the company remaining heavily sports-focused. Be it Samsung, Apple, or Garmin, whoever gets there first has a huge commercial opportunity.

The Tech: Smelling Breath vs. Seeing Through Skin

The launch of isaac at CES 2026 shows that volatile organic compound (VOC) analysis can track blood sugar via acetone in the breath. However, for a watch-based sensor, Garmin would more likely look at Silicon Photonics and Optical Absorption Spectroscopy to measure interstitial fluids.

The two methods represent very different engineering paths:

• Breath Analysis (isaac): Uses chemical sensors to detect acetone molecules (VOCs) exhaled from the lungs.
• Optical Analysis (Apple/Garmin): Lasers emit specific wavelengths of light through the skin tissues into the interstitial fluid. The watch measures reflected light to calculate glucose concentration.

Hurdle – Miniaturisation: To fit into a sleek wearable, Garmin must shrink lab-grade spectrometers into a module the size of its current Elevate Gen 5 sensor.

Precedents with breath analysis

Other precedents in non-invasive breath-related technology include the Lumen Metabolic Sensor, which measures the difference between exhaled and inhaled CO2. From the difference comes the amount of fat and carbs burned to generate the body’s energy needs, scientifically validated as accurate for the vast majority of people.

Note: Dexcom, Abbot and Supersapiens (now closed) use tiny needles via a different invasive technique to sample and test interstitial fluids, technically not the blood itself.

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For Athletes: Ending the “Bonk” is Unlikely

For endurance athletes, glucose is the ultimate fuel gauge. Near real-time monitoring allows for:

• Precision Fueling: Knowing how to keep supplying fuel to muscles via blood (blood glucose).
• Optimised Recovery: Seeing how post-run meals impact glycogen replenishment.

Difficulty: Unlike current adhesive patches (CGMs), breath-based or early optical tech requires a stable signal. Monitoring during exercise is technically challenging due to “noise” from movement and sweat. Almost certainly, sports usage would not happen in the first generation.

Primary Target: The Diabetes Community

While athletic users are likely to be of most interest to regular readers here, the most significant impact—and likely the first focus for Garmin, Apple and Samsung—is for those living with diabetes and closely monitoring blood glucose levels.

• Standalone Freedom: Moving the watch away from being a secondary display for the sensor (as with existing Dexcom patches) to becoming a single, integrated medical tool.
• Holistic Health: Integrating glucose data with Body Battery, Sleep Scores and other biomarkers to show how stress and fatigue affect insulin sensitivity.
• Automatic Alerts: Vibration-based “Low Glucose” warnings that work independently of a smartphone.

Where would Garmin add this kind of tech first? Venu, Vivo, and Fenix?

Forerunners are built for sports, so the typical buyers of Garmin’s other lines are far more likely candidates:

• Venu & Vivoactive: As Garmin’s premium lifestyle watches, these are the natural home for medical-grade wellness features aimed at daily health management.
• Fenix & Epix: The flagship “adventure” watches typically have ‘every feature’ plus the internal volume, price premium and battery capacity to house first-generation glucose sensors.

Timeline: With Garmin’s 2025 patent for HbA1c (long-term glucose) tracking, we could see the first “Metabolic Garmin” as early as 2027–2028 in its next-gen Elevate 6 sensor. This is the more likely technology for Garmin to deliver first. However, the tracking timeframes are not real-time; months-long is more the reality. VOC analysis provides a way to get significantly more granular, useful readings.

Conclusion

The Isaac breath tool is undergoing active FDA approval. Even if approved, it is unlikely to be of interest to any wearable company in its current form. More likely, another company will license PreEvnt’s patents or develop similar breath methods themselves. Unless that is already in motion, we are looking at time frames of at least 3 years to get this type of tech miniaturised and on our Garmin. The existing HbA1c data will likely yield more fruitful new features.

Last Updated on 31 January 2026 by the5krunner

the5krunner

tfk is the founder and author of the5krunner, an independent endurance sports technology publication. With 20 years of hands-on testing of GPS watches and wearables, and competing in triathlons at an international age-group level, tfk provides in-depth expert analysis of fitness technology for serious athletes and endurance sport competitors.