Jillian Lovell spends up to 60 hours a week in schools and private educational institutions working with children with special needs. But as a 23-year-old type 1 diabetic, maintaining a stable insulin level is a 24/7 concern.

"When it comes to glucose control, I need to constantly monitor my sugar levels to understand the foods that affect them and know when to modify them," said Gillian.

"I've been a diabetic for over 10 years, but it wasn't until I started working from home during the pandemic that I could see the immediate impact of whatever I ate and realized how it was the best option for me."

While the flexibility of distance learning helped Jillian manage her glucose readings and trends sensitively in the early days of the pandemic, the special needs teacher is back in the classroom five days a week, with after-hours home visits on three of those days. She cannot easily monitor blood glucose notifications on her iPhone SE as she does when she is conducting lessons on Zoom.

She knows that having an Apple Watch would help, but she doesn't know which model to buy. So she asked me, her best friend, for advice.

The Apple Watch by itself cannot check glucose levels; you can buy a continuous monitoring device from Dexcom ($245 for the transmitter, $1,035 for a 3-month disposable sensor) or FreeStyle Libre ($69.99 per receiver, $35 for a 10-day sensor .99) and other continuous monitoring systems. Whichever method is chosen, having a device like the Apple Watch that can display glucose readings would be essential.

"If your blood glucose levels are trending up or down or toward a change in blood sugar, you can get rescue before you feel symptoms," says Emi Pettit, a nurse at Duke University Hospital and one of Jillian's trusted sources for diabetes information.

"This is especially helpful in situations where you don't have immediate access to a cell phone, such as when you're at work or driving."

Dexcom, Gillian's glucose monitoring system of choice, offers a dedicated Apple Watch app (there is also a Samsung Galaxy Watch app and WearOS app) that allows notifications from the user's wireless insulin pump to be pushed to the wrist via the phone; the Dexcom app also displays the user's current glucose levels and general glucose trends at a glance. The Dexcom app provides an at-a-glance view of the user's current glucose levels and general glucose trends.

"With type 1 diabetes, you may need to know exactly what your glucose is doing at any given point in time," says Jake Leach, CTO of Dexcom, who is overseeing development of the next generation of glucose monitoring products.

The first question Jillian brought to me was whether there were any drawbacks to her getting the Apple Watch SE over the Apple Watch Series 6. The Series 6 is the best smartwatch we've tested and an impressive health tool, but it's out of her budget; the Series 3 doesn't have fall detection, which would be helpful if erratic insulin levels caused Gillian to faint. (For a deeper dive, see Apple Watch 6 vs. Apple Watch SE and Apple Watch SE vs. Apple Watch 3.)

Compared to the Apple Watch 6, the Apple Watch SE lacks an EKG reader, blood oxygen monitoring, and an always-on display. My experience with the Series 6 so far is that the always-on display is a real deal-breaker for the average user, but not so much of a selling point for Jillian. In fact, she worries that the never-darkening OLED screen on her wrist will distract students.

Jake Green, a 23-year-old who also has type 1 diabetes, has owned an Apple Watch Series 4 since Dexcom's Apple Watch app debuted two years ago. Despite the new features available, he has no plans to upgrade to the latest model of the smartwatch.

"For what I need, I'm set with the Apple Watch 4," Green said.

"Blood oxygen monitoring is not as important as it is in glucose monitoring. It's important to have the Dexcom app on my wrist."

Gillian wondered if an Apple Watch with LTE would allow her to get glucose readings from a pump attached to her body, even when her iPhone is broken or out of reach.

Unfortunately, this is not the case, as Dexcom and the smartphone must be linked via Bluetooth. However, for people with diabetes or other health conditions, having an Apple Watch with LTE has other advantages. If their smartphone breaks or, worse, is stolen, they can call for help with the Apple Watch.

Incidentally, the Apple Watch SE's LTE support is only $50 more than the standard $279 entry price. The Apple Watch Series 6 with Cellular, on the other hand, costs at least $499 in addition to the monthly service fee.

Jillian is used to making recurring payments. Fortunately, her insurance covers the $6,000+ annual cost of the Dexcom glucose sensor and transmitter, so we looked into whether BlueShield BlueCross would finance the Apple Watch as well. Instead, there is a program to finance Fitbit for daily activity. Unfortunately, Dexcom does not make an app for Fitbits.

Insurance companies like Aetna and United have insurance options for the Apple Watch. You should also check to see if there is a compatible smartwatch app for your glucose monitoring system; the One Drop glucose monitoring kit is a good alternative to Dexcom that you can use to view blood glucose data and analysis on your wrist.

In addition to checking insurance and system compatibility, you should always check with your doctor before purchasing any device you plan to use as a health tool, whether you are a diabetic or not. the Apple Watch 6 has blood oxygen monitoring and an FDA-approved ECG sensor but the company cautions that the former is not for medical use.

After consulting with Petty, Gillian made her choice. Says Gillian, "After considering all the compatible Dexcom options, I decided to buy the SE." When I realized it was a very good price for a new smartwatch, I was sold."

"Besides," she said, "the name alone makes the Apple Watch SE an obvious accessory for my iPhone SE."