OPINION: Luxury smartwatches are failing the health revolution

The luxury smartwatch scene looks very different today versus a decade or so ago. Back then, there was a rush from traditional watchmakers to grab a slice of the smartwatch pie, but most have quietly withdrawn and refocused their attention on their core offering. The technology was erratic and too often it proved a terrible value proposition for consumers. Plus, brands like Apple, Samsung, and Garmin did the crucial ‘tech’ bit so much better and cheaper anyway. But the market for wearables and health-related tech is enormous and going nowhere. Journalist Aaron Edwards explores how and why luxury watch brands are missing out on this goldmine.

Every morning, before I do anything else, I check my blood sugar. 10 years ago that would have been through a finger prick test, but now all I have to do is glance at my wrist. I complete that same glance at least another 50 times throughout my day.

As someone living with type 1 diabetes, constant monitoring of my blood sugar is crucial to my health. My continuous glucose monitor (CGM) sends my readings directly to my phone, but, to see them on my watch, I need to both own a watch from one of the main smartwatch brands and also download a third party app. There is a complete vacuum of luxury watches that will allow me to monitor crucial information for my health and that gap, small as it sounds, matters more than most luxury watchmakers seem to realise.

It’s worth noting that for the most accurate glucose readings, a finger prick is still the advisable method of testing, but having continuous monitoring makes constant decision-making much easier and convenient for someone whose brain is already crammed with important choices and adjustments.

The relationship between luxury watchmakers and the smartwatch has never been comfortable. One of the classic arguments from luxury watchmakers against the invading presence of smartwatches is that convenience is not a big enough justification. Being able to instantly see your heartbeat or tracking your sleep quality is not a necessary addition to a watch interface when all it ought to be is an artistic timepiece. But for people with long-term health conditions like type 1 diabetes, it is far from as simple as a matter of convenience.

When Apple launched its first watch in 2015, the Swiss watch industry largely dismissed it as a gadget destined to be obsolete within a product cycle. A decade later, that dismissal looks increasingly costly as Apple has surged into position as one of the best-selling watch brands in the world by volume. The broader smartwatch market has fundamentally reshaped what consumers expect from something worn on their wrist.

The traditional response from luxury brands has been to double down on what smartwatches cannot replicate, highlighting the heritage, craftsmanship, mechanical complexity, and investment value of the luxury market. For a large segment of the market, that argument holds. But with the health monitoring revolution well underway, wearable technology now represents something that luxury brands cannot simply dismiss as a question of taste. When a watch can detect a heart arrhythmia, monitor blood oxygen, or display real-time blood sugar readings for someone with diabetes, the conversation stops being about convenience and starts being about need.

Wearable technology has become a staple of British life. Between 40%–45% of UK adults now own or use a wearable device, with smartwatches accounting for 56% of that market in 2025. Nearly half of users say health monitoring is a primary reason they choose a device, tracking everything from heart rate and blood oxygen to sleep and activity levels. And according to one survey, 67% of Brits would use wearable technology specifically to monitor a long-term medical condition.

That last figure is the one the watch industry should be paying attention to.

Smartwatches were not always medical devices. Their early iterations were glorified fitness trackers: counting steps, estimating calories, nudging you to stand up. But that has changed. In 2018, Apple received FDA approval and subsequent MHRA clearance in the UK for the ECG function on its Apple Watch, making it the first consumer smartwatch to receive regulatory approval for detecting atrial fibrillation and other heart arrhythmias. It was, in retrospect, a turning point as doctors will now often urge patients to use smartwatch technology to get an accurate reading of their heart rate over time.

Since then, the list of conditions with smartwatch monitoring potential has grown steadily. Blood oxygen monitoring is now standard across most mid-range and premium devices, relevant for hypertension and respiratory conditions including asthma. Some devices can detect seizure-like movements during sleep, offering limited but meaningful utility for people with epilepsy. Tremor monitoring research is ongoing for Parkinson’s patients and even hypothyroidism, which is not a condition traditionally associated with monitoring technology, benefits from the accessibility of watch-based medication reminders.

Nowhere is this shift more developed, or more illustrative of the gap that still exists, than in diabetes care.

There are 4.6 million people living with diabetes in the UK, representing roughly 7%–8% of the population. Of those, between 400,000–464,000 have type 1 diabetes. An estimated 200,000 people in the UK were using continuous glucose monitors as of late 2022, a figure that has almost certainly grown significantly since both diabetes diagnoses and CGM availability have increased.

Continuous glucose monitors are small sensors worn on the body (typically the arm or abdomen) that measure blood sugar levels in real time and transmit that data wirelessly. For people with type 1 diabetes in particular, that data is not incidental. It is constant, urgent, and life-critical. Knowing your blood sugar is dropping while you are in a meeting, asleep, or mid-exercise is not a convenience feature. It is the difference between managing a condition and being managed by it.

The two dominant CGM systems in the UK are Abbott’s Freestyle Libre and Dexcom. Both now offer some degree of smartwatch compatibility: Abbott’s system works with Apple Watches from WatchOS 8.3, select Fitbit models, and Samsung’s Galaxy Watch 4 onwards. Dexcom is compatible with Apple Watch Series 6 and above, Samsung Galaxy Watch 4, Google Pixel Watch and, exclusively, Garmin.

That last compatibility is significant because Garmin is the only one of those brands currently operating in the luxury watch space through its MARQ collection — which starts at over £1,500 — that offers direct CGM integration. And even then, only with Dexcom, not Freestyle Libre, which is the more widely prescribed CGM in the UK.

Earlier this year Garmin released the Garmin Health Diabetes Insight Report, which focused on proactively preventing type 2 diabetes from developing by integrating third party software into their smartwatch for stronger analysis and self-empowerment in preventing the disease. It does this using a third party AI system — Twin Health in the USA, and Project Embrace in the UK — that draws on biometric data from the wearable technology to deliver personalised advice on medication, nutrition, activity, sleep, and stress. In 2025, Twin Health found that 71% of Twin participants reduced their A1C (average blood sugar levels) below the diabetes range and 92% eliminated at least one diabetes medication.

Garmin’s foray into type 2 prevention via AI shows what the tech is capable of, but it puts type 1 diagnostics aside leaving half a million people in the UK underserved by their product offerings. The result is a peculiar situation. If you have type 1 diabetes and want to see your blood sugar on your wrist in real time, your options in the luxury watch market are essentially one brand and one CGM system, with the more common of the two main CGM systems not supported. Even then, the system is not designed specifically with your chronic condition in mind, but the reversible condition of type 2 diabetes.

Meanwhile, TAG Heuer and Hublot are both in the process of developing their own watch operating systems, which in theory opens the door to app-based CGM compatibility. But neither has made any specific move towards health monitoring for people with long-term conditions. The development appears driven by the commercial logic of owning their software stack rather than any particular commitment to medical utility.

There is a broader argument to be made here beyond the commercial opportunity, and it is one that an increasingly environmentally conscious consumer base, particularly younger buyers, is likely to find compelling. The proliferation of health devices is itself a sustainability problem. A person with type 1 diabetes might currently carry a CGM receiver, a smartphone, and a fitness tracker, in addition to whatever watch they wear. Every redundant device represents manufacturing emissions, battery waste, and eventual landfill, on top of the 14–17kg of medical waste that a type 1 diabetic typically produces annually. 

While I know that, as someone reliant on that medication to survive, there is nothing I can do about the majority of the waste I produce, a luxury smartwatch could consolidate part of that load. A watch that can do that is not just a better product but a more responsible one, that can at least partially reduce any environmental guilt a type 1 diabetic may be dealing with.

The technology, in broad terms, exists. The demand is demonstrably there. What is missing is the will — or perhaps the awareness — among luxury watchmakers that the people most likely to spend £1,500 on a watch are also, statistically, old enough to be managing a long-term health condition, and would pay considerably more for one that helped them do it.

This article was first published in the August 2026 edition of Watch Insider.