In 2011, a startup called Avolonte Health set up shop in a small office park in Palo Alto, California. The company operated out of a bland, two-story building bristling with security cameras. Engineers interviewing for jobs there weren't even told what they'd be working on. Once new hires made their way into the lab, however, they learned that they would be trying to revolutionize diabetes care.
Avolonte wasn't just any health-care company. It was a project of Apple Inc., and its mission came directly from Steve Jobs. Apple's co-founder and then-chief executive officer, ill with the pancreatic cancer that would take his life near the end of that year, had tasked a group of his key executives to develop a noninvasive blood sugar monitor. It would be a potentially life-changing technology for diabetics, who would no longer need to prick themselves to monitor their blood glucose. Medical device makers had tried for years to develop something like it. Even Alphabet Inc. experimented unsuccessfully with using special contact lenses to measure the glucose in tears.
Four years after the quiet arrival of Avolonte, Tim Cook stood in the same packed auditorium where his predecessor, Jobs, had unveiled the original Macintosh and introduced the Apple Watch. Cook called it the “next chapter in Apple's story.” The new device boasted health features: a heart rate monitor, a way to measure steps taken and calories burned and a fitness app for tracking workouts. But the original vision had been grander. The company had envisioned the watch as a tiny medical lab, featuring the Avolonte glucose monitor as a centerpiece.
Today there remains a sense — both inside Apple and in the broader world of public health — of unfulfilled potential. The
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