The transition of blood glucose meters from offline devices to Bluetooth-connected IoT endpoints has introduced critical cybersecurity vulnerabilities. The primary risks involve Bluetooth Low Energy (BLE) implementations, where weak encryption and improper authentication allow attackers to intercept patient data or, more dangerously, inject false glucose readings.

Research has demonstrated that proprietary protocols from major manufacturers (e.g., OneTouch, Roche) can be reverse-engineered, enabling replay attacks or data spoofing that could trigger incorrect insulin dosing. In response, the FDA has tightened pre-market cybersecurity requirements, mandating Software Bills of Materials (SBOMs) and threat modeling. The industry is shifting toward encrypted transmission standards (like IEEE 2621) to ensure that the digital result generated by the test strip remains unaltered during transmission to smartphones and the cloud.