Around One in three Americans, 96 million adults, has prediabetes – but only two to three percent receive help to prevent the disease from progressing.

The medical impact of diabetes is, of course, significant – it affects vision, circulation and, in severe cases, may even require amputation. But there are other consequences too. Given the countless health care resources devoted to managing the myriad medical risks of the disease, it is not possible to Combating diabetes – and ideally preventing it – would save American taxpayers enormous amounts of money.

Remote patient monitoring holds great promise to help treat and improve the lives of patients with chronic diseases, including diabetics. And the rise of artificial intelligence and automation offers great opportunities to improve RPM technology.

Oren Nissim is CEO and co-founder of Brook Health, a developer of AI-powered remote monitoring tools, and he himself suffers from type 2 diabetes.

We interviewed Nissim to talk about the challenges of diabetes care, how RPM can help overcome some of those challenges, how AI can enhance RPM technology in treating chronic diseases, how proper diabetes care can save taxpayers money, and what Nissim calls “the next generation of remote care.”

Q: What does the diabetes landscape look like in America today and what are some of the biggest challenges?

A. When you hear about diabetes today, the main theme is that GLP-1 drugs have had a major breakthrough in the last few years. And that has been a transformative experience for people taking these drugs for two reasons. First, they help you control your blood sugar better. Second, and this is probably what gets the most attention, people who take a GLP-1 drug lose a lot of weight.

And that’s a good thing. The problem is that they are long-term medications, meaning patients have to commit to taking them for life. I doubt anyone wants to do that, but they all end up there because people become dependent on these drugs.

But not everyone should take GLP-1 drugs, and they are not always covered by insurance, so there is a growing trend of people paying for these drugs out of pocket, which is incredibly expensive and therefore not very equitable.

In addition to this inequality, the U.S. still has a large number of “food deserts,” which only exacerbates the overall poor eating habits in this country. Inaccessibility to nutrition management is also another obstacle that far too many people face. We need to make support from a nurse or dietitian more accessible to help people get their blood sugar under control. But improving access to care for someone living under a bridge or facing a diabetes-related amputation is a whole different challenge.

Most people with diabetes have type 2. For these people, controlling their blood sugar – while managing all other aspects of their lives – can be a real challenge. Many wonder if they can do it alone.

It’s no surprise that a “miracle drug” is such an attractive alternative. But who, other than pharmaceutical companies, really benefits from a drug that patients must take for life when other options are available?

Q: How can RPM technology help address some of these challenges?

A. Remote patient monitoring tools can help people with diabetes in a number of ways. They allow doctors and other caregivers to keep an eye on a person’s blood sugar levels, nudge patients with reminders, and help them create health plans.

Additionally, I think the immediacy of highly personalized information is really critical when you’re trying to create and form a new habit. Not only is this type of individualized data highly informative and relevant, but accessing it can be motivating and empowering – those are important emotional states for driving change and overcoming challenges.

Let’s say you go to the supermarket and pick out a yogurt. If you’re diabetic, the chances of finding a yogurt product that’s right for you are incredibly slim, almost zero. And you actually have to pick up each container and read the labels to be sure. If you’ve been to the dairy section of a supermarket recently, you’ll know that there are an overwhelming number of yogurt types and brands.

The food industry has made it incredibly difficult to make the right choices when you’re lactose intolerant. Now imagine if you could use AI technology remotely to better understand those labels, read them faster, and get recommendations while you’re on the go, living your life, and making those everyday decisions.

This is just one example of how you can make significant changes that improve the health of individuals through Technology for remote patient monitoring.

Q: How can AI improve RPM technology in managing chronic diseases like diabetes?

A. The key question is how to get this intelligent agent to support you in your day-to-day life in the way that best enables positive change. This is where AI can really shine.

Many people mistakenly assume that AI should mimic a nurse or doctor. But that’s not the right perspective. Ultimately, it’s more about encouraging healthy habits and behaviors and providing healthy coaching for those important daily decisions.

In fact, controlling blood sugar can also be achieved through lifestyle changes and greater awareness. This can be achieved with the right tools and support. No one should ever have to go so far as to have a foot amputated because their diabetes is out of control. 120,000 Americans with diabetes lose a leg or foot through amputation each year.

Additionally, AI can consider a person’s medical health conditions beyond their diabetes, such as other underlying conditions that need to be factored into suggestions, recommendations, and wellness plans. It’s more of a lifestyle intervention than a medical intervention, but the end goal is the same: better patient outcomes.

Q. How does what you call “the next generation of remote care” improve outcomes for this patient population? And how can proper diabetes management, particularly prevention, save American taxpayers money?

A. The vast majority of Americans with diabetes do not use AI or other advanced digital tools to manage their disease. But people who do use these tools have a unique helper with them at all times that understands what is going on in their daily lives.

This agent can help them make better, smarter, easier decisions on the go. This makes a dramatic difference in these people’s lives, because otherwise they’re making diet and lifestyle decisions based on their existing habits – and those existing habits aren’t getting them where they want to go.

Today, diabetics can go to a doctor or a health coach. They become part of a transactional experience where they are told what to do and then they have to go home and do it. Unfortunately, this system doesn’t really work because only people who are extremely motivated to change their habits succeed.

To help more people successfully manage their disease, we need to shift from a transactional, encounter-based model to one where disease management is embedded in patients’ lives. Most people are now so accustomed to digital technology that they could easily integrate these tools into their daily lives.

Appropriate management of diabetes, particularly through prevention and better treatment, can save American taxpayers enormous amounts of money by targeting one of the major sources of healthcare spending. Since 90% of Medicare spending is on chronic diseases like diabetes, focusing on prevention and effective treatment could significantly reduce overall healthcare costs.

New drugs like GLP-1 inhibitors, while effective, are extremely expensive and lead to lifelong dependence. Instead, leveraging widely available technologies like smartphones and AI-powered apps can help people make better decisions about their daily health at a fraction of the cost. This approach is not only less expensive but also more scalable than traditional medical interventions or expensive drugs.

Empowering people to better control their diabetes could prevent costly complications such as amputations and further reduce healthcare costs. Given that the U.S. currently spends more than 20% of its GDP on healthcare, preventing and better treating chronic diseases such as diabetes could significantly reduce this economic burden.

Ultimately, promoting self-management and education can empower individuals to make healthier choices and better understand their condition, reducing reliance on expensive medical interventions and saving taxpayers significant amounts in the long run.

Follow Bill’s HIT reporting on LinkedIn: Bill Siwicki
Send him an email: [email protected]
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