When I see these articles about IBM Watson getting involved in diabetes care, I get excited. IBM intend to use their supercomputer to develop a platform which can help us all manage our diabetes, it sounds great. But then as I read more about it, they nearly always involve using data from a continuous glucose monitor (CGM). I can’t afford a CGM, I can’t even afford a Freesyle Libre. So when Dr Chaing, Senior Vice President at the American Diabetes Association, says “This really impacts under-served communities,” I get annoyed. Do they plan to give out continuous glucose monitors for free? I doubt it and I think this is a big problem because it widens health inequalities.
I came across a similar problem in my PhD which examines food choices. If you focus on the average person, you may improve the average diet but if you do nothing about those with the poorest diet, you are widening health inequalities because the gap between the bottom and the average gets larger. And I think this is the same problem with IBM Watson. It will widen health inequalities not help the “under-served communities”
I would guess people who have a CGM already have a good HbA1c, at least better than the average. So when IBM come along and create a platform which improves support for people with CGMs, they’re effectively widening the health inequalities. They are ignoring the people at the bottom (high HbA1c) and only helping those who already have a CGM.
I understand type 1 diabetes requires a high level of motivation from the individual but we also need a lot of support and education. I think (and I may be wrong) a person with low motivation but a high level of support and education would be better off than a person with high motivation but no support or education? And when the new technology is focused on people with CGMs, it is only helping the already privileged.
Don’t get me wrong, I’m a big fan of technology and diabetes. I have a pump and I love it. It just annoys me when people say these advancements will help the people in “under-served communities”. Right now in Scotland, 35.7% of people with type 1 diabetes have a HbA1c above 75 (9%) (Table 26). I doubt many of those people with a HbA1c above 75 (9%) will have access to a CGM and therefore I struggle to see how IBM Watson will be able to help them.