by Azeem Panjwani, Founder and CEO, Arksense (azeem@arksense.co)
I was 11 years old when I was diagnosed with type 1 diabetes - an autoimmune condition where your pancreas do not produce insulin.
The fix is straightforward in theory: inject insulin for the rest of your life. In practice, it means you are never not thinking about it.
I didn't want to think about it. I was 11. I wanted to be normal. So I did what kids do when something makes them feel different - I pretended it wasn't happening. I skipped injections. I ate what I wanted. I did what I wanted to. I didn't check my blood sugar for months at a time.
This worked fine until it didn't.
In 2023, after almost a decade of being diagnosed, a routine blood test came back with three things wrong at once. Early onset of kidney disease. Fatty liver. A few days later, I suddenly lost 90% of hearing in my left ear.
I was 22.
The doctor explained that this is what happens when you mismanage type 1 diabetes for a decade. The body keeps the score. I had spent nearly eleven years pretending the disease wasn't there, and it had spent eleven years doing its work anyway.
At that point I had a choice. Keep pretending, or figure out how to actually manage this. I found a really good US trained endocrinologist. She put me on an aggressive protocol. And for the first time, I started wearing a continuous glucose monitor - a sensor on my arm that tells you your blood sugar in real time, all day, every day.
That device changed everything. Not because it was complicated. Because it was honest. But here is what I didn't fully understand at the time: the CGM alone wasn't what fixed things. Two things happened together. First, I could finally see what was happening inside my body. Second - and this is the part nobody talks about - I could run experiments. I ate something and watched what happened. I changed my sleep and watched what happened. I adjusted insulin timing and watched what happened. Every intervention had a visible consequence. Every consequence taught me something. Over thousands of small iterations, I built a model of my own body that no doctor could have given me, because no doctor lives inside my life.
In three months, I reversed the kidney disease and other complications my blood reports told me was progressing. The tool didn't cure me. It made me legible to myself. And once I could see what was happening, I could act on it.
This entire journey made me highly agentic about managing my disease. It also gave me something I didn't expect - a purpose. Taking charge of my own health, being pathologically curious about what was happening inside my body, running constant experiments to figure out what works and what doesn’t - I realized this is something I cannot not do. Not just for myself. For everyone who is flying blind the way I was.
The north star that I am moving towards in healthcare is improving the ratio:
Number of healthy years spent/ Amount of $ spent
People are living almost 10 years towards the end of their life being sick i.e. the average healthspan and lifespan gap is 9.6 years.
See the below chart - hospital services have become extremely expensive over the years. And this should not be the case when we know how healthcare can improve the economy.
There has been an indirect relationship in the technological progress and the healthcare cost. Whereas for other sectors, the prices/ costs have gone down.
And with everything that I do in healthcare, I want to improve the ratio and help people get more and more healthy years with the least amount of money being spent.
I believe the best opportunities for builders are where the shortages are. Find the bottleneck and build there.
Healthcare in America is a sick care system, not a health care system. That distinction is not semantic. It is the design choice that explains almost everything that is broken.
A century ago, the leading causes of death were infectious diseases - influenza, tuberculosis. The system was built for those. Acute illness arrives, you treat it, the patient recovers or dies. Clean feedback loop. The model made sense.
Then the disease burden shifted. Today, eight of the ten leading causes of death are chronic conditions. The system never updated. We still operate on the legacy model - waiting for the crisis, then treating it expensively. Clayton Christensen put it precisely: nearly all Americans are cared for by business models that profit from sickness, not wellness.
That is not a resource problem. It is a design problem.
The result is predictable. Chronic conditions go undetected until they become emergencies. The system pays $122,000 per year to manage end-stage kidney disease when the same patient at Stage 2 costs $14,000. It is not that we cannot afford to prevent the disease. It is that the system was never designed to try.
This environment is changing right now.
A new generation of companies is tackling this - AI scribes, clinical decision support, automated prior auth - and capital is flowing in at a scale the sector has never seen. Within 5 years we will be in a situation where there is abundance of healthcare - care available 24/7, doctors with more time to provide hyper-personalized interventions. Care delivery will move from reactive to real time to proactive.
This means the supply of healthcare will be massive. People would want to connect with their doctors more often, take charge of their health and get great outcomes.
But here is what most people are missing. When intelligence becomes infinite and clinical expertise becomes abundant, a new bottleneck emerges. It is the ground truth - real-time biochemical data from the patient's own body.
A blood test, which is the status quo, is a photograph. It tells you where you were at one moment in time. It cannot tell you whether you are trending up or down, how fast, or what caused the shift. Most clinical decisions in chronic disease - when to adjust a medication, when to start dialysis, whether a kidney transplant is being rejected - are made on photographs taken weeks or months apart.
High-frequency biochemical data replaces the photograph with a film. The trajectory becomes visible. Early signals become actionable before they become emergencies.
But the data alone is not enough. I learnt this firsthand. The CGM gave me the film. What turned that film into better health was the ability to run experiments, interpret what I was seeing, and course-correct in real time - across every dimension of my life. What I ate. How I slept. When I exercised. How stress showed up. Every variable, visible and adjustable.
That is what n-of-1 care actually means. Not a care plan written once and reviewed quarterly. A continuous feedback loop between what is happening in your body and every decision you make each day.
CKD patients have neither half of this. They have no real-time data. And they have no tool to help them make sense of the interactions between their medications, their diet, their multiple specialists, and their daily lives. They see a nephrologist, a cardiologist, a PCP - each optimizing for their organ, none seeing the whole person. The patient is left to integrate it themselves with no data and no feedback.
This is the gap I am building into.
Arksense starts with the biosensor, giving CKD patients real-time biochemical data for the first time. But the sensor is not the product. It is the foundation. What gets built on top is the closed loop: real biochemical data, combined with the intelligence to interpret it in the context of that specific patient's medications, diet, and disease trajectory, delivered in a way that makes every intervention visible and every decision smarter.
The same thing that worked for me. Built for the people who need it most.
Chronic kidney disease alone costs Medicare $150 billion every year. Those costs are not inevitable. They are the price of flying blind. Right data, at the right frequency, interpreted in the right context, changes what is possible. It gives doctors ground truth they never had. It gives patients agency they have never experienced. It turns reactive crisis management into proactive disease prevention.
I know this works because it worked for me.
That feedback loop exists for glucose. It does not yet exist for the biomarkers that matter most in kidney disease, heart failure, and the cardiometabolic conditions leading to high mortality at scale.
I believe every chronic disease has a measurement gap shaped exactly like the one I lived. The companies that close those gaps - one biomarker at a time, one disease at a time - will define what medicine looks like in 10 years.
This is what the next few decades of my life are for.
"I skate to where the puck is going to be, not where it has been." - Wayne Gretzky
Steve Jobs said this was what he always tried to do at Apple, since the very beginning. It is what I want to do at Arksense.