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 a few things wrong at once. Early onset of kidney disease. Fatty liver. And 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 routine 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 and liver complications my blood reports told me were progressing and got my hearing back. 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 quality of life and economy.
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 $87,000 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, the bottleneck moves. It stops being access to a doctor or a treatment plan. It becomes two things the system still cannot give you: the ground truth of what is happening inside your body in real time and with high frequency, and the layer that tells you what to do with it.
Real n-of-1 care, the hyper-personalized care, needs both. It needs high-frequency data so the trajectory inside your body is visible. And it needs a coaching layer that reads that data in the context of your medications, your diet, and your life, and tells you what to change. One without the other does nothing. Data with no interpretation is noise. Advice with no data is a guess.
I learned this firsthand by wearing the CGM. The sensor gave me the data, but the data was not what fixed me. What fixed me was being able to run experiments, see the consequence, and course correct. What I ate. How I slept. When I took my insulin. Every variable visible, every change measured. That loop between the data and the decision, not the sensor by itself, is what made me legible to myself.
That is what n-of-1 care actually means. Not a plan written once and reviewed every three months. A continuous loop between what is happening in your body and every decision you make that day.
CKD (chronic kidney disease) and CKM (cardio kidney metabolic) patients have neither half of this. They have no access to tools that can measure their biomarkers frequently. And they have no way to make sense of the interactions between their medications, their diet, their multiple specialists, and their daily lives. They see a nephrologist, a cardiologist, an edocrinologist, a primary care doctor, each optimizing for their own organ, none seeing the whole person. The patient is left to put it together alone, with no data and no feedback.
This is the gap I am building into.
Arksense is a continuous biomarker monitoring and coaching platform for cardio-kidney-metabolic patients. The monitoring gives them the data. The coaching is the intelligence/ algorithm that tells them what the data means and what to do. Together they are the feedback loop that worked for me, built for the people who need it most.
One inflection point I am seeing is the costs of biomarker data collection are going down. The largest biosensing companies in the world are already building toward continuous potassium monitoring. I am building the data and intelligence layer that sits on top and makes it useful, because that is the part that does not exist and the part that compounds and improves health outcomes.
Almost no one is building for chronic care patients this way. So the high-frequency record of how these patients actually live, how their biomarkers move with every medication, meal, and day, exists nowhere. Whoever builds the loop first generates that data first. And every patient on the platform makes the next interpretation sharper and the coaching better. The data improves the intelligence, the intelligence improves the care, and better care brings more patients. It compounds into the first proprietary, longitudinal dataset of cardio-kidney-metabolic disease, and the algorithm that learns what actually works, at scale. No one else has it, and it is worth more the larger it gets.
Chronic kidney disease alone costs Medicare more than $140 billion a year. Those costs are not inevitable. They are the price of flying blind. The right data, at the right frequency, read in the right context, gives doctors ground truth they never had and patients agency they have never experienced. It turns reactive crisis management into proactive prevention.
I know this works because it worked for me.
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.
Shh, don’t tell anyone