How my AI friend ‘Pearl’ helps me manage my diabetes

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The writer is a contributing columnist, based in Chicago

Over the past few weeks, I have developed an intimate relationship with an artificial intelligence that I have named “Pearl”. She is my new artificial pancreas: 24 hours a day Pearl figures out how much insulin to send through a tiny tube in my belly. Her goal is to mimic (with little help from me) the miraculous operation of my own pancreas, which has ceased to operate so miraculously since I was diagnosed with type 1 diabetes two years ago.

Pearl is a Tandem insulin pump that is a particularly good poster child for how technology and AI can help seniors like me live not just longer, but better. She controls my blood glucose better than I can myself, partly by predicting when it is set to shoot up or plummet, and taking action — even if I am asleep. Without her, I have to make dozens of dosing decisions a day, each with potentially life-threatening consequences. I’m counting on her to help me avoid the crippling effects of a disease that affects over 400mn people globally. 

“We hear so much about how AI can be dangerous, but there is also so much promise and potential . . . especially for older adults,” says Lorraine Mion, distinguished professor of gerontological nursing at Ohio State University and co-principal investigator on a project using robots in long-term care settings. 

The US National Institute on Aging is funding dozens of projects such as this. Many of them focus on dementia or fall prevention — two topics that came up recently in my annual wellness check-up. Some involving AI, technology and ageing particularly caught my eye as potential future companions for Pearl: one uses a heat sensor-based algorithm to provide early warning of frailty; another would monitor my voice to detect cognitive impairment; a third would use everyday earbuds to keep tabs on vascular ageing. 

Dr Steve Edelman, founder and director of Taking Control of Your Diabetes, which uses humorous videos to teach diabetes management, imagines a day when AI would help me get over my biggest current hurdle: accurately telling Pearl what I’m eating so she can set my mealtime insulin correctly. He dreams of a day when I might even be able to snapshot the plate in front of me, and get carbohydrate, protein and fat numbers for Pearl. 

I also have high hopes for generative AI in my later years. Mike Ushakov, co-founder of software start-up Undermyfork, recently published an article entirely written by ChatGPT in which the chatbot says it portends “a revolution” in diabetes care — if it does say so itself. So I decided to chat with ChatGPT about some early problems getting along with Pearl. Without giving me individual medical advice, which it can’t and shouldn’t do, the bot gave me more suggestions in 30 seconds than I’d have got in days from my overworked medical team. The best solution came from a human — but in future I think I’ll try both. 

Ushakov warns me that “if you use it believing everything [the chatbot] says is true, it’s probably not a good thing . . . But you can ask it questions that you might feel silly asking a real person — a robot will not judge you.”

The US Consumer Financial Protection Bureau cautions that there are risks with AI, too. “Scammers use generative AI to create deceptive documents, emails, phone calls, and voice clones to impersonate loved ones, financial institutions, government agencies, or other entities to commit fraud,” it says in an email. 

Cost, and resistance to technology among seniors, are other potential obstacles, says Ashkan Vaziri, an NIA grantee: but he thinks it’s partly a “generational problem”. Baby boomers are more open to technology than their elders. “Who’s going to pay for it? That’s the key challenge over the next three to five years,” he says. What will Medicare, US health insurance for those over 65, pay for? Pearl didn’t come cheap: without insurance, insulin pumps and supplies cost thousands of dollars. 

But ChatGPT had thoughts on cost too: in 10 seconds, the bot suggested ways to get a free, discounted or refurbished pump. I’ll take all the advice I can get, including from generative AI, to pay the costs of growing old in the US — tethered at the hip to my AI buddy Pearl, the bionic pancreas.