Diabetes Technology Provides the Roadmap to Healthy Longevity

At the 26th Annual Diabetes Technology Meeting, Kinexum Founder and Executive Chairman Alexander (“Zan”) Fleming, MD gave the below presentation on the intersection between diabetes technology and healthspan devices.

Alexander Fleming has interests in Kinexum, the Kitalys Institute, NuSirt, Adocia, Abbott, AdipoPharma, BioAge, Biomea, Carthera, Catalyst, CMC Magnetics, Diasome, Glyscend, Hagar, HDL Therapeutics, Mars Symbioscience, Metabolics Pharma, Northwestern, Oramed, Pano, Pleiogenix, PolTREG, Regor, Remodeless, RxMP, Sera Biopharma, Serpin, SFC Fluidics, Skinject, SROne, TIXiMED, Veroscience, vTv Therapeutics, Zealand Pharma, and Elvinix.

Age-related diseases include neurodegeneration, cardiovascular disease, cancer, MASH, and type 2 diabetes and may be caused by inflammation, macromolecular mishandling, impaired autophagy, intermediary dysmetabolism, mitochondrial dysfunction, oxidative stress, and more Increasing evidence suggests that, by targeting the shared root causes of age-related diseases, aging itself can be slowed or prevented. Diabetes technology provides the roadmap for increasing healthspan. Fundamentally, there is no more important project in science and medicine than bending the aging process.

Diabetes technology enables us to measure the problem with one technology and then intervene with another. Prevention requires both measurement and intervention.

Diabetes technology allowed us to close the loop and establish a paradigm of measure, interpret, intervene, remeasure, and adjust, leading to improved time in range, less variability, greater safety, and better quality of life. The breakthrough was not the measurement technology or the intervention technology. It was putting them together.

Now we can use technology to detect the drift before the disease. Disease begins before diagnosis, and physiological changes can be detected earlier using longitudinal data. Longitudinal data reveal direction of change, which is more informative than single measurements. Earlier intervention may change the trajectory of disease.

The individual becomes his/her own reference. The traditional approach asks, "Are you outside the population reference range?" A longitudinal approach asks, "Are you departing from your own health trajectory?" Risk may reside in the pattern and direction of change, not in any single measurement.

Let's imagine an aging curve that starts after the growth and development curve for children. It could monitor intrinsic capacity across the adult life course, including factors like locomotion, cognition, vitality, physiological capacity, and sensory capacity. Could we detect declining capacity while the trajectory is still modifiable?

Technology could make the aging trajectory measurable. Digital technologies can capture key domains of intrinsic capacity (e.g., mobility, cognition, vitality, cardiometabolism, senses) continuously or frequently. Integrating these signals can reveal meaningful trajectories over time, transforming functional capacity from an episodic assessment into a longitudinal trajectory.

Measuring the aging curve is not enough. The goal is to identify actionable deterioration and change the trajectory. Early intervention can change the course of aging. A range of interventions can improve the trajectory, including exercise and rehabilitation, emerging therapies targeting mechanisms of aging, drugs and devices, cardiovascular risk reduction, obesity and metabolic treatment, and nutrition.

Diabetes technology measures glucose and other physiologic signals, while healthspan technology measures multidomain functional/physiologic capacity. Diabetes technology tracks a glycemic trajectory, while healthspan technology tracks an intrinsic-capacity/health trajectory. Diabetes technology detects deteriorating control, while healthspan technology detects accelerating functional decline. Diabetes intervention involves drugs, pumps, devices, and behavior, similarly to healthspan intervention. Diabetes technology uses CGM and clinical outcomes to reassess, while healthspan technology uses capacity and clinical outcomes. Diabetes technology aims to protect complications, while healthspan technology aims to preserve function and extend healthspan.

Diabetes technology and healthspan technology follow a common paradigm: measure, detect, intervene, and improve lives. The same principles that transformed diabetes care can help prevent chronic disease and extend healthspan. We can detect deterioration earlier, connect meaningful measurements to actionable interventions, and demonstrate that changing the trajectory improves outcomes that measure, overall keeping people on a healthier curve for longer.

Dr. Fleming began with a description of the current basis of diabetes technology: measure, interpret, intervene, remeasure, and adjust. In this way, measurement allows intervention before serious health issues occur. He applied this theory to healthy longevity, outlining a similar paradigm for monitoring an individual’s own aging trajectory. The “aging curve” would be based on a variety of biomarkers. including the components of intrinsic capacity, such as mobility, cognition, cardiometabolic health, sensory function. Dr. Fleming’s approach would allow an earlier and longer window of intervention for age-related diseases and symptoms, transforming aging from something we simply observe into a trajectory that we can bend.

Published October 30, 2026