Dr. Bob Gabbay has spent decades at the intersection of diabetes research, clinical care, and technology innovation. From leading the Joslin Diabetes Center to serving as Chief Scientific and Medical Officer at the American Diabetes Association, he witnessed the field transform from sharpening needles on stones to closed-loop insulin systems. Yet despite incredible technological advances, a critical problem persists: the tools that could help people with diabetes simply aren't reaching them or being used effectively.

In this conversation, Dr. Bob shares how the DIY diabetes community's "We Are Not Waiting" movement pushed both industry and regulators forward, why A1C and time in range tell complementary stories about glucose management, and how his year of "semi-retirement" turned into mentoring startups and crystallizing decades of knowledge. He discusses the holy grail features still missing from automated insulin delivery, from exercise mode to meal-snap AI, and makes the case for why patient-reported outcomes deserve equal billing with clinical measures. Dr. Bob also reflects on moonshot thinking, the tension between individualizing treatment and population-level safety, and why the last mile problem matters more than the next breakthrough.

[00:00:00] Introduction and Dr. Bob's journey from chemistry sets to diabetes care

[00:06:00] Creating opportunities through cold calling and community building

[00:10:00] Med school without planning to see patients

[00:12:00] Leading the American Diabetes Association

[00:15:00] Seven turns in diabetes management

[00:17:00] A1C versus time in range as outcome measures

[00:21:00] Semi-retirement as a digital nomad

[00:23:00] Fluid knowledge versus crystallized knowledge

[00:26:00] The "We Are Not Waiting" movement's impact

[00:30:00] What's still not solved in automated insulin delivery

[00:34:00] The mascara metaphor and spoon theory

[00:39:00] Sotagliflozin and weighing DKA risk versus benefits

[00:46:00] Making emotional outcomes measurable

[00:51:00] Moonshots and the Startup Health approach

[00:55:00] Non-invasive glucose monitoring lessons

[00:58:00] Rapid fire questions

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LinkedIn: https://www.linkedin.com/in/drbobgabbay/