When Engineering Meets Parenthood: Lane Desborough's Path from "We Are Not Waiting" to Ecosystem Change

The moment that changes everything isn't always dramatic. Sometimes it's a phone call.

[00:11:00] Lane Desborough was at work when his wife called to say their 10-year-old son was in the hospital with type 1 diabetes. As a chemical engineer who had spent his career automating complex industrial systems, Lane understood feedback loops, control systems, and remote monitoring. [00:17:30] What he didn't understand was why he could monitor billion-dollar oil refineries from thousands of miles away, but couldn't see his child's glucose levels from the next room.

That disconnect between what technology could do and what was available to families became the foundation for one of the most influential movements in diabetes technology.

[00:15:30] From Individual Solution to Global Movement

Lane's engineering background shaped his approach to his son's diagnosis. [00:14:30] Where others saw a medical condition requiring careful management, he saw a broken feedback control system that could be automated. His first step was getting his son into clinical trials for automated insulin delivery systems at Stanford University, just seven days after diagnosis.

[00:21:00] But clinical trials weren't enough. Lane built a remote monitoring system that allowed him and his wife to check their son's glucose levels without entering his room. The technology worked reliably and offered significant safety improvements over manual checking. [00:22:30] Rather than keeping it to himself, Lane open-sourced the system.

[00:23:00] This became Nightscout, which grew into one of the most widely adopted open source medical tools on GitHub. The accompanying philosophy, "We Are Not Waiting", resonated with thousands of families who were ready to build their own solutions rather than wait for industry development cycles.

[00:12:30] The Duck Analogy: Understanding Hidden Complexity

Lane uses a striking metaphor to describe life with type 1 diabetes: [00:12:45] "The image in my mind is the duck that is paddling along and it looks smooth, but they're paddling furiously underneath. That's really the way I think every family who's affected with type one is like that duck where you don't even really know what's going on. But there's a lot that's happening just to get to the start line of a day when you're managing type one diabetes."

[00:33:00] This hidden complexity explains why individual engineering solutions, while valuable, have limitations. Lane recognized that his technical skills and resources represented "a fairly narrow segment of the population that's willing and able to do that." The broader challenge became clear: how to confer the benefits of advanced technology to everyone who needs it, especially those who would benefit most.

[00:43:00] From Personal Solutions to Ecosystem Thinking

[00:44:30] Lane's current work with AIDIF (Automated Insulin Delivery Interoperability Framework) represents this shift from individual solutions to ecosystem-level change. Rather than building another device or algorithm, he's creating the simulation and testing infrastructure that could accelerate development across the entire industry.

[00:51:00] Working with FDA through the Medical Device Development Tool pathway, Lane is developing what he calls an "FAA-level simulator" for diabetes technology. [00:38:00] This approach addresses what he identifies as the primary constraint in the innovation pipeline: the lack of credible simulation tools that can reduce development cycles from 15 years to months.

[00:06:30] The Engineering Mindset Applied to Healthcare

Lane's story illustrates how technical expertise from other industries can identify and address healthcare challenges in unexpected ways. His background in process control and automation provided a framework for understanding diabetes management that differed from traditional medical approaches.

[00:06:45] This crossover thinking, what Lane learned in graduate school about finding relevant materials in different academic libraries, continues to inform his work. The terminology may be different across domains, but the underlying principles often translate.

[00:47:00] Choosing Constraints Over Profits

Lane's decision to pursue grant funding rather than venture capital for AIDIF reflects his focus on addressing system-level constraints rather than building another company. [00:47:30] As he explains it, he's identified where the bottleneck exists in bringing transformative diabetes technology to market, and he's chosen to focus his energy on removing that specific constraint.

This approach acknowledges that other constraints will emerge once the current ones are addressed. It's systems thinking applied to innovation policy, identify the limiting factor, address it systematically, then move to the next constraint.

[00:32:00] The Ongoing Movement

The "We Are Not Waiting" movement that Lane helped launch continues to influence diabetes technology development. While individual families building their own solutions may represent a small percentage of the total population needing these tools, their innovations have pushed industry development in more patient-centered directions.

Lane's current work extends this influence by creating infrastructure that could benefit all developers working on diabetes technology, regardless of company size or resources. It's a shift from building solutions for his own family to building the tools that help others build better solutions.

The phone call that started Lane's journey into medical device development happened 15 years ago. The infrastructure he's building today could determine how quickly the next generation of diabetes technology reaches the families who need it most.

Listen to the full episode: https://creators.spotify.com/pod/profile/shannon-lantzy

This content was repurposed from the original podcast discussion by a genAI prompt.