Diabetes mellitus is a complex disease with many environmental inputs that contribute to the state of ‘controlled’ or ‘uncontrolled’ diabetes and its consequent outcomes.  The treatment is complex and may involve many medication classes, dietary modifications, and lifestyle interventions.  Syllogistically, one can conclude that amidst daily uncertainties, a patient with diabetes is a person in a fragile state of health.  In the modern age of evidence-based medicine, there is a tangled tapestry of variables that all contribute to the health and well-being of a person who must live with this erratic and insidious disease.  Diabetes continues to accelerate as a global health epidemic in defiance of the plentifulness of diabetic interventions.  The challenges of this multi-faceted malady present an epistemic opportunity for learning new ideas for thriving and not just surviving on a downhill slope.  Let us consider three antifragile approaches that include embracing innovative algorithms and simple heuristics that empowers the patient who must cope with diabetes to flourish.

Sandip Mehta, DO, FACOI, is an Internal Medicine physician practicing in North Texas who has been practicing for over 22 years. He is the Texas Health Physicians Group’s Medical Director of Quality and creator of the Microsoft Teams-based Quality Trust to advance quality knowledge and performance at Southwestern Health Resources, the largest and most successful ACO in the United States. Dr. Mehta is an Epic Physician Builder, creator of Speed Force Epic, a heuristic-based chronic disease documentation platform, and Speed Force Nexus, a hyperscale data fabric for real-time evaluation of per-patient quality measures, both operating within Epic CareConnect One, the custom EHR across all of Texas Health Resources ambulatory practices. He holds a bachelor’s degree in Astronomy from the University of Texas at Austin, a Doctor of Osteopathic Medicine from the University of North Texas Health Science Center in Fort Worth and is a Fellow of the American College of Osteopathic Internists. Dr. Mehta is an avid digital painter and photographer of flowers.