For Brandon Arbiter, CEO of Tidepool and a person living with type 1 diabetes (T1D), the future of diabetes care depends on connected data. He leads Tidepool with a clear vision: to shift care from reactive to proactive, bridge the gaps in access, and connect data to drive better outcomes for people living with diabetes and their clinicians. 

“We deserve better,” Arbiter told T1D Exchange. That phrase has guided his decade-long journey with Tidepool, the nonprofit he co-founded, to develop software that integrates and visualizes data from various diabetes devices.  

While powerful technology exists to profoundly improve outcomes for people who rely on insulin — such as advanced pumps, continuous glucose monitors (CGMs), and automated insulin delivery (AID) systems — each operates within its own ecosystem. This results in systems that are only compatible with a manufacturer’s clinical data platform, limiting a clinician’s ability to view and manage all patient data in one place.  

“That works fine if every person in your clinic uses the same device, “Arbiter explained. “But in reality, they don’t — and that fragmentation makes population health and remote patient monitoring nearly impossible.”

To solve that problem, Tidepool has invested years building a device-agnostic platform that unifies diabetes data across brands. By giving health systems and clinicians a complete view of their patients — regardless of the devices they use — Tidepool is helping shift diabetes care from one-on-one device support to scalable, proactive population management. 

 

From personal need to public mission 

Arbiter’s journey into diabetes technology began as he sought to better understand what was happening inside his own body.  

After his diagnosis in 2011, at age 27, Arbiter used his background in computer systems to build a prototype app that combined Dexcom continuous glucose monitoring (CGM) data, insulin pump information, and meal logs into a single view. That personal experiment grew into a calling. Two years later, he co-founded Tidepool with Howard Look, determined to make device data accessible, actionable, and meaningful. 

“I knew what was possible,” Arbiter said. “And I wanted other people (with diabetes) to have access to the same quality care I’ve been able to get and have the ability to link to the needed technologies.”  

He recalled how their early vision to help people living with diabetes better organize and see their health data revealed a broader need — to also serve healthcare professionals: “We wanted to make software for people living with diabetes,” Arbiter said. “What we stumbled upon was this huge need for software from clinicians.”  

Today, Tidepool supports 1,300 clinics and health systems every month and has touched over 900,000 lives through its software. He said: “It means we’re making a difference at a scale that frankly, we didn’t imagine when we started this.” 

 

The power of proactive care 

Tidepool offers two core products: Tidepool+, which integrates data from pumps and CGMs into EHRs for quicker clinical action, and Tidepool Loop, which Sequel Med Tech uses in its twiist™AID System, bringing a new level of personalization for automated insulin delivery (AID) users.   

Key features include a wide range of customizable glucose targets, pre-meal and workout settings, automated insulin delivery based on food types, editable carb calculations, and even dose insulin using an Apple Watch.  

After years of development and working towards commercialization, Loop is finally in the hands of real users. “We now have Loop in-market,” Arbiter said. “People are using it, and I’m incredibly proud of that achievement.” 

He also highlighted Tidepool+ as a tool to fuel proactive clinical care. “We have a new set of tools within Tidepool+ that endocrinologists and diabetes educators can use to automatically risk-stratify the entire patient population,” he said. This allows the diabetes care team to proactively reach out to the person with diabetes when they’re actively having an issue, rather than waiting for their next appointment. 

 

Bridging the gap between DIY and healthcare systems 

Tidepool emerged when a grassroots DIY movement — people with diabetes building their own closed-loop insulin systems — was redefining the possibilities of diabetes technology. Arbiter saw the opportunity to bring that spirit of innovation into the regulated world of medical devices. That same philosophy now drives Tidepool’s work with clinics and health systems.  

In a UC Davis pilot program, clinicians used Tidepool’s tools to enroll people living with diabetes in a remote monitoring program. A surprising outcome was that several individuals who had never used an insulin pump before were motivated, in part by increased provider attention, to begin AID therapy. Arbiter explained that, in this case, more consistent communication led to more equitable access to high-quality care. 

He said the study underscores a broader problem Tidepool aims to address: people living with diabetes who fall through the cracks of the medical system.  

“These tend to be people who are not on an insulin pump, and struggle to get in to see their healthcare provider because their work schedule doesn’t allow for it. They’re not on the latest technology, and, as a result, they might have had an episode of severe hypo or DKA that put them in the hospital at some point during the year,” he said. “When they finally do get in for their next appointment, they’re so busy talking about the hospital stay or the latest insurance problem, they don’t have time for a meaningful discussion about how to get ahead of their care.” 

“What we see happening with proactive care is it levels the playing field,” Aribiter said. “With more complete digital health data and better communication, it’s no longer about someone having an annual visit to the doctor, but now,” he said, “the clinician can spot problems and reach out to a patient the same week to talk about it.”  

 

Navigating leadership and loss 

The past year brought a profound shift for Tidepool. Co-founder Look, with whom Arbiter started the company in 2013, stepped down in March after a cancer diagnosis. “It was amazing to collaborate with him every day for 12 years,” Arbiter said, “and I miss that dearly.” 

He emphasized that Tidepool is built to thrive beyond any one person: In the past four years, as the company has hired a strong executive team, it has become, in Arbiter’s words, “less of a ‘Brandon-Howard show’ and much more of the collaborative strength of a bunch of people.” 

The core mission remains the same, Arbiter said: “I will honor the culture that he built — that we built together — to keep working on the vision to make great software.”  

As a nonprofit, Tidepool has taken a path that prioritizes the needs of people with diabetes, which comes with its own challenges. “Fundraising is hard because we can’t go out to investors,” Arbiter said, adding that the nonprofit model is right for Tidepool. “Many for-profit companies that take venture funds have to answer to investors,” he said, and that can put unnatural pressure on them “to do things that are not in the best interest of the diabetes community.” 

Looking ahead, Arbiter is optimistic: “Now we know what to do. We’ve learned how to scale this. We’ve learned how to make these technologies accessible.” With that foundation in place, Tidepool will continue to drive improvements in care — powered by technology and guided by a relentless focus on equity, he said.  

“Ultimately, it’s not just about data,” he said. “It’s about what the data can unlock — a more responsive, equitable, and human kind of diabetes care. If we can help clinicians gain visibility to their patients who might otherwise slip through the cracks, we’re doing what Tidepool was built to do.”