Diabetes, in its larger context
A strategic-design exercise: take an ambiguous human problem and map the whole system around it before reaching for a single screen.
A self-directed brief I used to pressure-test a method: how I decompose a problem I've never seen before. It is a thinking sample, deliberately stopping at synthesis rather than UI, and grounded in secondary research, no primary interviews. I've kept that limitation visible because it shapes how the output should be read.
- Role
- Strategic Design · Systems Thinking
- Timeline
- ~1 week · Design exercise
- Platform
- Research & synthesis
- Type
- Method sample
- Team
- Solo
01 At a glance
Problem
A pharma client wanted to understand how the social dynamics of Type-2 diabetes shape patients' lives, the thoughts, emotions and motivations behind the diagnosis, not just the clinical facts.
Approach
Rather than jump to a persona and an app, I used a systems lens, Saarinen's 'next larger context' and RISD's fourteen dimensions, to map the disease across patient, society, caregiver, physician, its history, its causes and its US geography before proposing anything.
Outcome
A holistic problem map across seven lenses, condensed into a single 'in a nutshell' synthesis that traces every proposed intervention back to a specific, evidenced insight, plus an honest list of what I'd validate before betting on any of them.
7
stakeholder & context lenses mapped
14
systems dimensions applied
1
synthesis, insight → intervention
02 The brief, and the trap inside it
The client framed it as a research question: understand the social dynamics of Type-2 diabetes so they can better serve current patients and support future ones. The easy answer is a patient persona and a tracking app.
That answer is a trap. Diabetes isn't a screen problem, it's a life problem that touches the people around the patient, the economics of their region, the supply of the doctors who treat them, and centuries of how the disease has been understood. Today 1 in 10 American adults has Type-2; on current trends it's 1 in 3 by 2050. It costs the US an estimated $327B a year and is the seventh leading cause of death. Reach for UI too early and you solve the wrong thing well.
So I treated the brief as a systems problem first. The goal of this phase wasn't a solution, it was coverage, making sure I understood the whole board before moving a piece.
The pain points
- 01Patient: average age 45, a desk job, expensive medical bills and a diet to rebuild. 69% also had high blood pressure, 44% high cholesterol, 39% chronic kidney disease.
- 02Society: 1 in 10 US adults has Type-2 today, projected 1 in 3 by 2050, with little public awareness and almost nowhere diabetic-friendly to eat at work or out.
- 03Caregiver: usually a spouse or parent. 26% of family caregivers report emotional distress; 44% of those caring for Type-2 patients show symptoms of depression.
- 04Physician: a worsening shortage of endocrinologists, worst in rural and underserved areas, driven by low pay and little exposure in medical training.
- 05Place: the five highest-diabetes US states overlap almost exactly with the lowest-income and highest sugary-drink states. Geography, income and the disease move together.
“Always design a thing by considering it in its next larger context, a chair in a room, a room in a house, a house in an environment. — Eliel Saarinen”
03 The method: think in dimensions
- 01
Borrow a lens that forces breadth
From my Strategic Design training at RISD I use a fourteen-dimension systems checklist, labour, economic, technological, historical, bodily, symbolic and more. It's a deliberate way to think in directions I'd otherwise skip. Not every dimension applies; the point is to choose consciously, not by default.
- 02
Warm up on something harmless
Before diabetes I ran the lens on a cup of tea, who grew it, how it travelled, what it costs, what it means culturally. A low-stakes warm-up proves the method is a repeatable thinking tool, not a one-off, and tunes it before pointing it at a problem where the stakes are real.
- 03
Map the disease, not just the patient
Then the same lens across diabetes through seven views: the patient, society, the caregiver, the physician, the history of the disease, its wider causes, and its geography across US states. Each view surfaced something a persona alone would miss, the caregiver's depression, the endocrinologist shortage, and the tight overlap between low income, geography and diabetes rates.
- 04
Hold the limitation in view
With no time for primary interviews, this leaned on secondary research, and I assumed parts of the persona. I stated that on the assumptions slide rather than dressing it up. Knowing what your map is missing is part of reading it correctly.
04 From map to a defensible shortlist
Every solution traces to an insight
The interventions aren't a brainstorm, they're answers to specific findings: a points-reward system for the low-income-motivation insight, diabetic menus at offices and restaurants for the 'nowhere to eat' insight, credit-card-funded health checkups for the awareness gap, and an endocrinologist-pipeline play for the doctor-shortage insight. Insight in, intervention out.
Synthesis over volume
The exploration produced a wide set of ideas across awareness, community, food, finance, care, apps and wearables. The value isn't the count, it's the final 'in a nutshell' view that collapses the whole disease, three core actors and their problems into one readable map, so a reader sees the entire argument at a glance rather than wading through twenty slides.
What I'd do before betting (the honest next step)
Senior work isn't a list of fifteen ideas, it's choosing. If this were real I'd interview five patients and three caregivers to replace my assumptions, then prototype and test the two highest-leverage bets, the points system and the office/restaurant menu, and deliberately kill the rest until those earn their place.
05 In a nutshell: insight → intervention
Motivation, food and cost
For the burden of bills and a diet to rebuild: a points-reward system that discounts medical bills as blood sugar drops (aimed squarely at the low-income-motivation insight), diabetic-friendly menus at restaurants and offices, and a tracking app with telehealth video calls and diabetic recipes so the daily load is lighter.
Awareness and belonging
For the awareness gap and the isolation: public-awareness campaigns, social-media community groups built around cycling, trekking and shared activity, and a partnership with credit-card companies to fund a free half-yearly full-body checkup, turning a finance channel into a screening channel.
Support the people who support
For the 44% of carers with depressive symptoms: structured wellness and therapy sessions and group support, built with healthcare professionals, so the emotional cost of caregiving is designed for rather than ignored.
Fix the doctor pipeline
For the endocrinologist shortage: exposure and incentives for medical students, better working conditions and expanded residency slots, plus wearables (CGM, non-invasive monitors) that stretch scarce specialist time further. A supply-and-demand answer, not a slogan.
06 What this exercise demonstrates
It's the front half of the design job done deliberately: framing an ambiguous, emotionally loaded problem, mapping the system around it across seven lenses, and landing on a synthesis where every proposed move is tied to a specific piece of evidence.
It deliberately stops before UI. That's the honest boundary of the piece, and naming it is the point. I'd rather show clear thinking with a stated limitation than a polished screen built on an unexamined problem.
Why this one matters to me
This is how I think when I'm handed a problem I've never seen, with no obvious answer. Instead of rushing to a screen, I map the whole board first: who's involved, what forces are at play, where the real leverage sits. The fourteen-dimension lens is the part that travels. It's a way to make sure I've understood the system before I move a single piece, and I'd run it the same way on a fintech flow or a sales tool as I did here.