In this week’s issue of The Savvy Diabetic: 

• • Sequel Med Tech, Diabeloop to Integrate Automated Insulin Delivery Algorithm into twiist Pump
  • A “twiist” of Fate: Why Sequel is Moving Beyond Tidepool to Embrace Diabeloop
  • Dexcom’s New CEO Outlines Approach to Stop a Repeat of G7 Supply Shortage
  • Clinical Concerns: Insulin Delivery System Sensors
  • Medtronic Gets FDA Clearance for Smart Insulin Pen App
  • Why Your Blood Sugars Make No Sense (And Why You’re Not Failing)
  • Top 10 T1D Myths: Debunked
  • Forget Drinking in Moderation: WhyAbstinence is Your Best Option for a Healthier Life
  • Low on energy? A New Understanding of Rest Could Help Revitalize You

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Sequel Med Tech, Diabeloop to integrate automated insulin delivery algorithm into twiist pump by Sean Whooley for DrugDeliveryBusiness.com, 13 January 2026.

Sequel Med Tech and Diabeloop announced a collaboration to integrate a new algorithm into the twiist automated insulin pump. The partnership aims to bring DBLG2, Diabeloop’s newest automated insulin delivery (AID) algorithm, to twiist. DBLG2 picked up FDA clearance last month. Sequel becomes the latest pump maker to adopt the algorithm, with ViCentra planning to roll out its next-generation Kaleido pump with DBLG2. It would mark the first integration of the Diabeloop algorithm into a commercial insulin pump in the U.S. market.

DBLG 1 requires users to only enter body weight and total daily insulin dose before adapting to the user’s needs. Its self-learning module refines parameters over time based on glucose trends and insulin delivery history. This enables responses to the diversity of type 1 diabetes physiologies, specific medical conditions and personal preferences. Users can also choose not to declare meals.

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A “twiist” of Fate: Why Sequel is Moving Beyond Tidepool to Embrace Diabeloop by Tim Street of Diabettech.com, 15 January 2026.

For those in the “We Are Not Waiting” camp, the Sequel twiist pump was supposed to be the commercial homecoming for Tidepool Loop. It promised the soul of a DIY algorithm, backed by a medical device giant. But as of today’s announcement, the narrative has shifted.  Sequel Med Tech and Diabeloop have announced a major partnership to integrate the DBLG2 algorithm into the twiist system. This isn’t just another integration; it’s a strategic pivot that suggests Sequel is looking for a more “hands-off” lead for their hardware as they eye both the home market and global scale.

While Sequel keeps its cards close to its chest, we can triangulate their current footprint as they head into 2026:

• • • • User Estimate: Industry analysts suggest that as of December 2025, the twiist system has roughly 2,000 to 5,000 active users (Source: Diabetotech Winter 2025 Update).
      • Launch Velocity: Having only launched in July 2025, with an initial waitlist of 4,000 people, Sequel spent the latter part of the year getting them onboarded.
      • Sensor Synergy: A significant chunk of growth comes from their partnership with Senseonics, as the first commercial patients recently went live using the twiist pump with the Eversense 365-day CGM (Source: Senseonics Q4 2025 Report).

All together, whilst these are speculative numbers, this would suggest that Sequel is still a small player in the insulin pump market compared to even Ypsomed, who were estimated to have approximately 70,000 users in the March 2025 based on data from their Investor 

Why would Sequel lead with this over Tidepool for the mass market?

• • • • The “Unannounced Meal” Factor: In their January 8, 2026 announcement, Diabeloop noted that DBLG2 is “one step closer to full closed loop.” The DBLG2 algorithm manages glucose automatically even if a user chooses not to declare a meal—a feature Tidepool Loop lacks by design (Source: Diabeloop News – January 2026).
      • Ease of Use: While Tidepool Loop requires significant human involvement in the setup and tuning of the system (PMID: 33226840), all of Diabeloop’s algorithms simply request weight and Total Daily Dose (TDD), then learn and adjust from there. Far less for the human user to do.
      • iiSure Synergy: Sequel’s iiSure™ technology (measuring insulin via sound waves) gives the algorithm a perfect feedback loop. Because the pump knows exactly how much was delivered, the DBLG2 algorithm could be more aggressive in its corrections. Compared to Loop, Diabeloop algorithms already have lower time below range (a little over 1%), and this hardware precision could enhance that even further (Source: Diabeloop CE MDR Announcement).

The Verdict

• • • • Sequel isn’t “dumping” Tidepool Loop, but it looks like they may be realizing that Tidepool potentially has a smaller audience amongst high-engagement users. Whilst they needed something to get started with, the Diabeloop/twiist integration is a mass-market product for the person who wants to stop counting carbs and is still happy with a time in range around 65%-70% (though clinical data often shows DBLG2 hitting closer to 80%).
      • What’s perhaps most noteworthy is that with this news, Sequel’s twiist becomes the first true commercial “interoperable” pump system, capable of working with multiple algorithms and sensors, giving users true choice. And if you start with one algorithm and you don’t like it? Then it’s much easier to change!

Read more: Sequel Med Tech, Diabeloop to integrate automated insulin delivery algorithm into twiist pump

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Dexcom’s new CEO outlines approach to stop a repeat of G7 supply shortage by Ben Adams for FierceBiotech.com, 13 January 206.

In his inaugural J.P. Morgan Healthcare Conference speech, Dexcom CEO Jake Leach looked to ease concerns over last year’s supply shortage of the company’s leading diabetes product.  He told investors: “It’s important that we learn from the different challenges we’ve had over time,” an indirect nod to the supply issues the company has faced.  This has been specific to Dexcom’s G7 sensor, its wearable continuous glucose monitoring device for diabetes patients to help them monitor their sugar levels.  But, early last year, Dexcom announced it was “experiencing temporary delays in our supply chain, which may lead to some pharmacies or DME distributors being on a backorder.”

Dexcom has “spent a good amount of time investing in our supply chain,” Leach said, touting the company’s “strong infrastructure and resilience” to serve its customers. “We’ve made significant updates to our quality management systems and test procedures,” Leach said at JPM. “We’ve [also] reorganized our teams, and we’ve brought in new talent and I’m very proud of how the teams have responded to this charge to enhance everything about the quality of our product [and] the quality of our service.”

Read more: Dexcom’s new CEO outlines approach to stop a repeat of G7 supply shortage

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Clinical Concerns: Insulin Delivery System Sensors by Anne L. Peters, MD for Medscape.com, 9 January 2026.

This is a great review by Dr. Anne L. Peters, endocrinologist at USC Medical Center.  It’s honest and gives us some precautions.

Watch the Video

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Medtronic gets FDA clearance for smart insulin pen app by Elise Reuter for MedTechDive.com, 13 January 2026.

Medtronic said Monday it received 510(k) clearance from the Food and Drug Administration for an app to connect its smart insulin pens with a glucose sensor made by Abbott.  The app, called MiniMed Go, provides alerts for missed insulin doses, a dose calculator and guidance on what to do if a person misses a dose. It also includes software reporting for providers.  

The pairing is part of a partnership Medtronic struck in 2024 for Abbott to make an integrated continuous glucose monitor sold exclusively by Medtronic.

Read more: Medtronic gets FDA clearance for smart insulin pen app

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Why Your Blood Sugars Make No Sense (And Why You’re Not Failing) by Kathryn Gentile-Alvarez for IntegratedDiabetes.com, 14 January 2026.

If you have ever eaten the same meal, taken the same insulin, followed the same routine, and still ended up with a completely different blood sugar result, you are not imagining things.  Diabetes is as much of an art as it is a science, and it’s also a bit of pixie dust. The definition of insanity is “doing the same thing over and over and expecting different results. Diabetes puts that definition to the test by showing us that different outcomes are not a failure of effort, but a reflection of a constantly changing body.

Diabetes is not always a math, settings, or timing problem. It can be a “biology” variable. And biology changes every day.

Why the Same Day Rarely Produces the Same Numbers (to name a few).  Even when carbohydrate, protein, and fat intake and insulin dosing remain consistent, many other factors do not.  Blood glucose is regulated by a complex network of overlapping variables rather than a single controllable factor. Even this list only scratches the surface of the variables involved.

• • • • Stress and emotional load can raise glucose levels, sometimes hours after the stressful event has passed
      • Sleep quality plays a major role in insulin sensitivity. Poor or disrupted sleep can make the next day’s blood sugars harder to manage, even when everything else looks unchanged
      • Exercise affects glucose differently depending on timing, type and intensity
      • Hormonal shifts, including illness, cortisol release, growth hormone, menstrual cycles, and dawn phenomenon, all influence blood sugar in ways that are not always obvious at the moment
      • Insulin absorption varies based on infusion site location, scar tissue, insulin age, and environmental factors such as heat, cold, or pressure. Even when dosing is correct, absorption may not be consistent
      • Digestion speed also matters. Fat, protein, fiber, hydration, and gut motility all affect when glucose appears in the bloodstream, not just how much appears.

What Helps When Numbers Feel Random: Instead of asking, “What did I do wrong?” it can be more helpful to ask:

• • • • Is this a one-time fluctuation or a recurring pattern?
      • Did anything change earlier that could explain what I am seeing now?

Read more: Why Your Blood Sugars Make No Sense (And Why You’re Not Failing)

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Top 10 T1D Myths: Debunked by Dan Heller for DanDeller.substack.com, 13 January 2026.

The aim of this article is to review the top ten myths of T1D that are either half-truths, exaggerations, or completely false. For each item, I will present the topic in a short, easy-to-understand form, followed by a link to my longer, more technical review.  This may look like a long article, but think of it as ten very short articles!   

Cartoon by Steve Cutts

• • • • #1. The #1 Cause of Death for T1Ds is not “dead in bed syndrome”. It’s MACE. But no autopsies have ever shown that the brain was deprived of glucose. It’s because an acute hypo can cause a heart attack or stroke—otherwise known as a Major Adverse Cardiovascular Event, or MACE.
      • #2. DKA is exceedingly rare: DKA doesn’t just spring up out of nowhere. It is a vanishingly rare, pathological state that requires three simultaneous conditions: a total lack of insulin, high glucose, and high ketone levels. It also takes 10 hours to set in, during which time one is extremely uncomfortable, making it painfully obvious that you should just take insulin. 
      • #3. “Basal insulin” — actual metabolic need, the 50/50 rule, and other myths: “background insulin” needs are pulsatile, intermittent, and significantly lower than standard guidelines suggest.
      • #4. Insulin and Food Absorption Variability: The myths of IOB and IOC Calculators: IOB and IOC are great if you’re learning T1D. But know that they are highly unreliable, especially as your duration with the disease passes around five years. Try to wean yourself off them and learn techniques to navigate these turbulent periods. 
      • #5. CGM “Accuracy” (MARD) and other blood glucose myths: T1Ds are often misinformed that a lower MARD (Mean Absolute Relative Difference) rating makes a CGM superior—or even simply “more accurate”. But MARD is largely a marketing term that can be easily manipulated in clinical trials. Moreover, “accuracy” has no bearing on clinical outcomes.
      • #6. Ultra-Low-Carb Diets: While ultra-low-carb diets (like the Bernstein diet) can produce impressive A1c numbers and be highly effective for short-term weight loss, long-term exposure to insufficient carbohydrate intake can introduce severe metabolic stress and cardiovascular risk.
      • #7. Artificial Sweeteners: There is a connection between how mice metabolise artificial sweeteners and adverse outcomes. It’s not a strong connection by any means, and it also typically involves unrealistically high doses of the sweetener to get the effect. Humans don’t metabolise sweeteners the way mice do. 
      • #8. The “Standard of Care” Myth of AID Systems: The American Diabetes Association designated AID systems as the “preferred method of insulin delivery” in most circumstances and advised doctors to consider several factors when advising patients.
      • #9. A Cure For T1D is far more complex than the headlines:  A true cure for established T1D requires solving two separate, enormous challenges: resetting the immune system to stop the autoimmune attack, and creating fully functional islets of Langerhans with proper architecture and vascularization.  Unless you have both, there is no cure.
      • #10. “Exercise makes glucose control harder” (or “Exercise is dangerous for T1Ds”): Exercise is the single most powerful intervention for metabolic health and longevity.

Read more: Top 10 T1D Myths: Debunked

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Forget drinking in moderation: Why abstinence is your best option for a healthier life by Ian Taylor for ScienceFocus.com, 1 January 2026.  Forget drinking in moderation: Why abstinence is your best option for a healthier life …

Sobering science tells us that no amount of booze is good for our health. So should we rethink the way we drink?

During Dry January in 2023, the World Health Organization (WHO) issued a statement about alcohol that poured warm, stale lager on the idea that any amount of booze is good for you. There’s no such thing as a safe drink, it said.  Issued in The Lancet Public Health, the statement reminded us that “alcohol is a toxic, psychoactive and dependence-producing substance and [was] classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago.” Sobering stuff, and a surprise for those of us who toast our health with the occasional tipple.

Is there a ‘threshold’ at which alcohol becomes carcinogenic, explains Dr Jürgen Rehm, from the University of Toronto, whose work looks at the harm of alcohol and other drugs on public health? “While even [the alcohol] industry doesn’t deny that alcohol is a carcinogenic substance, there have been discussions about a potential threshold,” he says. “That led to a re-evaluation of the evidence and a reiteration of the statement from the International Agency for Research on Cancer that there’s no lower threshold.”

In other words, just a single drink a week increases your risk of cancer. This echoes what other researchers have found in recent years.

And it’s not just cancer. In 2021, scientists at the University of Oxford found that no amount of alcohol is safe for brain function, tracking the loss of grey and white matter in the brain with increasing amounts of alcohol intake.  In 2022, researchers also dismissed the idea that light drinking is good for the heart. Using data from over 300,000 people in the UK Biobank, they found that even a few drinks increases the risk of hypertension and coronary artery disease.

AND MORE:  From a ScienceFocus.com post by Hatty Willmoth, 4 January 2026.

Giving up alcohol could add years to your life by slowing down your biological clock.  Quitting booze won’t slow down time or make you age backwards, like something out of Doctor Who.  That’s because we’re not talking about chronological time here, but biological time. In other words, it’s less about the number of trips you’ve taken around the Sun and more about the wear and tear your body experiences with every year you’re alive.

The idea is that life – with all its stresses, parties, workouts, sodas, chips, TV, holidays, and cake – takes a toll on the body. Our habits make their mark on us, and thus we age.

Read more: 

• • • • Forget drinking in moderation: Why abstinence is your best option for a healthier life
      • Why giving up alcohol may be the key to slowing down ageing

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Low on energy? A new understanding of rest could help revitalize you by Caroline Williams for NewScientist.com, 29 December 2025.

There is a state of relaxation that few of us spend much time in, but which comes with profound well-being benefits. But who has the time and energy to do more of anything? If this sounds familiar, it might come as good news that scientists have come up with a more appealing alternative – one that still promises to increase your chances of staying healthy for longer, but involves doing less, not more.  Or, more precisely, that involves perfecting the art of doing, physiologically speaking, as little as possible. This unusual, yet deeply effective, twist on the New Year’s resolution hinges on mastering a physiological state that many of us spend few of our waking hours in. It is called deep rest – a way of being in which signals between the body and brain align on one fundamental fact: that all is well, and there is absolutely nothing to worry about.

In essence, it is the polar opposite of stress. Deep rest is a state in which the body can take a break from fighting and fleeing, instead regrouping and catching up on much-needed maintenance and repair. And while it might take some trial and error to find your personal off switch, the evidence is accumulating that the payoffs could be huge: healthier ageing, reduced risk of disease and more energy to spend on something other than maintaining an ambient panic response.

Alexandra Crosswell, a psychologist at the University of California, San Francisco, who, along with a group of her colleagues, proposed the idea of deep rest in early 2024, says, “Deep rest is beyond relaxation – it’s a coordinated shift of the whole nervous, endocrine and immune system into an overall state of safety signalling.”

Ironically, there is some evidence that constantly being in “a little bit on” state makes the body less efficient at responding to acute stress, so when we actually need our fight-or-flight system, it’s as worn out as we are. In better news, the fact that allostatic states are temporary by nature raises the possibility that if we can find the right bodily switch, we can change the signal and the accompanying allostatic state to one where all is well and biological bankruptcy isn’t an immediate concern.

“It may be that you can create a ‘system reset’ partly by enhancing signals that current resources are sufficient,” says Karen Quigley, a neuroscientist at Northeastern University. This is where the idea of deep rest comes in.

Read more: Low on energy? A new understanding of rest could help revitalise you