WHAT’S IN THIS ISSUE
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- Losing Lyumjev: How the System Failed Patients
- Sex and Type 1: Study Offers Reassurance About Lows
- Continuous Ketone Monitoring Makes SGLT-2 Inhibitors Safer for T1Ds
- Islet Cell Therapies: Breakthrough T1D’s Clinical & Research Congress
- MiniMed’s Smart MDI System and Alert Response
- Do You Really Need to Fast Before Every Blood Test?
- Sugar-Rich Foods Amplifies Antibiotic Disruption of the Gut Microbiome
- Laughter, Sighs and Screams Reveal Unwritten Social Rules
NEWS FROM T1DTO100
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- T1Dto100 limited edition, first-run DAZZLING t-shirts
- Endocrinologist Discusses Life-or-Death Stakes of Weak Bones
- Finger-Stick Glucose Testing in Long-Term Care
FROM OUR READERS
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- Rick Phillips, Kathy and Casey Share Their Reactions
Losing Lyumjev: How the System Failed Patients by Tim Street for Diabettech,com, 5 October 2026
As MiniMed, Insulet, Tandem and CamDiab work toward fully closed-loop systems that may eliminate meal boluses, some European countries are losing access to Lyumjev, one of the fastest-absorbed subcutaneous mealtime insulins.
Eli Lilly has announced that selected presentations of its insulins will be withdrawn from selected European markets for commercial reasons. Lyumjev vials, cartridges and pens are affected differently across countries. The withdrawals are not related to a quality or safety issue. Tim Street examines whether prescribing policies, clinical guidelines and limited access contributed to low use of Lyumjev, which manufacturers now cite as part of the commercial rationale for withdrawal.
Lyumjev offers faster early insulin action and improved post-meal glucose control for some users, although infusion-site pain and reactions make it unsuitable for others. Street argues that as fully closed-loop systems advance, access to faster-acting insulin becomes increasingly important. His analysis raises questions about whether patients have been given a meaningful choice of insulin.
SAVVY NOTE: This is a disturbing issue of access and choice. For those of us using automated insulin delivery, insulin speed can make a real difference. I particularly appreciate Tim’s detailed examination of how decisions by manufacturers, healthcare systems and prescribing policies can affect what is actually available to people living with T1D.
READ MORE: Losing Lyumjev
Sex and Type 1: Study Offers Reassurance About Lows, based on research by Dominica Orłowska and colleagues, reported by News-Medical.net, 18 September 2026
For people with type 1 diabetes, fear of hypoglycemia can affect intimacy with a partner. Like other physical activity, sex may change glucose levels, but the subject is rarely discussed with healthcare providers. A small study examined CGM data from approximately 110 participants who engaged in sexual activity. Researchers found no clinically significant hypoglycemic events, although glucose levels sometimes decreased and sometimes increased afterward.
The findings may provide reassurance that sexual activity does not necessarily cause hypoglycemia. Because individual glucose responses varied, reviewing personal CGM trends may be more useful than assuming glucose will always fall.
SAVVY NOTE: Here’s a topic we don’t discuss nearly enough! It’s encouraging to see researchers addressing everyday quality-of-life issues that can affect relationships and confidence. And, as always with T1D, individual experiences matter.
READ MORE: Sex & T1D: Study Offers Reassurance About Lows
Continuous Ketone Monitoring Could Make SGLT-2 Inhibitors Safer for Type 1 by Andrew Saintsing & Paul Heltzel for diaTribe.org, 5 October 2026
SGLT-2 inhibitors can improve glucose management and provide heart and kidney benefits, but their use in type 1 diabetes is limited by concerns about diabetic ketoacidosis (DKA).
In a study presented at EASD 2026, 65 adults with type 1 diabetes in Australia received ketone-management training and wore continuous ketone monitoring devices. Half received dapagliflozin for three months, while the other half received a placebo. Participants taking dapagliflozin spent more time in range without additional time below range or any episodes of DKA during the study.
The findings suggest continuous ketone monitoring could help researchers investigate safer use of SGLT-2 inhibitors in T1D. Larger and longer studies are needed to determine whether this approach can reduce DKA risk.
SAVVY NOTE: THIS is an important development to watch. We have discussed the potential benefits of SGLT-2 inhibitors for T1D, along with the very real concern about DKA, including euglycemic DKA. Continuous ketone monitoring could eventually add another layer of safety, but this small study does not establish that the risk has been eliminated.
READ MORE: Continuous Ketone Monitoring Making SGLT-2 Inhibitors Safer for T1D
Islet Cell Therapies: Research Supported by Breakthrough T1D/T1D Fund by Sandy Vogt, PhD, for BreakthroughT1D.org, 9 October 2026
At the inaugural Breakthrough T1D Clinical & Research Congress in Philadelphia, October 2026, researchers presented several developments in islet cell therapies.
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- Tegoprubart: Dr. Piotr Witkowski reported that all 12 participants who received islet cell transplants with this alternative immunosuppressive treatment remain insulin-independent, with stable glucose levels and no reported kidney toxicity. A future study will include people with T1D and chronic kidney disease.
- Sana Biotechnology: Dr. Per-Ola Carlsson reported that immune-evasive islet cells continue to survive and produce insulin more than one year after transplantation in the first treated participant, without serious side effects.
- Century Therapeutics: Dr. Leonardo Velazco-Cruz described progress toward a scalable, manufactured immune-evasive islet cell therapy that does not require immunosuppression. The approach has shown promise in animal models and is moving toward human studies.
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The central message: islet cell therapies continue to advance, with researchers working toward treatments that are scalable and may eventually avoid lifelong immunosuppression.
SAVVY NOTE: Three very different approaches, all moving toward the possibility of restoring insulin production. I am especially interested in the research aimed at avoiding immunosuppression and expanding eligibility to people with kidney disease. These are exciting developments, although the treatments remain experimental.
READ MORE:
MiniMed Touts Smart MDI System Alert Response Benefits in Type 1 Diabetes Patients by Ross Law for MedicalDevice-Network.com, 6 October 2026
MiniMed reports on the potential benefits of its Smart MDI approach, which combines continuous glucose monitoring and connected insulin-delivery tools for people using multiple daily injections. The article focuses on alert response and the potential to support glucose-management decisions for people who do not use an insulin pump.
MiniMed’s Smart MDI system connects the InPen smart insulin pen with a continuous glucose monitor through the MiniMed Go app. This smart pen system tracks doses, provides dose calculations, and sends missed-dose and high-glucose alerts alongside glucose insights. MiniMed highlighted that Smart MDI, which secured US Food and Drug Administration (FDA) approval in January 2026, brings these functions into one app, instead of asking people to coordinate a pen, glucose monitor, and dosing decisions separately.
SAVVY NOTE: Not everyone wants to wear an insulin pump, and many people use MDI very successfully. I am always interested in technology that offers some of the decision-support benefits of connected diabetes systems without requiring automated insulin delivery.
READ MORE: MiniMed touts Smart MDI system alert response benefits. in T1Ds
Do You Really Need to Fast Before Every Blood Test? New Study Suggests Not by Sanjukta Mondal for MedicalXpress.com, 6 October 2026
Many medical practices still ask patients to fast for 8–12 hours before routine blood tests. Although fasting requirements were originally associated with glucose and lipid testing, the practice gradually became standard for many other routine laboratory panels. Researchers from South Korea examined whether such broad fasting requirements are necessary. The study raises questions about continuing to require overnight fasting for tests that may not need it.
For most tests, it made little clinical difference whether patients had fasted for a few hours or much longer. Only a handful showed meaningful changes. Blood glucose, triglycerides, liver enzymes, and lipase were noticeably higher when patients had fasted for less than 8 hours. The findings are published in JAMA Internal Medicine.
SAVVY NOTE: This caught my attention because fasting for laboratory tests can be particularly inconvenient for people using insulin. Of course, whether fasting is necessary depends on the specific tests ordered, so please check with your healthcare team rather than changing instructions on your own.
READ MORE: Do you really need to fast before every blood test? New study suggests not
Study Suggests Sugar-Rich Foods Amplify Antibiotic Disruption of the Gut Microbiome by Chris Dall for cidrap.umn.edu, 6 October 2026
A five-year study examined how diet influences antibiotic-related changes in the gut microbiome among patients with blood cancer. Researchers found that sugar-rich foods may amplify the disruption of intestinal microbial communities during antibiotic treatment. The findings, published in Nature, add to growing evidence that diet can influence how the gut microbiome responds to medications. The observational study, led by researchers with New York University Langone Health, Memorial Sloan Kettering Cancer Center, and City of Hope National Medical Center, followed blood cancer patients during hospitalization before and after stem cell transplantation. Because chemotherapy saps the immune system, cancer patients are highly vulnerable to infections and rely on antibiotics to help fight them off.
All of the patients in the study were on antibiotics at one point during the study, and many received broad-spectrum antibiotics, which are known to significantly disrupt the balance of good and bad bacteria in the gut microbiome and can leave people more susceptible to drug-resistant infections.
The observational study, led by researchers with New York University Langone Health, Memorial Sloan Kettering Cancer Center, and City of Hope National Medical Center, followed blood cancer patients during hospitalization before and after stem cell transplantation. Because chemotherapy saps the immune system, cancer patients are highly vulnerable to infections and rely on antibiotics to help fight them off.
All of the patients in the study were on antibiotics at one point during the study, and many received broad-spectrum antibiotics, which are known to significantly disrupt the balance of good and bad bacteria in the gut microbiome and can leave people more susceptible to drug-resistant infections.
SAVVY NOTE: Another reminder of how complicated the gut microbiome really is! This study involved blood cancer patients receiving antibiotics, so we should be careful about applying its findings to everyone taking antibiotics. Still, the interaction between medications, diet and gut health is fascinating.
READ MORE: Study suggests sugar-rich foods amplify antibiotic disruption of the gut microbiome
Laughter, Sighs and Screams Reveal Unwritten Social Rules in Everyday Life by Sanjukta Mondal for Phys.org, 6 October 2026
Alongside words, humans have a treasure trove of nonverbal tools to help express themselves. We chuckle, sigh, and gasp to communicate our feelings without uttering a word. What has amazed researchers for ages is how we rarely stop to think about how we know which sound belongs in which situation. Could unwritten social rules guide these everyday nonverbal sounds?A recent study from the Netherlands looked into when and where it is socially acceptable to express nonverbal sounds such as laughing, sighing, gasping, screaming or groaning. Instead of bringing participants into a lab or asking them to picture hypothetical situations, the author followed their experiences as they unfolded in everyday life.
Laughter and sighs were the most welcome sounds in everyday life, earning the highest acceptance across situations. Screams and retches drew the strongest disapproval and were rated least acceptable. The setting where the sounds were made also mattered. Vocal sounds were far more acceptable at home or in social settings like bars and parties than at work, at school or in public places like libraries and stores.
These findings reveal the situational principles behind everyday vocal display rules. Future studies could explore whether people actually follow the norms they report. The findings are published in Philosophical Transactions of the Royal Society B: Biological Sciences.
SAVVY NOTE: Just for FUN! Who knew there were so many unwritten rules about something as simple as a sigh or a laugh?
READ MORE: Laughter, sighs and screams reveal unwritten social rules in everyday life
NEWS FROM T1DTO100
Watch for our announcement: T1Dto100 limited edition, first-run DAZZLING t-shirts … in a few days!!!
I’ll be sending out a separate post as well as sharing on the T1Dto100.com website and our Facebook: T1Dto100 group.
Supplies are limited … when we are out, we are out!!! Very exciting times for T1Dto100!
Endocrinologist Discusses Life-or-Death Stakes of Weak Bones and How to Protect Against Devastating Falls by Max Larkin for Medical Xpress, 8 October 2026
Hip fractures are among the most serious health threats facing older adults. In the United States, someone fractures a hip approximately twice every minute, and about 22% of people who experience a hip fracture die within a year.
In an interview with Harvard endocrinologist Dr. Joy Tsai, the discussion focuses on why hip fractures are so devastating and, importantly, how many can be prevented.
Dr. Tsai emphasizes that osteoporosis is not simply an inevitable consequence of aging. Bone-density screening, appropriate medications and fall-prevention strategies can substantially reduce fracture risk.
Practical recommendations include removing loose rugs and cluter, avoiding distractions while walking, and recognizing that declining bone strength deserves the same attention we give to cardiovascular health.
SAVVY NOTE: This one really hits home for our aging T1D community! With neuropathy, balance issues and increased fracture risk, protecting our bones and preventing falls deserve much more attention. I especially appreciate Dr. Tsai’s message that we don’t have to accept fractures as an inevitable part of aging. There are steps we can take NOW.
READ MORE: Endocrinologist on life-or-death stakes of weak bones
Finger-Stick Glucose Testing as an Institutional Stressor: Staff Perspectives From Long-Term Care in a Letter to the Editor in Diabetic Medicine of the Wiley Online Library, 23 June 2026
Finger-stick glucose testing remains standard practice in many long-term care facilities. With diabetes affecting up to one-quarter of care home residents, glucose monitoring represents a significant part of daily care. The authors note that CGM implementation i
n long-term care has been shown to be operationally feasible, with substantial reductions in nursing time per glucose check and increased detection of hypoglycemia compared with finger-stick testing.
The letter raises questions about continuing to rely on finger-stick testing when CGM technology could improve monitoring workflows for staff and residents.
T1DTO100 NOTE: This is exactly the kind of issue we need to address as we age with T1D. We have spent years learning to use CGM and automated insulin delivery, yet many long-term care facilities remain dependent on finger sticks and traditional insulin protocols. We need care systems that can accommodate the technology we already use — and staff who are trained and supported in using it.
READ MORE: Finger-Stick Glucose Testing as an Institutional Stressor
FROM OUR READERS
Rick Phillips: On a pill for diabetic retinopathy: “Oh, let’s hope so.”
On CGM in critical care: “There’s a bigger question here, and we need Beta Bionics, Omnipod, Dexcom, and Abbott to help answer it. Each company has technology that could contribute to a default device for hospitals and long-term care facilities.” “Come on—we can do this. It’s time to stop administering fixed-dose insulin as if it were still the 1950s. We can do better, even in long-term care facilities. Yes, even there.”
On Dexcom G8: “It can—if it provides a stronger signal, improves accuracy, and Dexcom makes sure it doesn’t overpromise and underdeliver. Come on, Dexcom. Do better.”
On the T1Dto100 shirts: “Cool logo. Love it.”
Kathy: “Great!”
Casey: On CGM alarms in the ICU
“33 minutes in the medical ICU for staff help after a low soon alert? How many seizures are happening in the ICU? And what about outside of the ICU? Staff help is probably delayed even further there.”
“You really have to be your own medical advocate and have low supplies waiting on your bedside table and, hopefully, a family member or friend that can help if you’re not capable.”
On the T1Dto100 shirts and diabetes memorabilia: “So glad Kathy asked about the T1D to 100 shirts! They are beautiful and I will definitely be a customer as soon as details are released.”
“I just started making a little T1D Christmas tree last year. I hang syringes, CGMs, Pods, PDMs, etc. I really wish I would have started back in the 1990s, though, for comparison sake. It’s funny to see all the supplies and hardware get smaller and lighter. Progress.”
