A Personal Note from Joanne
A quick note to my wonderful Savvy readers. I’ve been in the hospital for the past two days and am still here as I put together this week’s issue.
Please forgive any missing links, formatting glitches or other little oversights. I wanted to keep our weekly Savvy Updates coming your way, even if this edition isn’t quite as polished as usual!
Thank you for your understanding, your friendship and your continued support. Hoping to be home and back in the swing of things soon!
Much love,
Joanne
What’s In This Issue
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- Patch Pump Purgatory: The Mechanics of a Patch Pump on Skin
- EASD 2026 Tech Update: Less Bolusing, New Pumps & Sensors Beyond Glucose
- Sleep Dysfunction, Not Duration, Linked to Liver Disease
- AI Model Maps Complication Risk in Type 1 Diabetes
- 6 Things Longevity Experts Wish People Would Stop Saying
- Heart & Kidney Care Alliance: A Global Advocate Supergroup
- New Survey Explores Diabetes-Related Nerve Damage and Treatments
- Theory vs. Physiology of Bolus Dosing: How Experienced T1Ds Decide
- Late-Night Eating Is Associated With MASLD and Cirrhosis
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What’s Happening at T1Dto100
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- Living Legends: Preserving the stories of longtime T1D survivors
- Supporting T1Dto100: Help us expand our programs and resources
- Growing Our Mission: Supporting older adults aging with Type 1 diabetes
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Patch Pump Purgatory: The Mechanics of a Patch Pump on Skin by Tim Street for Diabettech.com, 12 October 2026
Patch pumps eliminate tubing, but their attachment directly to moving skin can create mechanical challenges.
Tim Street explores how everyday movement, pressure, and accidental bumps may shift a pump and disturb the cannula beneath the skin. This could contribute to insulin leakage (tunneling) and inconsistent delivery, particularly toward the end of a pod’s wear period.
Cannula placement, pump dimensions, and adhesive design may influence these problems.
Conclusion: Patch pump mechanics may contribute to infusion-site failures, although further testing is needed to establish their effects.
SAVVY NOTES: Could some mysterious glucose fluctuations be mechanical rather than metabolic? For those of us relying on automated insulin delivery, dependable infusion sites are essential!
Read more: https://www.diabettech.com/patch-pump-purgatory-the-mechanics-of-a-patch-pump-on-skin/
Tech Update: Less Bolusing, New Pumps & Sensors Beyond Glucose for EASD 2026 by DiabetoTech.com, 10 October 2026
The EASD 2026 meeting highlighted progress toward smaller pumps, fewer meal announcements, and sensors capable of measuring more than glucose. Among the developments:
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- MiniMed Flex/Vivera: An investigational algorithm allows users to choose whether to announce meals. Early results showed time in range of 82.3% with meal announcements versus 73.8% without them.
- Tandem Mobi: This compact pump continues its international expansion.
- CamAPS Liberty: Users required fewer meal boluses, although median time in range declined from 70.8% to 65.8%.
- Inreda AP5: A dual-hormone insulin/glucagon system improved time in range compared with injections and CGM but showed no statistically significant advantage over hybrid closed-loop therapy.
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Conclusion: Technology is moving toward less daily decision-making, but convenience must be balanced against glucose outcomes and safety.
SAVVY NOTES: Less carb counting and fewer boluses sound wonderful, especially for older adults with T1D. But how much glucose control are we willing to trade for convenience? I’d love to see more longtime survivors included in these studies!
Sleep Dysfunction, Not Duration, Linked to Liver Disease by Nancy A. Melville for MedScape.com, 12 October 2026
New research suggests that sleep quality may matter more than sleep duration when it comes to liver health.
Two studies identified associations between disturbed sleep and metabolic dysfunction-associated steatotic liver disease (MASLD). Poor sleep quality was associated with greater MASLD risk, while obstructive sleep apnea was associated with MASLD, cirrhosis, and mortality.
Conclusion: Sleep dysfunction may be an important marker of liver disease risk, although these observational findings do not establish causation.
SAVVY NOTES: Many of us with T1D struggle with interrupted sleep, particularly as we age. Another reminder that sleep quality deserves attention—not just how many hours we spend in bed.
Read more: https://www.medscape.com/viewarticle/sleep-dysfunction-not-duration-linked-liver-disease MedScape.com: registration may be required.
AI Model Maps Complication Risk in Type 1 Diabetes by Veronique Duqueroy for MedScape.com, 13 October 2026
Researchers are using artificial intelligence to identify patterns of complication risk among people living with Type 1 diabetes.
Using data from the SFDT1 cohort, a machine-learning model identified seven distinct patient profiles, ranging from relatively well-controlled diabetes to elevated cardiovascular and kidney risk.
The research could eventually support digital twins—computer-based models to help clinicians better predict complications and personalize care.
Conclusion: AI may improve individualized complication-risk assessment, but further validation is required before clinical use.
SAVVY NOTES: Why do some people develop serious complications while others live with T1D for 50 or 60 years with relatively few? Perhaps this research will help us understand those differences.
Read more: https://www.medscape.com/viewarticle/ai-model-maps-complication-risk-type-1-diabetes-2026a10012bn MedScape.com registration may be required.
6 Things Longevity Experts Wish People Would Stop Saying by Melinda Wenner Moyer, NYTimes.com, 14 October 2026
Longevity researchers challenge familiar claims about supplements, weight loss, and lifestyle practices that supposedly guarantee longer lives.
Their central message: living longer doesn’t necessarily mean living healthier.
Promising results in animals don’t prove longevity benefits in humans. Weight loss in older adults can compromise muscle and bone. And women, although generally living longer than men, may spend more years managing chronic conditions. Genetics and other factors beyond lifestyle also contribute to exceptional longevity.
Conclusion: Preserving physical function, independence, and quality of life may be more meaningful than simply extending lifespan.
SAVVY NOTES: This is exactly why T1Dto100 focuses on healthspan, not just lifespan. Reaching 100 is one thing. Living those years with strength, independence, and purpose is what really matters!
Read more: https://www.nytimes.com/2026/10/13/well/longevity-experts-advice.html Subscription to NYTimes.com may be required.
Heart & Kidney Care Alliance: A Global Advocate Supergroup by Andrew Saintsing for diaTribe.org, 6 October 2026
The Heart & Kidney Care Alliance brings together patient advocates living with diabetes, cardiovascular disease, and kidney disease to improve awareness, education, and care.
Launched in 2025, the Alliance emphasizes the value of lived experience in healthcare decisions.
Advocates include Patrick Gee, whose unexpected discovery of advanced kidney disease motivated his advocacy, and Uroš Bogdanović, a person living with Type 1 diabetes and a board member of the International Diabetes Federation Europe.
Through initiatives such as What I Wish I Knew, participants share experiences to help others recognize risks and navigate care.
Conclusion: Patient voices provide important knowledge that complements clinical expertise and can help improve healthcare.
SAVVY NOTES: I love seeing patient experience recognized as expertise! At T1Dto100, we’re working toward the same goal—ensuring the voices and wisdom of longtime T1D survivors are heard in research, advocacy, and healthcare decisions.
Read more: https://diatribe.org/diabetes-complications/heart-kidney-care-alliance-global-advocate-supergroup Disclosure: diaTribe reports support from Bayer for this article, with independent editorial review.
New Survey Explores Diabetes-Related Nerve Damage and Treatments — Anna Brooks, diaTribe.org, 12 October 2026
Researchers at Johns Hopkins University are surveying adults with Type 1 and Type 2 diabetes about nerve damage, nerve compression, and possible treatment approaches.
The study focuses partly on lower extremity nerve decompression (LEND), a surgical procedure being investigated for certain neuropathy symptoms.
Researchers hope to identify gaps in awareness among patients and healthcare professionals.
The anonymous survey takes approximately 15 minutes and is open to U.S. adults with diabetes, with or without neuropathy symptoms.
Conclusion: The survey examines awareness and knowledge gaps. It does not establish that nerve decompression surgery effectively treats diabetic neuropathy.
SAVVY NOTES: Neuropathy is a major concern for many longtime T1D survivors. Better understanding of its causes and possible treatments is urgently needed. If you’re eligible, consider contributing your experience!
Read more: https://diatribe.org/diabetes-research/survey-explores-diabetes-related-nerve-damage-and-treatments
Theory vs. Physiology of Bolus Dosing: How Experienced T1Ds Decide — Dan Heller, Type 1 Diabetes: It’s Not That Simple (Substack), 7 October 2026
Insulin dosing formulas provide useful guidance, but real-life physiology rarely follows a perfectly predictable mathematical model.
Dan Heller examines limitations of insulin sensitivity factors (ISF), insulin-on-board (IOB) calculations, and conventional correction boluses.
Insulin absorption, infusion-site conditions, food composition, activity, and individual physiology can influence insulin needs in ways algorithms cannot fully predict.
Heller argues that experienced people with T1D develop practical judgment through years of observing their own responses—knowledge that deserves recognition alongside automated dosing technology.
Conclusion: Insulin dosing involves more than mathematical calculations. Individual physiology and experience remain important even as automated systems become more sophisticated.
SAVVY NOTES: Those of us who have managed T1D for decades know that insulin doesn’t always behave according to the formula! Technology is tremendously helpful, but our lived experience also matters. The challenge is bringing both together safely.
Read more: https://danheller.substack.com/p/theory-vs-physiology-of-bolus-dosing
Late-Night Eating Is Associated With MASLD and Cirrhosis: The Nurses’ Health Study and Health Professionals’ Follow-Up Study — Robert M. Wilechansky and colleagues, Clinical Gastroenterology and Hepatology, 29 September 2026
A large prospective study suggests that eating late at night may be associated with increased risks of metabolic dysfunction-associated steatotic liver disease (MASLD) and cirrhosis.
Researchers analyzed approximately 199,000 participants from three major U.S. cohorts followed for a median of 16 years.
They identified 4,477 new MASLD cases and 312 cirrhosis cases.
After adjusting for dietary quality, calorie intake, body mass index, diabetes, and other factors, late-night eating was associated with approximately 31% higher MASLD risk and 28% higher cirrhosis risk.
Conclusion: Meal timing may influence long-term liver health, although observational findings cannot establish that late-night eating directly causes liver disease.
SAVVY NOTES: Another reminder that when we eat may matter as much as what we eat. Of course, T1D adds complications—insulin timing, delayed digestion, and overnight lows. Interesting research, but applying it to our lives requires some nuance!
Read more: https://doi.org/10.1016/j.cgh.2026.09.047
What’s Happening at T1Dto100
Living Legends: Preserving the History of Type 1 Diabetes by Maddy Arnstein & Riva Greenberg for T1Dto100.com
Our Living Legends project continues to identify and interview remarkable people who have lived with Type 1 diabetes for more than 75 years.
These stories provide a unique perspective on decades of diabetes care, changing technologies, enormous challenges, and extraordinary resilience.
We’re working to preserve these experiences for future generations of people with T1D, families, clinicians, and researchers.
Learn more: https://t1dto100.com
Give ton T1Dto100: Support T1Dto100
Give to T1Dto100: https://www.zeffy.com/en-US/donation-form/donate-to-change-lives-24432
T1Dto100 is continuing to expand its work supporting older adults with Type 1 diabetes. Our priorities include education, research engagement, advocacy, community connections, and practical resources for the challenges of aging with T1D.
We’re especially interested in bringing the voices of older adults into research and healthcare conversations, where our needs and experiences are too often overlooked.
T1Dto100 is now a recognized 501(c)(3) nonprofit organization!
After our first year powered by dedicated volunteers, we’re building the resources needed to expand educational programs, webinars, advocacy, and support for the aging T1D community. Your support helps us continue this important work.
