In this week’s issue of The Savvy Diabetic: 

• • • Intact Fish Skin Graft to Treat Deep Diabetic Foot Ulcers
    • Oral Quadruple Receptor Agonist Confers Weight Loss with Minimal GI Adverse Events
    • Blue Circle Health Webinar:  Aging with Type 1 Diabetes
    • TCOYD: Thanksgiving and Diabetes Game Plan: 7 Blood Sugar Hacks
    • Mushroom in the Wild Playing Keyboard

Intact Fish Skin Graft to Treat Deep Diabetic Foot Ulcers Randomized Controlled Trial, NEJM on PubMed, DOI: 10.1056/EVIDoa2400171.Epub 2024 October 4.

Diabetic foot ulcers are chronic, difficult to heal, and potentially life-threatening. Few medical devices have been studied for diabetic ulcers that penetrate to bone or tendon. An intact fish skin graft was associated with faster time to healing.  

Conclusions: Among patients with deep diabetic foot ulcers, treatment with intact fish skin graft was superior to the standard of care in terms of the proportion of wounds healed at 16 weeks and was associated with a faster time to healing. (Funded by European Commission Fast Track to Innovation Horizon 2020, and Kerecis Ltd. ClinicalTrials.gov NCT04257370).

Read more: 

• • • • Intact Fish Skin Graft to Treat Deep Diabetic Foot Ulcers
      • Intact Fish Skin for Tissue Regeneration

Oral Quadruple Receptor Agonist Confers Weight Loss with Minimal GI Adverse Events by Michael Monostra for Healio.com/endocrinology, 4 November 2025.

A once-daily oral quadruple receptor agonist induced up to 13.8% weight loss at 13 weeks among adults with overweight or obesity, according to a speaker at ObesityWeek.  Lloyd Tran, PhD, CEO of Biomed Industries, presented data from a trial of what he described as the first-in-class quadruple receptor agonist. NA-931 (Biomed Industries) is a novel insulin-growth factor I/GLP-1/GIP/glucagon receptor agonist developed for the treatment of obesity. The addition of IGF-I is what differs NA-931 from previously developed agents.

“[NA-931] shows a biased signal at the GIP receptors and IGF-I [receptors],” Tran said during a presentation. “It favors the [cyclic adenosine monophosphate] response over other signaling pathways.”

Read more: Oral quadruple receptor agonist confers weight loss with minimal GI adverse events

Blue Circle Health Webinar:  Aging with Type 1 Diabetes with Scott Johnson, aired 5 November 2025.

Here’s a webinar by Blue Circle Health about aging with type 1 diabetes. Panelists:  Joanne Milo, founder of T1Dto100, and Kelly Dawes, founder of Grownup T1Ds. Discussion:  The unique challenges faced by individuals aging with T1D, the available resources (and their limitations), and how social support and community needs differ.

Your Thanksgiving and Diabetes Game Plan: 7 Blood Sugar Hacks for the Big Feast! by TCOYD, 27 October 2025.

For many people, Thanksgiving is the ultimate food holiday. Between the mashed potatoes, stuffing, rolls, and pies, it’s a day when carb counts soar higher than balloons in the Macy’s parade. If you live with diabetes, the thought of this annual feast might bring a mix of excitement and stress. How do you enjoy your favorite foods without sending your blood sugars into a tailspin? The good news: you don’t have to choose between celebrating and staying in range. With a smart Thanksgiving and diabetes game plan, you can savor the holiday while keeping your blood sugars steady. Here are seven blood sugar hacks to help you enjoy Thanksgiving and still feel good afterward.

1. 1. Pregame with a Protein-Packed Breakfast: Start the day with a protein-rich breakfast, such as scrambled eggs, Greek yogurt with nuts, or a veggie omelet. Protein helps keep your appetite in check and steadies blood sugars before you even hit the dinner table. Think of it as laying down a solid foundation.
   2. Exercise and Blood Sugar: Don’t Forget to Move Before (and After) the Meal:  A little physical activity before the meal can work wonders. Or go for a walk after dinner. Research shows that walking for just 10–15 minutes post-meal helps lower blood sugar spikes. Plus, it’s a great excuse to grab a friend or family member and stroll outside, giving your digestive system a head start.
   3. Load Up on the “Fab Four”: When filling your plate, start with the “fab four”: protein, fiber, fat, and non-starchy vegetables. These nutrients slow down the rate at which carbs are converted into glucose, resulting in fewer sharp spikes.
   4. Play the Portion Game: When it comes to Thanksgiving and diabetes, pick the carbs you truly love and keep portions of others smaller. 
   5. Master the Art of Pre-Bolusing: Taking your mealtime insulin 10–20 minutes before eating (instead of at the first bite) can help your blood sugar curve match the digestion curve.  Just keep in mind: holiday meals aren’t always on schedule. If you’re not sure when the food will actually hit the table, wait until serving dishes are moving around before dosing. And if you’re using an automated insulin delivery (AID) system, consider entering the carbs a little early so the system can start adjusting sooner.
   6. Dessert Without the Drama: Instead of skipping it completely or going overboard, aim for a mindful middle ground.
      • • • Pick one favorite dessert instead of sampling everything. 
          • Pair it with protein or fat (like nuts, whipped cream, or cheese) to slow digestion.
          • Take a walk afterward to help smooth out your blood sugar.
   7. Keep Stress in Check: Family dynamics, travel, and long days in the kitchen can all raise stress hormones, which in turn raise blood sugar levels.  And since stress and diabetes are closely linked, it’s worth planning ahead to keep calm in the chaos. This year, build in time for mini stress-busters. Step outside for a few deep breaths, excuse yourself for a quick walk, or focus on gratitude for the people around you. Joy and connection are just as important to your well-being as what’s on your plate.

*Bonus Hack: Remember, It’s Just One Day:  One of the most helpful mindsets is this: Thanksgiving is just one day. One meal won’t make or break your overall health. What matters most is your patterns and habits over the long term. If your blood sugar runs higher than usual for a day, it’s not a failure—it’s life.  The real win is enjoying the holiday without guilt and returning to your regular routine afterward.

Mushroom in the Wild Playing Keyboard by BionicandtheWires, featured by Nature.com, September 2025.

This is a mushroom playing in the wild in some woods near Glossop in Manchester. The attached sensors measure bio-electrical fluctuations in the mushroom. The fluctuations are converted into signals that control the robotic arms.  The keyboard is playing a synth in Ableton Live.

Our art reveals the hidden world of nature. Plants and fungi are often overlooked, but they’re not so different from us. Scientists have found they can communicate with each other, remember things, and solve problems.

Why did I include this?  I’m fascinated by the bio-electrical sensors… we may see these in use for our future metabolic sensing devices.