WHAT’S IN THIS WEEK’S ISSUE
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- NDAM: Assemblywoman Heather Simmons Advocates for T1D
- James Talarico Elected to U.S. Senate — A Voice Living With T1D
- twiist Insulin Pump Receives FDA Clearance for T2 Diabetes
- Supporting T1D at Mealtimes — Webinar, 18 November 2026
- Stronger Cholesterol Treatment Shrinks Plaque in Heart Arteries
- Abbott Libre Duo: A Closer Look at the User Manual
- Lower-Cost Component for Experimental Injectable Glucose Sensor
- Dexcom & Potential Expansion of Medicare CGM Coverage
- FDA’s New Drug Delivery Guidance: for Insulin Pumps
- ADA State of Diabetes — Community Events
- SafetyFromTheSeat.com – Find Sharps & Medication Disposal Locations
- A Self-Charging Toothbrush That Uses Electricity to Fight Bacteria
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FROM T1DTO100
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- Forty Years of Diabetes — Kerri Sparling
- Video: ABC’s & uACR! Diabetes, Hypertension & Kidney Health
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FROM OUR READERS
Thank you, Sue G. for sharing your experiences in hospital. We are always learning!
National Diabetes Awareness Month Spotlight: Assemblywoman Heather Simmons, New Jersey Legislature (https://www.njleg.state.nj.us), November 2026
November is National Diabetes Awareness Month, and New Jersey Assemblywoman Heather Simmons is bringing her personal experience living with type 1 diabetes to the State House. Diagnosed at age 14, Simmons has lived with T1D for more than four decades. She describes the daily responsibility of managing diabetes and the continuing challenges of obtaining affordable medications and healthcare.
Simmons emphasizes that people living with diabetes should not have to struggle to obtain the care and medications they need. Working with State Senator Angela McKnight, she is advancing three bills (These are proposed measures, not laws already in effect):
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- A5730 — ACCESS: Would require pharmacies to provide an emergency 30-day supply of insulin under specified circumstances.
- A5732 — AFFORDABILITY: Would provide health insurance subsidies for certain eligible people living with T1D.
- A5805 — AWARENESS: Would improve public information about access to emergency supplies of essential medications.
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SAVVY NOTE: I love seeing people who actually live with T1D helping shape legislation! Access to insulin and affordable healthcare should never depend on luck, finances or whether someone can reach their regular physician in an emergency. I hope these bills receive serious consideration.
READ MORE:
James Talarico Elected to the U.S. Senate — A New Voice Living With Type 1 Diabetes, reported by The Texas Tribune (https://www.texastribune.org), 3 November 2026
Texas State Representative James Talarico won the state’s U.S. Senate election on 3 November, defeating Republican Ken Paxton. Talarico lives with type 1 diabetes, which was diagnosed during his 2018 campaign for the Texas House. While walking 25 miles across his district, he developed nausea and extreme fatigue. Initially believing he was dehydrated, he later experienced a serious medical emergency. His family took him to the hospital, where his glucose was reportedly 900 mg/dL and he was diagnosed with diabetic ketoacidosis.
His first 30-day supply of insulin cost $684, which he charged to a credit card. Talarico subsequently helped advance bipartisan legislation in Texas limiting insulin copays to $25 per prescription for a 30-day supply under state-regulated health plans. Lowering prescription drug costs has remained one of his legislative priorities.
WHY IT MATTERS: Talarico brings firsthand experience with T1D, insulin affordability and the consequences of delayed diagnosis to the U.S. Senate. His election creates an opportunity for greater attention to diabetes-related healthcare policy at the federal level.
SAVVY NOTE: It’s encouraging to see another person living with T1D serving in a major national leadership role. His experience with DKA and the extraordinary cost of insulin is familiar to far too many people. I hope he will continue to be a strong voice for access, affordability and the needs of our entire T1D community — including those of us growing older with diabetes.
READ MORE: https://www.texastribune.org/2026/11/03/texas-ken-paxton-james-talarico-us-senate-elections-2026/
twiist Gets FDA Clearance for Type 2 Diabetes, by Christine Fallabel for Beyond Type 1 (https://beyondtype1.org), 20 October 2026
Sequel announced that its twiist insulin pump system has received FDA clearance for adults ages 18 and older living with insulin-dependent type 2 diabetes. The pump has been available in the United States for people with type 1 diabetes since its national launch in March 2026. The expanded clearance means healthcare professionals can now prescribe twiist to eligible adults with type 2 diabetes who use insulin.
Approximately 5.5 million adults with type 2 diabetes in the United States use insulin, representing a substantial population that may benefit from additional automated insulin delivery options. The twiist system offers an automated insulin delivery algorithm designed to respond to glucose levels, including hyperglycemia and insulin resistance.
WHY IT MATTERS: Expanding automated insulin delivery technology to people with insulin-treated type 2 diabetes increases treatment choices and may reduce some of the daily work associated with insulin management.
SAVVY NOTE: More choices are always welcome! It’s exciting to see AID technology becoming available to a broader population. I hope this expansion also encourages continued innovation, competition and affordability for everyone who depends on insulin.
READ MORE: https://beyondtype1.org/twiist-fda-cleared-type-2-diabetes/
IMPORTANT WEBINAR: Supporting T1D at Mealtimes with Dana Roseman and Jenny Smith, by T1Dto100.com, 18 November 2026
Mealtimes can be one of the most complicated parts of living with T1D — not only for the person managing diabetes but also for spouses, partners, adult children and caregivers. How can loved ones help without hovering? How do families share a kitchen, plan meals and coordinate food and insulin without creating unnecessary stress?
Diabetes educators and registered dietitians Dana Roseman, MPH, CDCES, RDN, LDN, and Jenny Smith, CDCES, RDN, LDN, of Integrated Diabetes Services will address these questions in a free webinar.
Topics include planning healthy meals, understanding what’s on the plate, timing food and insulin, and making diabetes management a partnership.
WHEN: Wednesday, 18 November 2026, at 5 PM PT / 8 PM ET
REGISTER: Click Here to Register
SAVVY NOTE: Such an important subject! Food, insulin and family relationships can become surprisingly complicated. I especially appreciate the focus on how loved ones can support us without making us feel watched or judged.
REGISTER FOR THE FREE WEBINAR: Click Here to REGISTER
Stronger Cholesterol Treatment Shrinks More Plaque in Heart Arteries, by Sanjukta Mondal for Medical Xpress (https://medicalxpress.com), 5 November 2026
Atherosclerosis develops when cholesterol and other fatty materials accumulate within artery walls, forming plaque that can restrict blood flow and increase the risk of heart attack and stroke. The randomized FLOWPROMOTE clinical trial investigated whether more intensive LDL cholesterol lowering could reduce existing plaque in coronary arteries. The findings, published in JAMA Cardiology, suggest that atherosclerotic plaque is not necessarily permanent and may regress with sufficiently intensive lipid-lowering treatment.
Researchers compared two treatment strategies over 18 months. The combination treatment provided more intensive cholesterol lowering.
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- Atorvastatin 40 mg daily
- Rosuvastatin 40 mg plus ezetimibe 10 mg daily
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THE RESULTS: Approximately 90% of participants receiving combination therapy experienced a reduction in coronary plaque volume, compared with 75% of those receiving atorvastatin alone.
THE CONCLUSION: More aggressive cholesterol reduction was associated with greater plaque regression in this trial. The findings do not mean that plaque can always be eliminated or that every patient should receive the same treatment regimen.
SAVVY NOTE: This is encouraging research! Heart disease remains an important concern for people living with diabetes over many decades. I especially appreciate studies showing that treatment may do more than slow the progression of disease — it may actually help reverse some existing plaque. Medication decisions, of course, need to be individualized.
READ MORE: Stronger Cholesterol Treatment Shrinks More Plaque in Heart Arteries
Abbott’s Libre Duo: We Found a Copy of the User Manual, by Tim Street for Diabettech (https://www.diabettech.com), 3 November 2026
Abbott’s Libre Duo is designed to measure glucose and ketones continuously using a single wearable sensor. Tim Street examined a copy of the system’s U.S. app manual submitted during regulatory development, providing an early look at how the technology may work. The document describes a sensor and smartphone application displaying glucose and ketone information, with features intended to help users recognize developing metabolic problems.
However, the manual dates from an earlier stage of development and describes a sensor intended for up to 15 days of wear. The FDA subsequently authorized a 10-day version in August 2026. That distinction matters: features shown in an older manual may differ from those included in the commercially released product. Bottom line: The older 15-day manual differs from the FDA-authorized 10-day system.
Tim also examines the clinical performance information available for the system and raises questions about how users will interpret continuous ketone readings.
WHY IT MATTERS: Continuous ketone monitoring may provide valuable additional warning information about diabetic ketoacidosis, particularly during illness or interruptions in insulin delivery. But accuracy, alert thresholds and clear instructions for responding to readings are critical.
SAVVY NOTE: I’ve been very interested in Libre Duo since its announcement. Continuous ketone monitoring could be an important safety advance, but I’m particularly curious about how the alerts will work and how much additional information people will need to interpret. Tim’s detailed analysis is worth reading.
READ MORE: Abbott’s Libre Duo: a Copy of the User Manual
Injectable Glucose Sensor Component Matches Pricier Alternative at One-Tenth the Cost, by Lesley Henton for Medical Xpress (https://medicalxpress.com), 3 November 2026
Researchers at Texas A&M University have identified a lower-cost sensing component for an experimental injectable glucose-monitoring system. The study, published in ACS Measurement Science Au, demonstrated that a sensing material costing approximately one-tenth as much as a commonly used alternative produced comparable performance in the experimental platform.
The technology uses near-infrared fluorescence rather than the enzyme-based methods used in many existing glucose-monitoring systems. Its sensing mechanism relies on competitive binding involving glucose, a fluorescent sugar compound and a protein called concanavalin A (ConA). As glucose concentrations change, the molecules compete for binding sites, changing the fluorescence signal. Researchers can use that signal to estimate glucose concentration.
THE CONCLUSION: The findings suggest that lower-cost materials may make future experimental glucose-sensing technologies more economical. This is a laboratory-stage development, not a clinically validated injectable CGM ready for patient use.
SAVVY NOTE: Affordability matters enormously in diabetes technology. I love seeing researchers investigate ways to reduce the cost of components while maintaining performance. Of course, there is a long road from a promising laboratory sensor to something reliable enough to wear — or implant — every day.
READ MORE: Injectable Glucose Sensor Component at One-Tenth the Cost
Dexcom’s Next Big Growth Driver Hinges on a CMS Decision Expected This Year, by Amanda Pedersen for MD+DI (https://www.mddionline.com), 2 November 2026
Dexcom is anticipating a decision from the Centers for Medicare & Medicaid Services (CMS) regarding potential expansion of continuous glucose monitoring coverage for people with type 2 diabetes who do not use insulin. The company points to the CONNECT randomized clinical trial, published in The New England Journal of Medicine, as important evidence supporting broader access to CGM.
During its third-quarter earnings call, Dexcom CEO Jake Leach described CONNECT as a landmark study for this population. The company expects CMS to make a coverage decision before the end of 2026.
WHY IT MATTERS: Current Medicare CGM coverage is more limited for people who do not use insulin. A favorable decision could substantially expand access, although the final eligibility criteria and coverage details would depend on CMS.
SAVVY NOTE: More evidence supporting the value of CGM is welcome. I’m particularly interested in how Medicare evaluates emerging technology and whether coverage policies can keep pace with research. We’ll have to watch for the actual CMS decision rather than assume expanded coverage is guaranteed.
READ MORE: Dexcom’s Next Big Growth Driver Hinges on a CMS Decision
FDA’s New Guidance on Drug Delivery: What Does It Mean for Insulin Pumps?, by Derek Brandt for Diabetes Center Berne, published on LinkedIn (https://www.linkedin.com), 4 November 2026
An insulin pump may have an excellent algorithm, a modern interface and impressive clinical results. But the most fundamental question remains: Does the insulin actually reach the patient in the intended amount and at the intended time?
Derek Brandt examines the FDA’s revised draft guidance, issued on 29 October 2026, concerning essential drug delivery performance characteristics. The guidance addresses drug delivery devices, including infusion pumps, and places greater emphasis on verifying reliable performance throughout a device’s lifecycle. The FDA document is draft guidance, not a newly enacted regulation.
Brandt identifies five important implications for insulin pumps.
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- Delivery accuracy. Pumps must demonstrate reliable basal and bolus delivery, not simply correct total delivery under ideal laboratory conditions.
- Real-world operating conditions. Temperature, humidity, pressure, vibration, physical shocks and device orientation may affect delivery performance.
- The entire delivery system matters. Reservoirs, cartridges, tubing, infusion sets, cannulas and insulin interactions can all influence whether the intended dose reaches the body.
- Design changes require evaluation. Changes in components, materials, manufacturing or device design can affect performance and must be appropriately assessed.
- Performance must be demonstrated. Manufacturers need clearly defined specifications, verification, validation and documented control strategies.
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THE TAKEAWAY: The intelligence of an insulin dosing algorithm is only one part of successful automated insulin delivery. The mechanical and physical reliability of getting insulin into the body is equally essential.
SAVVY NOTE: YES! We spend so much time talking about algorithms, time in range and new features. But if the insulin doesn’t reliably get where it’s supposed to go, none of that matters. For those of us who have experienced bent cannulas, leaking infusion sites or unexplained high glucose levels, this is a particularly important discussion.
READ MORE: FDA Guidance on Insulin Pumps
American Diabetes Association: State of Diabetes Community Events, American Diabetes Association (https://diabetes.org), 2026
The American Diabetes Association’s State of Diabetes events bring together employers, healthcare leaders and community members to discuss the impact of diabetes on individuals, families and workplaces. Programs include expert discussions of diabetes care, new treatments, healthcare costs and practical strategies for improving health and access to care. Attendees may also have opportunities to connect with local organizations and learn about ADA resources.
SAVVY NOTE: It’s encouraging to see opportunities for healthcare professionals, employers and community members to learn together. Diabetes affects so many parts of our lives, and better understanding can lead to better support and care.
FIND AN EVENT: Find Your Local ADA State of Diabetes Event
Find sharps and medication disposal locations near you, a FREE nationwide locator by SafetyFromTheSeat.com.
Use your location to instantly find nearby disposal locations for used needles, lancets, syringes, and unwanted medications. This Medical Sharps & Medication Disposal Finder is 100% free to use or share and could help readers find appropriate disposal options for used needles and unwanted medications. Finding appropriate sharps disposal options can help prevent accidental needle injuries and protect sanitation workers.
Read more: Free Sharps Disposal
A Self-Charging Toothbrush That Generates Electricity to Kill Bacteria While You Brush, by Paul Arnold for Medical Xpress (https://medicalxpress.com), 5 November 2026
Scientists have developed an experimental toothbrush that generates electricity through the motion of brushing, potentially helping reduce bacteria associated with dental plaque. Even with good oral hygiene, bacteria can accumulate rapidly in the mouth.
Researchers led by Yanhui Lu at the Peking University School and Hospital of Stomatology incorporated special materials into a conventional toothbrush design. As the bristles move, the materials generate electrical energy that can be used to act against bacteria. The work was reported in Science Advances.
THE CONCLUSION: The research demonstrates a promising experimental approach to combining mechanical brushing with an electrically generated antibacterial effect. It does not establish that the toothbrush improves long-term dental outcomes in everyday use.
SAVVY NOTE: What a clever idea! Oral health is especially important for people living with diabetes, and I’m always interested in practical innovations that might make prevention easier. We’ll need clinical evidence before knowing how useful this technology could become.
READ MORE: A Self-Charging Toothbrush That Generates Electricity to Kill Bacteria
FROM T1DTO100
Forty Years of Diabetes, by Kerri Sparling for KerriSparling.com (https://kerrisparling.com), 14 September 2026
Kerri Sparling, longtime T1D writer and creator of the much-loved Six Until Me blog, reflects on reaching 40 years of living with diabetes. She writes about the extraordinary feeling of being able to mark such a milestone and the value of returning to writing as a way to process the emotions and experiences that come with decades of T1D. Although she no longer writes her diabetes blog regularly, diabetes remains part of her life, and writing remains an important way to understand and express her experiences.
Kerri’s reflections remind us that living with T1D is about much more than glucose numbers, devices and medical appointments. It is also about identity, memory, resilience and the emotional weight of a lifelong condition.
T1DTO100 NOTE: I just had to share Kerri’s latest post. It’s so very real! Those of us who have lived with T1D for decades understand how complicated these anniversaries can feel. There is gratitude for the years we’ve lived, recognition of the work it has taken, and sometimes an emotional weight that’s hard to explain.
Thank you, Kerri, for continuing to put those feelings into words. Enjoy her post, share it with others, and please add your thoughts and comments!
READ MORE:
diaTribe Recording: ABC’s & u! Diabetes, Hypertension and Kidney Health, presented by The diaTribe Foundation (https://diatribe.org), 5 November 2026
For people living with diabetes or high blood pressure, kidney disease can develop without noticeable symptoms. That’s why knowing our numbers and understanding kidney screening are so important. The diaTribe Foundation’s discussion focuses on the familiar ABCs of diabetes care, with an important addition:
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- A — A1C, along with Time in Range.
- B — Blood Pressure.
- C — Cholesterol. & u — Urine Albumin-to-Creatinine Ratio (uACR).
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The uACR is a urine test that measures albumin, a protein that may leak into urine when the kidneys are damaged. An elevated uACR can identify kidney problems before symptoms appear, allowing patients and healthcare professionals to assess risks and consider appropriate follow-up. The panel explains who should be screened, how often testing may be needed, what the results mean and what questions to ask healthcare professionals.
T1DTO100 NOTE: Kidney health is such an important concern for those of us aging with T1D. Many people know their A1C, glucose trends and even their eGFR, but may not be familiar with uACR.
This is a simple and valuable reminder to understand both blood and urine tests used to assess kidney health. The earlier problems are identified, the more opportunities we may have to protect our kidneys.
WATCH THE DISCUSSION: ABC’s & u! Diabetes, Hypertension and Kidney Health
FROM OUR READERS
Sue G: Thank you for all you do! Thank you so much for inviting Dr. Hirsch to speak. This was really an eye-opener for me. I have been in the hospital a couple of times, other than diabetes related, and when a hospitalist, who hadn’t even come to see me after emergency spine surgery for Cauda Equina put me on a sliding scale, I was in the 300s all night. Fortunately, I left the next day. Other times I was able to keep my pump with my sensor even though my endo was not on staff at that time.
