Medtrum Nano CGM… A tale of two sensors by Tim Street for Diabettech.com, 20 February 2024.

Recently, Medtrum introduced the Nano, which has to vie for the title of “Smallest CGM currently available”. It has a very small form factor. Its first release, earlier in 2023 was, apparently, not that great, and an update took place early in the second half of 2023. Aside from being a tiny sensor, the Nano can be used in the Medtrum Easypatch app to enable low glucose suspend functionality with the Medtrum pump systems, or standalone with the Easysense app. It also has an online reporting system. It can be used either with, or without factory calibration. (Without factory calibration, it triggers a calibration after warm-up. With calibration, it requires the entry of a code). It also has an option to be used as a seven or 14-day sensor.

The overall “Too Long, Don’t want to read” data is that I don’t think Medtrum has moved on very much. I wouldn’t want to use this sensor, factory calibrated or otherwise, in either a low glucose suspend-based system or a hybrid closed loop, because its performance in my use was terrible.

One thing that has improved compared to my previous tests of the Medtrum CGM systems is the reliability. Both of these sensors lasted a lot longer, with one giving data for the entire 14 days and the other lasting 13. That’s a significant improvement on previous experiences. The new sensor profile is also great. It really is tiny. That’s about where the positives end though.

When I use the Medtrum sensors, they produce a lot of useless data. The results aren’t much better.  I wouldn’t want to use these sensors as part of a low glucose suspend system, let alone as part of a hybrid closed loop. I’m not even sure I’d be willing to participate in a clinical trial for a product that used them. They just aren’t good enough. 

Read more: Medtrum Nano CGM… A tale of two sensors

Can autoimmune diseases be cured? Scientists see hope at last by Cassandra Willyard for Nature.com, 23 January 2024.

In 2001, immunologist Pere Santamaria was exploring a new way use iron oxide nanoparticles to track the key immune cells involved in diabetes. Santamaria, who is at the University of Calgary in Canada, thought he could use these particles as a therapy to target and quiet, or even kill, the cells responsible for driving the disease — those that destroy insulin-producing islet cells in the pancreas. It seemed like a far-fetched idea. Now, more than two decades later, Santamaria’s therapy is on the cusp of being tested in people.

The immune system is known for its role in attacking pathogens. But it has another, equally important job: knowing when to stand down. If immune cells see the body’s own tissues as a threat, they can cause harm.

The arm of the immune system engaged in targeted attacks consists of cells called lymphocytes that differentiate to form T cells, which typically recognize and attack foreign or diseased cells, and B cells, which produce antibodies and support the immune system in other ways. Early in their development, these cells undergo a process to weed out those that target the body’s own tissues. But this process, known as central tolerance, is “leaky”, says Jeffrey Hubbell, a chemical engineer at the University of Chicago in Illinois. Some cells slip through.

The body has a backup system, a mechanism known as peripheral tolerance. This eliminates or deactivates wayward cells, or turns them into what are known as regulatory T cells, which suppress the immune response by preventing other cells from attacking.  In autoimmune diseases, both central and peripheral tolerance break down for reasons that are not entirely understood, and the immune system starts attacking antigens found in the body’s own cells and tissue. 

Picking the right antigen is tricky. Some autoimmune diseases are caused by a reaction to just one. But for many conditions — multiple sclerosis, diabetes, and rheumatoid arthritis, to name a few — the body develops an immune response against several antigens through a phenomenon called epitope spreading.  In his search for a master switch that, when flipped, turns off the autoimmune response while leaving the immune system intact, Santamaria thinks that he has found such a mechanism.

His team’s nanoparticles — which he calls navacims — are decorated with proteins called major histocompatibility complex molecules that jut out from the surface of the particle-like spikes. These spikes are meant to mimic those found on immune regulatory cells known as antigen-presenting cells, which mop up antigens all over the body and then take them to T cells, telling the cells whether to attack or ignore them. Santamaria likens them to T-cell bait.

Read more: Can autoimmune diseases be cured? Scientists see hope at last

Have you heard about Sensotrend.com? as reported in 15 Top Softwrd companies and startups in Tampere (Finland) in 2024, 22 February 2024.  

Sensotrend is an Automated Diabetes Diary, that makes life with type 1 diabetes easier. It operates as a service on PHR (Personal Health Record) platforms, combines data from wearables and wellness apps as well as from medical devices, visualizes this information in a way that’s meaningful for the treatment of diabetes and facilitates sharing the questions and insights with healthcare professionals and peer support groups. Sensotrend Dashboard brings all your data together, from glucometers and CGM’s, from insulin pumps and pens with a memory function, from activity trackers, meal logging apps, and sleep monitors. Unlike many diabetes diary apps, we don’t ask you to write everything down. Rather, we fetch the data from where it is already available. 

They currently working hard to get the first version of the Sensotrend Dashboard released. It will support Nightscout and Google Fit as primary data sources.  In the next phase, they will be introducing the visualizations on the Tidepool platform, and get all wellness data from Apple Health too. If you want to participate in alpha or beta testing phases, let them know, via email to info@sensotrend.com introducing yourself!

Sensotrend was founded by Mikael Rinnetmaki, a software professional and Type 1 diabetic. Sensotrend is a founding member of the MyData Global organization. They are also involved in the Finnish Innovation Fund Sitra’s IHAN project, advancing fair data economy. “We believe that many people with chronic conditions want to share their data with healthcare professionals to get the best possible personalized treatment. They want to share their data with medical research that gives them hope of better treatments in the future. It’s important to recognize that this sharing needs to happen on their terms, and only when they feel comfortable sharing their information. Transparency and trust are of key importance.”

Read more: Sensotrend

US FDA CDRH’s Shuren backs expansion of TAP program to speed device approval by Elise Reuter for MedTechDive.com, 21 February 2024.  The FDA started the Total Product Lifecycle Advisory Program to help medtech companies cross the “valley of death” by getting agency feedback early.

Jeff Shuren, the director of the FDA’s Center for Devices and Radiological Health, wants to see more medtech companies take advantage of a pilot program the agency started to help de-risk the development process for new devices. He shared an update on the agency’s Total Product Lifecycle Advisory Program (TAP) at device standards conference AAMI/FDA neXus. “The feedback has been tremendous,” Shuren said. “In fact, one company already in the program for about a year has said they have saved a year in development time.” 

The program is open to breakthrough devices early in the development process, which have not started a pivotal trial yet or sent a pre-submission to the FDA. The goal is to help device developers move to FDA authorization more quickly or “fail fast” by meeting earlier with review teams and stakeholders.

Read more: CDRH’s Shuren backs expansion of TAP program to speed device approval

Interview: Exploring the Future of Diabetes Technology with Prof. Lutz Heinemann by Dr. Inge von Boxelaer for Diabetotech.com, 19 February 2024.

Professor Lutz Heinemann, one of the most involved veterans in diabetes technology, graduated as an engineer in 1976 in Dusseldorf and qualified as a biologist in 1982. He worked until 1999 with Prof. Michael Berger, the former president of EASD, at the Clinic for Nutrition and Metabolism. In 1999, Professor Heinemann founded together with Tim Heise, the Profil Institute for Metabolic Research in Neuss, Germany, where he remained as CEO until 2009. He is a member of the German Diabetes Association (DDG), the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA). He also sits on the Scientific Advisory Boards of various companies, including Diabetotech. Since 2011, he has been the Managing Editor of the Journal of Diabetes Science and Technology.

Professor Heinemann’s scientific research is focused on insulin pharmacology and diabetes technology. Between 2010 and 2015, he acted as coordinator for the EU-funded project AP@home. In 2007 he received an award for “Leadership in Diabetes Technology” from the Diabetes Technology Society and, in 2012, was granted the “Artificial Pancreas Research Award” by the Diabetes Technology Society.

In an interview with Dr. Inge von Boxelaer, Professor Heinemann shares his thoughts about diabetes technology and what he sees for the future.

What concerns you most about the future of diabetes care? 

• • • • The increase in costs (by an additional usage of CGM systems, AID systems, and insulin pumps) is a hurdle, a barrier, an obstacle, and a no-go probably in some countries.
      • If you sell more of these products, you generate more waste.
      • And the number of physicians with a focus on diabetes is decreasing.

“What excites you most about diabetes care in the near and distant future? What is the most fun?”

• • • • The availability of different AID systems, which I think is obvious … this is such a help for patients in daily life. It’s not a cure for diabetes. It’s not the holy grail. But it comes close to it. It reduces the burden in daily life so much for patients. I think this is one of the most positive things. 
      • If we would have smart insulins, I think this would be a game changer.  [THIS GETS MY VOTE!}
      • There is ongoing development. There are a lot of patents.

Read more: Interview: Exploring the Future of Diabetes Technology with Prof. Lutz Heinemann

FDA: Avoid using smartwatches, smart rings to measure blood glucose by Jill Rollet for Healio.com/endocrinology, 22 February 2024.

The FDA is warning people with diabetes and the public that noninvasive smartwatches or smart rings that do not pierce the skin should not be used to measure blood glucose, according to a press release.  The FDA issued a new safety communication on 21 February 2024 to inform people with diabetes that glucose readings taken with smart devices that do not pierce the skin could be inaccurate. Those inaccurate measurements could lead a person to take the wrong dose of insulin or diabetes medication and precipitate dangerously low glucose levels, which could result in mental confusion, coma, or death within hours of the error.

Anyone who believes they had a problem related to an inaccurate blood glucose measurement or an adverse event related to an unauthorized smartwatch or smart ring to report the problem through the FDA MedWatch Voluntary Reporting Form at www.accessdata.fda.gov/scripts/medwatch/index.cfm?action=reporting.home.

Read more: Avoid using smartwatches, smart rings to measure blood glucose

Final Week of Book Give-Away of Haidee Soule Merritt’s Insulin Surplus Zine: Possible Uses for the Insulin Surplus (IF there’s ever a cure for diabetes).

I still have 4-5 copies ($8.50 value, postage included), free for the asking. It’s a fun, little booklet of cartoons about living with T1D … will make you giggle … and also makes a great gift at any T1D meetup or gathering!

What’s the catch?  Please tell me why you’d love a copy.  I’ll share your comments with Haidee … and I will mail a booklet to you, with postage paid! Please email your mailing address: joanne@TheSavvyDiabetic.com. One more cartoon … have you experienced this?  Especially when wearing white clothing?!?!?!

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