In this week’s issue of The Savvy Diabetic:
- Diabetes Research Institute (DRI) “Aggressively Working” on T1D Cure
- Microbiome Therapy To Delay T1D Onset
- Fully Closed AID Systems Effective Without Meal Announcements
- 2025 Breakthroughs in Diabetes Research by TCOYD Drs. Edelman & Pettus
- Diabetes Distress Linked to Autonomic Symptoms
- Medtech Industry Presses for Tariff Exemptions
- Hearing & Heart Failure Risk
- New Type of D: Malnutrition-Related Diabetes T5D
- Heat & Kidney Transplant Recipients
- Ex-FDA Chief Cites ‘Dysfunctional’ Congress
- FTC Chair Changes Course on Recusal on PBM Insulin Case
- Nursing Home Staffing Mandate Struck Down
- Alcohol Changes Fat Levels
The DRI is “Aggressively Working” on a T1D Cure. What does that mean? was shared by Stacey Simms in her podcast, DiabetesConnections.com, 8 April 2025.
The Diabetes Research Institute (DRI) is focused on curing and preventing diabetes. Stacey Simms talks with Dr. Matthias von Harath, Scientific Director of DRI and Michael Burton, CEO of Diabetes Research Institute Foundation, about safer islet cell transplant options without harsh drugs, smarter devices to protect islets, and what they call Quantum Leap projects.
Microbiome Therapy Could Delay Type 1 Diabetes Onset by The University of Queensland and published by TechnologyNetworks.com, 4 April 2025.
Professor Emma Hamilton-Williams, from the Frazer Institute, said 21 individuals with T1D were given an oral biotherapy containing short-chain fatty acids (SCFA), which are metabolites usually produced by gut bacteria during the fermentation of dietary fibre. “Type 1 diabetes is an autoimmune illness, and we know there is something different about the gut microbiome and gut barrier function that we think changes the immune response in individuals with the disease,” Professor Hamilton-Williams said.
“We’ve learned that it is possible to change the microbiome in individuals with T1D, and when we have done that, we have seen changes in the gut barrier function. “Then, when we further tested that microbiome by transferring it into mice, it delayed the onset of diabetes.”
Short-chain fatty acids are one of the cornerstone beneficial functions of the gut’s community of microorganisms, which play essential roles in digestion, immunity, and overall health. “There have been other approaches to restoring short-chain fatty acids, like giving probiotic bacteria or capsules, but they haven’t really worked,” Professor Hamilton-Williams said. “This has been the first time in T1D studies where researchers have managed to increase short-chain fatty acids in individuals.”
The research was funded by Breakthrough T1D (formerly JDRF Australia), Children’s Hospital Foundation, the National Health and Medical Research Council, and Monash University. The work was carried out in collaboration with researchers from Monash University, University of Sydney, Université libre de Bruxelles, QIMR Berghofer Medical Research Institute, and the Translational Research Institute. The study was published in Nature Communications.
Read more: Microbiome Therapy Could Delay Type 1 Diabetes Onset
Fully Closed AID Systems Effective Without Meal Announcements by Paul Heltzel for diaTribe.org, 31 March 2025.
Fully closed-loop automated insulin delivery (AID) systems could be a game-changer for people with diabetes in the near future. The systems require no meal announcements, yet advanced computing allows them to provide excellent blood sugar control.
In one study, presented at the ATTD 2025 conference in March 2025, an open-source AID system that runs on an Android smartphone was shown to achieve time in range about 66 percent of the time despite users making no meal announcements. The AndroidAPS system is capable of making small insulin dosing adjustments as blood sugar rises and falls, based on readings from a continuous glucose monitor (CGM). Neale Cohen, a professor at the Baker Heart and Diabetes Institute in New Zealand, presented the CLOSE IT study, which involved 75 participants with type 1 over three months. “A reliable, fully closed-loop system would change the paradigm for people living with type 1 diabetes,” Cohen said. “I think we’re close.”
In another study presented at ATTD 2025, research showed an AID system that uses a form of artificial intelligence and no user input was as effective at controlling blood sugar as a hybrid-closed loop system where users made meal announcements and manually bolused. Dr. Laya Ekhlaspour, a pediatric endocrinologist at the University of California, San Francisco, presented results from the FCL@Home study. The system uses neural networking technology, a type of advanced computing modeled on the human brain.
In the study, users of the fully closed, neural-network system had an average time in range of 62%, compared to 49% for the hybrid closed-loop group (one participant open-looped, meaning they used no automated dosing). The average blood sugar level in adults, young adults, and adolescents was all better for those who used the advanced fully closed-loop system. “We want a fully closed-loop algorithm because we want to decrease the user input,” Ekhlaspour said. “We want to improve glycemic outcomes, and we want to expand the use. As a pediatrician, I’m very excited to be able to introduce the system to our patients who can benefit.”
Studies show that fully closed-loop systems can achieve time in range comparable to hybrid closed-loop systems, without requiring user input for meals. Advancements in artificial intelligence, such as neural network-based insulin delivery, show promise in managing sugar levels.
Read more: Fully Closed AID systems Effective Without Meal Announcements
Diabetes Distress Linked to Autonomic Symptoms in Adults by Manasi Talwadekar for MedScape.com, 7 April 2025.
Elevated diabetes distress (DD) correlated with autonomic nervous system (ANS) dysregulation symptoms in adults with type 1 diabetes (T1D) or type 2 diabetes (T2D), with supradiaphragmatic and subdiaphragmatic symptoms being more pronounced in those experiencing high to moderate DD than in those with mild or no distress.
“This study adds evidence for the presence of physiologic symptoms of emotional regulation in DD,” the authors wrote. “The observed findings suggest the PVT appears to be a promising neurophysiologic paradigm to understand the phenomenon of DD in adults with T1D and T2D,” they added.
Read more: Diabetes Distress Linked to Autonomic Symptoms in Adults
Medtech industry pressures White House to exempt devices from tariffs by Ricky Zipp for BioPharmaDive.com, 8 April 2025.
AdvaMed and nine other healthcare organizations continue to pressure the White House to exempt medical devices and critical supplies from the Trump administration’s tariff policies.
AdvaMed, one of the largest medical device industry groups, and organizations including the American Dental Association, the Association of American Medical Colleges, and America’s Essential Hospitals sent a letter on April 1 to Jamieson Greer, the White House’s top trade negotiator. They outlined multiple concerns about the effects tariffs will have on the healthcare industry, such as disrupting the supply chain and increasing the costs of devices and dental equipment.
“This ultimately places further financial pressure on providers, hospitals, and health systems,” the letter stated, “particularly those located in rural and medically underserved areas.”
“We are also concerned that increased costs on medical and dental supplies could impede our ability to improve treatment outcomes, foster innovation, and meet the growing needs of pediatric and adult populations,” the groups wrote. The result, they added, could be longer wait times, reduced healthcare access, and increased pressure on providers, some of which are already struggling financially.
Read more: Medtech industry pressures White House to exempt devices from tariffs
Here’s what your hearing could say about your heart failure risk by Tom Howarth for ScienceFocus.com, 8 April 2025.
According to a new study published in the journal Heart, hearing loss is indeed linked to a heightened risk of heart failure. Heart failure doesn’t mean that your heart packs up and stops working altogether. Instead, it means the heart needs extra support to do its job. The condition is a long-term one which, while generally incurable, can be mitigated with treatment.
People with insufficient and poor hearing had a 15 and 28 per cent higher risk of heart failure, respectively, compared to those with normal hearing. Higher SRT scores – indicating worse hearing – were also linked to a greater risk of heart failure. Interestingly, this association was stronger in individuals who didn’t have heart disease or stroke at the start of the study. This was an observational study, so it can’t prove that hearing loss causes heart failure – only that the two are strongly linked.
Many of us lose hearing ability as we age, and without things like hearing aids, this can lead to increasing levels of social isolation, psychological distress, and neuroticism – all of which were also found to increase the risk of someone developing heart failure in the study. According to the study’s authors, this isolating effect may ramp up the body’s stress response, fuel inflammation, and damage blood vessels – all of which can put extra pressure on the heart and raise the risk of heart problems.
There could be a more biological link, too. “The rich distribution of capillaries in the cochlea [a cavity in your ear] and the high metabolic demand of the inner ear may render these regions more sensitive to systemic vascular disorders rather than just local circulatory issues,” the study’s authors wrote. In other words, because the inner ear relies on lots of tiny blood vessels and uses a lot of energy, it might be especially sensitive to problems with blood flow, which means hearing loss could act as an early warning sign of heart trouble, including heart failure.
The researchers also found that people with poor hearing and those who wore hearing aids had a similar increase in heart failure risk, suggesting that while hearing aids help you hear better, they don’t fix the underlying blood flow problems that might be driving that risk.
Read more: Here’s what your hearing could say about your heart failure risk
Einstein Research Leads to Designation of New Type of Diabetes by Albert Einstein College of Medicine, 8 April 2025.
Malnutrition-related diabetes—typically affecting lean, malnourished teens and young adults in low- and middle-income countries—is now officially recognized as a distinct form of the disease, known as type 5 diabetes. The new designation, made today by the International Diabetes Federation (IDF), stems largely from the research and advocacy of Meredith Hawkins, M.D., M.S., professor of medicine, the Harold and Muriel Block Chair in Medicine, and founding director of the Global Diabetes Institute at Albert Einstein College of Medicine.
“Malnutrition-related diabetes has historically been vastly underdiagnosed and poorly understood,” said Dr. Hawkins. “The IDF’s recognition of it as type 5 diabetes is an important step toward raising awareness of a health problem that is so devastating to so many people.”
Increasingly, said Dr. Hawkins, young people are being diagnosed with diabetes caused not by too much food but by too little—by malnutrition, in other words. Type 5 diabetes is estimated to affect 20-to-25 million people worldwide, mainly in Asia and Africa. “Doctors are still unsure how to treat these patients, who often don’t live for more than a year after diagnosis,” she said.
Read more: Einstein Research Leads to Designation of New Type of Diabetes
Soaring Temps Spell Trouble for Kidney Transplant Recipients by Kristen Monaco for MedPageToday.com, 11 April 2025.
Exposure to high temperatures may be renally taxing for kidney transplant recipients, a researcher reported here. Over nearly 5 years of follow-up, kidney transplant recipients exposed to hot temperatures also had a 30% higher risk for a major adverse kidney event. “Climate change is worrying for kidney health and health in general. We should all be aware of that,” Gabriel Cojuc-Konigsberg, MD, of Beth Israel Deaconess Medical Center in Boston, said at the National Kidney Foundation’s Spring Clinical Meeting.
“Preventing heat exposure in kidney transplant recipients should receive higher priority in research, public health efforts, and clinical practice to prevent adverse kidney transplant outcomes,” he urged.
Read more: Soaring Temps Spell Trouble for Kidney Transplant Recipients
Former FDA Chief Cites ‘Dysfunctional’ Congress as Top Agency Challenge by Jeremy Faust, MD, MS, MA and Greg Laub for MedPageToday.com, 8 April 2025.
In part one of this interview called “Exit Interviews” with 2-time FDA commissioner Robert Califf, MD, Califf reflects on the FDA’s structural limitations, his view on harm reduction strategies like vaping, and the ongoing tension between public health and personal freedom.
“I’d say in terms of challenges, I would just say it was a very difficult political time. Congress was very dysfunctional. People couldn’t get along with each other and were very dependent on a federal agency to reach an agreement with Congress on how to proceed, and that was probably the toughest thing for me.
FDA is made up of a bunch of really highly committed people, and there are plenty of issues within the FDA, and in fact, we did, as you know, the largest reorganization in the history of the FDA, and told you what just happened in the last 2 months. So yeah, there were plenty of issues to deal with within the FDA, but I think the dysfunction in Congress made a lot of things much more difficult than they needed to be.
One easy example would be the regulation of what you might call something that we thought about starting a center for bad decisions. These would be all the things that are readily available in the U.S., which do harm, but are sort of used by consumers for a variety of reasons and have their advocates. Vaping, in a way, is an example. There’s no health benefit of those things. So it doesn’t fit into the paradigm that was set up for drugs and devices, where presumably you’re trying to improve health as a primary goal. Marijuana would be another example. We should have been able to figure out how to create a regulatory system for those things that worked, but it was impossible.”
Read more: Former FDA Chief Cites ‘Dysfunctional’ Congress as Top Agency Challenge
FTC Chair Ferguson changes course on recusal from PBM insulin case by Paige Minemyer for FierceHealthcare.com, 4 April 2025.
Federal Trade Commission Chair Andrew Ferguson has reversed course on his decision to recuse himself from the agency’s legal battle with pharmacy benefit managers.
Ferguson said in a statement that he had previously made the choice to step back from the proceedings because he had advised Virginia’s attorney general as to whether to file an amicus brief in a class action case against PBMs during his time as the state’s solicitor general. At the time, there were three commissioners eligible to pursue the case, and his recusal did not hinder proceedings.
However, after former Chair Lina Khan resigned from the post and President Donald Trump fired the two remaining Democratic commissioners, there are no longer any commissioners who can participate. Earlier this week, the FTC issued an order seeking a stay in the case due to the lack of available commissioners.
The Federal Trade Commission is pressing pause on its legal fight with major pharmacy benefit managers. The agency submitted an order this week seeking an administrative stay in the case, as there are currently no sitting commissioners who are able to join the proceedings. The two sitting commissioners, Republicans Andrew Ferguson and Melissa Holyoak, have recused themselves.
Texas federal judge strikes down Biden-era nursing home staffing mandate by Susanna Vogel for HealthCareDive.com, 8 April 2025.
A Texas federal judge struck down a controversial Biden-era policy that sought to require nursing homes to increase their staffing and have a registered nurse on premises around the clock. Judge Matthew Kacsmaryk said the policy was “laudable” in its goal of improving nursing home quality, but that the HHS had ultimately overstepped its authority in issuing the rule. The plaintiffs, nursing home trade organizations including the American Health Care Association and LeadingAge, cheered the decision on Monday. The groups have argued that the staffing requirements were too onerous and could have led to nursing home closures.
From its inception in 2023, the landmark staffing mandate has been unpopular among both industry groups and some politicians, who have argued the industry can’t hire enough to meet the proposed staffing quotas.
The CMS estimated 79% of nursing homes would have to increase hiring to meet the requirement of providing 3.48 hours of patient care per resident, per day, while KFF predicted 81% of facilities would have to hire additional staff. The mandate was also likely to be expensive. The CMS predicted it could cost the industry anywhere from $1.5 billion to $6.8 billion to meet the hiring targets.
The rule was intended to address quality concerns brought to light during the COVID-19 pandemic, according to the Biden administration, which cited research that found higher staffing levels were associated with better care outcomes for patients.
Read more: Texas federal judge strikes down Biden-era nursing home staffing mandate
The 5 biggest lessons about how alcohol changes your fat levels by Dr. Nich Manek for ScienceFocus.com, 8 April 2025.
While enjoying the occasional glass of wine or pint of beer may seem harmless, regular or excessive alcohol consumption can significantly hinder your weight-loss journey for a few reasons:
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- Calories: Unfortunately, alcohol is quite calorie-dense, providing seven calories per gram. That’s almost as much as fat, which has nine calories per gram. Calories from alcohol are often referred to as ‘empty calories’ because they provide little to no nutritional value.
- Fat storage: When you drink alcohol, your body treats it as a priority for your metabolism because alcohol can’t be stored and must be processed immediately. As a result, the metabolism of other energy sources, like fats and carbohydrates, is temporarily paused. This shift means that the calories from the food you eat are more likely to be stored as fat, particularly if alcohol is paired with calorie-dense meals or snacks.
- Food choices: That late-night snack or takeaway often becomes harder to resist after a few drinks. Alcohol also stimulates appetite-regulating hormones, which can lead to overeating, especially of calorie-dense, less nutritious foods.
- Sleep: Sleep plays a crucial role in weight loss, and alcohol is notorious for disrupting sleep patterns and interfering with the REM (rapid eye movement) cycle. Poor sleep affects hormones such as leptin and ghrelin, which regulate hunger and satiety, potentially leading to increased appetite the next day.
- Hidden ingredients: Many alcoholic beverages, especially cocktails, contain added sugars and syrups that can further increase calorie intake.
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Like anything, moderation is key. Try sticking to occasional consumption, such as only choosing to drink if it’s a special occasion or on non-consecutive days. Additionally, drinking a generous amount of water alongside alcohol can slow down your consumption, possibly making you drink less overall.
Read more: The 5 biggest lessons about how alcohol changes your fat levels
