In this week’s issue of The Savvy Diabetic:
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- Metabolic Subtypes & Blood Sugar Responses to Carbohydrates
- Semaglutide & Diabetic Eye Risks
- Dianode-3 Study is RECRUITING Newly Diagnosed T1D Young Adults
- Test Strips NOT Covered by Medicare
- High Insulin & Irregular Periods
- HIV Med Improves Vision in Diabetic Eye Disease
- Spinal Cord Stimulation for D Neuropathy Pain
- CVS Closing 271 Stores
- Mindfulness and/or Hope
Blood sugar response to various carbohydrates may point to metabolic health subtypes by Sadie Harley for Stanford University Medical Center and published on MedicalXpress.com, 4 June 2025.
A study led by researchers at Stanford Medicine reveals that individual differences in blood sugar responses to specific carbohydrates are influenced by the details of an individual’s metabolic health status. A paper explaining the research was published in Nature Medicine. Tracey McLaughlin, MD, a professor of endocrinology. Yue Wu, Ph.D., postdoctoral scholar in genetics; Ben Ehlert, a graduate student in biomedical data science; and Ahmed Metwally, Ph.D., a former postdoctoral scholar at Stanford Medicine who is now a research scientist at Google, are joint first authors.
The differences in blood sugar response patterns among individuals were associated with specific metabolic conditions such as insulin resistance or beta cell dysfunction, both of which can lead to diabetes. The study findings suggest that this variability in blood sugar response could lead to personalized prevention and treatment strategies for prediabetes and diabetes.
“Right now, the American Diabetes Association dietary guidelines do not work that well because they lump everyone together. This study suggests that not only are there subtypes within prediabetes, but also that your subtype could determine the foods you should and should not eat,” said Michael Snyder, Ph.D., study co-lead and Stanford W. Ascherman, MD, FACS Professor in Genetics.
“Starchy foods were not equal; there was a lot of individual variability in which foods produced the highest glucose spike,” Wu said.
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- The highest blood sugar spikes after eating pasta occurred in participants who had insulin resistance, and the highest spikes after eating potatoes occurred in participants who were either insulin resistant or had beta cell dysfunction.
- The multi-omics profiling showed that the potato-spiking participants also had high levels of triglycerides, fatty acids and other metabolites commonly seen in people with insulin resistance.
- Glucose spikes to beans were associated with histidine and keto metabolism, a state in which the body primarily uses fat for energy. Participants whose blood sugar spiked after eating bread were more likely to have hypertension, or high blood pressure.
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Read more: Blood sugar response to various carbohydrates may point to metabolic health subtypes
Semaglutide Linked to Age-Related Macular Degeneration Risk by Randy Dotinga for MedPageToday.com, 5 June 2025.
Older adults taking GLP-1 receptor agonists, primarily semaglutide (Rybelsus, Ozempic, Wegovy), had a small uptick in their risk of developing neovascular age-related macular degeneration (nAMD), according to a retrospective, population-based cohort study from Canada.
“The longer the exposure, the higher the risk seemed to be,” said Reut Shor, MD, of the University of Toronto. “This was definitely surprising, especially given the growing enthusiasm for GLP-1 receptor agonists for their cardiovascular and metabolic benefits.”
While the absolute risks of nAMD were small in the study — 0.2% versus 0.1% in non-users — “it’s important to remember that nAMD is a condition with profound implications for vision and quality of life,” said Shor. A growing body of literature nevertheless suggests potential ocular safety concerns with the GLP-1 receptor agonist class of drugs. Why there is a higher risk remains unknown, however.
Read more: Semaglutide Linked to Age-Related Macular Degeneration Risk
GLP-1 Drug Can Cause Rare, Potentially Blinding Side Effect by Kristen Monaco for MedPageToday.com, 6 June 2025.
A potentially blinding condition is a very rare side effect of the GLP-1 receptor agonist semaglutide (Ozempic, Wegovy, Rybelsus), the European Medicines Agency (EMA) concluded. Following a review of all available data, the EMA’s Pharmacovigilance Risk Assessment Committee determined that semaglutide increases the risk for non-arteritic anterior ischemic optic neuropathy (NAION). As a result, the agency recommended a product information update to include NAION as a “very rare” side effect. This means it could affect up to one in 10,000 people taking semaglutide.
“If patients experience a sudden loss of vision or rapidly worsening eyesight during treatment with semaglutide, they should contact their doctor without delay. If NAION is confirmed, treatment with semaglutide should be stopped,” the EMA urged.
One such study on NAION risk found that diabetes patients taking semaglutide had more than a fourfold higher risk for developing the condition compared with patients not on a GLP-1 agonist over 3 years. Those prescribed semaglutide for overweight or obesity had a more than sevenfold higher risk for NAION.
Read more: GLP-1 Drug Can Cause Rare, Potentially Blinding Side Effect
Dianode-3 Study is RECRUITING!
Diamyd Medical develops precision medicine therapies for the prevention and treatment of autoimmune diabetes. The antigen-specific immunotherapy Diamyd® is a disease-modifying investigational medicine in clinical development phase, aiming to preserve and regenerate the patients’ own insulin production.
The DIAGNODE-3 clinical trial will investigate whether an investigational drug called Diamyd® is able to preserve the body’s own insulin-producing capacity by halting or delaying the immune system’s attack on the insulin-producing cells (beta cells) in the pancreas. Sustained beta cell function is associated with better blood sugar control and a decreased risk of low blood sugars (hypoglycaemia), ketoacidosis and complications later in life.
Newly diagnosed with Type 1 diabetes? If you (or someone you know) have been diagnosed within the last six months and are between the ages of 12 and 28, please consider participating in Diamyd Medical’s DIAGNODE-3 trial.
Learn more and find your nearest clinic at www.diagnode-3.com. Compensation will be provided for study-related travel.
Read more: Diamyd Medical
CMS Medicare No Longer Covering Fingerstick Test Strips for CGM Users, But Policy Can (and Should) Be Rescinded by Scott Strumello for blog.sstrumello.com, 4 June 2025.
Integrated Diabetes Services, a diabetes services company run by Gary Scheiner, ADCES, MS, T1D, recently published a blog post entitled “‘Buy-Buy’ Test Strips for CGM Users” which I encourage you to read at https://integrateddiabetes.com/cms-has-stopped-covering-meters-strips-for-cgm-users/ which addressed how CMS (the Centers for Medicare and Medicaid Services, which runs Medicare and also helps states implement Medicaid, on May 13, 2022 proposed a policy (see https://www.cms.gov/files/document/cms-1738-r.pdf) whereby Medicare will no longer be covering traditional fingerstick blood glucose testing supplies (strips) for Continuous Glucose Monitor (CGM) users. That policy is now in effect. But what it portends for those covered by commercial health insurance policies is what we need to be aware of.
This is not exactly what the U.S. Food and Drug Administration has determined for continuous glucose monitors (CGMs). That means that FDA still believes fingerstick tests are required for CGM users unless the patient is checked into a hospital where there are nurses around who can treat patients for hypoglycemia if the patient is unable to treat a low for themself. Specifically, FDA determined that “Non-adjunctive CGM usage was for in-hospital sites, allowing BG levels to be monitored from a central nurses’ station backed up with ancillary resources.” However, “out-of-hospital sites usually lack ancillary resources except EMT vehicles. Ancillary resources represent ‘proven workarounds'”.
But more troubling (at least to me) aspect of this was the following observation IDS made about what this CMS determination will likely mean for patients who are covered by commercial healthcare insurance plans. Specifically, in the fourth paragraph, IDS wrote: “This ruling most likely will be promulgated to all health plans.”
This should terrify people. As IDS opens its article, T1D is a numbers game. Run out of numbers, and the game is over. Diabetes, by its very nature, is an ever-changing condition, honed through experimentation, much like parachuting. Jumping with a failed main chute and no functional reserve chute is unlikely to produce anything good.
Not only is Medicare not covering strips for people who arguably need coverage of at least some test strips, but this will also be a convenient excuse for people covered by employer-sponsored healthcare insurance plans to stop covering test strips for patients who use continuous glucose monitors (CGMs) as well.
IDS recommends that you immediately contact your Congressman/woman and both of your Senators to withdraw this errant policy issue, cancel, correct, revise [or burn] this CMS ruling 1738-r in order to restore Blood Glucose Meter (BGM) coverage and test strips when using a non-adjunctive CGM for out-of-hospital settings so we can all rest easier at 03:00 AM.
Read more: CMS Medicare No Longer Covering Fingerstick Test Strips for CGM Users
High Insulin Linked To Irregular Periods by Dennis Thompson for HealthDay.com, 4 June 2025.
Elevated insulin levels may be contributing to irregular menstrual bleeding in women, according to a new study. Women with excess levels of insulin are three times more likely to suffer from abnormal uterine bleeding, researchers reported today in the journal Menopause.
That means they are more apt to bleed between periods, experience prolonged bleeding, or have extremely heavy periods. This finding could open up a new way to help women suffering from abnormal bleeding by preventing it through lifestyle changes and better blood sugar control, researchers said.
“Few studies and treatment recommendations focus on potential preventive strategies for abnormal uterine bleeding, with most management centered around standard medical and surgical treatments familiar to gynecologists,” wrote the research team led by Dr. Andrea Salcedo, an OB/GYN with the Loma Linda University School of Medicine in California.
Read more: High Insulin Linked To Irregular Periods
Inexpensive HIV Medicine Improves Vision in Diabetic Eye Disease by Shrabasti Bhattacharya for MedScape.com, 3 June 2025.
Oral lamivudine, an inflammasome inhibitor originally approved for suppressing HIV, was a relatively safe and effective treatment for improving visual acuity in adults with center-involving diabetic macular edema, a serious complication of diabetic retinopathy.
“These findings open the door to a more accessible and less invasive treatment approach for DME [diabetic macular edema], with the potential to benefit millions of patients globally,” said the researchers.
Read more: Inexpensive HIV Medicine Improves Vision in Diabetic Eye Disease
Spinal Cord Stimulation for Diabetic Neuropathy Pain by Meghna Rao for EndocrinologyAdvisor.com, 2 June 2025.
Spinal cord stimulation (SCS) effectively relieves pain. It restores nerve function in patients with painful diabetic peripheral neuropathy (DPN), according to the findings of a small study presented at the 2025 American Academy of Neurology annual meeting, in San Diego, CA.
The researchers concluded, “Our current data indicate that SCS can effectively treat [painful] DPN by eliciting relief of pain, sensory and autonomic symptoms, and restoring large- and small-nerve function.”
Read more: Spinal Cord Stimulation for Diabetic Neuropathy Pain
CVS is shutting down 271 stores in 18 states. Is your pharmacy affected? by Katherine Rodriguez for NJ.com, 5 June 2025.
CVS Pharmacy is closing hundreds of stores in 2025 as part of restructuring efforts. According to its recent annual report from February 2025, CVS announced it will close 271 retail pharmacies this year. This announcement followed the retail pharmacy chain’s closure of 900 locations between 2022 and 2024.
The CVS 2024 annual report said CVS decided to close pharmacy locations in 2025 as part of its “enterprise-wide restructuring plan intended to streamline and simplify the organization.” A spokesperson confirmed to Newsweek that the pharmacy closures would be a way to optimize “existing stores and pharmacies.” They added that the recent closures were based on shifting consumer trends, rather than industry pressures.
Read more: CVS is shutting down 271 stores in 18 states
Mindfulness doesn’t work on you? Try this instead by Jan Taylor for ScienceFocus.com, 2 June 2025.
Over the last decade or so, mindfulness has emerged as one of the most significant revelations in the field of wellness science. Researchers have demonstrated that meditative practice can lower stress, reduce blood pressure, enhance sleep quality, and promote a positive mood. But there’s a but, because in science, there’s almost always a but.
Mindfulness doesn’t work for everyone, and for some people, it can lead to adverse effects, such as increased anxiety or depression, which makes sense. Being present in the moment feels good when the moment in question is generally positive or neutral. But if you happen to be going through a bad time, mindfulness can serve to increase awareness of your own emotions and exacerbate the psychological problems that come with them.
In 2024, an interesting study compared mindfulness with a different kind of positive mindset: hopefulness. Researchers at Clemson University and North Carolina State University sought to understand how these various mental states impacted individuals during a particularly challenging time. Scott and her colleagues found that hope improved the study participants’ resilience and professional engagement. Mindfulness, in contrast, increased job tensions and stress. It was a stark result that begs another question: What exactly is hope?
To be beneficial, hope has to be something active and proactive, strategic, and forward-looking. “It’s quite a goal-oriented mindset,” study author Dr Kristin Scott said. “It’s saying, ‘I don’t know how things are going to go, but I feel that if I do these things and if I stay focused, I think that I can get positive outcomes.’ “You don’t get so caught up in the noise and distractions of the negative. You put that information more in the back of your mind.”
The finding chimes with evidence on the power of optimism. Multiple long-term studies have found that optimists live longer, happier lives and are more likely than pessimists to adopt healthy behaviors.
Read more: Mindfulness doesn’t work on you? Try this instead
Cultivate Joy and Resilience with Mindfulness by David Weingard for IJustBreathe.net. David (he/him) is a father to three adult children, husband, triathlete, lives with Type 1 Diabetes (diagnosed at age 36), is the founder of Cecelia Health, and “all in” to transform the chronic disease and mental health landscape positively.
Find the inner support and resources to “ride the waves” of life’s journey through mindfulness practice, including within the proven 8-week Mindfulness-Based Stress Reduction (MBSR) program designed to help you reduce stress, build resilience, and enhance well-being.
Mindfulness-Based Stress Reduction (MBSR) is an 8-week, evidence-based program that offers intensive training in mindfulness meditation and movement practices. It helps participants integrate mindfulness into their daily lives, fostering awareness, resilience, and well-being.
Developed by Dr. Jon Kabat-Zinn in 1979, MBSR blends ancient contemplative practices with modern medical approaches. Through both formal and informal mindfulness exercises, participants tap into their inner resources to manage stress, enhance focus, and improve their overall quality of life.
DISCLAIMER: I have not participated in David’s fee-based program. This is not an endorsement; it is informational.
For a long time, I’ve been scared about the potential of CGM use meaning the non-payment of test strips. That’s ridiculous. I haven’t had a Dexcom G7 work accurately and consistently for 6 months! And I’ve never had a single CGM work correctly during the first 12 hours since I started using a CGM. Test strips are still necessary. I certainly use a lot less than I did prior to CGM use, and my physician prescription for test strip quantity reflects that, but I still use them. Scary.