In this week’s issue of The Savvy Diabetic:
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- Smartwatch Could Spot Changes in Insulin Resistance
- Are Insulin and Amylin Better Together?
- Some REMARKABLE Diabetes Conferences!
- Children with Diabetes Friends for Life, Orlando, FL
- TCOYD ONE Conference, San Diego, CA
- Modular Medical 1st phase of Pivot pump launch
- Fracture Risk Increased in T1D, Highest if T1D with CKD
- Creating the Roadmap for Type 1 Fighters: Jon Kunneman’s Rise in MMA
- Aaron Prager, Teen Programmer of Award-Winning Diabetes App Boost-T1D
News from T1Dto100
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- AID May Simplify Diabetes Management for Older People With Type 1
- T1Dto100 is looking for a few good people!
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Landmark treatment slashes cholesterol by 62% with a single dose by Michael Day for ScienceFocus.com, 15 August 2026.
A one-off treatment could lead to a cure for high cholesterol, according to medical researchers in London. In an early-stage clinical trial, a single dose of a new experimental therapy cut levels of LDL ‘bad’ cholesterol by up to 62 percent and kept them low for up to a year, raising hopes that patients could one day avoid taking daily medication for the rest of their lives.
The treatment, called VERVE-102, is delivered through an IV drip and works by permanently altering a gene involved in cholesterol regulation. Researchers reported no serious safety concerns in the trial, and the results were published in The New England Journal of Medicine.
Lowering LDL cholesterol reduces the build-up of fatty plaques in the arteries, helping to cut the risk of heart attacks and strokes. While statins can achieve similar reductions to gene therapy, they generally need to be taken every day. If larger studies confirm that VERVE-102 is safe and effective, a single treatment could provide long-lasting protection against cardiovascular disease. “It is still early days, but this is an extremely exciting milestone,” said Prof Riyaz Patel, a clinical academic at University College London (UCL) and consultant cardiologist at Barts Health and UCL Hospitals (UCLH), and one of the local leads for the trial. “These findings show the technology works, is safe and helps lower cholesterol.”
Read more: Landmark treatment slashes cholesterol by 62% with a single dose
Amylin design debate heats up as Lilly’s crucial mid-stage weight loss data near by Elizabeth Cairns for Endpoints.news, 19 August 2026.
In the amylin race, drug design appears to be a key differentiator. Later this year, Novo Nordisk’s CagriSema is likely to become the first approved drug containing an amylin analog and a GLP-1 agonist to treat obesity. But keenly awaited mid-stage data on a similar combination approach by Eli Lilly are due to be presented in the fall, and might show this combo to be more effective.
Phase 1 data already indicate that Lilly’s combo can produce the kind of weight loss that’s only been seen before with bariatric surgery. And that might be down to the receptors that the amylin does — or doesn’t — target.
There are two broad amylin drug classes: dual amylin and calcitonin receptor agonists (DACRAs) such as the one in Novo’s CagriSema or Zealand Pharma’s petrelintide, and selective amylin receptor agonists (SARAs) like Lilly’s eloralintide. Lilly’s early-stage data, described in an abstract ahead of the European Association for the Study of Diabetes (EASD) annual meeting in Milan in September, may suggest that there’s some benefit to the single-receptor approach.
The DACRAs “hit amylin receptors and calcitonin receptors equally hard,” William Blair analyst Andy Hsieh told Endpoints News. With Zealand’s petrelintide, for example, “the adverse event profile is very clean, but there seems to be some sort of ceiling in terms of weight loss, and that kind of comes in under that double-digit threshold.” Lilly’s product is “a little bit harder on amylin, less so on the calcitonin,” and has been associated with more side effects, but “the weight loss is pretty impressive,” Hsieh said.
Read more: Amylin design debate heats up
For people living with type 1 diabetes (T1D), insulin pump technology has seen significant advancements. Yet a persistent challenge remains: knowing when insulin delivery has been interrupted. Unlike those who inject long-acting insulin, insulin pump users rely entirely on rapid-acting insulin. As a result, when insulin delivery is compromised, blood glucose can rise quickly. If the issue is caught early and addressed promptly, it can help reduce the risk of ketones and diabetes-related ketoacidosis (DKA).
For many people, that process is all too familiar. If you live with T1D, you have likely experienced stubborn high glucose that won’t respond to correction boluses, only to realize hours later that the issue is bigger than needing more insulin — it’s time to replace an infusion set or a patch pump.
Reality is that by the time an occlusion alarm sounds — if one sounds at all — your continuous glucose monitor (CGM) may have been waving red flags for hours. Researchers agree that delayed detection of infusion site failures is one of the biggest safety challenges for insulin pump users, despite advances in automated insulin delivery (AID) systems.
A study by T1D Exchange of 248 adults, conducted between June and July, 2025, found up to 89% of insulin pump users experienced an unexplained high glucose level (greater than 250 mg/dL). Yet only a fraction of those with more than one unexplained high — about 3% — triggered a pump occlusion alarm. Most reported relying upon CGM (70%) or physical symptoms (20%) as their reliable detection systems. Those findings, along with other expert discussions, highlight why infusion site failures remain a significant unmet need in insulin pump therapy.
A new approach: Measuring insulin flow directly: The Sequel Twiist™ automated insulin delivery (AID) system uses iiSure™ ultrasonic sensing technology to measure insulin flow and volume in the pump. Instead of relying solely on motor movements or pressure changes, the system uses sound waves to monitor the actual movement of insulin. According to testing published by Sequel, the system can detect flow abnormalities up to nine times faster than conventional pumps. Even so, it can’t detect every delivery failure, such as a disconnection — but it represents one of the first major changes to insulin delivery sensing in years.
Read more: Could Your Insulin Pump Detect an Occlusion Before Your Glucose Rises?
Yale Researchers Identify New Strategy to Protect the Brain in Type 1 Diabetes by Jordan Shaked for Medicine.Yale.edu, 17 August 2026.
Insulin is a cornerstone of treatment for patients with type 1 diabetes, essential for lowering blood glucose levels. However, if insulin doses are not appropriately matched to the body’s needs, glucose levels can fall too low, resulting in hypoglycemia, a common and potentially dangerous complication of treatment. Hypoglycemia can impair thinking and cause symptoms ranging from dizziness and confusion to loss of consciousness.
New research from Yale School of Medicine, published in Diabetes, identifies a potential new strategy for protecting the brain from the cognitive effects of hypoglycemia in people with type 1 diabetes. The brain relies heavily on glucose as its primary source of fuel, explains Raimund Herzog, MD, MHS, associate professor of medicine (endocrinology and metabolism) at Yale School of Medicine and senior author of the study. “When glucose falls below a certain threshold, the neurons in the brain stop working properly,” he says.
“The easiest answer would be to take less insulin, but we know that higher glucose over the long term causes complications,” Herzog adds. “The challenge is balancing good glucose control with the risk of hypoglycemia.”
Read more: Yale Researchers Identify New Strategy to Protect the Brain in Type 1 Diabetes
Cellular “invisibility cloaks” may enable side-effect-free diabetes treatment by BioEngineer.org, 14 August 2026.
Penn State researchers have developed a microscopic “invisibility cloak” that may allow transplanted insulin-producing cells to function inside the body without being destroyed by the immune system. In experiments involving diabetic mice, the protective coating helped donor islets restore healthy blood sugar levels within a week, and most treated animals remained diabetes-free for more than 100 days without continuous immunosuppressive drugs. The technology, described in Nature Biomedical Engineering, represents a preclinical attempt to address one of the central obstacles in cell-based treatments for diabetes: protecting transplanted cells while allowing them to communicate chemically with the rest of the body.
Cell therapy for diabetes is designed to replace or supplement the insulin-producing cells that are missing or damaged, particularly in people with type 1 diabetes. Small clusters of pancreatic cells known as islets contain beta cells, which sense blood glucose and release insulin when it rises. Transplanting functional islets can therefore restore a biological system that regulates blood sugar automatically, potentially reducing or eliminating the need for repeated insulin injections. Yet donor islets are recognized as foreign tissue, and the recipient’s immune system can attack and destroy them. Patients receiving islet transplants may consequently need long-term immunosuppressive medication, which can increase vulnerability to infections, cancer and other serious complications.
The Penn State-led team addressed this problem by coating donor islets with a thin hydrogel layer called biomimetic zona pellucida, or BZP. The material is designed to imitate the zona pellucida, a natural protein-rich coating surrounding mammalian egg cells. In a biological system, this extracellular layer provides structural protection and regulates interaction
s between the egg and its environment.
Read more: Cellular “invisibility cloaks” may enable side-effect-free diabetes treatment
NIH funds new blood biomarkers to track islet dysfunction in type 1 diabetes by Robert McTiernan for AllSci.com, 19 August 2026.
Battelle Pacific Northwest Laboratories has received USD 1.92 million in first-year funding under a new NIH R01 grant from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to develop blood-based biomarkers of islet cell dysfunction across the natural history of type 1 diabetes (T1D), addressing a persistent gap in tools for monitoring disease progression and treatment response.
The project centers on intermediate products of prohormone processing — partially cleaved peptides generated as α-cells and β-cells convert precursor hormones into their active forms. Because altered prohormone processing has been observed at different stages of T1D, the researchers hypothesize that circulating intermediates could provide cell-type-specific measures of islet dysfunction and potentially predict disease progression. The research team is led by principal investigators Emily K. Sims and Wei-Jun Qian,
Read more: NIH funds new blood biomarkers to track islet dysfunction in type 1 diabetes
A1c and T1D Complications: What It Reveals, What It Hides, and How the Damage Actually Happens by Dan Heller for DanHeller.substack.com, 21 August 2026. The ubiquitous HbA1c test is an easy but highly fraught metric for tracking diabetes management, risks and outcomes.
Yes, there is an association between elevated A1c levels and complications, but the processes that actually cause harm do not lie with glucose alone. Furthermore, while that association shows up in population-wide data, the rate of individual variability is so high as to make the connection nearly useless.
The T1D management guidelines we live by are aimed primarily at driving A1c levels lower — more insulin, tighter automation, carbohydrate restriction — and they were built on a population-level finding that’s been mis-applied to individuals. Meanwhile the physiology that actually determines your outcome goes unmeasured, untracked, and unmentioned. Nobody is testing for it, nor are they telling you how to slow it down. The result is a corrosion in our bodies that runs for decades before anything shows up on a chart.
If that seems counterintuitive it’s because the real cause of complications is not glucose — it’s oxidative stress. Yes, glucose is a fuel source for it, but the process that causes harm lies downstream of that. The good news is that you have far more control over those downstream processes than you do over reducing glucose levels. It’s not that you should ignore glucose levels at all, but you need to do so with techniques that don’t cause the underlying harm.
The key to understanding the A1c is that it doesn’t measure your blood sugar. It measures how much of your hemoglobin — the protein inside red blood cells that carries oxygen — has glucose stuck to it. That’s called glycation, and everything that follows starts there. That’s the water in the seams. It’s not rust yet.
But note: this glycation is on hemoglobin, and hemoglobin turns over every few months. Glycated hemoglobin doesn’t harm you. What harms you is glycation on tissues that turn over slowly or not at all — collagen in your joints, your skin, your artery walls. The A1c doesn’t tell you about any of that.
Read more: A1c and T1D Complications: What It Reveals, What It Hides, and How the Damage Actually Happens
Help change the future of type 1 diabetes research and care by T1DRegistry.org.
The T1D Exchange Registry is a research study, designed to harness the power of individuals with type 1 diabetes.
You complete a questionnaire once a year.
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- Add your voice, experiences, and data to a body of evidence that grows over time.
- Help accelerate the discovery and development of new treatments and potentially inform policy and insurance decisions .
- Once you enroll, you can participate in more studies on specific topics related to type 1 diabetes.
- The Registry is open to both adults and children with type 1 diabetes living in the United States.
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Previous T1D Exchange research has led to:
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- Insurance coverage for blood glucose meter strips.
- Changes in American Diabetes Association guidelines for A1c goals for pediatric patients.
- Food and Drug Administration’s decision to expand the Dexcom CGM labeling to include fingerstick replacement.
- Medicare coverage of CGM devices.
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To Join: T1D Exchange
Tandem Expands Plans With Tubeless Mobi and Pharmacy Push by Jenna Woolf for Diabetech.info, 11 August 2026.
Tandem Diabetes Care is making a major push to expand access to insulin pump therapy. During Canaccord Genuity’s 46th Annual Growth Conference, Tandem outlined plans to make its technology more affordable, expand internationally, and give users more flexibility in how they wear their pumps.
During the presentation, Tandem stated that only about 40% of the roughly 2 million people with type 1 diabetes in the U.S. use insulin pumps, while pump adoption among people with type 2 diabetes is even lower. Earlier this year, Tandem’s pumps received CE Mark approval for use in European countries, which will help the company reach into new markets. This year, Tandem has expanded into the United Kingdom, Switzerland, and Austria with plans to move into France before the end of the year and new European markets already queued up for 2027.
Tandem is shifting more of its U.S. business toward the pharmacy channel. Its pay-as-you-go (PayGo) model allows the pump itself to be provided without the traditional upfront cost, with users paying for supplies through the pharmacy benefits channel. Tandem is converting its current customers by comparing the costs between pharmacy and durable medical equipment (DME), the traditional benefits channel for insulin pumps and supplies. If a user decides to pursue the pharmacy channel, Tandem then has to receive a new prescription from the user’s physician.
Read more: Tandem Expands Plans With Tubeless Mobi and Pharmacy Push
Supply Issues Could Affect Some Insulin Pump Users by Anna Brooks for diaTribe.org, 20 August 2026.
If you use an insulin pump, delays for infusion sets, which include a small tube and needle (cannula) to deliver insulin, can be stressful – especially when your supply is running low.
The manufacturer of steel infusion sets for Tandem, MiniMed, and Beta Bionics is experiencing supply issues attributed to strong demand. Unomedical, owned by medical device maker Convatec, is investing in additional manufacturing capacity, but the shortages are expected to last through the year. Earlier this year, the company received an FDA warning letter about infusion set manufacturing issues. Pumps that use plastic cannulas, including the Omnipod, are not affected by the shortage.
A search of online pharmacies and third-party distributors showed that some, but not all, steel infusion sets were out of stock. At least one manufacturer has recommended contacting your doctor if you’re having trouble getting infusion sets, obtaining a new prescription, and ordering them through pharmacies, which have been less affected by the shortage. It’s also possible, with some pumps like MiniMed, to switch to a non-steel infusion set. If your usual infusion set is unavailable, your care team may be able to help you decide whether ordering through a pharmacy or temporarily switching infusion sets could be an option.
Read more: TruSteel Supply Constraint Update
Detecting MASH: Liver Disease Screening by Andrew Saintsing for diaTribe.org, 17 August 2026.
Liver disease affects many people with diabetes, but few notice it developing. Early-stage metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) don’t typically cause symptoms.
That’s why screening for liver disease is essential.
Most liver or chemistry panels will measure three enzymes: alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP). The liver uses these enzymes to process protein and other molecules, but if you have a lot of them leaving the liver and circulating through your blood, that could be a sign that your liver is damaged. High levels of ALP can also indicate problems with bone health, so that particular enzyme is usually measured alongside gamma-glutamyl transferase (GGT). High levels of both ALP and GGT would indicate that the liver is responsible for the increased enzyme levels. Additionally, many panels will measure albumin, an important protein that the liver makes and pumps into the blood, and direct bilirubin, a waste product that the liver disposes of. Having too little albumin or too much direct bilirubin in your blood could also indicate that there’s a problem with your liver.
Historically, liver specialists have used biopsies to confirm any diagnosis of MASLD or MASH, but now many healthcare providers have become more confident diagnosing liver disease based on the results of an ultrasound-based test like FibroScan or MRE.
If you have MASLD or MASH, your healthcare provider will recommend that you abstain from drinking and smoking. Cigarette smoking and minimal alcohol use actively worsen MASLD and MASH. Your healthcare provider may also recommend changes to your diet and exercise plan that will help to manage any metabolic conditions. They may also review the medications you are using to treat those conditions.
Read more: Detecting MASH: Liver Disease Screening
FDA Authorizes First-Of-Its-Kind Robotic Blood Draw Device by FDA.gove/News-events, 19 August 2026.
The U.S. Food and Drug Administration today authorized the Aletta, the first standalone robotic device that can draw blood from a patient’s arm without hands-on operator intervention. The device is authorized for use in adults in outpatient settings and must be operated under the oversight of a supervisor trained in phlebotomy. One phlebotomist can oversee up to three Aletta devices at the same time, which may help address the current phlebotomist shortage in the U.S.
“This authorization reflects the FDA’s commitment to advancing innovative medical devices that help meet a critical public health need while maintaining the safety and effectiveness patients deserve,” said Michelle Tarver, M.D., Ph.D., Director of the FDA’s Center for Devices and Radiological Health. “Blood draws are one of the most commonly performed medical procedures in the United States, yet patients may face delays due to a growing shortage of trained phlebotomists.”
Read more: FDA Authorizes First-Of-Its-Kind Robotic Blood Draw Device
Cottage cheese vs. Greek yogurt: Which is healthier? by Erica Sloan for WashingtonPost.com, 22 August 2026.
Greek yogurt and cottage cheese “both pack a lot of nutrition in each bite and are high-quality, complete proteins,” meaning they contain all nine essential amino acids, said Caroline West Passerrello, a registered dietitian and spokesperson for the Academy of Nutrition and Dietetics.
The similarities: Nutrition facts are generally broken down per serving of a food item; the typical serving size for Greek yogurt is ¾ cup, and for cottage cheese, it’s ½ cup. Cup for cup, cottage cheese contains a bit more protein than Greek yogurt — roughly 24 to 25 grams versus 19 to 22, depending on the type you choose.
Overall, Passerrello said, “if protein is your goal, you could pick either.” While the ideal daily protein intake depends on factors like weight, age and activity level, experts commonly recommend 25 to 30 grams per meal — so, a single serving of either dairy item gets you about halfway there.
Both cottage cheese and Greek yogurt are great sources of several vitamins and minerals, too, including potassium (which helps your kidneys flush out sodium to lower blood pressure and regulates your heartbeat) and calcium (which helps bone density and facilitates muscle movements)
If you’re looking to support your gut health: One other distinction between Greek yogurt and cottage cheese is that generally, the former contains an abundance of probiotics, or healthy bacteria, while the latter does not.
Read more: Cottage cheese vs. Greek yogurt: Which is healthier?
News from T1Dto100
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- Shout out to T1Dto100 at TCOYD!!!
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We got a great mention during the experts’ discussion at TCOYD! Our podcast with Dr. Steve Edelman, Dr. Athena Philis Tsimikas and myself had one of the largest audiences among TCOYD events! SO COOL!
Accelerated Brain Aging in Type 1 Diabetes Across Painful and Painless Peripheral Neuropathy, a study published by DiabetesJournals.org, 11 August 2026.
MRI shows structural brain alterations in diabetes, including accelerated brain aging. The brain age gap (BAG) is likely caused by a combination of factors, including mechanisms associated with diabetic peripheral neuropathy (DPN) and neuropathic pain.
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- Accelerated brain aging has been reported in diabetes, but its links with diabetic peripheral neuropathy (DPN) and neuropathic pain remain unclear.
- We explored brain age gap (BAG) in type 1 diabetes to determine if it differs across neuropathic phenotypes, relates to clinical characteristics including DPN measures, and shows distinct regional patterns.
- Diabetes participants had 3.5 years of BAG, rising to 6–7 years in those with DPN. Diabetes duration was the main driver of BAG, whereas DPN had limited impact and neuropathic pain no clear contribution. BAG was widespread across the brain.
- Accelerated brain aging appears to affect people with diabetes regardless of neuropathic complications.
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Read more: Accelerated Brain Aging in Type 1 Diabetes Across Painful and Painless Peripheral Neuropathy
