In this week’s issue of The Savvy Diabetic:
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- Type 1 Diabetes in the Hospital … IT’S TRICKY and OFTEN DANGEROUS!
- Diabetes Technology in the Hospital: Where We Stand
- Type 1 Diabetes in the Hospital by Michael Hughes, MD
- Could a Future Smart Ring Check Glucose and Ketones?
- Cannabinoid Pathways May Offer Targets for Kidney Disease
- Type 1 Diabetes in the Hospital … IT’S TRICKY and OFTEN DANGEROUS!
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- News from T1Dto100
- Reducing Protein Intake for Healthy Aging by Reshaping Metabolism
- Who is Kaylea Bowers from Jeopardy?
- News from T1Dto100
Type 1 Diabetes in the Hospital … IT’S TRICKY and OFTEN DANGEROUS!
Diabetes Technology in the Hospital: Where We Stand by Diabetotech.com, 25 July 2026. THIS IS A MUST-READ for anyone trying to understand the issues and how to manage T1D in a hospital setting!
Hospitalization is one of the hardest places to manage glucose. Acute illness, surgery, infection, steroids, changing intake, less movement, shifting insulin needs — all of it pushes glucose around, toward both highs and lows. And this is not a small group. Around 38–40% of hospitalized patients have hyperglycemia or diabetes, rising to 70–80% of those admitted with critical illness or for cardiac surgery. Meanwhile, more and more patients arrive already wearing a sensor or running a closed loop at home.
So the question is no longer whether diabetes technology belongs in hospital. It is what it does, and how to use it well.
That last clause is the whole story. Every attempt to chase tighter control with intensive insulin drove hypoglycemia up.1 And hypoglycemia tracks with worse outcomes. So the targets sit higher than we would accept outside the hospital. This is on purpose. There is also a growing argument that one target does not fit everyone.
Someone who has spent years building a time-in-range they are proud of will watch it fall apart over a week on a ward. And will usually be told nothing about why. The fall is largely intentional. Chasing 70–140 mg/dL (3.9–7.8 mmol/L) through an acute illness, with a regimen adjusted by people who do not know that patient, has repeatedly produced more hypoglycemia and worse outcomes. In interviews with hospitalized adults, people described being tested but not told the result. And being aware their glucose was drifting while feeling powerless to act. The anxiety is not irrational. It is what happens when a number someone has been trained to treat is left unexplained. Saying the target out loud, once, costs thirty seconds.
Across a larger multi-center study, the themes recurred: no control over glucose management, no involvement in care planning, meals arriving out of step with insulin. This matters clinically, not only experientially. Being able to self-administer insulin in hospital is independently associated with greater inpatient treatment satisfaction. And staff themselves describe the current arrangement as offering less safety than it appears to. The person in the bed is often the most experienced insulin user in the room. But satisfaction is not safety, and home experience does not transfer cleanly to the ward. Steroids, NPO orders, changing renal function, and different targets all shift the calculation.
CONCLUSION across technologies in hospital: The evidence points in one direction: diabetes technology can improve inpatient glucose management—modestly with CGM, and substantially with AID.
But perhaps the most important implication is simpler. Hospitals should first support the patients who already arrive using this technology. Removing a working system is an intervention in itself. It takes away the expertise patients have built up through years of daily self-management and shifts insulin dosing to busy healthcare professionals working with an unfamiliar regimen. Delayed insulin administration, postponed correction doses, and communication gaps can all follow. In contrast, involving patients in dosing decisions—even when every injection is ultimately given by staff—is associated with greater satisfaction and fewer insulin timing errors.
RECOMMENDATIONS: The practical first step is therefore straightforward: allow patients to continue using the devices they already rely on whenever it is safe to do so, supported by clear protocols for patient assessment, POC validation, documentation in the electronic health record, and timely access to a diabetes specialist team. These measures are inexpensive, already recommended by several professional organisations, and give hospitals the experience needed before expanding technology use more broadly.
Then do the part that costs nothing: communicate. Explain the glucose targets and why they may differ from those at home. Explain that occasional POC validation is what allows CGM to remain part of inpatient care. Explain how insulin decisions will be made and what role the patient will play. Qualitative studies consistently show that what patients remember most is not the protocol itself, but whether anyone took the time to involve them.
BOTTOM LINE: The question is no longer whether diabetes technology belongs in the hospital. Increasingly, it already does. The challenge now is to build hospital systems that are ready for it.
This is a very in-depth review and the issues and approaches are very clearly laid out. Please READ and SHARE in your T1D communities!
Read more: Diabetes Technology in the Hospital: Where We Stand
Type 1 Diabetes in the Hospital by Michael Hughes, MD, Emory University, Atlanta … a presentation delivered at ChildrenwithDiabetes Conference and the BreakthroughT1D NorCal E-Meet & Greet for Adults Living with T1D, July 2026.
This is a GREAT presentation, full of actual statistics about Type1Ds in hospital, their care, their control, their devices!!! Every single slide is so important and informative. And there are some valuable pointers and strategies for you to learn before any hospital excursion. I’ll just share a few slides:
In August, T1Dto100 will host Dr. Hughes for a webinar where you can ask any and all of your questions. I love his expertise and understanding about both T1D patients and existing hospital systems. Let’s all learn how to keep ourselves safe!
Could a Future Smart Ring Check Glucose and Ketones? by Anna Brooks for diaTribe.org, 31 July 2026.
Wearable technology like smart rings, watches, and wristbands can help identify daily patterns that help support diabetes management. But current wearables don’t offer a noninvasive way to measure glucose or ketones.
Researchers have developed a prototype ring called CHARM that analyzes sweat drawn from a user’s finger. The ring can monitor glucose, ketones, alcohol, and vitamin C and send the readings to a smartphone. The small, proof-of-concept study showed readings consistent with those from commercial continuous monitoring systems and blood ketone meters.
Larger studies would be needed to gauge accuracy over time, during lows, and when people are dehydrated, among other factors. For now, smart rings can help people gain insights into how activity, sleep, heart rate, and signs of stress relate to glucose patterns.
Read more: A fully integrated smart ring for daily biochemical monitoring
Cannabinoid pathways may offer targets for kidney disease as CKD affects 850 million people by Stephanie Baum for MedicalXpress.com, 31 July 2026.
Approximately 850 million people globally (9.1% of the world’s population) have chronic kidney disease (CKD). The number of affected individuals has grown steadily during the past 20 years and is on track to continue rising. Existing drugs, such as RAAS inhibitors and angiotensin receptor blockers, are commonly prescribed, but their effectiveness varies from patient to patient. Moreover, these drugs can slow disease progression but cannot stop it. Now, a research team from the Autonomous University of Aguascalientes in Aguascalientes, Mexico, argues that cannabinoid pathways may serve as a novel therapeutic target. Their discussion of this possibility appears in Frontiers in Pharmacology.
The need for new therapies is urgent. Many people with CKD also live with diabetes, high blood pressure and obesity, which collectively account for more than two-thirds of disability-adjusted life years among this population. Overall population aging also plays a part in increasing diagnoses of the disease. In its later stages, CKD can lead to heart disease and end-stage renal disease (ESRD). The review authors note, “… patients with ESRD can only be treated by dialysis and/or kidney transplant. However, these therapies are insufficient and often hamper patients’ quality of life.
The glomerulus, the kidney’s filtration barrier, includes a glomerular basement membrane; fenestrated endothelial cells, which feature tiny pores; and podocytes, specialized epithelial cells whose foot-like extensions help filter blood as they wrap around blood vessels. The glomerulus and renal tubules comprise a nephron, the kidney’s basic filtering unit. As CKD progresses, it diminishes the podocyte basement membrane, decreases the proteins nephrin and podocin, interferes with crucial podocyte foot processes, promotes cell death, and causes tubular fibrosis and collapse. Interestingly, both glomeruli and renal tubules have been identified as sites of cannabinoid receptors. “The specific localization of cannabinoid receptors within renal structures, such as glomeruli and tubules, and their physiological actions may reveal their pharmacological utility,” the review authors note. “There is evidence in animal models that targeting the cannabinoid receptors could modulate the progression of CKD and AKI [acute kidney injury].”
The human endocannabinoid system (ECS) could represent a new CKD treatment target; reaching this target may not be straightforward. The ECS plays a complex role in glucose control, inflammation, obesity, and cardiovascular regulation. Mixed results from existing studies point to the need for deeper investigation of how cannabinoids might work in CKD caused by specific conditions. The researchers contend that cannabinoids hold promise in kidney disease research. Future work should include in vitro and animal studies as well as multi-organ analysis, they recommend.
Read more: Cannabinoid pathways may offer targets for kidney disease
- News from T1Dto100
- Reducing protein intake could support healthy aging by reshaping metabolism by Gaby Clark for MedicalXpress.com, 31 July 2026.
A new review covering more than 350 papers on protein restriction and aging—published July 31 in the journal Cell Press Blue—suggests that consuming less protein could have greater health benefits and could, in some cases, extend lifespan. The authors describe how protein restriction slows aging by improving metabolism, changing how cells respond to nutrients, reducing cellular damage, and preserving healthy cell function. “It’s absolutely crystal clear that there are benefits of protein to muscle growth and exercise response of active individuals,” says Dudley Lamming, the paper’s corresponding author, of the University of Wisconsin-Madison. “But because most people are relatively sedentary, many people are likely consuming more protein than they actually need, which probably has negative health consequences.”
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- Fibroblast growth factor 21 (FGF21) is a hormone which rises when protein intake is low. FGF21 can increase the body’s energy expenditure, improve blood sugar control, and reduce inflammation.
- Several amino acids, the building blocks of protein, appear to drive many of these effects, including methionine, isoleucine, and valine. Studies show that consuming too much of these amino acids could trigger biological processes that promote growth, increasing the risk of obesity, inflammation and other age-related diseases.
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Read more: Reducing protein intake could support healthy aging by reshaping metabolism
Who is Kaylea Bowers from Jeopardy? Meet the Disney Data Leader, Analytics Expert, and Type 1 Diabetes Advocate by Alex Matthews for TVRegular.com, 8 June 2026.
A respected leader in marketing technology and data strategy, Kaylea Bowers has spent nearly 15 years helping organizations transform complex information into actionable insights. Today, she plays a key role at The Walt Disney Company, where she oversees major data initiatives that help shape marketing decisions across one of the world’s most recognized brands.
Based in the Greater Orlando, Florida area, Bowers has built a career that bridges communications, analytics, product management, and emerging technologies. Along the way, she has earned industry awards, contributed to major corporate and public-sector projects, volunteered extensively in her community, and became a strong advocate for Type 1 diabetes awareness. Her appearance on Jeopardy! showcases a contestant whose professional accomplishments are matched by a lifelong commitment to learning and service.
Kaylea Bowers currently serves as Manager of Data, Analytics & Innovation for Disney Experiences, a division of The Walt Disney Company responsible for theme parks, resorts, cruises, and consumer experiences around the world. Managing data systems at a company as large as Disney requires both technical expertise and exceptional communication skills, making Bowers one of the organization’s key leaders in marketing technology and analytics.
One of the most meaningful aspects of Bowers’ life has been her commitment to Type 1 diabetes advocacy. She was diagnosed with Type 1 diabetes in July 2000 and has remained actively involved with JDRF International ever since. For more than two decades, she has supported efforts to raise awareness, fund research, and improve the lives of people living with the condition. Her connection to the cause is deeply personal. Publicly available information indicates that her younger sister was diagnosed with Type 1 diabetes approximately nine years after Kaylea’s own diagnosis. This shared family experience has strengthened her dedication to advocacy and support for others facing similar challenges. Throughout her life, she has used her experiences to educate others and contribute to organizations focused on advancing treatment options and ultimately finding a cure. Her long-term volunteer work demonstrates resilience, compassion, and a commitment to making a positive difference in the lives of other.
Read more: Who is Kaylea Bowers from Jeopardy?
