Tandem’s Control-IQ to Integrate Dexcom G7 and FreeStyle Libre 2 as announced in the Tandem Diabetes Care, Inc., Q2 2023 Earning Call, 3 August 2023.

According to John Sheridan, CEO:  “We want our customers to have the benefits of the latest CGM technologies, and being first to market with these new CGMs is evidence of our commitment to enable access and lead and systems integration. It takes a lot of collaboration and coordination to launch an integrated CGM system. I’d like to thank Dexcom for their continued partnership and Abbott for their new partnership as we bring the benefits of our AID systems to even more people living with diabetes.”

Further, Mr. Sheridan said: “In the United States, we are planning for Dexcom G7 integration to be broadly available in the first part of Q4 and Freestyle Libre 2 integration to be broadly available in the middle of Q4. These will be followed by international launches with DexCom G7 and FreeStyle Libre 3. The pump software updates for these integrations will be offered to all in-warranty customers for no charge and can be completed from a personal computer.”

Read more: Tandem Diabetes Care Q2 2023 Earnings Call Transcript

Senseonics Faces Headwinds In Competitive CGM Market by Stephen Ayers for SeekAlpha.com, 1 August 2023.

Senseonics is a medtech firm specializing in long-term, implantable glucose monitoring technology for the global diabetes community. Their breakthrough product, Eversense, includes various continuous glucose monitoring (CGM) systems that accurately measure glucose levels through an under-the-skin sensor, smart

Recent updates saw Senseonics’ shares jump ~9% as UnitedHealthcare began covering the Eversense E3 glucose monitor from July 2023, potentially reaching 300M insured individuals. However, analysts have given them an Underperform rating on Senseonics, citing its niche market, mandatory in-office implantation, daily charging, lack of pump integration, and sub 1% market share

Read more: Senseonics Faces Headwinds In Competitive CGM Market

Glucotrack’s 2-year CGM implant passes first feasibility study by Andrea Park for FierceBioTech.com, 26 July 2023.  

A new technology currently under development by Glucotrack aims to hugely cut down on that required maintenance—even potentially quadrupling the lifespan compared to the Eversense device.  Glucotrack is looking to market its own implantable CGM system with a longevity of at least two years. So far, the prognosis is good: An early feasibility study has proved that the technology could indeed stay implanted that long.

“We are pleased to have met our goal to confidently project a long-term sensor life that is at least four times longer than what is currently available for an implantable CGM, without the requirement for external wearables or frequent calibrations,” CEO Paul Goode, Ph.D., said. Glucotrack acquired the implantable CGM technology last fall, though it didn’t disclose the seller of the IP .

Read more: Glucotrack’s 2-year CGM implant passes first feasibility study

Glytec unveils updated Glucommander insulin dosing software by Sean Whooley for DrugDeliveryBusiness.com, 2 August 2023.

Glytec unveiled the newest version of its Glucommander insulin dosing software that enables best practice, personalized care.  The Glucommander platform helps to streamline workflows, improve outcomes and support electronic health record (EHR) systems. Waltham, Massachusetts-based Glytec says it closely follows the next evolution of GlucoMetrics released this past spring. GlucoMetrics provides new insights and analytics to help hospitals improve glycemic management.

More than 300 hospitals in the U.S. utilize Glytec’s eGlycemic Management System (eGMS). The company built that around Glucommander, the only cloud-based, FDA-cleared software for personalized IV and subcutaneous insulin dosing. Glucommander software, the latest release, offers better ease of use more intuitive features, the company said.

“Glytec is leading the way to a future where every hospital across the country provides the highest quality glycemic care possible,” said Dr. Jordan Messler, Glytec chief medical officer. “We are working towards making that vision a reality by establishing Glucommander as the standard of care for insulin dosing through innovation, continuous improvement, collaboration, and clinical excellence. Since our inception, we have worked closely with customers and partners to understand workflows in busy hospitals and ensure our tools fit seamlessly to enhance operations and support improved patient outcomes. Today’s release is an important milestone in our journey and paves the way for even greater things to come.”

Read more: Glytec unveils updated Glucommander insulin dosing software

Insulin-like hormones critical for brain plasticity by Max Planck of the Florida Institute for Neuroscience for MedicalExpress.com, 4 August 2023.

Research from the Max Planck Florida Institute for Neuroscience has identified a mechanism through which insulin-like growth factors facilitate brain plasticity. The insulin superfamily of hormones, including insulin, insulin-like growth factor 1 (IGF1), and insulin-like growth factor 2 (IGF2), play a crucial role not only in regulating blood sugar, metabolism, and growth but also in healthy brain development and function, including learning and memory.

These hormones can enter the brain through the bloodstream from the liver or can be synthesized directly in neurons and glial cells within the brain. They bind to receptors, including the IGF1-receptor, activating signals that modulate neuron growth and activity. Disruption of this signaling pathway is involved in cognitive decline and diseases such as Alzheimer’s.

Senior author on the publication and Max Planck Scientific Director, Dr. Ryohei Yasuda, summarized the findings. “This work reveals a local, autocrine mechanism in neurons that is critical for brain plasticity. When a synapse undergoes plasticity, IGF is released locally to activate the IGF1-Receptor on the same neuron. Disrupting this mechanism impairs the plasticity, highlighting its critical role in maintaining cognitive health.”

This discovery of this new mechanism sheds light on how memories are encoded in the brain and highlights the importance of further study on the insulin superfamily of hormones in the brain. The scientists hope that understanding the mechanism through which IGF hormones facilitate brain plasticity, will lead to research into whether targeting this signaling pathway could prevent cognitive decline and combat diseases like Alzheimer’s.

Read more: Insulin-like hormones critical for brain plasticity

Climate change presents special concerns for people with diabetes by Michael Monostra for Healio.com/endocrinology, 1 August 2023.

Climate change and air pollution may be having a substantial influence on adverse outcomes and mortality for people living with diabetes.

In a review article published in Clinical Diabetology, researchers examined 42 studies that analyzed the impact of climate change and other environmental hazards for people living with diabetes. The authors grouped the studies into three topics: extreme temperatures, natural disasters, and air pollution.

In the review, researchers found people with diabetes had a higher hospitalization risk and worse glycemic control during temperature extremes compared with normal temperatures. Some studies showed that during natural disasters, people with diabetes were often unprepared and lacked emergency access to supplies, medications or care. Four studies showed that people with diabetes exposed to more pollution, particularly small particulate matter, had an increased risk for hospitalization.

Extreme temperatures were the subject of the largest portion of the studies that we found, so we were able to dive a bit deeper into this topic. The majority of these studies said exposure to hot temperatures would increase the risk of hospitalization, especially for elderly populations. Some of these studies speculated and looked deeper into why. They showed that people with diabetes are more sensitive to extreme temperatures because of impaired thermal regulatory control and capacity. The capacity for them [to handle heat] is not as high as it should be, so they’re living in that heat state. Also, some studies said that the medications that are used to treat diabetes, especially those that treat fluid balance, can also exacerbate the risk of heat-related illness. 

Read more: Climate change presents special concerns for people with diabetes

Sexual Dysfunction Significantly Associated with Women Having Type 1 Diabetes by Jacinthlyn Sylvia for MedicalDialogues.in, 30 July 2023.  

Sexual dysfunction (SD) in women with diabetes is a complex problem influenced by hormonal, neuropathic, and psychosocial factors. Recent research suggests that the prevalence of SD is higher in women with type 1 diabetes compared to those with type 2 diabetes or without diabetes altogether. The findings of the study were published in Diabetic Medicine Journal. The findings of the meta-analysis revealed that women with type 1 diabetes are three times more likely to experience SD compared to women without diabetes.

This review underscores the significant issue of SD in women with type 1 diabetes. The higher prevalence rates highlight the need for increased attention from diabetes professionals and policymakers. Incorporating female SD (FSD) into care pathways and clinical guidelines can help address this overlooked aspect of diabetes management.  The implications of this study extend beyond the medical realm. Sexual well-being is a vital aspect of overall quality of life, and addressing SD in women with type 1 diabetes can have positive effects on mental health and relationship satisfaction. 

Read more: Sexual Dysfunction Significantly Associated with Women Having Type 1 Diabetes

Kombucha Shows Potential Diabetes Benefit in Small Trial by Kristen Monaco for MedPageToday.com, 1 August 2023.

Drinking kombucha helped improve blood glucose levels in people with type 2 diabetes, according to a randomized, controlled pilot trial. After drinking the fermented tea for a month, participants saw a significant reduction in average fasting blood glucose levels (164 vs 116 mg/dL) not seen in those in the placebo group (162 vs 141 mg/dL), Robert Hutkins, PhD, MS, of the University of Nebraska in Lincoln, and colleagues found. Despite the significant reduction seen for kombucha drinkers, glucose levels weren’t significantly different between the two groups at the end of the 4-week period, the researchers detailed in Frontiers in Nutrition. 

“If this outcome was obtained in a well-powered study, kombucha could have the potential to greatly affect diabetic care,” the researchers wrote.  In addition to the animal data on kombucha, other human research on drinking apple cider vinegar — another fermented beverage — also showed benefits on blood sugar. The real-world drink market is much larger for kombucha though, co-author Chagai Mendelson, MD, of MedStar Georgetown University Hospital noted.

Read more: Kombucha Shows Potential Diabetes Benefit in Small Trial

Mayo Clinic repeats as top US hospital for diabetes, endocrinology by Richard Smith for Healio.com/endocrinology, 1 August 2023.

The Mayo Clinic in Rochester, Minnesota, is the No. 1 hospital in the U.S. for diabetes and endocrinology, according to the 2023-2024 Best Hospitals rankings released by U.S. News & World Report. This year’s ranking added several changes to the methodology, including the introduction of outpatient outcomes in key specialty rankings and surgical ratings; expanded inclusion of other outpatient data, increased weight on objective quality measures; a reduced weight on expert opinion and more.

“A recent survey of U.S. News users revealed more than four in five (84%) consider a hospital’s quality metrics to be important factors when deciding where to seek treatment for a serious medical issue,” Ben Harder, chief of health analysis and managing editor at U.S. News & World Report, said in a press release. “Consumers want useful resources to help them assess which hospital can best meet their specific care needs. 

“We are honored that Mayo Clinic is once again the nation’s top-ranked hospital across the most specialties,” Gianrico Farrugia, MD, Mayo Clinic president and CEO, said in a press release. “Our staff work tirelessly to deliver the highest level of care to every Mayo Clinic patient. Today’s recognition is a testament to them and their daily commitment to providing hope and healing to those in need, and to their creativity, ingenuity and drive to create the future of healthcare.”

The top five U.S. hospitals for diabetes and endocrinology according to the 2023-2024 Best Hospitals rankings are:

      1. Mayo Clinic in Rochester, Minnesota
      2. NYU Langone Hospitals
      3. New York-Presbyterian Hospital-Columbia and Cornell
      4. Houston Methodist Hospital
      5. Northwestern Medicine-Northwestern Memorial Hospital

Read more:

REVIEW:  The World’s First CKM, with Some Data by Tim Street for Diabettech.com, 2 August 2023.

Remember this?  Continuous Ketone Monitoring – a world’s first from SiBio?

Well, now we’ve got a few measurements to try and figure out how well it really works. It’s only a few, as Ketone test strips are not readily available and are also quite expensive.  Obviously, as an Interstitial Fluid based sensor there are going to be differences compared to blood tests, but what are they?

Firstly, it seems that CKMs are prone to the same compression problems as CGMs, which should be no real surprise. From a measurement perspective, values are noticeably different with ketones present. The blood tends to be considerably higher than the sensor reads. There seems to be one paper available that has compared interstitial and blood ketone levels. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146213/

It indicates that in their experimentation, ketones in ISF are generally found at higher levels than in blood and that they could be used as an early indicator of DKA. That’s obviously not what I’ve observed in the behavior of these particular sensors, where blood levels are showing as higher than the readings I’ve got from the sensors.

Conclusions: There’s not a lot that we can take from this. Firstly, the device isn’t being sold as a medical device. It’s purely marketed for consumers to get an indication of whether they are in ketosis, and I think it works well enough for that. But as an alternative to fingerpricks for ketones? At this stage, I’d say no. Given the details the paper mentioned outlines, it isn’t aligned with how ketones seem to work, based on the available knowledge so far. And there’s no real data related to this device. Whether that’s how it tracks ketones, how it’s calibrated, or any trials they’ve done. So all in all, use it for determining your state of ketosis when following a ketogenic diet. Don’t use it for anything medical. There’s something not quite right in that respect.

Read more: The world’s first CKM, with some data

HOORAY FOR CANADA!!!  Do-It-Yourself Automated Insulin Delivery: A Position Statement from the Diabetes Canada Clinical Practice Guidelines Expert Working Group, July 2023.

Despite the increasing popularity and compelling testimonials of DIY AID in the T1D community, diabetes healthcare practitioners (HCPs) have limited knowledge of DIY AID and are hesitant to discuss or care for people using these systems given the lack of regulatory approval and poor understanding of how they work  In some other countries, guidelines advise against providers prescribing DIY AID systems but recommend that providers assist in diabetes management to ensure individual safety

Summary and Key Messages:  The evidence supports that DIY AID can provide significant improvements in A1C, TIR, and quality of life. The evidence also suggests that a wide range of PWD can benefit from AID regardless of their education or comfort with technology.

In the spirit of shared decision-making and facilitating self-management, and in keeping with the ethical and legal principles of duty of care and autonomy, HCPs are obligated to discuss all available options with PWD, including making them aware of DIY AID. This does not mean that HCPs need to become experts in the setup and building of a DIY system, but rather that HCPs direct PWD to the online diabetes community to learn more about the DIY systems and support them at follow-up appointments to adjust and optimize settings. Reviewing the glucose and insulin data should still be a part of all routine follow-ups. HCPs and PWD should agree on how to review the data and make joint decisions on how to further improve TIR, decrease glycemic variability and meet the PWD goals. A companion user’s guide has been published for HCPs who wish to learn how these systems work and develop an approach to helping PWD meet their personalized diabetes goals.

Read more:  Do-It-Yourself Automated Insulin Delivery: A Position Statement

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