IN THIS ISSUE

• • How Meta Smart Glasses Are Changing Life With Sight Loss
  • Taking Stock: How To Keep Diabetes Supplies on Hand
  • Zucara’s ZT-01: What Could Taking the Brake Off Glucagon Do?
  • The 20% Rule: What Two Hospitals Missed — And What Caught It

FROM T1DTO100

• • “One Spot of Joy at a Time”: Managing Type 1 in Midlife
  • T1Dto100’s Maddy Arnstein Testifies Before US Congressional Hearing 
  • The Management of Type 1 Diabetes in Adults: The Updated 2026 Consensus Report
  • The Single Cheapest (and Most Surprising) Way to Add Years to Your Life
  • PAID Study by Vertex : PWDs Living with painful Diabetic Peripheral Neuropathy

How Meta Smart Glasses Are Changing Life With Sight Loss, with Dave Steele for Henshaws.org.uk, 29 January 2026

Meta Smart Glasses are changing life for people living with sight loss. In this video, Dave Steele shares his experience using the glasses as someone with Retinitis Pigmentosa (RP). Built-in AI can help him understand his surroundings and read text, while the glasses can also take calls, play music and capture video hands-free.

Steele demonstrates using the glasses to hear descriptions of what is in front of him and read signs, menus, books and food packaging. One of the attractions is that these capabilities are incorporated into affordable, mainstream technology rather than specialized assistive equipment.

The video explores the potential for accessible technology such as Meta Smart Glasses to support greater independence for people who are blind or visually impaired.

SAVVY NOTE: I find this fascinating — not only as assistive technology for people with significant vision loss, but as another example of AI quietly moving into devices we already use. For those of us living with diabetes-related vision problems as we get older, I’ll be watching this technology closely.

Taking Stock: How To Keep Diabetes Supplies on Hand, by Paul Heltzel for diaTribe.org, 21 September 2026

Insulin, CGM sensors, pump supplies and prescriptions can be delayed, fail unexpectedly or become unavailable. The article recommends creating a multi-week reserve based on what you actually use, how frequently supplies fail and how long replacements and refills take.  Dr. Diana Isaacs of Cleveland Clinic recommends discussing those realities with your diabetes provider. Prescriptions may need to account for higher insulin needs, priming pens and devices, and more frequent changes of pump supplies. Device failures should also be reported promptly so replacements can be obtained.

Travel requires another layer of preparation. Heltzel says his own rule is to carry twice the insulin and related supplies he expects to need after once dropping his only vial of insulin on a restaurant bathroom floor while traveling.

And then there is the trusty go bag.  The article quotes yours truly on keeping diabetes supplies, medications, hypo treatments, chargers and personal items ready for an unexpected hospital visit or other emergency. I also recommend a smaller version for ordinary trips away from home, plus refrigerated backup insulin.  My favorite line — because I apparently said it!:  “It’s work, but it’s a lot less work than being caught by surprise.”  diaTribe also links to my full go-bag list and information on creating a Personal Medical Resume.

SAVVY NOTE: You KNOW how strongly I feel about this! Preparedness is one of those things we can keep putting off because nothing is wrong TODAY. Then a pump fails, a sensor dies, a prescription gets delayed, we land unexpectedly in the hospital — or there is an earthquake, fire or evacuation. Especially as we get older, please don’t assume you will be able to assemble everything you need in the middle of an emergency.

READ MORE: Taking Stock: How To Keep Diabetes Supplies on Hand

Zucara’s ZT-01: What Could Taking the Brake Off Glucagon Do? by Tim Street for Diabettech.com, 23 September 2026

 Type 1 diabetes has a glucagon timing problem. When glucose falls, the glucagon response that should help protect us from hypoglycemia becomes impaired. Yet when glucose is normal or rising — particularly after eating — glucagon may be inadequately suppressed and add more glucose from the liver. That makes Zucara Therapeutics’ experimental drug ZT-01 (axareotide acetate) particularly interesting.

ZT-01 is a selective somatostatin receptor 2 antagonist. By reducing somatostatin’s restraint on pancreatic alpha cells, it may allow them to release glucagon as glucose falls. A recently published Phase 1 study found that ZT-01 could restore a glucagon response during experimentally induced hypoglycemia. But there is an important wrinkle.

In the same study, ZT-01 also produced a temporary increase in glucagon while glucose was normal, accompanied by a modest rise in glucose and a higher intravenous insulin infusion rate during the glucose-clamp experiment.  That does not establish that ZT-01 will increase everyday insulin requirements or worsen glucose control in real life. It does raise an important question: Can glucagon be restored when it is needed to prevent hypoglycemia without creating unwanted effects when additional glucose from the liver is not needed?

The Phase 2 ZONE study is evaluating ZT-01 in adults with T1D who experience nocturnal hypoglycemia. Its primary clinical goal is to determine whether the treatment reduces nighttime glucose below 54 mg/dL. The study does not allow participants to use automated insulin delivery, so questions about how ZT-01 might interact with AID systems will remain.

SAVVY NOTE: This is REALLY interesting to me. We spend so much of our lives thinking about insulin, but glucagon is another major piece of the T1D puzzle. If our bodies could regain some of their natural defense against hypoglycemia — particularly overnight — that could be important. But as Tim Street points out, the question isn’t simply whether ZT-01 can increase glucagon. It is whether it can increase it at the right time.

READ MORE: Diabettech — Zucara’s ZT-01: What Could Taking the Brake Off Glucagon Do?

The 20% Rule: What Two Hospitals Missed — And What Caught It, by Alice Jane Morgan for diaTribe.org, 21 September 2026

Alice Jane Morgan’s 25-year-old son Spencer, who has lived with T1D for 11 years, developed large ketones, vomiting and glucose over 300 mg/dL and went to a community hospital with DKA.  The hospital treated the DKA successfully. The problems began afterward.

Spencer uses an automated insulin delivery system, but the hospital did not have the pump supplies needed to change the infusion set suspected of contributing to the DKA. His insulin was dosed using a sliding scale rather than according to carbohydrate intake, and his CGM data were not used for treatment decisions.  Eventually, Spencer and his mother left and contacted his usual teaching hospital. They decided that temporarily returning to multiple daily injections was the safest way to remove uncertainty about insulin delivery.

At home, Morgan used Claude, an AI assistant, to double-check insulin calculations. But this is where her story becomes particularly interesting.  Morgan knew from her own diabetes-industry experience that transitioning from pump insulin to long-acting insulin may require a different dose. She believed the long-acting dose Spencer had been given was approximately 20% too low. The AI did not identify that issue independently. Morgan did. She then used the AI to help check her calculation.

Her larger point is not that AI should manage diabetes. Quite the opposite: AI can calculate, double-check and help people think through a problem, but it cannot necessarily know which question needs to be asked or what important information has been left out.  Morgan also points to the larger hospital problem. The ADA’s 2026 Standards of Care say hospitals should continue patients’ insulin pumps when appropriate, but training, supplies and protocols have not necessarily caught up.

SAVVY NOTE: There are TWO issues here that hit very close to home for me: hospital safety with T1D and the appropriate use of AI.

• • • We have talked repeatedly at T1Dto100 about going into the hospital prepared, because even excellent hospitals may not understand the technology or highly individualized insulin management that we use every day.
    • And I use AI constantly — including putting together Savvy Updates! But this story beautifully illustrates the distinction: AI can be an extraordinary assistant. It is NOT a substitute for knowing your own diabetes, asking questions, recognizing when something doesn’t make sense and having knowledgeable humans involved in your care.

READ MORE: diaTribe — The 20% Rule: What Two Hospitals Missed — And What Caught It

NEWS FROM T1DTO100

“One Spot of Joy at a Time”: Managing Type 1 in Midlife, by Paul Heltzel for diaTribe.org, 24 September 2026.  Joanne Milo, author of “The Savvy Diabetic” and founder of Loop and Learn, talks about adapting to life with type 1 — and building resilience — in your late 40s and early 50s.

After decades of managing type 1 diabetes, midlife brought changes that disrupted once-familiar patterns.

“You don’t feel invincible anymore,” Milo said. “You’re aware that you’re not as fit or that things are a little harder. It’s really subtle. Some people just keep pushing through, and people who are more attuned go, ‘Oh, it’s changing.'”  Perimenopause was one of the first major disruptions:“Everything went out the window. I was disappointed because I had really gotten it. I got a hold of it, and it slipped away. Managing blood sugar became a lot more irregular and erratic.”

Milo emphasizes finding things that bring joy, connecting with other people living with T1D, and planning ahead for the changes that come with growing older.“It’s all planning… No one wants to do it. I understand that. But I think it’s how we make things easier as we transition. Aging is hard, and there is fatigue. How do you deal with it? One spot of joy at a time.”

T1DTO100 NOTE: Well, this one is obviously personal! But I love the message that came out of the conversation: planning for growing older with T1D matters — but so do community, resilience and joy. Maybe we need to plan for those, too.

READ MORE: diaTribe — “One Spot of Joy at a Time”: Managing Type 1 in Midlife

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T1Dto100’s Maddy Arnstein Testifies Before US Congressional Hearing about the challenges of aging with T1D, Russell Senate Office Building in Washington, DC, 22 September 2022.

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The Management of Type 1 Diabetes in Adults: The Updated 2026 Consensus Report, published in Diabetes Care by the American Diabetes Association and European Association for the Study of Diabetes, September 15, 2026

The American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) have published their updated consensus report on managing type 1 diabetes in adults. The new report builds on the 2021 consensus report and reflects the rapid advances that have occurred in T1D care during the past five years.

There is particular emphasis on integrating new diabetes technologies, while all sections have been revised to incorporate new evidence, changes in clinical practice and new therapies — including interventions that may delay progression to Stage 3 type 1 diabetes.  The report also broadens its attention to screening for long-term diabetes complications and managing obesity and cardiovascular risk factors.  Psychosocial care and diabetes self-management education and support remain central components of care.

The report recommends person-centered management beginning with a detailed evaluation and followed by individualized ongoing care. Technology troubleshooting, plans for system failure and treatment of hypoglycemia should be reviewed at least annually.

T1DTO100 NOTE: THIS is an important document for us.

We are finally seeing adult T1D discussed as something that changes over a lifetime — with technology, cardiovascular risk, complications, obesity, psychosocial needs and education all part of the picture.  My immediate question, of course, is how thoroughly it addresses the specific needs of those of us growing older — and OLD — with T1D. Stay tuned!

READ MORE: The Management of Type 1 Diabetes in Adults. The Updated 2026 Consensus Report

The Single Cheapest (and Most Surprising) Way to Add Years to Your Life, by Abbi Henderson for BBC Science Focus, September 12, 2026

It isn’t the latest technology, supplement or expensive gym membership.  It is social connection.  Research has repeatedly linked strong social relationships with longer life and, importantly, more years of healthier life.  A 2010 meta-analysis involving 148 studies and more than 300,000 participants found that people with stronger social relationships had a 50% greater likelihood of survival over the study periods than those with weaker relationships.

The long-running Harvard Study of Adult Development has also found an association between satisfying relationships and healthier aging. Participants who were healthiest at age 80 were not necessarily those with the greatest wealth or conventional success; satisfaction with relationships earlier in life was strongly associated with later health.

The issue is not simply the number of people around us. Researchers emphasize meaningful connection and belonging. A few close, trusting relationships and participation in communities with a shared interest or purpose may matter more than a large network of superficial contacts.

And small interactions count too — talking with a neighbor, sharing a laugh, making eye contact or simply thanking someone.  The recommendation is surprisingly practical: be intentional about relationships. Schedule and protect time for social connection much as we do exercise, meals and sleep.

T1DTO100 NOTE: Well, THIS certainly speaks to what we are building!  T1Dto100 started because there was so little information about growing older with T1D. But something else happened: we found each other.

Our Facebook community, webinars, Open Mics, support groups and conversations aren’t simply ways to exchange diabetes information. They create connection with people who understand what it means to live this life.

Maybe community really IS part of the prescription for healthy aging. I rather love that idea.

READ MORE: The Single Cheapest (and Most Surprising) Way to Add Years to Your Life

FROM OUR READERS

Casey:  “This change was made a little while ago, but I just want to say I love the addition of the Savvy Note and the T1Dto100 Note following each article! It’s fun to read an immediate reaction, question, curiosity, etc., after each piece.”

Richard H.: “Ditto those sentiments. This newsletter is one of the best I receive – it is informative & current. I appreciate the links to original articles also if I choose to dive deeper into a topic. Thank you.”

SAVVY NOTE: Thank you, Casey and Richard! I’m loving them too — and apparently, the Savvy Notes and T1Dto100 Notes are here to stay!