#19 - T1D Tech Breakthrough: Retinopathy Remission

Hey readers! 👋 This week's diabetes tech roundup brings exciting developments in automated insulin delivery systems, promising research for early-stage T1D, and real-world studies showing how technology is changing outcomes. From retinopathy remission to school cell phone policies affecting diabetes management, we've got the latest insights to keep you informed. Let's dive in!

Type 1 diabetes technology devices explained — Breakthrough T1D has created short, informative videos explaining key diabetes management technologies including CGMs, insulin pumps, and hybrid closed-loop systems. These 90-second explainers offer clear insights into how each device functions and their benefits for improving blood glucose management. – Breakthrough T1D

mylife Loop system integrates YpsoPump with advanced algorithm — The mylife Loop combines the YpsoPump insulin pump with the CamAPS FX app and compatible CGM sensors to provide automated insulin delivery via smartphone. The system continuously learns and adjusts insulin delivery every 8-12 minutes, with clinical trials showing significant improvements in HbA1c, time in range, and reduced hypoglycemia. Parents and caregivers report improved sleep and reduced management burden.

Diabetic retinopathy remission with automated insulin delivery — A groundbreaking two-year study found that 50% of patients using the MiniMed 780G AID system experienced diabetic retinopathy remission, compared to 0% in the multiple daily injection group. This remarkable finding suggests AID systems may actually modify the course of diabetes complications through improved glycemic control metrics. – Elsevier Masson SAS

Omnipod 5 shows significant real-world benefits — An observational study of Omnipod 5 users found significant improvements in time in range (+16%) and HbA1c reduction (-3 mmol/mol), with the greatest benefits seen in those with higher baseline HbA1c levels. The study suggests prioritizing AID systems for individuals at greatest risk of complications. – Diabetic Medicine

Nine-sensor CGM comparison reveals surprising results — A comprehensive 15-day comparison of nine CGM sensors against 150 fingerprick tests found that newcomers like Caresens Air and Syai Tag performed comparably to established market leaders. The study highlights that real-world accuracy often differs from clinical trial results, with most sensors struggling at low glucose levels. – Diabettech

Head-to-head comparison of AID systems at summer camp — A study comparing Medtronic MiniMed 780G and CamAPS FX in children with T1D during a two-week summer camp found both systems achieved similar time in range (75.5% vs. 71.1%), significantly outperforming sensor-augmented pump therapy. MiniMed 780G showed less overnight hypoglycemia than CamAPS FX, demonstrating both systems are safe and effective in physically active settings. – S. Karger AG, Basel

Open-source vs. commercial AID systems comparison — The CODIAC study extension compared open-source AndroidAPS with commercial systems Control-IQ and MiniMed 780G. While all systems achieved comparable time in range and HbA1c levels, AndroidAPS showed higher time in tight range but also increased hypoglycemia risk compared to commercial systems. – PubMed

Single-cell analysis reveals T1D progression mechanisms — Researchers mapped over 850,000 pancreatic cells across non-diabetic, autoantibody-positive, and T1D stages, identifying cell type-specific changes in gene expression and chromatin accessibility. The study revealed molecular drivers of T1D in the pancreas, highlighting potential therapeutic targets for disease prevention. – PubMed

Oxymatrine shows potential in T1D treatment — A study found that oxymatrine (OMT) may have therapeutic effects on type 1 diabetes by negatively regulating T follicular helper cells, which are elevated in T1D patients. In a mouse model, OMT treatment reduced Tfh cell expansion, increased serum insulin levels, and protected pancreatic tissues. – Elsevier B.V.

Early diagnosis plea for pre-symptomatic T1D — Researchers advocate for early detection of individuals at risk of developing symptomatic T1D through screening for auto-antibodies. The recently FDA-approved drug teplizumab has shown efficacy in slowing beta cell decline in both stage 2 and early stage 3 patients, representing a disease-modifying treatment currently under EMA evaluation. – PubMed

School cell phone bans impact students with T1D — Nearly half of U.S. states have policies restricting student cell phone use in schools, creating challenges for students with T1D who rely on phones connected to CGMs and insulin pumps. A 504 Plan can legally ensure students can carry phones as medical devices, but parent-school collaboration is essential for proper accommodations. – Kara Sweet

Hypoglycemia common during unstructured physical activity — The RAPPID study found that despite using automated insulin delivery systems, hypoglycemia remains common during unstructured physical activity, with clinical hypoglycemia occurring in 20% of sessions. While temporary glucose targets were used in 73% of sessions, they were often initiated too late, highlighting the need for individualized education to enhance safety. – Diabetes, Obesity and Metabolism

Parental perceptions of school-based diabetes management — A qualitative study of parents of children with T1D found that while they experienced a range of emotions including frustration and disappointment, most felt their children were safe at school due to parent-instituted practices. Five key themes emerged: pre-school preparation, parents as educators, longing for normalcy, communication facilitating safety perceptions, and the role of policies and technology. – PubMed

Mobile app education shows limited impact on HbA1c — A meta-analysis of structured educational interventions delivered through mobile health apps found no significant difference in HbA1c levels at 3 months between intervention and control groups in adolescents with T1D. Results on self-efficacy were inconclusive, suggesting the need for better-designed studies with larger samples. – PubMed

Recent-onset T1D clinical research advances — Four promising clinical trials are targeting the 'honeymoon period' after T1D diagnosis: denosumab (used for osteoporosis), frexalimab (developed for multiple sclerosis), JAK inhibitors (abrocitinib and ritlecitinib), and difluoromethylornithine (DFMO). These trials aim to preserve beta cell function and slow disease progression in newly diagnosed patients. – Monica Harrington

UCSF conducting numerous T1D clinical trials — UCSF has 24 ongoing clinical trials for Type 1 Diabetes, with 10 currently open for eligible participants. Studies include evaluation of novel therapies like VX-880 infusion and frexalimab, technology-focused assessments of insulin pumps and CGMs, and specialized interventions for Latinx youth and pregnant individuals with T1D. – UCSF

Breakthrough T1D clinical trials seeking participants — Current trials include a 26-week study comparing once-weekly insulin icodec with daily insulin glargine, a year-long evaluation of a fully implanted CGM system, an app-based study to improve carbohydrate counting, and a trial testing a new treatment to preserve insulin production in newly diagnosed adults. – Breakthrough T1D

Pediatric T1D management challenges in Southern Spain — Analysis of 2,215 pediatric T1D patients using the Andiacare digital platform revealed only 25.8% achieved recommended Time in Range and just 9.5% met all glucometric targets. Age significantly influenced adherence and goal achievement, highlighting the potential of digital platforms to improve management of large pediatric cohorts. – PubMed

That's all for this week! Remember, technology continues to advance rapidly in the T1D space, offering new hope and improved management options. Stay tuned for more updates in our next issue.

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