#33 - 🐷 Pig cells, year-long CGMs & more

Hey readers! 👋 As we wrap up 2025, the T1D research world is buzzing with some fascinating developments, from year-long implantable sensors to pig cell transplants (yes, really). Let's dive into what caught our attention this week.

Top T1D Exchange Research Highlights of 2025 — The T1D Exchange released their annual research roundup, and the message is clear: start technology early. Data shows that children who begin CGM and automated insulin delivery within six months of diagnosis have better long-term outcomes, including lower A1C and fewer severe hypoglycemia events. But here's the sobering part: 54% of surveyed adults reported financial stress from diabetes costs, which correlates directly with higher A1C and increased complications. Technology adoption also drops significantly in young adults and those with chronic kidney disease, highlighting where we need to focus support. – T1D Exchange

Evaluation of Accuracy and Safety of the 365-Day Implantable Eversense Continuous Glucose Monitoring System — The ENHANCE study delivered impressive results for the year-long Eversense implantable CGM. Across 110 adults, the system achieved 8.8% MARD with only weekly calibration, and 90% of sensors were still working after a full year. Alert detection hit 96.6% at 70 mg/dL and 97.9% at 180 mg/dL, with zero serious device-related adverse events. For those tired of frequent sensor changes, this is worth watching. – PubMed

GlucoModicum unveils Sofio needle-free CGM — After 30 years of failed attempts by various companies, GlucoModicum claims to have cracked needle-free glucose monitoring. Their Sofio device uses magneto-hydrodynamics to draw interstitial fluid through the skin without needles. Clinical data shows 11.5% MARD, approaching the 10% benchmark of traditional CGMs. It's designed for single-day monitoring, targeting type 2 patients who don't need 24/7 wear, but the technology could eventually expand. – Drug Delivery Business

Porcine Cell Recipient Interview — Kelly, who has lived with T1D for 38 years, is the second person in the U.S. to receive a porcine islet cell transplant. The procedure places encapsulated pig islet cells into the omentum without requiring immunosuppressants. A month post-surgery, she hasn't seen changes yet but expects results within six weeks. Her candid discussion about diabetes burnout and hope for cell-based therapies is worth a listen. – Juicebox Podcast

Pilot Study: Stem Cell-Derived Islets in Non-Human Primates — Researchers tested human stem cell-derived islets microencapsulated with alginate and CXCL12 in primates without immunosuppression. In the diabetic primate, C-peptide remained detectable for 13 weeks and insulin requirements dropped significantly. Retrieved cells were still glucose-responsive after six months, though viability had declined. This approach could eventually eliminate the need for lifelong immunosuppression in islet transplants. – Wiley Periodicals

Immune Education Through Controlled Islet Rejection — A pilot study gave six recent-onset T1D patients a deliberately small dose of donor islets with short-term immunomodulation. At 12 months, all participants maintained 91-100% of baseline C-peptide and achieved partial remission. At five years, some patients still retained partial beta-cell function. The approach essentially uses controlled rejection to "educate" the immune system. – Lorenzo Piemonti

DBLG1 Algorithm Updates Improve Time in Range — Post-market data from 937 patients showed that upgrading the DBLG1 hybrid closed-loop system from version 1.12 to 1.16 increased time in range from 65.3% to 71.3%. A further update to version 1.17 pushed it to 70.8% with no increase in hypoglycemia. Software matters. – PubMed

Machine Learning Predicts Hypoglycemia with 80% Sensitivity — A meta-analysis of 20 studies found that ML algorithms using CGM data can predict hypoglycemia with 80% sensitivity and 89% specificity. Adding contextual data like insulin doses, carbs, and activity improves accuracy further. False positives remain a concern, but this technology is maturing. – Tehran University of Medical Sciences

AID from Diagnosis Improves Outcomes in Kids — Children started on the MiniMed 780G at diagnosis achieved higher time in range after 12 months compared to those on sensor-augmented pumps with predictive low glucose suspend. C-peptide levels were similar between groups, suggesting AID doesn't compromise beta-cell preservation. – Journal of Diabetes Investigation

Financial Barriers to Physical Activity — A survey of 281 U.S. adults with T1D found that cost is a significant barrier to exercise, not just hypoglycemia fear. Middle-income participants were less likely to meet physical activity guidelines than higher-income individuals. Insurance reimbursement for exercise programs emerged as a key facilitator. – NIH

Diabetes Distress in Ethiopia — Nearly half (45.6%) of diabetes patients at a hospital in northwest Ethiopia reported moderate to high distress. T1D, rural residence, insulin-only treatment, and poor family support were all associated with higher distress. A reminder that psychosocial support needs to be part of diabetes care everywhere. – PubMed

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