#32 - 🧬 Stem cell trial results are in

Hey readers! 👋 This week brings some genuinely exciting news from the research and tech worlds, including stem cell trial results that have the diabetes community buzzing, plus a major algorithm update coming to Omnipod users. Let's dive into what matters most for your daily management and the bigger picture of T1D care.

Stem Cell-Derived Islets Show Promise in Phase 1-2 Trial — A small but significant study published in the New England Journal of Medicine tested zimislecel, an allogeneic stem cell-derived islet therapy, in 14 adults with T1D. All participants achieved detectable C-peptide, indicating the transplanted cells were functioning. Among the 12 who received a full dose, 83% achieved insulin independence at one year, with none experiencing severe hypoglycemia and all maintaining HbA1c below 7%. The therapy was generally well tolerated, though neutropenia was the most common serious adverse event. These are early-stage results requiring immunosuppression, but they represent meaningful progress in understanding how stem cell approaches might work. – New England Journal of Medicine

November Research Roundup from Diabetes UK — Three notable advances emerged last month. First, researchers found that young children's beta cell clusters are destroyed before they can fully mature, explaining why T1D onset is often more aggressive in early childhood. Second, a mouse study combined donor islet cells with blood stem cells to create a hybrid immune system that prevented T1D without long-term immunosuppressants. Third, a drug called 2-HDP showed promise in protecting retinal cells from diabetic retinopathy damage in early testing. – Diabetes UK

Gut Microbiome Differences in T1D — A study analyzing gut bacteria and metabolites found that people with T1D have distinctly different microbiome compositions compared to healthy controls, with reduced diversity and shifts in specific bacterial species. The research identified connections between depleted beneficial bacteria and anti-inflammatory metabolites, suggesting the gut-immune relationship may play a role in autoimmune diabetes. – Yuan et al.

Omnipod 5 Gets FDA Clearance for Algorithm Enhancements — Insulet received FDA clearance for what they're calling the most significant update since the system launched in 2022. The changes include a new 100 mg/dL target glucose option (previously the lowest was 110), with six customizable settings in 10 mg/dL increments. Real-world data shows the lower target improves time in range by roughly 12% without increasing lows. The algorithm also reduces interruptions in Automated Mode, meaning fewer exits during prolonged high glucose events. Expect the update to roll out in the first half of 2026. – Beyond Type 1

MIT Develops Non-Invasive Glucose Monitor — Researchers at MIT created a device using Raman spectroscopy that shines near-infrared light on the skin to measure glucose without needles. In preliminary testing on a healthy volunteer, readings matched commercial CGMs over a four-hour period. The team has shrunk the prototype from desktop-printer size to cellphone dimensions and plans a small clinical trial with people who have diabetes next year. – Drug Delivery Business

Dermal CGM Shows Faster Response Time — A clinical study of 55 T1D patients compared a novel dermal CGM called Laxmi with standard subcutaneous sensors. The dermal sensor achieved a time lag of just 0-2 minutes for 93% of readings, compared to the -10 to +10 minute variation seen in current commercial devices. Faster sensing could enable tighter glucose targets with less hypoglycemia risk. – PubMed

Real-World Exercise Data Reveals Hypoglycemia Patterns — The Type 1 Diabetes Exercise Initiative analyzed over 8,000 physical activity sessions across 45 activity types. Key findings: hypoglycemia risk increases with longer exercise duration, lower starting glucose, and higher insulin on board. Aerobic activities caused the greatest glucose drops, while closed-loop systems showed lower hypoglycemia risk compared to open-loop. Interestingly, carb intake before exercise was associated with larger glucose drops, but this was explained by the higher insulin levels and lower starting glucose in those situations. – Type 1 Diabetes Exercise Initiative

Post-Camp Glucose Control Dips in Youth — A study of 93 youth who attended diabetes camp in Greece found that while time in range improved during camp, it deteriorated the week after returning home. Kids using the MiniMed 780G maintained better post-camp control than those on the 640G. The findings suggest families might benefit from extra support during the transition back to regular routines. – PubMed

Fitness Differences in Long-Term T1D — Adults with long-term T1D showed significantly lower cardiorespiratory fitness compared to matched controls, with reduced carbohydrate oxidation during exercise. The study suggests metabolic inflexibility may contribute to earlier fatigue during intense activity, with different factors affecting men and women. – Journal of Diabetes

Sleep Quality Varies Among T1D Adolescents — A study of 269 adolescents identified three distinct sleep profiles: good sleep (67%), poor sleep efficiency (13%), and daytime dysfunction (19%). Poor sleep efficiency was linked to higher HbA1c, while diabetes-related stigma and lower help-seeking behaviors were associated with worse sleep patterns. – International Pediatric Research Foundation

Stigma's Impact on Adolescent Self-Management — A critical review found that T1D adolescents experience multiple forms of stigma that undermine self-management and lead to non-disclosure of their diagnosis. The authors emphasize the importance of support systems and coping strategies. – PubMed

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