#34 - 🦠 Your gut bacteria & glucose control

Hey readers! 👋

Welcome to another week of T1D updates! This week we're diving into some fascinating research on how your gut bacteria might be influencing your glucose control (spoiler: eating Mediterranean could be doing more than you think), plus there's exciting news on the automated insulin delivery front. We've also got a heartwarming podcast story, some practical findings about CGMs at 30,000 feet, and research that might make you feel a little less guilty about occasionally prioritizing life over perfect diabetes management. Let's get into it!

Gut microbiome profiles and associated functional pathways are linked to Mediterranean diet adherence and blood glucose control in adults with type 1 diabetes mellitus examines 253 adults with T1D and finds that those following a Mediterranean diet had lower HbA1c levels (7.1% vs 7.7%) and better time in range. The study identified specific gut bacteria, including Faecalibacterium prausnitzii, that were more abundant in high-adherence participants. Machine-learning models could even predict dietary patterns from microbiome data alone. – Elsevier B.V.

Automated basal insulin delivery versus multiple daily injections in type 1 diabetes presents results from a multicenter trial comparing MiniMed 670G/770G systems to MDI therapy. Participants with higher baseline HbA1c saw a 0.7% reduction with AID, while those already well-controlled experienced significantly less time below 70 mg/dL. Safety outcomes were reassuring across both pediatric and adult populations. – Medtronic Diabetes

Baseline Serum Metabolites as Predictors of Teplizumab Response identifies 15 metabolites that can predict who will respond to teplizumab immunotherapy with impressive accuracy (AUC of 0.88). Responders showed higher levels of mitochondrial-related metabolites, while non-responders had elevated glutamate. This could help personalize treatment decisions for those at risk of T1D. – NIH

Carbohydrate Counting as a Precision Method for Glycemic Control in Youth confirms what many already suspected: carb counting works. This meta-analysis of 599 young people found an average HbA1c reduction of 0.94%, with the greatest benefits seen in experienced counters using automated bolus calculators. – International Journal of Pediatrics

Simplera Sync sensor now FDA approved for use with MiniMed 780G gives MiniMed users another CGM option. The calibration-free sensor provides readings every five minutes and integrates with SmartGuard technology for continuous glucose prediction and correction. – Beyond Type 1

Performance of continuous glucose monitoring systems during commercial flights tested four CGMs simultaneously on 20 adults during mid-haul flights. Good news for travelers: Dexcom G7 and Libre 3 maintained excellent accuracy (MARD around 9.5%) regardless of flight phase or meal timing. Simplera and iCan i3 showed more variability. – Diabetes, Obesity and Metabolism

Real-world glycemic outcomes of Omnipod 5 shows the tubeless AID system increased time in range from 57.3% to 67.3% over just 14 days in Italian adults, with no increase in insulin doses required. – Angelino et al.

The twiist AID System FAQ details Sequel Med Tech's new pump featuring Tidepool's Loop algorithm, the widest correction range available (87-180 mg/dL), and iiSure technology that detects occlusions up to nine times faster than competitors. Available through pharmacies with no contract required. – Sequel Med Tech

Diabetes Self-Care in Daily Life: Goal Conflict Management in Emerging Adults validates what many young adults experience daily: the constant tension between diabetes management and living life. Participants reported that social activities created the most conflict, and when merging goals wasn't possible, many prioritized non-diabetes goals unless serious health risks were present. The resulting guilt and sadness highlight the emotional burden that often goes unacknowledged. – Dutch type 1 diabetes care and research center

#1726 Cinderella Story - Part 1 features Olivia, diagnosed at 16 months old, sharing how managing T1D became an unexpected source of stability during a chaotic childhood marked by divorce and split custody. A powerful reminder that our relationship with diabetes is deeply personal. – Scott Benner

Experiences of Family Members Supporting Adults With Type 1 Diabetes explores how family support evolves over time, from actively seeking knowledge to balancing involvement with the adult's independence. – PubMed

Pathogenesis and advances in immunotherapy for type 1 diabetes treatment reviews current immunotherapy strategies including teplizumab, rituximab, peptide vaccines, and cell-based approaches. While teplizumab marks a milestone as the first FDA-approved agent to delay disease onset, challenges around durability, cost, and safety remain. – PubMed

Oral Akkermansia muciniphila may ameliorate immune dysregulation shows this probiotic improved intestinal barrier function and immune regulation in diabetic mice, though it didn't change blood glucose directly. The findings suggest potential for immune-focused interventions. – Baishideng Publishing Group Inc

That's all for this week! As always, discuss any changes to your care with your healthcare team.

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