Hey readers! 👋
This week's news has me genuinely excited about where T1D technology is heading. We've got an implantable pump getting FDA attention, a year-long CGM proving its staying power, and some fascinating research on how our immune systems shape the disease. Plus, there's an important study reminding us that the mental health side of diabetes management deserves just as much attention as the tech. Let's dive in!
🔬 Research & Science Updates
Advances in stem cell-derived beta-cell therapy: A new frontier in type 1 diabetes treatment offers a comprehensive look at where cell replacement therapy stands today. The review highlights recent progress in improving cell maturity, graft survival, and immune protection, while acknowledging the hurdles that remain, including immune rejection and cell dedifferentiation. Future directions include genome editing, personalized therapy, and AI-driven monitoring. – Dr Krishnaa S. Upadhye
Identification of a type 1 diabetes-associated T cell receptor repertoire signature from the human peripheral blood reveals that high-risk HLA alleles restrict the T cell repertoire more strongly in people with T1D. Using deep learning, researchers identified specific TCR motifs enriched in T1D patients that correlate with genetic risk variants. This could eventually lead to TCR-based diagnostics and targeted therapies. – Nature Medicine
Israeli researchers make pioneering breakthrough in diabetes treatment describes a cell-based implant developed at Technion that functions as an autonomous artificial pancreas. The key innovation is a crystalline shield that protects implanted cells from immune attack without requiring immunosuppressants. Animal trials have been successful, and human clinical trials are planned. – The Jewish Chronicle
"This is essentially a factory for manufacturing drugs inside the body. The implant knows when insulin is needed and releases the exact amount at the right time." — Dr. Shadi Farah
⚙️ Technology & Devices
Portal earns FDA breakthrough nod for implantable insulin pump is the big news this week. Portal Diabetes secured FDA breakthrough device designation for its implantable closed-loop system that uses temperature-stable insulin and CGM integration. A Phase 1 study is planned for late 2027. If successful, this would be the first implantable closed-loop pump in the U.S. – Drug Delivery Business
"No more meal announcements, no more exercise announcements, no more night wakings; that is our goal."
The implantable artificial pancreas being developed provides personal context from current users of similar devices. They report feeling more normal and well, attributing this to insulin delivery directly to the liver, which restores a sense of bodily equilibrium that conventional therapy cannot achieve. – @diabetesmyths
Evaluation of Accuracy and Safety of the 365-Day Implantable Eversense Continuous Glucose Monitoring System confirms the year-long CGM performed well in the ENHANCE study. With a mean absolute relative difference of 8.8% and only weekly calibration required, 90% of sensors lasted the full year with no serious device-related adverse events. Alert detection rates exceeded 96% for both lows and highs. – Eversense
Eversense 365: CGM with Insulin Pump Integration announces expanded compatibility with the twiist automated insulin delivery system, making it the only year-long CGM cleared for AID use. Data sharing with Apple Health, Glooko, Tidepool, and other platforms is also supported. – Eversense
New tech for managing type 1 diabetes is effective for older adults shares results from the largest clinical trial evaluating AID systems in adults 65 and older. The hybrid closed-loop system achieved 74% time in range and significantly reduced hypoglycemia. Older adults, including those with mild cognitive impairment, found the devices easy to use, though onboarding required additional support. – Dexcom and Tandem Diabetes Care
"There's a stereotype that technology is harder for older adults, but they did quite well."
🧪 Clinical Trials & Studies
Join Trial Testing Automated Insulin Delivery for Cystic Fibrosis-Related Diabetes is recruiting 150 teens and adults with CFRD to evaluate the iLet Bionic Pancreas. Participants will alternate between their usual regimen with a new CGM and the iLet system over 26 weeks. If AID proves effective for this population, it could significantly ease the management burden for people already facing complex health challenges. – Diatribe
New UVA Clinical Trial Explores AI-Powered Insulin Delivery for Better Diabetes Care describes a three-week trial testing the Bolus Priming System with Reinforcement Learning. This AI-driven feature aims to automate insulin dosing without user input, potentially improving control during meals and overnight while reducing the mental burden of management. – School of Data Science
💭 Mental Health & Wellbeing
Incidence, prevalence and mortality of anorexia nervosa in individuals with childhood-onset type 1 diabetes is an important Swedish study finding that females with childhood-onset T1D have significantly higher rates of anorexia nervosa compared to controls. Most concerning, co-occurrence of T1D and AN was associated with a markedly elevated mortality risk. The findings underscore the need for routine eating disorder screening in adolescent and young adult females with T1D. – BMJ Group
Caregiver perspectives on medical trauma in adolescent type 1 diabetes explores how diagnosis and ongoing management act as sources of medical trauma for both teens and their caregivers. Unresolved trauma often resurfaces during the transition of care responsibilities, leading to caregiver hypervigilance and adolescent disengagement. The authors advocate for trauma-sensitive care practices. – Elsevier Inc
"I don't think either of us have really got over the diagnosis."
📱 Quick Hits
Now We Know What a Type 1 Cure Could Look Like argues that recent clinical data from Vertex, Sana, and ProTrans have shifted cure research from theory to a concrete, multi-step blueprint. – Diabettech
The Daily Bolus: Retinopathy Pills, Diabetes Risk Watches, and Immune Fixes covers three emerging innovations: an oral drug for diabetic retinopathy, Huawei's diabetes risk smartwatch app, and immune-based approaches to insulin resistance. – Diabettech
Understanding Time in Range and Diabetes explains TIR and the emerging Time in Tight Range metric, defined as 70-140 mg/dL. – diaTribe
Diabetes Devices & Technology from the ADA provides a helpful overview of smart pens, CGMs, and pumps for those exploring their options. – American Diabetes Association
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