It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: Tandem announces it’s taking orders and starting to ship the Mobi pump, Insulet gets European approval for the Abbott Libre integration with Omnipod 5, new study looks at type 2 remission and gastric bypass surgery, one type of medication seems to do a much better job preventing kidney stones in people with type 2, big new grant to look at exercise and type 1 and a look back at diabetes at the Super Bowl.

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Episode transcript:

Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now.
In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark
Our top story this week…
Tandem diabetes announces the US launch of the Tandem Mobi, the small durable pump – this means they’re taking orders and shipping them out. The Mobi uses The Control-IQ advanced hybrid closed-loop automated insulin delivery feature, cleared for use by people with type 1 diabetes age 6 and up
Infusion Set Options – Compatible with all existing Tandem-branded infusion sets manufactured by Convatec, including a new 5-inch tubing option made just for Tandem Mobi. Infusion sets allow users to temporarily disconnect from their pump for convenience and provide the flexibility of more than 30 mix-and-match infusion site and tubing length combinations.

Tandem Mobi Mobile App – Full iOS mobile control through a user’s compatible iPhone5

Sensor Compatibility – Compatible with the Dexcom G6 Continuous Glucose Monitoring (CGM) System. Additional CGM sensor integrations are planned, including Dexcom G7 in the second quarter of 2024, followed by integration with the Abbott FreeStyle Libre 3 sensor.

Insulet received European approval for integration of the Abbott (NYSE:ABT) FreeStyle Libre 2 Plus with Omnipod 5. Currently, Omnipod 5 works with Dexcom 6 CGM and is working on G7 integration.
Insulet expects availability for the system with Abbott’s CGM to come first in the UK and the Netherlands through a phased launch in the first half of 2024. It then projects other markets in Europe to follow. Dexcom’s technology remains the only approved CGM for use with Insulet pumps in the U.S.

Insulet integrates Abbott FreeStyle Libre 2 Plus, Omnipod 5 in Europe

Despite diabetes technology, many with type 1 diabetes (T1D) miss glycemic targets and experience severe hypoglycemia and impaired awareness of hypoglycemia (IAH).

The clinical management of T1D through technology is now recognized as the standard of care, but its real-world impact on glycemic targets and severe hypoglycemic events and IAH is unclear.
Researchers assessed the self-reported prevalence of glycemic metrics, severe hypoglycemia, and hypoglycemia awareness according to the use of continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems.
They enrolled 2044 individuals diagnosed with T1D for at least 2 years (mean age, 43.0 years; 72.1% women; 95.4% White) from the T1D Exchange Registry and online communities who filled an online survey.
Most participants (91.7%) used CGM, and 50.8% of CGM users used an AID system.
Despite advanced interventions, only 59.6% (95% CI, 57.3%-61.8%) of CGM users met the glycemic target (A1c < 7%), while nearly 40% of CGM users and 35.6% of AID users didn’t reach the target.
At least one event of severe hypoglycemia in the previous 12 months was reported in 10.8% of CGM users and 16.6% of those using an AID system.
IAH prevalence was seen in 31.1% (95% CI, 29.0%-33.2%) and 30.3% (95% CI, 17.5%-33.3%) of participants using CGM and CGM + AID, respectively.
“Educational initiatives continue to be important for all individuals with type 1 diabetes, and the development of novel therapeutic options and strategies, including bihormonal AID systems and 𝛽-cell replacement, will be required to enable more of these individuals to meet treatment goals,” the authors wrote.

In late January 2024, the medical journal JAMA Internal Medicine published a new study showing that SGLT2 inhibitors could reduce the risk of kidney stone formation in people with type 2 diabetes. The work was a collaboration between Massachusetts area experts in diabetes and nephrology, led by Julie Paik, MD, ScD, MPH. The study examined the insurance records of over one million American adults with type 2 diabetes. They found that those who had begun using an SGLT2 inhibitor were about 30 percent less likely to experience a kidney stone than those who used alternative glucose-lowering medications. The positive effect took hold very quickly — most patients only participated in the study for about six months.

It’s also worth noting that SLGT2 inhibitors outperformed the blockbuster GLP-1 receptor agonist class, which includes the world’s most hyped drug, semaglutide (Ozempic). Although early evidence suggests that semaglutide can also protect kidney health, the JAMA study shows that it is not nearly as effective at preventing kidney stones. GLP-1 users were about 40 percent more likely to receive treatment for a kidney stone.
Sodium-glucose co-transporter 2 (SGLT2) inhibitors are pills that help lower blood glucose levels by stopping the kidneys from reabsorbing the sugar in your bloodstream. Extra sugar leaves the body through the urine. They are approved for use in type 2 diabetes, and are also frequently prescribed off-label for people with type 1 diabetes.

There are four SGLT2 inhibitors available today in the United States:

Canagliflozin (Invokana)
Dapagliflozin (Farxiga)
Empagliflozin (Jardiance)
Ertugliflozin (Steglatro)

Diabetes and Kidney Stones? This Drug Could Help

New research shows that gastric bypass surgery in people with type 2 diabetes results in lasting remission of the disease, even after regaining their weight. The study, from the Mayo Clinic and published in the Journal of the American College of Surgeons, shows that gastric bypass patients were more likely to remain in remission five years later even after weight is regained, compared with those who had undergone sleeve gastrectomy, who were five times more likely to see their diabetes return.
Gastric bypass surgery bypasses a part of the small intestine called the duodenum, while sleeve gastrectomy, which is minimally invasive and a more popular surgery, works by making the stomach smaller thereby restricting the amount of food a person can consume.

Ghanem noted that the duodenum helps regulate what is referred to as the “gut metabolic pathway” and that bypassing it contributes to many physiologic actions or changes in metabolism including the regulation of glycemia.
Among the entire group, 75% of gastric bypass patients had their diabetes remain in remission compared with 34.8% of those who received a sleeve gastrectomy. After adjusting for patient weight-related factors the sleeve gastrectomy group was 5.5 times more likely to have their diabetes return compared with those who underwent gastric bypass surgery.

Gastric Bypass Surgery Results in Lasting Type 2 Diabetes Remission Even after Weight Is Regained

As Americans age, a skyrocketing number is anticipated to be diagnosed with diabetes in the next few decades.

McKinsey analysts predicted that age-related diseases like diabetes or kidney diseases could soar by 60 percent by 2040 globally. At that time, one in six people worldwide will be over 60.
Jones said this will create a greater need for medical interventions, medications and long-term care, meaning the average American could see far higher health care costs,” Jones said. “Health care resources may need to be reallocated to address the growing burden of chronic diseases. This could affect the availability of health care services for other medical conditions.”
Can type 2 diabetes lead to more back problems? New study show type 2 can alters the behavior of disks in the vertebral column, making them stiffer, and also causes the disks to change shape earlier than normal. As a result, the disk’s ability to withstand pressure is compromised. Warning.. this was a study in rats –
“These findings provide novel insight into the potential mechanisms underlying diabetes-related disk tissue damage and may inform the development of preventative and therapeutic strategies for this debilitating condition,” the researchers write.
Big new grant to help support research aimed at helping people with type 1 more safetly incorporate exercise into their lives. The Helmsley Charitable Trust announced more than $12 million, to building onto the T1D Exercise Initiative (T1-DEXI). It is the largest observational exercise study in people with T1D.
The seven funded projects are:
DiabetesWise for exercise
A team led by Dessi Zaharieva, PhD and Korey Hood, PhD, at Stanford University will work to include education around exercise as an integral part of T1D management into the DiabetesWise platform for people with T1D. DiabetesWise provides unbranded and unbiased information for diabetes technologies, and the expansion to include exercise information will allow people with T1D to have easy access to evidence based information helping them improve their quality of life with exercise.
Educational intervention to support Diabetes Guidance for Exercise (EDGE)
Robin L. Gal, MSPH, CCRA at the Jaeb Center for Health Research in collaboration with Michael C. Riddell, PhD at York University and Michael Rickels, MD, MS, and Jorge Kamimoto, MD at the Perelman School of Medicine at the University of Pennsylvania will lead a remote study, that will seek to understand if easily accessible, evidence-based education can improve glycemic control for adults with T1D who exercise. Jaeb will develop the modular, multimedia, on-demand education and conduct a clinical study to evaluate its impact. Data from this study will help identify areas of improvement for current T1D exercise guidelines.
Exercise-specific AID algorithm for T1D
Yao Qin, PhD, at the University of California, Santa Barbara will lead a team including collaborators from Stanford University, Tidepool, and University of Trento to conduct a clinical trial to help people with T1D maintain their time in range during and after exercise with Automated Insulin Delivery (AID). Current systems are not designed to manage exercise well, and algorithms need to be adjusted to handle glucose variability that can occur with exercise. This project will design and evaluate an exercise-specific AID algorithm. If successful, it could enhance the FDA-cleared Tidepool Loop algorithm, making it more effective in handling exercise.
Development of a personalized decision support tool using net insulin on board
Rayhan A. Lal, MD. at Stanford University will lead a team including collaborators from CeADAR’s team AI/Machine Learning researchers at University College Dublin under the leadership of Arsalan Shahid, PhD, MBA, and OpenAPS developer Dana Lewis to explore the incorporation of the net insulin-on-board concept and its relationship to exercise management for T1D. The project will also develop a prototype decision support tool to inform pre-exercise decision-making for people with T1D. The prototype will include net insulin on board education and simulations to understand the impact of different types of exercise on glucose outcomes in combination with user behaviors.
Leveraging new ultra-rapid insulins with AID
Robin L. Gal, MSPH, CCRA, at the Jaeb Center for Health Research in collaboration with Dr. Riddell, York University and Dr. Rickels, University of Pennsylvania will lead an in-clinic pilot study that will examine the safety and efficacy of new, ultra-rapid insulins (Affrezza and Lyumjev) for better management of exercise induced glucose levels in adults using AID.
Whey protein to reduce risk of hypoglycemia during exercise with T1D
Dale Morrison, PhD will lead a study at the University of Melbourne to test whether the use of whey protein, as an alternative to carbohydrate ingestion, during or after exercise will reduce the risk of hypoglycemia for people with T1D. The study will provide practical advice and a potentially cost-effective solution for people with T1D engaging in exercise.
Impact of Menstruation on glycemic response and exercise
A team led by Janet Snell-Bergeon, MPH, PhD, at the University of Colorado, Denver will study the impact of menstrual cycles and hormonal birth control on glycemic response and exercise for people with T1D. Additionally, the study will help understand how people can personalize insulin dosing to optimize glucose management during menstrual cycles.
There is growing evidence that ongoing inflammation in the mouth, such as that seen in gum disease, in addition to causing bad breath is associated with serious diseases such as Alzheimer’s disease or type 2 diabetes. Now, researchers report that when people with type 2 diabetes gargled with an antiseptic mouthwash, the numbers of periodontitis-related bacteria decreased. In addition, some patients with reduced bacteria also achieved much better control of their blood sugar, hinting at promising future clinical applications.
Given that poor oral health is linked to serious disease, simple methods to improve oral hygiene have important ramifications. If researchers can identify patients who are likely to respond well to antiseptic mouthwash, this easy-to-use treatment may improve the lives of people with periodontitis-linked diseases such as diabetes, dementia, cardiovascular disease, and respiratory tract infections.
JDRF, the leading global type 1 diabetes (T1D) research and advocacy organization, is recognizing Grammy award-winning megastar Usher and NFL Super Bowl Champion Noah Gray of the Kansas City Chiefs for shining a spotlight on T1D during Super Bowl LVIII.

Usher’s now teenage son was diagnosed with T1D at just six years old. As Usher prepared for his highly anticipated Super Bowl Halftime Show and the release of his forthcoming album, he also prioritized raising awareness for T1D and the importance of screening. The music star spoke about his journey as the parent of a child with T1D and the need for greater knowledge and understanding about the disease in numerous media interviews in the run up to Super Bowl LVIII.

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