A Conference of Technology and Research

The CWD Team had the opportunity to attend the Advanced in Technologies and Treatments in Diabetes (ATTD) conference again this year, and it did not disappoint. Here are some of the important updates for the T1D community, many of which were presented in the ATTD Yearbook session.

Automated Insulin Delivery (AID) System Improvements

AID systems were front and center for discussion at ATTD. There were a few areas of focus this year:

• Infusion set research and development – detection of infusion set failure, detecting ketones, and reducing inflammation at the infusion set are all on the horizon.
• Algorithm improvements – using machine learning and artificial intelligence to improve the systems is being studied in various ways.
• Expanded use in other populations and settings—AID systems are beneficial in hospitals, during pregnancy, and for people with type 2 diabetes.
• Patient-reported outcomes (PROs) related to AID: All systems improve quality of life and reduce diabetes distress, which arguably are equally important as time in range.
• Exercise Trackers & AID – Dessi Zaharieva presented data at the ATTD Yearbook about using fitness trackers with AID systems to help increase time in range and specifically reduce time below range during physical activity. This could be a real game changer given that the largest barrier to physical activity for PWD remains fear of hypoglycemia.
• Industry updates for AID –
  1. Tandem reported positive results from a study in using their t:slim X2 and Mobi pumps in people with type 2 diabetes.
  2. Insulet showed data from a randomized controlled trial (RCT) that changing from multiple daily injections to the Omnipod 5 system was very beneficial.
  3. Sequel announced that their twiist system will be integrated with the Abbott Libre CGM.
  4. Ypsomed and CampDiab launched an iOS app for the Loop AID system.

Some of these will be available for use soon, while others need to be studied longer. For example, the newer insulin pump company Sequel is anxiously awaiting the launch of its insulin pump, which touts a novel infusion set failure detection. Additionally, many women with pre-existing diabetes who go through pregnancy can use AID systems. However, the use of AID systems in the hospital setting is still being studied.

Continuous Glucose Monitoring (CGM) Updates

Although CGM for people with T1D is recommended and widely utilized, other uses for CGM were a topic throughout the conference. Here are some highlights –

• Chantal Mathieu, winner of the CWD President’s Award for 2025, presented on use of CGM in early detection and management of type 1 diabetes. Her research has identified trends in CGM values that help identify progression from stage 2 to stage 3 diabetes.
• The use of CGM for at-home oral glucose tolerance testing (OGTT) for people with diabetes and for women who are pregnant and need to be screened for gestational diabetes was discussed.
• Researchers from the UK presented data on utilizing CGM vs. HbA1c to identify cognitive impairment risks, including dementia risk.
• Dexcom presented data on the use of G7 for 15 days vs. 10, and the data was very positive – showing a mean absolute relative difference (MARD) of 8%. The G7 is also connecting with Novo Nordisk smart pens in Germany, which may help the population who does not want to or cannot wear insulin pumps.
• Medtronic presented data on using their Simplera CGM (approved in Europe and awaiting FDA approval) with the smart pen system, InPen, that showed an increase of Time in Range (TIR).

Another area of focus discussed was CGM use by people with diabetes who are hospitalized, which continues to be studied and more often utilized. All of these uses for CGM will require further study and consensus recommendations to ensure safe and effective uptake.

Obesity and T1D

An ever-growing area of interest is the rise of obesity in people with type 1 diabetes. It is challenging to address due to several issues, and multiple sessions were presented on the topic.

• Causes of weight gain in T1D – avoiding physical activity due to fear of hypoglycemia, overtreating lows due to fear of hypoglycemia, taking insulin in general, disordered eating behaviors, and other hormonal disruptions that affect weight gain and satiety.
• Risks of obesity combined with T1D – difficulty getting glucose levels in range or to target, increased cardiovascular risk (high blood pressure, high cholesterol, etc.), and higher risk for kidney disease and retinopathy. Basically, it exacerbates many of the existing risks with T1D.
• Treating obesity in T1D – significant focus on using GLP-1 agonists in T1D, which is still “off-label.” GLP1s have shown a significant reduction in HbA1c, weight, LDL cholesterol, triglycerides, and blood pressure. Insurance coverage continues to be a barrier for many, and a reduction in insulin doses is needed at the start and throughout the use of the medications.

Hopefully, with continued discussions and studies showing benefits for PWD of all types, this class of medications will soon be approved for use in T1D.

Other Presentations

There were also poster presentations and sessions with updates on prevention, immunology, disparities in care, behavioral health, and many more topics. Of note, Dr. Ananta Addala gave an oral presentation about the lack of diversity in clinical trials for type 1 diabetes. She discussed the challenge of determining treatments that work well for all populations if most of the participants in clinical trials are from the same group—typically privately insured, middle-class, non-Hispanic Caucasians.

Dr. Melissa-Rosina Pasqua also presented an oral poster on the quality of life and qualitative data of people using AID systems and GLP-1 agonists. Given the widespread uptake of the medications, this is a growing area of research that still needs significant attention. Their group also studied the bowel symptoms and found that most people using Semaglutide (the drug in the study) had an increase in the frequency and severity of GI symptoms. However, this did not correlate with decreased quality of life or diabetes treatment satisfaction and did not increase diabetes distress. Suggesting that for many, the benefits outweigh the challenges of GLP1s.

There is always so much to learn at diabetes conferences. This year, the CWD team learned a lot, shared the mission and happenings of CWD with others, and had a wonderful time.

Written and clinically reviewed by Marissa Town, RN, BSN, CDCES