[Diabetes-Talk] Our September 2026 Diabetes Action Network Newsletter

[Lino Morales]

Howdy Mr. Gary. I'm interested in the seminar in FEB of next year. Will 
more info be made available closer to time about payment? I'm not a 
member of NIB or CAB so will that be a problem? Thanks.

On 9/23/2026 1:25 PM, Gary Under via Diabetes-Talk wrote:
> Hello, good people. Our September newsletter is attached as a MS Word
> document and in the body of this email. It should be easily navigable by
> headings in the Word version, but, of course, we hope you find all of it
> worth a read.
>
>   
>
> We welcome your comments, your participation, and your wisdom.
>
>   
>
> Warmly,
>
>   
>
> Gary Wunder, Denise Charlier, and ISMAEL COLLAZO
>
>   
>
> Diabetes Action Network Newsletter
>
> September 2026
>
>   
>
> Looking Back and Moving Forward with DAN
>
> By Debbie Wunder
>
> Last July, sixty-three of us came together at the National Federation of the
> Blind Convention for the Diabetes Action Network meeting. We had the chance
> to learn, to listen, and to hear each other's experiences.
>
> One panel brought together three couples: Jean and Ron Brown, Dean and
> Denise Charlier, and Curtis and Peggy Chong. They spoke candidly about how
> they support one another through the diabetes journey, including the moments
> when that support can be difficult.
>
> We also heard from our youngest speaker ever, Khaleesi, just ten years old
> and living with type 1 diabetes. She talked about going to school, wearing
> an insulin pump, and how she handles diabetes as part of her daily life.
>
>  From Meghan Whalen we learned about the remarkable work of training dogs to
> serve not only as guides for people who are blind, but also as diabetic
> alert dogs. We heard about the training process and how these dogs can alert
> their handlers to high or low blood sugar.
>
>   
>
> We also welcomed three new board members: Joanne Wilson, Ismael "Izzy"
> Collazo, and Joy Ruth Stigile. We asked those gathered to share their hopes
> and dreams for the future of diabetes care and for DAN itself.
>
>   
>
> Looking ahead, there is more to be excited about. Our quarterly newsletter
> is growing, and we are inviting members to help name it. Send your
> submissions to debbiewunder at socket.net. The person who submits the winning
> name will receive a $50 Amazon gift card.
>
>   
>
> And on the last Friday and Saturday of February 2027, we will host our
> fourth annual Knowledge Is Sweet seminar. This will be a two-day virtual
> event with a $30 registration fee. More details will be coming soon.
>
>   
>
>  From a ten-year-old showing us how she navigates school, to couples sharing
> honest moments of support and struggle, to members sharing their hopes for
> the future, we were reminded just how much we can learn from one another.
>
>   
>
> That's what DAN is about: sharing, listening, supporting one another, and
> making sure no one walks this road alone.
>
>   
>
> We've done a lot, but there is much more ahead. We hope you'll be a part of
> it.
>
> By Any Other Name
>
> By Gary Wunder
>
> It is said that a rose is a rose by any other name, but this observation
> doesn't go any distance toward naming our newsletter. We wanted to have a
> name that reflects what we do, who we are, and what we aspire to see happen
> for people who are blind and deal with diabetes. To this end, we have
> created a contest to see that this gets done. Anyone wishing to name our
> newsletter should make their submission to our president through email by
> writing to
>
> debbiewunder at socket.net. The reward will be a $50 Amazon gift card, and we
> welcome your suggestions. Please put your mind to this, and let us come up
> with something that encompasses all that we are and all that we may be!
>
> The Great Halloween Sugar Showdown: Keeping Your Diabetes from Getting
> Spooked
>
> By Denise Charlier
>
>   
>
> October is coming, which means cooler temperatures, colorful leaves,
> football, pumpkin everything. and enough Halloween candy to make a
> diabetic's blood sugar meter scream, "BOO!"
>
> For those of us living with diabetes, Halloween can feel like a month-long
> obstacle course filled with miniature chocolate bars, caramel apples,
> cupcakes, cookies, donuts, and candy bowls that seem to magically appear
> everywhere. The good news? You do not have to hide in the closet until
> November 1 to survive it.
>
> You can enjoy Halloween, participate in parties, and have a little fun
> without completely derailing your diabetes management.
>
> The Candy Bowl Is Not Your Enemy-but It Is Persistent!
>
> Let's be honest. There is something about a miniature candy bar that makes
> it seem harmless. After all, it is tiny! Unfortunately, our blood sugar does
> not care about the size of the candy bar. A few small pieces here, a handful
> there, and suddenly those "just one more" treats can add up.
>
> The first step is not to declare candy forbidden. For many people, telling
> themselves they can never have something makes them want it even more.
> Instead, plan for treats. If you want a piece of your favorite Halloween
> candy, have one and enjoy it. Sit down, savor it, and move on. You do not
> have to eat six pieces while standing next to the candy bowl wondering where
> the other five went.
>
> Do Not Arrive at the Party Starving
>
> One of the best Halloween strategies is surprisingly simple: eat before you
> go. If you arrive at a Halloween party ravenously hungry, that bowl of candy
> corn suddenly looks like a perfectly reasonable dinner. Instead, have a
> balanced meal or snack beforehand that includes protein, fiber, and a
> reasonable amount of carbohydrate. This can help you feel satisfied and make
> it easier to make thoughtful choices when the treats appear.
>
> A small Greek yogurt, an apple with a little peanut butter, vegetables with
> hummus, or a small turkey sandwich can be much better than showing up hungry
> enough to consider eating the decorative pumpkin.
>
> Bring Something You Can Actually Eat
>
> If you are going to a Halloween party, offer to bring a dish. This gives you
> the opportunity to put something diabetes-friendly on the table. Consider
> bringing:
>
> 1.           A vegetable tray with a lighter dip
>
> 2.           Fresh fruit arranged in a fun Halloween design
>
> 3.           Cheese and whole-grain crackers
>
> 4.           Turkey or chicken skewers
>
> 5.           A big salad with vegetables and a lean protein
>
> 6.           Deviled eggs
>
> 7.           Roasted vegetables
>
> 8.           Greek yogurt dip with vegetables
>
> 9.           A lower-sugar fruit dessert
>
> 10.        Air-popped popcorn in individual portions
>
> And remember, "diabetes-friendly" does not have to mean "boring." You can
> make food festive without covering everything in frosting.
>
> Make Halloween Treats Work for You
>
> There are plenty of ways to enjoy Halloween flavors without turning your
> blood sugar into a haunted house. Try Greek yogurt with a few berries and a
> sprinkle of cinnamon. Have a small apple with peanut butter. Enjoy a small
> portion of dark chocolate if it fits into your meal plan. Make a pumpkin
> spice yogurt or oatmeal using unsweetened pumpkin puree and cinnamon.
>
> You can even create Halloween-themed snacks. Think:
>
> "Monster" veggie plates with cucumber, peppers, and carrots.
>
> "Ghosts" made from banana slices with small blueberry eyes.
>
> "Pumpkin patches" made with orange slices and berries.
>
> A little creativity can make healthier choices feel like part of the
> celebration rather than punishment.
>
> Remember That Drinks Count, Too
>
> Halloween parties can also bring plenty of sugary beverages. Punch, apple
> cider, specialty coffees, and regular soda can add a surprising amount of
> sugar and carbohydrate. Water, sparkling water, unsweetened tea, or a
> zero-sugar beverage can be easier choices. If you want a special drink, make
> it part of the plan rather than drinking several servings without thinking
> about it. And do not forget the simple trick of carrying a water bottle.
> Sometimes we are not hungry at all-we are simply thirsty, bored, or standing
> within three feet of a bowl of candy.
>
> Use the "Pick Your Favorite" Rule
>
> Halloween offers a ridiculous number of choices. Chocolate. Gummies.
> Caramels. Peanut butter cups. Cookies. Cupcakes. Candy corn.
>
> Instead of sampling everything, choose the treat you genuinely love. If you
> do not really care about candy corn, why waste your carbohydrate budget on
> something that tastes like a candle wearing an orange costume? Choose the
> treat that makes you happy. Have a reasonable portion. Enjoy it. Then move
> on.
>
> Portion Control Is Your Halloween Superpower
>
> You do not have to eat directly from the package. Put your chosen treat on a
> plate or in a small bowl. Seeing the portion can help you keep track of how
> much you are eating. And consider buying smaller quantities of candy rather
> than keeping a giant supply in the house for weeks. Because let's be honest:
> "I'm keeping this candy for the trick-or-treaters" sounds great until you
> realize the trick-or-treaters are three weeks away, and the Reese's cups are
> disappearing mysteriously.
>
> Get Moving!
>
> Halloween is also a great opportunity to add some activity. Take a walk and
> look at the decorations in your neighborhood. Walk with your family or
> friends. Visit a pumpkin patch. Dance at a Halloween party. Play games with
> the kids or grandkids.
>
> Physical activity can be an important part of diabetes management, and it
> does not have to mean spending an hour on a treadmill. Just remember that if
> you use insulin or medications that can cause low blood sugar, talk with
> your diabetes care team about how activity and changes in food intake may
> affect your blood sugar. Check your glucose as recommended by your
> healthcare team, and be prepared to treat a low if you are at risk.
>
> Do Not Let One Treat Become an Entire Weekend
>
> Perhaps the most important Halloween rule is this: One treat does not equal
> failure. If you eat a cupcake, candy bar, or piece of pie, you have not
> ruined everything. Do not fall into the "I already messed up, so I might as
> well keep eating" trap. Enjoy the treat, acknowledge it, and get back to
> your normal eating plan at the next meal.
>
> Diabetes management is not about being perfect. It is about making healthy
> choices most of the time and learning how to handle the occasions when
> things do not go exactly as planned.
>
> Halloween Can Still Be Fun
>
> Having diabetes does not mean you have to sit at home wearing a black cape
> and glaring suspiciously at everyone else's candy. You can dress up. You can
> attend parties. You can hand out candy. You can enjoy Halloween traditions
> with your family. You can have an occasional treat. The trick is to make
> treats a small part of the celebration instead of allowing them to become
> the entire celebration.
>
> Plan ahead. Eat balanced meals. Bring foods you enjoy. Watch portions.
> Choose your favorites. Stay active. Keep an eye on your blood sugar. And
> most importantly, give yourself some grace. Because Halloween is supposed to
> be a little spooky. Your blood sugar meter does not have to be.
>
> Happy Halloween, and may your October be filled with more pumpkin spice,
> laughter, and good memories than sugar spikes!
>
> The Biography of Ismael Collazo
>
> Ismael "Izzy" Collazo has lived with type 1 diabetes for more than 41 years,
> having been diagnosed when he was just eleven months old. He has also been
> totally blind for approximately twelve years.
>
> Izzy serves as president of the National Federation of the Blind of South
> Dakota. He advocates at the local, state, and federal levels for
> accessibility, independence, and equal opportunities for blind and disabled
> people.
>
> Diabetes advocacy is deeply personal to Izzy. In addition to managing type 1
> diabetes himself, he is the father of a ten-year-old daughter who also has
> type 1 diabetes. This gives him the perspective of both a person living with
> the disease and a parent supporting a child through it.
>
> Izzy is also a writer and public speaker who uses honesty, humor, and lived
> experience to educate others about blindness, diabetes, accessibility, and
> healthcare.
>
> He is honored to serve as a new board member of the Diabetes Action Network
> and looks forward to helping blind people with diabetes gain better access
> to technology, education, and peer support.
>
> The Biography of Joy Ruth Stigile
>
> Hello. My name is Joy Ruth Stigile. Two weeks after being diagnosed with
> type 1 diabetes in October 1966, I started taking insulin the old-fashioned
> way with glass syringes and metal needles that screwed on to the glass
> syringe after boiling them in a big pot of water to sterilize them after
> each use. Now, I am very happy that my treatment has evolved over the years,
> now using plastic syringes, insulin pens, and now the Tandem Mobi insulin
> pump and a continuous glucose monitor (CGM), the Dexcom G7.
>
> I am very pleased to rejoin the Diabetes Action Network as a board member. I
> am also on the Diabetes Action Network of California board as president. I
> am an active member of my local National Federation of the Blind of
> California chapter, which is the San Fernando Valley Chapter, where I serve
> as the fundraising chair. I enjoy hiking and reading best-selling novels.
>
>   
>
> I am very happy to be married for twenty-six years to Robert. We have been
> very fortunate to have adopted two older girls who have blessed us with two
> wonderful sons-in-law, and each of them has given us a precious
> granddaughter.
>
>   
>
> Life is good! Yes, indeed life is good!
>
> Giving Grace
>
> By Debbie Wunder
>
> Some days, diabetes feels heavier than others. Not because of the food or
> the numbers, but because of everything that comes along with them-the mental
> load, the constant decisions, the second-guessing, and all those "what ifs."
>
>   
>
> And then there is life itself. Maybe you are anxious about an upcoming
> event. Maybe you aren't feeling well. Maybe you're dealing with family
> concerns, work, grief, lack of sleep, or just the ordinary stresses that
> everyone faces. All of those things can affect diabetes, sometimes in ways
> we can't predict or control. And when our blood sugar doesn't cooperate, it
> can be very easy to add one more burden: being hard on ourselves.
>
> That's when we need to remember the importance of giving grace. Giving
> yourself grace doesn't mean giving up or not caring about your diabetes. It
> means recognizing that you are human. It means taking a breath before
> reacting to a high or a low and resisting that little voice that asks, "What
> did I do wrong?"
>
> Sometimes there isn't a simple answer. Giving grace might mean choosing an
> easy meal on a difficult day without feeling guilty about it. It might mean
> asking someone for help. It might mean acknowledging that today was hard and
> saying, "That's okay. I'm still showing up."
>
> We spend so much time trying to manage diabetes that it can be easy to
> forget that caring for ourselves involves more than insulin, medications,
> food, exercise, and numbers. How we speak to ourselves matters, too.
>
> Grace isn't a prize we earn for having perfect numbers. Grace is part of the
> care. So perhaps, especially on the difficult days, we can give ourselves a
> little more of it.
>
> May we meet ourselves the way we'd meet a friend-with patience, softness,
> and room to breathe.
>
> GLP-1 Drugs: Are They Really as Remarkable as They Seem?
>
> By Gary Wunder
>
> I recently visited my doctor, and one of the things we discussed was my
> beginning treatment with a GLP-1 drug. I am now waiting for the necessary
> insurance preauthorization. At age seventy-one, with diabetes, stage 3
> kidney disease, and a need to lose weight, I have good reason to explore
> whether one of these drugs might be useful to me.
>
> Therefore, what follows is not an account of my personal experience with a
> GLP-1 drug. I don't have that experience yet. What I do have is considerable
> curiosity, some reading on the subject, and the opportunity to watch the
> rather remarkable effects these drugs have had on people I love.
>
> The more I have read, the more questions I have had. Here are some of them,
> along with the best answers I can find.
>
> Admittedly this is a rather long article. The fact that it is broken up by
> questions can let you easily skim if you wish. You can easily search for the
> word question:, or you can navigate by heading if you find that you are not
> interested in the answer to a question or already know it. One caution
> should precede everything that follows. This article is intended to provide
> information, not medical advice. Our knowledge of these drugs continues to
> develop, and nothing here can substitute for a conversation with a physician
> who knows your health, medications, and medical history.
>
>   
>
> Question: What are GLP-1 drugs, and why do they seem so revolutionary?
>
> GLP-1 stands for glucagon-like peptide-1. GLP-1 is a hormone our bodies
> already make, primarily in the intestine after we eat. Among other things,
> it helps tell the pancreas to release insulin when blood sugar is elevated,
> reduces the release of glucagon-a hormone that can raise blood sugar-and
> affects the digestive system and brain in ways that influence appetite and
> how much we eat.
>
> Scientists developed drugs that imitate or enhance these effects. These are
> called GLP-1 receptor agonists.
>
> Some of the names are already familiar. Semaglutide is sold as Ozempic for
> type 2 diabetes and Wegovy for weight management and certain other
> indications. Liraglutide has been sold as Victoza for diabetes and Saxenda
> for weight management. Tirzepatide, sold as Mounjaro for diabetes and
> Zepbound for weight management and obstructive sleep apnea in certain
> adults, is technically somewhat different. It acts on both GLP-1 and another
> hormone system called GIP, or glucose-dependent insulinotropic polypeptide.
> Nevertheless, it is commonly included in conversations about the new
> generation of GLP-1 drugs.
>
> What makes these medications so unusual is the number of important things
> they appear capable of doing. They can lower blood sugar substantially. They
> can make people less hungry. They can produce weight loss of a magnitude
> that was once difficult to achieve without bariatric surgery. Certain drugs
> in the class have also demonstrated benefits involving the heart and
> kidneys. This combination of effects explains much of the excitement
> surrounding them.
>
> Question: How were GLP-1 drugs discovered?
>
> They grew out of a much longer scientific effort to understand why the body
> handles food differently when it enters the digestive tract.
>
> Researchers discovered that the intestine does more than digest food. It
> also sends chemical messages. One of those messengers is GLP-1. Scientists
> eventually learned how to create medications that could activate the GLP-1
> receptor but remain active much longer than the naturally occurring hormone.
>
> The original goal was not to create a revolutionary weight-loss drug. GLP-1
> receptor agonists were developed as treatments for type 2 diabetes. The
> profound effect on appetite and weight became increasingly important as
> researchers and physicians gained experience with them.
>
> Question: How much weight can a person actually lose?
>
> This varies enormously from person to person and from one drug to another,
> so averages should not be mistaken for promises.
>
> Still, the numbers explain why these drugs have attracted so much attention.
> In a major trial of semaglutide at the dose used for obesity treatment,
> participants without diabetes lost an average of about fifteen percent of
> their starting body weight over sixty-eight weeks. The comparison group
> receiving placebo and lifestyle intervention lost about two percent.
>
> The results with tirzepatide have been even larger in some trials. In one
> major study of people with obesity but without diabetes, participants
> receiving the higher doses lost, on average, roughly twenty percent of their
> starting body weight over seventy-two weeks.
>
> These are averages. Some people lose considerably more; others lose much
> less. But consider what twenty percent means. For a person beginning at 250
> pounds, twenty percent represents fifty pounds. That begins to explain why
> these drugs are being discussed differently from earlier weight-loss
> medications.
>
> Question: Isn't this simply another form of calorie restriction? If the drug
> makes me eat less, how is that different from deciding to eat less?
>
> At one level, the question is perfectly reasonable. A person loses weight
> because the body is taking in less energy than it is using. GLP-1 drugs do
> not repeal the laws of metabolism.
>
> The important difference may be in what makes eating less possible.
>
> Anyone who has tried to lose substantial weight knows that the difficult
> part is often not understanding what to do. Eat less. Choose nutritious
> foods. Exercise. Most of us have heard this repeatedly.
>
> The body, however, has powerful systems regulating hunger, fullness, and
> energy balance. When a person deliberately restricts food, hunger may
> increase and the body may respond in ways that encourage regaining the lost
> weight.
>
> GLP-1 drugs intervene in those biological signals. They can reduce hunger,
> increase the feeling of fullness after eating, and reduce food intake. Some
> people also describe a striking reduction in what has come to be called
> "food noise"-persistent thoughts about food and eating.
>
> So the difference is not that calories suddenly cease to matter. It is that
> the drug may change how difficult it is for a person to consume fewer of
> them.
>
> Question: What about intermittent fasting? Couldn't a person get the same
> results simply by restricting the hours during which he or she eats?
>
> Intermittent fasting or time-restricted eating works well for some people.
> It can provide a simple structure: rather than continually deciding what not
> to eat, a person establishes periods for eating and periods for fasting.
>
> But fasting and GLP-1 treatment are not the same thing. Fasting changes when
> food is consumed. GLP-1 drugs alter biological signaling involving blood
> sugar, digestion, appetite, and fullness.
>
> The two approaches are not necessarily competitors. Some people taking GLP-1
> drugs may also follow a time-restricted eating schedule. But anyone
> combining substantial dietary restriction with one of these medications
> should pay attention to nutrition. If appetite becomes very small, eating
> enough protein and other essential nutrients becomes important, as does
> preserving muscle through appropriate physical activity.
>
> Question: Doesn't calorie restriction cause the body's metabolism to slow
> down? What happens to the so-called set point when a person uses a GLP-1
> drug?
>
> This is an area where we should be careful about making claims that science
> has not yet settled.
>
> The "set point" is a useful shorthand for the observation that the body
> appears to defend its weight through complicated systems involving hunger,
> hormones, energy expenditure, and the brain. But there is no single
> thermostat in the body with a dial marked "weight."
>
> GLP-1 drugs appear to alter some of the biological signals involved in
> appetite and weight regulation. That may be one reason weight loss can be so
> much greater than with conventional dieting.
>
> But it would go too far to say that these drugs permanently reset a person's
> set point or eliminate the body's tendency to regain weight. In fact, what
> happens when the medication is discontinued suggests the opposite.
>
> Question: Does the weight come back when a person stops taking the drug?
>
> Frequently, yes, although the amount varies.
>
> In a follow-up to a major semaglutide trial, participants regained about
> two-thirds of the weight they had lost during the year after the medication
> was withdrawn. Many of the improvements in cardiovascular and metabolic risk
> factors also moved back toward their starting levels.
>
> This raises an important question for anyone considering treatment: Am I
> prepared for this to be a long-term medication?
>
> Perhaps the useful comparison is with medication for high blood pressure. We
> generally do not say that a blood pressure drug has failed because blood
> pressure rises after the drug is discontinued. The medicine was controlling
> a chronic condition while it was being taken.
>
> Increasingly, obesity is being approached in a similar way-as a chronic
> condition involving biology as well as behavior. That does not necessarily
> mean that every person who starts a GLP-1 drug must take it for life. It
> does mean that stopping deserves as much discussion with one's physician as
> starting.
>
> Question: How much of the benefit comes from losing weight, and how much
> comes directly from the drug?
>
> This is one of the most interesting questions.
>
> Weight loss itself can accomplish a great deal. Losing substantial excess
> weight can improve blood pressure, mobility, sleep apnea, blood sugar, and
> many other conditions. Therefore, when a person taking a GLP-1 drug becomes
> healthier, separating the benefit of the drug from the benefit of losing
> thirty, forty, or fifty pounds can be difficult.
>
> But weight loss does not appear to tell the entire story.
>
> GLP-1 receptor agonists stimulate insulin release when glucose is elevated
> and suppress inappropriate glucagon release. This can improve blood sugar
> before dramatic weight loss has occurred. Major clinical trials have also
> demonstrated cardiovascular benefits with semaglutide in selected
> populations, including people with established cardiovascular disease and
> overweight or obesity who did not have diabetes.
>
> So it is inaccurate to regard these drugs merely as appetite suppressants
> that happen to help diabetes. Their metabolic effects are part of their
> basic mechanism.
>
> Question: Do GLP-1 drugs combat insulin resistance?
>
> They can improve the overall problem, but saying simply that they "make the
> body more sensitive to insulin" leaves out some important detail.
>
> In type 2 diabetes, the body may still produce insulin but not respond to it
> efficiently. GLP-1 drugs help lower blood sugar partly by increasing insulin
> secretion when glucose is high and reducing glucagon. Weight loss itself can
> also substantially improve insulin sensitivity.
>
> The practical result for many people with type 2 diabetes is better glucose
> control, often accompanied by a lower A1C. Exactly how much comes from
> direct drug action and how much from subsequent weight loss varies. Exercise
> is still the best way to make the body respond better to the insulin the
> muscles receive.
>
> Question: What about the kidneys?
>
> This is particularly interesting for people with diabetes because diabetes
> is a major cause of chronic kidney disease.
>
> There is now strong evidence that at least some GLP-1 drugs can do more than
> simply avoid harming the kidneys. In the FLOW trial, involving people with
> type 2 diabetes and chronic kidney disease, semaglutide reduced the risk of
> major kidney outcomes and slowed the loss of kidney function.
>
> This needs an important qualification concerning metformin. It is sometimes
> said that metformin is "hard on the kidneys." That is misleading. Metformin
> is not generally regarded as a drug that damages the kidneys. Rather,
> because the kidneys clear metformin from the body, impaired kidney function
> can allow the drug to accumulate, which can increase the risk of a rare but
> serious complication. This is why physicians pay close attention to kidney
> function when prescribing it.
>
> GLP-1 drugs have their own cautions. Severe vomiting or diarrhea, for
> example, can cause dehydration, and dehydration can injure the kidneys.
> "Kidney friendly" should therefore not be interpreted as "incapable of
> causing kidney problems."
>
> Question: Can these drugs help with sleep apnea?
>
> Here the evidence has become particularly interesting.
>
> Obstructive sleep apnea occurs when the airway repeatedly becomes blocked
> during sleep. Excess weight is an important risk factor, although thin
> people can certainly have sleep apnea as well.
>
> In December 2024, the Food and Drug Administration approved Zepbound, or
> tirzepatide, for moderate to severe obstructive sleep apnea in adults with
> obesity, together with reduced calorie intake and increased physical
> activity. It was the first medication approved by the FDA specifically for
> certain people with obstructive sleep apnea.
>
> Much of this benefit appears to be associated with weight reduction.
> Therefore, someone using CPAP or another sleep-apnea treatment should
> certainly not conclude that starting a GLP-1 drug means the machine can go
> into the closet. Changes in sleep-apnea treatment should be based on medical
> evaluation and, when appropriate, repeat sleep testing.
>
> Question: Are there other benefits now being investigated?
>
> This may be one of the most fascinating parts of the GLP-1 story.
>
> Researchers are investigating possible effects involving the brain,
> including Alzheimer's disease and other forms of cognitive decline. Animal
> experiments and observational studies have provided reasons for further
> research into whether GLP-1 signaling might affect inflammation, brain
> function, and neurodegeneration.
>
> But this is precisely where enthusiasm must not outrun evidence. A finding
> that a drug improves memory or longevity in mice does not establish that it
> will preserve memory or extend life in people. Animal studies can tell
> researchers where to look next; they cannot tell physicians what will
> necessarily happen to their patients.
>
> For now, possible benefits involving memory, dementia, addiction, and
> longevity belong in the intriguing-but-unproven category. They are reasons
> for research, not yet reasons by themselves for taking the medication.
>
> Question: What are the adverse effects?
>
> The most common are gastrointestinal: nausea, vomiting, diarrhea,
> constipation, and abdominal discomfort. These are often most troublesome
> when treatment begins or the dose increases. In weight-loss trials,
> gastrointestinal problems have been among the most frequently reported
> adverse effects.
>
> There are also less common but more serious concerns. Depending on the
> particular drug, prescribing information includes warnings or precautions
> concerning pancreatitis, gallbladder disease, severe gastrointestinal
> problems, dehydration and resulting kidney injury, hypoglycemia when used
> with certain other diabetes drugs, and other complications. Semaglutide and
> tirzepatide carry boxed warnings concerning thyroid C-cell tumors based on
> findings in rodents; whether the same risk applies to humans has not been
> established.
>
> For people with diabetes, rapid improvement in blood sugar can also require
> adjustment of insulin or certain other diabetes medications. This is another
> reason these drugs should be regarded as medical treatment rather than
> simply as weight-loss aids.
>
> Question: Are all GLP-1 drugs essentially the same?
>
> No.
>
> They belong to the same broad therapeutic family, but they differ in their
> chemistry, duration of action, approved uses, effectiveness, dosing, and
> side-effect profiles.
>
> Semaglutide is a GLP-1 receptor agonist. Tirzepatide activates both GLP-1
> and GIP receptors. Liraglutide is another GLP-1 receptor agonist but has a
> shorter duration of action than semaglutide.
>
> Brand names can also create confusion. Ozempic and Wegovy contain the same
> active drug, semaglutide, but are approved for different indications and are
> used at different doses. Similarly, Mounjaro and Zepbound both contain
> tirzepatide but have different approved uses.
>
> This is one reason asking, "Should I take a GLP-1?" is only the beginning of
> the conversation.
>
> Question: Who should consider one of these drugs?
>
> That question belongs in the physician's office.
>
> A person's weight, type of diabetes, blood-sugar control, kidney function,
> other medical conditions, current medications, treatment goals, insurance
> coverage, and tolerance for possible adverse effects can all enter into the
> decision.
>
> Nor should these drugs be regarded as appropriate only for someone who wants
> to be thinner. For a person with type 2 diabetes, cardiovascular disease,
> chronic kidney disease, obesity, or a combination of these conditions, the
> discussion can involve far more than appearance or a number on the bathroom
> scale.
>
> Question: Why do we need such powerful drugs in the first place? What causes
> type 2 diabetes and obesity?
>
> Perhaps this is the question behind all the others.
>
> It would be comforting to have a simple answer: We eat too much, exercise
> too little, and suffer the consequences. There is certainly truth in saying
> that food intake and physical activity matter, but that explanation is far
> too simple.
>
> Both obesity and type 2 diabetes involve complicated interactions among
> genetics, environment, diet, physical activity, sleep, hormones,
> medications, aging, insulin resistance, the brain's regulation of appetite,
> and the circumstances in which people live.
>
> Two people can eat similarly and have very different tendencies to gain
> weight. Two people of similar weight can have very different metabolic
> health. Some people with obesity never develop diabetes, while some people
> with type 2 diabetes are not obese.
>
> The success of GLP-1 drugs may itself teach us something important: appetite
> and body weight are not controlled by willpower alone. They are powerfully
> influenced by biology.
>
> That does not make choices irrelevant. What we eat and how much we move
> still matter enormously. But a drug that changes biological signals and
> produces weight losses approaching fifteen or twenty percent in clinical
> trials forces us to reconsider the idea that obesity is simply a failure to
> exercise sufficient self-control.
>
> Question: Are GLP-1 drugs miracle drugs?
>
> "Miracle drug" is asking too much of any medication.
>
> GLP-1 drugs have adverse effects. They do not work equally well for
> everyone. Some people cannot tolerate them. They can be expensive, and
> insurance coverage can be difficult. Weight frequently returns after
> treatment is stopped. We are also still learning about their effects after
> decades of use and about some of the additional benefits now being
> investigated.
>
> But neither should we minimize what has happened.
>
> We now have medications that can substantially lower blood sugar, produce
> weight loss that was once extremely difficult to achieve without surgery,
> and, for certain groups of patients, reduce serious cardiovascular or kidney
> complications. Tirzepatide has even become the first FDA-approved medication
> for certain adults with obesity and obstructive sleep apnea.
>
> So, while it would be too much to call GLP-1 drugs miracle drugs, their
> value is certainly worth considering and discussing with one's physician.
> They will not solve every problem associated with diabetes or obesity, but
> the evidence increasingly suggests that they represent a significant step
> forward.
>
> A Step Toward Insulin Independence: What the Eledon Tegoprubart Trial Means
> for Type 1 Diabetes
>
> By Ismael Collazo
>
>   
>
> For people who have lived with type 1 diabetes for years or even decades,
> the word "cure" deserves to be approached carefully. We have heard exciting
> research announcements before, and advances in insulin, continuous glucose
> monitors, and insulin pumps have transformed diabetes management without
> eliminating the disease itself.
>
> That is why recent results from a clinical trial at the University of
> Chicago deserve both our attention and a healthy measure of caution.
>
> At the American Diabetes Association's 86th Scientific Sessions in June
> 2026, researchers presented updated results from a clinical trial involving
> pancreatic islet transplantation and an experimental immune therapy called
> tegoprubart. All twelve participants in the trial had achieved insulin
> independence at the time the results were reported, meaning they were no
> longer using external insulin.
>
> That result is remarkable. But understanding what happened-and what has not
> yet been proven-is just as important.
>
> What Are Islet Cells?
>
> The pancreas contains clusters of cells known as pancreatic islets. Within
> those islets are beta cells, which produce insulin in response to changes in
> blood glucose.
>
> In type 1 diabetes, the immune system destroys insulin-producing beta cells.
> Replacing those cells has therefore been one of the major goals of diabetes
> research for decades.
>
> Islet transplantation itself is not new. Researchers have previously
> demonstrated that transplanted islets from deceased donors can restore
> insulin production and, in some recipients, result in insulin independence.
> The challenge has been keeping those transplanted cells alive and
> functioning while preventing the recipient's immune system from rejecting
> them.
>
> What Is Different About the Eledon Trial?
>
> The University of Chicago study is investigating an experimental drug called
> tegoprubart, also known as AT-1501.
>
> Tegoprubart is a monoclonal antibody that targets CD40 ligand, or CD40L,
> which plays an important role in communication between immune cells. By
> blocking this pathway, researchers hope to prevent the immune system from
> rejecting transplanted cells without relying on calcineurin inhibitors such
> as tacrolimus.
>
> Tacrolimus has long been used to prevent transplant rejection, but it can
> cause significant side effects, including kidney toxicity, and can also be
> toxic to insulin-producing islet cells. Researchers are investigating
> whether a tegoprubart-based regimen can protect transplanted islets while
> avoiding some of those problems.
>
> The participants in this study were adults with long-standing type 1
> diabetes who had experienced serious and unpredictable hypoglycemia despite
> intensive diabetes management. These were not simply twelve randomly
> selected people with type 1 diabetes. They were people facing significant
> problems with severe hypoglycemia.
>
> The transplanted islets came from deceased organ donors and were delivered
> into the portal vein of the liver. Because these cells came from another
> person, participants still needed medications to suppress the immune
> response and prevent rejection.
>
> What Did Researchers Find?
>
> The results presented in June 2026 were striking.
>
> All twelve participants achieved insulin independence following
> transplantation. In other words, at the time of the report, they were
> producing enough insulin from the transplanted cells that they no longer
> required chronic external insulin therapy.
>
> All twelve participants also had a most recent A1C below 6.5 percent. The
> average was approximately 5.4 percent.
>
> Before transplantation, all of the participants had histories of recurrent
> severe hypoglycemia. Researchers reported no severe hypoglycemic episodes
> following transplantation.
>
> They also reported stable islet graft function across the group, with a
> median follow-up of approximately eight months and the longest-followed
> participant reaching approximately twenty-two months after transplantation.
>
> Researchers had not observed signs of graft rejection or newly developed
> donor-specific HLA antibodies. They also reported no unexpected safety
> concerns and no evidence of the significant kidney toxicity that can be
> associated with traditional calcineurin inhibitor-based immunosuppression.
>
> Those findings are encouraging, but the length of follow-up matters.
> Twenty-two months is very different from knowing what happens after five,
> ten, or twenty years.
>
> Is This a Cure for Type 1 Diabetes?
>
> This is where we need to be careful with our language.
>
> These results demonstrate that transplanted cells can produce enough insulin
> for these participants to live without external insulin. This is sometimes
> described as insulin independence or a potential functional cure.
>
> It is not yet the same thing as permanently eliminating type 1 diabetes.
>
> The participants received donor islet cells, and they still require
> immune-suppressing treatment to prevent their bodies from attacking or
> rejecting those transplanted cells. Tegoprubart itself is an investigational
> drug and has not been approved for routine treatment of type 1 diabetes.
>
> We also do not yet know how long these transplanted cells will continue
> functioning.
>
> The current study is small, and the ClinicalTrials.gov record describes it
> as an ongoing phase 1/phase 2 study. Larger studies and longer follow-up
> will be necessary to understand the long-term effectiveness and risks.
>
> So while the results are exciting, saying that researchers have "cured type
> 1 diabetes" would go beyond what this study has established.
>
> Another Major Barrier: Where Do the Cells Come From?
>
> There is another important limitation.
>
> The transplanted islets used in this study came from deceased organ donors.
> Donor islets are a limited resource. Some participants have also required
> more than one islet transplant to achieve insulin independence.
>
> That makes this particular approach difficult to scale to the millions of
> people living with type 1 diabetes.
>
> However, researchers around the world are also working on producing
> insulin-making cells from stem cells. If scientists eventually develop a
> reliable and scalable source of replacement beta cells, they will still face
> another major problem: protecting those cells from the immune system.
>
> That is one reason the tegoprubart research is so interesting. Finding a
> safer and more effective way to protect transplanted insulin-producing cells
> could potentially become an important part of future cell-replacement
> treatments.
>
> What Does This Mean for Blind People with Diabetes?
>
> For members of the Diabetes Action Network, progress in diabetes treatment
> involves another important consideration: accessibility.
>
> Blind people with diabetes have experienced firsthand what happens when a
> medical advancement is introduced without accessibility being considered
> from the beginning. We have had to fight for independent access to glucose
> monitors, insulin pumps, smartphone applications, and other diabetes
> technology.
>
> If cell-replacement therapies eventually become routine treatment,
> accessibility must be part of their development and delivery.
>
> Information about eligibility, informed consent, medication schedules,
> infusion appointments, glucose monitoring, transplant follow-up, patient
> portals, and any technology associated with these treatments must be
> independently accessible to blind patients.
>
> A medical breakthrough does not reach its full potential if blind people
> cannot independently access the treatment and the information surrounding
> it.
>
> Reasons for Hope-and Reasons for Patience
>
> Twelve people with long-standing type 1 diabetes received transplanted
> pancreatic islets under a tegoprubart-based immune-suppression regimen, and
> all twelve were reported to be living without external insulin when the
> latest results were presented.
>
> That deserves our attention.
>
> It does not mean insulin pumps and insulin pens are about to disappear. It
> does not mean tegoprubart has been approved as a cure for diabetes. And it
> does not tell us whether these transplanted cells will continue working
> decades from now.
>
> But it does demonstrate something important.
>
> Researchers are getting better at replacing insulin-producing cells and,
> perhaps just as importantly, finding ways to keep those cells functioning
> after transplantation.
>
> For those of us who have spent years or decades managing type 1 diabetes,
> that is genuine progress worth watching.
>
> The right response is neither hype nor cynicism.
>
> It is cautious hope.
>
> Sources
>
> ClinicalTrials.gov. "NCT06305286: Safety, Tolerability, and Efficacy of
> Immunomodulation With a Monoclonal Antibody Against CD40L in Combination
> With Transplanted Islet Cells in Adults With Brittle Type 1 Diabetes
> Mellitus (T1D)."
>
> Eledon Pharmaceuticals. "Eledon Announces Updated Data from
> Investigator-Initiated Islet Transplant Trial of Tegoprubart in Patients
> with Type 1 Diabetes (T1D) at UChicago Medicine." June 8, 2026.
>
> Breakthrough T1D. "All 12 Clinical Trial Participants Off External Insulin:
> New Data on Tegoprubart Continues to Impress." June 7, 2026.
>
> American Diabetes Association. 86th Scientific Sessions. June 2026.
>
>   
>
> Recipes from Joyce
>
> By Joyce Stigile
>
>   
>
> Easy Microwave Vegetable
>
>   
>
> 2 cups sliced yellow squash
>
> 2 shakes black pepper
>
> 1 shake garlic powder
>
> 2 teaspoons butter
>
>   
>
> Directions:
>
> Wash and dry yellow squash, slice off the stem and 1/4 inch off the bottom,
> then slice into rounds about 1/8 inch to 1/4 inch wide; place in a
> microwave-safe container, add seasonings and butter, and cover. Cook in
> microwave for 2 minutes. Wait 5 minutes, then stir. Squash should be limp;
> if not, cook an additional 30 seconds. Serves 2-4 people.
>
>   
>
> Second Recipe
>
> During the holiday season, instead of previous spices, add 1/8 teaspoon
> pumpkin spice blend.
>
> A pinch of your favorite sugar substitute.
>
>   
>
> Yummy!
>
> (Other names for yellow squash are summer squash or crookneck.)
>
> A Blind Dad, His Type 1 Daughter, and Our First National Convention Together
>
> By Ismael Collazo
>
> Going to a National Federation of the Blind National Convention is an
> experience all its own. Anyone who has attended one knows the pace: go, go,
> go. There are meetings, presentations, exhibits, conversations in the
> hallways, and seemingly always somewhere else you need to be.
>
> This year in Austin, Texas, I experienced National Convention differently.
> For the first time, my daughter attended with me.
>
> We also happen to share something besides being father and daughter: we both
> live with type 1 diabetes.
>
> That meant preparing for Austin wasn't as simple as packing clothes and
> getting on a plane. When two people with type 1 diabetes travel together,
> you pack twice as much-and sometimes it feels like four times as much. Pump
> supplies, continuous glucose monitor supplies, insulin, glucose tablets,
> snacks, backup supplies, and backups for the backups. With diabetes, you
> learn quickly that "we probably won't need it" isn't a very comforting
> reason to leave something at home.
>
> Of course, I made one mistake in all that careful planning: I forgot that I
> was traveling with a growing kid. I thought I had packed enough snacks for
> both of us, but she ate nearly all of them the first day. So, despite all
> that preparation, I found myself making a second Walmart run to restock our
> snacks. Apparently, when traveling with type 1 diabetes and a growing child,
> "pack extra" means more than I thought.
>
> My daughter currently uses a Tandem t:slim X2 insulin pump and a Dexcom
> continuous glucose monitor. Even with today's diabetes technology, however,
> diabetes doesn't always cooperate with your plans.
>
> National Convention provided a perfect example.
>
> With everything happening around us, stopping for meals wasn't always
> convenient. We had places to be and things we wanted to experience. There
> were times when we had to stop for snacks or lunch because our blood sugars
> had other ideas.
>
> Then there was the day we skipped lunch.
>
> That was a mistake.
>
> Between the two of us, we went through an entire bottle of glucose tablets.
> It was a pretty good reminder that type 1 diabetes doesn't care how
> important your next meeting is or how packed your convention schedule might
> be. Sometimes you simply have to stop and take care of yourself.
>
> But those challenges aren't what I will remember most about Austin.
>
> I will remember watching my daughter begin to find her own voice.
>
> During the convention, she had the opportunity to present to the Diabetes
> Action Network division. It was her first time presenting, and she talked
> about something nobody could explain better than she could: what it is like
> to grow up as a child with type 1 diabetes.
>
> She talked about her own experiences and some of the struggles that come
> with managing this disease as a kid.
>
> As her dad, that was important to me.
>
> I didn't want her simply sitting in the audience listening to adults talk
> about diabetes. I wanted her to understand that her experiences matter.
> Children living with type 1 diabetes have something valuable to contribute
> to conversations about diabetes technology, independence, accessibility,
> school, family life, and everything else that comes with this disease.
>
> At the same time, she was getting a chance to see another part of my life.
>
> She watched what I was doing in the organized blind movement. She saw the
> panels I participated in. She saw the meetings, the advocacy, and the work
> that happens when blind people come together and speak for ourselves.
>
> For years, she has watched her blind dad live with the same disease she
> lives with. In Austin, she got to see something more. She got to see that
> our experiences-whether with blindness, diabetes, or both-can become
> something we use to help other people.
>
> And I got to see my daughter begin doing exactly that.
>
> There is a lesson in that experience that I hope stays with her long after
> Austin.
>
> Diabetes is going to interrupt things. There will be low blood sugars,
> alarms, supplies to carry, meals that cannot always be skipped, and days
> when the plans have to change. There may even be another bottle of glucose
> tablets sacrificed to an overly ambitious convention schedule.
>
> But diabetes doesn't have to prevent us from participating.
>
> For me, National Convention has always been about independence, advocacy,
> and the belief that blind people should have the opportunity to live the
> lives we want.
>
> This year, I got to share that with my daughter.
>
> And somewhere between the meetings, the panels, the diabetes supplies, the
> glucose tablets, and her first presentation, Austin became more than another
> National Convention.
>
> It became the beginning of her finding her own voice.
>
> Concluding Thoughts
>
> if you have thoughts about this newsletter, please share them with me at
>
> gwunder at earthlink.net <mailto:gwunder at earthlink.net> .
>
> If you liked it, please consider becoming a member of our organization. We
> need you. Your input will make us stronger. Your participation will make us
> more inclusive and more representative of blind diabetics. Thank you for
> reading, and thank you for being proactive in helping make life easier for
> blind diabetics.
>
>   
>
> _______________________________________________
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-- 
Lino Morales KW4NIGH