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

[Gary Wunder]

Hello, Lino. We will certainly be providing more information about how to register for the Diabetes Action Network seminar, so keep following this list. Although we would love to have you as a member and can use the energy of everyone to advance our cause, it is not a requirement that you be a member in order to participate in the seminar. Perhaps something in the seminar will convince you that it is worthwhile to be a part of what we do. Whether it does or not, we gladly share the information and are glad for those who benefit from it.

Warmly,

Gary

-----Original Message-----
From: Diabetes-Talk <diabetes-talk-bounces at nfbnet.org> On Behalf Of Lino Morales via Diabetes-Talk
Sent: Wednesday, September 23, 2026 2:07 PM
To: Gary Wunder via Diabetes-Talk <diabetes-talk at nfbnet.org>
Cc: Lino Morales <linomorales001 at gmail.com>
Subject: Re: [Diabetes-Talk] Our September 2026 Diabetes Action Network Newsletter

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


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