Diana Isaacs, PharmD, is an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic.

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!

Diabetes Dialogue hosts discuss top takeaways from ATTD 2026

Diabetes Dialogue: ATTD 2026 Recap

Advances in artificial intelligence, automated insulin delivery, and sensor integration were central to discussions at the 2026 International Conference on Advanced Technologies & Treatments for Diabetes (ATTD), where clinicians highlighted how emerging technologies may further reduce diabetes management burden while improving glycemic outcomes.

In this episode, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, reviewed key highlights from the meeting, with particular emphasis on AI-driven tools and evolving closed-loop systems.

A major theme was the growing role of artificial intelligence, including the concept of “digital twins”—virtual models built from patient-specific data such as glucose trends, insulin dosing, and behavioral inputs. These models allow clinicians and patients to simulate therapy adjustments, such as changes in insulin sensitivity or basal rates, before applying them in practice. Data presented at the meeting suggested use of digital twin modeling improved time in range, whereas providing data feedback alone did not meaningfully change outcomes.

The discussion also examined real-world performance data from newer automated insulin delivery platforms. Early data from the Twiist system demonstrated time in range approaching 76% to 77% across initial user cohorts, with higher time in range observed among individuals using lower glucose targets, albeit with an expected increase in hypoglycemia. Expanded analyses in larger populations showed similarly strong outcomes, reinforcing the importance of target selection and individualized system settings.

Sensor performance and reliability also emerged as a key topic. Investigators presented data suggesting unrecognized infusion set occlusions may contribute to unexplained hyperglycemia, highlighting potential advantages of newer pump technologies designed to detect occlusions more rapidly. In parallel, comparative analyses of sensor integration in hybrid closed-loop systems demonstrated consistent glycemic outcomes across multiple sensor platforms, suggesting algorithm performance, rather than sensor variability alone, plays a dominant role in achieving time in range.

Lastly, hosts shared early data from fully closed-loop systems in type 2 diabetes, including a small trial evaluating automated insulin delivery without meal bolusing. Participants achieved substantial improvements in time in range, increasing from approximately 44% at baseline to 68%, with minimal hypoglycemia. Although not yet achieving traditional glycemic targets, these findings underscore the potential for reducing patient burden while maintaining clinically meaningful glucose control.

Editor’s Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others.

Senseonics. First Ever Real-World Evidence of Eversense 365 Presented at ATTD Demonstrates Sustained Performance and Positive Impact Throughout One-Year of Wear. Senseonics.com. Published March 14, 2026. Accessed March 18, 2026. 

https://www.senseonics.com/investor-relations/news-releases/2026/03-14-2026-141507610

Insulet Corporation. Insulet Presents Promising Study Results for Fully Closed-Loop Automated Insulin Delivery System for Adults with Type 2 Diabetes. Insulet.com. Published March 10, 2026. Accessed March 18, 2026. 

https://investors.insulet.com/news/news-details/2026/Insulet-Presents-Promising-Study-Results-for-Fully-Closed-Loop-Automated-Insulin-Delivery-System-for-Adults-with-Type-2-Diabetes/default.aspx

Podcasts

ATTD 2026 reveals AI “digital twins,” next-gen closed-loop pumps, and sensors that boost time-in-range and ease diabetes management.

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Type 1 Diabetes

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Diabetes Dialogue

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives is a monthly podcast hosted by Diana Isaacs, PharmD, and Natalie Bellini, DNP, aimed at providing a regular roundup of the latest clinically applicable insights across diabetes and metabolic diseases, with a focus on leveraging technology to improve care.

Endocrinology

The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

podcasts page features a feed of medical news and interview podcast series, including DocTalk, Lungcast, Derm Discussions, and Heart Trials.

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for HCPLive. He is also the executive producer of two podcasts: Skin of Color Savvy and The Medical Sisterhood. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

On March 13, the US Food and Drug Administration (FDA) 

, specifically those aged 12 years and older.

This approval, positioning secukinumab as the only interleukin (IL)-17A inhibitor currently indicated for this population, made this the first differentiated mechanism in nearly a decade. In light of the FDA’s addition of this biologic option to the limited agents available in the pediatric HS armamentarium, the 

 team interviewed Alexa Kimball, MD, MPH.

Kimball, the president and CEO of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center and professor of dermatology at Harvard Medical School, was an investigator on the trial program leading up to this approval. The following Q&A transcribes her responses to 

This approval marks the first new mechanism in pediatric HS in nearly a decade, and only the second approved treatment option for this population overall. How significant is that from a clinical standpoint?

Studies suggest that initiating treatment early in the HS disease course is associated with higher responsiveness to treatment. This advantage is consistent with what I have experienced with the patients I treat. Intervening before scars and tunnels develop is a clear clinical goal for our patients

The label is supported by a combination of adult HS trial data, pharmacokinetic modeling, and pediatric data extrapolated from other indications. Can you walk us through why that evidentiary approach was appropriate here, and how confident you are in the weight-based dosing regimen?

I defer to the FDA on this question. It does appear that the methodology used here is consistent with how other similar approvals have been evaluated.

HS in adolescence carries a particularly heavy psychosocial burden. Did you see meaningful quality-of-life improvements in younger patients alongside the clinical endpoints, and how do you weigh those outcomes when evaluating a therapy for this age group?

We would need specific studies to determine the answer to your question above. There is a concept increasingly accepted across dermatology emphasizing that early treatment for chronic dermatologic diseases is important because success can alter important trajectories such as education, employment and relationships. That concept, Cumulative Life Course Impairment, would further support the important of early treatment.

Secukinumab already carries more than a decade of real-world safety data. How much does that established track record factor into your comfort level prescribing it to a pediatric population, and are there any monitoring considerations specific to adolescents that clinicians should keep in mind?

Working with medications with established safety profiles is always reassuring. There isn’t any monitoring I would do differently in adolescents than in adults.

Kimball’s institution received grants from Abbvie, Admirx, Anapyts Bio, Aristea, Bristol Myers Squibb, Chemocentryx, Eli Lilly, Incyte, Janssen, Moonlake, Novartis, Pfizer, Prometheus, UCB; Sonoma Bio. Kimball received consulting fees from Abbvie, Alumis, Bayer, Bristol Myers Squibb, Boehringer Ingelheim, Eli Lilly, Janssen, Moonlake Novartis, Pfizer, Priovant, Sonoma Bio, Sanofi, UCB; Target RWE, Ventyx; and serves on the board of directors of Almirall.

Smith T. FDA Approves Secukinumab for Pediatric Patients 12 Years and Older with HS. HCPLive. March 13, 2026. Accessed March 18, 2026. 

https://www.hcplive.com/view/fda-approves-secukinumab-for-pediatric-patients-12-years-older-hs

Novartis Cosentyx® receives FDA approval for pediatric patients aged 12+ with moderate to severe hidradenitis suppurativa. Novartis. March 13, 2026. Accessed March 18, 2026. 

https://www.novartis.com/us-en/news/media-releases/novartis-cosentyx-receives-fda-approval-pediatric-patients-aged-12-moderate-severe-hidradenitis-suppurativa

Articles

The FDA approved secukinumab for moderate to severe hidradenitis suppurativa in patients aged ≥12 years, establishing the only IL-17A inhibitor indicated for this age group and introducing the first differentiated mechanism in nearly a decade. Early intervention was emphasized as clinically meaningful, with greater treatment responsiveness when initiated before irreversible scarring and sinus tract formation. The evidentiary basis combined adult HS trials, pharmacokinetic modeling, and pediatric extrapolation. Longstanding real-world safety experience was cited as reassuring, without adolescent-specific monitoring differences.

This Q&A highlights Dr. Alexa B. Kimball's responses to questions on the FDA approval of secukinumab for pediatric patients with hidradenitis suppurativa (HS).

Hidradenitis Suppurativa

Hidradenitis Suppurativa condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatology research, treatment, and drug development.

Dermatology

The HCPLive dermatology page is a resource for medical news and expert insights on skin disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for dermatologic conditions, and more.

Reflecting on FDA Approval of Secukinumab for HS in Children, With Alexa Kimball, MD, MPH

Christine Limonte is an assistant professor at UW Medicine and a study investigator for the Kidney Precision Medicine Project.

Kidney Biopsies Challenge Diabetic Nephropathy Diagnoses in CKD, With Christine Limonte, MD

According to data from 39 kidney biopsies, only 54% of patients clinically diagnosed with diabetic kidney disease actually had diabetic nephropathy confirmed on biopsy.

The data may challenge long-held beliefs about chronic kidney disease (CKD) prognosis, highlighting that before biopsies were performed, only 15% of clinicians expected to find something different, yet 26% reported the results were different than expected.

These findings come from the Kidney Precision Medicine Project (KPMP), a multicenter prospective cohort study obtaining research protocol biopsies in adults with suspected diabetic kidney disease (DKD) or hypertension-associated chronic kidney disease (HCKD) for comprehensive clinicopathologic characterization.

"Only about half of participants enrolled into the diabetic kidney disease or hypertensive chronic kidney disease cohorts actually had classic diabetic nephropathy or hypertension-associated nephropathy on biopsy, respectively," said study investigator Christine Limonte, MD, assistant professor of medicine at UW Medicine. "A number of participants had unexpected findings, IgA nephropathy, fibrillary glomerulonephritis, as well as nonspecific findings that precluded a definitive diagnosis."

Beyond missed or unexpected diagnoses, biopsies frequently revealed lesions not captured by existing diagnostic frameworks: acute tubular injury, interstitial inflammation extending into nonfibrotic parenchyma, glomerular microaneurysms, and tubular mitochondrial abnormalities. These findings were prevalent even among participants with confirmed diabetic nephropathy, suggesting the histopathologic heterogeneity of common CKD presentations is broader than traditional classifications reflect.

"In our group of 39 participants, we obtained clinician post-biopsy reports and found that over 70% of clinicians reported that biopsy results did affect their prognostic discussions with patients, and in about 38% of cases, impacted clinical management," Limonte noted.

For nephrologists managing patients with presumed DKD or HCKD, these findings underscore the diagnostic limitations of a clinical-only approach.

Limonte CP, Aw S, Alpers CE, et al. Case Series of Histopathological Findings in Chronic Kidney Disease: Insights From the Kidney Precision Medicine Project. 

. Published online December 2025:101206. doi:https://doi.org/10.1016/j.xkme.2025.101206

Videos

Data from 39 kidney biopsies may challenge longterm beliefs about diabetic nephropathy in CKD.

Nephrology

The HCPLive nephrology page is a resource for medical news and expert insights on kidney disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in nephrology, and more.

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Corey Cavanaugh, DO, is an academic nephrologist at the Cleveland Clinic. 

Who Gets What, When? Navigating Therapy Selection in IgA Nephropathy, With Corey Cavanaugh, DO

 has considerably expanded recently, clinicians continue to navigate how best to select and sequence these emerging therapies for their patients.

New breakthrough developments have brought treatment options well beyond traditional approaches, such as corticosteroids and supportive care, now encompassing complement inhibitors and APRIL/BAFF-targeting agents.

“On the immunosuppressive side, we still have corticosteroids, we still have targeted release… sort of the newer kids on the block, if you will, are the complement inhibitor… and then our anti April therapies that are numerous and rolling out. Those are the major ones we're fixating on,” ​​said Corey Cavanaugh, DO, an academic nephrologist at the Cleveland Clinic, in an interview with HCPLive. “The major question is, who gets what and when, and that still is… this is a matter of, just to be clear right off the bat, this is not necessarily evidence-based. This is all just opinion-based.”

2025 Kidney Disease: Improving Global Outcomes (KDIGO) 

updated IgAN guidelines marked a conceptual shift, recommending clinicians to initiate therapies targeting pathogenic IgA production simultaneously with those addressing the consequences of existing nephron loss, a dual-track approach departing from the traditional stepwise model. The guidelines also introduced a more stringent proteinuria target, with the goal of achieving <0.3 g/d.

 proteinuria and eGFR remain the only validated biomarkers 

to guide therapy selection in the continuously expanding therapeutic landscape. Combination regimens may offer additive benefits, but supporting evidence is still emerging, and there is no existing evidence-based framework for sequencing decisions yet.

Meaningful progress toward personalized therapy in IgAN will depend on identifying biomarkers which can guide which patients are most likely to benefit from complement inhibition, APRIL blockade, or targeted intestinal therapy with Nefecon.

“My personal preference is to avoid steroids as much as I can, whether it be targeted release or oral systemic corticosteroids. That's just my personal preference. When we have a steroid-sparing option, I'm going to choose it. Young people don't like steroids… like anyone else.”

Current evidence supports guideline recommendations to avoid corticosteroid therapy in those with an eGFR <30 mL/min/1.73 m² and the suggestion to exercise cautiously in individuals at high risk of developing corticosteroid-related side effects, such as those with diabetes mellitus, obesity, latent infections, active peptic ulceration, uncontrolled psychiatric illness, and severe osteoporosis.

Editor’s Note: Cavanaugh reports relevant disclosures with Otsuka Pharmaceutical Co, Novartis Pharmaceutical Corporation, Travere Therapeutics, and Vera Therapeutics.

Floege J, Barratt J, Cook HT, et al. Executive summary of the KDIGO 2025 Clinical Practice Guideline for the Management of Immunoglobulin A Nephropathy (IgAN) and Immunoglobulin A Vasculitis (IgAV). 

https://doi.org/10.1016/j.kint.2025.04.003

In a rapidly evolving therapeutic landscape, how can clinicians make decisions to personalize IgAN care?

IgA Nephropathy

The HCPLive Berger disease page is a resource for medical news and expert insights on IgA nephropathy. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in Berger disease, and more.

Abigail Brooks is an assistant managing editor for 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

The US Food and Drug Administration has cleared MiniMed’s MiniMed Flex™, a next-generation discreet, smartphone-controlled insulin pump designed to fit seamlessly into everyday life.

As described in a March 18, 2026, release from the Company, the MiniMed Flex is about half the size of the MiniMed™ 780G pump and roughly the size of 2 stacked insulin vials. It is cleared for individuals ≥ 7 years of age with type 1 diabetes and for individuals ≥ 18 years of age with insulin-requiring type 2 diabetes. MiniMed Flex is the company's first screenless design created in partnership with people living with diabetes to deliver an intuitive, lifestyle‑friendly way to manage the condition.

"MiniMed Flex™ represents an important leap forward for MiniMed," Anders Carlson, MD, Medical Director of the International Diabetes Center at Park Nicollet, Director of the HealthPartners Diabetes Program, and an assistant professor in the University of Minnesota Medical School, said in a statement. "For many people living with diabetes, the burden of daily management can be overwhelming. By combining a discreet, screenless form factor with a powerful adaptive algorithm that responds quickly to changes in glucose, MiniMed Flex™ brings meaningful innovation exactly where it's needed—into the flow of everyday life. This level of automation, paired with the freedom of smartphone control, has the potential to improve consistency, confidence, and ultimately clinical outcomes for a broad range of patients with diabetes."

In January 2026, the FDA granted 510(k) clearance to Medtronic’s MiniMed Go Smart Multiple Daily Injection (MDI) app for use by patients with type 1 diabetes or type 2 diabetes aged ≥7 years, as well as for children between 2-6 years under adult supervision.

The new MiniMed Flex™ is powered by MiniMed’s most advanced SmartGuard™ algorithm with Meal Detection™ technology, which has proven clinical performance that exceeds worldwide Time in Range recommendations. At commercial launch, MiniMed Flex™ will support the company's newest sensor portfolio, including Simplera Sync™ sensor and the Instinct sensor, made by Abbott.

Key product features include the small, sleek design with high insulin capacity, delivering a 300-unit insulin reservoir to support a range of insulin needs; the ability to manage the product through a compatible mobile app; sensor compatibility with the Company's newest sensor portfolio, including Simplera Sync™ sensor and the Instinct sensor, made by Abbott; extended infusion set options; and proven AID performance, with real-world results demonstrating 80% Time in Range with recommended settings.

MiniMed additionally announced the MiniMed™ Forward Program, which allows customers who start on the MiniMed™ 780G system to upgrade to the MiniMed Flex™ system at no cost.

"At MiniMed, our Mission is to make every day a better day for people with diabetes," said Que Dallara, chief executive officer of MiniMed. "MiniMed Flex™ embodies that promise. It's designed to work quietly and reliably in the background — advanced automation wrapped in a compact, smartphone‑controlled pump. The result is technology that lets people spend less time managing diabetes and more time living their lives. Securing FDA clearance for our first product as a standalone, public company — just one week after our IPO — marks a major milestone and underscores our commitment to delivering the breakthrough innovation our customers deserve."

MiniMed. MiniMed Announces FDA Clearance of MiniMed Flex™, the Company's Smallest Insulin Pump Featuring Its First Smartphone-Controlled Design. March 18, 2026. Accessed March 16, 2026. 

https://www.prnewswire.com/news-releases/minimed-announces-fda-clearance-of-minimed-flex-the-companys-smallest-insulin-pump-featuring-its-first-smartphone-controlled-design-302716864.html

Livingston R. FDA Clears MiniMed Go Smart MDI App for Adults and Children with T1D, T2D. HCPLive. January 12, 2026. 

https://www.hcplive.com/view/fda-clears-minimed-go-smart-mdi-app-for-adults-and-children-with-t1d-t2d

FDA clearance enables commercialization of MiniMed Flex, a compact, screenless, smartphone-controlled insulin pump positioned to reduce daily management burden in diabetes. The device is approximately half the size of the MiniMed 780G and supports a 300‑unit reservoir. Indications include type 1 diabetes in patients aged ≥7 years and insulin-requiring type 2 diabetes in adults. Flex runs the latest SmartGuard algorithm with Meal Detection and is slated to pair with Simplera Sync and Abbott-made Instinct sensors, with reported real-world performance near 80% time-in-range.

The MiniMed Flex is a discreet, smartphone-controlled insulin pump that is roughly the size of 2 stacked insulin vials.

FDA News

FDA Clears MiniMed Flex, A Smaller and Smartphone-Controlled Insulin Pump

Viet Le, DMSc, PA-C, is a preventive cardiology PA at Intermountain Health and the former president of the Academy of Physician Associates in Cardiology.

Le discusses the AHA/ACC clinical guidelines for the management of dyslipidemia, highlighting the shifting attitude towards hypertriglyceridemia treatment.

Cardiology

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ACC/AHA Dyslipidemia Guidelines Refocus Hypertriglyceridemia Treatment, With Viet Le, DMSc, PA-C

This discussion reflects on great speakers, the unique pressures women face on the podium, and what it takes to build a national platform in academic medicine.

Networking, Niches, and Why Authenticity Is Your Biggest Career Asset in Dermatology

Andrea Kossler, MD, describes her multidisciplinary co-management model with ophthalmologists and outlines a forward-looking vision for earlier diagnosis, precision medicine, and optimized surgical integration in thyroid eye disease.

Video Series

Combination Strategies, Multidisciplinary Care, and the Future of TED Management

Andrea Kossler, MD, explores the management of thyroid eye disease in special populations, emerging IGF‑1R agents and alternative targets such as interleukin 6 (IL‑6) and FcRn, and the potential role of serologic biomarkers in predicting response and relapse.

Special Populations, Emerging Targets, and Biomarkers

Andrea Kossler, MD, reviews the current therapeutic armamentarium for moderate to severe thyroid eye disease, including corticosteroids, teprotumumab, radiotherapy, and orbital decompression surgery, and discusses how these therapies fit into contemporary practice.

Therapeutic Landscape—Steroids, Biologics, Radiotherapy, and Surgery

Chelsie Derman is an associate editor for 

who covers psychiatry, sleep medicine, geriatrics, migraine, and allergy. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

BrainsWay’s SWIFT protocol reduced treatment visits from ~36 to 6 while maintaining response and remission rates in a randomized multisite trial.

Psychiatry

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Accelerated Deep TMS Matches Standard Outcomes in TRD in 6 Days

Andrea Kossler, MD, discusses when to involve ophthalmology and how evolving use of activity and severity scores intersects with quality-of-life considerations in decisions about initiating therapy.

Referral Thresholds and Activity/Severity Scoring

 Andrea Kossler, MD, outlines her screening workflow for newly diagnosed Graves disease in light of updated American Thyroid Association guidelines and describes practical initial management strategies for early thyroid eye disease.


Screening, American Thyroid Association Guidelines, and Initial Management

Patrick Campbell is the editorial director of HCPLive. Patrick has spent years spearheading coverage surrounding cardiometabolic health and rheumatic disease for MJH Life Sciences. Before joining MJH Life Sciences in 2019, he spent time as a beat reporter and/or multimedia specialist with the Pocono Record, Star News Group, and NJ Advance Media. He is the executive producer for multiple HCPLive podcasts, including Diabetes Dialogue, Don't Miss a Beat, Kidney Compass, Medical Ethics Unpacked, The Medical Sisterhood, and Skin of Color Savvy. 


Follow him on Twitter @RealPatCampbell or reach him via email at PCampbell@mjhlifesciences.com.

FDA clears once-daily icotrokinra for moderate-to-severe plaque psoriasis in adults and teens.

Plaque Psoriasis

The HCPLive plaque psoriasis page is a resource for medical news and expert insights on psoriasis. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for psoriatic disease, and more.

Icotrokinra, an Oral Il-23 Inhibitor, Receives FDA Approval for Psoriasis

Overview of KIT D816V–driven disease biology in ISM and practical approaches to longitudinal symptom monitoring, including emerging use of the Mastocytosis Control Test.

Latest News

Diabetes Dialogue: ATTD 2026 Recap

Reflecting on FDA Approval of Secukinumab for HS in Children, With Alexa Kimball, MD, MPH

Kidney Biopsies Challenge Diabetic Nephropathy Diagnoses in CKD, With Christine Limonte, MD

Who Gets What, When? Navigating Therapy Selection in IgA Nephropathy, With Corey Cavanaugh, DO

FDA Clears MiniMed Flex, A Smaller and Smartphone-Controlled Insulin Pump