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: Tech Updates on Twiist, MiniMed Go, and More

In this episode, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, provide an in-depth review of several notable developments in diabetes technology, focusing on innovations in insulin pump interoperability, automated insulin delivery algorithms, continuous glucose monitoring, and decision-support tools for people using multiple daily injections (MDI).

00:00:01 Intro
00:00:19 The Sequel Twiist
00:01:05 Diabeloop's new algorithm
00:09:01 Leaving CamAPS behind?
00:09:57 Eversense approaching a spring launch
00:12:27 MiniMed Go and the InPen
00:17:40 Outro

The episode begins with a major announcement from Sequel Med Tech regarding the Twiist insulin pump. Now fully commercially available after an initial limited launch, Twiist is distinguished by its interoperable design and current pairing with the Tidepool Loop algorithm. The hosts highlight Sequel’s announcement of a new partnership with Diabeloop, whose recently FDA-cleared algorithm is designed to operate as a fully closed-loop system. Unlike most existing systems, the Diabeloop algorithm does not require meal announcements, though optional meal inputs may further improve time in range. Isaacs and Bellini emphasize how this level of automation represents a significant step forward in reducing user burden, potentially rivaling or exceeding the automation seen with systems such as the Beta Bionics iLet.

The hosts explore the clinical and practical implications of offering two distinct algorithms on a single pump platform. Diabeloop’s minimal user interaction may appeal to individuals seeking simplicity or lower engagement, while Tidepool Loop’s adjustable parameters and customization options may better suit experienced users who want greater control. Bellini raises questions around how easily patients might switch between algorithms over time, drawing parallels to the flexibility clinicians currently have when changing CGM sensors. The discussion also touches on regulatory and safety considerations, with both hosts noting that algorithm switching would likely require safeguards to prevent user error.

Isaacs notes some disappointment that CamAPS, the only algorithm currently approved for use during pregnancy in the United States, is not part of Sequel’s announced partnerships. However, both hosts acknowledge the strategic rationale for selecting Diabeloop and suggest future collaborations remain possible.

The conversation then shifts to CGM integration, with confirmation that Twiist compatibility with the Eversense implantable CGM is approaching public release, following internal employee use. Anticipated availability in early spring is framed as an important milestone, particularly for patients interested in long-wear sensors. The hosts discuss benefit design considerations, emphasizing that pharmacy access to alternative CGMs may mitigate concerns about long-term commitments.

The episode concludes with discussion of Medtronic’s newly FDA-cleared MiniMed Go mobile app, designed to work with the InPen smart insulin pen. The hosts highlight improved real-time CGM integration using Medtronic’s rebranded Libre 3 Plus–based Instinct sensor, enhanced detection of missed boluses, and actionable prompts intended to support insulin dosing decisions. Bellini underscores the importance of these features for people using MDI who may not want pump therapy, positioning MiniMed Go as a meaningful advance in improving time in range and clinical support for this population.

Podcasts

Diana Isaacs, PharmD, and Natalie Bellini, DNP, review tech updates from Sequel Med Tech, Diabeloop, and Medtronic.

News

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Clinical

clinical page is a resource for content on every specialty, disease, and topic available on our medical news site.

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.

Type 2 Diabetes

Type 1 Diabetes

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

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.

Strategic Alliance Partnership

Sidhartha Sinha, MD, is an assistant professor of gastroenterology and hepatology at Stanford University.

When Medications Fall Short: Exploring Diet in Mild Crohn’s Disease, With Sidhartha Sinha, MD

For patients with mild Crohn’s disease (CD), treatment decisions are often complicated by a lack of appropriate therapeutic options. While corticosteroids, the onlyUS Food and Drug Administration (FDA)-approved therapy for this population, can rapidly improve symptoms, their long-term toxicity often outweighs their benefits. As a result, there has been a growing interest in nonpharmacologic strategies for disease management.

“We often think about [steroids] as being some of the best drugs and some of the worst drugs at the same time. They can make patients feel better, and sometimes we need to do that and do that quickly, but they come with a whole slew of side effects,” Sidhartha Sinha, MD, an assistant professor of gastroenterology and hepatology at Stanford, told HCPLive. “We're always looking at ways to improve the treatment of patients, and fortunately, now we have many advanced therapies that offer some benefit, but patients who have mild and sometimes very moderate Crohn's disease fit into this area where there may not be therapies that are appropriate for them. In these cases, we think that lifestyle can really make an impact.”

With this therapeutic gap in mind, he and a team of investigators conducted an open-label, randomized, controlled, clinical trial assessing the effectiveness of a fasting-mimicking diet (FMD) for reducing clinical disease activity in patients with mild-to-moderate CD. In the study, patients consumed a FMD for 5 consecutive days per month for 3 consecutive months. For the remaining days in each month, patients consumed their regular baseline diet. Patients in the control group continued their baseline diet.

Study results showed that short, structured periods of significant caloric restriction were associated with improvements in clinical disease activity and biochemical markers of inflammation. In some cases, patients achieved complete clinical remission.

However, Sinha emphasized that FMD should not be viewed as a replacement for standard medical therapy. Instead, he says the results suggest that diet may serve as a complementary strategy, especially for patients who fall into the gray zone between minimal symptoms and disease severe enough to justify immunosuppressive or biologic treatment.

One of the notable strengths of the study was its real-world design. Participants reflected everyday clinical practice, including patients already receiving pharmacologic therapy as well as those who had chosen not to initiate medication. Across both groups, the dietary intervention was associated with reductions in disease burden, reinforcing the idea that nutritional strategies may exert benefits independent of medication status.

Sinha went on to emphasize the importance of considering safety, noting that an intervention should never cause harm. Accordingly, his study only enrolled patients with mild to moderate disease and excluded those who were pregnant, underweight, or otherwise at risk.

He noted that despite the low caloric intake during the fasting periods, no significant differences in weight were observed between the intervention and control groups, likely due to post-intervention caloric rebound. Adverse effects such as fatigue and headache were mild, transient, and resolved quickly once normal eating resumed, something Sinha says can likely be expected after long periods of not eating much food or skipping meals.

Taken together, he says the findings suggest that carefully designed dietary interventions like FMD may offer a promising, low-risk adjunct for patients with mild Crohn’s disease while also opening the door to more mechanistically informed lifestyle research in IBD.

Editors’ note: Sinha reports no relevant disclosures.

Brooks A. Fasting-Mimicking Diet Elicits Clinical, Biochemical Response in Mild Crohn’s Disease. HCPLive. January 13, 2026. Accessed January 16, 2026. 

https://www.hcplive.com/view/fasting-mimicking-diet-elicits-clinical-biochemical-response-in-mild-crohn-s-disease

Ha C. Management of Patients With Mild Crohn's Disease. 

https://pmc.ncbi.nlm.nih.gov/articles/PMC11346010/

Videos

Sinha explains current unmet needs in mild Crohn’s, the shortcomings of steroids for these patients, and what benefits a fasting-mimicking diet may offer.

Gastroenterology

Gastroenterology condition center page is a comprehensive resource for clinical news and insights on digestive and GI conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for 

, IBS and IBD, Crohn's disease, and more.

Inflammatory Bowel Disease

On the HCPLive inflammatory bowel disease page, resources on the topics of medical news and expert insight into IBD can be found. Content includes articles, interviews, videos, podcasts, and breaking news on IBD and more.

Alex Hillenbrand is an assistant editor for 

. She earned her BA in English from Lafayette College in 2023 and went on to write for pop culture, entertainment, and sports media outlets before joining MJH Life Sciences in 2025. In her free time, Alex enjoys cooking, going on walks, and meeting new people. Contact her at mjhlifesciences.com.

New data from the SCREAM project highlight a simple, low-cost strategy which may enable earlier detection and primary prevention of

 by investigators from Karolinska Institutet and are accompanied by a newly developed, web-based clinical tool utilizing age- and sex-specific estimated glomerular filtration rate (eGFR) percentiles.

In the absence of systematic screening programs, CKD is often diagnosed late in its course, typically after patients cross fixed diagnostic thresholds, most commonly defined as falling to an eGFR <60 mL/min/1.73 m². By this point, more than >50% of kidney function may already be lost. Although urine albumin testing can detect kidney damage earlier, it remains underutilized in routine practice, leaving creatinine-based eGFR reporting as the primary driver of CKD detection.

“This creates a passive approach to care, where action is delayed until kidney damage is already substantial,” Juan Jesús Carrero, MD, PhD, professor of epidemiology at Karolinska Institutet and senior author of the study, said in a statement. “In practice, we often wait until eGFR falls below 60, even though a large amount of kidney function has already been lost by then.”

To address this gap, Carrero and colleagues applied growth charts, a concept often used in pediatrics, to kidney function. Using nearly 7 million eGFR measurements collected between 2006 and 2021, the investigators constructed age- and sex-specific population distributions for eGFR and examined whether deviations from the population median eGFR were associated with adverse outcomes.

The SCREAM project included 1.1 million adults aged 40 to 100 years, representing approximately 80% of the population of Stockholm, Sweden.

Upon analysis, investigators found only about 25% of individuals with eGFR values > 60 mL/min/1.73 m² but < the 25th percentile had undergone additional urine albumin testing, underscoring missed opportunities for early evaluation and prevention.

Among individuals with eGFR values ≥ 60 mL/min/1.73 m², those with values < the 25th percentile for their age and sex had a significantly increased risk of kidney failure requiring dialysis or transplantation. They observed mortality followed a U-shaped pattern, with increased risk observed at both low and high extremes of the eGFR distribution.

For example, investigators explained the case of a 55-year-old woman with an eGFR of 80 mL/min/1.73 m². In clinical practice, she would typically be considered to have normal kidney function. However, in the study’s age- and sex-specific charts, this value corresponds to approximately the 10th percentile and was associated with a 3-fold higher risk of future dialysis initiation.

To support clinical implementation, the researchers made the eGFR distribution charts publicly available and developed a web-based calculator, allowing healthcare professionals to view a patient’s eGFR percentile relative to age- and sex-matched population norms.

“This approach is low-cost and easy to implement. When a creatinine test is ordered, clinicians could automatically receive not only the eGFR value but also its percentile for age and sex,” concluded Carrero. This would provide a simple way to identify patients who appear “normal” but are already deviating from expected kidney function and may benefit from earlier evaluation and prevention efforts.”

Simple method can enable early detection and prevention of chronic kidney disease. EurekAlert! Published January 16, 2026. Accessed January 16, 2026. 

https://www.eurekalert.org/news-releases/1112495

National Kidney Foundation. Estimated Glomerular Filtration Rate (eGFR). National Kidney Foundation. Published July 13, 2022. 

https://www.kidney.org/kidney-topics/estimated-glomerular-filtration-rate-egfr

Articles

The SCREAM project introduces a cost-effective strategy for early detection and prevention of chronic kidney disease (CKD) using age- and sex-specific eGFR percentiles. Traditional CKD diagnosis often occurs late, after significant kidney function loss. The study applied pediatric growth chart concepts to eGFR data, revealing that individuals with eGFR values below the 25th percentile face increased risks of kidney failure. A web-based tool was developed to help clinicians assess eGFR percentiles, facilitating earlier intervention. This approach aims to identify patients at risk before substantial kidney damage occurs.

A population-based analysis suggests age and sex specific eGFR percentiles and a web-based calculator can identify CKD risk before diagnostic thresholds. 


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.

Chronic Kidney Disease

Age, Sex Specific eGFR Percentiles May Enable Earlier CKD Detection

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.

Appropriate escalation of treatment improves 

 control, new data suggest, and many patients living with poorly controlled CSU are not provided with guideline-recommended treatment escalation.

This was the conclusion of a recent analysis looking at CSU treatment patterns and unmet needs within real-world practice settings. Pavel Kolkhir, MD, from the Institute of Allergology, Charité – Universitätsmedizin Berlin in Germany, led a team of other investigators in the authoring of this analysis.

Kolkhir et al highlighted the hives and angioedema associated with CSU, noting the condition is estimated to impact about 0.5%–1.4% of the global population.

 CSU is also a disease with a substantial impact on patients’ quality of life.

“The objective of this analysis was to describe real-world treatment patterns and identify unmet needs, with particular focus on treatment escalation, the clinical outcome, and the response to treatment changes in patients with CSU prospectively collected through the chronic urticaria registry (CURE) from baseline (BL) to 6-month follow-up (FU),” Kolkhir and colleagues wrote.

In their study, Kolkhir and coauthors used CURE, an investigator-led, prospective, multinational observational disease registry. CURE is used across 79 sites across the world, representing the first global registry designed for advancing the world’s understanding of chronic urticaria and urticarial vasculitis via the systematic characterization of disease trajectory and outcomes. Additionally, CURE characterizes overall burden, associated comorbidities, varying therapeutic approaches and responses, and patterns of health care utilization.

For their current analysis, data were gathered through the CURE registry between December 2015 - April 2023 using standardized physician- and/or patient-completed questionnaires, as previously reported. Looking at adult participants with confirmed CSU diagnoses, the analysis was aimed at assessing treatment patterns at baseline and at a 6-month follow-up visit. Data deemed eligible for the study were drawn from 28 countries across Asia, Europe, Africa, and Latin and South America.

Effectiveness of patients’ treatments was assessed by looking at any shifts in the Urticaria Control Test scores between the point of baseline and 6 months. The definition used by Kolkhir and colleagues for complete treatment response was attainment of a UCT score of 16 along with an improvement of 3 points at minimum from the point of baseline. At baseline, evaluable information were available for 3995 individuals living with CSU. There were 1288 who had assessable UCT scores at follow-up.

Among patients who underwent treatment escalation between baseline and follow-up appointments, variation in complete response rates was by treatment step. Kolkhir and coauthors specifically highlighted 5.3% of subjects who changed from zero treatment to licensed-dose second-generation H1 antihistamines attained a complete response. This also took place among 6.0% of those escalated from licensed-dose to up-dosed second-generation H1 antihistamines.

A substantially greater proportion (28.4%) of patients who escalated from any dose of second-generation H1 antihistamines to omalizumab, by contrast, achieved complete disease control. In their multivariable analysis, the investigative team identified several factors linked to a diminished likelihood of treatment escalation at the point of follow-up. Specifically, those showing a baseline UCT score of 12 or greater and those already on omalizumab at baseline were noted to be significantly less likely to have their therapy escalated. Both associations reaching high statistical significance (

Notably, Kolkhir et al found among patients who met clinical criteria for escalation at baseline, 28.6% did not report appropriate treatment intensification. Among those within this subgroup, 18.0% remained on the same medication. At the same time, 10.6% were actually stepped down, and all continued to have inadequate disease control by their follow-up appointments.

In looking at the lack of escalation, various characteristics were shown to be associated with this lack of change among individuals with poorly-controlled disease. Shorter CSU duration (

 = .071) and the existence of both wheals and angioedema were linked with a lower likelihood of stepping up therapy (

 = .014). Additionally, the investigators found better baseline quality of life scores showed a correlation with non-escalation (

 = 0.001) along with ongoing treatment with up-dosed second-generation H1 antihistamines (

“The lack of guideline-recommended treatment escalation in patients with poorly controlled CSU highlights an important gap between evidence-based recommendations and actual clinical practice—a point that deserves further investigation,” Kolkhir and coauthors wrote.

Kolkhir P, Salameh P, Weller K, et al. Unmet Needs in Treatment Escalation for Chronic Spontaneous Urticaria: Findings From the CURE Registry. Allergy. 2026 Jan 14. 

Maurer M, Weller K, Zuberbier T, et al. Unmet clinical needs in chronic spontaneous urticaria. A GA²LEN task force report. Allergy. 2011 Mar;66(3):317-30. doi: 10.1111/j.1398-9995.2010.02496.x. Epub 2010 Nov 17. PMID: 21083565.

Recent data indicate that appropriate treatment escalation significantly improves control of chronic spontaneous urticaria (CSU), yet many patients do not receive guideline-recommended escalation. An analysis led by Pavel Kolkhir, MD, utilized the CURE registry to assess real-world treatment patterns and unmet needs in CSU management. Findings revealed that treatment escalation, particularly to omalizumab, resulted in higher complete response rates. However, a substantial proportion of patients did not receive necessary treatment intensification, highlighting a gap between clinical practice and evidence-based guidelines.

This study analyzed the Chronic Urticaria Registry (CURE), evaluating CSU treatment patterns and looking into unmet needs in real-world practice.

Urticaria

The HCPLive urticaria page is a comprehensive resource for clinical news and insights on chronic idiopathic urticaria and chronic spontaneous urticaria. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for urticaria, and more.

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.

Unmet Needs Highlighted Regarding CSU Treatment Escalation

Linda Stein Gold, MD, is a dermatologist at Henry Ford Health. 

Final reflections from physicians Stein Gold, Soung, and Cotter, emphasizing multidisciplinary, patient-focused advances in psoriasis and PsA care.

Closing Thoughts on the Impact of IL-23s in Psoriasis and Psoriatic Arthritis

, despite the expanding therapeutic landscape. Linda Stein Gold, MD, and her colleagues analyze patient- and provider-reported data from the 

 surveys, revealing that many patients remain dissatisfied with current therapies and that oral agents are overwhelmingly preferred over injectables. The experts discuss how patient lifestyle, comorbidities, and psychosocial burden influence shared decision-making and treatment adherence. They also interpret the 

International Psoriasis Council’s (IPC)

 and explore its implications for reducing “topical churn” and advancing systemic therapy earlier in the disease course.

 and its potential to close current gaps in care. The panel provides an in-depth review of the 

 clinical development program, summarizing the 

 trials, which demonstrated superior efficacy versus deucravacitinib at both 16 and 24 weeks, with favorable safety and tolerability. They also discuss new 

 showing sustained clearance and no new safety signals in adults and adolescents. The faculty reflect on ICO’s implications for adolescent psoriasis and how early, aggressive oral intervention may help prevent progression to psoriatic arthritis, marking a significant milestone in the evolution of oral IL-23–targeted therapy.

The final portion of the series shifts focus to 

managing active psoriatic arthritis (PsA)

. The experts discuss new findings from the 

 demonstrated the first clear evidence of IL-23–mediated inhibition of structural joint damage, reinforcing the rationale for early biologic use in high-risk patients. They compare APEX to prior IL-23 studies, discuss implications for therapy sequencing, and highlight other emerging data from 

 studies. In closing, Stein Gold and colleagues emphasize a forward-looking approach that integrates personalized therapy selection, early detection of PsA, and cross-specialty collaboration to elevate standards of psoriasis care

Video Series

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.

Reduced IgE binding and blunted basophil activation in response to Gal d 1 and Gal d 2 suggest that heat-treated egg proteins could improve the safety of OIT for egg-allergic patients.

Allergy

Allergy condition center page is a comprehensive resource for clinical news and insights on allergic and inflammatory diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for food and seasonal allergies, as well as allergic asthma and related conditions.

Food Allergy

Heat-Denatured Egg Allergens May Offer Safer Oral Immunotherapy

Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

A cohort study of patients from the Women’s Health Study has highlighted the direct correlation between lipoprotein(a) levels and cardiovascular risk in healthy patients.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

Dyslipidemia

Very High Lipoprotein(a) Levels Linked to Cardiovascular Disease Among Healthy Women

A smartphone-based patient-caregiver educational program was evaluated in its impact on relapse rates in children with moderate-to-severe atopic dermatitis.

Atopic Dermatitis

Atopic Dermatitis 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 dermatitis research, treatment, and drug development.

Digital Eczema Education Decreases Relapse Rates in Children in the Short-Term

Berotralstat becomes the first once-daily oral prophylactic option for long-term prevention of hereditary angioedema in children aged 2–11 years.

FDA News

FDA Approves Oral Berotralstat for Pediatric HAE, With Jolanta Bernatoniene, PhD

Frances Lee, MD, is an assistant professor of medicine in the division of liver diseases at Mount Sinai.

Lee describes misconceptions about ALD, the importance of multidisciplinary care, and what the future of pharmacotherapy for this disease may hold.

Hepatology

Addressing Stigma and Advancing Care in Alcohol-Associated Liver Disease, With Frances Lee, MD

New sequence analysis suggests racial and ethnic disparities in KRT are pronounced in younger adults, affecting mortality, transplantation, and dialysis modality use.

Younger Adults Face Pronounced Racial, Ethnic Gaps in Kidney Therapy

Guy Young, MD, is the director of the Hemostasis and Thrombosis program at Children’s Hospital Los Angeles and professor of pediatrics at Keck School of Medicine of USC.

The SWITCH phase 1 trial aims to determine the optimal time to switch medications to minimize thrombotic risk and avoid leaving patients untreated.

Hematology

Ongoing Trial Investigates Switching from Emicizumab to Fitusiran in Hemophilia A, With Guy Young, MD

The Mortality Estimation in Renal Disease (MERD) score may help identify transplant candidates at highest risk of waitlist mortality.


New MERD Risk Score Predicts Mortality for Kidney Transplant Waitlist Patients

Ritlecitinib was evaluated for the treatment of non-segmental vitiligo (NSV) in different subgroups, stratified by demographics as well as various clinical characteristics.

Vitiligo

Vitiligo condition center page is a comprehensive resource for clinical news and insights on the dermatologic condition. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for the affected skin of vitiligo patients.

Latest News

Diabetes Dialogue: Tech Updates on Twiist, MiniMed Go, and More

When Medications Fall Short: Exploring Diet in Mild Crohn’s Disease, With Sidhartha Sinha, MD

Age, Sex Specific eGFR Percentiles May Enable Earlier CKD Detection

Unmet Needs Highlighted Regarding CSU Treatment Escalation

Closing Thoughts on the Impact of IL-23s in Psoriasis and Psoriatic Arthritis