Natalie Bellini, DNP, FNP-BC, BC-ADM, CDCE

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

Diabetes Dialogue: Luna Automated Insulin Delivery, With Jon Brilliant and John Sjölund

 Introduction and Background of Luna Diabetes

 Overview of Luna and Its Unique Features

 Details of Luna's Functionality and User Experience

 Clinical Trials and Feasibility Study Results

 Potential Applications and Future Directions

In this episode of Diabetes Dialogue, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, sit down with John Sjölund and Jon Brilliant, co-founders of Luna Diabetes, to explore their novel approach to automated insulin delivery (AID) designed specifically for individuals with 

The discussion introduces Luna, a small, wearable overnight patch pump that delivers automated insulin doses during sleep, addressing one of the most persistent gaps in diabetes care: nighttime glucose variability.

Unlike traditional AID systems that require full-day pump use, Luna is built for simplicity and intermittent use. It integrates with any continuous glucose monitor (CGM), requires no input on insulin type, and adapts automatically without user-programmed settings. The system supplements a patient’s existing basal insulin, providing algorithm-driven microdoses of rapid-acting insulin at night. The device operates with minimal user interaction—patients fill the pod with up to 10 units of insulin, apply it before bed, and remove it in the morning.

Preliminary data from Luna’s feasibility study showed promising results: an average 10% increase in time-in-range and a 15% reduction in time spent above 250 mg/dL, without increased hypoglycemia. The ongoing pivotal trial, enrolling 120 participants with type 1 diabetes (T1D), aims to further evaluate safety, efficacy, and patient-reported outcomes, particularly sleep quality, across 13 weeks.

Sjölund and Brilliant emphasized Luna isn't designed to match the full clinical performance of traditional AID systems, but rather to expand access by lowering barriers—providing improved overnight control and reducing cognitive and emotional diabetes burden, especially for those who prefer to avoid pumps.

Isaacs and Bellini highlighted Luna’s potential not only for people with type 1 diabetes but also for those with type 2 diabetes (T2D), particularly in conjunction with GLP-1 therapies or for patients early in their insulin journey. Luna's no-training-required model could also enable broader adoption in primary care settings, where most diabetes management occurs.

Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

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Hosts explore Luna Diabetes automated insulin delivery system, designed to enhance sleep and improve glucose control for people with diabetes who use pens.

Diabetes Dialogue: Tirzepatide vs Semaglutide for Obesity, Understanding SURMOUNT-5

Full results from the SURMOUNT-5 trial show tirzepatide (Zepbound) led to significantly greater weight loss than semaglutide 2.4 mg (Wegovy) in 

 and presented at the 32nd European Congress on Obesity.

“The SURMOUNT-5 head-to-head results demonstrated tirzepatide led to greater weight reduction compared to semaglutide, providing further evidence to support tirzepatide as an effective option for obesity management,” said principal investigator Louis J. Aronne, MD, director of the Comprehensive Weight Control Center and the Sanford I. Weill Professor of Metabolic Research at Weill Cornell Medicine, in a press release.

The phase 3b trial enrolled 751 participants across 32 US and Puerto Rican sites, with 750 receiving at least one dose of study drug. Participants were randomized to their maximum tolerated dose of tirzepatide (10 mg or 15 mg) or semaglutide (1.7 mg or 2.4 mg). The primary endpoint was percent change in body weight at 72 weeks.

Results showed tirzepatide produced a 20.2% average reduction in body weight versus 13.7% with semaglutide, a 6.5-point difference (P<0.001). In absolute terms, patients lost 22.8 kg with tirzepatide versus 15.0 kg with semaglutide.

Tirzepatide also outperformed semaglutide for the proportion of patients achieving 10%, 15%, 20%, 25%, and 30% weight loss thresholds, with more than 64% of tirzepatide patients achieving a 15% or greater body weight reduction.

Both drugs had safety profiles consistent with previous trials, with gastrointestinal symptoms being the most common adverse events. Serious adverse events occurred in 4.8% of tirzepatide users and 3.5% of semaglutide users. Six patients from each group discontinued due to side effects.

In this special edition episode of Diabetes Dialogue, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, breakdown the trial, how they interpret the findings, and how it could impact care decisions in the future.

Aronne L, Horn D, le Roux C. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. 

. Published online May 11, 2025. doi: 10.1056/NEJMoa2416394

Eli Lilly and Company. Zepbound (tirzepatide) showed superior weight loss over Wegovy (semaglutide) in complete SURMOUNT-5 results published in The New England Journal of Medicine | Eli Lilly and Company. Eli Lilly and Company. Published May 11, 2025. Accessed May 11, 2025. 

https://investor.lilly.com/news-releases/news-release-details/zepbound-tirzepatide-showed-superior-weight-loss-over-wegovy

"In the SURMOUNT-5 trial, Zepbound demonstrated a significantly higher magnitude of weight reduction compared to Wegovy across all comparisons," said Leonard Glass, MD, FACE, senior vice president, global medical affairs, Lilly. "These data confirm Zepbound as a leading treatment option for people living with obesity and equip healthcare providers with critical insights to make well-informed treatment decisions as part of a comprehensive obesity care plan."

Aronne L, Horn D, le Roux C. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. 

Eli Lilly and Company. Zepbound (tirzepatide) showed superior weight loss over Wegovy (semaglutide) in complete SURMOUNT-5 results published in The New England Journal of Medicine | Eli Lilly and Company. Eli Lilly and Company. Published May 11, 2025. Accessed May 11, 2025. 

Eli Lilly and Company. Lilly’s Zepbound® (tirzepatide) superior to Wegovy® (semaglutide) in head-to-head trial showing an average weight loss of 20.2% vs. 13.7% | Eli Lilly and Company. Eli Lilly and Company. Published December 4, 2024. Accessed May 11, 2025. 

https://investor.lilly.com/news-releases/news-release-details/lillys-zepboundr-tirzepatide-superior-wegovyr-semaglutide-head

Discover the latest findings on tirzepatide vs semaglutide for obesity treatment, highlighting significant weight loss results & clinical insights.

Diabetes Dialogue: Dexcom G7, Libre App, and Medtronic Simplera Sync

In this episode of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, break down new key updates on continuous glucose monitoring (CGM) systems for 

, incuding the Dexcom G7, Libre App, and Medtronic Simplera Sync.

On April 10, 2025, the FDA granted clearance to the Dexcom G7 15-day continuous glucose monitoring (CGM) system for individuals aged 18 years and older with diabetes. The G7 CGM now boasts the longest-lasting CGM system with 15.5 days of wear and best-in-class accuracy with a mean absolute relative difference (MARD) of 8.0%.

Isaacs and Bellini discussed the sensor life of the G7 CGM, with Dexcom announcing only 73.9% of sensors lasted the full 15 days. When using the product per package labeling, approximately 26% of sensors may not last for the full 15 days.

With the launch of the new Libre app, Abbott is replacing the Libre 2 and 3 apps with a new all-in-one app that works with all Libre sensors. With the upcoming discontinuation of Libre 2 and 3 (non-Plus) sensors in the US by September 2025, intermittent scanning will be phased out, improving data continuity and aligning with American Diabetes Association (ADA) recommendations.

They also highlight Libre’s new integration with Glooko, allowing direct data syncing via Bluetooth from the app. This streamlines clinical workflows, supports EHR integration, and includes features like voice-activated carb logging, reducing both patient and provider burden.

On April 18, 2025, the FDA approved Medtronic’s Simplera Sync sensor for use with its MiniMed 780G insulin delivery system, expanding CGM options for users. The new all-in-one, fingerstick-free sensor offers simplified insertion and enhanced user flexibility while maintaining compatibility with the system’s Meal Detection™ technology and adaptive insulin algorithm. A limited US launch is planned for fall 2025.

Isaacs and Bellini noted this long-awaited update could improve access and uptake in the US., especially for newly diagnosed patients, thanks to easier usability and compatibility with Medtronic’s strong insulin delivery algorithm.

In this episode, hosts explore updates on continuous glucose monitoring (CGM) systems from April 2025.

Diabetes Dialogue: Semaglutide for MASH in ESSENCE Trial with Arun Sanyal, MD

 Introduction and Participant Backgrounds

 Phase 2 and Phase 3 Trials of Semaglutide

 Significant Findings and Clinical Implications

 Data on Weight Loss and Liver Improvement

 Potential for FDA Approval and Future Studies

In this episode of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, break down new Phase 3 data from the ESSENCE trial examining semaglutide 2.4 mg (Wegovy) for 

metabolic dysfunction-associated steatohepatitis (MASH) 

With results published in The New England Journal of Medicine, hosts are joined by first author Arun J. Sanyal, MD, director of the Stravitz-Sanyal Institute for Liver Disease and Metabolic Health at Virginia Commonwealth University, to discuss key takeaways from part 1 of the ESSENCE trial, semaglutide’s impact on liver outcomes and weight loss, and what the data could mean for the future of MASH treatment.

Once-weekly semaglutide 2.4 mg significantly improved liver outcomes in patients with metabolic dysfunction–associated steatohepatitis (MASH) and stage 2 or 3 fibrosis, according to findings from the ESSENCE trial.

In part 1 of the ongoing, double-blind, placebo-controlled trial, 800 patients were evaluated at 72 weeks for two primary endpoints: resolution of steatohepatitis without worsening fibrosis, and fibrosis improvement without worsening steatohepatitis. Spanning 253 sites in 37 countries, the full trial enrolled 1197 biopsy-confirmed patients between May 2021 and April 2023.

At the interim analysis, semaglutide achieved both primary endpoints. Resolution of steatohepatitis without fibrosis worsening occurred in 62.9% of patients receiving semaglutide compared with 34.3% in the placebo group (difference, 28.7%; 95% CI, 21.1–36.2; 

 <.001). Reduction in fibrosis without worsening steatohepatitis was observed in 36.8% of the semaglutide group versus 22.4% with placebo (difference, 14.4%; 95% CI, 7.5–21.3; 

Secondary outcomes showed combined resolution of steatohepatitis and fibrosis reduction in 32.7% of semaglutide-treated patients versus 16.1% with placebo (difference, 16.5 percentage points; 

 <.001). Patients on semaglutide also experienced a mean body weight reduction of 10.5% versus 2.0% in the placebo group (difference: −8.5%; 

While semaglutide was linked to a slight improvement in bodily pain scores on the SF-36, the result did not reach prespecified statistical significance. Adverse events occurred in 86.3% of the semaglutide group and 79.7% of the placebo group, primarily gastrointestinal. Rates of serious adverse events were similar at 13.4% in both groups.

Resmetirom (Rezdiffra) is the only US Food and Drug Administration (FDA)-approved treatment for noncirrhotic MASH. These findings position semaglutide as a potential future option, pending results from the full ESSENCE trial and regulatory review.

In this episode, hosts explore the promise of semaglutide 2.4 mg in improving liver outcomes for MASH in the Phase 3 ESSENCE trial.

Natalie Bellini, DNP, FNP-BC, BC-ADM, CDCE

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