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

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

Diabetes Dialogue hosts discuss November 2025 technology updates, including Omnipod updates from Insulet Corporation

Diabetes Dialogue: Upcoming Upgrades for Omnipod Technology

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, break down what Insulet Corporation’s announcements surrounding forthcoming updates to Omnipod mean for the diabetes community.

At its 2025 Innovation Showcase, Insulet Corporation highlighted a series of major product advancements that are expected to significantly expand the clinical utility of automated insulin delivery (AID) for both type 1 and 

. The company outlined 3 sequential product launches between 2026 and 2028, each designed to simplify therapy, enhance glycemic outcomes, and broaden access to AID across diverse clinical settings.

Pending FDA clearance, Insulet plans upgrades to the current Omnipod 5 system, which became the first FDA-approved AID system for type 2 diabetes in August 2024,  to strengthen glycemic control, improve usability, and expand ecosystem connectivity. Key clinical-facing improvements include:

Full interoperability with all major continuous glucose monitoring (CGM) systems.

Improved algorithmic performance designed to optimize time-in-range and reduce hypoglycemia.

Omnipod Discover, a new machine-learning insights platform, intended to streamline onboarding, simplify dose adjustment, and support clinical decision-making with real-time, data-driven recommendations.

Insulet’s next AID platform, Omnipod 6, introduces a redesigned system built to elevate both personalization and simplicity:

An adaptive insulin-dosing algorithm that continuously learns and adjusts to each user’s glucose patterns.

A configurable Pod engineered to function with 

A new app and controller interface emphasizing intuitive setup, patient autonomy, and reduced clinic training burden.

Omnipod 6 is intended for use in both type 1 and type 2 diabetes, expanding AID applicability to the large population of insulin-requiring type 2 patients who have had limited access to pump therapy.

Omnipod Fully Closed Loop for Type 2 Diabetes (Expected 2028)

Insulet also announced plans for the Omnipod Fully Closed Loop for Type 2, which is designed as the first out-of-the-box, fully automated insulin delivery system for type 2 diabetes:

No meal announcements, carb counting, or manual boluses required

An intelligent algorithm that autonomously manages basal and bolus insulin delivery

Zero-setup design intended to enable prescription and use in primary care, dramatically broadening AID access

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.

Insulet Corporation. Insulet Outlines Long-Term Strategy to Drive Growth and Value Creation at 2025 Investor Day. Insulet.com. Published November 20, 2025. Accessed November 25, 2025. 

https://investors.insulet.com/news/news-details/2025/Insulet-Outlines-Long-Term-Strategy-to-Drive-Growth-and-Value-Creation-at-2025-Investor-Day/default.aspx

Insulet Corporation. Omnipod® 5 Automated Insulin Delivery System is now FDA-cleared for People with Type 2 Diabetes. Insulet.com. Published August 26, 2024. Accessed November 25, 2025. 

https://investors.insulet.com/news/news-details/2024/Omnipod-5-Automated-Insulin-Delivery-System-is-now-FDA-cleared-for-People-with-Type-2-Diabetes/default.aspx

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Discover the latest advancements in diabetes technology from November 2025, including Omnipod updates and the new Pivot pump.

In this episode of Diabetes Dialogue, hosts discuss Semaglutide for Alzheimer Disease and new trial data on Tirzepatide showing promise in T1D

Diabetes Dialogue: Semaglutide Falls Short Alzheimer Disease, Tirzepatide Shows Promise in T1D

In this episode, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, breakdown recent trial news from the 2 most popular incretin therapies: semaglutide and tirzepatide. First, hosts breakdown the November 24, 2025 announcement from Novo Nordisk disclosing their evoke and evoke+ trials of oral semaglutide in early symptomatic 

 failed to slow disease progression. Next, hosts break down the TIRTLE study, which examined use of tirzepatide in patients with 

Semaglutide Misses Mark in Alzheimer Disease

Novo Nordisk announced top-line results from the evoke and evoke+ phase 3 trials showing oral semaglutide 14 mg did 

 slow disease progression over 2 years in adults with early symptomatic Alzheimerdisease, with no significant difference in CDR-SB change versus placebo. Despite improvements in Alzheimer-related biomarkers across both studies, neither trial demonstrated a slowing of clinical decline.

evoke was a global, randomized, double-blind, placebo-controlled trial enrolling 1,855 participants aged 55–85 with amyloid-positive CDR 0.5 MCI or CDR 1.0 mild dementia, treated 1:1 with semaglutide or placebo for 104 weeks plus a planned 52-week extension. evoke+ mirrored this design, randomizing 1,953 participants with the same eligibility criteria to daily semaglutide 14 mg or placebo for a total planned duration of 156 weeks.

Findings from the trials will be presented at the 2025 Clinical Trials in Alzheimer’s Disease (CTAD) conference on December 3, 2025. The lack of efficacy led to discontinuation of the planned 1-year extension period across both trials, though safety and tolerability remained consistent with prior semaglutide experience in diabetes and obesity.

TIRTLE: Tirzepatide Shows Benefit in Type 1 Diabetes

In a 12-week, double-blind, placebo-controlled phase 2 trial of 24 adults with type 1 diabetes and BMI >30 kg/m², tirzepatide produced a 10.3-kg mean weight loss versus 0.7 kg on placebo, an −8.7-kg treatment difference (

 < 0.0001) corresponding to 8.8% total body weight reduction.

All tirzepatide-treated participants achieved ≥5% weight loss, and 45% achieved ≥10%, compared with 9% and 0% in the placebo group. Eligibility criteria required patients to be 18 years of age or older, with confirmed type 1 diabetes, obesity (BMI >30), and stable insulin therapy. Tirzepatide also improved glycemic control, reducing HbA1c by 0.4%, and decreased total daily insulin dose by 35% relative to placebo (−24.2 vs −0.3 units/day). Safety data suggested no significant adverse events occurred, with 22 of the 24 participants completing the study.

Novo Nordisk. Novo Nordisk A/S: Evoke phase 3 trials did not demonstrate a statistically significant reduction in Alzheimer’s disease progression. Novo Nordisk. November 24, 2025. Accessed November 24, 2025. 

https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=916462

Snaith JR, Frampton R, Samocha-Bonet D, Greenfield JR. Tirzepatide in Adults With Type 1 Diabetes: A Phase 2 Randomized Placebo-Controlled Clinical Trial. 

. Published online November 20, 2025. doi:

Explore the latest findings on GLP-1 drugs, including their impact on Alzheimer's and promising results for type 1 diabetes treatment.

Diabetes Dialogue: Semaglutide Falls Short in Alzheimer Disease, Tirzepatide Shows Promise in T1D

Diabetes Dialogue: Updates on Dexcom G7 and Semaglutide Pricing

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 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, review two major developments in diabetes care: the forthcoming 15-day Dexcom G7 continuous glucose monitor (CGM) and significant new price reductions for semaglutide across Ozempic and Wegovy.

00:00:01 Introduction
00:00:30 Dexcom G7
00:01:55 A 15-Day Sensor With a 12-Hour Grace Period
00:04:27 Seamless transition to the new G7
00:05:23 Looking back at Dexcom's advancements
00:06:34 Dexcom's Smart Basal feature
00:10:34 Price cuts for semaglutide - Wegovy and Ozempic
00:14:54 Cheaper GLP-1s on the pharmacies' end
00:20:33 Outro

Isaacs and Bellini first outline Dexcom’s announcement that the 15-day G7 sensor will launch on December 1 through durable medical equipment channels, with pharmacy availability to follow shortly afterward. The extended-wear sensor maintains the same form factor, app platform, and accuracy profile users expect, now with a 15.5-day life enabled by a built-in 12-hour grace period. Integration with Omnipod 5 and iLet will be available at launch, with Control-IQ+ compatibility expected later. Both hosts emphasize how reduced sensor-change burden and seamless pump integration can streamline therapy, particularly as CGM adoption accelerates in primary care and among people with 

. They note, however, that the initial FDA clearance is limited to adults 18 and older, with pediatric expansion expected as post-market data develop.

The hosts also highlight advances in data-sharing and the newly cleared Smart Basal feature within the G7 15-day app experience. This tool uses CGM-driven analytics to support clinicians and patients in basal insulin titration, particularly for glargine. The system adjusts doses based on comprehensive glycemic patterns rather than isolated fasting values, incorporates customizable hypoglycemia safeguards, and identifies a final “optimal dose” once glucose stabilizes. Isaacs and Bellini underscore the potential impact for primary care, where under-titration of basal insulin is common and follow-up intervals can be lengthy.

The conversation then shifts to sweeping pricing updates for semaglutide. New self-pay pricing allows patients to access Ozempic for $199 for the first two months and $349 thereafter—a steep reduction from previous cash prices. Wegovy pricing aligns similarly across all doses. While acknowledging that affordability remains a challenge for many, the hosts view this as a substantial improvement, bringing U.S. pricing closer to international norms and potentially expanding access for individuals who fall between traditional insurance coverage and patient-assistance eligibility. They also note updated criteria for assistance programs, ongoing availability of copay cards, and similar price reductions for tirzepatide’s Zepbound starter dose. Practical considerations for pharmacies, insurance dynamics, and cash-pay logistics are discussed, with the hosts optimistic about simplified access and broader uptake.

They conclude by emphasizing how these advances - longer-wear CGM technology, AI-supported insulin titration, and more accessible incretin-based therapies - collectively strengthen the future of diabetes management and expand opportunities for improved outcomes across clinical settings.

This episode covers the upcoming release of Dexcom's G7 15-day patch and major price cuts for semaglutide.

 Diabetes Dialogue: FINE-ONE and Finerenone in Type 1 Diabetes at Kidney Week 2025

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 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, break down 1 of the most anticipated presentations from 

American Society of Nephrology (ASN) Kidney Week 2025

The first phase 3 study to evaluate finerenone for chronic kidney disease (CKD) in type 1 diabetes, FINE-ONE was a global, randomized, double-blind, placebo-controlled phase 3 trial enrolling 242 participants across 80 sites in 9 countries. Participants received once-daily finerenone (10 mg or 20 mg) or placebo, with dose based on eGFR and titration permitted at 30 days if potassium remained ≤4.8 mmol/L and eGFR decline was <30%. All participants continued optimized background therapy for BP, lipids, and glycemia; insulin regimens were unchanged.

At 6 months, finerenone achieved a 25% relative reduction in UACR vs placebo, meeting its primary endpoint. Investigators noted 68.1% of finerenone-treated patients reached a ≥30% UACR reduction, compared with 46.6% on placebo, which exceeded the ADA-recognized threshold linked with slower CKD progression. The safety profile for finerenone was consistent with prior trials in T2D, with no new hyperkalemia or cardiorenal signals.

Isaacs and Bellini emphasize the significance of having a non-glucose-lowering therapy with demonstrated renal benefit in type 1 diabetes in light of the limitations of SGLT2 inhibitors in this population due to euglycemic DKA risk. 

Despite the encouraging findings, the hosts caution that the sample size is modest and the study was not powered for cardiovascular outcomes. They note an FDA indication will be critical for broad adoption, payer coverage, and field education, which are historically areas where type 1 diabetes therapies often lag. 

Discover groundbreaking findings from the FINE-ONE trial on finerenone, offering hope for type 1 diabetes patients with CKD.

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

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