Gastric/Digestive Issues in T1 Diabetes

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Dr. Marina Basina & Dr. Linda Nguyen
Stanford University
Monday, 18 October 2021, 5pm PDT (12am GMT)
https://us02web.zoom.us/j/85406937371

Please feel free to share with your other T1D groups and medical professionals. There will be an open Q&A after the presentation. (This event may be recorded)

GI/Gastric/Digestive issues make up some of T1D's most unpleasant complications and no one mentions them or wants to talk about them. They absolutely impact how we T1Ds absorb food and how we need to adapt our bolus strategies.

Though gastrointestinal (GI) complications are common among long-term T1Ds, changes in the gut begin as early as 6 months after diagnosis of T1D, even in young children. The awareness of these complications is low among physicians. Early identification and appropriate management of GI complications will improve both diabetic management and quality of life.

Our speakers are influential clinicians at the Stanford University School of Medicine:

Dr. Marina Basina is Clinical Professor of Medicine, Endocrinology, Gerontology and Metabolism, Stanford University. She is a clinical endocrinologist and clinical researcher with a focus on diabetes management, thyroid, and adrenal conditions. Her primary interests are in Type 1 Diabetes, Diabetes technology, and Diabetes in pregnancy. Dr. Basina is Board certified in Endocrinology and Internal Medicine. She received numerous teaching awards and the Stanford Hospital award for excellence in patient care. As if she weren’t already busy enough, she is an active member of medical advisory boards for several community diabetes organizations as well as a medical director of inpatient diabetes program at Stanford and a chair of the diabetes task force.

Dr. Linda Nguyen is Clinical Professor, Medicine - Gastroenterology & Hepatology at Stanford University, with special interests: Gastroparesis, Chronic Nausea, Cyclic Vomiting, Irritable Bowel Syndrome, Autonomic dysfunction, and Brain-gut disorders.
She has said, “Food has always been a big part of my life. Imagine what life would be like if eating made you sick? Because we need food to survive and we are social creatures who revolve much of our lives around food, not being able to eat impacts physical, mental and social well-being. It is this intricate interconnection between the brain and the gut which drew me to the field of Neurogastroenterology & Motility. My research includes understanding the role/impact of physiologic testing on clinical care, exploring novel therapies for gastroparesis, and expanding the role of neuromodulation in the treatment of GI motility disorders and pain.”

What’s so special about this area of research?

There is growing evidence that there is a strong relationship between Type 1 diabetes and the gut microbiome. In fact, the gut microbiome might be a pivotal hub of T1D‐triggering factors. 

Click on the links to the research papers below for some “light” reading.

Loopdocs Updates

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There have been lots of updates to LoopDocs as a result of iOS 15 / Xcode 13.  The updated LoopDocs pages support the new requirement to use Workspace when building. Feedback is welcome.

Loopers who are rebuilding right now are encountering new errors.  The two most common errors occur when Builders forget to click Loop (Workspace) in #2 in the diagram, and when they don't wait patiently for Indexing/Processing to finish before they click the build triangle in #5.   If you run into problems building, be sure to take screenshots using command+shift+3 and provide details so that  volunteers can help you troubleshoot.  

As always, we recommend that you update your computer first and then your phone.  Please disable the auto-update feature on your looping phone by clicking iPhone Settings/General/Software Update.

New Video:  Building Loop Using the Build Select Script

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If you'd like a step by step visual guide to building Loop, check out our new video, Building Loop with the Build Select Script.  Be sure to subscribe to our YouTube channel to be notified as new videos are released!

Replay:  Dr. Elliot Botvinick, UC Irvine

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Developer of iGLOBE

(Insulin+Lactate+Oxygen+ Beta-hydroxybutyrate LifeStrip)

Dr. Elliot Blotvinick and his colleague Dr. Gregory Weiss have won a three-year, $3.5 million grant from the Leona M. and Harry B. Helmsley Charitable Trust to further the development of an innovative continuous-use monitor for those with type 1 diabetes.

iGLOBE is a first-of-its-kind device that will simultaneously measure insulin, glucose, lactate, oxygen, and the ketone body beta-hydroxybutyrate with a single probe inserted just beneath the skin.  It will include continuous insulin monitoring and improve dosing efficacy by providing real-time feedback on the dynamics of insulin pump therapy as well as real-time estimates of a patient’s sensitivity to the insulin.

Dr. Botvinick has been named the UCI Samueli School of Engineering “Innovator of the Year” and “Entrepreneurial Leader of the Year for several years running. He holds more than 10 patents.

Replay:  Dr. Nally, Pediatric Endocrinologist, Yale University School of Medicine

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Laura Nally, MD, was diagnosed with type 1 diabetes at the age of 6 years in 1990. She trained to become a pediatric endocrinologist at Stanford University, where she began Looping in 2018. She currently works at Yale University as an Assistant Professor and receives funding from the National Institutes of Health to study metabolic changes that occur on very low carbohydrate diets in youth with T1D.

Below, you will find links to ISPAD guidelines for PreSchool T1Ds, as well as Dr. Nally's paper on Looping in Pregnancy.