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DIABETES MANAGEMENT
Your go-to hub for tips, tricks, and real talk on living boldly with diabetes
Why Your CGM May Be Making You More Anxious (And What You Can Do About It)
Continuous glucose monitors (CGMs) have transformed the way we live with type 1 diabetes. They give us access to real-time glucose data, trend arrows, alerts, and insights that were unimaginable just a few years ago. But there's a side of CGM use that doesn't get talked about enough. For some people, this constant stream of diabetes data doesn't create peace of mind. It creates anxiety. I've worked with hundreds of adults living with type 1 diabetes, and there's a pattern I see again and again. Instead of feeling more confident after starting a CGM, they find themselves looking at their phone every few minutes, reacting to every blood sugar fluctuation, and feeling like diabetes is taking up more mental space, not less. The problem isn't the technology. The problem is that more information doesn't automatically create more confidence. Without the psychological skills to respond to uncertainty, more information often leads to more anxiety. The Anxiety Feedback Loop Imagine you're sitting at your desk working. You glance at your phone and see your blood sugar has drifted from 118 mg/dL to 132 mg/dL. Ten minutes later, you check again. Now you're 146 mg/dL with a diagonal arrow up. Your mind immediately starts racing. Should I correct? Should I wait? Did I miscount lunch? Did I not take enough insulin? A few minutes later, you check again. Before you know it, you've spent the last 30 minutes thinking about your blood sugar, even though it's been in range the entire time. This is how people become trapped in an anxiety feedback loop. You feel anxious about your blood sugar, so you check your CGM. Looking at the number gives you a brief sense of relief. That relief teaches your brain that checking reduces anxiety. So the next time you feel anxious, you check again. Over time, this becomes automatic. You're no longer looking at your CGM because you need information. You're looking because you've trained your brain to use checking as a way to manage anxiety. The problem is that the relief only lasts for a moment. Before long, the uncertainty returns, and so does the urge to check. The cycle repeats itself all day long. The Answer Isn't Less Data. It's Better Boundaries. The way to break this cycle isn't to stop using your CGM. It's to create healthier boundaries with it. Boundaries are the key to any healthy relationship, including your relationship with your CGM. That may sound strange at first. After all, isn't the whole point of having a CGM to look at it? Yes, but there's a difference between using your CGM as a tool and allowing it to become the center of your attention all day long. Five Boundaries That Can Reduce CGM Anxiety 1. Check your CGM with intention, not out of habit. Before you look at your phone, ask yourself one simple question: Why am I checking right now? If the answer is because you're about to eat, exercise, drive, or respond to an alert, that's intentional. If the answer is, "I just want to make sure everything is okay," you're probably looking for reassurance rather than information. 2. Remember that not every number requires action. Blood sugars naturally fluctuate. Many people start treating every small rise or fall as a problem that needs to be fixed immediately. Learning to tolerate normal glucose fluctuations is one of the most important psychological skills you can develop. 3. Make your alerts work for you, not against you. Alerts are one of the greatest safety features of CGMs. They can also keep your nervous system in a constant state of vigilance if they're set too aggressively. Work with your healthcare team to make sure your alerts support your goals instead of constantly pulling your attention back to diabetes. 4. Give yourself permission not to look. If your CGM isn't alerting you and you're not making a diabetes decision, you don't need to know your glucose every five minutes. Choosing not to check becomes an opportunity to build trust, both in your CGM and in yourself. 5. Don't let your CGM decide how you live your life. This is the most important boundary. I've seen people cancel walks because of a trend arrow, say no to dinner invitations because their blood sugar was running a little high, and avoid playing with their kids because they were worried about what might happen. Your CGM should inform your decisions. It should never make them for you. Psychological Diabetes Care Can Help CGMs have transformed the way we manage type 1 diabetes. But they haven't solved the psychological challenges of living with diabetes. A CGM can tell you what your blood sugar is and can even predict where it's going. It can't teach you how to tolerate uncertainty, resist the urge to seek reassurance, or stop fear from driving your decisions. Those are psychological skills. The problem is that diabetes education teaches you how to manage your blood sugar. It doesn’t teach you how to manage the stress of living with diabetes. That's the gap Psychological Diabetes Care is designed to fill. Psychological Diabetes Care is the missing half of diabetes care. It teaches psychological skills, such as boundaries, that you need to respond effectively to fear, uncertainty, frustration so those emotions no longer dictate your behavior or consume your life. That's why I wrote LiveFree with T1D - a free, digital resource designed to fill that gap. The book introduces the principles of Psychological Diabetes Care and gives you practical, evidence-based tools to respond to the stress of T1D so you can live life on your own terms.
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Beyond Your CGM: Diabetes Apps Worth Exploring
If you live with diabetes, your phone is probably already doing a lot of heavy lifting. Your CGM sends alerts. Your pump has an app. Maybe you use your manufacturer's platform to review reports before an endocrinology appointment. But some of the most helpful apps aren't the ones that came with your diabetes devices. Some help you better understand your glucose patterns. Others make diabetes feel a little less overwhelming. A few simply help you build habits that make day-to-day life easier. Here are a few apps worth exploring, whether you're looking for better insights, less mental load, or a little extra support along the way. Sugarmate Sugarmate has become a favorite among Dexcom users for good reason. While it displays your glucose readings, its real strength is making that information more accessible throughout your day. The app offers customizable alerts, Apple Watch integration, desktop widgets, calendar integration, and even the ability to receive urgent phone calls during severe overnight lows. For many users, those extra features make it an invaluable companion to the Dexcom app. Best for: Dexcom users looking for more customizable alerts and easier access to glucose data. Happy Bob Managing diabetes doesn't always have to feel so serious. Happy Bob adds a little personality to your CGM data with encouraging messages, humor, and playful notifications. Instead of another stream of clinical numbers, the app offers a lighter approach that many people in the diabetes community have come to love. Sometimes a little encouragement goes a long way. Best for: Anyone who appreciates a more positive, lighthearted diabetes experience. Nightscout Originally created by parents who wanted remote access to their children's CGM data, Nightscout has grown into one of the most influential open-source projects in diabetes. It allows users to visualize, customize, and share glucose data in ways that go well beyond many standard manufacturer apps. While it does require a bit more technical setup, Nightscout offers incredible flexibility for people who enjoy tailoring their diabetes technology. Best for: Tech-savvy users who want maximum customization. Tidepool If you use multiple diabetes devices, keeping everything in one place can make a huge difference. Tidepool brings together data from compatible insulin pumps, CGMs, and blood glucose meters into a single dashboard, making it easier to identify patterns and share reports with your healthcare team. Instead of bouncing between multiple apps, you can see the bigger picture. Best for: People who want to review diabetes data across multiple devices. Glucose Guide Food is one of the biggest variables in diabetes, and learning how different meals affect your blood sugar takes time. Glucose Guide is designed to help connect the dots by pairing meal tracking with glucose insights, making it easier to recognize patterns over time. Rather than simply logging what you ate, the app helps you better understand how different foods affect your body so you can make future decisions with more confidence. Best for: People looking to better understand how food impacts their glucose. Calm When people think of diabetes apps, mindfulness usually isn't the first thing that comes to mind. But managing diabetes also means managing stress, sleep, and the mental load that comes with making countless health decisions every day. That's why Omnipod recently partnered with Calm to create the Mind in Range Collection, a series of guided meditations, breathing exercises, and sleep content created specifically for people living with diabetes. Whether you're decompressing after a challenging day or winding down before bed, it's a reminder that caring for your mental health is part of caring for your diabetes. Best for: Supporting stress management, sleep, and emotional well-being. Finch Finch is a self-care app designed to make healthy habits feel a little more rewarding. Each day, you complete small goals to care for a virtual pet, turning everyday habits into something a little more rewarding. It's become especially popular among people living with chronic illnesses because it encourages consistency without adding pressure. Whether your goal is drinking more water, taking a walk, or simply getting out of bed on a difficult day, Finch celebrates progress instead of perfection. Best for: Building healthy routines and making self-care feel more approachable. Waterllama Hydration can play an important role in how you feel day to day, and it's especially easy to fall behind during hot weather, long workouts, or travel. Waterllama turns water tracking into something surprisingly fun, using playful visuals and gentle reminders to help you stay on top of your hydration goals. It may not be a diabetes app, but it's one that many people find themselves opening every day. Best for: Creating consistent hydration habits. Final Thoughts No app can take diabetes off your plate, but the right one might make that plate feel a little lighter. Whether it's giving you better insight into your glucose trends, helping you understand how meals affect your body, encouraging sustainable habits, or simply reminding you to take a deep breath, technology has evolved far beyond blood sugar graphs. You don't need to download every app on this list. But finding one that fits your routine could make managing diabetes just a little easier.
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The Biggest Diabetes Clinical Trials to Watch Right Now
Type 1 diabetes research has never been busier. Every year, researchers launch new clinical trials exploring better ways to treat, prevent, and one day fundamentally change the course of type 1 diabetes. Some are focused on slowing the autoimmune attack that causes the disease. Others are working to replace the insulin-producing cells that have been lost. And some are tackling one of the biggest remaining challenges: helping those new cells survive for the long term. Here are some of the clinical trials generating the most excitement in the type 1 diabetes community today. Preserving Beta Cells After Diagnosis For decades, diabetes treatment has largely focused on replacing the insulin the body can no longer produce. A growing area of research asks a different question: what if we could preserve the insulin-producing beta cells that remain after diagnosis? Researchers know that many people continue producing small amounts of insulin for months (or even years) after being diagnosed with type 1 diabetes. Several clinical trials are investigating whether immune therapies can protect those remaining cells and extend their function. Baricitinib Originally approved to treat rheumatoid arthritis, baricitinib is now being studied as a way to slow the immune attack responsible for type 1 diabetes. Early research suggests it may help preserve insulin production in people who have been recently diagnosed, though larger studies are still needed to understand its long-term role in diabetes care. Anti-Thymocyte Globulin (ATG) Another promising approach involves anti-thymocyte globulin (ATG), an immune-modulating therapy that's been used in transplantation medicine for years. Researchers are studying whether carefully adjusting the immune response shortly after diagnosis can help preserve beta cell function and extend what's commonly known as the honeymoon phase. Why it matters: Even preserving a small amount of natural insulin production can make blood sugar management easier and may reduce the risk of severe hypoglycemia and long-term complications. Researchers aren't trying to stop diabetes overnight – they're trying to help the body hold onto what it still has. Delaying Type 1 Diabetes Before It Starts One of the biggest shifts in diabetes research is happening before someone is ever diagnosed. Scientists now understand that type 1 diabetes develops gradually, often years before symptoms appear. During that time, the immune system is already attacking insulin-producing cells, even though blood sugars may still be normal. That discovery has opened the door to prevention studies. TrialNet TrialNet is one of the world's largest type 1 diabetes research networks. Through screening programs for relatives of people with type 1 diabetes, researchers can identify individuals who are at increased risk long before symptoms develop. Those discoveries have led to numerous prevention studies aimed at slowing or delaying disease progression. Tzield (Teplizumab) One of the biggest milestones to come out of this work is Tzield (teplizumab), the first FDA-approved therapy shown to delay the onset of Stage 3 type 1 diabetes in certain high-risk individuals. While Tzield is now an approved treatment, researchers continue to study how similar immune therapies—or combinations of therapies—might delay diagnosis even longer or benefit additional groups of people. Why it matters: These studies are changing the conversation from treating type 1 diabetes after diagnosis to potentially delaying it before symptoms even begin. Replacing the Cells Lost to Type 1 Diabetes Perhaps the most closely watched area of research today is cell replacement therapy. Instead of improving insulin delivery, these studies are attempting to restore the body's ability to produce insulin by replacing the beta cells destroyed by the immune system. Vertex Pharmaceuticals Vertex has become one of the biggest names in this space with zimislecel (formerly VX-880), an investigational therapy created from stem cell-derived islet cells. The treatment is designed to replace insulin-producing cells in people with type 1 diabetes, allowing the body to once again make its own insulin. Early clinical results have been encouraging, with several participants achieving insulin independence following treatment while receiving immunosuppressive therapy. Larger studies are now underway to evaluate long-term safety and effectiveness. Vertex also explored a second program, VX-264, which aimed to protect transplanted cells inside an implanted device to avoid lifelong immunosuppression. Although that program has since been discontinued, the broader goal of protecting transplanted cells without suppressing the immune system remains an active area of research. Why it matters: These studies aren't focused on making insulin therapy better. They're exploring whether the body can regain the ability to produce insulin at all. Making Cell Therapy Safer Replacing beta cells is only part of the challenge. The immune system still recognizes those new cells as something to attack, which is why many transplant recipients currently require lifelong immunosuppressive medications. Several clinical trials are focused on improving that process. Eledon Pharmaceuticals Eledon is studying tegoprubart, an investigational anti-CD40L antibody designed to protect transplanted islet cells while potentially avoiding some of the drawbacks associated with traditional immunosuppressive medications. Recent investigator-led studies at the University of Chicago have shown encouraging results, with participants achieving insulin independence following islet transplantation while maintaining stable graft function. Sernova Sernova is taking a complementary approach with its Cell Pouch platform, a small implanted device designed to house insulin-producing cells in an environment where they can survive and function. The company is evaluating the Cell Pouch alongside newer immunosuppressive strategies, including a collaboration with Eledon to study tegoprubart as part of its ongoing clinical program. Why it matters: Replacing insulin-producing cells is only half the battle. Finding safer, less toxic ways to protect those cells could make future cell therapies a realistic option for many more people living with type 1 diabetes. Final Thoughts Clinical trials rarely produce overnight breakthroughs. Progress usually happens one carefully designed study at a time. Today's investigational therapies won't change diabetes care tomorrow, but they are helping answer important questions that could shape the future of treatment for years to come. Type 1 diabetes research isn't moving in just one direction. It's advancing on multiple fronts, with scientists around the world working toward the same goal: improving life with type 1 diabetes through smarter, safer, and more effective therapies. Clinical trials evolve quickly as new participants enroll, studies conclude, and additional data become available. This article reflects the current research landscape at the time of publication and highlights several of the most closely watched clinical trials in type 1 diabetes.
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