ATTD 2025: Nadia Swann’s round up

ATTD 2025 – what is it? 

ATTD is where over 5,000 healthcare professionals, technology and pharmaceutical companies from all over the world get together to share what they know about the latest breakthroughs and developments. It’s always an exciting and uplifting place, so I thought I’d share some of the things I saw and heard there, particularly around new technologies.  

What’s next for closed loop systems? 

On the tech side, I was keen to hear about progress toward fully closed loop (FCL) systems, which unlike hybrid closed loop (HCL) systems, handle both basal adjustments and meal bolusing, eliminating the need for carb counting. 

While there are a few people who build their own fully closed loop, we are still some way off having many systems commercially available that will free us from carb calculations and meal boluses. There are some fully closed loop systems in trials and one commercially available, but it requires you to wear two sensors and two pumps, so wouldn’t be suitable for many people. 

Dr. Sufyan Hussain, an endocrinologist and someone who has lived with type 1 for 30 years, discussed the need to develop a fully closed loop system that offers the same functionality as the ‘build it yourself’ models, but with greater simplicity. Personally, I cannot wait for this and am following the trial work closely!  

Breakthrough T1D have been part of funding a study called FCL@Home, which tested fully closed loop for five days under supervision and for seven days monitored at home. Prof Hovorka, who developed CamAPS FX, a hybrid closed loop system said that he had not seen many trials yet where FCL performed better than HCL because for this we need faster insulins, but, for me, the quality of life which comes from no meal bolusing will be really significant. 

In the exhibition hall, I came across a couple of other interesting tech developments. One is continuous ketone monitoring or CKM, which can be used as an early warning system to tell people when their ketones are high in order to reduce the risk of diabetic ketoacidosis. I think I would want to see that in one sensor with a CGM ultimately though, as wearing two sensors might not suit some people.  

I was really interested in a stand from a company that makes an inhalable insulin that isn’t available in the UK yet. This product is designed to allow people with type 1 to inhale a mealtime dose of insulin rather than injecting a bolus.  Anything that means fewer injections has got to be a good thing, I think.  

Screening developments 

A huge area of development is early detection of type 1, which involves screening for autoantibodies that give us warning that type 1 diabetes may be developing. This is important is because we now have something which might slow down the development of type 1 diabetes, a medication called teplizumab, which was also a hot topic at ATTD, as screening programmes progress.  

There is currently a project called EDENT1F1 where 200,000 children across 13 countries are being screened for type 1 diabetes biomarkers. We already have early data showing that screening can reduce hospitalisation and DKA. This large-scale is adding strength to the data we have.