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Expert opinion

ATTD 2025: Nadia Swann’s round up

I’m a parent, sister and niece of people living with type 1 diabetes and a trustee at Breakthrough T1D UK. I also study closed-loop systems at Oxford and last week I spent a couple of days at the Advanced Technologies and Treatments for Diabetes (ATTD) conference in Amsterdam.
Content last reviewed and updated: 22.04.2025

Nadia Swann standing in front of an illustrated back drop of Amsterdam at ATTD 2025

 

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. 

Beta cell therapies are effective 

One of the highlights of the week for me was the session where researchers talked about their latest work on insulin producing beta cells and the immune system cells that attack them in type 1 diabetes.

There were so many attendees keen to learn about the latest research that people had to sit on the floor (me included) to hear it! It’s a complicated area and includes a range of ideas from trying to regenerate beta cells using medication, to looking at how we can use stem cells to make replacement beta cell islets.  

My personal favourite, because it sounds so futuristic, was the talk given by Prof Hebrok. He explained how we may be able to use ‘suppressor cells’ to form a shield or protection around the islet to protect them from immune attack.  

A challenge, of course, with most kinds of beta cell therapy currently is that you still need to take immunosuppressant drugs to prevent rejection by the body and prevent the attack from the immune system. There was much discussion about ways to reduce or prevent this in the future.  

The great thing about the suppressor cells research is that immunosuppressant drugs may not be needed in order to stop transplanted islets being rejected. The suppressor cells may work to suppress the immune system response locally (e.g. just in one organ like the kidney or pancreas) rather than suppressing the immune system in the whole body. It’s early days for this research, but it looks promising! 

Your support makes change happen

What I really took away from this week is the number of times researchers and professors thanked Breakthrough T1D for their support and how they could not have carried out some of this amazing research without us.  

So really, they were thanking you. It’s your support that makes this work possible. Your support is changing the world of living with type 1 diabetes. I saw with my own eyes this week how it really is making a difference in the incredibly complex world of type 1 diabetes research.  

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