• DCB Innovation, a division of the Swiss Diabetes Center Berne (DCB), has partnered with UK startup SmartStart Health to launch SmartStart CGM, the first digital support app for people with diabetes using continuous glucose monitoring (CGM) technology
• CGM is currently used by c.40% of Americans with type 1 diabetes; worldwide, nearly 50% of people with type 2 diabetes on frequent insulin injections are expected to adopt CGM by 2030[i]
• Scalable education provided by SmartStart CGM will help healthcare professionals support more patients to benefit from CGM

CGM technology constantly tracks glucose levels and can alert users when they are too high or too low. Despite proven health benefits, starting on CGM can be complex and overwhelming for people with diabetes. As many as 27% of CGM users discontinue use in the first year and up to 30% use the technology too inconsistently to benefit from it.[ii] Patients with more education regarding CGM use have better outcomes[iii] and more research is needed to create high-quality, evidence-based training and support.[iv] CGM use is expanding rapidly, creating the need for a scalable solution.

Melissa Holloway, CEO and Founder of SmartStart Health

SmartStart Health is rising to the challenge of CGM-specific patient education with SmartStart CGM, a user-friendly smartphone app. Supported by DCB, diabetes centres in the US and Switzerland will evaluate the new scalable solution in a proof-of-concept study. The partnership aims to analyse the results in Q3 2022 and publish by mid-2023.

“CGMs can make everyday life easier for people living with diabetes – provided they receive a proper introduction to the technology as well as ongoing support. At DCB, we are truly convinced that SmartStart Health will contribute significantly to achieving this,” said Derek Brandt, CEO of DCB.

The SmartStart CGM app is designed to inform and empower users with interactive micro-learning based on real-world scenarios that reflect the reality of living with diabetes. A telehealth portal for healthcare professionals will enable clinicians to assess patient engagement with the programme.

Dr. Thomas Grace, a diabetes specialist from Ohio, US, who will use the new CGM education app in his practice as part of the proof-of-concept study, said:

“Starting on CGM can bring a real learning curve for patients as well as a time commitment for my team. I’m excited to use SmartStart CGM to support our patients in using CGM and optimise our interactions.”

SmartStart Health Founder and CEO Melissa Holloway said:

“As a long-term user of CGM providing peer support to fellow CGM users every day, I am passionate about supporting people with diabetes to get the best out of this life-changing technology. The goal for SmartStart CGM is to unlock the benefits of CGM for more people.”

For more information on SmartStart CGM, visit the SmartStart Health website at www.smartstart.health and subscribe to updates.

[i] https://www.healthcaredive.com/news/abbott-dexcom-diabetes-tech-type-2-jefferies/608157

[ii] Yu S et al. Diabetes Technol Ther 2018;20(6):420–427. https://doi.org/10.1089/dia.2017.0435

[iii] American Diabetes Association Professional Practice Committee; 7. Diabetes Technology: Standards of Medical Care in Diabetes—2022. Diabetes Care 1 January 2022; 45 (Supplement_1): S97–S112. https://doi.org/10.2337/dc22-S00

[iv] Heinemann L, Klonoff DC. J Diabetes Sci Technol 2020 (6):983-986. https://doi.org/10.1177/1932296819895083

About SmartStart Health

As an advocate for access to diabetes technology, Melissa Holloway identified the need for validated, scalable continuous glucose monitoring (CGM) user education through thousands of peer interactions with other people living with type 1 diabetes. With nearly 20 years of diabetes industry experience, Melissa founded SmartStart Health after participating in the 2021 DCB Open Innovation Challenge.

SmartStart Health is developing SmartStart CGM, an app-based education program to support patient onboarding and diabetes self-management with CGM. The app provides interactive mobile learning modules to empower people living with diabetes to learn about CGM and offers a telehealth portal to help healthcare teams tailor clinical care for CGM users.

Professor Maria Luisa Balmer of the Diabetes Center Berne, University Berne, and University Hospital Bern

Magnesium deficiency is linked to a variety of illnesses, such as infections and cancer. We know from previous studies that cancerous tumours spread more quickly in the bodies of mice when they are fed a diet that is low in magnesium. This low-magnesium diet also impairs their ability to fight off flu viruses. Until now, there has been little research into exactly how this vital mineral affects the immune system.

A team of researchers led by Professor Christoph Hess, from the University of Basel and University Hospital Basel, and University of Cambridge, in collaboration with University and University Hospital Bern, have discovered that T cells can only effectively eliminate abnormal or infected cells in a magnesium-rich environment. More specifically, magnesium contributes to the proper functioning of a T-cell surface protein called LFA-1.

LFA-1 functions as a binding site that plays a key role in the activation of T cells. “In the resting state, however, this binding site is in a closed position and therefore cannot efficiently bind infected or abnormal cells,” explained Christoph Hess. “That’s where magnesium comes in. If magnesium is present in sufficient quantities in the environment surrounding the T cells, magnesium binds to the LFA-1 protein and ensures that it remains in an open position, keeping the binding site active.”

As part of the research team, Professor Maria Luisa Balmer is delighted with what the team has achieved so far and adds:

“Many people associate the trace element magnesium primarily with its effects on muscle function. What this new study shows is that magnesium also regulates fundamental processes in immune cells, and that this regulation has a significant effect on how they function. This research is a prime example of how findings from basic research can lead to further investigations that may directly benefit patients and the wider population.”

Relevance to cancer patients

The fact that magnesium is essential for the function of T cells could have significant implications in terms of how modern immunotherapies are used to treat cancer. Immunotherapy aims to mobilise the immune system—and cytotoxic T cells in particular—against cancer cells. The researchers were able to use experimental models to demonstrate that increasing the local magnesium concentration in tumours enhanced the immune response of T cells against cancer cells.

“We are now looking for ways to specifically increase the concentration of magnesium in tumours so that we can test this observation in the clinical context,” said Christoph Hess. Further analyses carried out by the research team led by Hess and his colleague Dr Jonas Lötscher, the lead author of the study, demonstrate how promising such strategies can be. Using data from studies in cancer patients that have already been completed, the researchers were able to show that immunotherapies were less effective in patients who had low blood magnesium levels.

However, according to Lötscher, the data collected to date is not sufficient to answer the question of whether regular magnesium intake has an effect on the risk of cancer in general.

“Our next step will be to conduct prospective studies to test the clinical effect of magnesium as a catalyst in the immune system.”

Original publication
Jonas Lötscher et al.
Magnesium sensing via LFA-1 regulates CD8+ T cell effector function.
Cell (2022)
DOI: https://doi.org/10.1016/j.cell.2021.12.039