Menstrual Cycle Study

Recognizing the challenges faced by women with insulin-dependent diabetes, research specifically investigating the menstrual cycle’s impact on diabetes management remains limited so far. This lack of focused study has hindered the development of tailored treatment strategies for women. The partnership between Diabetes Center Berne (DCB) and Tidepool aims to fill this critical research gap. Their joint effort is focused on the examination of the interplay between the menstrual cycle and diabetes management, with the goal of enhancing care and improving quality of life.

To explore the relationship between menstrual cycles and insulin-dependent diabetes with the goal of supporting the development of tools and products to lower the burden of diabetes management throughout the menstrual cycle, Tidepool and DCB are joining forces and will start with a first study. Tidepool facilitates access to the data of people living with type 1 diabetes who menstruate and provides their expertise in data collection for this initiative and DCB will provide expertise in clinical research and research infrastructure.

“Tidepool and DCB share common goals,” says Martina Rothenbühler, Data Science Lead at DCB. “We are both non-profit organizations aiming to make life with diabetes easier, fostering innovation, and sharing a deep interest in translating scientific findings into recommendations and tools that make diabetes management easier.”

Stefanie Hossmann, Clinical Research Lead at DCB, adds: “Partnering with Tidepool offers us an opportunity to meet with a highly motivated team dedicated to analyzing different aspects around the menstrual cycle, the Tidepool Period Project.”

“The DCB team has a strong academic focus that complements the roadmap we have built out for the Tidepool Period Project and the skills that we have on the Tidepool team, and we are so excited about this partnership,” said Saira Khan-Gallo, Access & Equity lead at Tidepool. 

About DCB
Diabetes Center Berne (DCB) is a private, independent Swiss foundation established in 2017 with the aim of making life with diabetes easier. DCB supports ideas and projects in the field of diabetes technology worldwide by providing expertise, access to clinical research facilities and its own laboratories, as well as financial resources. The aim is to bring them a big step closer to market entry in a collaborative partnership. The work of the DCB is non-profit – the goal is new insights and innovations around diabetes management as well as a vibrant community.

About Tidepool
Tidepool is a recognized innovator in diabetes software on a mission to make diabetes data more accessible, actionable, and meaningful for people with diabetes, their care teams, and researchers. Founded in 2013, Tidepool hosts a suite of software tools for people with diabetes and the clinics that serve them, including Tidepool Web, Tidepool Mobile, Tidepool Uploader, and soon Tidepool Loop. Tidepool is a registered 501(c)3 nonprofit organization. Learn more at tidepool.org. Follow us on Twitter at @Tidepool_org and on Facebook and Instagram.

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In Switzerland, approximately one child in six is overweight, and the number is increasing. This is concerning, given that being severely overweight increases the risk of cardiovascular disease, cancer and diabetes. “We have known for some time that intestinal flora play a key role in the development of obesity,” says Maria Luisa Balmer, a specialist in Internal Medicine at Inselspital and head of a research group at the University of Bern. But the links are complex. In her research, Balmer is investigating the interactions between intestinal bacteria, their metabolic products and the immune system (*1).

In recognition of her research work, she has been awarded the Marie Heim-Vögtlin Prize 2023 by the Swiss National Science Foundation (SNSF). The award ceremony will take place at the University of Bern on 21 November.

Maria Luisa Balmer (Photo: Sina Lou Ravasio)

Identified: Fattening Bacteria

It is already known that morbidly obese people generally have different intestinal flora from slim, healthy people. Certain types of bacteria proliferate very vigorously, suppressing others as they do so. But what does that mean? And is the change in intestinal flora a cause or consequence of obesity? One of the researcher’s approaches to investigating these questions involves germ-free mice, which the University of Bern breeds in a facility that is unique in the world. “We can use these animals to investigate what effect individual bacterial species have and elucidate cause and effect relationships,” Balmer explains.

Using this approach, her team was actually able to identify five bacterial species that increase the susceptibility of the mice to obesity. As a next step, the team intends to investigate how this comes about – for example, which bacterial metabolic products contribute to the fattening effect, and what impact they have on the immune system.

In a preceding study, Balmer had already demonstrated that the metabolic product acetate has a positive effect on immune cells (*2). By doing so, she illustrated the link between diet, intestinal flora and the immune system, because one of the conditions under which acetate is formed is when bacteria in the intestines metabolise dietary fibre of the type contained in vegetables or wholegrain products.

Promoting health with chewing gum

Balmer’s research group is currently investigating the effect of dietary fibre in more detail in a clinical study involving over 100 severely obese children. The team has developed a chewing gum that has been enriched with water-soluble dietary fibre. And the best thing about this completely new idea is that the children do not realise the “FibreGum” is medicine. Like normal chewing gum, it tastes of mint. It is intended to promote intestinal metabolism in children almost without them noticing and at the same time help them reduce snacking on other sweets. “Low-threshold treatments are particularly important for children,” says Balmer. She hopes the study will demonstrate whether the nutritional fibre consumed with the FibreGum does actually improve intestinal flora, and ultimately whether it helps the children lose weight more easily.

Career snapshots: “We need a change of ideas”

Maria Luisa Balmer’s research already won her an SNSF Eccellenza Professorial Fellowship in 2020. She says she regards winning the Marie Heim-Vögtlin Prize as a huge accolade. But she also sees the prize as an opportunity to gain visibility as a researcher who is a doctor and mother as well. “As far as that’s concerned, our whole society needs an urgent rethink,” she emphasises. “We need to update our traditional role models for group leaders at higher education institutions because the bar for couples with jobs is unrealistically high for both mothers and fathers. I feel it is important to demonstrate that you can have a family or hobbies that demand a lot of time and still conduct cutting-edge research and be successful if you have people around you to support you.”

(*1) J. Lötscher and M.L. Balmer: Sensing between reactions – how the metabolic microenvironment shapes immunity. Clin Exp Immunol (2019). doi: https://doi.org/10.1111/cei.13291.

(*2) M.L. Balmer et. al: Memory CD8+ T Cells Balance Pro- and Anti-inflammatory Activity by Reprogramming Cellular Acetate Handling at Sites of Infection. Cell Matabolism (2020). doi: https://doi.org/10.1016/j.cmet.2020.07.004.

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