What does it take to safely manage type 1 diabetes while flying a commercial jet?

In this episode, Dr. Jeremy Pettus and Dr. Steve Edelman talk with Quinton Weiskittel, a commercial pilot living with type 1 diabetes. Quinton shares what it was like to be diagnosed mid-career, how FAA rules have changed, and the real-world routines he uses to stay steady through long flights, time zones, busy airports, and long stretches of sitting.

They also cover what the FAA requires for certification, how Quinton uses CGM data and smart “buffer” strategies to prevent lows, and why he’s chosen MDI over pump therapy while flying.

Key Topics

• Being diagnosed with diabetes mid-career: the moment everything changed
• FAA rules on pilots with diabetes and the path back to the cockpit
• CGM targets, reporting requirements, and medical follow-ups as a pilot with diabetes
• Preventing lows during flights: alerts, trends, and planning ahead
• Food choices and low-carb strategies while flying a plane
• What coworkers need to know (CGM alarms, injections, and professionalism)
• Travel tips for diabetes: airports,travel lulls and wait time, and insulin logistics
• Pump therapy in the air: pressure concerns and practical tradeoffs
• Advocacy and finding the right endocrinology support
• Life perspective: staying grounded while chasing big goals

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What new advancements are actually coming in diabetes care in 2026 and what’s in store in the near future? In this episode, Dr. Steve Edelman and Dr. Jeremy Pettus both take a look at the diabetes treatments and technologies they believe are most likely to arrive in 2026.

Together, they walk through emerging therapies for both type 1 and type 2 diabetes, focusing on developments that are no longer theoretical but actively moving through late-stage trials and regulatory review. The conversation covers disease-modifying treatments, next-generation medications, and technology advances that could meaningfully change daily diabetes management.

Key Topics:

• Disease-Modifying Therapies for T1D: Preserving beta cell function after T1D diagnosis and why this represents a major shift in treatment goals.
• New Medications for Type 2 Diabetes: Oral GLP-1s, dual- and triple-agonist therapies, and what they may offer beyond current options.
• GLP-1s in Type 1 Diabetes: Where the research stands, off-label use today, and what future approvals could look like.
• Once-Weekly Basal Insulin: Why it’s promising for type 2 diabetes and who it’s best suited for.
• Inhaled Insulin Updates: New dosing guidance and expanded use cases.
• Continuous Ketone Monitoring: How this technology could improve safety and open doors for additional therapies in T1D.
• Cure-Oriented Research: Stem cell and gene therapy approaches that aim to restore insulin production.
• The Big Picture in 2026: Why 2026 represents real momentum — and what it could mean for access, outcomes, and quality of life.

We also created an article on this topic, which you might want to read: https://tcoyd.org/2025/12/diabetes-predictions-2026/

✨ Subscribe for must-know updates, advocacy news, and technology breakthroughs that empower people with diabetes to live longer, healthier, and happier lives. Let's stay informed and take control together!

We've got tons of other great resources on how to live a long and healthy life with diabetes:
Website: https://tcoyd.org
Blog: https://tcoyd.org/blog/
Podcast: https://tcoydthepodcast.transistor.fm
Instagram: / tcoyd
Facebook: / tcoyd

Stay connected! Sign up for our monthly e-newsletter here: https://tcoyd.org/newsletter-subscribe/

Please consider helping TCOYD continue to improve the lives of those living with diabetes by supporting our educational programs: https://tcoyd.org/donate

Why did the FDA deny sotagliflozin —even with strong data showing heart, kidney, and glucose benefits? In this episode, Dr. Steve Edelman sits down with special guest Stacey Simms to break down the full story behind SGLT inhibitors and their complicated path in type 1 diabetes.

Together, they walk through how SGLT inhibitors transformed type 2 diabetes care, why many clinicians believe people with type 1 should have access, and how the risk of DKA shaped the FDA’s decision. Dr. Edelman also shares insights on who might benefit, how to reduce risk, and why continuous ketone monitoring could be a game-changer for future approvals.

They also touch on the growing discussion around GLP-1 medications in type 1 diabetes, new study results, and what emerging evidence could mean for future treatment options.

In this episode:

• Sotagliflozin & SGLT Inhibitors in T1D: Why these medications matter and what the latest data shows.
• The FDA Denial: Understanding the DKA concerns and why approval remains challenging.
• Real-World Experience: How clinicians are using SGLT inhibitors safely today in select patients.
• Continuous Ketone Monitoring: Why dual-analyte sensors could unlock safer use in T1D.
• GLP-1s in Type 1 Diabetes: What recent research reveals about potential benefits.
• Who Might Benefit Most: Kidney protection, heart health, and metabolic improvements.
• Looking Ahead: How ongoing studies and patient advocacy could shape future guidelines

Learn more about Diabetes Connections with Stacey Simms: https://diabetes-connections.com

Visit TCOYD's Website for more diabetes edutainment for people living with diabetes: tcoyd.org

**Tune in for two new episodes each month! Like what you hear and want to help us grow? Please rate and review this podcast so we can reach more people living with diabetes!**

Follow our social media channels to empower yourself with the essential areas of diabetes knowledge led by two endocrinologists living with type 1 diabetes: Facebook | Instagram | YouTube

Continuous glucose monitoring didn’t start as sleek apps and tiny sensors — it began with chunky receivers, short wear times, and a lot of skepticism. In this episode, Dr. Jeremy Pettus and Dr. Steve Edelman sit down with Dexcom CEO and original sensor engineer Jake Leach to trace the evolution of CGM from those early “Tylenol-shaped” receivers and repurposed pagers to today’s G7 system and beyond.

They walk through the major turning points: abandoning long-term implants for subcutaneous sensors, proving that real-time CGM meaningfully improves time in range and safety, and pushing back against old-school thinking that insisted patients shouldn’t see their own data. From STS 3-Day to Seven Plus, G4, G5, G6, and now G7, Dr. Edelman, Dr. Pettus, and Jake Leach break down what each generation added — better accuracy, easier insertion, smartphone and cloud connectivity, and integration with pumps and AID systems.

Most importantly, Dr. Edelman, Dr. Pettus, and Dexcom CEO Jake Leach, focus on what’s coming next and what it means for people living with diabetes today: the 15 day Dexcom G7 sensor, Smart Basal insulin titration for people with type 2 diabetes, AI-powered food logging, and the upcoming G8 platform designed to measure multiple analytes (glucose plus ketones and more) — all while pushing toward broader access and affordability.

Key Topics:

• Early Dexcom Days & STS 3-Day: How Dexcom pivoted from implantable sensors to disposable subcutaneous CGMs and what the earliest systems were really like.
• Blinded vs Real-Time CGM: The ethics debate, safety implications, and studies proving real-time data improves time in range and reduces hypoglycemia.
• Seven Plus, G4 & G5: Major accuracy improvements, longer wear times, and the move to smartphone-based monitoring.
• G6 & Auto-Applicators: Eliminating mandatory calibrations and making sensor insertion faster and easier.
• G7 Wins & Growing Pains: Reduced size, faster warm-up, early reliability challenges, and how Dexcom addressed manufacturing and support issues.
• 15-Day Wear & Smart Basal: Extended wear life and CGM-guided basal insulin titration for type 2 diabetes.
• G8 & Multi-Analyte Sensing: A preview of Dexcom’s next-generation platform measuring glucose plus ketones and other markers.
• AI Food Logging & Smarter Care: Photo-based meal tracking and pairing nutrition data with glucose trends.
• Access & Affordability: Expanding CGM access globally and using data to reshape how diabetes care is delivered.

0:23 - Introduction & TCOYD’s 30th Anniversary
1:39 - Meet Jake Leach: 21 Years at Dexcom
3:08 - The Early Days: From Implantable Sensors to Patches
5:26 - The First Commercial CGM (STS 3-Day) & The "Pager" Receiver
8:35 - The Evolution to 7-Day Wear (Seven Plus)
10:15 - The Early Struggles with Insurance Coverage
12:32 - Why Unblinded Real-Time Data Changed Everything
16:36 - The G4 Era: Improved Accuracy & The "Share" Cradle
20:26 - G5: The Shift to Smartphone Connectivity
27:04 - Real Talk: Addressing G7 Connectivity & Sensor Failures
29:07 - Dexcom's "Unlimited Replacement" Policy for Failed Sensors
31:39 - CONFIRMED: The New 15-Day Sensor Launch
32:43 - "Smart Basal": A New Tool for Type 2 Diabetes
35:44 - G8 Reveal: Measuring Ketones, Lactate & Potassium
39:12 - New Feature: AI Smart Food Logging
41:22 - The Future of CGM: Pre-Diabetes & Heart Health
46:34 - Closing Thoughts

Visit TCOYD's Website for more diabetes edutainment for people living with diabetes: tcoyd.org

**Tune in for two new episodes each month! Like what you hear and want to help us grow? Please rate and review this podcast so we can reach more people living with diabetes!**

Follow our social media channels to empower yourself with the essential areas of diabetes knowledge led by two endocrinologists living with type 1 diabetes: Facebook | Instagram | YouTube

Get a practical breakdown of Afrezza, the ultra-rapid inhaled insulin, with this comprehensive guide to efficacy, timing, and real-world application. Join Drs. Jeremy Pettus and Steve Edelman—endocrinologists living with Type 1 diabetes—as they reveal why this unique tool is often misunderstood and how to use it effectively to flatten post-meal spikes.

In this episode, we move beyond the basics to correct the biggest mistake users make regarding Afrezza dosage. If you’ve tried this therapy before and felt it "didn't work," the issue often lies in the conversion ratio. We review data from Afrezza MannKind studies (such as INHALE-3) to explain the shift from the old 1:1 ratio to the more effective 1:3 ratio. We also cover why this "rapid-on, rapid-off" insulin is the ultimate solution for exercise and how to navigate insurance coverage and prior authorizations.

Topics covered in this episode:

• The Dosing Fix: Why you often need a higher Afrezza dosage compared to subcutaneous insulin.
• Speed & Kinetics: How inhaled insulin mimics the body's natural beta cells to clear glucose fast.
• Lifestyle Benefits: Managing "sticky highs," exercise without crashing, and dietary freedom.
• Safety & Screening: Spirometry requirements and who should (and shouldn't) use Afrezza.
• Pediatric Updates: The latest on clinical trials and potential approval for children.
• Whether you are managing Type 1 or Type 2 diabetes, this episode provides the practical "tips and tricks" you need to determine if Afrezza is the missing tool in your diabetes management kit

Timecodes:

0:00 Start
0:24 Intro: What is Afrezza?
1:39 "Rapid On, Rapid Off" vs. Injectable Insulin
2:44 Preventing Delayed Hypoglycemia (Lows)
4:03 The Early Dosing Mistake (The 1:1 Ratio)
4:35 Jeremy’s Story: Why He Quit Using It Initially
5:44 The Correct Dosing Conversion (1:2 to 1:3)
8:09 Timing: Do You Need to Pre-Bolus?
9:16 "Follow-On" Doses for High Protein/Fat Meals
11:00 Cartridge Sizes & "Bucket" Dosing Strategy
13:10 Using Inhaled Insulin for Exercise
14:23 Real-World Test: Trix Cereal & Afrezza
15:28 Storage Tips: Fridge vs. Room Temp
16:44 Managing the Cough Side Effect
17:29 Proper Inhalation Technique
19:37 Using Afrezza with Insulin Pumps (Hybrid Closed Loop)
21:54 Pediatric Update: Is it Safe for Kids?
23:11 Why You Must Use a CGM
23:49 Lung Safety, Smokers & Spirometry Tests
24:49 How to Get It Prescribed (Overcoming Doctor Resistance)
26:27 Utilizing Trainers & Prescription Combos
29:08 Conclusion

Visit TCOYD's Website for more diabetes edutainment for people living with diabetes: tcoyd.org

**Tune in for two new episodes each month! Like what you hear and want to help us grow? Please rate and review this podcast so we can reach more people living with diabetes!**

Follow our social media channels to empower yourself with the essential areas of diabetes knowledge led by two endocrinologists living with type 1 diabetes: Facebook | Instagram | YouTube

Type 1 diabetes doesn’t always travel alone — in fact, it often brings other autoimmune conditions along for the ride. In this episode, Dr. Jeremy Pettus and Dr. Steve Edelman shine a light on the most common ones that tend to show up with T1D, why they happen in the first place, when you should be screened, and what subtle symptoms should raise a red flag.

They walk through what’s common but manageable, like thyroid issues and celiac disease — as well as what’s rare but critical not to miss, like Addison’s disease (adrenal failure), which can be dangerous if left undiagnosed but incredibly treatable once caught early.
Most importantly, Jeremy and Steve explain how simple blood tests can catch these conditions before they spiral, and how the right medication can completely change how you feel day-to-day.

Key Topics:
• T1D & Autoimmunity 101: Why having one autoimmune condition raises your risk for others
• Thyroid Disorders: The most common — hyper vs. hypo, yearly screening, easy treatment
• Celiac Disease: Why it’s up to 10x more common in T1D and often missed without symptoms
• Addison’s Disease Awareness: The “silent” cortisol deficiency you don’t want to miss
• Proactive Care Mindset: How to build autoimmune screening into your diabetes warranty plan

(00:00) Intro: The "Raindrop" Analogy
(02:26) Thyroid Disease: The Most Common T1D Link
(05:25) Hypothyroidism (Low Thyroid): Symptoms & Easy Treatment
(09:30) Hyperthyroidism (Graves' Disease): Symptoms & Cures
(13:25) Your "Diabetes Warranty": Why You Need a Yearly TSH
(14:48) Celiac Disease: The 10% Risk Factor (19:28) Celiac Screening vs. "Gluten Sensitivity"
(25:31) Addison's Disease: The Other One to Know
(29:43) Final Takeaway: Be Your Own Advocate

Visit TCOYD's Website for more diabetes edutainment for people living with diabetes: tcoyd.org

**Tune in for two new episodes each month! Like what you hear and want to help us grow? Please rate and review this podcast so we can reach more people living with diabetes!**

Follow our social media channels to empower yourself with the essential areas of diabetes knowledge led by two endocrinologists living with type 1 diabetes: Facebook | Instagram | YouTube

Gene therapy isn’t science fiction anymore, it’s becoming one of the most exciting frontiers in diabetes care. In this episode, Dr. Jeremy Pettus and Dr. Steve Edelman sit down with Dr. Fraser Wright, career gene therapist and Co-Founder/Chief Gene Therapy Officer at Kriya Therapeutics, to explore how gene therapy could one day help the body make its own insulin.

Together, they unpack what gene therapy actually is, Dr. P’s involvement as a medical consultant for Kriya Therapeutics, how AAV (adeno-associated virus) vectors work, and what makes this “one-and-done” approach so different from traditional treatments. From success stories in blindness and hemophilia to emerging type 1 diabetes studies, the trio breaks down the science, the safety, and the hope behind this revolutionary research.

You’ll learn how gene therapy has moved from rare diseases to more common ones, why the first human trials in diabetes are on the horizon, and what and what this could mean for long-term blood sugar control and independence from injections.

Key Topics:

• Gene Therapy 101: How gene therapy differs from protein-based drugs like insulin, and why AAV vectors act as safe, engineered delivery vehicles rather than infectious viruses.
• Why AAV, Why Now: Seven FDA-approved AAV-based therapies have proven the potential of long-term, single-dose treatments.
• From Eyes to Endocrine: Lessons learned from retinal gene therapy are now guiding approaches to metabolic conditions like diabetes.
• The Type 1 Diabetes Approach: A muscle-targeted program aims to help the body naturally produce insulin and stabilize blood sugar levels.
• Control and Safety: Built-in glucose sensing and the ability to turn off gene expression ensure precision and reversibility.
• Real-World Considerations: How exercise, treatment site, and existing technologies like pumps or CGMs could work alongside this therapy.

0:00 – Intro: Jeremy and Steve introduce gene therapy and why this topic is a game-changer
2:15 – What gene therapy is and how it’s different from standard protein-based treatments
4:54 – Understanding AAV: safety, engineering, and why it’s the preferred delivery method
8:50 – Real-world success: seven FDA-approved AAV therapies for genetic diseases
12:20 – Lessons learned from treating blindness and how they apply to diabetes
17:40 – The Type 1 Diabetes model: using muscle tissue to produce insulin
22:15 – Managing control, glucose sensing, and preventing hypoglycemia
25:50 – Safety measures and how treatment can be reversed locally if needed
28:30 – Exercise, durability, and what animal studies reveal about real-life performance
31:10 – Timelines, trials, and what’s next for gene therapy in diabetes. What’s Ahead: Clinical trials expected to begin around 2026, offering cautious but real optimism for the future of diabetes treatment.

Visit TCOYD's Website for more diabetes edutainment for people living with diabetes: tcoyd.org

**Tune in for two new episodes each month! Like what you hear and want to help us grow? Please rate and review this podcast so we can reach more people living with diabetes!**

Follow our social media channels to empower yourself with the essential areas of diabetes knowledge led by two endocrinologists living with type 1 diabetes: Facebook | Instagram | YouTube