Podcast Summary: 2026 Diabetes Predictions – Retatrutide, Oral GLP-1s, Stem Cell Breakthroughs and More!

Podcast: Taking Control Of Your Diabetes® – The Podcast!
Hosts: Dr. Jeremy Pettus and Dr. Steve Edelman
Date: January 12, 2026
Episode Theme: Confident diabetes predictions for 2026—covering cutting-edge therapies and technology for both Type 1 and Type 2 diabetes.

Episode Overview

Drs. Jeremy Pettus and Steve Edelman, both experienced endocrinologists living with type 1 diabetes, offer an in-depth—and entertaining—discussion about the diabetes breakthroughs they are almost certain will arrive (or nearly arrive) during 2026. Their predictions encompass medical therapies, technology, and structural changes in access to care, touching on both type 1 and type 2 diabetes. The episode is full of optimism and a healthy dose of humor as the hosts riff off each other’s research and personal experiences.

Key Topics & Insights

1. New Indication for Tzield in New-Onset Type 1 Diabetes

Timestamps: 02:05 – 06:28

• Current Status: Tzield, currently approved to delay the onset of type 1 diabetes in high-risk individuals, is hard to prescribe due to the need for pre-symptomatic screening.
• Prediction: Approval (by early 2026) for use in people newly diagnosed with type 1 diabetes—making it far more accessible.
• Mechanism & Benefit: Administered as a 14-day IV infusion, Tzield helps preserve remaining beta cells, prolonging the "honeymoon phase" and improving disease management.
• Clinical Impact: "Those remaining cells are worth saving. And if you don't do anything, they die." (Dr. Pettus, 04:28)
• Practicality: “There won’t be enough infusion centers.” (Dr. Edelman, 06:21)

2. Breakthroughs in Type 2 Diabetes Medications: GLP-1s and Beyond

Timestamps: 06:32 – 15:08

A. Upcoming Oral GLP-1 Agonists

• Approval of once-daily oral GLP-1s like Orforglipron predicted for 2026.
• Increased Accessibility: Particularly good for people reluctant to do injections.
• Debate: Pill vs. injection for adherence—“True injection phobia is very, very rare.” (Dr. Pettus, 08:45)

B. Supercharged Injectables

• Sema-cagrelintide: Weekly combo of semaglutide (Ozempic) and a new amylin analog (cagrelintide). Offers unprecedented weight loss (up to 24–25% of body weight).
  “It’s kind of this weight loss space race—what can we add to what?” (Dr. Pettus, 11:26)
• Retatrutide: Triple-agonist (GLP-1, GIP, and glucagon), labeled as “supercharged Mounjaro.” Shown in trials to produce massive weight loss and help prevent muscle loss.

3. Stem Cell–Derived Islet Cell Replacement for Type 1 Diabetes

Timestamps: 15:22 – 19:08

• Vertex Breakthrough: Phase 2 and 3 trials; possible approval in 2026. Patients can receive lab-grown beta cells, often eliminating the need for insulin—first time for a scalable cell source.
• Limitation: Recipients must take (mild) immunosuppressive drugs.
• Analogy:
  "With the stem cell therapy, where we can generate these cells indefinitely in a lab, we've gotten rid of the supply problem and now we're left with this immunosuppression issue." (Dr. Pettus, 16:56)
• Emerging Tech: Mention of Sana’s CRISPR-edited cells to potentially eliminate need for immunosuppression; still very early days (one patient so far).

4. Accessibility of Weight Loss Medications

Timestamps: 19:18 – 21:18

• Big News: Government action means Zepbound and Wegovy will be available to Medicare patients with severe obesity for $50/month, recognizing obesity as a serious disease.
• Medicaid accessibility is in progress.
• Implication: Life-changing therapies will reach more people. Anticipation that new drugs and expiring patents could further reduce costs.
  “For the folks out there in the world that just cannot afford it but really want it... it's coming.” (Dr. Edelman, 20:46)

5. GLP-1s for Type 1 Diabetes

Timestamps: 21:27 – 24:06

• Lilly is running a pivotal phase 3 trial of tirzepatide (Mounjaro) in type 1 diabetes, data expected late 2026/early 2027.
• These drugs, used off-label, improve sugars, reduce insulin needs, and promote weight loss in type 1s.
• Barriers: Pharma hesitancy due to potential side effects and risk to blockbuster drug labels.
• “I’m tired of being left out.” (Dr. Pettus, 22:51)
• Early published studies already show promising results, but insufficient for FDA approval.

6. New Insulin Options – Once-Weekly Basal and Inhaled

Timestamps: 24:09 – 29:01

• Once-Weekly Basal Insulin: Analogous efficacy to daily insulin, high potential for better adherence (especially in nursing homes, for those struggling with daily injections).
• Brands: Lilly’s insulin efsitora alfa and Novo’s icodec. Already approved in Canada; U.S. approval expected in 2026.
• Nuances: Dosing education needed; not likely to suit type 1s due to increased hypo risk.
• Inhaled Insulin (Afrezza): Paradigm shift in dosing—higher dose needed compared to injectable, label updates and education coming. Full podcast to follow.

7. Gene Therapy for Type 1 Diabetes

Timestamps: 29:01 – 33:20

• Kriya’s Approach: Human trials begin in 2026. Uses virus as a “delivery truck” to carry genes for insulin and glucokinase into leg muscle. Muscle becomes an insulin/glucokinase “factory.”
• Advantages:
  • No immunosuppression needed.
  • Potential for a one-time, long-lasting (possibly lifelong) effect.
• Limitations: Approval and broad availability still several years away, but represents a breakthrough alternative to islet cell transplantation.
• “It’s not going to be approved in 2026, but… they're going to hear about it.” (Dr. Edelman, 32:08)

8. Technology Predictions – Wearables & Closed Loop Systems

Timestamps: 33:31 – 37:28

A. Continuous Ketone Monitoring

• Abbott and Dexcom expected to have FDA-approved CGM devices with integrated ketone monitoring in 2026.
• Could dramatically reduce DKA (diabetic ketoacidosis) by early warning, especially beneficial for those on SGLT-2 inhibitors.
• Potential for further sensors (e.g., potassium, lactate) in the future.

B. Closed-Loop Systems for Type 2 Diabetes

• All pump companies focusing on Type 2s; 25–30% of pump users are now type 2s.
• Future: fully hands-off, no carb-input closed-loop systems coming soon.
• “These systems make much better decisions than people with diabetes… automatic insulin delivery.” (Dr. Edelman, 36:12)

Memorable Quotes & Moments

• On new treatments and hope:

  • “These are here and now things that we feel confident people can actually look forward to.” — Dr. Pettus (00:48)
  • “We're getting closer to this idea of a cure for Type one, which is nuts. It's nuts.” — Dr. Pettus (38:15)

• On the surge of new weight loss and diabetes drugs:

  • “It's kind of this weight loss space race...” — Dr. Pettus (11:26)
  • “Apparently adding this glucagon agonist helps with preventing muscle loss.” — Dr. Edelman, on Retatrutide (14:01)

• On next-gen technology:

  • “In 2026, we will have a continuous ketone monitor approved.” — Dr. Pettus (33:32)

• On the golden age of diabetes:

  • “This is a great time to have diabetes.” — Dr. Pettus (38:20)
  • “I'm so happy I have diabetes.” — Dr. Edelman, tongue-in-cheek (38:23)

Notable Timestamps for Key Segments

| Topic | Timestamp | |------------------------------------------|-----------------| | Tzield new indication for type 1 | 02:05–06:28 | | Type 2 Med breakthroughs (GLP-1, etc) | 06:32–15:08 | | Stem cell islet replacement | 15:22–19:08 | | Access to weight loss meds update | 19:18–21:18 | | GLP-1s in type 1 trials | 21:27–24:06 | | Once-weekly/Novel Insulins, Afrezza | 24:09–29:01 | | Gene therapy for type 1 | 29:01–33:20 | | Tech: Ketone monitoring, Closed loops | 33:31–37:28 | | Optimism about the diabetes future | 38:15–end |

Final Takeaways

• 2026 is poised for unprecedented advancement, with therapies (GLP-1, stem cells, gene therapy) and technologies (CGM, ketone monitoring, insulin delivery) that will change diabetes care for both type 1 and type 2.
• There’s a sense of excitement, both scientific and personal—“It’s a fun place for us to work...things are changing so rapidly.” (Dr. Pettus, 38:19)
• Most predictions are close to reality, not distant dreams—emphasizing the need for education and access as the next great hurdles.