Session: ADA Symposium—Major Advances and Discoveries in Diabetes: The Yr in Review
Speakers at this ADA Scientific Sessions presentation included: Chaired by Rodica Busui, MD, Ph.D. (University of Michigan) and President of Medicine & Science for the American Diabetes Association, John B. Buse, MD, Ph.D. (Senior Associate Dean, Clinical Research University of North Carolina School of Medicine and Director of the UNC Diabetes Care Center), Anath Shalev, MD (Division of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham), and Michael Schwartz, MD (University of Washington Medicine, Diabetes Institute).
This panel of experts presented the highlights in clinical science within the last yr and the way they may translate into take care of individuals with diabetes. Listed here are a number of exciting advancements that individuals with diabetes can start talking to their providers about now!
Food and Drug Administration (FDA) approvals
Dr. Buse emphasized that there have been quite a lot of FDA approvals this past yr for the treatment of type 1 diabetes (T1D) and type 2 diabetes (T2D).
The FDA approved the drug teplizumab. This drug targets and manages stage two of T1D, which is a little-known phase before T1D could be detected (pre-clinical phase) and before blood sugar levels are consistently high.
Teplizumab can delay the onset of T1D and the necessity for insulin therapy—if began before diagnosis.
The FDA also approved several recent insulin pump systems with automated insulin delivery features (AID). These systems are revolutionizing care and are allowing individuals with T1D and T2D to administer blood sugar levels higher than ever before.
Systems recently approved include Insulet’s Omnipod 5, Medtronic’s 780g, and the iLet Bionic Pancreas.
Most strikingly, Dr. Buse was impressed with the FDA’s approval of an open-source AID system, Tidepool. This was the primary ever community-led diabetes innovation to be approved by the FDA— with the power for users to dose insulin directly from an app on their phones.
The FDA approved continuous glucose monitoring (CGM) systems, including the long-awaited Dexcom G7, which has a much shorter warmup time of half-hour in comparison with two hours with the G6.
Also of note was the approval of biosimilar insulins, including Rezvoglar, which received its interchangeability designation in late 2022 (could be used interchangeably with Lantus), and the fifth SGLT-2 inhibitor, Brenzavvy (Bexagliflozin) was also approved by the FDA.
Sotaglifozin was also approved to forestall cardiovascular death and hospitalization for heart failure in patients with heart failure with or without type 2 diabetes.
Progress on newer medications
Dr. Buse noted that many medications are usually not quite ready for the market yet, but much progress has been made—including progress on once-weekly insulin for individuals with T2D.
Strikingly, Jardiance is being investigated as a treatment for chronic kidney disease (CKD) and to assist improve heart health in individuals with diabetes.
Dr. Shalev talked concerning the translation of technological and therapeutic advances into take care of individuals with T1D and talked concerning the common drug Verapamil.
Verapamil has been shown to extend the pancreas’s insulin secretion in children with newly-diagnosed T1D. Verapamil also limits the overall day by day insulin needed to take care of blood sugar levels in range and in addition decreases hypoglycemic events, with no severe opposed unwanted effects reported.
Verapamil continues to supply significant advantages to people using the medication even after 2 years. Verapamil combined with metformin for individuals with type 2 diabetes is being investigated.
A holistic approach to diabetes care
There was an ideal emphasis on whole-body care and not only specializing in blood sugar levels, especially for individuals with T2D.
Over the past yr, researchers are beginning to look more at sleep health, together with weight management, cardiovascular and renal health to enhance the general quality of life for individuals with diabetes.
In alignment with a more holistic approach to diabetes management, the American Diabetes Association (ADA) lowered its blood pressure and lipids goal—to sync with other diabetes advocacy organizations.
Dr. Schwartz emphasized the necessity to goal the brain and body within the treatment of diabetes. He presented recent insights into the neuroscience of metabolism and viewed the load loss efficacy of incretin medications from the “neuroscience of energy homeostasis” perspective.
Advancements in coverage + access
Dr. Buse mentioned one in every of the largest wins of the yr was the reduction in insulin pricing in the US, and notably, the voluntary price caps announced by all three insulin manufacturers. These changes can have remarkable effects on health equity in the approaching years.
Considered one of the largest advancements in access to take care of individuals with diabetes was the Medicare coverage eligibility change, making CGMs available for all insulin-dependent people (T1D and T2D) and people who have recurrent hypoglycemia.
State Medicaid programs are also expanding CGM coverage; laws was just signed in Florida that may expand coverage to Medicaid individuals with diabetes within the state.
The challenges we still face
Dr. Buse said the largest challenges of the past yr were the semaglutide (Wegovy and Ozempic) and tirzepatide (Mounjaro) shortages and health equity issues over the expense of those medications.
He also emphasized that we’d like more research on the efficacy of GLP-1 receptor agonist medications for individuals with T1D.
Finally, the researchers said there must be greater equity within the delivery of healthcare across many realms: socioeconomic status, gender, race, sexuality and disability.
We’ve got to give attention to policy and practice on the community and system level to ensure these tools and recent discoveries in medicine are implemented equitably for all people living with diabetes.
Individuals with diabetes should experience normal life expectancies without advanced complications.
These advancements in medications and technology are all very exciting for the diabetes community. At Beyond Type 2, we’re committed to following these advancements to maintain the community informed, so ensure to enroll in our newsletter and follow our news coverage!