Another ADA Scientific Session
July 09, 2010
Virginia Valentine CNS, BC-ADM, CDE
My first ADA meeting was in 1982 and boy… we have come a long way baby! At my first ADA meeting I was relatively new to diabetes, both as a patient and as a diabetes educator. It was exciting and impressive then and it still fills me with excitement for the future.
The program, overall, is so big that it is impossible to summarize, except to say it covered everything diabetes from A to Z. There was something for everyone at this meeting. There were more than 17,000 attendees with more than half traveling to the meeting from outside the US. This was truly a worldwide meeting of diabetes experts. Some of the exciting new therapies presented included incretin-based therapies, new insulins and new classes of medications, such as SGLT-2 inhibitors.
Numerous presentations on incretins
Presentations on incretins included new data that showed the value of these gut hormones for not only improving glucose control but also weight loss. Separately, I saw an investigational study that combined exenatide with long acting insulin. There were many additional presentations on these new incretin-based therapies that are coming in the future. To look at all the presentations and conversations about this important new class of medications you would think that most patients with type 2 diabetes were already using these medications. In reality, they still are not being used as often as they should be.
SGLT-2 inhibitors looked really interesting
SGLT-2 inhibitors, a new class of medications currently being studied, will allow you to “spill” more glucose from the kidneys which will lower your glucose and allow people to lose weight, since those are calories going out in the urine! Interesting that folks with type 1 and type 2 diabetes could potentially benefit from these medications.
New insulin pumps in development and some really old pumps
In the exhibit hall I saw some pumps that I’ve never seen in the real world. Patch pumps seem to be taking one of two paths; they are either simpler, disposable devices for people with type 2 diabetes, or more sophisticated devices with features for people with type 1 diabetes. I also saw some great developments in new insulins. The fast are getting faster and long-acting insulins are getting longer and flatter — and these features are resulting in less weight gain with fewer lows. Hopefully some of these new insulins will make it to market.
Lots of discussion about obesity
There are a number of new medications being studied and the results showed significant weight loss, but not as much loss as you see on the TV show “The Biggest Loser.” People seem to get frustrated with only losing 5-10% of their body weight, even though they understand that it has a positive impact on diabetes, hypertension and lipids. As we see these potential new medications come to market, hopefully we will see better support from insurance companies. I can’t understand why they are so willing to spend tens of thousands of dollars on bariatric surgery but won’t spend relatively small amounts on a dietitian and FDA-approved medications.
Lots of cool new products such as new monitors; some were better than others
We first saw glucose monitors for patients almost 30 years ago and, in some ways, they have made huge improvements (e.g., smaller blood samples and smaller meters), but patients still wonder how accurate they are. There are monitors with great features that would benefit some patients and, hopefully, we will be able to get the glucose meter to the patient who needs it. So many insurance companies select one meter for all patients, without taking into account that a “one size fits all” approach may not be the best way to judge meters. With the second and third generations of continuous glucose monitoring devices and results of the STAR trial announced at the ADA, researchers have demonstrated that continuous monitoring is making a big difference for patients.
After almost 30 years of diabetes meetings I can definitely see the huge improvements in technology, products and therapies for people with diabetes, but it still comes down to having great clinicians available to translate all the science into practical, individualized approaches to help people with diabetes get into good control.
Virginia Valentine is CEO and Co-owner of Diabetes Network, Inc.