What to Watch at ADA, and Why It’s Important for Patients
June 24, 2010
Kelly L. Close
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In my many years following the diabetes industry, I am always struck by the excitement that precedes the ADA conference. It may be the star-studded faculty in attendance, the new data presented, or the anticipation of the bustling exhibit floor. Whatever it is, the conference draws more than 25,000 people from around the world, passionately interested in treating, curing, and preventing diabetes. For patients that keep a close eye on the field, the conference represents the crossroads of industry and research – a checkpoint for where we are as a community. Many of us hinge daily on every move that will tell us where diabetes care is heading – countless patients think about their diabetes 24/7, whether they want to or not. My medicine that helps me take care of my diabetes is how I stay alive and there really isn’t a second of the day that I’m not aware of the precipice and how easily I could slip. In more recent years, I’m more attuned to how close my life could someday get to “normal” because of advances being made in the field. In the meantime, I wait, and I hope, as do the 24 million other people living with diabetes in the US and the hundreds of millions globally.
So what’s important to patients this year? There’s a lot happening in technology at ADA this year. Dr. Richard Bergenstal, the very highly-regarded President, Medicine & Science of the ADA, will kick off the late-breaking clinical trial session by presenting results of the STAR 3 study, a one-year randomized controlled trial that compares the efficacy of sensor-augmented pump therapy to that of multiple daily injections (MDI) for insulin delivery in type 1 diabetes. I personally can’t imagine how I would ever get along without my insulin pump, which makes my life much more sane (it makes me feel as close as I’ll ever be to having a regular pancreas like everyone else without diabetes)! Continuous glucose monitoring (CGM) is another area we’re watching closely at this meeting. This is relatively nascent technology that is still improving dramatically and the reality is that trial results coming out now could be quickly outdated by improvements in technology. Last year, talks on continuous glucose monitoring (CGM) played before packed lecture halls, and this year, judging by the increased number of abstracts and symposia, the interest continues to grow quite significantly. This technology, slowly but undeniably, is moving into the mainstream. Whereas it once was more for type 1 patients, it is becoming an important tool for type 2 patients to check in intermittently to see how they are doing.
On the drug front, data will be presented on promising late-stage and early-stage compounds. While we are always watching basic science, we aren’t expecting breakthroughs on this front at this year’s meeting based on our review of the abstracts over the last two weeks. In late-stage development, SGLT2 inhibitor candidates are potentially the next major class of oral agents to enter the market and we are eager to see how differentiated this class is. Of course, the long-acting GLP-1 therapies will have their fair share of attention. Along with several presentations on once-weekly GLP-1 therapies in development, these investigational drugs represent a new era of hope for patients and healthcare providers alike.
As for earlier-stage compounds, “next-generation” insulins (longer-acting basal insulins, short-acting bolus insulins, oral formulations, combinations with GLP-1) have the potential to transform insulin therapy and we expect exciting updates on these novel compounds. There should also be a slew of data on novel oral agents, such as IL-1 beta antibodies, glucokinase activators, selective PPAR gamma modulators, PTP-1B inhibitors, and various PPAR agonists. And, finally, we’ll be seeing more combinations of incretins with insulin – these are exciting to think about as I believe they have the potential to keep patients well for longer.
Finally, what fun would ADA be without a little controversy? This year, there are several debates that should propel our thinking. Notably, former director of the FDA’s Division of Metabolism and Endocrinology Products, Dr. David Orloff, will debate Dr. Steven Nissen, the Cleveland Clinic cardiologist, on the need for a pre-approval cardiovascular risk requirement for diabetes drugs. We expect to see some sparks flying at this one …
In every ADA over the past decade that I have attended, ADA has proved to be supremely worthwhile, whether it meant getting a front row seat at the late-breaking clinical trial session or absorbing all the nuances, opinions, and questions about the latest drugs and devices. This year promises to be no different. Patients, of course, want the advances to come now. Short of that, ADA allows us patients to all envision a future that is surely better than today.
Kelly Close is the president of Close Concerns, Inc. (www.closeconcerns.com) a healthcare information firm exclusively focused on diabetes and obesity. Close Concerns publishes news service Closer Look and patient newsletter diaTribe (www.diaTribe.us). Kelly has had type 1 diabetes for 25 years.
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