Covering the American Diabetes Association’s Scientific Sessions was once described as “drinking from a fire hose.” This year was no different, so I decided to give the responsibility of wrapping up this year’s Scientific Sessions blog posts to David Kendall, MD, Chief Scientific & Medical Officer at the American Diabetes Association.
Thanks to the encouragement of my mentors and colleagues, I’ve had the pleasure of attending the Association’s Scientific Sessions for 21 consecutive years. Over these years, I have had the chance to play many roles – from participant, to planner, to speaker, to moderator, to official representative. While Scientific Sessions can be a period of information overload, the opportunity to hear of and digest so many new ideas, from initial concept to the development of new therapies and technologies to novel treatment strategies is always rewarding. This year’s 71st Scientific Sessions has been no different, with more than 14,000 clinicians and researchers, and over 17,500 total participants met to discuss the present challenges of diabetes care and the hopeful future of treating this devastating disease.
Let’s begin with some of the highlights that focused on the treatment and prevention of type 1 diabetes. Again this year there was much discussion about the use of advanced technology to “close the loop” on the artificial pancreas. At the same time, there was added focus on the potential limitations of diabetes technology – limitations that may, in part, depend on better educating the person living with type 1 diabetes so that they might leverage all the potential of the technology. We also heard about therapies in development that could one day sustain, or even restore, the production of insulin in people who have been recently diagnosed with type 1 diabetes – one step on the path to true prevention.
All of us within the American Diabetes Association and across the diabetes community are still working toward a cure, and these conversations will shape the direction of research, technology and clinical care for people with type 1 diabetes in the years to come.
In the ever expanding world of type 2 diabetes, technology was also a focus (for example, could using CGM help many with type 2 diabetes? Perhaps!), yet the development of new drugs led the news headlines. Some of these therapies, many of which may soon be available, were specifically designed with the patient in mind. Much of the focus has shifted to long-acting medications, such as once-weekly exenatide, implantable drug delivery systems and ultra-long-acting insulin. Reducing the frequency of dosing will hopefully improve effectiveness, as this can and should help patients overcome some of the daily hassles of diabetes care and limit the challenges with adherence to diabetes treatment regimens.
A call to action was put forth in the Behavioral Medicine and Psychology Interest Award lecture in which Barbara J. Anderson, PhD, said it is the responsibility of the next generation of diabetes researchers to transform the way families of children with type 2 diabetes are viewed – much like her generation transformed the view of families of children with type 1 diabetes by encouraging them to be a part of the diabetes team and a positive influence to help improve outcomes.
We also saw development in the field of diabetes-related complications, where a novel method for treating vision loss due to diabetic macular edema was presented. The use of these novel biologic treatments was associated with very promising outcomes. Indeed, the combined results from two studies found that this treatment not only prevented vision loss, but it actually restored vision in some people. If confirmed, such an approach will represent the first significant change in the treatment of macular edema and eye disease since the introduction of laser surgery more than 30 years ago.
Among the biggest news to be reported at this year’s meeting, was Tuesday’s late-breaking presentation that showed prevention of type 2 diabetes – as achieved in the landmark Diabetes Prevention Program – is cost effective and improves the quality of life for those at high risk for developing diabetes. While we have always believed this to be likely, it’s rewarding to see the data that support these approaches. Both intensive lifestyle changes and earlier use of metformin were cost effective when compared to usual care. The next step will be for all of us to ensure that we work to change policy and support our public health professionals in developing and implementing large-scale programs to prevent type 2 diabetes and curb this epidemic.
Attending the Scientific Sessions is a privilege, and reminds us that advances in science and clinical care are indeed iterative processes – processes of discovery – that help us apply the new knowledge gained each year. It is this cumulative understanding built up over the past 71 years – that has changed the face of diabetes care. There is no doubt in my mind that there has been remarkable progress in all fields of diabetes research and that we continue to build on our mission to prevent and cure diabetes and to improve the lives of all people affected by diabetes.