ADA Preview! The Sessions We Are Most Excited to See at ADA 2019

A preview of the most exciting conference updates on diabetes drugs, devices, and more; stay tuned!

The American Diabetes Association (ADA) 79^th Scientific Sessions is right around the corner! The biggest scientific diabetes conference of the year will take place in San Francisco, California from June 7-11! As always, diaTribe is excited to comb through the schedule, identify the most important highlights, and share the latest advances in diabetes therapies and technologies with you. Below is a preview of what we’re particularly looking forward to. If you want daily updates during the conference, sign up here. Otherwise, look out for expanded coverage after the conference!

Diabetes Drugs

• REWIND: Heart health outcomes for Trulicity (GLP-1 agonist) in type 2 diabetes – In November 2018, we learned from REWIND data that compared to placebo (a “nothing” pill), Trulicity significantly reduced the risk of heart attack, stroke, and heart-related death. We’re excited for the presentation on the full results on the heart protective benefits of this once-weekly drug.   

• CAROLINA: Heart health outcomes for Tradjenta (DPP-4 inhibitor) in type 2 diabetes – The CAROLINA trial compared Tradjenta to glimepiride (a sulfonylurea, or “SU”) and found that Tradjenta did not improve heart health outcomes more than glimepiride. We’re intrigued by this study because of the growing concern that SU’s are not safe for the heart.

• PIONEER 6: Heart health outcomes for pill version of Ozempic in type 2 diabetes – In January 2019, initial results revealed that compared to placebo, oral semaglutide (Ozempic) reduced the risk of heart attack, stroke, and heart-related death by 21%. However, the results did not achieve statistical significance (confidence that the difference was not due to chance). Detailed results at ADA will provide more data on the trial’s outcomes.

Diabetes Prevention

• Can Vitamin D supplements delay type 2 diabetes? The D2d study examined whether people with prediabetes taking vitamin D could delay progression to type 2 diabetes. This research is based on some early evidence that vitamin D plays a role in insulin sensitivity and glucose metabolism.

• What’s the most effective combination of diet and exercise for type 2 diabetes prevention? The European PREVIEW trial studied four different combinations: 1) high-protein, low-glycemic index (GI) diets + moderate physical activity, 2) high-protein, low-GI diets + high-intensity physical activity, 3) moderate protein, moderate-GI diets + moderate physical activity, and 4) moderate protein, moderate-GI diets + high-intensity physical activity. Study participants had overweight or obesity and increased risk for type 2 diabetes.

• Teplizumab for prevention of type 1 diabetes in relatives: This phase 2 trial (phase 2 trials explore whether a treatment works) studied whether teplizumab can prevent or delay the onset of type 1 diabetes in relatives with a high risk for type 1. Teplizumab is a monoclonal antibody treatment – it works by blocking the auto-immune response in type 1 diabetes that results in destruction of insulin-producing beta cells.

Diabetes Technology

• Tandem Control-IQ automated insulin delivery in type 1 diabetes: We’re excited to see the results of Tandem’s pivotal study of its hybrid closed loop system with Dexcom’s G6 continuous glucose monitor (CGM). The data will be used to submit Control-IQ to the FDA; Tandem hopes to launch in the last three months of 2019, offering a software update for current t:slim X2 users. Control-IQ works by adjusting basal insulin delivery based on readings from the Dexcom G6; this system is also the first to deliver automatic correction boluses (for high blood sugars) and to use a no-calibration CGM. Not a single participant in the pivotal trial dropped out, a positive early sign on the user experience.

• CGM in older adults with type 1 diabetes: The WISDM trial examined whether real-time CGM can help reduce hypoglycemia in adults over 60 years old. At the start of the trial, participants averaged 57% time-in-range (70-180 mg/dl), with 35% above 180 mg/dl and 5% below 70 mg/dl. We’re hoping to see how CGM will changed these numbers! Although less than 4% time below 70mg/dl is recommended, we’d love to see even lower than this!

• CGM in adolescents with type 1 diabetes: The CITY trial studied whether real-time CGM can improve outcomes for people with type 1 from 14-25 years. At the start of the trial, participants had an average A1C of 8.9%, a time-in-range of 35%, and a full 60% of the day spent above 180 mg/dl with 3% below 70 mg/dl.

Living with Diabetes

• Making a difference in five minutes: This exciting session will focus on the importance of diabetes psychology. There will be talks on weight loss strategies, dealing with diabetes burnout, and more.

• Effects of meal timing on weight, blood sugar management, and more: This series of presentations will discuss intermittent fasting and the circadian clock, a comparison of the effects of intermittent fasting versus continuous fasting, and more!

• Low-carb diets in type 1 and 2 diabetes and prediabetes: Dr. William Yancy, an author on the recently-published ADA nutrition guidelines, will chair a session on low-carb and very low-carb diets for diabetes management.

• #LanguageMatters: ADA will also bring perspectives from healthcare providers and people living with diabetes on the importance of language in diabetes care – see our piece here.