Ah, the summer string of diabetes conferences is upon us! Along with a handful of other D-advocates from the online world, Mike and I are both heading to Chicago for the American Diabetes Association's 73rd Scientific Sessions, so be sure to watch our Twitter feed and Facebook page for updates. The hashtag for the ADA conference this year is #2013ada.
In addition, The Endocrine Society's annual meeting took place about a week ago in San Francisco, and we were fortunate to connect with a fascinating attendee: Shara Bialo, an endo-in-training and type 1 herself who was one of our 10 patient scholarship winners attending the 2012 DiabetesMine Innovation Summit.
As both a patient and aspiring endocrinologist, here's what Shara has to report about her inaugural diabetes conference experience:
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A Guest Post by Shara Bialo
The Endocrine Society's annual meeting is the world's largest meeting of endocrinologists, and in this 95th year for the 4-day conference it came close to breaking records with over 9,000 physicians, scientists, and healthcare professionals in attendance.
Being my first-ever professional conference like this, I was a little overwhelmed.
So much so that when I walked into the Moscone Center in San Francisco on the first day, the sheer volume of people and exhibits was so dizzying that I instinctively thought to check my blood glucose.
I'm at the tail end of my first of three years of fellowship training in pediatric endocrinology and this was the first time I got to go to a big professional meeting like this. Being that I also have type 1 diabetes, I am always blaming normal human emotions and experiences on my blood glucose. I checked it anyway, and discovered the dizziness was solely from the shock of my surroundings.
Hey, at least I wasn't Low!
Many who've attended these conferences have probably said this before me, but as a newbie the Expo floor full of Pharma reps felt like the Disney World of Pharma Displays. The lengths that companies go to in order to "woo us" and push their products was impressive. Novartis had a real-life wrecking ball at their display to emphasize that their new drug Signifor "knocks-out" symptoms for Cushing's disease — not exactly diabetes, but that's one of the themes we saw. There were so many flashy LED screens spanning the convention center! A few exhibitors set up complementary dessert stations and many more offered specialty espressos and coffee (they know their audience well).
One of the more striking advertisements set up right when you walked into the conference was a billboard showcasing Sofia Vergara, who's famous for her busty character on the hit TV show Modern Family, but also had her thyroid removed in a battle with cancer. She was advertising the thyroid drug Synthroid (which many PWDs take, including Mike!). We all knew sex sells, but I never knew it was powerful enough to sell thyroid hormones!
Now, as to the professional endo part of the conference, I think it's important to put this out there: We patients with diabetes don't always realize that endocrinologists manage and treat a bevy of other diseases on top of just the Big D. Insulin is just one of many hormones that can go awry in the human body. Where I train, PWDs make up about half of our patient base but other offices vary widely. ENDO 2013 attendees traveled from all corners of the earth to present data that they devote their lives to compiling and to learn from leaders in the field.
While this Endocrine Society conference is a massive gathering of endos, it doesn't get the kind of play and recognition that other big conferences like ADA or AADE or even AACE often get. Many don't know what this group actually does. So here's the scoop on that, as I understand it.
It's the most active organization aimed at research on hormones and the clinical practice of endocrinology. They've got 4 medical journals, and they issue clinical practice guidelines along with advocating for endo research funding and other related public policy.
Want some proof that they want the patients to be well-informed? The society has an educational program that it calls The Hormone Health Network, which offers hormone-related health info for patients and their providers.
Like any conference of this nature, sessions included research poster presentations, symposia to discuss nitty-gritty details on specific topics, a 'Meet the Professor' series that offered a broader overview of individual topics, educational review courses for credit, and educational sessions for patients to attend. There were so many events happening simultaneously that the conference developed it's own app to help attendees with personal scheduling (as does ADA and other big events).
Some of us were live-tweeting as we went along, using the hashtag #ENDO2013.
The whole world of endocrinology is working feverishly to advance the field even further, and the projects in the pipeline were very exciting to hear about. Even for someone who trains in the field, it was completely overwhelming to take in the expansive area that endocrinology covers. It's impressive to see how much we have discovered about the human body, and incredible to learn how many areas still remain a mystery. Example: pathways of hormone action and consequences of specific genetic mutations... OK, it may not be an X-Files style-mystery or all that interesting to those outside the field, but for us in the endo world it's right up there at the top of our list of professional curiosities!
Hearing scientists speak firsthand about their research experience is a humbling reminder that everything I take advantage of today as a patient did not come easy. I have been studying medicine for 8 years since graduating college, and the details of the science behind how a CGM (continuous glucose monitor) really works to calculate a blood sugar from our interstitial fluid still eludes me.
Yet, I rely almost hourly on my CGM to alert me to Highs and Lows and it's a huge part of my life, regardless of whether I understand how it might really be working inside of me!
As far as diabetes research-in-practice goes, the biggest buzz was on the latest news involving artificial pancreas projects. Part of that touched on the troubles we see in creating a more stable form of glucagon, which is underway and would be a huge benefit to those who need to use it quickly when hypos happen. Several researchers are launching new experiments to fix the glucagon problem, and several more are working on ultra-fast insulin to avoid the need for glucagon altogether. None of the researchers mentioned this being public yet, but I scanned DiabetesMine coverage on the topics and saw it's been written about quite a bit, like this post and this one as recent examples.
CGM advancement got a healthy amount of screen-time, including newer versions that use fluorescence instead of the current electrochemical versions. OK, what's that mean in non-endo talk? Think implantable CGMs and glucose-sensing tattoos! All of that could be possible.
With all of these presentations happening, I counted a multitude of times that someone made a crack or eluded to the FDA -- and they were present too, of course. The FDA roamed the exhibit floors where vendors were set up to ensure that no one was hawking off-label use of their products, and that made for an interesting set of conversations. In a convention full of doctors who routinely use drugs and devices to their liking and don't always see eye-to-eye with the FDA, it made for an amusing juxtaposition of nervous Pharma reps and bold physicians. When a doctor tried to show a Pharma rep a CGM sensor she was wearing on a "not-FDA approved" arm site, the rep nervously turned her back to her and whisper-screamed "AHH! I didn't see that!"
I tried to not display my diabetes all the time, but had fun connecting with other endos who also happen to be fellow PWDs. By chance, I met two other endocrine fellows-in-training who also have type 1 because we were sharing our experiences with different pumps and CGMs with lecturing professors. There were also multiple Pharma reps who openly discussed their own D-stories, and I spotted several pumps on people from afar. It was less surprising than usual meetups 'in the wild' given that we were at a conference devoted to endocrinology, but nice nonetheless.
All in all, the conference was not about FDA-bashing nor empty promises for cures. Scientists are just as aware of what they do not know as what they do know, and luckily it motivates them to push ahead instead of give up. Despite feeling so overwhelmed by all of the information I have yet to learn, I also came away more motivated than ever to continue my journey in this field.
Hopefully one day, I will be able to offer my own piece to the enormous puzzle that is endocrinology.
Thanks for the unique perspective, Shara. Here's hoping, too, that you're on the verge of great things along with the next wave of truly empathetic medical professionals!