The biggest annual diabetes conference in Europe took place last week -- the European Association for the Study of Diabetes (EASD) -- bringing thousands from the D-field this year to Austria, for what many of us in the States refer to as "Europe's version of the annual ADA Meeting."
Today, we're happy to feature a report from Germany based D-peep Ilka Gdanietz, who was diagnosed with type 1 as a 10-year-old girl back in 1990. She now blogs at the German-language site Mein-Diabetes-Blog, and works professionally as communication lead for diabetes app-maker mySugr, which is based in Austria and is behind the popular MySugr Companion app.
Here's her report from the ground in Vienna. (Keep in mind, some of the links are international so may not be in English.) A Guest Post by Ilka Gdanietz (T1 since 1990)
This year, the EASD 50th annual meeting brought about 18,000 people from scientific, medical and research disciplines to Vienna, Austria, for a few days. The mission of this conference, one of the largest worldwide meetings about diabetes, is to promote excellence in diabetes care through research and education.
Why is this such a big deal?
Let's put diabetes into perspective -- did you know there are more deaths each year linked to diabetes than deaths in every year of the First World War? This is really freakin' frightening and underlines the importance of such conferences. As long as there is no cure, we as PWDs (people with diabetes) will always be looking for effective new tools to ease our daily lives with diabetes.
Not surprisingly, this year we didn't see anything revolutionary that we hadn't already seen or heard about before either at last year's conference in Barcelona or through other press channels, but there are still some interesting updates from "across the pond."
Abbott Freestyle Libre
Without any doubt, Abbott was "King of EASD 2014."
A cluster of people constantly were gathered around the Abbott booth and seemed to have brought their entire staff to manage the great rush of attendees. This was announced last year, but the FreeStyle Libre Flash Glucose Monitoring (FGM) System received the CE mark in August 2014 and is now ready for the market in Europe.
This new glucose sensing technology consists of a small, round sensor recommended to be worn on the back of the upper arm, which measures glucose every minute in the interstitial fluid. It can be worn up to 14 days and no finger prick calibration is needed. The meter (or should one call it receiver?) picks up the readings using wireless technology, and also allows fingerstick testing and ketone testing as well. (See our 'Mine post for details about the new system.)
As stated during the EASD conference at their official Abbott symposium, this is seen as an alternative to traditional blood glucose monitoring that could replace regular BG monitoring within 5 years.
Thinking ahead, together with patch pumps it could be a very powerful combination. The FreeStyle Libre will launch in Sweden and the Netherlands at the end of September; then in Italy, Germany, Spain and a few other markets later this year, followed by Australia and New Zealand at the beginning of 2015. In comparison to common systems for glucose monitoring, the Freestyle Libre will be available for purchase only online through a website tailored to each market. Sadly, there was no talk of Abbott's FGM coming to the United States. I got the sense that either no one knows when, or they just don't want to talk about that.
"The Enemy is Life-Threatening Hypos, Not A1C"
Dr. Stefano Genovese in Italy said this during Abbott's Symposium, and explained that the FGM's use of an Ambulatory Glucose profile (AGP) was important for addressing hypoglycemia for both type 1s and type 2s. A video of a type 1 PWD traveling around the world wearing a FreeStyle Navigator CGM was shown during his talk. It was nice to see the personal experience of a patient showcased and how he worked with his healthcare team to use these tools to have an exciting positive experience, instead of being shown simply graphs/charts of patient data.
btw, I am testing the new Abbott system for two weeks myself now, and finding it is really, really great and makes things easier.
Europe's First Touchscreen Pump
Outside the U.S., the international OmniPod is known as the myLife OmniPod and it's been on the market in Europe since July 2010 -- about two years after Insulet launched the OmniPod in the States. Swiss diabetes company Ypsomed distributes the patch pump, and the second generation model has now been available in places like Germany for the past month or so.
Ypsomed is going back to its insulin pump roots and launching a new tubed pump in 2015 called the YpsoPump (detailed in this article, in German). This is the first device that the company's made since selling its insulin pump business and the Disetronic to Roche Diagnostics back in 2003, and this new YpsoPump will be Europe's first touchscreen pump! It features user-friendly symbols to navigate the screens, uses pre-filled insulin cartridges, and will be smaller than traditional insulin pumps that are available now. A first prototype of that pump has already been shown and tested by some European diabetes bloggers. It's kind of like a combination of the best features of the Tandem t:slim pump with touchscreen and the new Snap pump using pre-filled cartridges in the U.S. -- neither of which are available yet in Europe.
Dexcom Pipeline Overseas?
There was talk of a planned cooperation between CGM-maker Dexcom and Insulet, makers of the OmniPod, which may have been related to the recent news that the two companies have agreed that their future tech will include data integration. This added to the talk of the next-gen, direct-to-smartphone Dexcom G5 sensor planned for 2015 in Europe and the U.S. No details were revealed just yet, and timing is always TBD, but this estimate fits with timing predictions we've heard if regulators cooperate.
Swedish Study on Pump Therapy
One hot topic covered at an EASD press conference was a study on reductions in mortality and cardiovascular disease in PWDs using insulin pumps by Dr. Soffia Gudbjörnsdottir from the University of Gothenburg in Sweden. The population-based study proved that people with type 1 diabetes, who are supplied with an insulin pump (CSII), have a lower risk of death than patients who are on MDI.
Dr. Gudbjörnsdottir analyzed whether or not insulin pumps -- first developed more than 30 years ago -- actually help reduce the potential for complications thanks to better blood sugar control, and she examined the Swedish diabetes register which stores nationwide data of people with type 1 diabetes. The researcher compared the data from 2,441 patients using an insulin pump to another 15,727 patients using multiple daily insulin injection therapy. Results: The patients with pump therapy had a reduced risk of death by 29% during this analysis spanning seven years.
The probability of dying from cardiovascular disease was reduced by as much as 43%. Both results were statistically significant. In addition, Gudbjörnsdottir's results indicated an 18% lower risk of coronary heart disease. This data was compelling, however not significantly significant. There was also a non-significant reduction in pump users of non-fatal cardiovascular disease and deaths from other diseases.
AP for a Month!
Another study making a splash was using Artificial Pancreas technology for four full weeks in an outpatient setting. That is, researchers from the University of Cambridge Metabolic Research Laboratories "reported striking, positive results with the artificial pancreas — a closed-loop insulin-delivery system — in 40 patients with type 1 diabetes, comparing the device vs a sensor-augmented insulin pump for unsupervised, at-home, overnight delivery of insulin."
This is the longest and largest analysis of an AP device in a home setting so far, involving 4 randomized studies in which adolescents used it for 3 weeks and adults used it for 4 weeks — with no supervision.
Medscape reports: "When patients used the closed-loop device overnight, their glucose levels remained in the target range (3.9—8.0 mmol/L) for 18% longer than when they used only sensor-augmented insulin pump. Their mean overnight glucose was reduced by 0.8 mmol/L, and they were hyperglycemic or hypoglycemic for less time with the artificial pancreas."
This is great news for moving AP research forward, out of the lab and into our lives.
No Preview of Medtronic's 'Coming-Soon' Device
Everyone was very excited about getting a first glance at the Medtronic MiniMed 640G pump system which already had received press. But... for some reason, it was not shown. No details were provided, and even the European launch, expected to take place in April 2015, was not confirmed.
Instead, Medtronic showed the MiniMed Duo combo (something we in the DOC refer to as the "snake bite" based on its dual-puncture design weaving an insulin infusion set and CGM sensor into one). This is what Medtronic refers to as another small step toward the closed loop system that will include both insulin infusion and CGM and possibly a second-hormone infusion like glucagon.
Medtronic also highlighted its OpT2mise study, which shows that people with type 2 on insulin pumps were more satisfied with their treatment than those on MDI and glucose control was better in this group. The study results may not be shocking, but it is important concerning pump reimbursement by payers for people with type 2 diabetes.
Roche Data Connectivity
At their press conference, Roche showed the new Accu-Chek Connect system and explained the importance of sharing important diabetes data between patients and their healthcare professionals -- anytime and anywhere (ya think?) Their new system includes an app that helps sent data wirelessly from the Accu-Chek Performa Connect glucose meter to the Accu-Chek Connect mobile app and web-based Accu-Chek Connect Online system.
The app works on Android phones (iPhone in the making), and at the beginning it will only work on the 5 or 6 most common Android models.
Roche also showed its new Accu-Chek Insight insulin pump which looks a little bit like a bulky smartphone, and is connected to the Accu-Chek Aviva Insight Diabetes Manager meter (with a full-color touch screen). In comparison to the old Accu-Chek Aviva Combo, the new one is really sleek and much smaller than the current Accu-Chek Combo, and feels much more modern.
New and handy is the use of cartridges that the user can pre-fill themselves -- complete with a new cartridge filling system that makes it easy to fill with one click.
The UK and Italian launches are planned for next month. Germany, which is probably the most important market for them, will follow in Q1 2015. No date was communicated for a U.S launch.
Roche also plans an upcoming study in Q4 2014 about the benefit of pump therapy in children compared to MDI, called "Insight Kids."
Remember, I work for mySugr! We had an EASD Party at the mySugr office with around 60 people from the diabetes sphere including professionals, industry and bloggers. And it was a great pleasure for us to have Dr. Bill Polonsky and Dr. Bruce Buckingham joining the party.
By the end of this year we will launch the new mySugr Academy, because we think learning can be fun! The mySugr Academy is an online learning hub that features our signature diabetes monster, of course. The first lessons we will offer are for people with type 2 diabetes, consisting of levels, each containing a video, readings and challenges. And for everything you do, you will get points. We want to guide people to a better life while simply playing a game. We will launch the Academy in German and English. Also, the mySugr Companion app will get a very nice update very soon. Stay tuned for more on that!
Diabetes Bloggers Unite!
Once again, the EASD featured a bloggers summit, organized for the third year in a row by Animas/J&J, including bloggers from the US, UK, Italy, and Australia. It was great, as always. This year, every blogger had the chance to do a presentation about the projects he or she had worked on since last year's EASD meeting. We also talked about "The language of diabetes" which is an issue everywhere -- diabetic, PWD, affected by... person with... Diabetes burnout was also a topic, and we agreed there is not enough real help offered for those who are affected by diabetes burnout so there's a big need for more professional focus on that. Kerri Sparling pointed out what great power the global DOC has to reach people and support each other, pointing to initiatives such as Spare a Rose aimed at getting insulin to children with diabetes.
Folks from the Global DOC
Thanks for the great report, Ilka! As always, we'll be watching these device developments closely.