Sixteen-thousand doctors, scientists, and other healthcare providers. Hundreds of Pharma industry folks and food and diabetes supply vendors manning 171 booths in a cavernous exhibit hall. Over 2,500 research reports, plus over 2,000 more studies presented on mini-billboards known as research posters. More than 150 live sessions where experts present nearly 378 reports on every imaginable aspect of diabetes in the human body.

This is the American Diabetes Association annual Scientific Sessions conference, taking place this year from June 8-12 in Philadelphia. Once again, we are there.

First impressions?

Amy: "I love the focus on behavioral issues and on youths transitioning into adulthood with diabetes this year. Those are two areas that are traditionally so underserved! So it's great to see a lot of new research in that area. Also, no one's saying 'pipe dream' about Artificial Pancreas technology anymore, are they?!"

Mike: "Being my first-ever time attending, let me just say... WOW! I'm amazed at the scope of everything going on. It's an incredible experience with a lot to absorb. But at the same time it's a little disappointing to feel like a lot of these experts are missing the point; it's not about stats, graphs, and scientific concepts. It's about us as people and patients."

Allison: "It's always remarkable to see so many people focusing in the intricacies of diabetes. Each time I attend conferences, I gain even more appreciation for how complicated this disease is! But I also bemoan the fact diabetes is so complicated... Advancements just never seem to come fast enough, do they?!"

Device Updates

On the technology side, the big buzz was of course the official launch of Tandem's t:slim insulin pump, a sleek little model with color touch screen reminiscent of Apple products. We wrote about the t:slim in some detail last fall. The company is taking orders as of today, and the product will ship to customers starting in August. Insurance coverage is still TBD, and the out-of-pocket price tag is about $5,000.


At a "Product Theater" presentation Saturday, conference-goers got to see a full live demo of the t:slim's features and functionality. It sure as heck looks easy and intuitive to use! One function that I thought was awesome is a little "IOB clock" that appears on the home screen, showing how much "insulin on board" is still active in your system, complete with a time count-down to let you know when it's wearing off. Useful! Look for more details on the t:slim launch from us soon.

On the topic of next-generation pumps: conspicuously absent from ADA this year were the Debiotech folks with their wireless, smartphone-connected Jewel Pump, which made such an impression a few years ago.

But looking at their site, it seems they're in the midst of a multi-center user study in Europe on an algorithm for a closed-loop system including the Dexcom sensor, as part of the European Artificial Pancreas consortium. So maybe they're holding back on a pump introduction until they can offer a more integrated system. We'll keep you posted.

Another pre-FDA-approval wireless pump from CellNovo that includes integrated glucose testing and can actually be controlled via cell phone was getting a lot of attention in its expo booth, despite the fact that nothing much seems to have changed since the system was demo'ed last summer. Company reps tell us the product's doing well in Europe, but U.S. FDA approval is being held back by two things: an upgrade from 3G to 4G wireless technology. and a necessary changeover to the OneTouch Verio test strip (in Europe the system currently uses another, which is not sold in the U.S.). They're also in the midst of a UK-based usability trial.

The new iBGStar meter was of course on display, and Sanofi had an eye-popping 3D movie showcasing this device that passed FDA approval in December. We were already impressed, as it's the first and only cable-free meter that connects directly to an iPhone and iPod touch, but there's nothing like a bunch of doctors wearing red 3D glasses oohing and aahhing through a film about a BG meter taking them on a journey through time! (Actually, the film almost made it look like iBGStar is continuous glucose monitor, if you just watched it without knowing any better.)

Remember the all-in-one Pogo ("Press & Go") blood meter by Intuity Medical? Well, it was on display again (five years running) but it's still not available to buy. The company says they filed for FDA approval last summer. The most noticeable change is that the motor's even quieter now (as in, you can barely hear it lance). No blood or needle seen, thanks to the 10-strip drum inside. They've also got a separate FDA submission filed for a web-based data software called Patterns that would be downloadable for free. The Pogo looks cool, but we've seen this for so many years, the story is the same: let us know when it hits the market!

T1D Exchange National Type 1 Registry!

One of the most exciting things announced here, hands-down, was the Helmsley Charitable Trust official launch of its T1D Exchange Registry, "the most comprehensive analysis of people with type 1 diabetes ever undertaken in the United States." This new national registry has collected data from 25,000 participants to date from 67 clinics across the country, and the analysis of that data has yielded some very surprising things — mainly that A1Cs on the whole are too high for comfort, especially in the over-50 T1 crowd, which also had the highest rates of severe hypoglycemia and ER visits. I would've pegged adolescents, for sure!

What's particularly exciting with T1D Exchange is that this group is on a holy mission to help accelerate progress in research and development of new treatments. At a Saturday evening reception, the room was humming with anticipation as David Panzirer, Dana Ball and other project leaders outlined how T1D Exchange plans to act as a liaison between industry, regulatory, academic and patient groups to get things moving better, faster, and more productively. Patient-reported data is key to this, they say: "We'd love to transform the way clinical trials are done in America." Wow! Considering how much they've accomplished in just a year and a half — creating and launching the registry + fantastic online community called (do check it out!) — I for one cannot wait to see where this group is going! (Disclosure: myself and a few other well-known DOCers are part of an outreach advisory board for this project.)

Insulin News

Novo's new degludec beat Lantus in lowering glucose in Type 2's in a recent study, but we heard word at the conference that FDA approval of degludec has been delayed until at least October.

Meanwhile, cancer risk from insulin was a key topic this year. A huge Sanofi-sponsored study showed that there was no increase in cancer risk from using Lantus, as had previously been reported. This will come as a relief to many, not least the company!

Another study, sponsored by the NIDDK (acronym ORIGIN), shows the first-ever clinical evidence that long-term use of any kind of insulin is safe! In more than 12,500 patients over a median of 6.2 years, researchers found that daily injections "neither increased or reduced the risk of heart attacks, strokes, cancer or cardiovascular-related mortality."

SGLT2 Inhibitors

This is a new class of drugs under development that works primarily by helping the body slough off excess glucose in urine — in a healthy way. Beohringer, Lilly and J&J are all working on a daily pill for type 2s that could hit market as early as 2013. J&J's canagliflozin is the most advanced to date and is already under evaluation by the FDA. These drugs also have promise for treating type 1s, I am told.

Further on the research side, here are some of the ADA updates we found most noteworthy:

{Source: references to all research abstracts can be found on the ADA website here}

* Transition of Youth to Adult PWDs

We love that this topic was finally in the spotlight! Remember just a few short years ago, when the diabetes establishment seemed to be oblivious to the fact that all puppies grow up to be dogs (err, all "juvenile diabetics" have to keep on truckin' after age 18)?

New research "sheds light on the health status and psychosocial challenges faced by this population." Unfortunately, the facts are grim. One study showed that non-diabetic college coeds scored higher than PWD youths on "purpose and life satisfaction," BUT the two groups scored the same on depressive symptoms, disordered eating, alcohol use, smoking and sleep quality. (So everyone has an equal opportunity to crash and burn in college years?)

Another study showed that type 1 adolescents were at 20% higher risk for suicidal tendencies than their non-D counterparts. Another showed that as young PWDs transition from pediatric care to adult doctors, they "experience sadness and loss over leaving the doctors with whom they had grown up, felt like their new doctors were more like partners in care but didn't know then as well and felt as if they needed to be matched with their new new doctors by personality style." Amen to that!

One more study in this area found that those who transition out of pediatric care too early face higher risks to their health, i.e. their A1Cs tend to shoot up once dropped into the free-falling world of "adult care." Maybe the next round of research here ought to be on how we can make adult diabetes care more like the nurturing world of pediatric care?

* Islet Cell Transplantation Update

The results are much more encouraging here. One study showed that a new method of transplanting islet cells into the liver, called the Clinical Islet Transplantation 07 (CIT07) protocol, actually helped transplanted cells survive better than the current gold standard "Edmonton Protocol." Both protocols use the same immuno-suppressing drugs, but with CIT07, the islet cells are "cultured" prior to transplantation. Results suggest that the immuno-suppressing drugs may not be toxic to islets, as previously suspected. Which is good news!

Two other studies looked into use of the drugs sitagliptin and pantoprazole with transplantation. Results showed that these meds can "augment beta cell function," but fall short of actually regenerating beta cells (i.e. no new cells are created).

Another study found that transplanted cells function better and may survive longer when the patient takes a long-acting GLP-1 analog. So after transplant surgery, you may be off insulin but have to use another injectable drug?

One more study looked at patients who've had their pancreas removed. Does tight BG control in the hospital immediately following islet cell transplantation help the cells survive better? It does appear that way.

A few other studies looked at patients with pancreatic tumors and pancreatitis. The upshot is that the more islet cells transplanted, the better for long-term outcomes. And in the case of the tumor patients, "isolating" the islet cells during transplant procedures is also beneficial.

The more they learn about successful transplantation techniques the better, I always say!

* LADA is Not Different (?)

Really?! In contrast to a session we reported on from the recent AACE conference (American Association of Clinical Endocrinologists), a study presented here at ADA testified that LADA (latent autoimmune diabetes in adults) is NOT a distinct form of auto-immune diabetes.

This multi-country European study did find a few differences by age of onset: those diagnosed younger tended to have lower BMI and earlier need for insulin therapy.

But they found "insufficient differences in auto-antibodies to characterize LADA" as anything other than plain old type 1 in grown-ups. And the debate marches on...

* "Sleep Yourself Healthy"

There's actually an expression in German: Schlaf Dich Gesund, which literally means you can "sleep yourself healthy." And now it's a proven scientific fact! At least according to two studies presented here at ADA.

The first showed that not getting enough sleep, and poor sleep quality, significantly raises risk of developing diabetes in those who are at-risk. Folks in the study who got a full night's rest were 60% less likely to be diagnosed.

A second study showed that folks with sleep apnea had significantly higher post-meal BG levels "associated with greater risk for cardiovascular events." Conclusion? "Sleep apnea may have a substantial impact upon glucose regulation" and it's bad for your heart too. Bah! If you've got sleep disorders, get 'em treated, please!

* "An Apple a Day..."

It's no wives' tale. Research now shows that eating more fruit per day ("equivalent to about one apple or two bananas") is associated with lower incidence of diabetic retinopathy. In this 8-year study, those who ate the most fruit had the lowest incidence of retinopathy. But wait: TWO BANANAS a day with diabetes?! My, that sounds like a BG control disaster to me. Makes me wonder: don't these researchers cross-reference their work? Surely the two-banana group suffered in terms of rising A1C results...?

* Do Pollution and Cow's Milk Trigger Type 1?

Who read Dan Hurley's book Diabetes Rising, outlining all the prominent theories on what may trigger type 1 diabetes? Yup, environmental pollution and early consumption of cow's milk are right up there on the top of the list. Two new studies that looked at pollutants (pesticides and heavy metal concentrations) found that "only lead seems to be associated with an increased risk for this condition." Heck, lead in your bloodstream is surely not good for any aspect of your health, IMHO.

So what about giving your baby cow's milk too early in life? Continued analysis from an ongoing study called DAISY (Diabetes Autoimmunity Study In the Young) showed that this does NOT contribute to risk of type 1 diabetes. However, infants who get fruit too early and rice and barley too late appeared to be at greater risk. Researchers conclude: "There is a complex relationship between the timing and type of food an infant is exposed to and his or her risk of developing type 1." (No pressure, new moms! Geez!!)

* Ancient Drug Could Help Type 2s

I'm quoting the press release on this one:

"In the first modern-day clinical trial of one of the world oldest drugs, researchers have found that salicylate, first used by the ancient Egyptians and Greeks to ease pain caused by inflammation, also has glucose-lowering properties and may be a potential treatment for people with type 2 diabetes."

The drug is derived from the bark of the willow tree, is relatively inexpensive, and is still used commonly for treating joint pain. "Nobody has ever looked before to see what other properties it might have," says principal investigator Dr. Steven Shoelson of Joslin Diabetes Center. In his study, it reduced A1C and fasting glucose levels in 286 T2 patients.

Wow. Back to basics, ay? Just like I recently discovered that good 'ol fashioned white vinegar cleans your house better than most of those fancy, expensive spray products. (Housewife tip!) Keep your eye out for more news on salicylate.

* Artificial Pancreas Update

So much work is being done in this area! Very exciting!

Some of you may have caught the JDRF/Helmsley AP webinar last week, so you heard that Medtronic is developing dual-sensor technology to increase the accuracy (i.e. safety) of a potential closed-loop system. Obviously, sensor reliability is key!

Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.