Reader Alert: Visit ADA Chief Scientific and Medical Officer, Dr. Richard Kahn's blog, for drug industry news and "official" coverage of the conference presentations. For the uncensored and totally unofficial scoop, read on. (Plus note that I didn't get this posted last night due to a snafu with the Internet connection at my @#$! hotel, which never happens to Mr. Kahn, I'm sure)

Wash, DC, June 9, 2006 -- So here I am among the busy "pre-conference" bustle (the exhibition floor and major presenation tracks begin on Saturday) already wondering if I'm missing anything ground-breaking by choosing to be in one place instead of another, with so much science being presented in so many meeting rooms simultaneously. Let's start by making perfectly clear that the ADA "Scientific Sessions" is most decidedly not a patient-oriented event. It is a gathering of doctors, scientists, and pharma industry strategists in all their glory: foreheads protruding as they push past the crowds in their button up shirts, convention neck tags dangling, briefcases and backpacks bumping along. A sea of cell phones and blackberries. The women schlepping oversized designer totes and wearing high-end, generally flat and sensible shoes (except me, cute and blistered).

Upon registration, one is handed a directory of abstracts as thick (and about as enticing) as a phone book, plus several other novel-sized handbooks and a load of slick newsletters and brochures, on everything from diabetes disaster preparedness to neuropathy treatments. The corporations hold their strategic sessions at nearby hotels, briefing insiders on product roadmaps and market strategies. It's all very Academic and Corporate and feels a bit like another world (another Dimension, even) from the place where people like me prime their insulin pens and stand in line at the pharmacy for test strip prescriptions they're not allowed to renew yet.

But do not for a moment underestimate this crowd: Everyone Who's Anyone in Diabetes is here -- which is surreal in itself, to think that if a bomb went off at the Wash DC Convention Center this weekend, a good 75% of the world's brain power on diabetes would be lost. Ooh, discard that thought! (relax, Mom, I'm just musing here)

Some stuff I learned on Day 1:

* Initial presentations were held on diabetes and depression and on "clinical inertia," i.e. the trouble with doctors not treating diabetes as well as they should (See aformentioned coverage by Mr. Kahn)

* A new diabetes-centered feature documentary called "Conquering Sugar Mountain" is on its way. Andre Garrison of Ellipse Productions has followed a group of nine Type 1 children as they climb Mount Kilimanjaro, the tallest mountain in Africa. He aims to promote awareness and raise funds for the JDRF, hopefully by releasing this piece into mainstream theaters, I hear. Now wouldn't that just rattle our view of the entertainment industry?

* A new-ish test called GlycoMark "could replace the A1c someday" says David Mendosa (whom I met yesterday and who is plain-spoken and kindly and recently lost 50 lbs on Byetta, he tells me). He recently reported on this new blood test, which gives an accurate reading of your post-prandial levels over the last 2-3 days. And a high A1c (i.e. less-than-optimal diabetes control) is all about those after-meal "glycemic excursions" of course! So this test could be even more useful than the Standard Deviation, since it specifically measures your off-target periods and when they occured.

* (For Carol) Dr. Ian Blumer of the Canadian Diabetes Assoc. says actually, most new diabetes devices are released in the US first, and Canada lags behind for several months at the least. Minimed's combo pump/CGMS system was the exception. He wasn't exactly sure why.

* Answers from Diabetes Research Institute Director and islet cell expert Dr. Camilo Ricordi:

- Yes, a reliable procedure does exist to test whether an insulin-dependent patient still has functioning beta cells. It's called the ISLET CHALLENGE TEST, which is kind of like the glucose tolerance test given to pregnant woman. The patient's BG is tested before and after drinking a specially prepared solution, in this case a glucose/enzyme cocktail that's meant to simulate a meal. This is the test researchers use on prospective beta cell study participants in advance to determine their current beta cell status.

- But no good procedure currently exists to reliably preserve the existing beta cells of Type 1 diabetics. Why? "It's because of the autoimmunity. It's kind of like that arcade game where kids get a hammer and bang down the gophers as they pop up," Dr. Ricordi says. "The cells might be there or regenerate, but the immune system keeps banging them down. So the preservation techniques we do have are just not as effective on Type 1's."

- In an endocrine session just prior to the ADA Conference, a certain Dr. Voltarelli from Sao Paolo presented some very exciting new research showing that it may be possible to intervene with newly diagnosed Type 1 diabetics -- within 6 weeks after diagnosis -- and effectively "reset the clock to before the autoimmune attack." The way I understand it, the unusual strategy is to remove stem cells from the patient's own bone marrow, then give the patient an immune-suppressive "bomb" (one-time high dose) and then re-inject the patient's own cells, now ideally safe from destruction by the autoimmune system. Early studies show that patients don't need insulin for 6 months up to 2.5 years after this procedure. Watch for MSM news on this one!

Much more on advances in islet cell transplants to come... I'm off to the show floor now (in slightly more sensible shoes today).

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