We're off to Orlando!
As we do each summer at this time, our DiabetesMine team is heading to the American Diabetes Association's annual Scientific Sessions, a five-day conference being held this year in Orlando, FL, that gathers roughly 17,000 experts together from across the globe to discuss the latest in diabetes research and treatments. It's basically the biggest diabetes meeting in the world.
The event runs from Friday, June 22 - Tuesday, June 26. We're also hosting our #DData ExChange technology forum in Orlando on Friday, though it's not ADA-affiliated and is held off-site from the massive Orlando convention center.
It's always an action-packed five days, with attendees constantly on the move from early morning to the many after-hours receptions and parties late into the evening. Seriously, we hardly have a moment to sit down at these huge gatherings, where hundreds of presentations are happening alongside a sprawling exhibition hall.
We expect a lot of med-tech buzz this year, from updates on closed loop technology (that will automate glucose monitoring and insulin delivery) to much ado about newly FDA-approved products like the Bluetooth-enabled OmniPod DASH system, the new Dexcom G6 continuous glucose monitor, and Medtronic's stand-alone Guardian Connect CGM. And that's all just from the expo floor!
Official SciSessions hashtag: #2018ADA (yep, year before the org).
That being noted, we're pleased to report that ADA is taking a new approach to its controversial social media policy from years past. Their ban on sharing photos from this conference caused an uproar last year and now the ADA has revised the policy by promoting a #RespectTheScientist approach that requires getting each speaker's permission before posting any photos or research/slides they are presenting. This is good news of course, and we hope ADA eventually takes it down a notch and encourages more open sharing... since so many can't attend these big conferences in person.
Hot Topics at This Year's ADA Meeting
In total, these 78th Scientific Sessions include 375 oral presentations; 2,117 poster presentations, including 47 moderated poster discussions; and 297 published-only abstracts.
"I think this meeting is cutting-edge, just based on all the data presented and the new areas we're going into," says ADA Chief Medical and Scientific Officer William Cefalu.
Journalists and bloggers traditionally receive a news tips sheet from the ADA in the days before the event, but most of the details are embargoed until the time they are announced at the conference. So we can only give a broad overview of what's to come:
- Women in Diabetes: the ADA's President of Medicine and Science Dr. Jane E.B. Reusch says a new initiative this year focuses on women in diabetes. She's also the associate director of the Center for Women's Health Research at the University of Colorado - Denver, and has led the creation of this new ADA program. It's dubbed the Women's Interpersonal Network of the American Diabetes Association (WIN ADA), a members-only network for women working as scientisits, clinicians, and in other professional healthcare roles in this field. Dr. Reusch tells us it's a two-pronged effort aimed at supporting the careers of all women in diabetes, as well as examining the science on gender as a biological factor for women's health in PWDs and clinical outcomes. Currently, the ADA doesn't have specific figures on women working in the diabetes field, but that's a goal for this initiative going forward. Aside from highlighting that new research, the ADA will be highlighting women to receive recognition, and kicking off this initiative with a symposium called "Overcoming Gender Gaps in Science." Dr. Reusch says they also plan to pursue closer relationships with groups like DiabetesSisters in the future.
- Kids and Heart Disease: You may think heart disease is a D-complication specific to older PWDs (people with diabetes), but research is showing that kids and teens with T1D are experiencing cardiovascular (CV) disease more and more often. Yep, it's actually the leading cause of death in youth with type 1 and is directly connected to insulin resistance, for both lean and obese youth. There may be a way to address this, which will be discussed on Sunday afternoon.
- More Cardiovascular Questions: This year's meeting will also look at CV risk and treatment in adults with both type 1 and type 2, with particular focus on the cost-effectiveness of existing treatments. A symposium will explore a 21-year study on the topic, noting that treatments prolong life and improve outcomes, making them cost-effective even when the cost-per-person appears high. Other studies show improvements with various medications, and how those translate to real-world changes for PWDs.
- TEDDY Trial: Known officially as the Environmental Determinants of Diabetes in the Young, this is a major study that will show data from over 13 years that includes 8,500+ kids at risk of type 1 diabetes. Dr. Cefalu tells us that TEDDY is one of the largest studies of its kind looking at infants who are at the highest risk of developing the autoimmune condition and examining the environmental factors that may play a part.
- Veterans and Diabetes: The Veterans Affairs Diabetes Trial (VADT) will showcase data from 15 years, looking at macrovascular complications in more than 1,300 men with type 2 diabetes who served their country. This ADA Daily story on the study sets the stage for the upcoming June 24 research presentation. Dr. Peter Reaven of the VA Health Center in Phoenix is quoted as saying: “We know from the 10-year follow-up data that intensive glycemic control during the active treatment portion of VADT showed a statistically and clinically significant improvement in cardiovascular outcomes. Now that we have another five years of follow-up, key questions that remain are: What’s the trajectory of that benefit? Is there a legacy benefit to good glucose control? And is there evidence, one way or another, about the impact of glucose control on mortality?”
- Ajunctive T1D Therapies and SLGT Inhibitors: On Tuesday, we'll be watching a special symposium on pivotal trial data about T1s using, as adjunctive treatments along with with insulin, the class of drugs that include AstraZeneca's Farxiga/Forxiga, Boehringer Ingelheim's Jardiance, and Sanofi's SGLT-1/SGLT-2 inhibitor Lexicon.
- Behavioral Health: This year, the mental health and behavioral change elements of diabetes will be a big theme, we're told. The presidential lecture on healthcare and education, as well as another key symposium will discuss the interaction between mental health and diabetes. "Surprisingly, over many years, we have failed to be able to take care of people because of mental health issues," Dr. Reusch says. "This has been a overwhelming issue in our healthcare system, in failing people with diabetes." There's also a session on strategies to develop protocols for providers, as well as the new initiative with the American Psychological Association to train diabetes providers in mental health care delivery.
- BCG Vaccine Cure Research Update: While the second phase of her research is ongoing and years from showing any results, Dr. Denise Faustman at Massachusetts General Hospital will provide an update from earlier parts of her work on the BCG vaccine, which she believes could be a generic vaccine to reverse "advanced" type 1 diabetes. The follow-up comes from the first phase of research, showing that doses of the vaccine improved A1C levels to near-normal levels and that continued for five years. We'll follow this closely at ADA and report back on the full findings once released.
- Insulin Pricing Impact: This is the big elephant in the room, especially after the ADA published a critical white paper in early May. But interestingly, there are not many studies or presentations on the issue of affordability and access, other than one on Friday afternoon that will report on how increasing prices have impacted PWDs' ability to effectively manage their diabetes. This is a cross-sectional survey of hundreds of patients that looked at the different ways cost-related issues impact insulin use.
- Technology: Embedded throughout the meeting is a focus on new D-technology and the practical uses of it in the real world. On Friday morning, there will be a session for HCPs to learn about these tools and how to best advise patients on using them. Over the next several days, there will be presentations on next-gen tech like the Eversense implantable CGM on teh verge of getting FDA approval, and future closed loop systems coming soon. "The explosion of science and techology in the field of diabetes is impressive and so exciting," Dr. Reusch says.
Diabetes Tech Happenings
News announcements are already hitting the wire heading into the event -- such as Medtronic partnering with the Nutrino nutrition app, FDA approval of DreaMed diabetes software for personalized insulin recommendations, and launch of the InPen insight tool -- the first diabetes management report powered by a smart pen. We'll be reporting more details on all those next week.
We also expect to hear more about these new products recently approved and/or launched since last summer's conference:
Dexcom G6: With the G6 system approved by FDA in March and just launched at the start of June, this newest Dexcom CGM model will likely carry the company's conversation for much of the SciSessions. We expect to see that on full display, as well as conversation about Medicare's revised policy allowing for smartphone use along with covered CGM devices. Many of the scientific presentations will also delve into optimal CGM use for those on multiple daily injections, so we expect Dexcom to be a part of many aspects of this year's conference far beyond the Exhibit Hall.
Medtronic: The big insulin pump and CGM maker has quite a lineup on tap for ADA's SciSessions. There will be a big showing of its stand-alone Guardian Connect CGM which was approved in March and just launched a week before this conference. Medtronic has also jusst announced launch of its updated iPro2 professional CGM app for healthcare professionals, which now weaves in the Nutrino Foodprint feature to offer nutrition guidance in the logging app. We'll surely also get some more exciting updates from Medtronic's diabetes pipeline on display and being discussed at the conference as well.
OmniPod DASH: Insulet will also have its newly-approved system ready to show off at the SciSessions, after the FDA approved this product in early June. The DASH makes the Omnipod tubeless pump Bluetooth-enabled and is powered by a new touchscreen Personal Diabetes Manager (PDM). Aside from displaying that device on the Exhibit Hall floor, there are many symposia and sessions in which this new system will be discussed.
Abbott Libre Flash: Since last year's ADA conference, the FDA in September 2017 approved the much-anticipated FreeStyle Libre Flash Glucose Monitoring system and that has since launched for PWDs here in the States. We checked with the company and we're told they won't have any big new announcements timed with ADA, such as bringing the LibreLink mobile app for data-sharing to the U.S. Boo to that. But Abbott does tell us they'll be presenting some new data related to use of the Libre Flash.
Other D-Tech: There are always surprises in the Exhibit Hall, and sometimes those have to do with who is NOT present. This year, Roche Diabetes and the data sharing app mySugr they acquired are noticeably missing from the list of exhibitors (?). Meanwhile, rumor has it that Tandem Diabetes Care's Predictive Low Glucose Suspend (PLGS) technology, dubbed Basal IQ, is getting close to FDA approval, along with the Cellnovo hybrid-patch pump that now belongs to Eli Lilly, and of course Senseonics' implantable Eversense CGM, which is expected to be approved any day now. We'll keep our eyes peeled for all this around the conference!
We'll be live tweeting from @DiabetesMine using the event hashtags and posting updates on our Facebook page, so be sure to follow us. Also, stay tuned here for our post-conference coverage, from our POV as PWDs just like you.