A Year in Review: Advances in Diabetes Technology + Research

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Meeting: ADA Symposium – Major Advances and Discoveries in Diabetes: The Year in Review

Speakers at this ADA Scientific Sessions presentation included: Chair: Rodica Busui, MD, Ph.D. (University of Michigan) and President of Medicine and Science of the American Diabetes Association, John B. Buse, MD, Ph.D. (Senior Associate Dean, Clinical Research University of North Carolina School of Medicine and Director of the UNC Diabetes Care Center), Anath Shalev, MD (Department of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham) and Michael Schwartz, MD (University of Washington Medicine, Diabetes Institute).

This panel of experts presented the highlights of clinical science over the past year and how they will impact the care of people with diabetes. Here are some exciting advances people with diabetes can now talk to their providers about!

Food and Drug Administration (FDA) approvals.

dr Buse emphasized that there have been numerous FDA approvals for the treatment over the past year Type 1 diabetes (T1D) And Type 2 diabetes (T2D).

The FDA has approved the drug teplizumab. This drug targets and manages the second stage of T1D. This is a little-known phase before the detection of T1D (preclinical phase) and before blood sugar levels are consistently high.

Teplizumab can delay the onset of T1D and the need for insulin therapy—if started before diagnosis.

The FDA has also approved several new ones insulin pump systems with automated insulin delivery (AID) capabilities. These systems are revolutionizing care, allowing people with type 1 diabetes and type 2 diabetes to better control blood glucose levels than ever before.

Recently approved systems include: Insulet’s Omnipod 5, Medtronics 780gand the iLet Bionic Pancreas.

Most notably, Dr. Buse was impressed by FDA approval of a drug Open source AID system, Tidepool. This was the first community-driven diabetes innovation to be approved by the FDA – with the ability for users to dose insulin directly from an app on their phone.

The FDA has granted approval Continuous glucose monitoring (CGM) systems.including the long-awaited Dexcom G7, which has a much shorter warm-up time of 30 minutes than the G6’s two hours.

Also noteworthy was the approval of biosimilar insulinsincluding Rezvoglar, which received its interchangeability designation (can be used interchangeably with Lantus) in late 2022, and the fifth SGLT-2 inhibitor, Brenzavvy (bexagliflozin), also received FDA approval.

sotaglifozin has also been approved to prevent cardiovascular death and heart failure hospitalizations in patients with heart failure with or without type 2 diabetes.

Advances in newer drugs

dr Buse noted that many drugs aren’t quite ready for the market yet, but big advances have been made — including advances in once-weekly insulin for people with type 2 diabetes.

striking, Jardiance is being studied as a treatment chronic kidney disease (CKD) and to improve heart health in people with diabetes.

dr Shalev spoke about the implementation of technological and therapeutic advances in the care of people with type 1 diabetes and spoke about the common drug verapamil.

Verapamil has been detected to increase pancreatic insulin secretion in children with newly diagnosed T1D. Verapamil also limits the total daily amount of insulin needed to maintain blood sugar levels within a certain range and also decreases hypoglycemic events, with no serious side effects reported.

Verapamil continues to offer significant benefits for people who continue to take the drug even after 2 years. Verapamil in combination with metformin for people with type 2 diabetes is being studied.

A holistic approach to diabetes care

Especially for people with type 2 diabetes, great importance was attached to whole-body hygiene and not just to the blood sugar level.

Over the past year, researchers have begun to focus more on sleep health, weight management, cardiovascular and kidney health to improve the overall quality of life for people with diabetes.

In line with a more holistic approach to diabetes management, the American Diabetes Association (ADA) has lowered its blood pressure and lipid goals — to align with other diabetes advocacy groups.

dr Schwartz emphasized the need to target the brain and body when treating diabetes. He presented new insights into the neuroscience of metabolism and considered the effectiveness of incretin drugs in weight loss from the perspective of the “neuroscience of energy homeostasis”.

Advances in coverage and access

dr Buse mentioned that one of the biggest accomplishments of the year was the reduction in insulin prices in the United States, and the United States in particular announced voluntary price caps from all three insulin manufacturer. These changes will have remarkable implications for health equity in the years to come.

One of the biggest advances in access to care for people with diabetes was the Medicare eligibility change, making CGMs available to all insulin-dependent people (T1D and T2D) and those with recurrent hypoglycemia.

State Medicaid programs are also expanding CGM coverage; Florida just signed legislation that would extend coverage to Medicaid patients with diabetes in the state.

The challenges we still face

dr Buse said the biggest challenges of the past year have been shortages of semaglutide (Wegovy and Ozempic) and tirzepatide (Mounjaro) and health equity issues in the cost of these drugs.

He also stressed that we need more research on the effectiveness of GLP-1 receptor agonist drugs for people with type 1 diabetes.

In conclusion, the researchers said that health care needs to be more equitable in many areas: socioeconomic status, gender, race, sexuality and disability.

We need to focus on policy and practice at the community and system levels to ensure that these tools and emerging medicines are implemented equitably for all people with diabetes.

People with diabetes deserve a normal life expectancy without advanced complications.

These advances in medicines and technology are all very exciting for the diabetes community. At Beyond Type 2, we aim to track this progress to keep the community informed. So be sure to register for ours Newsletter and follow our reporting!

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