Anne L. Peters, MD


June 03, 2016

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This time of year I'm always excited about attending the American Diabetes Association (ADA) Scientific Sessions. This year, they will be held in New Orleans from June 10th through 14th. While I'm not able to tell you any secrets—and, frankly, I don't think I know any—I'm going to talk about what I'm looking forward to learning about and a few things I think will be important.

We know that results from the LEADER trial—the cardiovascular outcomes trial for liraglutide—will be presented on June 13. The headline of these results is that they're positive, but we don't know what cardiovascular outcomes were improved in which patients—basically what this looks like. These results will be very, very important to our understanding of the benefits of GLP-1 receptor agonists on cardiovascular outcomes. I love learning that diabetes drugs also benefit cardiovascular outcomes.

Results of EMPA-REG[1] were reported last fall, and empagliflozin was shown to have significant benefits in terms of reduction in cardiovascular events and overall mortality. But that was just the tip of the iceberg. We have lots to learn; more data about empagliflozin and other SGLT2 inhibitors will be presented at this meeting.

In terms of drugs we have on the market, there are going to be some new twists. Scientists have been studying the combination of a GLP-1 receptor agonist and a basal insulin. They put these together in a pen and give them to patients, gradually increasing the dose. This particular combination has been very effective at reducing A1c's while minimizing side effects. New data on a variety of different combinations should be presented at the ADA meetings.

Because I love technology and devices, the DIaMonD trial is looking at the benefit of continuous glucose monitoring in individuals with type 1 diabetes who are on a multiple daily insulin injection regimen. These are not patients on insulin pumps but patients on injections. I'm hopeful that there will be benefit. I certainly see benefit in the patients I follow in my own clinic.

Finally, there will be lots of information about programs and applications designed to help manage patients with diabetes. There are tools, devices, and apps for your iPhone, and ways to send data back to a clinic, mentor, or a coach to help improve outcomes. But the problem with many of these systems is that they require a lot of feedback. They require time and energy from healthcare providers on the other side of the data. I'll be very interested to see how these applications work in a variety of different settings. I'll try to imagine how they can be useful in my own healthcare settings, where I take care of many patients and want to improve their outcomes—particularly over time. It's easy to get good control over the short haul, but it's maintaining that control over many years that I think is the real challenge for those of us who routinely treat patients with diabetes.

Keep your ears open, listen for diabetes news from June 10 to June 14, and I'm sure you'll hear all sorts of new things. No cure, but there will be a lot to interest you in the coming month. Thank you.


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