Gregory A. Nichols, PhD


June 14, 2018

Attending the ADA

Every June, the American Diabetes Association (ADA) holds its annual Scientific Sessions, a convention of more than 12,000 health professionals from around the world who come together to discuss the latest advances in diabetes research, treatment, and care. This 5-day event can be a bit overwhelming, so I use the ADA's online itinerary planner to prepare for the meeting. The only difficult thing about filling my itinerary is choosing between interesting sessions scheduled at the same time!

Friday, June 22

The first session that caught my eye is entitled "Real-World Evidence in Diabetes," scheduled for 2 PM. Symposia consist of several 20-minute expert presentations followed by a panel discussion. This one will cover how real-world evidence can close the gaps in knowledge, as well as methodologies for overcoming bias that is inherent in observational studies. Right up my alley.

At 4:15 PM will be a debate on the value of cardiovascular outcomes trials in diabetes. Debates consist of a 20-minute presentation by each of two experts who take opposing sides of a question, followed by a discussion. Another debate begins at 5:20 PM on the topic of whether metformin should remain the first-line therapy for type 2 diabetes. I find these debates especially valuable because they often provide rationale for my research proposals and manuscripts.

Don't miss the networking reception at 6:30 PM!

Saturday, June 23

The first full day of the meeting begins at 8 AM, unless you are extra motivated and decide to attend a corporate-sponsored symposium, which usually begins at 5:30 AM. I'm coming from the West Coast, so that is way too early for me.

Instead, I'll be catching the oral session on "Emerging Targets for Diabetes Treatment" at 8:00 AM. This might seem like an odd choice for someone who does real-world observational studies, but there is a method to my madness. These talks will be presented (or at least coauthored) by employees of pharmaceutical companies. I get research funding from the industry, but such sponsorship is cyclical for most firms, so it is helpful to know which companies have something on the horizon and are likely to be looking for the types of studies I conduct.

For similar reasons, I'll check out one of the product theaters at 10:15 AM, where pharma companies introduce and discuss new products that are typically new to the market. A second round of product theaters will begin at 12:15 PM, which can conflict with the poster sessions, so pre-planning is essential.

The first poster sessions of the meeting will begin at 11:30 AM. In the moderated poster sessions, authors take turns explaining their poster, and the moderator leads a brief question-and-answer period after each one. The general poster session will be running simultaneously, where authors stand by their posters and are available for one-on-one discussions.

A second moderated and general poster session will begin at 12:30 PM. You will have to peruse the abstracts ahead of time to find the posters that interest you.

The first thing I look for is research similar to mine—things I've done in the past, am currently doing, or hope to do in the future. I like meeting people with similar interests, and these introductions can lead to collaborations. I also notice who is sponsoring the research to get clues about whom to approach with new project ideas. And if you're starting to get a sense that my job includes a constant hunt for funding, you're right.

The general sessions will pick back up at 1:45 PM. Because I've recently been doing work in kidney disease, I'll be attending the state-of-the-art lecture on "What is New in Diabetic Kidney Disease?" These types of sessions begin with a half-hour talk by a renowned expert in the field and are then followed by six oral abstract presentations. I'll be scribbling notes during the lecture to help me with my literature review for a planned manuscript on chronic kidney disease.

Finally, at 4:00 PM, an epidemiology-type session, entitled "The Impact of Diabetes Interventions and Behaviors on Outcomes," will include presentations on the 30-year follow-up of the Da Qing Diabetes Prevention Study and data coming out of the Diabetes Prevention Program Outcomes Study. I routinely cite these studies in proposals and manuscripts, so it is essential that I stay abreast of their ongoing findings.

Sunday, June 24

As I mentioned above, the most difficult part about filling out my itinerary is choosing between concurrent sessions of interest. Such will be the case at 8:00 AM on Sunday morning. The conflicting sessions are "Diabetes Complications and Risk Factors" and "Prediction and Prevention of Cardiovascular Disease." To choose between sessions, I drill down and review the specific abstracts in each session. Fortunately, the rooms for these two are close enough in proximity that I can catch the first six presentations of one and then bounce over to the last two presentations of the other.

At 10:15 AM will be the President, Medicine & Science Address and Banting Medal for Scientific Achievement lecture. Although these don't often apply directly to my work, I attend because I learn a lot.

Another set of moderated and general poster sessions will commence at 12:00 PM. Again, plan ahead. I will be presenting three posters during this time slot, so come say hello!

We will all be graciously granted a session break from 1:00 to 2:00 PM, but the program will resume in earnest at 2:15 PM. For me, attending the Kelly West Award for Outstanding Achievement in Epidemiology Lecture is an annual affair. It is my field so I feel somewhat obligated, but I would probably attend anyway.

The award winner this year is Catherine Cowie, who will talk about "Diabetes Diagnosis and Control—Missed Opportunities to Improve Health." Again, right up my alley. It will last only 45 minutes, so I'll scoot over afterwards to catch the last half of the "Management of Patients with Progressing Diabetic Kidney Disease (DKD)" symposium, where I'll pick up some nuggets for my own DKD research.

Much of my work involves the epidemiology of diabetes complications. As such, one of the sessions about which I am most excited is at 4:30 PM, "Diabetes Prevention—What Are We Preventing?" This symposium will include talks on preventing diabetes versus treating prediabetes; preventing microvascular and macrovascular disease; and preventing cancer, cognitive decline, and physical impairment.

Monday, June 25

By now I'll be tempted to sleep in, but because of my current work in chronic kidney disease, I'll attend the session entitled "Role of the Kidney in Heart Health" at 8:00 AM. I recently published a related paper, so I'm curious about how my work will fit in to this symposium.

The National Scientific & Health Care Achievement Awards Presentation and Outstanding Scientific Achievement Award Lecture are scheduled for 10:10 AM. As with the Saturday award presentation, this lecture won't apply directly to my work, but I typically attend because I learn a lot.

From 12 to 1:00 PM will be another set of poster sessions followed by a much-needed session break.

I'll be back at it at 2:15 PM, attending a symposium entitled "Cost-Related Nonadherence to Diabetes Care." I've done a lot of adherence-related research, and this is a very important health services research topic, especially with the explosion of high-deductible plans.

Another chronic kidney disease–related session will take place at 4:30 PM, entitled "Albuminuria—Two Debates." I will be presenting a poster on Sunday (#1556) that demonstrates the critical role of albuminuria in the progressive worsening of the estimated glomerular filtration rate. One of the debates is whether albuminuria should be a treatment target. Given our findings, I say yes. I'm extremely curious to hear the argument against.

Tuesday, June 26

Many attendees will have left by now, but the ADA always cleverly schedules an important session for Tuesday morning. This year, it's the presentation at 8 AM of the draft 2018 ADA/European Association for the Study of Diabetes (EASD) consensus report on the management of hyperglycemia in type 2 diabetes. I will cite this report frequently going forward, and revisions to the last report (2012) will shape future diabetes care. The last talk in this session will include key knowledge gaps, which will provide me with ideas for future research.

To be honest, I may not end up attending all of the sessions listed above. I'll need to carve out time to talk with collaborators and funders, and, of course, friends. It should be another exhausting, rewarding, and delightful ADA meeting.


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