The American Diabetes Association’s huge annual conference hits the city of San Francisco this Friday, June 6. Of course I plan to be there, running around like a madwoman trying to catch all the interesting briefings, the movers-and-shakers for interviews, and the best giveaways in the best booths 
. Dr. Jackson and I have also been invited to show off our KYN book in the AgaMatrix booth on Saturday and Sunday afternoon. So stop by if you happen to be attending.
btw, rumor has it that Anita Manning, formerly of USA Today, will be liveblogging the ADA conference. I guess Richard 
Kahn’s diary blog wasn’t quite peaking the imagination of the American public at large. See Anita’s ADA Now blog site here.
So what’s big news this year? The headlines will be about results being released from three major clinical trials, along with several companies revealing new data on promising drugs under development, according to diabetes industry analyst David Kliff of Diabetic Investor.
(He doesn’t expect much news at all from the medical device sector, unless you count a possible announcement from DexCom on the company they’ll choose to partner with for their new hospital-based CGM system.)
But keep your eyes peeled, because CNN, Forbes, Reuters and all the others will be flashing headlines on these big trial results:
* ACCORD Trial – more on that controversial study of tight glucose control in high-risk Type 2 patients that was halted by researchers after a number of patients died.
* Advance Trial Study Results – the largest-ever study of intensive treatment in high-risk T2 patients, which showed that tight control does NOT necessarily increase risk of death (!)
* Glycemic Control and Cardiovascular Outcomes: The VA Trials – a huge, costly trial looking at the effect of intense BG control on complications in T2 diabetes.
The great debate is how these three landmark studies will eventually inform the medical establishment. The conference will host a number of symposia and panel discussions on all the nuances (which would surely put us to sleep, but I promise to report back if I hear of any significant outcomes… in the form of a nice, short, bulleted list – my favorite shortcut to what matters).
What matters in fact is whether the FDA will be influenced by any of these study results to alter the standards they currently use to approve diabetes drugs. Will they consider standards beyond glycemic control? (Not forgetting that they need to straighten out their own organization first)
On the new drug front, the huge success of Byetta (from Amylin) has apparently done away with any concerns and established GLP-1 therapy (injectable hormones) as one of the most promising regimens for treating Type 2 diabetes. It’s amazing results with weight loss are the icing on the cake, if you’ll pardon the expression.
Now Novo Nordisk has recently submitted its own GLP-1 Liraglutide drug for FDA approval, while Amylin prepares to submit a long-acting, once-a-week version of Byetta. Two presentations on Sunday June 8 “should offer a glimpse into the future of the GLP-1 market,” Kliff says. “The big question Novo has to answer is why will physicians prescribe Liraglutide over Byetta when it appears Byetta is more effective at helping patients lose weight?” Good question!
Roche Diagnostics is also getting in on the game with its new GLP-1 compound R1583, which Kliff calls “the wild card here.” Phase I trial data will be presented at the ADA conference to much excitement; some researchers beliveve that R1583 is the most promising of the new GLP-1 treatments.
Yo! You still awake? Good, ’cause there’s a little bit more.
A company called Vivus will present about its new obesity drug Qnexa as well. According to the study abstract, Qnexa also helped patients drop their average BG levels by 1.1 percent, compared to just 0.6 percent in the placebo group. The Qnexa-treated patients also lost nearly 6x as much weight as the placebo patients. So another possible “blockbuster” — as long as no nasty side effects emerge?
The news may be all about the oral drugs this year, but I remain true to my personal passion for the insulin delivery devices, glucose gadgets, and “life-changers.” Stay tuned in the next few weeks for all the news that’s fit to print about that.
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Wow, all type 2 stuff. I’m a little tired of all the research, all the money, and all the media attention being on the Type 2s – cause that’s where the numbers are and that’s where the money is. I’m sorry, but there’s already a cure for type 2 – it’s called not being fat. Now, can we cure my autoimmune disease so I don’t have to wear this device on my hip?
With all due respects to Fenton, T2 is not necessarily a condition of obesity, though obesity can cause a T2 syndrome to hit clinical diagnosis state, and while weight loss can often lessen the intensity of T2, it does not cure T2. (I’m waiting for the pundits to realize that what’s currently called “T2″ is a spectrum of disorders, some of which are comorbid conditions.)
The current safety issues with T2 meds — like some of the issues Jenny (Janet Ruhl of http://www.bloodsugar101.com/) suspects of insulin analogues — are one of the issues behind the push to develop new oral medications (another, of course, is that proprietary chemical configurations fall out of patent protection much sooner than creative works under the copyright laws).
As far as T1, I should certainly like to see you be able to “get rid of that device on your hip”. One would hope that eventually novel genetic engineering should be able to address that; unfortunately, the path is frought with long development times, socialpolitical issues, and moralistic misdirection (“if we can mess with diabetes genes, why shouldn’t we mess will all genes and create what is effectively a society of clones?”). Meanwhile, it would seem that if the Artificial Pancreas Project could get the expert-systems correct, the next step would be a completely implantable device… which would still require periodically refilling the internal reservoir.
On the third hand… has anyone experimented with using immunosuppresants on people with autoimmune disorders (and does the efficacy thereof depend on the degree to which the disorder has affected the body’s systems)?
If the “cure” for type 1 involves immunosuppressants (esp T cell modulators) the cure will be worse then the disease. I’ll take T1 over cyclosporine or infliximab.
I also hate the word “cure,” which I hear most often from the parents of type 1s rather than type 1s themselves. In medicine, at least in my experience, there are very few magic bullets. There are very effective measures for preventing disease (e.g. vaccines) and there are treatments of varying efficacy, but cures don’t abound. Personally, I think anyone diagnosed with type 1 will be dependent on exogenous insulin for the rest of their life. I would like research to focus on preventing complications and lengthening the lifespan of diabetics rather than chasing a pipe dream.