Stumble It!
Fact Finding at ADA, in the ‘Big Easy’
It’s been a whirlwind few days here at the 2009 American Diabetes Association annual conference in New Orleans. Consider:
- 389 oral presentations
- 100 clinical symposia (more science talks)
- 104 late-breaking abstracts (papers submitted after the conference program was filled up)
- 1,538 research posters
- 465 published abstracts (research synopses)
- 150+ exhibitors on one enormous exposition floor
In short, it’s been factual overload — beginning with the first thing I learned this weekend: I didn’t even know New Orleans was nicknamed ‘the Big Easy.’
So what kind of “wow’s” were being shown for insulin-dependent patients? Not a lot. Mostly stuff we saw already last year. Other than new decorative skins for several favorite pump and glucose meter models, the few exciting new products were a little “too new,” as in still filed under the “future: not available yet” tab:
Photos: Medgadget.com
* Mannkind’s new inhalable insulin Afresa is under review by the FDA, meaning that despite booking a sizable booth here at the show, the company was showing nothing but a bunch of research papers. No prototype. Not even a photo of the current delivery device (the image here is borrowed). Bugger! What they could say was that Afresa will be a “post-meal” treatment only; patients will be expected to use long-acting Lantus or Levemir in addition, if basal insulin is required. Hmm, so much for a completely needle-free lifestyle… See the study results they can brag on here. More on them soon, I hope.
* Oral-lyn insulin spray from Generex Biotechnology is currently in Phase 3 clinical trials. This 
one looks exactly like an asthma inhaler and I’m told that it’s also “post-meal” (bolus) treatment only. It has some very weird aspects to it, such as one puff=one unit of insulin. So if you’re a Type 2 who needs 15 or 20 units of insulin for a single meal, do you sit there sucking on it 20 times in a row? What if you get distracted and lose count? Not to mention the fact that said action wouldn’t exactly be “discrete” in a restaurant or at a party…? I really wonder if the patients in those positively reported Phase 2 trials actually had a social life (?)
* Medtronic’s new Paradigm Veo system, which I mentioned yesterday. It’s been launched in Europe, but is still awaiting FDA approval for launch in the US, and nobody’s venturing a guess at how long that might take. This one’s essentially Paradigm-plus, taking a combo pump/CGM device “one step closer to closed-loop system” by adding an algorithm that can automatically suspend insulin delivery if you don’t respond to the alarms alerting you to a low.
* Medtronic’s new patch pump design, which will compete with the OmniPod (!) There was no sniff of a prototype or image of this one on the Expo floor here, but the company apparently previewed its concept with select industry analysts last week. Here’s what I know so far, direct from Medtronic’s spokespeople:
• The ‘pod’ will be a two-part model, that allows you to temporarily disconnect without wasting the entire set or the insulin inside
• It will be smaller than the current OmniPod
• The design will be totally new, and will not resemble any existing MiniMed/Paradigm products
• Don’t expect this to be available commercially before the first quarter of 2011
Medtronic is also introducing a new Sof-Sensor for its Guardian CGM device. Goodbye, uncomfortable shell shape that needs to be plastered down with a huge adhesive. Hello, new white rectangle sensor made of foam-ish substance!
Other Hot Topics:
* In-hospital CGM: GluMetrics and Edwards Life Sciences are both (separately) working on new systems to significantly improve glucose monitoring/control in hospitalized patients. The recent NICE-SUGAR clinical study “illustrates the need for accurate and continuous glucose measurement in critically ill patients,” and also in well-controlled patients who might happen to need surgery. I sure as hell don’t want to have to worry about massive hyperglycemia in the hospital, not to mention severe lows. Kudos to these solutions!
* According to Dr. Francesco Rubino, “bariatric surgery may now be renamed to ‘metabolic surgery’ because it’s really directed at improving diabetes – the weight loss may be an additional benefit rather than the primary goal.” This from an interview conducted by Close Concerns. The ADA is endorsing “a new, more drastic treatment” for surgery candidates. See this ScienceLine story for details.
And did you know…
* Roche & Novo Nordisk are teaming up with the World Diabetes Foundation (WDF) to provide support for children with diabetes in developing countries? The program, called Changing Diabetes for Children, kicked off in five developing countries starting April 15. (Awesome! But it’s not clear what happens to supported kids who are cut loose from the program at age 18?)
* Sanofi-Aventis posted sales of Lantus for 2008 at $3.6 billion, and has announced plans to DOUBLE Lantus sales by 2012! (confirmed by spokespeople at the show)
* Type 1 race car driver Charlie Kimball is collaborating with American Diabetes Wholesale to bring you a new diabetes contest called
GlucoStories: you just submit your story in text format to the website, and you could win a trip to the Homestead-Miami Speedway to attend Charlie’s Oct. 9 championship race, a signed Charlie Kimball helmut, or (of course) a $250 gift card for American Diabestes Wholesale online store. Enter by July 6, 2009.
So, hit your factual overload zone yet?
Explore posts in the same categories: D-News Examined, Diabetes Product Parade, Products
All of these reports coming out of the conference/convention and those being discussed in the WSJ makes me really think that we need to work on separating Type 1 and Type 2 diabetes as truly separate diseases. With the coming ObamaCare I fear that Type 1’s will always be associated with T2’s. For example, todays WSJ talked about a study done on diabetics and heart disease. The study showed that stents and other new drugs did not show any improvement in longevity. I am certain this study only included T2’s. With that type of info, the Govt. controllers will decide across the board, that it wont cover stents in diabetics. Imagine trying to make that point to some government employee and trying to educate them on the diff betwixt T1 and T2. I’m curious if anyone here thinks that their diabetes care will be improved with a government plan? From previous posts, it seems that most posters here are strongly for govt. control.
Posted by: Jules | June 8th, 2009 at 6:25 amThanks for summarizing all this! Kinda cool about the new Medtronic Sof Sensor. I’d love to lose the tape. Hope you will post about the CGM session(s). Glad they are including the psychological aspect in the talks.
Posted by: Carol | June 8th, 2009 at 6:51 amJules- I am not for government control! Though I have noticed the same trend from other comments. I am not sure to what extent this is a knee-jerk ‘grass is always greener’ line of thinking versus factually-based opinion. I think my insurance company is a pain in the neck to deal with, yes, but that does not dictate my opinion on nationalized healthcare
Posted by: Katie | June 8th, 2009 at 7:53 amIs there any hint from Abbott about the Aviator? I’ve been wondering about where that thing is…
Posted by: Wendy | June 8th, 2009 at 7:55 amI can’t imagine they will be marketing the inhalable insulin to type 1’s? Didn’t we already go through this? What I want is to be able to control my diabetes precisely. I would never give up my pump over inhalable insulin, especially if I still require basal/long-acting insulin. Who is consulting for these companies? This money could be better spent elsewhere in my opinion.
Thanks for the updates, Amy.
Posted by: Anne Findlay | June 8th, 2009 at 10:21 amAnne, I couldn’t agree more. I get tired of hearing about inhalable insulin since it seems like a sub par therapy choice.
Wendy, I may be behind the times, but I believe Abbott was partnering with the Cozmo pump on the Aviator. So now that Smith’s Medical (owner of Cozmo technology) is exiting the pump market, I wonder if anyone will (or has) jumped in with Abbott on that.
Posted by: Carol | June 8th, 2009 at 11:01 amCarol, the Navigator is Abbott’s CGM. The Aviator is Abbott’s pump that has passed FDA review, but has not been released. Rumors are that they are frantically scurrying around to integrate the Navigator with it, because they no longer have the option to do it with Cozmo.
Any word on the release date of Medtronic’s new Sof-Sensor?
Posted by: Megan | June 8th, 2009 at 11:39 amOral-lyn is not an inhable insulin. It is absorbed through the bucal mucossa of the mouth (the tough lining of the cheeks). This is way better than potentially cancer causing inhalable stuff. It is already available in Egypt and South America. Please, don’t group it with inhalable insulin. Give a detailed report on what you are seeing. Who boluses 20 units at a sitting?! Not me, and I’ve been type for 29 years.
Posted by: steve | June 8th, 2009 at 3:12 pmHaving just defected to the Dexcom 7 Plus cgms, I am curious as to when Minimed with debut the Sof-Sensor? We had been holding off for a solid year; when we saw not action, we just went over to Dex (my niece has been without a cgms for that solid year). I would be annoyed to find MM is NOW bringing out Sof-sensor, though happy for other children. We had asked endo and MM repeatedly when SofSensor (and, more importantly, smaller introducer needle) was arriving; no one knew….I’m guessing it will be another year-long wait, though……
Posted by: Jan | June 8th, 2009 at 5:46 pmAccording to the D Kliff’s newsletter, the Abbott Navigator is pretty much DOA and Edwards hospital based CGM effort is a partnership with Dexcom.
Posted by: mcityrk | June 8th, 2009 at 6:17 pmJules, maybe WSJ is the organization that needs to get the difference between type 1 and type 2 straight, especially after their earlier remark on Sotomayor’s diabetes. I would take ObamaCare any day over the current for-profit system, because Obama is smart and has smart people working with him, while the people running companies such as Anthem Blue Cross are both ignorant and greedy. I firmly believe in single-payer health care after dealing with the nightmare that is for-profit insurance, from both the patient’s and the physician’s perspective.
Talk about not understanding the difference between type 1 and type 2 — Blue Cross reps have told me, on multiple occasions, that metformin is a “generic” (and, coincidentally, dirt-cheap) alternative to insulin. I have to explain, to no avail, that type 1 requires insulin. The continual fights I have with them to get my insulin “authorized” have been infuriating. They often authorize Lantus but not Humalog, and I have to call to explain that I need both, because while they are both insulins they have different kinetic profiles, about every few months. On and on and on.
The current for-profit system is a disaster. I have a chronic condition and I need insulin to live. I won’t wake up tomorrow and magically be cured of my insulin dependence, unless I have a fairy godmother at work. Why should I have to fight and argue to have insulin temporarily covered, when I faithfully pay my inflated premium? And how many billions in profit does this company make, while screwing sick people out of care and coverage? It’s just wrong.
Posted by: Lauren K | June 9th, 2009 at 2:24 amJules – I am one of the lucky ones with a darn good health insurance plan at the moment. I KNOW my care would be diminished under a government “universal” plan. Those without insurance or who are underinsured would get care they desperately need, but those of who currently have deluxe plans would suffer. I suppose that’s fair, but universal care scares the heck out of me.
Posted by: Strawberry | June 9th, 2009 at 2:15 pmOn the flipside, insurance tied to my job (or right now my husband’s job) is terribly scary as well. If we ever lose it, we are completely screwed under our current health care system.
I do not know the answer, and while Obama is indeed smart, he and his smart workers will NOT be able to solve this problem.
Our system is woefully broken.
Hi,
Very intresting read. I have read a few posts on your site now and thourghly enjoy it..
Posted by: Steve | June 9th, 2009 at 5:53 pmWith regards to the Oral-lyn insulin spray, will there be only one strengh (one unit per puff) Or will there be different strenghs as in asthsma inhalers? I could see the problem you mention, could be really big.
For instance a person who takes over 50 units a day would surley go through a lot of inhalers. I doubt that you would even get 50 puffs in a single pump anyway, (I maybe wrong) is just my opiniun.
I have been presenting 1-4 abstracts in ADA every year since 2005. This year I submitted 3 abstracts and all were accepted (P-1081, Poster oral abstract, titled “Diabetes education through mobifilms” and one Published Only abstract (No: PO-2204). What pinched me this year was that several poster presenters did not turn up and their sites remained vacant. Several Published only abstracts could have been accommodated in their place, had there been any system with ADA to have firm commitment with presenters and in case of omission, some Published only abstracts could have been elevated to the status of Poster presentation.
Posted by: Dr. L.K. Shankhdhar, M.D. | June 14th, 2009 at 5:46 pm