2024 ADA Scientific Sessions: Key Research Highlights

The American Diabetes Association’s 2024 Scientific Sessions in Orlando assembled the top experts in diabetes care and research, revealing groundbreaking discoveries and innovations.

This summary digs into the key highlights, offering valuable insights for people in the diabetes community.

Disease-Modifying Agents

TZIELD study shows promise in preserving insulin production for newly diagnosed type 1 diabetes patients

• The results from the TZIELD study show promising benefits for newly diagnosed individuals with type 1 diabetes.
• Dr. Kevan Herold led the PROTECT clinical trial. The study looked into whether Tzield could help young people (ages 8–17) newly diagnosed with type 1 diabetes. Dr. Herold wanted to see if Tzield could slow down the loss of beta cells and preserve their function.
• Participants who received the experimental treatment alongside standard care showed improved ability to produce insulin compared to those on standard care alone.
• This means potentially better long-term blood-sugar control and a reduced need for insulin injections.
• The study’s findings suggest a hopeful direction for managing type 1 diabetes early on— possibly influencing future treatment strategies.

Adjunct Therapy and Type 1

SGLT2 improves kidney function and blood-sugar control in youth with type 1 diabetes

The ATTEMPT trial looked at how well SGLT2 inhibitors work to improve diabetes management and prevent early kidney problems in children and teenagers with type 1 diabetes.

• The trial specifically focused on the SGLT2 inhibitor dapagliflozin.
• During a 16-week study, researchers looked at kidney function, blood-sugar levels, and safety in 98 people with type 1 diabetes.
• The study demonstrated that a low dose of dapagliflozin could safely be given to youth and adolescents to improve kidney function and blood-sugar management.
• Treatment with dapagliflozin led to a noticeable drop in A1c levels and slowed down the decline in kidney function.

GLP-1s reveal promising outcomes in people with type 1 diabetes

• Promising results were found when researchers looked into the use of GLP-1 receptor agonists as an adjunct treatment for type 1 diabetes.
• According to a study, adding tirzepatide—also known by the brand name Mounjaro—to insulin therapy resulted in a considerable improvement in blood-sugar control.
• Participants experienced reduced A1c levels and fewer episodes of severe hypoglycemia compared to those on insulin alone.
• This adjunct therapy also showed benefits in weight management, with some participants experiencing weight loss.
• These results suggest that GLP-1 agonists may be an advantageous supplement to type 1 diabetes treatment plans, possibly lessening the need for insulin dosage and enhancing overall metabolic outcomes.

Study explores DPP-4 Inhibitors as adjunct therapy in type 1 diabetes

• In people with type 1 diabetes, dipeptidyl peptidase-4 (DPP-4) inhibitors have been proven to be an effective adjuvant therapy.
• Researchers noticed slight improvements in blood-sugar control, such as lower spikes in glucose levels after meals and better responsiveness to insulin.
• Furthermore, there were suggestions that using DPP-4 inhibitors may have kidney-protective benefits.
• DPP-4 adjunct therapy was generally well-tolerated, with no major safety concerns identified during the study period.

Artifical Intelligence (AI) in Diabetes

AI-powered predictive analytics for hypoglycemia prevention:

• Researchers have developed an AI-driven model that accurately predicts low blood sugar (hypoglycemia) in people with type 1 diabetes.
• This model uses data from CGMs along with machine-learning algorithms to foresee hypoglycemic events up to an hour in advance.
• This advance warning can help patients take preventive actions to avoid dangerous drops in blood-sugar levels.

AI in diabetic retinopathy screening

• An AI system for diabetic-retinopathy screening was led by Aaron Y. Lee, MD, from the University of Washington.
• Diabetic retinopathy is a significant problem that can compromise vision. The approach showed great sensitivity and specificity, exceeding previous methods, and allowing for early detection and treatment.
• This advancement highlights the potential of AI to enhance screening accuracy and efficiency in clinical settings.

Natural language processing (NLP) for diabetes management

• Researchers introduced an NLP-based tool that analyzes electronic health records (EHRs) to identify patients at high risk of diabetes-related complications.
• This tool aids healthcare providers in prioritizing high-risk patients for proactive management and intervention.

CGMs and Diabetes

Impact of CGM on blood-sugar control in type 1 diabetes

• This study demonstrated that the use of CGM significantly improved blood-sugar control in individuals with type 1 diabetes.
• Participants using CGM showed a substantial reduction in A1c levels and an increase in time spent in the target blood-sugar range compared to those using traditional blood-sugar monitoring.

CGM use in pregnancy with gestational diabetes

• Researchers found that CGM use during pregnancy in women with gestational diabetes improved maternal and neonatal outcomes.
• The study reported better blood-sugar control, fewer episodes of hypoglycemia, and a reduction in large-for-gestational-age infants among the CGM group.

Study reveals delays in CGM access for children with type 1 diabetes

• Another study highlighted that minority and publicly insured children with type 1 diabetes face delays in accessing CGM technology.
• Analyzing data from over 250 children, the study found that those with private insurance or from non-Hispanic white families began CGM treatment sooner.
• Early CGM initiation was linked to better A1c outcomes, underscoring the need for equitable CGM access.
• Principal investigator Dr. Mette K. Borbjerg emphasized the importance of timely CGM access to reduce complications, calling for policies to address these barriers in diabetes care.

CGM and behavioral interventions in adolescents

• A study on adolescents with type 1 diabetes integrated CGM with behavioral interventions.
• The combination led to significant improvements in blood-sugar control, increased adherence to monitoring, and enhanced quality of life.

CGMs can predict stage-3 type 1 diabetes

• It was discovered that the use of CGM metrics, as opposed to baseline characteristics of people with early-stage disease, was more effective in forecasting the progression of type 1 diabetes to stage 3.
• This insight allows for proactive management strategies, potentially delaying or preventing full-disease onset.
• CGM’s real-time data offers a promising tool in the fight against diabetes, empowering early intervention and personalized care.

Automated-Insulin-Delivery (AID) Systems

MiniMed 780G: Promising results in tackling type 1 diabetes challenges

• The latest MiniMed™ 780G system from Medtronic shows promising results in managing type 1 diabetes by addressing persistent blood-sugar challenges.
• Recent data presented highlights its ability to automatically adjust insulin delivery based on real-time blood-sugar levels, reducing both highs and lows.
• The goal of this technology is to improve type 1 diabetes patients’ quality of life by delivering more stable blood-sugar control.
• The MiniMed 780G, with its adjustable settings and predictive alarms, is a noteworthy technological improvement in diabetes management, providing more convenience and possibly lessening the workload associated with monitoring daily blood-sugar changes.

Tandem Mobi improves quality of life for people with type 1

• Tandem Diabetes Care‘s tX2 insulin pump with Control-IQ technology—branded as Tandem Mobi— has been shown to significantly enhance the quality of life for individuals with type 1 diabetes.
• This advanced system automates insulin delivery based on real-time blood-sugar levels, thereby stabilizing blood sugar and reducing the frequency of high and low blood-sugar events.
• Its intuitive design and integration with mobile devices offer greater convenience and control over diabetes management, allowing users to lead more flexible and active lifestyles.

Stem-Cell Therapy and Type 1

Vertex’s VX-880 stem cell therapy shows promising results in restoring blood-sugar regulation

• Vertex’s phase 1/2 trial of VX-880, a stem-cell therapy, has shown promising results in restoring blood-sugar regulation through islet-cell implantation.
• All patients receiving a full dose exhibited better blood-sugar control, with nearly all reducing or stopping insulin therapy.
• Those monitored for a year maintained normal blood-sugar levels without severe hypoglycemia.
• The trial is now expanding to include more participants.

Stem-cell-derived beta cells for type 1 diabetes

• This study showcased the transplantation of stem cell-derived beta cells into patients with type 1 diabetes, resulting in significant insulin production and reduced dependence on exogenous insulin.
• The trial demonstrated promising safety and efficacy over a six-month period.

Gene-edited stem cells for diabetes therapy

• Researchers reported on the use of CRISPR-Cas9 technology to edit stem cells, making them resistant to autoimmune attacks before differentiating them into insulin-producing cells.
• This approach showed sustained insulin production and protection from immune system attacks in animal models.

Stem Cell Therapy for diabetic wound healing

• A study highlighted the use of mesenchymal stem cells (MSCs) to enhance wound healing in diabetic ulcers.
• The MSC treatment accelerated wound closure, improved tissue regeneration, and reduced inflammation in treated patients compared to controls.

DRI announces breakthrough transplantation approach for type 1 treatment

• Researchers at the Diabetes Research Institute developed an innovative approach to treat type 1 diabetes. They combined human stem cell-derived islets (insulin-producing cells) with an immunomodulatory microgel.
• This combo can reverse type 1 diabetes without the need for lifelong immune-suppressing drugs.
• The study showed that this therapy reverses diabetes and preserves the function of the transplanted islets.
• It’s a promising step toward a cure!

The Artificial Pancreas

Adding AI to artificial pancreas enhances efficiency

• Researchers from the University of Virginia Center for Diabetes Technology compared an advanced experimental artificial pancreas system with an artificial-pancreas algorithm incorporating AI (referred to as a “Neural-Net Artificial Pancreas”).
• The AI-supported artificial pancreas maintained blood-sugar levels within the target range for an almost identical amount of time as the advanced system.
• However, it significantly reduced computational demands, making it suitable for implementation in devices with low processing power, such as insulin pumps or pods.

FDA approval for CamAPS FX

• The U.S. Food and Drug Administration (FDA) approved the use of CamAPS FX, an artificial pancreas developed by researchers at the University of Cambridge.
• CamAPS FX is an Android app that allows compatible insulin pumps and CGMs to communicate, creating an artificial pancreas.
• It has been authorized for use in people with type 1 diabetes aged 2 and older, including during pregnancy.
• The closed-loop algorithm of CamAPS FX is considered one of the best in the field.

Long-term safety and efficacy data

• Studies presented at the Scientific Sessions demonstrated the safety and efficacy of artificial pancreas systems for insulin delivery and blood-sugar control.
• These findings indicate that this technology is moving closer to approval and widespread use.
• While these advancements are promising, additional research is needed before widespread adoption. Incorporating AI into artificial pancreas systems holds great potential for personalized insulin delivery and improved management of blood-sugar levels.

Immunotherapy and Diabetes

Single-dose GLP-1-based pancreatic gene therapy

• In a recent study, researchers found that a single dose of gene therapy based on GLP-1 (a hormone involved in blood-sugar regulation) had promising effects.
• Even after stopping semaglutide (another diabetes medication), the gene therapy helped maintain healthy body composition and blood-sugar levels in obese mice.
• This suggests that gene therapy could offer long-term benefits for managing diabetes.

The LonP1 protease and pancreatic beta-cell survival

• Scientists discovered that a protein called LonP1 is essential for the survival of pancreatic beta cells.
• It controls how proteins fold within mitochondria, the cell’s energy factories.
• This exciting finding could pave the way for novel treatments to improve beta-cell function and survival in diabetes.

Impact of truncated apolipoprotein C-I on diabetes risk

• In a study involving people from different ethnic backgrounds, researchers found that having lower levels of a protein called truncated apolipoprotein C-I was linked to a higher risk of diabetes.
• This discovery could open up new possibilities for identifying biomarkers and developing targeted therapies to prevent diabetes.

Inhaled insulin

• Researchers tested inhaled insulin (called Afrezza) combined with long-lasting insulin injections for type 1 diabetes.
• Better Blood-Sugar Control: Inhaled insulin improved A1C levels more than standard care. About 21% on inhaled insulin had significant improvements, compared to 5% with standard care.
• Preference for Inhaled Insulin: Many participants liked using inhaled insulin during meals.
• Some Caveats: Not everyone benefited—26% had worse A1C levels. But overall, it’s promising for diabetes management.