Update on the American Diabetes Association's 78th Sessions
June 27, 2018
The American Diabetes Association's 78th Scientific Sessions, the largest annual American diabetes research conference of the year, was held June 22-26 in Orlando, Florida. The JDCA attended the conference with the purpose of identifying advancements and news related to T1D Practical Cure research.
The main headline for the JDCA community is there were no new practical cure projects announced at the conference. There were updates on three PC projects which are detailed below.
The conference featured 2,174 research abstracts (summaries of key research findings) and 282 formal presentations. Overall, the majority of the conference discussion was focused on type 2 diabetes. Among research abstracts, the JDCA counted 229 that specifically addressed type 1 diabetes directly – about 10.5 percent of the total. Among formal presentations, the JDCA counted 22 that directly address type 1 diabetes - about eight percent of the total.
Practical Cure Project News
Only three Practical Cure projects were addressed during the conference:
- ATG/GCSF: In a presentation on key learnings from TrialNet, the combination therapy of ATG/GCSF preserved insulin production in patients newly diagnosed with type 1 diabetes. Although this is not a PC trial, it does have positive implications for University of Florida's second ATG/GCSF trial which is a PC and testing in fully established T1D.
- BCG: Presented a poster in a late-breaking session. Twelve patients who were given two BCG vaccinations three weeks apart saw a 20 percent reduction in HbA1c. Nine patients were followed five years and three patients for eight years. There was no reporting or indication of a reduction in C-peptide or insulin requirements. In addition, all patients were taking insulin throughout the study and follow-up period.
- ViaCyte: Two year follow up data from ViaCyte's phase 1/2 study showed their "Pec-Encap" encapsulation device to be safe and tolerable when implanted in humans. The device also appeared to protect encapsulated cells from the body's autoimmune attack. However, the study remains paused due to “low levels of engraftment due to a foreign body giant cell response.”
Other Noteworthy T1D Research Topics
Three T1D topics stood out in terms of the amount of conference focus and media coverage they received:
Many Companies Making Progress on Closed-Loop 'AP'
Most of the major companies developing closed-loop systems showed posters that revealed ongoing improvements in blood glucose monitoring accuracy and overall glucose control. Several companies provided updates on their closed-loop systems including Medtronic, Tandem, Omnipod, and Diabeloop, among others. Highlights include:
- The Medtronic 670G Artificial Pancreas has been approved for use in children aged 7-13.
- Tandem’s new t:slim insulin pump with basal-IQ technology has been approved for commercial use by the FDA.
- Omnipod’s closed loop system was shown to significantly improve glycemic control in adults with T1D.
- A Canadian study found that a dual-hormone AP improved glucose control and reduced glucose variability in adults with T1D compared to an insulin-only artificial pancreas.
- Diabeloop’s closed-loop insulin delivery system showed better glycemic control compared to an open-loop system.
- Senseonics fully implantable CGM was found to be safe in adults for up to 180 days.
- OpenAPS developed a method to calculate sensitivity changes in insulin.
- Zealand Pharma found that Dasiglucagon effectively counteracts low blood glucose and could be applicable for future use in a dual-hormone AP.
Updates from The Environmental Determinants of Diabetes in the Young (TEDDY) Trial
TEDDY is a large cohort study designed to identify environmental factors, infectious agents, or psycho-social factors which trigger T1D in susceptible individuals. Data from this study observed two different forms of autoimmunity, defined by which antibodies appear first. Genetic background and environmental risk factors differ when comparing the two.
Many Insulin Adjunct Therapies Help to Lower Insulin Requirements
A number of presentations featured adjunct insulin T1D therapies which showed improvements in glycemic control and lowered insulin requirements. These presentations include, but are not limited to Dapagliflozin, Sotagliflozin, Empagliflozin, and Liraglutide.