Gutted as I and many others of the GBDOC are to not be at the European Association for the Study of Diabetes (EASD) annual meeting in Munich, there’s still a lot that can be learned from it. And of course, if you’re there until the end of the conference, why not stay on a bit for the opening weekend of the Oktoberfest? Before I go there, let me just clear up what the EASD meeting is.
It’s the Annual Meeting of the European Association for the Study of Diabetes. It’s probably the pre-eminent gathering of those studying, researching, caring and manufacturing for Diabetes in Europe. And for many of us, the information that comes out of it is really exciting!
The schedule can be found here and provides links to all the daytime stuff that is going on. More importantly, it allows access to the details of all the Scientific Sessions, including Abstracts, methods, results and conclusions.
This gives us proles the ability to look ahead and ask our favourite bloggers and tweeters that are present to go, pretty please with sugar on top, to which ever sessions are on and see if they are interested. The presence of social media means that we at least get a rolling stream of updates, and some idea of the interactivity within the halls.
From the Industry Day yesterday, for example, there were interesting discussions regarding the importance of blood glucose profiles (what appears to be the new name for Glycaemic Variation) and what seemed to the Twitter observer to be an understanding that BG profiles are the new Hba1C. Or in other words, it makes a lot of sense to use CGM to better manage T1D.
Plus, of course, the news that Accu-Chek will soon be releasing their own CGM system – the Accu-Chek Insight CGM. They’ve focused on Accuracy, so we look forward to seeing the MARD and Clarke Error results. With the caveat that the sensor battery dies after 7 days to stop anyone extending it. Boo Accu-Chek. And Boo again. You’d better be pricing this product a lot lower than current CGM if that’s your plan! As an aside from that, I also expect that we’ll see, in the not too distant future, the Insight II Pump. I don’t think it’s too hard to suggest/predict that it will have some form of predictive suspend and maybe even full Hybrid APS. Just a question of when and at what cost? Other than this, there’s nothing particularly
But that’s industry stuff. What of the scientific sessions?
Well, thanks to that online list of what’s going on, there are a few that appeal to me.
First up on my list is the session on combination therapies. The abstract on “Efficacy and safety of liraglutide added to insulin treatment in type 1 diabetes, the ADJUNCT ONE™ treat-to-target randomised trial” ties in with posts I’ve written previously on Glucagon management. Sadly, the conclusions they’ve drawn shows that use of a GLP-1 inhibitor in T1s increases the risk of hypoglycaemia, quite substantially. It sounds as though titration for this type of therapy is tough!
In other streams, especially the one named “Insulin Insights”, there is coverage of both the Novo Faster Aspart Clinical Trial and the Bio Chaperoned Lispro (BCLispro) trial from Lilly. Both of these promise faster action and therefore lower post prandial spikes, but according to the presented abstracts, the extended post prandial hypo risks are no worse than existing rapid insulins.
The figures from Faster Aspart suggest improved Hba1Cs when taking pre-prandially:
Someone tell me when I can get hold of this?
Then there’s the session on whether we can make new beta cells. The popular press reports suggest so. The research here? Well, it’s optimistic. But I wouldn’t say more than that!
Then on Thursday, there’s the session on “Devices and Desires“, looking at the benefits of using various devices. I’m hoping there’s some Twitter attendance as these as they look fascinating, and are, in reality, the closest thing we have to some form of massive improvement in management of T1 in the near term.
Nearly all the sessions in this one provide a great deal of interest for me. They split into those looking at existing devices, mainly CGM, and then the futures and clinical trials with APS systems.
Starting with the CGMs, the stand out item for me is this one:
Real-time continuous glucose monitoring improves time spent in euglycaemia and prevents severe hypoglycaemia in type 1 diabetes mellitus patients with impaired awareness of hypoglycaemia
It’s basically an RCT that proves the benefits of CGM in those with hypo unawareness, and should be used by everyone in the UK that is challenging their CCG to provide CGM as a result of IAH.
Then we have the closed loop/artificial pancreas trials. There are two of them:
Hybrid closed-loop (HCL) pivotal trial in type 1 diabetes from Medtronic that was part of their submission to the FDA and the Home use of a bihormonal bionic pancreas vs conventional insulin pump therapy in adults with type 1 diabetes: a multicenter randomised clinical trial from Harvard. Both reported reduced hypoglycaemia, better euglycaemia and really back up what the OpenAPS patient study showed. Closed Loop system make managing life with T1 easier. All good news. It’s the dual hormone one that we really want to keep an eye on!
Those are just the breakout papers. When we look at what’s going on as Full Hall sessions, there are tons of interesting items there too. Suffice to say it’s a packed agenda with loads of things that are really interesting. I’ve just focussed on the T1 related items, but there’s a lot of good T2 stuff as well.
So if you haven’t been taking any notice, I encourage you to do so, and ask your favourite member of the DOC Twitter community who is there for some feedback and suggest sessions. The more widely these are broadcast, the better the understanding of the community as a whole.
Can I have a ticket next year please?
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