The American Diabetes Association’s 78th Scientific Sessions

The annual meeting of the American Diabetes Association (ADA) was held from June 22 to 26 in Orlando, Florida, and attracted approximately 14,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in diabetes. The conference highlighted the latest advances in diabetes research and improving patient care, with presentations focused on treatment recommendations and advances toward a cure for diabetes.

In one study, Kausik Ray, M.D., of the School of Public Health of Imperial College in London, and colleagues found that alirocumab in combination with a statin was safe and reduced cardiovascular events to a greater extent than placebo in patients with diabetes and recent myocardial infarction.

“Patients with diabetes have twice the event rate for major cardiovascular events following a heart attack,” said Ray. “In these patients, their LDL, despite statins, was greater than 70. Yet diabetes patients with a recent heart attack can get a further 64 percent reduction in LDL cholesterol to levels of 25 to 50 with the use of alirocumab, a PCSK9 inhibitor. This results in a greater absolute benefit with smaller numbers needed to treat compared with non-diabetic heart attack patients.”

Several authors disclosed financial ties to pharmaceutical and medical device companies.

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In the DEPICT-2 study, Chantal Mathieu, M.D., Ph.D., of Catholic University of Leuven in Belgium, and colleagues found that the selective SGLT2 inhibitor dapagliflozin added to intensive insulin therapy in adult patients with type 1 diabetes without optimal glycemic control improved blood glucose levels, with lower insulin doses and lowering of weight.

“We examined the impact of adding dapagliflozin (two doses tested, 5 and 10 mg) in a double-blinded manner versus placebo to background insulin in people with type 1 diabetes reaching insufficient glycemic control (HbA1c 7.5 to 10.5 percent),” said Mathieu. “At 24 weeks, HbA1c dropped by 0.37 percent and 0.42 percent versus placebo in the dapagliflozin 5 mg and 10 mg arms, respectively, with 10.78 and 11.08 percent less insulin and 3.21 percent and 3.74 percent less weight versus placebo for dapagliflozin 5 mg and 10 mg, respectively.”

The investigators also found that adverse events included an increased risk of genital infections but no increase in either overall or severe hypoglycemia. There was also an imbalance in the occurrence of diabetic ketoacidosis (DKA).

“Longer-term studies as well as careful analysis of the DKA cases in this study will help us understand the potential of this adjunct therapy,” Mathieu said.

The study was funded by AstraZeneca, and multiple authors disclosed financial relationships with AstraZeneca and other pharmaceutical and medical device companies.

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In another study, Joachim Gaede, from the University of Copenhagen in Denmark, and colleagues found that intensified, multifactorial treatment of high-risk type 2 diabetes patients increased the life span by a median of 7.9 years and delayed the first incident of cardiovascular disease by a median of 8.1 years but was no more costly than conventional treatment.

“We found that there was no statistically significant difference in total health care costs between the intensive treatment group and the conventional treatment group after 21.2 years of follow-up even though patients in the intensive treatment group lived a median of 7.9 years longer. We did find a significant reduction in costs per patient year in the intensive treatment group,” said Gaede. “Further, we saw that the intensified treatment was more costly in prescription drugs but less so in cardiovascular-related inpatient admissions and in expenses in primary health care.”

One author disclosed financial ties to Novo Nordisk.

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ADA: T1D, T2D, GDM Before 26 Weeks Tied to Higher ASD Risk

TUESDAY, June 26, 2018 (HealthDay News) — The risk of autism spectrum disorder (ASD) in offspring is increased in association with type 1 diabetes (T1D), type 2 diabetes (T2D), and gestational diabetes mellitus (GDM) diagnosed by 26 weeks’ gestation, according to a research letter published online June 23 in the Journal of the American Medical Association to coincide with the annual meeting of the American Diabetes Association, held from June 22 to 26 in Orlando, Florida.

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ADA: Closed-Loop Insulin Improves Glycemic Control

TUESDAY, June 26, 2018 (HealthDay News) — Use of an automated, closed-loop insulin delivery system results in significantly better glycemic control than conventional subcutaneous insulin therapy among patients with type 2 diabetes receiving noncritical care, according to a study published online June 25 in the New England Journal of Medicine to coincide with the annual meeting of the American Diabetes Association, held from June 22 to 26 in Orlando, Florida.

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