Diabetes Dialogue: Hot Topics and Updates from ATTD 2024

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In this episode, hosts discuss GLP-1 RA use and CGM technology, updates in once-weekly insulins, the concept of continuous ketone monitoring, and practical application of artificial intelligence into care.

In the third and final recap episode from the 17th annual International Conference on Advanced Technologies & Treatments for Diabetes, hosts of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives Diana Isaacs, PharmD, and Natalie Bellini, DNP, take a deep dive into a series of topics from the meeting, including GLP-1 receptor agonist use and CGM technology, updates in once-weekly insulins, the concept of continuous ketone monitoring, and application of artificial intelligence into care.

For more on ATTD 2024, check out our other ATTD 2024 episodes on All Things Automated Insulin Delivery and coverage of T1D Glycemic Improvement and the CRISTAL Study.

GLP-1 RAs and CGM Technology

The first topic of interest for the episode was data Abbott detailing the effects of GLP-1 receptor agonist use alone and in conjunction with CGM technology. At the meeting, Abbott presented data from a real-world study examining the effect of a first FreeStyle Libre acquisition among 1781 patients with type 2 diabetes identified using Optum’s deidentified Market Clarity Data. This cohort had a mean age of age 55±10 years, 52% were male,the mean 499 days from GLP-1 initiation to FreeStyle Libre. Investigators pointed out the cohort had a baseline HbA1c of 9.8±1.5% and 38% used bolus insulin therapy.

Results indicated people with type 2 diabetes and an HbA1C equal to or greater than 8% using GLP-1 receptor agonists experienced a significant improvement in their HbA1C (-1.5%) at 6 months following the addition of Abbott’s FreeStyle Libre technology to their treatment. Investigators pointed out these trends were consistent across subgroups defined by GLP-1 duration, GLP-1 type, or insulin therapy type.

Once-Weekly Insulins

The next topic of interest for the final ATTD 2024 recap episode was once-weekly insulins, which were the subject of a Friday morning session at the meeting. Chaired by Chantal Mathieu and , the session brought practitioners and diabetes care and education specialists updates on once-weekly insulin codec, which Novo Nordisk announced received a positive opinion from the European Medicines Agency's Committee for Medicinal Products for Human Use in late March, and once-weekly insulin efsitora alfa from Eli Lilly and Company. These updates were delivered by Julio Rosenstock, MD, director of the Dallas Diabetes Research Center at Medical City, and Juan Frias, MD, medical director and principal investigator of National Research Institute, respectively. These presentations were followed by an insight into CGM derived data on weekly insulins from Chantal Mathieu, MD, PhD, professor of medicine at the Katholieke Universiteit Leuven and vice president of the European Association for the Study of Diabetes.

Continuous Ketone Monitoring & Artificial Intelligence in Diabetes

The final 2 topics of discussion for the episode centered around data and presentations from the meeting on a pair of developing areas in diabetes care in continuous ketone monitoring and use of artificial intelligence. The portion of the discussion on continuous ketone monitoring centers around a presented by Jennifer Sherr, MD, PhD, associate professor in Pediatrics (Endocrinology) at Yale School of Medicine, detailing the effects of a dual continuous glucose/ketone monitor from Abbott in a cohort of 23 patients.

Before concluding the episode, hosts touch upon the subject of artificial intelligence in diabetes management. As Isaacs describes in the episode, this portion is prompted by key points in a presentation from Tadej Battelino, MD, PhD, ATTD 2024 co-chair and head of the Department of Endocrinology, Diabetes & Metabolism at the University of Ljubljana. In the presentation, Battelino described multiple scenarios where artificial intelligence is being used to improve care, including predicting risk of adverse outcomes.

Relevant disclosures for Dr. Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Dr. Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

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