Novel Strategies in Type 2 Diabetes and CVD


Robert A. Gabbay, MD, PhD: The pipeline of diabetes solutions is really expanding. No longer is it strictly in the pharmaceutical world (where we still have a lot of exciting new drugs that are coming out), but in the device world, the decision support, I think that’s where you’re going to see the biggest change. In the device world, we’ve long had continuous glucose monitors. They’ve gotten better and better, and now they’re being made smaller and are more accurate. And presumably, through some large partnerships, they are much cheaper. They’ve already been demonstrated to improve glucose control not only in people on insulin pumps (which is a very small sector of patients with diabetes), but also in people doing insulin injections.

Having that data of continuous glucose monitoring in and of itself can really improve glucose control. So, that’s one exciting area, and that couples to this next area where I think we’ll see an explosion: decision support tools—mechanisms through which providers, as well as patients, can take the data that they have and then understand what changes they can make in their medical regimen and in their lifestyle.

We’re in a very data-driven world. Diabetes is a data-driven disease, and I think we’re probably going to see the union of those 2 to create new solutions that really, in large part, are unimaginable and will live on patients’ smartphones. It could provide reminders. It could provide information. People are used to using that for every other aspect of their life, but the use of smartphones for their health is just beginning to happen and I think you’re going to see an incredible explosion of that in the next few years.

Scott Solomon, MD: One of the most exciting areas, now, is the intersection between cardiovascular disease and diabetes. We’ve always known that diabetic patients were at increased risk for cardiovascular events. In particular, they’re at increased risk for heart failure. But we treated them almost as separate entities, and we’re now starting to put them together. There are a number of trials that are in either planning stages or just starting, now, to look at SGLT2 inhibitors in patients with heart failure. This includes both patients with heart failure with reduced ejection fraction and heart failure with preserved ejection fraction. So, we’re very excited about these studies because even though EMPA-REG showed a benefit in terms of heart failure reduction, these were not heart failure patients who were treated. They were diabetic patients. The studies have not yet been done in patients with heart failure, and that’s what’s coming next.

Transcript edited for clarity.

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