The American Diabetes Association’s 76th Scientific Sessions
The annual meeting of the American Diabetes Association was held from June 10 to 14 in New Orleans 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 focusing on treatment recommendations and advances toward a cure for diabetes.
In the SEARCH cohort study, Dana Dabelea, M.D., of the University of Colorado in Aurora, and colleagues assessed the prevalence of several early complications (diabetic kidney disease, retinopathy, peripheral neuropathy, cardiac autonomic neuropathy, arterial stiffness, and hypertension) in youths with type 1 (T1D) and type 2 (T2D) diabetes of similar duration (approximately eight years) and young age (approximately 21 years). The authors explored potential risk factors for the observed differences by diabetes type.
“We found that approximately one in three youths with T1D (32 percent) and two in three youths with T2D (72 percent) have at least one such complication,” Dabelea said. “The burden of all micro- and macrovascular outcomes (except cardiac autonomic neuropathy) was significantly higher in youths with T2D versus those with T1D (range from two-fold to seven-fold), and disproportionately affected minorities.”
The investigators were unable to completely explain the risk differential in microvascular complications in youths with T2D versus T1D by risk factors such as glycemic control, central obesity, and high blood pressure.
“This is the first U.S. study to directly assess and compare the burden of early diabetes-related complications in youths with T1D and T2D. We are surprised that this burden is so high, given the short disease duration and young age of the cohort, and particularly concerned with the disproportionately high burden in youths with T2D and in those of minority race/ethnic background,” Dabelea said. “Such patients are more likely to develop blindness, kidney failure, and heart disease sooner rather than later in life. This may further increase their out-of-pocket costs, reduce quality of life, and may shorten their life expectancy. Our findings suggest that endocrinologists may want to be more vigilant in managing young people with diabetes.”
In another study, Edward R. Damiano, Ph.D., of Boston University, and colleagues evaluated the efficacy of a dual-hormone (insulin and glucagon) bionic pancreas in adults with type 1 diabetes living at home and performing their normal activities without restrictions on diet or exercise. The investigators compared the blood glucose control of the dual-hormone bionic pancreas versus conventional insulin pump therapy.
“Relative to conventional insulin pump therapy, the bionic pancreas was associated with a reduction in the average blood glucose level of more than 20 mg/dL, and a more than three-fold reduction in hypoglycemia. Both of these reductions were found to be statistically significant,” Damiano said.
Several authors disclosed financial ties to the pharmaceutical, biotechnology, and medical device industries.
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Qian Shi, M.P.H., of the Tulane University School of Public Health and Tropical Medicine in New Orleans, and colleagues provided evidence that long-term metformin therapy has a potentially protective effect on the incidence of neurodegenerative diseases (ND) among patients with type 2 diabetes.
Specifically, the investigators found that more than two years of metformin treatment was associated with significant risk reduction for ND, compared to no metformin treatment at all, after adjusting for multiple covariates. The investigators demonstrated similar findings for dementia, Parkinson’s disease, and Alzheimer’s disease.
“We further examined the hazard ratio between patients with and without metformin. Overall, metformin treatment decreased the risk of ND 31 percent, compared to no metformin treatment,” Shi said. “After controlling for demographics, medication, medical history (including kidney function), we found that the longer patients were exposed to metformin treatment (at least two years) the less likely they were to suffer from ND. Similar risk reduction occurred in dementia and Parkinson’s disease. No significant associations were found for other subtype disease, most likely due to the small number of events.”
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