Back to News and Inforamtion ADA 2002 Scientific Sessions

The American Diabetes Association 2002 Scientific Sessions were held in San Francisco in June 2002 and offered an opportunity to learn about the latest in diabetes research, meet with researchers and clinicians, and meet with industry representatives. Children with Diabetes had a small exhibit to show our web site to the thousands of people who attended from all over the world. Below is our preliminary report about some of the activities at the Scientific Sessions. Watch for a full report next week.

Research and Poster Presentations

  1. A standing-room-only crowd packed in to hear about the latest information about glucose monitoring and sensing. Six teams of researchers presented their research, including the impact of the GlucoWatch in kids and what defines "normal blood glucose" when using the Medtronic MiniMed CGMS.

    1. Dr. Peter Chase of the Barbara Davis Center presented data from his study of the GlucoWatch in kids aged 7 to 17. This research was funded by a grant from the Children with Diabetes Foundation. Key findings were that kids who used the GlucoWatch experienced a significant improvement in their HbA1c readings and were able to detect many more hypoglycemic episodes compared to kids who didn't use the GlucoWatch. Dr. Chase, reporting that only one of 40 kids in the study had to drop out because of skin irritation, noted that kids seem to be able to tolerate the GlucoWatch better than the adults who tested it at his center. See also The GlucoWatch® Biographer Improves Glucose Control and Increases Detection of Hypoglycemia in Children and Adolescents with Type 1 Diabetes.

    2. Dr. Timothy Ford reported on a study his team undertook to compare the Medtronic MiniMed Continuous Glucose Monitoring System in adults with type 1 diabetes and without diabetes. Key points from his study include the fact that both groups (diabetes and control) experienced essentially the same number of reported hypoglycemic events (< 60 mg/dl) and that the control group showed elevated blood glucose readings (> 150 mg/dl) 4% of the time. To test the reliability and accuracy of the CGMS, the study had some people wear two CGMS systems at the same time. The results of this showed considerable differences in reported bood glucose values between the two CGMS systems. In one case, one CGMS reported 40 mg/dl while the other reported readings between 120 and 180 mg/dl over the same period. The author urged caution in using readings from the CGMS to make changes in insulin regimens, but questioners from the audience noted that the usefulness of the CGMS is in identifying patterns and trends, not in providing absolute blood glucose readings, and that the FDA also approved the device for trend identification. Many other presentations lauded the data provided by the CGMS, including one study that showed that repeated use of the CGMS in kids with type 1 decreased the frequency of nocturnal hypoglycemia without degrading overall control.

  2. Dr. Tim Wysocki presented data from a study on the impact of severe hypoglycemia (coma or convulsions) on school-age children and adolescents which showed that there was essentially no negative cognitive impact of severe hypoglycemia over the course of the 18 month study, even in the youngest kids in his study (age 7). Dr. Wyscoki's team used a relatively new cognitive assessment tool that they hoped would be able to show subtle changes in cognitive ability, if there were any. The fact that this study showed no negative impact from severe hypoglycemia on kids is good news for anxious parents, but as pointed out by Dr. Wysocki, this does not mean that we should not be vigilant in preventing hypoglycemia in kids, especially in kids under five who are experiencing rapid brain development.

  3. Elizabeth Boland from Yale reported on her teams use of unconventional basal rate patterns in kids. The Yale program has achieved excellent HbA1c results in kids on pumps (average HbA1c of 7.2), and their unusual basal patterns may be part of the reason. The basic premise of their program is that kids' insulin needs are different from adults' insulin needs, and that in particular, overnight basal profiles are different in kids compared with adults. Also, between 62 and 66 per cent of the total daily dose, which is more than is typically the case in adults.

  4. A team from Italy reported on a study they conducted that put newly diagnosed patients with type 1 diabetes on insulin pump therapy immediately upon diagnosis, without ever using injection therapy. In CSII Versus Intensive Insulin Therapy at Onset of Type 1 Diabetes: The IMDIAB 8 Two-Year Randomized Trial, they reported excellent results, which should encourage families who are interested in pump therapy, even for recently diagnosed kids.

  5. The poster Insulin Glargine Provides Long-Term Effective Glycemic Control in Children and Adolescents with Type 1 Diabetes reported on a multicenter study (26 centers in 10 countries) that assessed the long-term efficacy and safety of insulin glargine (Lantus) in children (as young as age 5) and adolescents. Subjects in the study received one injection of glargine before bed and regular human insulin before meals for the 36 months of the study. The poster concludes that "glargine maintains effective glycemic control and is well tolerated during long-term administration in children and adolescents with Type 1 diabetes."

  6. In Changing to LisPro insulin in Type 1 Diabetes from the Patient's Perspective, a team from the Bournemouth Diabetes and Endocrine Centre in the UK reported that patients who switched from regular insulin to lispro insulin (Humalog) experienced a significant improvement in HbA1c (9.8 +/- 1.5 baseline, 8.7 +/- 1.2 at 12 months, p > 0.0001) without weight gain, and that the switch reduced the negative impact of diabetes.

  7. A team from the Sansum Clinic in Santa Barbara, California presented Comparison of an Insulin Analog, Insulin Aspart, and Regular Human Insulin with No Insulin in Gestational Diabetes Mellitus (GDM). In this poster, the team reports that insulin aspart (NovoLog) is more effective than regular human insulin in reducing postprandial glucose peaks, resulting in lower HbA1c readings. The poster also notes that larger studies are needed to assess the impact of insulin aspart, if any, on the child.

  8. Basal Insulin: Continuous Glucose Monitoring Reveals Less Overnight Hypoglycemia with Continuous Subcutaneous Insulin Infusion than with Glargine, a poster from the Diabetes Care Center in Salinas, California, reports on a study that compared 11 patients on a pump (CSII) and 8 patients using glargine (Lantus) and lispro (Humalog). In this study, the patients on the pump spent more time within the target range overnight (70-160 mg/dl) than the patients using glargine (61.2% vs. 39.7%, p=0.04). Patients on glargine experienced three times as many episodes of low blood sugar than pump users (< 70 mg/dl, 34.7% vs. 12.8%, p=0.03). In summary, the study concludes that pump therapy (CSII) resulted in fewer hypo- and hyper-glycemic excursions than basal glargine.

  9. Insulin Detemir is Associated with more Predictable Glycemic Control and Lower Risk of Hypoglycemia compared to NPH Insulin in Subjects with Type 1 Diabetes, a poster presentation, reports that the new insulin analog called insulin detemir, under development by Novo Nordisk, resulted in much less hypoglycemia compared with NPH (22% reduction in overall risk of hypoglycemia and 34% reduction in nighttime hypoglycemia). The study participants also experienced a reduction in body weight.

  10. Prepubertal Children Are at High Risk of Intramuscular Insulin Administration Based Upon Subcutaneous Fat Thickness, a post presentation, reports on a study of 73 healthy diabetic children ages 6-14 years. The study demonstrated that many insulin injections in kids are intramuscular, even when the injection site is pinched up. Thin children, especially prepubertal males, were at greatest risk.

  11. A team from Yale presented the poster entitled Repeated Use of the Continuous Glucose Monitoring System (CGMS) in Children with Well-Controlled T1DM Decreases the Frequency of Nocturnal Hypoglycemia Without Sacrificing Metabolic Control. In this study, 22 youth aged 11 +/- 5 years (21 on pump therapy) wore the CGMS three times at 6-8 week intervals. Their diabetes team adjusted overnight basal insulin based on CGMS readings. Use of the CGMS resulted in a significant decrease in nighttime hypoglycemia, with the percentage of nighttime readings below 40 mg/dl decreasing more than 50%. The duration of those events when they did occur did not change, however. The team concludes that the use of the CGMS to adjust nighttime basal insulin can decrease nighttime hypoglycemia, but that "prolonged, asymptomatic hypoglycemia during the night remains a major obstacle to successful management of children with T1DM."

  12. In Continuous Subcutaneous Insulin Infusion Improves Glycemic Control and Quality of Life in Type 1 Diabetes Patients with Long Standing Poor Glycemic Control, a team from the Netherlands reports on a randomized cross-over trial that studies 79 patients in 11 Dutch clinics. Their data showed that even in patients with poor control, switching to pump therapy (CSII) resulted in improved control and quality of life. This study should encourage people who have difficulty achieving good control with MDI to seek pump therapy.

  13. The poster entitled Option or Essential Tool? Insulin Pump Therapy in Young Women, from a team in Ontario, Canada, reported on their experiences with advocating pump therapy for women. They studied 75 women, 92% of whom had been using intensive insulin therapy but none were achieving optimal control. After switching these women to pump therapy, these young women experienced "a profound and dramatic decrease in HbA1c and improvement in many other parameters of diabetes management." The team suggests that for women, pump therapy should be offered as the preferred treatment method.

  14. Safe and Effective Use of Continuous Subcutaneous Insulin Infusion in Young Children With Type 1 Diabetes Mellitus, a poster presented by a team from the University of Rochester School of Medicine and Dentistry, reported on their experience with 53 young children who use an insulin pump. Five patients were aged 2-3, 21 were 5-9, and 27 were 10-12. In this group, HbA1c decreased significantly (p<0.0001), the range of glucose excursions were decreased significantly (p<0.0001), and the rate of severe hypoglycemia decreased significantly (p<0.049). They conclude that pump therapy in young children results in better control and fewer episodes of severe hypoglycemia, showing clearly that young children benefit from pump therapy.

  15. A team from Duke University Medical Center presented a poster entitled Insulin Pump Therapy in Infants and Preschool Children with Type 1 Diabetes. The poster reported on their experience with nine toddlers with diabetes. HbA1c dropped significantly from an average 9.5 +/- 0.4% to 7.9 +/- 0.3% (p<0.001), and mean episodes of severe hypoglycemia dropped from 0.52 episodes per month to 0.09 (p<0.05). Furthermore, parental contacts with the diabetes team declined more than 80%, reflecting increased parental confidence and independence in diabetes management. Families reported significant improvement in quality of life and high levels of satisfaction with pump therapy. All parents preferred pump therapy to MDI. They conclude that pump therapy is a safe and effective treament for preschool children with type 1 diabetes.

New and Updated Products

Companies that make products for people with diabetes often introduce new and updated products at the ADA conference. Here are a few selected highlights:

1. Deltec showed off their new insulin pump, called Cozmo. The Deltec pump is quite small (approximately 3-1/4 in. x 2-1/8 in.), yet still uses a 300 ml cartridge. Cozmo has many new features, including the ability to customize the screen display and alarms to remind users to bolus at times they should have but didn't. The pump is also waterproof. More information about the new pump is available online at The Cozmo pump is currently awaiting FDA approval for sale in the United States.   Product Photo
The new Cozmo pump. Click for a larger image.

2. Animas has a new booklet entitled Kids, insulin pumps & you ... A Parents guide to insulin pump therapy for kids. This 30 page guide, written by Kathy Spain, RN, BSN, CCRN, is an excellent introduction to what pump therapy means for kids and their families. It discusses the pros (flexibility, control, less hypoglycemia, etc.) and the cons (cost, more frequent testing, risk of DKA), spells out the responsibilities that come with wearing a pump, discusses the pumps and infusion sets that are available today -- basically, this book covers almost anything a family considering pump therapy might want to know. Even if you're not interested in the pump right now, this booklet provides a great overview of what pumping is all about. Contact Animas at 1-877-937-7867 in the US for your copy.   Product Photo
Book cover

3. TheraSense showed off two new products: Tracker, a FreeStyle module that fits into the expansion slot of a Handspring Visor PDA, and FreeStyle Web, a web-based diabetes data management system. For anyone who uses a Visor PDA, Tracker offers a great innovation: the ability to analyze your blood glucose readings using the power of the PDA. (If you're not using a PDA yet, this might be a good excuse to get one.) The FreeStyle Web-Based Data Management System provides patients with the ability to upload blood glucose data to a secure web site, generate a wide range of analysis and reports, and share that data with their diabetes team.   Product Photo
The Freestyle Web glossy. Click for a larger image.

4. LifeScan showed the OneTouch® UltraSmartTM; meter, which is essentially a OneTouch Ultra meter with a built-in, sophisticated electronic diabetes data management log book. With a high-resolution display and eight buttons for data entry, the OneTouch Ultra Smart lets patients enter information about exercise, medication, food, and other medical tests into their blood glucose meter. This data can then be analyzed and displayed using LifeScan's updated InTouch software. Availability of the OneTouch UltraSmart is expected later this year, pending FDA approval.   Product Photo
The OneTouch UltraSmart product glossy. Click for larger image.

5. BD showed their new BD UltraFine II syringe with half-unit markings. Anyone who uses small amounts of insulin will appreciate this new syringe, since it will help make it easier to measure half units accurately. BD will continue to sell the 30 unit syringes without half-unit markings.   Product Photo
The new BD 30 unit syringe with half-unit markings, side-by-side with the 30 unit syringe without half-unit markings

6. Bayer announced a name change for its diabetes care products: Ascensia. Beginning in the fall of 2002, products that previously had the Glucometer name will now be referred to as Ascensia, such as the Ascensia Dex2 and Ascensia Elite. The products are the same; just the name will change.   Product Photo
New Dex Packaging
  Product Photo
New Elite Packaging

Other Links About ADA 2002

  1. Official ADA site for the 2002 Scientific Sessions
  2. ADA 2002 Sessions Highlights Online offers highlights of research presentations, including
    1. Causes of Cerebral Edema
    2. Distinguishing Type 1 From Type 1.5 and Type 2
    3. Does Islet Transplantation Cure Hypoglycemia?
    4. Data From the Workgroup on Outcomes of Hyperglycemia
  3. Studies presented at ADA annual meeting underscore that insulin delivery by a pump yields better blood glucose control than daily insulin shots

Posted June 16, 2002
Updated June 21, 2002

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Last Updated: Thursday August 29, 2002 21:04:38
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