Global Diabetes Summit 2007
The Ohio State Medical Center hosted a Global Diabetes Summit from November 29 to December 1, 2007 in Columbus, Ohio. Over 600 health care professionals, researchers, and people with diabetes met and heard from a world class faculty on various diabetes topics. While most sessions focused on type 2 diabetes, several sessions covered topics specifically related to type 1 diabetes.
- In a workshop entitled Immunological Advances in Type 1 Diabetes, we heard from three speakers who addressed topics related to identification of genetic and environmental risk factors, prevention studies, and interventions at diagnosis. Dorothy Becker, MD, from Pittsburgh explored current understanding of risk and examined the potential that gut permeability may be permitting proteins that trigger the autoimmunity to pass into the body. Jay Skyler, MD, from Miami reviewed the major type 1 prevention studies and their outcomes, including the subgroup that benefited from oral insulin and the current TrialNet effort to explore that success further. Robert Hoffman, MD, from Columbus focused on interventions immediately after diagnosis aimed at preserving islet cell mass.
- Frank Vinicor, MD, from the Centers for Disease Control in Atlanta, presented The Challenges of Diabetes in the New Millennium: USA Experience. Focusing on the epidemic of type 2 diabetes, Dr. Vinicor stressed that preventing obesity would have the most significant impact in reducing the incidence of type 2 diabetes in the future.
- Alain Baron, MD, the Senior Vice President of Research at Amylin Pharmaceuticals, presented Exendin-4 and GLP-1 Agonists: New Therapeutics for Diabetes, during which he expressed his opinion that incretin therapy for type 2 diabetes will revolutionize care. He explained how exenatide (Byetta) works and suggested that is can be both a first and last medication for patients with type 2 diabetes for whom lifestyle modification is ineffective.
- Bernard Zinman, MD, from Toronto gave an excellent presentation entitled Unique Features of New Insulin Analogs: Pros and Cons for Early Intervention in Diabetes. While again focusing on the use of insulin in type 2 diabetes, Dr. Zinman reviewed the significant variability of action experienced by patients using old insulin formulations (Regular and NPH) and the difficulty that this variability caused in achieving glycemic control and in increasing the risk for hypoglycemia. He reviewed the insulin analogs currently available, both basal and prandial, and summarized that all of the analogs have significant clinical benefits compared with older insulins. The only "con" he noted was cost.
- In Lifestyle Approaches to Prevention of Type 2 Diabetes: Lessons from Finnish Diabetes Prevention Study, Jaakko Tuomilehto, MD, from Helsinki noted that interventions to prevent type 2 diabetes may need to be targeted to an individual's genetic risk factors, since some prevention strategies are effective only for people with specific polymorphisms. This is an important insight and may help explain why some people achieve great results while others do not when using the same approach.
- Aaron Kowalski, Ph.D., and Irl Hirsch, M.D., chaired a workshop entitled Insulin Delivery and Glucose Sensing Technologies. Alan Marcus, MD, Vice President and Global Director of Medical Affairs for Medtronic Diabetes, presented New Technologies in Insulin Delivery Systems in Diabetes which explored sensors, pumps, sensor augmented pumps, and, briefly, the work toward closing the loop. Dr. Marcus noted that Medtronic Diabetes will release in Europe in 2008 an enhanced sensor augmented pump that will shut off insulin delivery for two hours in response to a low alarm if the patient doesn't take action. He also noted that leaving pump infusion sets in place for more than three days has been shown to lead to higher mean glucose levels -- an important point for pump users. Christopher Saudek, MD, from Johns Hopkins reviewed the implanted insulin pump, noting that its delivery of insulin was markedly superior to subcutaneous delivery but also noting -- with sadness -- that Medtronic would not be continuing to sell the implanted pump. Barry Ginsberg, MD, recently retired from BD, spoke about closing the loop and noted that "industry experts" felt that a closed loop system could be available in the 2013-2015 time frame. Irl Hirsch, MD, from Seattle finished the session by beginning with praise for his alma matter Missouri and then presenting real world examples of how continuous sensing has made significant improvements in the care for individual patients. Dr. Hirsch stressed that continuous sensing may be a better tool for patients with lower HbA1c levels than for patients with higher HbA1c levels, for whom improvements can be achieved by other means.
December 2, 2007
Last Updated: Monday December 03, 2007 07:50:10
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