American Diabetes Association, June 25-29

The American Diabetes Association 81st Scientific Sessions

The annual meeting of the American Diabetes Association was held virtually this year from June 25 to 29 and attracted more than 11,500 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 in management technology.

In the GRADE study, David Nathan, M.D., of Massachusetts General Hospital and Harvard Medical School Boston, and colleagues found that insulin glargine and liraglutide are more effective than glimepiride and sitagliptin for maintaining hemoglobin A1c levels in the target range.

The authors performed a comparative effectiveness study of four commonly used medications (the sulfonylurea glimepiride, the dipeptidyl peptidase-4 inhibitor sitagliptin, the glucagon-like peptide 1 receptor agonist liraglutide, and insulin glargine) to treat type 2 diabetes with the goal of determining which medications work best when added to metformin to maintain glucose levels in the accepted target range. The researchers found that insulin glargine and liraglutide were more effective than glimepiride, which was, in turn, more effective than sitagliptin in keeping hemoglobin A1c levels in the range less than 7 percent. The secondary outcomes revealed other differences among the four medications with regard to side effects and other effects of the medications.

“The balance of benefits and risks of the four medications should help patients and their health care providers select the glucose medications that are most appropriate for them. Further analyses that explore differential effects of the medications in subgroups of patients will help individualize diabetes treatment,” Nathan said. “Currently, the treatment of type 2 diabetes is often a ‘one size fits all’ approach with only modest attention to the relative advantages and disadvantages of specific medications. The results of the unique, long-term head-to-head comparisons in GRADE will facilitate the rational choice of medications to treat type 2 diabetes.”

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In another study, Daniel S. Hsia, M.D., of the Pennington Biomedical Research Center in Baton Rouge, Louisiana, and colleagues found that more children have been diagnosed with type 2 diabetes during the pandemic (March to December 2020) and required hospitalization at diagnosis compared with a similar time period during 2019.

The author conducted a retrospective chart review of hospital admissions for new-onset type 2 diabetes from March 2019 to December 2019 and for the same period in 2020 at a tertiary care children’s hospital. Children younger than 19 years of age were identified using ICD-10 codes, and each admission was carefully reviewed to exclude patients with type 1 diabetes or hyperglycemia unrelated to diabetes. The researchers observed an increase in the number of children and adolescents diagnosed with type 2 diabetes. In addition, children admitted to the hospital in 2020 had higher acuity as indicated by higher blood sugar, higher hemoglobin A1c, and higher indicators of dehydration compared with children admitted in 2019.

“Stay-at-home orders and other restrictions due to COVID-19 have worsened risk factors for type 2 diabetes like decreased physical activity, more screen time, disturbed sleep, and increased intake of processed foods, which can all lead to weight gain,” Hsia said. “These results from our one center may be a microcosm of what is happening at other children’s hospitals across the country. Providers need to be aware of children presenting with type 2 diabetes who may present with higher acuity due the circumstances around the COVID-19 pandemic.”

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In a retrospective study, Sudip Bajpeyi, Ph.D., of the University of Texas in El Paso, and colleagues found that patients with COVID-19 infection and unmanaged diabetes had greater infection severity and experienced longer hospitalization and recovery times compared with those who managed their condition with medication.

The authors aimed to gain insight into the impact of unmanaged diabetes on COVID-19 infection severity and recovery in a high-risk population (Hispanic and Latinx communities). The retrospective study analyzed medical records from 369 patients admitted to the University Medical Center in El Paso, Texas, with COVID-19 infection. Patients were categorized based on hemoglobin A1c levels into normoglycemic, prediabetes, and diabetes groups. The researchers found that approximately 40 percent of Americans who died of COVID-19 infection also had comorbid diabetes. In addition, one in 10 patients with diabetes hospitalized for COVID-19 infection died within one week.

“The public health implications of our findings include the importance of managing blood glucose levels in hospitalized COVID-19 patients and the need for diabetes prevention and education, particularly for Hispanic and Latinx communities,” Bajpeyi said.

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ADA: Peds Hospitalization Rates for New-Onset T2DM Up During Pandemic

WEDNESDAY, June 30, 2021 (HealthDay News) — Hospitalization rates for new-onset pediatric type 2 diabetes increased during the COVID-19 pandemic, according to a study presented at the annual meeting of the American Diabetes Association, held virtually from June 25 to 29.

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ADA: Tirzepatide Noninferior, Superior to Semaglutide for T2DM

TUESDAY, June 29, 2021 (HealthDay News) — The dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, tirzepatide, is noninferior and superior to semaglutide for reducing glycated hemoglobin levels among patients with type 2 diabetes, according to a study published online June 25 in the New England Journal of Medicine to coincide with the annual meeting of the American Diabetes Association, held virtually from June 25 to 29.

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ADA: Efpeglenatide Lowers Risk for Adverse CV Events in T2DM

TUESDAY, June 29, 2021 (HealthDay News) — For patients with type 2 diabetes and a history of cardiovascular disease or current kidney disease, the risk for adverse cardiovascular events is lower with efpeglenatide, an exendin-based glucagon-like peptide 1 receptor agonist, than placebo, according to a study published online June 28 in the New England Journal of Medicine to coincide with the annual meeting of the American Diabetes Association, held virtually from June 25 to 29.

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HealthDay Now: Diabetes Care in 2021

In our latest HealthDay Now, Mabel Jong spoke with Dr. Robert Gabbay, the ADA’s chief scientific and medical officer. Dr. Gabbay shared important takeaways from the meeting and addressed insulin prices and racial disparities in diabetes care.

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