It’s In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: lots of news from the EASD conference, including info from Dexcom, Vertex, and more, the ADA issues new guidelines for CGM use at school around caregivers' ability to follow, a new study says women should be screened at a younger age for type 2 diabetes, and congrats to Lauren Dahlin, who lives with type 1, for qualifying for the Ironman race in Hawaii.
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Hello and welcome to Diabetes Connections In the News! I’m Stacey Simms and these are the top diabetes stories and headlines happening now
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Lots of news out of EASD – the European Association for the Study of Diabetes happening this week. Including, a new trial finds that antiviral medications, when given soon after a child is diagnosed with type 1 diabetes, might help preserve those vital beta cells.
The team followed 96 children aged 6 to 15 who were all diagnosed with type 1 diabetes within three weeks prior to their enrollment in the study. The children were randomly selected to receive either the two antiviral medicines or a placebo for six months.
After one year of follow-up, the researchers found that C-peptide levels remained "significantly higher" in kids who'd gotten the antiviral treatment compared to those who hadn't. That suggests the treatment helped shield the child's pancreatic beta cells from destruction.
While C-peptide levels dropped a full 24% in children who received the placebo, it fell by just 11% in those who got the antivirals, the investigators found.
On top of that, 86% of kids who'd gotten the antivirals still produced their own insulin at a level that makes treatment with supplementary insulin easier, the team said, and is also known to be linked to lowered risks for diabetes complications.
The treatment appeared to be safe, with no severe side effects noted.
According to Mynarek's team, their research supports the notion "that a low-grade persistent virus infection is an underlying disease mechanism, and that type 1 diabetes may be prevented by development of new vaccines."
The researchers concluded that "further studies should be done at an earlier stage in the disease process, to evaluate whether antiviral treatment could delay the progression of beta-cell damage leading to clinical type 1 diabetes."
https://consumer.healthday.com/type-1-diabetes-2665779376.html
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Also at EASD, an update on once a week insulin icodec for the treatment of type 1 diabetes. While several other studies have investigated once-weekly insulins in type 2 diabetes, this was the first data to be presented from a large-scale phase 3 study in type 1 diabetes.
The study, ONWARDS 6, included 582 people with type 1 diabetes who received either insulin icodec or insulin degludec. Participants had an average age of 44 years and an average diabetes duration of 20 years. Both the icodec and degludec group received basal insulin in combination with mealtime insulin (insulin aspart, or NovoLog) over a period of 57 weeks.
Overall, participants treated with once-weekly icodec and once-daily icodec had similar reductions in A1C of -0.5%, suggesting that this new insulin may offer another option for treating type 1 diabetes.
What were the key findings?
This study showed that insulin icodec was effective at reducing A1C in people with type 1 diabetes, although icodec did lead to higher rates of hypoglycemia compared to degludec.
Researchers are still investigating some questions related to the hypoglycemia events that occurred in this trial, such as how the time of injection and exercise may affect hypoglycemia.
https://diatribe.org/once-weekly-insulins-type-1-diabetes-latest-research-update
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Vertex Pharmaceuticals says a third type 1 patient no longer needs insulin after it’s investigational stem cell-derived therapy VX-880, being assessed for type 1 diabetes.
Two patients who had been followed for at least 12 months likewise met the study’s endpoint of the elimination of serious hypoglycemic events (SHE) between 90 days and 12 months.
Tuesday’s results follow an earlier data drop in June 2023, detailing the first two patients that achieved insulin independence and met the study’s primary endpoint.
The first patient achieved insulin independence 270 days into treatment, lasting through month 24 of the follow-up. The patient had type 1 diabetes (T1D) for “nearly 42 years,” according to Vertex’s announcement, and was taking 34 units of insulin daily.
Insulin independence came on day 180 for the second patient, persisting through 12 months of follow-up. The patient had T1D for 19 years and was taking 45.1 units of exogenous insulin daily. This patient had to restart insulin treatment at month 15, though at a much lower daily dose of four units.
The third patient stopped needing insulin at 180 days of treatment, which happened after the data cut-off, according to Vertex.
Aside from insulin independence, the new data from the Phase I/II study showed that VX-880 induced islet cell engraftment in all participants in parts A and B of the study at 90 days. In turn, these patients are now capable of endogenous glucose-responsive insulin production and demonstrated better glycemic control across various measures, including HbA1c and time-in-range.
Before receiving VX-880, all enrolled participants had long-standing T1D and showed no signs of endogenous insulin secretion and required 34.0 units of insulin per day on average, according to Vertex’s announcement on Tuesday. All patients also had histories of recurrent severe hypoglycemic events.
An investigational allogeneic stem cell-based therapeutic, VX-880 works by delivering fully differentiated and insulin-producing islet cells, in turn restoring the body’s glucose-responsive insulin production capabilities and boosting glucose control. VX-880 is designed to be delivered via an infusion through the hepatic portal vein. Patients need to be on an immunosuppressive regimen to receive the candidate.
Vertex’s T1D program also includes VX-264, an investigational therapy that encapsulates stem cell-derived islet cells in a protective device to be implanted into the patients’ bodies, according to the company’s website. Because the device is designed to shield the therapeutic cells from the body’s response, VX-264 is being studied without the use of immunosuppressive therapies.
https://www.biospace.com/article/vertex-touts-promising-data-for-stem-cell-based-type-1-diabetes-treatment/
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I mentioned Dexcom’s presentation at EASD in our long format interview earlier this week..
One of the company’s studies, for example, recruited insulin users in the U.K. to test out the Dexcom ONE device, which offers a more simplified interface compared to the company’s flagship G-series sensors. Though both Type 1 and Type 2 patients joined the study, Dexcom specifically singled out its results in the Type 2 population: The group saw their average HbA1c levels drop from a baseline of just over 10% to 8.5% after three months, then down to 8.3% after another three months, according to a company release.
The data marked the first real-world study conducted on the Dexcom ONE CGM, Leach said.
Another study presented at the EASD conference this week verified the use of the G7 sensor in pregnant women with Type 1, Type 2 or gestational diabetes—making Dexcom’s G6 and G7 devices the only commercially available CGMs backed by clinical data for use during pregnancy, the company said.
That group makes up about 10% of all pregnancies, he said, and “whether you’re on insulin therapy or not, just the benefit of having a
Supported by those findings, Dexcom said in the release that it now plans to make the G7 sensor available for use with Tandem’s t:slim X2 insulin pump in the U.S. and “multiple markets across Europe and Asia-Pacific” before the end of 2023.
https://www.fiercebiotech.com/medtech/easd-dexcom-cgms-notch-wins-among-type-2-and-pregnant-users-and-7-year-real-world-data
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Metformin may lengthen the time until insulin initiation, lower fasting glucose and improve neonatal outcomes for pregnant women with gestational diabetes, according to data from a randomized trial.
In findings presented at the European Association for the Study of Diabetes annual meeting and simultaneously published in JAMA, researchers compared glycemic, maternal and neonatal outcomes for women with gestational diabetes randomly assigned up to 2,500 mg metformin daily with those receiving placebo. The metformin group had a lower mean fasting glucose at 32 and 38 weeks of gestation, and the offspring of women receiving metformin had a lower mean birth weight than the offspring of those receiving placebo.
Metformin reduces the likelihood for large for gestational age among offspring of women with gestational diabetes.
Infants from mothers in the metformin group had a lower mean birth weight than offspring of mothers from the placebo group (3,393 g vs. 3,506 g; P = .005). The percentage of infants born large for gestational age was lower in the metformin group vs. placebo (6.5% vs. 14.9%; P = .003). Mean crown-to-heel length was shorter in offspring of mothers from the metformin group compared with placebo (51 cm vs. 51.7 cm; P = .02).
“Caution should continue with metformin and small for gestational age, especially in those where small for gestational age may be more likely, so those with hypertension or nephropathy,” Dunne said during the presentation.
https://www.healio.com/news/endocrinology/20231004/metformin-provides-glycemic-neonatal-benefits-for-women-with-gestational-diabetes
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More voices are calling for more screening for type 1 diabetes. About 85% of people with type have no family history.
Various research programs are going on worldwide to establish the best ways of implementing universal screening, including programs in Germany, the USA, Israel, the UK, and Australia. A new program (Edent1fi) has just been funded that will include multiple new European countries, including the UK, Germany, Poland, Portugal, Italy, and the Czech Republic. "These are all research programs. The next steps before universal screening for type 1 diabetes becomes general policy will require guidelines for monitoring and endorsement of screening and monitoring guidelines by applicable societies," explains Dr. Sims. This will also be helped by broader access to disease-modifying therapies to impact progression and the need to start insulin injections.
Screening for adults, who can also develop T1D, is less well studied. Although optimal approaches have yet to be elucidated, this population will also likely benefit from identifying early-stage disease and the advantages of education, monitoring, and access to therapy.
https://www.news-medical.net/news/20231003/Universal-screening-A-game-changer-in-early-detection-and-management-of-type-1-diabetes.aspx
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As I mentioned briefly in my last episode, one of the winners of this year’s Nobel prize for medicine has lived with type 1 for almost 60 years. Dr. Drew Weissman and Katalin Karikó won the Nobel for their work on the COVID-19 vaccines received a Nobel Prize of Medicine.
Karikó and Weissman met by chance in the 1990s while photocopying research papers, Karikó told The Associated Press. Weissman was diagnosed at age 5 and I’ll link up a great interview that Mike Hoskins posted – he used to write for DiabetesMine.
http://www.thediabeticscornerbooth.com/2021/02/we-can-thank-this-researcher-with-type.html?m=1&fbclid=IwAR254vGL8G0aU3uUnvfHbJa79WCiFgS8ihMgHMf0V2hK2QYJBLaa9zwMn7U
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Should women be screened for type 2 diabetes at a younger age than men? A recent study published in Diabetes Therapy explores this hypothesis – there’s a lot here and I’ll link it up, but they examine the theory that menstruation can throw off an A1C.
Women with diabetes between 16-60 years of age have an increased mortality risk by about 27% as compared to diabetic men of the same age when both are compared to the general population. Women lose an average of 5.3 years from their lifespan with diabetes as compared to 4.5 years for men. The study comprised two cohorts. The first included over 146,000 individuals using a single HbA1c reading at or below 50 mmol/mol obtained between 2012 and 2019. The distribution was replicated using readings from a second cohort of about 940,000 people, whose samples were analyzed in six laboratories between 2019 and 2021.
The mean HbA1c level in women at any given age corresponded to that observed in men up to ten years earlier. These findings were corroborated with data obtained from the second cohort.
An undermeasurement of approximately 1.6 mmol/mol HbA1c in women may delay their diabetes diagnosis by up to ten years. Ten years in which they weren’t being treated.
https://www.news-medical.net/news/20231004/The-cut-off-for-HbA1c-based-diagnosis-of-diabetes-may-be-too-high-in-women.aspx
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Commercial – Edgepark
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Very recently, the Americans with Diabetes Association released updated CGM guidance for use in schools. The link to the new guidance is below.
This came about after discussions with stakeholders, including myself and Attorney Roswig. Be clear, this was revised because of the discussions and “rallying” of families impacted, where in some cases schools were pointing to certain flaws in the language in the prior guidance.
While this new guidance may address your CGM issue with your particular school, the new guidance, in our opinion, still needs work. Please know that this work will continue.
If you have any more specific questions, please contact me and I will attempt to address the same. Thank you for your patience, thus far, and anticipated trust and patience going forward. https://diabetes.org/sites/default/files/2023-09/cgm-final-9-22-23.pdf?fbclid=IwAR1t4cpPUSmDoitWiH2hSgNnXWdeYQjPW4rlewjWkWHiOYWc65HX8ub74Yo
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have to show everyone and show myself that this doesn’t change anything,” said Lauren Dahlin about her diagnosis with type 1 diabetes (T1D) at 26 years old in 2017. Today, she’s a true athlete who has competed in nine Ironman races — consisting of a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile run. Completed within about 14 hours!
This past summer, Dahlin competed in the annual Ironman in Lake Placid, NY. The event came with a lot of pressure because placing within the top 24 racers meant qualifying for the biggest Ironman event of all: the World Championship in Kona, HI.
She did it. Dahlin placed 9th amongst about 600 other female competitors — becoming one of the first women with T1D to qualify for the Ironman in Kona, HI. Happening next weekend Oct 14th
Here’s a closer look at Dahlin’s journey from diagnosis to rockstar competitive athlete.
Diagnosed just days before a potential DKA coma
“I couldn’t even walk half a flight of stairs without getting extremely winded because I was so far gone,” explains Dahlin of her pre-diagnosis symptoms. “The clinic gave me an inhaler for asthma and sent me home!”
Dahlin saw six different providers before someone finally gave her the appropriate diagnosis. They even performed a full-blood panel workup and didn’t diagnose her T1D. Eventually, Dahlin went to the emergency room in Boston, where she lived, and the staff told her she was experiencing diabetic ketoacidosis (DKA). She then spent ten days in the intensive care unit learning about her new life living with T1D.
“I was bummed that the doctors hadn’t caught my diagnosis earlier because there were a lot of clinical trials happening in Boston that I could have been a part of.”
Regardless, Dahlin didn’t want to slow down — within one month of her diagnosis, she signed up for her first half-marathon.
https://t1dexchange.org/ironman-world-championship-type-1-diabetes/
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That’s In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.