American Diabetes Association 77th Scientific Sessions

June 9-13, 2017; San Diego, CA; Advance Preview – Draft

Executive Highlights

ADA Website

Advance Program

2016 Full Report

The advance program for the ADA’s 77th Annual Scientific Sessions was recently made available – the meeting will be held in sunny San Diego, CA from June 9-13 (less than 90 days away!) It’s hard to believe that nearly a year has passed since last year’s festivities in New Orleans, LA and we can’t wait for all of the new insights this year’s meeting will bring!

For context, the advance program contains the full lineup of mini-symposia, symposia, oral presentations, and keynote presentations. Individual talks and speaker names are available for the symposia though not the oral presentations – the details on orals will be available when the full program is released, likely in mid-May (usually it's just several weeks ahead of the Scientific Sessions). By our count, the agenda features around 114 symposia and 44 oral presentation sessions, although slight changes are possible between now and when the final program is released. For comparison, last year's meeting included roughly 104 symposia and 38 oral sessions. The eight theme areas remain unchanged from last year: (i) Acute and Chronic Complications; (ii) Behavioral Medicine, Clinical Nutrition, Education, and Exercise; (iii) Clinical Diabetes/Therapeutics; (iv) Epidemiology/Genetics; (v) Immunology/Transplantation; (vi) Insulin Action/Molecular Metabolism; (vii) Integrated Physiology/Obesity; and (viii) Islet Biology/Insulin Secretion.

The advance program also contains plenty of logistical information for prospective attendees. The deadline for registering online is June 1, and the deadline for registration at the Advance rate is April 27. The housing deadline is May 12 but availability (especially at the best hotels) tends to run out quickly – we would advise all prospective attendees to jump on this quickly as we’ve heard that San Diego is already filled up! Pre-registered attendees will receive an email in early April with information on registration for corporate symposia – these have yet to be listed.

Below, we outline some of the biggest highlights from each day's agenda. Please note that the advance program is subject to change – we recommend checking back in a few weeks when the full program comes out to confirm timings.

Friday, June 9

  • Therapy: ADA 2017 is kicking off on a high note, with a stellar agenda for the first day featuring some of the biggest names in diabetes with cutting-edge insights. We’re particularly looking forward to the afternoon symposium that promises all the latest on CVOTs: Dr. Tina Vilsbøll will present that SUSTAIN 6 results for Novo Nordisk’s GLP-1 agonist semaglutide (first presented at EASD 2016, though we hope that Dr. Vilsbøll may present additional sub-analyses), and Drs. Anne Peters, Lawrence Leiter, and Amanda Adler will respectively discuss whether diabetes guidelines should be update in response to CVOTs, explore the impact of recent findings on the broader role of CVOTs in diabetes, and weigh the cost-effectiveness of new diabetes therapies. Despite positive CVOT results for SGLT-2 inhibitor empagliflozin, questions about the class clearly remain, as evidenced by the late-afternoon symposium headlined by Dr. Julio Rosenstock exploring the clinical role of SGLT-2 inhibitors and their associations with DKA, bone fractures, and glucagon. (Also, the mechanism can’t be explained. It’s unclear the view on this – should that prevent its use?) In type 1 diabetes specifically, we’re looking forward to TrialNet’s Dr. Carla Greenbaum’s presentation on disease-modifying therapies in type 1 diabetes (wow!), as well as Dr. Philip Zeitler’s discussion of metformin for type 1.
  • Technology: Diabetes technology, digital health, and big data make a big splash on the first day of ADA 2017. We’re psyched to hear JDRF’s Dr. Aaron Kowalski face off against Dr. Jeffrey Millman on the future of diabetes care – Dr. Kowalski will advocate for the role of closed loop therapy while Dr. Millman will make the case for beta cell replacement. Of course, we think there’s certainly a role for both in the “future,” though closed loop is more imminent and will be available in the next few months to years, while beta cell replacement therapies are likely many years from being viable for widespread use. Also on Day #1, Tidepool lead designer Ms. Sarah Krugman will present personal patient and family experiences with diabetes data as part of a symposium on the opportunities and challenges related to diabetes mobile apps – she’s a major star and we’re so excited for her to have this platform. Dr. Rich Bergenstal will headline a forum about (finally!) CGM standards, with Dr. Anne Peters, Dr. Aaron Kowalski, Dr. Thomas Danne, and Dr. Simon Heller – it will be co-chaired by Dr. Bruce Buckingham and Kelly Close, who will undoubtedly reference outcomes beyond A1c and the extreme importance of getting to agreed-upon standards. We applaud the work of various groups to come together to unite on standards – this could be enormously helpful from clinical, regulatory, patient and reimbursement perspectives.

Saturday, June 10

  • Therapy: The high quality of ADA symposia continues in Day #2! The morning will feature a s-t-a-c-k-e-d Diabetes Care symposium featuring Drs. Jay Skyler, Bernard Zinman, Ele Ferrannini, and Matthew Riddle on the past, present, and future of diabetes treatment. Also in this session, newly-minted ADA Chief Scientific, Medical, and Mission Officer Dr. William Cefalu will present the “Profiles in Progress” plaques to those “whose contributions and discoveries were so noteworthy and remarkable that the findings truly changed the landscape of diabetes management forever” – wow! The celebration of diabetes innovators will continue in the afternoon with the ADA’s annual Pathway to Stop Diabetes Symposium – this is one of our very favorite sessions each year and we’re also so excited to learn about the latest diabetes research from the up-and-coming generation of diabetes researchers. In particular, we can’t wait to hear an update from the brilliant Dr. Zhen Gu on his glucose-responsive insulin patches. Also on Saturday, the growing debate over rising insulin costs will take center stage – in a symposium promising an “active dialogue” on the topic, the very cost-conscious Dr. Kasia Lipska will provide a historical perspective on the rising costs of insulin, Dr. Alan Carter will illuminate the various players and stakeholders in the drug pricing discussion, and Dr. David Robbins will provide guidance on clinical decision-making in an era where formulary lists, rather than clinical characteristics, so often dictate the medications patients take. The highlight of the session is sure-to-be former ADA Chief Scientific and Medical Officer Dr. Robert Ratner, who returns to the Scientific Sessions to offer a perspective on the path forward and the next steps in the insulin pricing controversy. Also on Day #2, we’ll hear from Dr. Jens Holst on the gut in glucose homeostasis, Dr. Michael Nauck on the past and future of incretins, and Dr. Melanie Davies on glucagon-based therapies for both diabetes and obesity.
  • Technology: The Day #2 agenda for diabetes technology is small but mighty. We’re particularly looking forward to the late-afternoon session on digital health, featuring the highly-respected Dr. Judith Fradkin on the NIH perspective on research involving connected health and Dr. Bakul Patel on the CDC perspective on health app regulation. We’re also excited to hear from Dr. Ananda Basu on multi-hormone artificial pancreas systems featuring glucagon.

Sunday, June 11

  • Therapy: A year following the incredibly impressive presentation of the LEADER CVOT results for Novo Nordisk’s GLP-1 agonist Victoza (liraglutide), ADA 2017 features all-new (!) data and analyses from the trial. Dr. Steve Nissen will kick off the session with a recap of the CV outcomes and new analyses – we’re very curious what these may be and expect that he’ll look at the impact of liraglutide on specific sub-groups, perhaps divided by age, baseline CV status and CV disease type, and/or baseline medications. Following, Drs. Richard Pratley and Stephen Bain will present (i) long-term clinical and metabolic data; and (ii) safety data, respectively. We hope that we’ll get a closer look at the very impressive hypoglycemia results in particular and perhaps we’ll be treated to additional granularity on liraglutide’s impact on microvascular – particularly renal – complications. Also on Sunday, full results from the five-year JDRF-sponsored REMOVAL trial (ClinicalTrials.gov page) of metformin in type 1 diabetes will be presented – the trial has a CV-related primary endpoint of averaged mean far wall common carotid artery IMT, with secondary endpoints including A1c, LDL cholesterol, weight, insulin dose, markers of kidney function, retinopathy, and endothelial function. There are few large-scale, long-term trials of metformin in type 1 diabetes, despite the drug’s popularity as an off-label treatment, and we hope that these results may be able to influence prescribing patterns or even perhaps support a label update. Metformin should, of course, be approved in pre-diabetes and we’d love to see more on that too though that is not the focus of this session. Looking to newer therapies, we can’t wait for the results presentation of the ODYSSEY DM program, which evaluated the LDL cholesterol-lowering efficacy of Sanofi’s PCSK9 inhibitor Praluent (alirocumab) in diabetes patients specifically. Also on the therapy front, Day #3 will feature symposia on innovations in insulin-related therapy (featuring Dr. Satish Garg on concentrated insulins), the impact of diabetes drugs on diabetic nephropathy (with discussion of SGLT-2 inhibitors, GLP-1 agonists, DPP-4 inhibitors, and insulin), and a look at early-stage therapeutic targets from the great Drs. Matthias Tschöp and Michael Schwartz.
  • Technology: For tech-watchers, Sunday morning will be headlined by the joint ADA/JDRF symposium on Progress Towards an Artificial Pancreas, featuring heavy-hitters Drs. Roman Hovorka, Richard Bergenstal, Stuart Weinzimer, and Eda Cengiz. With the imminent launch of Medtronic’s MiniMed 670G – the very first hybrid closed loop system to reach the market – we’re eager to hear perspectives from these leaders at the forefront of the automated insulin delivery field. The afternoon of Day #3 features Drs. Jeremy Pettus and William Polonsky squaring off in a series of three back-to-back debates on CGM use in people with type 2 diabetes (i) on intensive insulin therapy; (ii) on basal insulin therapy; and (iii) not on insulin. The back-and-forth between this dynamic duo is sure to be lively and we wouldn’t miss it for the world!
  • Other: Day #3 of the Scientific Sessions also features a number of can’t-miss speakers on bigger picture topics related to diabetes and clinical care. A morning symposium on shared decision-making will feature the CDC’s Dr. Ann Albright, the NIDDK’s Dr. Judith Fradkin, and UNC’s Dr. John Buse, among several others. In the afternoon, we’ll hear from J&J’s Dr. Richard Insel (formerly of JDRF) on the staging of pre-symptomatic type 1 diabetes and from the extraordinary Dr. Jane Dickinson on the importance of thoughtful language in diabetes care.

Monday, June 12

  • Therapy: Monday is always crazy-packed day at ADA, but 2017’s Scientific Sessions kicks it up an extra notch with not one but two (!) CVOT presentations back-to-back. First up, at 2:15 pm, the long-awaited full results from the DEVOTE trial of Novo Nordisk’s Tresiba (insulin degludec) will be presented – topline results indicated that Tresiba therapy is reassuringly neutral with regards to cardiovascular risk, though we’re especially interested in the details of Tresiba’s hypoglycemia benefit compared to Sanofi’s Lantus mentioned in the topline results (the real-world impact will, we suspect, trump RCT however). Immediately after, results from the CANVAS trial of J&J’s Invokana (canagliflozin) will be presented. Topline results have not yet been announced and this trial will be our very first indication of whether or not the cardiovascular benefit demonstrated for empagliflozin in EMPA-REG OUTCOME is a class effect. If that weren’t enough, immediately following the two CVOT presentations, Drs. Jay Skyler and Desmond Schatz will introduce and present the results from TrialNet’s trial of oral insulin for early type 1 diabetes intervention in people with multiple antibodies but normal glycemia. Also on Monday, Drs. John Buse, James Gavin, Roopa Mehta, and Luigi Meneghini will explore the role of fixed-dose and fixed-ratio combination treatments in diabetes care – a particularly relevant topic as GLP-1 agonist/basal insulin and SGLT-2 inhibitor/DPP-4 inhibitor combinations are launched.
  • Technology: Insights on real-world use of automated insulin delivery continue through the second-to-last day of ADA 2017, with Dr. Steven Russell discussing the relationship between exercise and diet and artificial pancreas systems. On the digital health front, we’re eager to hear from Dr. Courtney Lias, providing guidance from the FDA perspective on clinical liability and patient safety related to digital data. 
  • And Monday night learning from TCOYD and The diaTribe Foundation! As usual, there will be a Forum from 6:30 to 9:00 pm sponsored by TCOYD and The diaTribe Foundation – more on that soon! So far, we can tell you that it is a dynamite program, with Drs. Bruce Buckingham, Vanita Aroda, Ralph DeFronzo, and of course host Dr. Steve Edelman along with Kelly Close. Boy will this be amazing to hear from all the thought leaders! Afterwards, Adam Brown and Kelly will again host “Musings Under the Moon” and will share through amazing CEOs some late-night views on digital health and diabetes technology. There’ll be enough time to go change and get a drink and come back in time for the 10 pm panel start! Invites to follow shortly on these …

Tuesday, June 13

  • Scientific Program: After an absolutely packed first four days of the meeting, ADA 2017’s half-day on Tuesday represents a bit of a breather. Nonetheless, we definitely recommend sticking around for the prediabetes-focused symposium on this last day – and especially so you can come to the TCOYD / The diaTribe Foundation Forum the evening before. The pre-diabetes session will feature discussions on the pathobiology of prediabetes, the role of prediabetes as a role for diabetes prevention, and whether a diagnosis of prediabetes impacts patient behavior. As always, the meeting will end with the "ADA President’s Oral Session," featuring some of the top oral presentations of the conference.

 

--by Helen Gao and Kelly Close