Patient fatigue with counting carbs and consuming high-protein snacks may drive interest in exploring dietary alternatives for type 2 diabetes management. Krista A. Varaday, PhD, discussed the effects of intermittent fasting and exercise on fasting insulin, insulin resistance, and insulin sensitivity, as well as the barriers to patient adherence to time-restricted eating. Read more

Loss of beta cell function happens abruptly around the time of type 1 diabetes onset, noted panelist Matthias von Herrath, MD, though many individuals with long-standing type 1 diabetes retain beta cell mass and some degree of beta cell function. Hallmarks of progression include upregulation of major histocompatibility complexes and the appearance of CD8-positive T-cells in islets. Read more

Among the available screening tools for type 1 diabetes, autoantibody testing can identify people who are in the early stages of the disease and are at high risk of developing clinical type 1 diabetes, providing a window of opportunity for early intervention and potentially preventing diabetic ketoacidosis, explained Chantal Mathieu, MD, PhD. Read more

Investigators found that three of the subphenotypes have increased glycemia, but only individuals in two clusters have imminent diabetes risks, explained Robert Wagner, MD. By contrast, they found another cluster of individuals with prediabetes who have only moderate risk of type 2 diabetes but an increased risk of kidney disease and all-cause mortality. Read more

Raja Kandaswamy, MD, reviewed indications and recent outcomes of pancreas transplant alone and simultaneous pancreas-kidney transplant in patients with type 1 and type 2 diabetes. Simultaneous transplants have excellent short- and long-term results, but long-term results of solitary pancreas transplants need to improve, he said. Read more

Little is known about the impact of low-calorie sweeteners on taste preferences, insulin secretion, adipogenesis, the gut microbiome, glucose absorption, and the risk of cardiometabolic disease, according to Michelle Pang, BSc. One reason for that is that they are structured differently but are often studied together, resulting in conflicting findings. Read more

An analysis of Diabetes Control and Complications Trial data, as well as a number of cross-sectional and longitudinal studies, provide evidence supporting the association between time in range and microvascular complications, cardiovascular disease, and mortality, according to Roy Beck, MD, PhD. Read more

Exercise management is trial and error and always will be as long as exogenous insulin is being manipulated, according to Laurel Messer, PhD, RN, CDCES, one of four experts who shared several clinical pearls in the practical use of automated insulin delivery systems. Read more

Insulin availability is a challenge across the globe, particularly in many lower- and middle-income countries. Panelists including Sylvia Kehlenbrink, MD, outlined the breadth of this obstacle to diabetes care and potential national and international strategies for overcoming it. Read more

To identify ways to help older adults increase their use of diabetes technology, several factors must be taken into consideration at each level of care, including systemic, clinician, personal caregiver, and patient factors. “The thing with technology is that you have the shoe, but it must fit for the right outcome,” said Medha Munshi, MD. Read more

Eda Cengiz, MD, MHS, who reviewed some of the most recent technological advances in diabetes care and management, said the most exciting development in this area has been automated insulin delivery, also known as artificial pancreas, hybrid closed-loop system, or bionic pancreas. Read more

Therapeutic inertia does not have a single cause. Clinician-, patient-, and systematic-related factors all contribute, said Christine Beebe, MS. Meta-analysis indicates that diabetes management programs should be set up to treat patients while taking into consideration different clinician types, clinic settings, and patient communications for optimal effectiveness. Read more

Expectant mothers who exercise have greater levels of docosahexaenoic acid (DHA) in late pregnancy than those who do not, explained Linda May, PhD, MS, FAHA. DHA helps mothers deliver on time, is good for placentas, helps control the mother’s lipids, and is essential for the baby’s growth and development. Read more

In a report to Congress earlier this year, the National Clinical Care Commission (NCCC) outlined more than three dozen recommendations for a national effort across multiple agencies and levels of government to address social determinants in the pathogenesis and progression of diabetes. NCCC Chair William H. Herman, MD, MPH, and other Commission members highlighted their recommendations at the 82nd Scientific Sessions. Read more

Carol H. Wysham, MD, says there is serious therapeutic inertia at play as patients often remain in poor glycemic control for more than seven years before intensification of treatment. Yet repeated studies show that up-titrating GLP-1 receptor agonist dosing improves glycemic outcomes as well as loss and maintenance of weight. Read more

Obesity can lead to insulin resistance, which sets the stage for the development of beta amyloid plaques and tau tangles in the brain, both hallmarks of Alzheimer’s disease. Some early trials of inhaled insulin in people with type 2 diabetes show improved memory, Auriel A. Willette, PhD, MS, and Vera Novak, MD, PhD, explained. Read more

An expert panel including Paul McGuigan, RN, CDCES, stressed that creating a continuum of care and support starting in high school, including promoting health insurance literacy, is key to setting up young people with type 2 diabetes to successfully manage their disease as they transition to adulthood. Read more

Afternoon training improves glucose sensitivity, increases fat loss, and increases work performance while reducing nocturnal blood glucose levels, said Juleen R. Zierath, PhD, one of the panelists discussing the molecular mechanisms known to affect the circadian rhythms of liver function. Read more

A distinguished panel of experts reviewed the latest information on the development of weekly insulins, oral insulins, glucose-sensitive insulin, and the role of biosimilars and interchangeable insulins on Monday, June 6. Michael A. Weiss, MD, PhD, MBA, discussed the development of glucose-sensitive insulin, or “smart insulin,” that can be activated through the use of a synthetic “switch” that can be opened or closed using a simple sugar sensor. Read more

Four weight loss researchers discussed the value of behavioral therapy, intensive lifestyle interventions, and pharmacotherapy during a Scientific Sessions symposium on Sunday, June 5. “There’s quite a bit of evidence showing that individuals who self-monitor over time generally are the best in terms of maintenance of behaviors and weight,” said Hollie Raynor, PhD, RD, LDN. Read more

An expert panel examined several barriers limiting the use of diabetes technology in under-resourced communities at the 82nd Scientific Sessions. “Regardless of their socioeconomic status, everyone deserves access to the right technology at the right time, especially in a chronic condition like diabetes,” said Vivian N. Ayuk, PharmD, CDCES. Read more

A panel of clinical leaders discussed the importance of educating hospital staff about diabetes management and care during a Scientific Sessions symposium on Monday, June 6. “It really does affect the patient experience when we don’t do an excellent job managing their glycemia, and that’s the point of education,” said Leigh B. Bak, MSN, APRN, ACNS-BC, CDCES. Read more

Racial, ethnic, and socioeconomic disparities that limit access to diabetes medications and technologies lead to poor glycemic control, diabetic emergencies, and adverse cardiovascular outcomes, according to Sara Jane Cromer, MD, one of three presenters in a symposium on Monday, June 6, that examined disparities in the use of diabetes medications and technologies. Read more

After SURMOUNT-1 trial results were reported at the Scientific Sessions on Saturday and made worldwide headlines, a special session on Tuesday, June 7, will showcase more than 20 tirzepatide abstracts presented over the five days of the meeting. “Attendees are seeing and hearing data that is being presented for the first time here in New Orleans,” said Katherine R. Tuttle, MD, FASN, FACP, FNKF, one of the session’s presenters. Read more

Genomic analysis, single-cell sequencing, and epigenomic approaches are uncovering new mechanisms in the development and progression of diabetic kidney disease. A panel of researchers, including Jose C. Florez, MD, PhD, will provide an update on the latest discoveries. Read more

Richard David Leslie, MBBS, MRCS, MD, FRCP, FAoP, says diabetes should be rethought. He will open a unique symposium on the final day of the 82nd Scientific Sessions that will examine various aspects of heterogeneity in diabetes. Read more

Three neurological researchers—Auriel Willette, PhD, Vera Novak, MD, PhD, and Valory Pavlik, PhD (left to right)—will discuss the links between diabetes and cognitive decline and explore possible interventions during a Scientific Sessions symposium on Tuesday, June, 7. Read more

Once thought of as nonfunctional vestigial relics of evolutionary history, cilia are emerging as critical components in multiple signaling pathways that control sight, smell, renal function, feeding behavior and obesity, skeletal formation, and, most recently, insulin secretion and glucose homeostasis. “Cilia biology is going to explode in diabetes,” predicts Jing Hughes, MD, PhD. Read more

Four researchers, including Dongyin Guan, PhD (left), Kristin Eckel-Mahan, PhD, will discuss how circadian misalignment impacts metabolic health during a Scientific Sessions symposium on Tuesday, June 7. Read more

Frances M. Ashcroft, DBE, FRS, FMedSci, recipient of the ADA’s 2022 Banting Medal for Scientific Achievement, discussed a novel approach—inhibiting glucokinase activity to improve insulin secretion—for treating type 2 diabetes during her award lecture on Sunday, June 5. Read more

Linda DiMeglio, MD, MPH, David A. D’Alessio, MD, and Silvia Corvera, MD (left to right), reviewed some of the key advances in diabetes research and care during the annual Year in Review session. Read more

Five behavioral health specialists discussed the effects of stigma in diabetes care during an afternoon symposium on Saturday, June 4. Alan M. Delamater, PhD, opened the symposium by recounting his 40-year journey in behavioral diabetes research as he presented the annual Richard R. Rubin Award Lecture. Read more

The recent emergence of effective anti-obesity medications raises the question of whether weight loss, rather than glucose control, should be considered the primary target for intervention in type 2 diabetes. Ildiko Lingvay, MD, MPH, MSCS, and Jeffrey I. Mechanick, MD, debated that question at the 82nd Scientific Sessions. Read more

Losing weight, no matter how much or how little, has health benefits for obese people with type 2 diabetes. And the more they lose, the better the outcome, said Priya Sumithran, PhD, one of three panelists in a Scientific Session symposium that explored the use of lifestyle interventions, bariatric surgery, and pharmacotherapy to manage obesity and type 2 diabetes. Read more

Research examining central nervous system control of systemic metabolism suggests that the CNS plays an important, and perhaps a dominant role in the pathogenesis and progression of at least some forms of diabetes. Four leaders in the field, including Vincent Prevot, PhD, and Sarah Stanley, MB, BCh, PhD, will review the latest findings at the Scientific Sessions. Read more

Cardiovascular disease is recognized as one of the most common complications of diabetes. Clinicians have long viewed coronary arterial disease and atherosclerosis as the major culprits, but heart failure has emerged as a larger problem—and one that’s more difficult to manage, according to Rong Tian, MD, PhD. Read more

Four cardiologists, including Yi Tan, PhD (left), and Harold E. Bays, MD, will discuss the underlying mechanisms, diagnosis, and treatment of cardiomyopathy, a familiar yet underappreciated complication of diabetes. “My sense is we are on the cusp of some really interesting times in cardiomyopathy in diabetes,” Dr. Bays said. Read more

Otis W. Kirksey, PharmD, RPh, CDCES, BC-ADM, ADA President, Health Care & Education, discussed his dedication to the diabetes community on Saturday, June 4, saying that improving the lives of people with diabetes takes equal parts of dedication and hard work. Read more

Amy Hess-Fischl, MS, RDN, LDN, BC-ADM, CDCES, received the ADA’s 2022 Outstanding Educator in Diabetes Award at the 82nd Scientific Sessions. Diabetes self-management education and support (DSMES) should be the standard-of-care for every person with diabetes, she said. Read more

Davida F. Kruger, MSN, APN-BC, BC-ADM, told women at the Saturday afternoon symposium that if they’re not invited to the table, show up anyway—with a chair. And keep moving that chair closer and closer to the table. Read more

Physical activity is an integral part of the diabetes management toolbox, but not everyone responds to physical activity the same way or has the ability to exercise regularly. A panel of exercise scientists, including Carlos Crespo, PhD, examined how health disparities and sex differences impact physical activity during a morning symposium on Saturday, June 4. Read more

During an afternoon symposium on Friday, June 3, a diverse interprofessional panel of experts—including an epidemiologist, a health services researcher, a historian, and a medical anthropologist—shared their work and insights on the role of race and racism in diabetes research and diabetes care. “Implicit bias training alone does not work in terms of being sustainable. It has to be accompanied by systemic structural interventions—they go hand in hand,” said Marshall Chin, MD, MPH. Read more

Four experts, including Satish K. Garg, MD, and Holly Willis, PhD, RDN, CDCES, will discuss practical strategies to improve eating habits and optimize the growing number of insulin-dosing options to improve glucose control, increase time in range, reduce A1C, and lower the risk of long-term complications from poor glucose control. Read more

Jamie Feldman, MD, will chair a Scientific Sessions symposium examining diabetes, metabolic health, and clinical care among people who are lesbian, gay, bisexual, transgender, gender diverse, queer, or questioning. Read more