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.

Combining conventional risk factors with metabolites, including microbiome-related metabolites, can help predict gestational diabetes, explained Yeyi Zhu, PhD, during a session outlining the mechanisms and next steps for implementing precision medicine during and after pregnancy.

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.

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.

Multimodal intervention is the most effective approach to population-based diabetes prevention, Jaakko Tuomilehto, MD, PhD, explained at the 82nd Scientific Sessions, citing a Finnish program targeting weight reduction, fat intake, fiber consumption, and daily physical activity. Dr. Tuomilehto was part of the expert panel featured in the ADA Diabetes Care Symposium.

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.

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.

Most type 2 diabetes complications are related to excess adiposity, Dina Griauzde, MD, MSc, explained at the 82nd Scientific Sessions. Experts explored the benefits of weight loss for patients with type 2 diabetes, as well as medical management and surgical options for achieving weight loss.

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.

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.