During one of the most popular annual presentations at the Scientific Sessions, three experts summarize a year’s worth of discovery, innovation, and paradigm shifts in diabetes research and care. This year’s session, The Year in Review—Highlights of the Past Year in Basic, Translational, and Clinical Sciences, will be presented from 4:30 p.m. – 6:30 p.m. ET Sunday, June 27.
The session offers a broad look at advancements throughout the world of diabetes and will be insightful for anyone in the field, newcomers especially, said Maureen Gannon, PhD, who will discuss basic science developments during the session.
“For those who are new to the field, in particular trainees or people who are moving into diabetes research from other fields, this session will give them an appreciation of the depth of the research and the hot topics in diabetes research over the past year to help them put their research into a better context and to figure out where the field is going,” she said.
Dr. Gannon, Associate Dean for Faculty Development and Professor of Medicine, Vanderbilt University Medical Center, will discuss an array of discoveries, including conflicting data sparking debate about the potential for direct infection of beta cells by SARS-CoV-2.
“We still don’t know whether COVID-19 can infect beta cells and whether that would increase risk of type 1 diabetes development, or if that’s contributing to the risk that people with diabetes have in terms of worsening disease with COVID,” she said.
Despite the many unknowns surrounding COVID-19, the past year has seen potentially game-changing advancements in the understanding of diabetes. Previously, the regulation of insulin secretion was thought to be highly dependent on glucose metabolism and glucokinase, but recent papers show pyruvate kinase also plays a significant role.
“That has really shaken the field up and changed decades of our understanding of insulin secretion,” Dr. Gannon said.
Additionally, new glucagon-like peptide-1 (GLP-1) receptor agonists called conjugated peptides have been shown to have reduced brain penetrance when tested in animal models and, as a result, reduce the negative effects GLP-1 analogs can have.
“This new compound is really exciting, suggesting you might get the beneficial effects of stimulating insulin secretion without some of the negative side effects,” Dr. Gannon said.
Dr. Gannon also will discuss developments related to diabetes complications, including insulin-responsive organs and diabetic cardiomyopathy. Beta cell stress and mitochondrial dysfunction have been recurring themes in the basic science sphere, she noted. Recent papers show that beta cell de-differentiation and beta cell stress are common in both type 1 and type 2 diabetes, and that mitochondrial dysfunction is common in multiple organs in diabetes—not only in the beta cell with regulation of insulin secretion but also in diabetic cardiomyopathy, in skeletal muscle, and in the liver.
The most recent research from the National Institutes of Health-funded Human Islet Research Network (HIRN) examines the immune system’s role in type 1 diabetes and T-cell activation. HIRN researchers also are trying to generate beta-like cells from stem cells. Dr. Gannon will address both topics.
After serving as the Year in Review session chairperson in 2019, Jay S. Skyler, MD, MACP, joins the session as a presenter in 2021. He will discuss the most recent additions to the clinician’s toolkit for treating type 1 and type 2 diabetes.
“The clinical developments that have occurred in the past year have been a continuation of the cardiovascular outcome trials, but also an expansion to include outcomes related to heart failure and related to the kidney,” said Dr. Skyler, Professor of Medicine, Pediatrics, and Psychology, University of Miami Leonard M. Miller School of Medicine, and Deputy Director for Clinical Research and Academic Programs at the Diabetes Research Institute, University of Miami. He will provide an overview of studies involving empagliflozin, sotagliflozin, dapagliflozin, and finerenone.
“We are now beginning to have more and more treatments that are demonstrating benefit in heart failure and kidney disease, as well as in the traditional cardiac outcomes that were sought with the earlier studies with diabetes drugs,” Dr. Skyler said.
Research into incretin mimetic agents also is expanding. Semaglutide has demonstrated “profound” weight loss, while the combination drug tirzepatide has shown potential to rival other glucose-lowering and weight-loss drugs.
Meanwhile, insulin management is being transformed with the expansion of weekly basal insulin options, which Dr. Skyler will discuss in the context of icodec and basal insulin Fc trials.
Immune intervention was another hot research area in the past year, including a study that used an anti-TNF (tumor necrosis factor) drug to preserve beta cell function in type 1 diabetes and another that tried to stimulate beta cell function with liraglutide.
“I think what it signals is there’s going to be many more combination studies that are going to evolve over the next few years as we try to pay attention, not only to the immune system attacking the beta cell, but also trying to preserve beta cell health and function,” Dr. Skyler said.
Dr. Skyler also will examine data on the dramatic improvement seen in adults and children with type 1 diabetes while using the Omnipod 5 hybrid closed-loop insulin delivery system.
The session’s other expert presenter, William T. Cefalu, MD, will provide an overview of recent translational science developments in diabetes. Dr. Cefalu is the Director of the Division of Diabetes, Endocrinology, and Metabolic Diseases at the National Institute of Diabetes and Digestive and Kidney Diseases.