Diabetes Developments

ADA: Day 4

San Francisco — Some numbers that the American Diabetes Association told me today can give you a sense of the scale of its meeting here at San Francisco’s Moscone Center. Its 68th Scientific Sessions started Friday and ends tomorrow.

The ADA’s press office says that so far they have counted 15,630 attendees. Most of these are medical professionals. But when they include exhibitors at the many booths, they’ve counted 20,912 people here so far.

We are hear to learn the latest diabetes information presented in symposia, oral sessions, and poster sessions. The 96 symposia (including presentations on current hot-button issues, lectures, and case studies) have the biggest halls and draw the biggest crowds. This is the top of the presentation pyramid and is the area where I’m focusing my attention. After I get home and get a chance to digest the material, I will be writing about what I have learned in the big areas of interest here — which correspond to my own interests — nutrition and exercise.

Most people consider the oral presentations to be the second tier. Diabetes professionals are presenting nearly 400 papers in 51 oral sessions. But I skipped all of these presentations, because I just don’t have the time to absorb this information orally. I will read it later.

Much more efficient than listening are viewing the more than 1,500 posters. In a couple of hours I was able to walk through the areas of my interest, looking at the posters to the degree that they interest me. Those areas are the same areas that most closely affect all of us with diabetes — nutrition, exercise, and glucose monitoring and sensing.

What posters are may need a little explanation. I know that I was puzzled for many years about them, until I was able to come and see them in person. The are displays about 4 or 5 fee wide and a couple of feet high mounted on boards is as big a meeting hall as you can imagine.

Some of the people who prepare the posters are thoughtful enough to provide a stack of copies that they leave by the posters even when they themselves aren’t physically present. For other interesting posters, people take notes or pictures.

In the photo below the lead author, Asha Jain of the Walter Reed Army Medical Center in Washington, D.C., presents her poster #1696 on “Glycemic Responses to Nutritional Supplements in Type 2 DiabetesMellitus” (while the ADA discourages press photos of the posters, Asha asked me to take this shot). Full disclosure: I work with her and her co-authors on a different consulting contract.

Posters like Asha’s and others in the nutrition, exercise, and glucose testing areas will provide me with most of the news in the next few months. But the hot news now on the poster and presentation fronts here in San Francisco is the battle between Amylin andNovo Nordisk. Each company is showing dozens of posters of their drugs.

Amylin developed the first GLP-1 mimetic, Byetta. Novo just submitted its GLP-1 drug, liragultide, to the FDA. It could be as big a blockbuster as Byetta, but a long-acting release version of Byetta in development could well leap-frog it.

Success of these drugs with our medical teams — and with us — will mean literally billions of dollars for the winning company. So I’m not surprised that they are already fighting it out at the ADA here.

These three drugs and others in the same class being developed by Roche, sanofi-aventis, and others are extraordinarily effective in reducing our A1C levels. But many drugs do that. The difference with the GLP-1 mimetics is that that also help us to lose weight.

Liraglutide could be even better in these respects than Byetta, but we don’t really know yet, because we can’t get our hands on it. Clearly, liraglutide will have a big advantage in convenience of use over Byetta in that it will take only one shot a day instead of the two that Byetta requires. The problem forNovo is that the long-acting release formulation from Amylin will probably be available almost simultaneously with the availability of liraglutide — and the long-acting release means that we will only need one shot per week.

This fight must be a nightmare for Amylin and Novo. But the outcome — no matter who wins in the marketplace — will be a dream come true for millions of people with diabetes.

This article is based on an earlier version of my article published by HealthCentral.

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  • Reply David Mendosa August 18, 2008 at 7:05 pm

    Dear Bonnie Jean,

    That is so sad. I am so sorry.

    I haven’t heard anything about antibody problems for a couple of years.


  • Reply Bonnie Jean August 18, 2008 at 7:44 am

    My experience with Byetta has been that high glucose is just delayed by about three hours and I’ve experienced arthritis-like symptoms with dull pain in my midsection. I have lost weight, but at the expense of muscle wasting and bone loss (Calcium, CK, and Vit D below normal). I hope that with the Liraglutide being closer to my natural GLP1, I won’t experience these problems. Did they address antibody problems?

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