The 83^rd session was accessible to participants both virtually and in-person this year. We count 1,965 original research presentations (i.e., posters) and more than 190 debate and discussion seminars. The JDCA team reviewed the abstracts of these presentations for general trends. It comes as no surprise that the primary focus of the event was centered around T2D research. Eighty percent of the research presentations (n=1,579) focused on T2D specifically or general diabetes topics, such as complications. The remaining 20% specifically referenced and focused on T1D (n=386). This is a slight decrease from prior years. In 2022, T1D-focused research presentations were 25% of the total and 23% in 2021.

Most Prevalent and Blogged Topics

Unsurprisingly, the two most represented and trending topics coming out of the conference were primarily related to T2D. But, in both cases, there was some additional discussion about the potential impact on people with T1D. The two ‘most prevalent’ topics were:

• GLP-1 inhibitors: Significant time and discussion was given to GLP-1 inhibitors (e.g., Ozempic, Rybelsus, Victoza) for their impact on weight loss and their related risks. While most of the discussion of these topics focused on T2D, there was a minority discussion about the potential of GLP-1 inhibitors on aiding glucose control in T1D people.

• Diabetes Complications Treatment: A close second in the running for ‘most prevalent topic’ was an avalanche of various diabetes complications (kidney disease, cardiovascular health, neuropathy, retinopathy, and hypoglycemia, to name a few) and potential pathways of treatment, the analysis of preventative measures, and risk factors.

T1D Specific Highlights

Among the 386 T1D-focused research presentations shared at this year’s conference, there were three key themes covered in depth. They are as follows:

1. Two Potential “Functional Cure” Solutions Show Positive Results in Human Trials

Vertex VX-880
Vertex Pharmaceuticals shared an update on VX-880, their phase 1/2 ongoing clinical trial of stem-cell derived, allogeneic, fully differentiated, pancreatic islet cell replacement therapy in T1D patients with severe hypoglycemia. VX-880 utilizes chronic immunosuppressants to stunt the autoimmune attack.

New results were shared for the first time, revealing that two of the six patients in the trial remained insulin independent with HbA1c levels of 5.3% after 12 months.

An additional Vertex human trial, VX-264, includes an encapsulation device that hopes to eliminate the need for immunosuppressants. On a separate path, Vertex is also starting work with CRISPR to modify cells against the autoimmune attack.

Sernova Cell Pouch
Sernova shared new human trial results from its Cell Pouch product. In this trial, the Cell Pouch is filled with cadaver-sourced islet cells, and patients are required to take chronic immunosuppressants. Additional work is underway to provide autoimmune resistance (with DRI) and alternative sources of cell supply (via a partnership with Evotec for iPSC).

Five of the six patients in the trial remained insulin independent for at least six months. More specifically, the company stated that patients experienced “insulin independence for periods ranging from 6 months to greater than 3 years.”

2. Early Detection and Onset Delay

Many presentations focused on recent therapeutic breakthroughs in onset delay. Identifying and providing protocols for early detection (measuring autoantibodies) and related training, physician implementation, and patient acceptance was a key theme. A second key theme was the presentation of several emerging therapies, all hoping to build from the market approval for Tzield.

Additional related highlights:

• The ADA revised its Standards of Care in Diabetes to encourage and clarify protocols for autoantibody screening for children and adults (autoantibodies are present only when there is damage to beta cell mass). The main protocol change dictates that when two or more autoantibodies are present, the new Standards recommend the patient be diagnosed with stage 1 (pre-symptomatic) T1D, enabling them to begin a delay treatment (and presumably helping to ensure it will be covered by insurance).

• Tzield received a fair bit of attention as the first FDA-approved treatment to delay the onset of stage 3 T1D (fully symptomatic) in patients aged eight years and older. In their trial, stage 3 T1D was postponed, on average, by 50 months (a little over four years).

3. Next Generation Glucose Monitors — The Race for Non-Invasive

There was a variety of new research presentations featuring the next generation of continuous glucose monitors (CGMs). These innovations sought to deliver a range of benefits, including enhancements to be more user-friendly, and implementing novel ideas to create non-invasive technology. One such CGM in trials is the miniature Osmotic Pressure-Based Glucose Sensor, an implantable device whose final form will be the size of a grain of rice. This first human clinical study utilized a wired version of the device, demonstrating that the osmotic pressure sensor follows glucose changes similar to the FreeStyle Libre device and sensor.