UPDATES from ATTD (Advanced Technologies & Treatments for Diabetes) 2024, held in Florence, Italy, 6-9 March 2024.

The world’s largest congress dedicated to diabetes technology, which concluded last week with over 5000 attendees both in-person in Florence and virtually.  I’m sharing the FIVE standout revelations by Dr. Inge von Boxelaer of Diabetotech.com. 

• • The rollout of Dexcom G7 direct-to-Apple Watch: The feature will be available in March 2024 in UK and Ireland, with wider availability in the first half of this year. The Dexcom G7 sensors already have this functionality built into them, so all you need is an app update. Dexcom will be the first CGM to have a direct-to-watch functionality, and we commend them for prioritizing this.
    • Direct-to-watch means the Dexcom G7 sensor will send your glucose data directly to your watch. 
    • This means you’ll have access to your glucose data even when you only have your watch with you, making it a great solution for exercising without your phone.
    • If necessary, the data can simultaneously be sent to your phone and your insulin pump.
    • This feature is exclusive to the Dexcom G7 and not available for the Dexcom G6, Dexcom ONE, or Dexcom ONE Plus, and only for people who use an iPhone and Apple Watch, not for any other smartwatches. Dexcom is also working on implementing this functionality for other watches, such as Garmin watches.
  • FDA approval for Dexcom Stelo:  Dexcom announced that the Stelo CGM received FDA clearance. It is indicated for adults (>18 years) who do not use insulin and will be marketed for people with type 2 diabetes who don’t use insulin.  It is contraindicated for people with problematic hypoglycemia “since it lacks a predictive low alert”. The Stelo app will focus on the unique needs of this population, helping users understand the connection between lifestyle and glucose values.
    • The Stelo sensor has the same form factor as the Dexcom G7.
      • However, it can be worn for 15 days
      • and only sends glucose data every 15 minutes instead of every 5 minutes.
      • The company has not disclosed the Mean Absolute Relative Difference (MARD), but the FDA stated that the sensor performs similarly to other iCGMs.
    • Dexcom plans to launch this new sensor in the summer of 2024. In the US, it will be the first CGM that can be sold without a prescription (over-the-counter). In many European countries, prescriptions are not required for sensors.
  • The dual glucose-ketone monitor from Abbott:  The benefit of having access to a continuous ketone monitor (CKM) is to not only reduce diabetic ketoacidosis but also to enable the use of SGLT2 inhibitors in people with t1d. There is already one CKM commercialized by Sibionics, but there hasn’t been any accuracy data and it’s also quite expensive.  It will be exciting to have a combined glucose and ketone monitor from Abbott, as it appears to be a logical upgrade from the current FreeStyle Libre 3. There is no timeline yet for this dual glucose-ketone monitor from Abbott, and they haven’t decided on its name. However, it’s evident that it’s in the pipeline and is of high priority for Abbott’s development team.

• • EVOLUTION trial: the Omnipod 5 fully closed-loop system is feasible. 
    • The EVOLUTION trial assessed Insulet’s fully closed-loop algorithm in individuals with type 1 and type 2 diabetes in New Zealand.
    • What stood out was the amazing treatment satisfaction expressed by these participants! As one participant wrote: “The system was freeing and empowering and let me get on with the rest of my life without thinking too much about injections”.

• • CRISTAL trial: the MiniMed 780G is safe to use in pregnancy. This study compared 43 pregnant women with type 1 diabetes using the MiniMed 780G to 46 pregnant women with type 1 diabetes using a glucose sensor and either multiple daily injections (MDI) or an insulin pump. The study showed that the MiniMed 780G was safe for use during pregnancy and resulted in improved TIRp overnight, reduced TBRp, less hypoglycemia unawareness, less glycemic variability, and improved treatment satisfaction.  

Read more: UPDATES from ATTD (Advanced Technologies & Treatments for Diabetes) 2024

How Big Pharma is fighting Biden’s program to lower seniors’ drug costs by Tony Romm for WashingtonPost.com, 11 March 2024.

Pharmaceutical giants are mounting a vigorous legal battle against President Biden’s plan to lower seniors’ prescription drug costs, urging federal judges here and around the country to invalidate a new program that aims to reduce the price of medications for high blood pressure, heart disease, cancer, and diabetes.

In a flurry of lawsuits, these drugmakers have blasted the government initiative as unconstitutional, defended their pricing practices, and warned that regulation could undermine future cures — even as millions of older Americans say they are struggling to afford essential treatments.

The pharmaceutical industry specifically seeks to block a new law that enables Medicare to negotiate the price of select drugs under its prescription benefit, known as Part D. The idea is modeled after similar systems internationally, which have helped lower costs in other countries even as Americans face sky-high prices for some of the same treatments.

Read more: How Big Pharma is fighting Biden’s program to lower seniors’ drug costs

White House meets with UnitedHealth, industry groups on Change cyberattack fallout by Emily Olsen for HealthCareDive.com, 13 March 2024.

The cyberattack on Change, a technology firm owned by insurer UnitedHealth Group, has snarled the healthcare industry since it was first disclosed on Feb. 21. Providers have reported a range of challenges since the outage began, including problems receiving payment from patients and insurers, verifying coverage, submitting prior authorization requests and exchanging clinical records.

Cybersecurity has become a mounting challenge for the healthcare sector. In recent months, the HHS released its strategy to bolster cybersecurity in the industry. Regulators also put out voluntary safeguards for healthcare organizations. At the roundtable, Anne Neuberger, White House deputy national security advisor for cyber and emerging technologies, urged the sector to build resilience against attack by implementing the HHS’ voluntary cybersecurity performance goals, noting the “interconnectedness” of the healthcare industry. 

Read more: White House meets with UnitedHealth, industry groups on Change cyberattack fallout

Could an intervention as simple as eye drops treat eye damage in diabetes? by Corrie Pelc for MedicalNewsToday.com, 12 March 2024.

Data recently released from the new treatment’s phase 1b/2a trial reported it to be safe and tolerable, with 100% of participants completing the study. Additionally, researchers reported a significant decrease in central macular thickness after 85 days of use and inhibition of further increases in vascular leakage. The researchers will present the full results of the phase 1b/2a trial at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO) in May 2024.

According to Dr. Loic Lhuillier, chief operating officer of Exonate Ltd. — the manufacturer of the new eye drops — and presenting author of this study, new ways to treat diabetic retinopathy and diabetic macular edema are needed because the current standard of care for diabetic macular edema involves frequent injections of anti-VEGF agents in the eye, which, although efficacious, are uncomfortable and necessitate clinical time for the procedure. “There is a need for a noninvasive solution, which would improve [the] quality of life for these patients, by increasing patient comfort and, being self-administered, reducing inconvenience,” Dr. Lhuillier explained.

The new eye drop, called EXN407, is reportedly the first topical treatment for retinal vascular diseases such as diabetic retinopathy and diabetic macular edema. The eye drop is a small-molecule therapy using a serine-arginine protein kinase 1 (SRPK1) inhibitor.

“Development of diabetic eye disease is driven by many factors, mainly the overgrowth of blood vessels in the retina,” Dr. Lhuillier detailed. “These blood vessels then become leaky, leading to the appearance of subretinal edema, and ultimately blindness. This phenomenon is triggered by a growth factor called VEGF. EXN407 is a molecule that allows the re-balancing of VEGF by only inhibiting the disease-causing members of the family while leaving the non-disease-causing members intact,” he added. “It offers a more subtle approach than anti-VEGF agents, added to the convenience of being an eyedrop formulation vs injection.”

Read more: Could an intervention as simple as eye drops treat eye damage in diabetes?

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