The American Diabetes Association 2001 Scientific Sessions were held in Philadelphia in June 2001 and offered an opportunity to learn about the latest in diabetes research, meet with researchers and clinicians, and meet with industry representatives. Children with Diabetes had a small exhibit to show our web site to the thousands of people who attended from all over the world. Below is our report about some of the activities at the Scientific Sessions.
Research and Poster Presentations
- Injected Insulin Fails to Prevent Type 1 Diabetes.
- New Data Presented At American Diabetes Association Meeting Suggests Promising Role For Glucowatch® Biographer In Pediatric Care.
- Study Released At American Diabetes Association Meeting Documents Glucowatch® Biographer's Role In Detection Of Postprandial Hyperglycemia.
- Postprandial Glucose Excursions Following Four Methods of Bolus Insulin Administration Using an Insulin Pump
Peter Chase, Safleh Z. Saib, Todd Mackenzie, Michelle Hansen and Satish K. Garg
This study compared four types of bolus administration to determine the optimum method for dealing with a high carbohydrate, high fat meal (pizza, tiramisu, and regular Pepsi Cola). All test subjects used the MiniMed 508 insulin pump with Humalog insulin. Bolus methods compared were:
- single bolus (100% bolus 10 minutes before meal),
- two insulin boluses (50% 10 minutes before meal, 50% 90 minutes later),
- square wave (100% starting 10 minutes before meal and continuing for two hours), and
- 70% given 10 minutes before meal, 30% as square wave for two hours ("dual wave")
In this study, the "dual wave" (option d) resulted in the best control as measured by blood glucose levels at 90 and 120 minutes after eating. Hypoglycemia (< 60 mg/dl) was also least frequent when the "dual wave" was used.
- Better Glycemic Control and Reduced Need for Cesarean Sections with Insulin Lispro Treated Pregnancies in Type 1 Diabetes
Satish K. Garg, Sunitha Anil, Peter Gottlieb, Todd MacKenzie, William E. Jackson
Barbara Davis Center for Childhood Diabetes
Ninety-three pregnancies were followed during this study, 33 using human regular insulin and 60 using insulin lispro. The insulin lispro treated group showed significantly lower HbA1c values throughout pregnancy, had significantly fewer severe hypoglycemic episodes, had significantly longer gestation periods with significantly higher infant birth weights, and had a significantly lower rate of cesarean section. Of equal importance, there was no significant difference in the number of severe congenital abnormalities or progression of diabetic retinopathy or nephropathy between the two groups.
- Type 1 Diabetes and Cow Milk in Sardinia: Beta Casein Variant Consumption
Anna Casu, Manlio Fadda, Gian Franco Bottazzo, Robert B Elliot, Marco Songini
This study investigated the possible role of consumption of beta casein A1-B towards the incidence of type 1 diabetes in Sardinia, which has the highest incidence of type 1 diabetes in the world. The team examined data from 1989 through 1998 and found that the beta casein A1-B variants do not seem to play a major role in the development of type 1 diabetes in Sardinia.
- Reduced Hypoglycemia with Insulin Aspart in Type 1 Diabetic Patients
Simon Heller, Stephen Colagiuri, Stein Vaaler, Bruce H.R. Wolffenbuttel, Klaus Kølendorf, Hans F. Friberg, Kristian Windfield, Karsten Søndergaard, and Anders Lindholm
This double-blind, randomized crossover trial showed that, in a basal-bolus regimen using NPH as the basal insulin, insulin aspart significantly reduced rate of severe nocturnal hypoglycemia by 72% compared with regular human insulin; that mild hypoglycemic episodes were significantly fewer with insulin aspart; and that the reductions in hypoglycemia were achieved while maintaining glycemic control.
- Insulin Aspart Efficacy and Safety Compared to Buffered Regular Insulin (Velosulin®) and Insulin Lispro for Continuous Subcutaneous Insulin Infusion
Bruce Bode, Richard Weinstein, David Bell, Janet McGill, Daniel nadeau, Philip Raskin, Jaime Davidson, Dennis Kim, Rickey Reinhardt
This study examined subjects with Type 1 diabetes from 13 cities in the US for 16 weeks. Subjects were required to use a pump and provide their own pump for the trial. A total of 132 out of 146 subjects completed the study. Data from the study included:
- More subjects using insulin aspart reported no nocturnal hypoglycemia than those using insulin lispro or buffered regular (41% vs. 25% and 20%, respectively)
- Subjects in all treatment groups entered the study in good control and maintained good control throughout
- Blood glucose levels after meals tended to be lower for users of insulin aspart compared with users of buffered regular
- Insulin aspart was shown to be safe and effective for use in an insulin pump
- Lower Fasting Blood Glucose (FBG) and Less Symptomatic Hypoglycemia with QD Insulin Glargine (Lantus) Compared to BID NPH Insulin in Subjects with Type 1 Diabetes
Kenneth Hershon, Tom Blevins, David Donley, and Christy Littlejohn
A total of 394 subjects with Type 1 diabetes were treated with either Lantus (n=195) or NPH (n=199) for up to 28 weeks. The study concluded that once-daily Lantus is similar to twice-daily NPH in lowering blood sugar levels, that Lantus users reported significantly fewer episodes of hypoglycemia compared to NPH users, and that Lantus achieved significantly lower fasting blood sugar levels than NPH.
- Oral Spray Insulin In Patients With Type 1 Diabetes and Residual Beta Cell Function
MG Cavallo, G Coppolino, S Romeo, P Modi, and P Pozzilli
This poster reported on a study of Oralin, a new oral spray insulin that is absorbed in the mouth, and its effect on blood glucose levels in patients with Type 1 diabetes who still had some beta cell function as measured by c-peptide levels. The study showed that, in these patients, Oralin was as effective as regular insulin in controlling blood sugar levels.
- Contact Lens Glucose Sensor
Ciba showed two posters about a novel contact lens glucose sensor under development. Image One shows how the sensor works [1000 x 799 pixels, white spots are reflections of light from the poster]. Basically, a special polymer, embedded within the contact lens, responds to reflected light differently depending upon the concentration of glucose in the tears. A special device is held in front of the eye to measure the glucose. Image Two [1000 x 719 pixels, white spots are reflections of light from the poster] shows the slight time delay found in tear glucose levels compared with blood glucose levels.
New and Updated Products
Companies that make products for people with diabetes often introduce new and updated products at the ADA conference. Here are a few selected highlights:
1. MiniMed showed their new Paradigm insulin pump, which will replace the 508. The Paradigm is smaller than the 508 and offers several new features, including being waterproof and using a single AAA battery. MiniMed also showed their infusion set insertion tools, including the Sil-SerterTM for inserting the popular Silhouette infusion set. Finally, they showed a new book called Optimal Pumping, a 92-page paperback book that offers excellent information and tips for anyone using an insulin pump, even from other pump makers.
Poster showing the new Paradigm pump, compared to a 508
Poster showing insertion set tools
MiniMed's new pumping book
2. LifeScan and Novo Nordisk both showed a new product called the InDuoTM, which combines LifeScan's ONE TOUCH Ultra glucose meter with Novo's Innovo® insulin delivery system to produce the world's first combined insulin doser and blood glucose monitor. The insulin delivery part has a memory that recalls the last dose and elapsed time since the dose, and uses PenFill® 3mL insulin cartridges with either NovoLog® (insulin aspart) or Novolin® insulin. US availability is expected in fall 2001.
The InDuo showing a blood glucose reading, in mmol/l
The InDuo showing the insulin doser being removed
3. Novo Nordisk also showed their new NovoPen Junior, which is made from metal to stand up to the use and abuse of kids. The NovoPen Junior offers half-unit dosing and uses PenFill® 3mL insulin cartridges, including the new fast acting NovoLog® (insulin aspart). The NovoPen Junior is not yet available in the US.
The NovoPen Junior is a new pen aimed at kids
The NovoPen Junior offers half-unit dosing
4. Therasense showed a version of their FreeStyle meter mated to a Handspring Visor PDA. This innovative product is simply a FreeStyle meter that has been re-engineered to fit into the accessory module of the Visor. A comprehensive diabetes management program runs on the Visor and records blood glucose and other data to help you in your diabetes care. This product has not yet been approved by the FDA.
The FreeStyle-Visor combination was quite a hit
5. Metrika introduced their "A1c Now" product, a small, disposable A1c tester. The A1c Now takes just a drop of blood and produces a reading in eight minutes. The A1c Now is CLIA waived and cleared for patient home use with a prescription. The company is working on getting FDA approval to market it directly to consumers without a prescription. Until then, you can have your doctor write you a prescription and test your A1c conveniently in your home. After testing, the A1c Now displays the test result for about a week.
The A1c Now by Metrika
Other Links About ADA 2001
- Official ADA site for the 2001 Scientific Sessions
- Medscape news from the 61st Scientific Sessions (free Medscape membership required)
- Success, setbacks on diabetes front (MSNBC)
Posted June 30, 2001
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