Session Three: Innovating Beyond Glucose Control in Diabetes Care

This Sanofi sponsored symposium, titled ‘Evolving Standards and Innovation in Diabetes Care’, took place on 11th September 2017 as part of the 53rd Annual Meeting of the European Association for the Study of Diabetes (EASD) in Lisbon, Portugal

Symposium Chair: Elizabeth Seaquist1
Session Chair: Thomas Danne2
Speakers: Dirk Müller-Wieland,3 Lawrence A. Leiter,4 Anne Peters,5 Boris Kovatchev,6 David Kerr7

1. University of Minnesota, Minneapolis, Minnesota, USA
2. Bult Diabetes Centre for Children and Adolescents, Hannover, Germany
3. Clinical Research Center, Department of Medicine, University Hospital Aachen, Aachen, Germany
4. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, Toronto, Canada
5. Keck School of Medicine, University of Southern California, California, USA
6. Center for Diabetes Technology, University of Virginia, Charlottesville, Virginia, USA
7. William Sansum Diabetes Center, Santa Barbara, California, USA

Disclosure: Elizabeth Seaquist has been a consultant for, advisor for, or received honoraria from the American Board of Internal Medicine, American Diabetes Association, Eli Lilly, Endocrine Society, Locemia, Novo Nordisk, and Zucera. She has received research support from Eli Lilly, Juvenile Diabetes Research Foundation and the National Institutes of Health, and has received travel/speaker reimbursement from the American Board of Internal Medicine, American Diabetes Association, Eli Lilly, Endocrine Society, National Institutes of Health, and Novo Nordisk. Thomas Danne has undertaken speaking engagements, participated in advisory boards, and received research support from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, DexCom, Eli Lilly, Johnson & Johnson, Lexicon, Medtronic, Novo Nordisk, Roche, Sanofi, Unomedical, and Ypsomed. He is also on the Board of Directors and has stock options/holdings for DreaMed Ltd. Dirk Müller-Wieland is part of the Speaker Bureau for Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, MSD, Novartis, Novo Nordisk, and Sanofi. He has also been a consultant and participated in advisory boards for Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, MSD, Novartis, Novo Nordisk, and Sanofi. Lawrence A. Leiter has received research grants from Amgen, AstraZeneca, Eli Lilly, Esperion, Kowa, Merck, Regeneron, The Medicines Company, and Sanofi. He has also been a consultant for Amgen, AstraZeneca, Eli Lilly, Merck, Regeneron, and Sanofi. Anne Peters has been a consultant, participated in advisory boards, and undertaken speaker engagements for Abbott Diabetes Care, Becton Dickinson, Bigfoot, Boehringer Ingelheim, Dexcom, Eli Lilly, Janssen, Lexicon, Livongo, Medscape, Merck, Novo Nordisk, Omada Health, Sanofi, and Science 37. Boris Kovatchev has been a consultant, participated in advisory boards, and undertaken speaker engagements for Dexcom and Sanofi. He has received research support (managed by the University of Virginia) from Dexcom, Roche Diagnostics, and Tandem Diabetes Care. He co-founded and has shareholdings in TypeZero Technologies. Patents and patent applications related to diabetes technology are managed by the University of Virginia Licensing and Ventures group. David Kerr is a Medical Advisor to Glooko and Vicentra. He has received research funding from Eli Lilly, Abbott Diabetes Care, Dexcom, and Sanofi and has consultancy agreements with Novo Nordisk and Becton Dickinson.
Acknowledgements: Writing assistance was provided by Dr Lisa Michel, Ashfield Healthcare Communications Ltd., London, UK.
Support: The publication of this article was funded by Sanofi. The views and opinions expressed are those of the speakers and not necessarily of Sanofi.
Citation: EMJ Diabet. 2017;5[1]:56-69.

Meeting Summary

Advances in treatment offerings are moving beyond classical considerations around glucose control to focus on other aspects of the disease. Such advances include the development of treatments that address the high cardiovascular (CV) risk in patients with diabetes, or have novel mechanisms of action, and new technologies that will facilitate the future integration of care.

The proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors represent a new therapeutic approach for managing CV risk in patients with diabetes. New clinical data recently generated from dedicated diabetes studies have established PCSK9 inhibitors as an efficacious and well-tolerated treatment option for patients with diabetes and persistently elevated low-density lipoprotein-cholesterol levels, despite optimised lipid-lowering therapy.

Treatments with novel mechanisms of action are also being investigated. Sotagliflozin, a dual inhibitor of the sodium-glucose cotransporter 1 (SGLT1) and sodium-glucose cotransporter 2 (SGLT2), may offer additional clinical benefits beyond those of existing selective SGLT2 inhibitors in patients with Type 1 diabetes mellitus. The sotagliflozin inTandem Phase III programme will provide valuable insights regarding the potential role of dual SGLT1 and SGLT2 inhibitors as an adjunct to insulin therapy in patients with Type 1 diabetes mellitus.

Furthermore, advances in diabetes devices, such as implantable drug delivery systems, non-invasive glucose monitoring, and closed-loop artificial pancreas systems, are fuelling the development of new models of patient care. While there will inevitably be other innovations, three major advances will dramatically change diabetes care over the next 10–20 years: 1) digital diabetes health technologies, 2) artificial intelligence and machine learning, and 3) virtual reality.

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