News of the Center

Message from the Director

​

June 2022

 

Dear Friends,

 

There was big diabetes news even before the start of this year’s live and in-person gathering of the American Diabetes Association Scientific Sessions. Two FDA approval

announcements were made, one for the new medication called Mounjaro (Tirzepatide) a dual GIP + GLP-1 receptor agonist [See full report] and the new Libre 3 CGM sensor [See full report].  

 

The weight-loss reported in the Mounjaro and higher-dose Ozempic trials spurred the discussion at the ADA about shifting the focus of T2DM management from primarily glucose reduction to weight loss. However, both have always been important to me and are inseparable in the management of diabetes. What is news is that these newer agents can cause more weight loss and A1C reduction than ever before, which goes a long way in terms of reaching both goals

 

After two years of virtual conferences, the ADA meeting in New Orleans was followed by the Endocrinology Society meeting in Atlanta. It was great seeing friends and colleagues in person again at the meetings and I loved the opportunity to work with the T1D Fellows at the Endocrine Society pre-meeting. However, they were also “super spreader” events and many colleagues developed COVID afterwards even though all were vaccinated. Our team did not get sick, but we were sensible and wore masks indoors and ate meals outdoors (unlike most people) proving that following simple rules work.

 

The COVID induced pause in my busy travel schedule has allowed me to re-evaluate my need and desire for travel. Beyond the risks of COVID I like avoiding the disruption of travel and feeling jet lagged. Additionally I find I can do everything I need to do remotely, so I am very happy with a more limited travel schedule, except for my monthly long weekends in Montana. Besides, it gives me more time to see patients in clinic.

 

For the first time in my career, I have seen progress in terms of the prevention and treatment of type 1 diabetes. Earlier this year TrialNet published results of their trial with teplizumab showing a delay in the development in adult and children with high-risk of developing type 1 diabetes by two years and an extension of that trial is underway. Approval of teplizumab is under review by the FDA. There are real-world benefits of delaying the onset of type 1 diabetes, and the trial team is looking into the differences in the participants who responded to teplizumab better than others.

 

I was part of the Vertex team at the ADA who presented the results of the first stem cell-derived beta-cell transplants in two people with type 1 diabetes. Both were selected because they had life impacting recurring episodes of severe low blood sugar reactions. One was a 64-year-old man who had had type 1 diabetes for more than 40 years and now has an A1C level below 7% completely off insulin. The other participant was able to reduce her insulin use by 30% after the transplant and stopped having severe lows. However, the price is that they are taking immunosuppressive medications as part of the treatment, which have their own side effects. Currently this trial is on hold in the United States because the FDA has it under extra scrutiny for safety but is on-going in Canada. Now that we have proven we can make new beta-cells from stem cells many companies on working on ways to modify them so that they are not attacked by the immune system. Stay tuned for more exciting news in this area of diabetes research in the coming years.

 

I love hearing about new medications and tools to help people with diabetes, but access is also essential. With the help of generosity of donors and changes in state policies, many of my patients with type 1 diabetes in East LA now have access to sensors and we are even having success using automated insulin system pumps. These individuals still face many social and financial stressors, but we not surprisingly found that if you give people the right tools and the right resources, you can improve their outcomes. We received an incredibly generous multi-year grant from the Hankey Foundation which is allowing us to expand our work to treat patients with both type 1 and type 2 diabetes using remote continuous glucose monitoring. We hope to be able to prove benefit across a greater population of people who need it.

 

I’m now working on another project funded by the Helmsley Charitable Trust called Blue Circle Health which is a nonprofit organization started to create a model for providing free type 1 diabetes care for under-resourced patients diabetes around the country. The first sites for the program are in Florida, where we can use an existing Helmsley program utilizing trained health coaches. Once we implement the program there it can be expanded to other places.

 

Emergency COVID funding and donation support is welcome, but it is also tenuous. The generous support from our patients – big and small - helps to launch these programs and keeps them going over time. Please provide any support that you can. Here’s how to donate.

 

Thank you for being part of our Westside diabetes community.