ADA 2021

Summaried highlights from the American Diabetes Association 81st Scientific Sessions held virtually June 25-29, 2021.

GLP-1 signaling is powerful target for obesity

Presenters: Melanie J. Davies, CBE, FMedSci, Robert F. Kushner, MD, John Wilding, DM, and Lee M. Kaplan, MD, PhD

Semaglutide, 2.4 mg/week, was approved for weight management by the U.S. Food and Drug Administration on June 4, 2021. Per the FDA approval, it is indicated as an adjunct to diet and exercise in adults with obesity (initial body mass index [BMI] ≥30 kg/m2) or overweight (BMI ≥27 kg/m2) with at least one weight-related comorbidity. The approval was based on the phase 3a STEP program, which was the subject of a symposium.

Fructose metabolism is key to development of metabolic disease

Presenters: Kathryn E. Wellen, PhD, Cholsoon Jang, PhD, Michael Karin, MD, and Mark A. Herman, MD

Fructose consumption has been increasing over the past several decades and has been linked to increasing rates of several metabolic diseases in addition to hepatocellular carcinoma (HCC). Fructose metabolism was the focus of a symposium in which four presenters summarized the current knowledge with respect to the role of excess fructose consumption in metabolic disease.

Combinations exert synergy in glucose control and beyond in type 2 diabetes

Presenters: Ralph A. DeFronzo, MD, Chantal Mathieu, MD, PhD, Tina Visbøll, MD, DMSc, and David D’Alessio, MD

Glucose-lowering combinations for type 2 diabetes mellitus should take advantage of complementary mechanisms of action to improve glucose control while minimizing the risk of hypoglycemia and reducing the rate of adverse cardiovascular and renal outcomes, said speakers during a therapeutics symposium.

Efforts ongoing to prevent diabetes in vulnerable populations

Presenters: O. Kenrik Duru, MD, Gia E. Rutledge, MPH, and Yvette Roubideaux, MD, MPH

The challenges and opportunities of implementing the National Diabetes Prevention Program (DPP) in vulnerable populations was the focus of a special symposium.

Carb counting for bolus insulin dosing: Consider fat and protein content of diet as well

Presenters: Becky Sulik, RDN, CDCES, LD, Kirstine Bell, APD, CDE, PhD, Holly Willis, PhD, RDN, LD, and Bruce A. Buckingham, MD

Carbohydrate counting is an approach used for bolus insulin decision-making. It can be complex and burdensome. The utility of carbohydrate counting with evolving insulin delivery technologies was the subject of a clinical nutrition symposium.

Should SGLT2 inhibitors and GLP-1 receptor agonists be initiated in the hospital?

Presenters: Sandeep Das, MD, and Jennifer B. Green, MD

The inpatient cardiovascular care setting is an opportunity to initiate SGLT2 inhibitors and GLP-1 receptor agonists, both of which have demonstrated efficacy in reducing the rate of major adverse cardiac events (MACE) in patients with type 2 diabetes. But should they be started in acutely ill inpatients to improve cardiovascular outcomes, which would be an extrapolation of existing data?