Every year, over 10,000 scientists meet up at the American Diabetes Association’s Scientific Sessions to present their latest ground-breaking research findings. From once-weekly insulin to beta cell therapies and artificial intelligence-powered diabetes care, here are some of the most exciting developments making the headlines.
In this month's article:
- More manageable once-weekly insulin treatment for type 2 diabetes
- Promising results from beta cell therapy trials in type 1 diabetes
- Revolutionising diabetes care with Artificial Intelligence
- Swapping diet drinks for water doubles remission rate in women with type 2
- Insights into menstruation and managing diabetes
More manageable once-weekly insulin treatment for type 2 diabetes
Previous studies have shown that frequent insulin injections and dose adjustments can make managing type 2 diabetes with insulin therapy challenging.
Over time, missing doses can lead to dangerously high blood sugar levels and serious long-term health complications. This highlights the ongoing need for simpler, more manageable treatment options.
A large clinical trial led by US researchers tested a new insulin that could ease this burden by requiring just one injection per week instead of daily injections.
The study included 795 adults with type 2 diabetes who were starting basal insulin for the first time. Half the participants received once-weekly basal insulin (efsitora), while the other half received the standard once-daily basal insulin (glargine). Those on once-weekly insulin had their dose adjusted every four weeks using one of four fixed levels, depending on their blood sugar levels.
After one year, both treatments had similar effects on blood sugar levels. Average HbA1c levels dropped from around 66 mmol/mol (8%) to around 53 mmol/mol (7%), with fewer than one hypo event per person, on average. In addition, people taking once-weekly insulin required a lower total weekly insulin dose and fewer dose adjustments compared to those on daily insulin.
These findings suggest that for people with type 2 diabetes, once-weekly basal insulin injections could be an effective and safe alternative to daily basal insulin injections.
Next, the research team plans to seek approval for the use of efsitora in clinical practice from regulatory authorities. They hope this new option will ease the burden of insulin therapy for people with type 2 diabetes leading to better long-term health outcomes.
The findings were published in The New England Journal of Medicine.
Promising results from beta cell therapy trials in type 1 diabetes
Scientists have been looking for ways to replace the destroyed insulin-producing beta cells in people with type 1 diabetes with healthy new ones, so they could make their own insulin again.
One promising approach is to grow beta cells in the lab from stem cells - a special type of cell that can become almost any type of cell in the body.
Biotech company Vertex has been testing this idea in a clinical trial on their pioneering beta cell therapy, called VX-880 (also known as zimislecel). This treatment uses lab-grown beta cells derived from stem cells. Following their promising early results announced last year, Vertex presented full one-year outcomes from their trial at this year’s ADA meeting.
In the trial,12 people with type 1 diabetes and severe hypos received a one-time infusion of VX-880 cells into the liver, alongside immunosuppressive drugs to prevent rejection.
One year after receiving their treatment, all participants are producing their own insulin again, and none have experienced severe hypos. Everyone met the recommended blood sugar level targets of an HbA1c below 53 mmol/mol (7%) and with over 70% of time in range.
Ten of the 12 people no longer need to take insulin. Across the group, there was a 92% average reduction in insulin requirements.
No unexpected safety concerns were reported. The side effects seen so far were considered mild or moderate, and consistent with other islet transplant procedures and existing immunosuppressive therapies.
The Vertex team is now expanding recruitment to 50 participants worldwide by the end of 2025.
These results represent another encouraging step forward for beta cell therapies as a potential breakthrough treatment for type 1 diabetes, offering the possibility of restoring natural insulin production and reducing or eliminating the need for insulin therapy.
In the UK, the Type 1 Diabetes Grand Challenge is driving progress in this area, working to make sure these treatments reach people with type 1 sooner.
Revolutionising diabetes care with Artificial Intelligence
At this year’s ADA meeting, artificial intelligence (AI) was in the spotlight with its growing potential to transform diabetes diagnosis, care and treatment.
Researchers introduced a new AI tool designed to detect people at risk of developing type 1 diabetes, well before symptoms appear. The tool was developed using health records from nearly 90,000 people with type 1 diabetes and 2.5 million without.
By analysing patterns in these records, the AI tool was trained to spot differences and early warning signs that often appear long before a clinical type 1 diagnosis.
When tested on a large real-world population, the tool correctly identified 80% of those who later developed type 1 diabetes.
The study also revealed that 29% of people who developed type 1 diabetes had initially been misdiagnosed with type 2 diabetes or another condition. This likely delayed appropriate treatment and increased their risk of complications. AI could help close this gap by enabling early and accurate detection.
Research presented at the ADA meeting also demonstrated how AI-powered tools could potentially help prevent type 2 diabetes.
One study tested a fully automated diabetes prevention programme that uses AI through a mobile app, requiring no human coaching, and a smart body weight scale. Researchers recruited 370 adults with prediabetes who were living with overweight or obesity. Half took part in the AI-led programme, while the other half followed a traditional prevention programme run by people.
Similar results were seen across the two programmes - around 36% of participants in both groups met at least one of the study’s key prevention goals over 12 months. This included losing weight, becoming more active, and lowering their blood sugar levels, which can all risk the risk of of type 2 diabetes.
These results suggest that an AI-led programme can be just as effective as more traditional in-person programmes, offering a more scalable and accessible way to support people at risk of developing type 2 diabetes.
Swapping diet drinks for water doubles remission rate in women with type 2
Whilst diet drinks are calorie-free, they may affect the body differently to water. Research has shown potential links between their regular consumption and increased risks of conditions like type 2 diabetes, heart conditions, and obesity, although a direct cause-and-effect relationship has not yet been confirmed.
A team of researchers from the University of Nottingham investigated the effects of swapping diet drinks for water in women living with type 2 diabetes and obesity or overweight who regularly drank diet drinks and were enrolled onto a weight management programme.
The team randomly assigned 81 women to one of two groups. Over 18 months, one group replaced diet drinks with water, and the other group continued drinking diet drinks after lunch (five times a week).
By the end of the study, women who drank water had lost significantly more weight on average (around 6.8kg) than women in the diet drink group (around 4.9kg). Furthermore, 90% of participants in the water group went into diabetes remission compared to 45% in the diet drink group.
The study highlights the potential of water, as an alternative to low-calorie drinks, to support weight loss in women with type 2 diabetes. These findings need to be further explored in large-scale trials in diverse groups of people.
Insights into menstruation and managing diabetes
The menstrual cycle brings about hormonal changes that impact on blood sugar levels and insulin resistance in women living with diabetes.
This makes managing diabetes more challenging for many women both before and during the menstruation stage of the cycle - because insulin dosages must be adjusted throughout the month.
Links between blood sugar management and hormonal changes throughout the menstrual cycle remain largely understudied.
Researchers from San Francisco explored views about the effects of the menstruation stage of the menstrual cycle on managing diabetes in women living with diabetes in the US and Europe (686 and 899 people respectively).
Participants completed an online survey to assess how satisfied they were with their blood sugar level management, and whether they had discussed the impact of menstruation on managing their condition with healthcare professionals. They also provided feedback on changes they’d like to see happen in diabetes care.
Results revealed that few women were highly satisfied with their blood sugar level management. Across both the US and EU, over half of women in the study reported that managing their diabetes was harder during menstruation (and 60% of these women were living with type 1 diabetes).
Only 36% of women in the study had discussed the impact of menstruation on their diabetes management with a healthcare professional. Women were less likely to have had these conversations if they were living with type 2 diabetes, especially if they didn’t use insulin.
Many women in the study said that they lacked information on how menstruation-linked hormonal changes affect blood sugar levels and expressed a need for personalised diabetes technology that takes into account information about menstruation.
To tackle unmet gender-based needs in diabetes care, this research underscores the importance of recognising and managing the blood sugar fluctuations linked to menstruation, which could be addressed both in the support women receive from their diabetes teams and through the use of diabetes technology.
