In June, thousands of diabetes scientists from around the world gathered in New Orleans for the American Diabetes Association (ADA) Scientific Meeting. Here are some of their updates.
In this month's article:
- CGM could benefit more people with type 2 diabetes
- A new way of protecting cell transplants
- New type 2 diabetes drugs shows promise in head-to-head trials
CGM could benefit more people with type 2 diabetes
Results from a first-of-its-kind trial suggest that continuous glucose monitors (CGMs) could help a wider group of people living with type 2 diabetes.
Earlier this year, the UK-based FreeDM2 trial provided important new evidence about the benefits of CGM for people with type 2 using basal (long-acting) insulin.
Now, findings from the CONNECT trial, presented at ADA, suggest these benefits could extend to people with type 2 who aren’t using insulin.
CONNECT is the first large, high‑quality study of CGM in people with type 2 diabetes not treated with insulin. It involved 283 adults who started with HbA1c levels of 7.5% or higher. They were randomly assigned to use a CGM device or continue with standard finger‑prick checks.
After six months, people using CGM reduced their HbA1c by an average of 18 mmol/mol. This was around 10 mmol/mol greater than the improvement seen in people receiving routine care. They also spent around five extra hours each day in their target blood sugar range.
Importantly, more than 8 in 10 people using CGM saw a clinically meaningful reduction in their blood sugar levels, which is associated with a lower risk of diabetes complications.
People using CGM also reported greater treatment satisfaction and less diabetes distress than those receiving routine care.
Researchers say these findings provide the strongest evidence to date that CGM can benefit people with type 2 diabetes who are not using insulin, and could help shape future guidance on access to diabetes technology. A further six-month extension of the study is now underway to investigate whether these benefits can be maintained over the longer term.
A new way of protecting cell transplants
At ADA, researchers from the Eledon trial shared their latest findings, and the results remain promising.
The Eledon trial is testing a new drug, called tegoprubart, alongside islet cell transplants in people with type 1 diabetes.
Islet cell transplants are an existing treatment available to a limited group of people with type 1 diabetes. They involve transplanting insulin-producing cells from a donor pancreas to help someone with type 1 make their own insulin. But because the cells come from another person, the immune system recognises them as foreign and tries to destroy them.
To prevent this, people currently need immunosuppressing drugs. But these can cause serious side effects and may even be harmful to the transplanted cells themselves.
Tegoprubart works differently. Instead of broadly suppressing the immune system, it blocks a specific immune pathway involved in transplant rejection. Researchers hope this more targeted approach could protect transplanted cells while avoiding some of the side effects associated with current drugs.
The trial, led by researchers at the University of Chicago Medicine, has now enrolled 12 adults with type 1 diabetes. Before their transplant, participants had an average HbA1c of around 64 mmol/mol (8.0%).
The latest results revealed that all 12 participants were producing insulin on their own and were able to stop insulin therapy after their transplant. Their most recent average HbA1c was around 36 mmol/mol (5.4%).
The transplanted islet cells also appear to be continuing to work well, with some participants now being followed for almost two years after their transplant.
As seen in the earlier results, there were no signs of serious side effects that are commonly associated with standard immunosuppressive drugs.
Islet transplants can be life-changing, but the need for long-term immunosuppression limits who can benefit from them. These latest findings suggest that tegoprubart could offer a safer way to protect transplanted insulin-producing cells, potentially making islet transplantation an option for more people with type 1 diabetes.
These are still early results from a small study, so larger trials will be needed to confirm tegoprubart's safety and effectiveness. But the findings add to growing excitement around beta cell therapies to free people from insulin.
Our Type 1 Diabetes Grand Challenge researchers are working to drive innovative and speed up progress in this field.
New type 2 diabetes drugs show promise in head‑to‑head trials
A wave of new medications continues to reshape how type 2 diabetes is treated. At ADA, results from large, international clinical trials put a new GLP-1 agonist tablet treatment, orforglipron, head‑to‑head against existing type 2 drugs.
In the ACHIEVE‑2 trial, almost 1,000 adults with type 2 diabetes were randomly assigned to different doses of orforglipron or the SGLT2 inhibitor dapagliflozin, and followed for 40 weeks. Across all doses, orforglipron led to greater reductions in HbA1c than dapagliflozin. Participants taking orforglipron also lost more weight, with the highest dose leading to average weight loss of almost 8% of body weight.
A second trial, ACHIEVE‑3, compared orforglipron with the tablet form of semaglutide, and again found larger reductions in HbA1c with the new drug.
Alongside this, researchers explored even newer approaches. A trial involving 262 people with type 2 tested zenagamtide, a new drug that targets two hormone pathways at once (GLP‑1 and amylin). Over 36 weeks, people taking the drug saw significant improvements in both HbA1c and body weight.
These studies show how quickly the type 2 diabetes treatment landscape is evolving.
