LONDON, UK (GlobalData), 6 June 2012 - The 72nd Annual American Diabetes Association (ADA) Scientific Sessions is set to kick off on Friday, June 8th, 2012. The conference is designed to give healthcare workers, physicians, and researchers an opportunity to learn about the most recent advances in the diabetes landscape. Presenters include renowned scientists, clinical researchers, and industry leaders like Novo Nordisk and Amylin.
At this year’s Sessions, Novartis is set to present about mitigating micro and macrovascular risk in Type-2 Diabetes patients; Vision2Voice/Abbott Diabetes Care will introduce their FreeStyle InsuLinx; MediKinetics/Amylin Pharmaceuticals will give a presentation on improving efficacy, adherence, and weight in Type-2 Diabetics taking GLP-1 receptor agonists; and Novo Nordisk will talk about the roles and differences between GLP-1 and DPP-4 in Type-2 Diabetics.
Along with corporate presentations, there will also be many new abstracts being presented at this year’s ADA meeting. The topics range from “Resting-State Brain Functional Connectivity Is Altered in Type 2 Diabetes,” to “Transient Receptor Potential Vanilloid 1 Activation Enhances Gut Glucagon-Like Peptide-1 Secretion and Improves Glucose Homeostasis,” and “Famine Exposure in the Young and the Risk of Type 2 Diabetes in Adulthood”.
Another interesting abstract not to be missed is a presentation from Oramed Pharmaceuticals, who will be presenting about a combination oral insulin and oral exenatide capsule (ORMD-0901). This capsule was shown to significantly improve the regulation of blood glucose levels in pigs prior to food intake, when results were compared to separate administration of each therapy.
New to this year’s meeting will be breakout sessions known as “Ask the Experts,” where the ADA will host expert question-and-answer sessions on various “hot topics” in the diabetes space. One such topic that will likely create some interest is the discussion with David G. Armstrong, DPM, MD, PhD, labeled “The Diabetic Foot–A Marriage of Team, Technology, and Tenacity.” Dr. Armstrong is a Professor of Surgery at the University of Arizona, Southern Arizona Limb Salvage Alliance, and has authored or co-authored over 325 peer-reviewed manuscripts, mainly focusing on the prevention of limb amputation in diabetics.
Dr. Armstrong will likely discuss his recent paper in the journal Wound Repair and Regeneration, titled “Comparative effectiveness of mechanically and electrically powered negative pressure wound therapy devices: A multicenter randomized controlled trial.” This paper evaluates a 16-week study where patients with non-infected, non-ischemic, non-plantar wounds were treated with either a mechanically powered Smart Negative Pressure (SNaP) Wound Care System or a Vacuum Assisted Closure (VAC) Wound Care System to see which platform had greater efficacy. The trial concluded that both systems were equally effective.
This “Ask the Expert” session will be particularly interesting because of the astounding statistics behind diabetic foot conditions. According to GlobalData, 15% of the 24 million Americans with diabetes will develop a diabetic skin ulcer in their lifetime; 14-24% of these cases will result in amputation. Each year there are 1.3 million new cases of diabetic foot ulceration, and the 3-5 year mortality rate for diabetic amputee patients is 50%. In a study by Gibbons et al. it was reported that diabetic patients with one amputated limb due to ulceration had a 58% chance of developing an ulcer on the contralateral limb within 18 months, and a 50% chance of contralateral limb amputation within 3-5 years. Therefore, any progress in the diabetes care market will have a significant impact on the quality of life enjoyed by an enormous patient population.
Another hot topic to watch for will be the duel presentation from Timothy S. Kern, PhD, and George M. King, MD, titled “Microvascular Complications.” Dr. Kern is a Professor of Medicine and Ophthalmology at Case Western School of Medicine and specializes in microvascular lesions in the retina. Dr. King is a Professor of Medicine at the Harvard School of Medicine and Chief Scientific Officer at the Joslin Diabetes Center. The two published a paper in 2009 in Nature Medicine titled “Activation of PKC-delta and SHP-1 by hyperglycemia causes vascular cell apoptosis and diabetic retinopathy.”
A link between hyperglycemia and peripheral vascular disease is made in the paper by Dr. King and Dr. Kern, who state, “These findings elucidate a new signaling pathway by which hyperglycemia can induce PDGF (platelet derived growth factor) resistance and increase vascular cell apoptosis to cause diabetic vascular complications.” The paper goes on to explain that these effects were not reversible after blood glucose levels were stabilized with insulin. This observation can be applied to other conditions such as cellular apoptosis in lower extremities resulting in diabetic ulcers. In Bojanowski et al (2006) from the journal Wound Repair and Regeneration, researchers looked at stimulating angiogenesis, a key component of wound healing, in transplanted human skin mouse models through a plant extract known as SBD.4. They found that this extract was able to stimulate vascular formation within the model. Because diabetic skin and foot conditions are derived from peripheral vascular disease, where blood vessels die due to cellular apoptosis as described in the King and Kern paper, therapies that stimulate blood vessel growth have the potential to counteract or potentially prevent downstream ulceration and amputation in diabetics. Given the market size of $1.6 billion, a patient population of 3.6 million individuals who are affected with lower extremity ulceration, and those that require amputation (436,000-864,000), there is a clear unmet need for a therapeutic paradigm that could infinitely change the diabetic treatment landscape. Furthermore, the market size will grow significantly if ulcer prevention is included in these numbers. There are no current therapeutics that stimulate angiogenesis for diabetic conditions, and according to clinicaltrials.gov, only one study so far has looked at stimulating vascular formation for diabetic conditions. The National Taiwan University Hospital conducted a study looking at Fractalkine, a CX3C Chemokine, as a mediator for angiogenesis. If a manufacturer could create a product that prevents or even reverses the effects of microvascular apoptosis to prevent ulceration, they could create a market that would be not only lucrative, but save countless lives.
*The 72nd American Diabetes Association Scientific Sessions Set to Commence June 8th
This expert insight was written by GlobalData’s senior healthcare analyst for cardiovasular and metabolic disorders, Michael Leibfried. If you would like an analyst comment or to arrange an interview, please contact us on the details below.
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