Silly Superlatives: ADA’s Scientific Sessions 2011

by Elizabeth Snouffer on 06/28/2011

This past week, dozens of news reports have been posted on the web every 12 hours or so with breaking news (or not) on which new, second generation or rejected and discarded diabetes products are making waves at the Scientific Sessions.  Additionally, highlights from promising studies and research have exploded or teetered out on the scene.   What follows is the best superlatives from this graduating ADA Scientific Sessions class of 2011.

Every class has a "most likely to succeed" candidate

Most Likely to Break the Rules – Dr. Denise Faustman
(or Most Awe Inspiring Scientific Study and Whistle Blower Extraordinaire)

Dr. Denise Faustman, director of the Massachusetts General Hospital Immuno-biology Laboratory, presented two abstracts from a clinical trial funded by the Boston-based Iacocca Family Foundation at this past week’s Scientific Sessions,  which showed that low doses of an 80-year-old tuberculosis vaccine (Called BCG, and now available generically) temporarily reversed type 1 diabetes in a Phase 1 human trial.   BCG induces the immune system to make tumor-necrosis factor, which kills the T-cells that cause the pancreas to stop producing insulin.  Here’s more:

Faustman’s team went to Iacocca’s foundation for funding after repeatedly having the door slammed in their faces by drug companies. The MGH scientists had plenty of animal studies showing that it was possible to regenerate the pancreas, and therefore restore insulin production in diabetes models. But when MGH went to the pharmaceutical industry looking for funding to research a pancreas-regenerating drug, “everyone said,

‘You’re reversing the disease. How are we going to make money?’ ’’ Faustman says.

Faustman cautions that the drug is not a cure … yet, and BCG doesn’t reverse diabetes permanently.  Still it gives a satisfyingly “Gotcha” to big Pharma, and hope for patients.  Thank you, Dr. Faustman.

“Thinks they are” Most Likely to Succeed – Bariatric Surgeons everywhere

Several studies have found that starvation diets and weight-loss surgery can reverse type 2 diabetes,  but researchers are still trying to figure out why bariatric surgery (also called gastric bypass) works.   This was the focus of discussions taking place last Friday, 24th June, at the Scientific Sessions.

A recent report in the Archives of Surgery found that more than 80 percent of gastric bypass patients came off their diabetes medication, sometimes just days after surgery (Reuters).  Lee M. Kaplan, MD, PhD, director of the obesity research center at Massachusetts General Hospital in Boston says that physiological changes associated with weight loss surgery, such as changes in gut hormones, are the key to reversing diabetes, not reduction in caloric intake. Even more supportive of surgical procedures related to diabetes and obesity beyond successful outcomes, is cost.  A person diagnosed at age 50 can expect to spend $172,000, the equivalent of seven gastric bypass procedures, on the condition. Shocking.

Bariatric surgeons must be full of attitude these days – and why not, with the potential for 200 million + lives saved from the complications of diabetes, these surgeons stand to become the real heroes of the day, curing T2 diabetes, eliminating obesity and saving billions of dollars.  Maybe.

Class Clown – Wal-Mart

Wal-mart was a top performer in this category because recent revelations mark their strategies as comically superficial. Here is what they did: Wal-Mart started offering generic drugs for $4 a prescription in 2006, which is incredibly great for those who can use generics to manage their diabetes regimen.  Or was it?

It was purely a lure.

Dr. Ronald Tamler, an endocrinologist for the Mount Sinai Medical Center in NYC, co-authored a price study which looked at how the “differential between pharmacy prices for generic diabetes drugs fell 60 percent between 2008 and 2010, compared with an increase of 113 percent for brand-name drugs.” Wal-mart has substantially reduced generic drug prices by a significant amount and all other retailers followed suit.  However, Wal-Mart and another super-store, K-Mart,  have also simultaneously increased brand name drugs for diabetes at an alarming rate (32-35%) and their guise of goodness is finally showing cracks.  Big name retailers – stop clowning … note to patients, shop around!  Don’t be fooled by the 2 for 1 big packs of detergent  – brand medications will always cost you more with these retailers!

Most Optimistic – Tie, GAD Research (Diamyd and Trial-Net); the Artificial Pancreas Project

The goal was to see if a vaccine fortified with GAD-alum would preserve insulin production in recent-onset type 1 diabetes.  You know when the quote on a scientific study says, “an important step in research toward future interventions” it really is code for a failed attempt.  For Dr. Wherrett and Dr. Skyler (Wherrett DK, et al “Antigen-based therapy with glutamic acid decarboxylase (GAD) vaccine in patients with recent-onset type 1 diabetes: a randomized double-blind trial” Lancet 2011; DOI: 10.1016/S0140- 6736(11)60895-7.), it must have been a hard day reporting that their study had no effects whatsoever, and fortunately no side effects either.
“Although antigen-based therapy is a highly desirable treatment and is effective in animal models, translation to human autoimmune disease remains a challenge,” they wrote.

The ADA Scientific Sessions and announcements related to the Artificial pancreas were pretty much a non-event.  I don’t know if you noticed but there was nothing published by any media outlet on news related to the closed loop system.  Geez, has it really been that quiet in the lab, or does this silence smack of industry protection, in case a competitor learns too much?  Well … either something is afoot and we’re not allowed to know or the project is in neutral gear and neither of these two positions feels good.  The only news I could find reported from San Diego is one, the Mayo Clinic is now going to develop an artificial pancreas, too and two, the already previously released news that the FDA “wants the technology just as much as patients” and for this very reason, has drafted guidance for closed loop systems which will be available by year-end.  I guess that’s considered fast-tracking “draft” guidance papers.  Ho-hum.

Later this week, interpreting results and getting a closer look at the event from my friend and braniac, Scott King, who attended multiple San Diego sessions.  Watch this space.

 

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