Not all diabetes conferences are the same. They range from being focused on technology, to those aimed at health care professionals (HCPs), through to the highly scientific ones. These days there are even ones just for the people living with diabetes (PWDs). You might think that the people living with the condition should be attending the other types of conferences, and in my opinion you would be absolutely right. However, the rules and laws around industry being able to talk to PWDs directly about their products vary between countries and are often very strict which puts challenges that (again in my opinion) should never become obstacles to them being able to attend.
Having been extremely fortunate in the past few years, I have attended several conferences either as a blogger or speaker, and they all have one thing in common. They are busy. REALLY busy! Industry and HCPs from around the globe descend on one location for 3 days to learn as much as possible about new technologies, therapies and research. They also use the opportunity to meet with colleagues and peers that they only see once or twice a year face to face. Industry symposia and scientific program sessions run in parallel and one after another for the entire event. On top of that, there are the exhibition and poster halls which are packed with additional research and supporting information about products and companies.
So, how does one Grumpy old bloke with diabetes cover all of these sessions on his own in order to report it back to those who are not able to go? Simple answer is that I can’t. So I’m about to try and summarise the main topics of discussion and provide an idea of my highlights.
I covered the exhibition in my post for Day 2 of the conference which can be found below this one, if you haven’t read it and are interested.
Posters are just that. Posters of information from things like research projects that summarise their findings. Usually there are vast numbers of them lined up in a hall, each with a number identifying them and they are listed in the Program Book. I’ve often found myself lost in the maze of posters wishing that I had Sat Nav to find my way out. This year at ATTD there were some e-Posters where they were displayed on large screens. I think this is a great idea and could be more widely used to save us losing our favourite HCP in the poster maze forever…
The industry symposia are often about new products that will be available soon, or the next generation of an existing one. Accuracy is always a main focus for any BG meter or CGM/Flash system, but I personally wonder whether there is a line of useful accuracy and if, or when, we will pass it. I guess my analogy for this would be, if the speedometer on my car reads accurately to 0.1 of a mile per hour but my accelerator pedal only lets me contain the cars speed by 1.0 mile per hour, what is the point in employing such an accurate speedometer? With my BG meter, CGM or Flash system being the speedometer and my insulin delivery system being my accelerator. I still believe accuracy is important, but I wonder also at what point the R&D budget should stop being spent on finessing the product and be used to develop it so that it is cheaper to manufacture, reducing the cost to PWDs. Is it better to have the perfect product for the few, or an extremely good one for the many?
I am starting to see a change in the industry symposia though. It feels that the advances in technology are slowing down a bit. There are fewer new and shiny devices coming out and this seems to be driving some of the discussions more towards how the technologies can actually be used to improve outcomes and quality of life for the PWDs that are using them.
Also, there is more discussion about how best to use the different technologies together and make sure they complement each other rather than one technology being there to replace another. For me this is hugely important. The majority of PWDs globally do not have access to a lot of this equipment and we should be looking to ensure that the management of their diabetes is not disadvantaged by the fact that they just happen to be born in a different country, district or postcode than someone more fortunate.
The subjects included in the Scientific Program are vary varied. They also have ridiculously long titles. Such as “Closing the Loop - NIH- Funded AP Research Efforts” but wait, I can beat that one! “Glyco-Metabolic Control, Inflammation Markers and Cardiovascular Outcomes in Diabetic Patients on Insulin Pump or Multiple Daily Injection”. I skipped that session by the way….
The really long and complicated titles cover a wide range of subjects and here is my summary of what they were discussing:
Technology - There remains a lot of talk about closed loop and Artificial Pancreas systems. From what I was hearing there are still plenty of live/ongoing trials, all still proving that these systems would be great for a lot of PWDs that want them (keep in mind that not all of us will). The systems are still in development and not yet available. Yet there are PWDs who are already “Looping”. These are the increasing number of PWDs that are using “DIY AP” systems that they have put together themselves using industry devices and additional, programmable technologies. This is of course completely off-label, out of warranty and not approved by any regulatory bodies. However, they seem to work well and, to date, safely for those who are using them. It’s reassuring too they were discussed in some of the sessions at ATTD this year. There is no point hiding from the fact that this is happening and I don’t think anyone should be judging PWDs for doing this. It’s a difficult subject of course, as these are medical devices, but we can, and should, all learn from each other in the hope that it drives better outcomes for those living with this condition.
Biotechnologies - So as I’m clearly not an expert, HCP or scientist, as far I could make out from these sessions, they are all about things like prevention, cure or fixing the bits of the pancreas that decided to give up the ghost when we developed diabetes and joined the club that nobody wanted to join. A cure is a long way off and it may never happen, certainly in my life time, but we should never stop looking for one. Every bit of research helps us to understand this condition which still poses multiple questions to medicine. And everything that is learnt can be used to try and help us PWDs to manage our diabetes in the way that we want to, in order to live and thrive with it. Work still goes on trying to find a vaccine to stop people developing diabetes, along with beta call encapsulation and transplants in an attempt to start our bodies producing insulin again and to protect the cells from being attacked and destroyed again. The encapsulation is important. I wasn’t overly pleased when I developed diabetes the first time, so you can imagine how Grumpy I’d be if they fixed it only for it to happen again!
Other sessions covered subjects related to living with diabetes such as pregnancy, physiological impacts of living with this condition and the risks and complications that are associated with having diabetes. Great scientific sessions I’m sure (unfortunately I couldn’t attend any of these since I was in others). However, there is very often one thing that I think is missing from these. If you are going to talk about living with diabetes, who may you expect to hear from? Yep. The people that are living with diabetes. All too often, that most important voice is utterly absent from the conversation in these sessions. Science is great, but experience can often be different. Neither is wrong but each can learn from one another and improve the outcomes and quality of life for all of us living with this condition. After all, isn’t that what these conferences set out to do?
One final thing that stood out for me at this conference. There was a lot less talk about HbA1c and a lot more talk about “Time in Range”. I think that time in range is a better way to measure how my diabetes management is going compared to the way I want it to.
So that is my whirlwind attempt to describe what went on at ATTD and give you an idea of the kind of things that are discussed from the perspective of just one person that has lived with the condition for a few years now.