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[00:08]
A
Right.
[00:09]
B
I'm so glad everybody is here today. And this is being recorded live. So for our home audience, everyone should know this is not an ordinary podcast. This podcast is being recorded live on the floor of the exhibit hall of the American Diabetes Association's Scientific Sessions 2026. And you can feel the sense of excitement. Good idea. A little clap. And that was a collective clap for all of the incredible information and relationships that are shared when you come to ada. I don't want to take much time with introduction. I'm Dr. Neal Skolnick. I'm a professor of Family and Community Medicine at the Sidney Kimmel Medical College at Thomas Jefferson University. And we are really fortunate at the American Diabetes association to have a number of superb podcasts now that represent different ways of looking at information and. And give different voices to different views of the information, different slices of information, deep pathophysiology, not as deep, but important clinical approaches. And what we're gonna do, the way we're gonna organize things, is we're gonna each introduce ourself who we are one host. We are all hosts of the different podcasts. We, one host from each podcast will describe what their podcast does, the intention, whether we meet our intentions. That is for our viewers to decide. And then we will go around a second time in reverse order. So you keep you on your toes and say what it is we like most about Scientific Sessions and something that we went to that was particularly notable. Your call.
[02:16]
C
All right. Thanks, Neil. I'm Kirk Hawbager. I'm a professor of nutrition and medicine at the University of Alabama at Birmingham. I'm one of the co hosts of Diabetes Bio. We cover two articles from each month's Diabetes Journal. And my co hosts are Darlene Sandoval, who's not here today, and Kevin Williams, who actually has an additional segment that we cover each month. And that's Sweet Talk, right?
[02:43]
D
Correct. I'm Kevin Williams. I'm an associate professor at UT Southwestern Medical center in Dallas, Texas. And the segment that I kind of direct is the Sweet Talk segment, which we're quite proud of in that name of Sweet Talk in a diabetes podcast. But that segment is really for special topics. We try and highlight different aspects of what's going on here at the scientific session. So we might interview the chair of the program or planning committee. Mark Atkinson's been on a couple times to try and discuss what's going on at this meeting. It's a way to get advanced information as to what you might be expecting every year. We also interview authors that have contributed articles to the Journal of Diabetes that are on classic topics, Maybe some topics that you might have read as you were a graduate student, as a postdoc, you might be referring to them now as an independent investigator. And you're building your hypotheses on these really seminal studies. So we try to bring on some of those investigators that perform those studies, but also the people that are highlighting that work. And then I think another aspect is that we interview award winners. So the Outstanding Scientific Achievement Award winner that was recipient this year, Timo Mueller, was just on about a month or two ago, and we've interviewed many other award winners. And then a final topic is how many people here know that the American Diabetes association, in addition to the scientific sessions, all of the vendors that are here and the works that are presented, how many know that the ADA is actually funding science? Do you all know? Okay, about half of y' all have raised your hands. But the ADA has different mechanisms. One of them is the Pathway to Stop Diabetes award or initiative. And these initiatives really go out to quite commonly those investigators are there trying to transition from their junior positions as a postdoc onto a faculty position. So any trainees in the audience, you all should be aware of this. And their seven year award mechanisms really get you a anchor, a footprint into your independent career. This Mechanism started in 2013, has been going on for now about 13, 14 years. They are seven year awards. So we've had several investigators that have completed their funding mechanism, and so we have them on to try and discuss what the impetus of their award was, what was our hypothesis, what happened during that award mechanism, and what are they doing now with it. So I think it's pretty exciting. I think we try and put a face to the research and personalize it by having these different investigators on to talk about what's going on. So definitely tune in.
[05:20]
B
What I love about what you just described is how we really span all the way and you just talked about deep science and research and for people who are interested in that and also the personalities behind who does that deep science and research. That is the perfect podcast and it's the perfect introduction for our newest podcast, which takes us all the way to the other side of not the other side of clinic care, but to where that basic research is used and implemented.
[05:53]
C
Richard?
[05:54]
E
Thank you, Neil. It's very exciting. You talk about excitement. I'm very excited to be the new kid on the block here. And, you know, I feel like I've come a full circle. When I was a resident, I thought I was subscribing to Diabetes, but instead I got sent this brand new journal called Diabetes Care. And I didn't know what that was. And that was the birth of that journal. And here I am with a little more gray hair and being involved in the birth of a brand new journal, Diabetes, Obesity and Cardiometabolic Care. And it's great. And thank you for giving me a couple minutes. Talk a little bit about this journal, Diabetes, Obesity and Cardiometabolic Care. The mission is to advance the care and management of diabetes, obesity and cardiometabolic diseases, of which there's lots of overlap, by providing health professionals with the latest evidence based, rigorous, objective scientific research, clinical insights and practical applications. And that's sort of the mission statement stated by our editor in chief, Dr. Eliza Siegel. And the vision for this journal really is to integrate all of these areas of expertise and translate it, transmit it, transpose it to practical terms so that people out there in the real world can understand the science and use it in their daily lives, whether they're in practice or research. And so far, we've gotten a lot of very positive feedback. The focus really is being on treatment, education and research. We target a whole lot of providers, primary clinicians, weight management clinicians, diabetes educators, pharmacists, behavioral health professionals, nurse practitioners, nutritionists. I hope I got everybody in there and all professionals really dedicated to developing care for people with diabetes. So that's what the journal is. And I think it's a very exciting journal. It's exciting to see it evolve and cover these overlapping areas for overlapping types of interests. Now, the Points of Care podcast, which evolved from that, is the American Diabetes association podcast relating to this journal. And I'm one of the co hosts along with Jane Rouch, who unfortunately couldn't be here today. And we've really had a good time. We've done three podcasts so far, plus a special one based on the symposium for the journal that was just held a couple of days ago. And the podcast mission really is to provide authors of key articles within the journal the opportunity to speak about their work, what the work's relevance is to people out there in the real world, and just have a dialogue about where the research that they've done or the observations that they've made should be going in the future. And it's very exciting to get the authors involved in this dialogue. Why is the information important, the impact and the future. And then Jane and I, for the second part of the podcast, will go through a number of the other articles in the current edition and talk about them briefly. Give people a sort of tantalizing taste of what's in the journal so that they can see how these articles could be very relevant to their daily practice.
[09:30]
B
I'm going to work on my language because tantalizing taste is just an incredible. It just flows. And I'm going to use that next podcast.
[09:38]
E
You're welcome to, but I won't charge royalties.
[09:40]
A
All right, so thanks, Neil and Richard reminded me where Diabetes Care started, which was Jay Skyler, who was the first editor in chief.
[09:48]
E
Exactly.
[09:49]
A
During your residency. And it's come a long way since then. And what Alice and I attempt to do in our podcast is first highlight feature articles. So the deputy editors of Diabetes Care pick three articles in each month's issue that are available for public access. So when they're. While everyone here has. I hope ADA members has access to the whole issue. Everyone who has access to podcasts can hear about two of the feature articles, but they have access to all of them free of charge. And so Alice and I will each pick one of the articles to interview one or more of the authors to hear about their insights, motivations, and key implications that we hope our listeners can take back to their own research, clinical practice, and teaching. And then, similarly, we have a second segment of the podcast that I'll let Alice introduce to you that we call our Rapid Exchange.
[11:00]
F
Yeah, absolutely. So, thank you, Mike. So, I'm Alice Chang, University of Toronto, and it's been my honor to co host Diabetes Care on air with my friend here, Mike. And the latter part of our podcast episode is what we call the Rapid Exchange, which is where we each pick about three articles and we just chat about them briefly with our thoughts. But Mike left out probably the funnest part of our podcast, which is at the intro, there is always either a silly question or a silly fact, or we get Mike to talk like a pirate. So if you haven't heard that episode, you can go back to. I think it was the first year we did this, and I think I managed to get Mike to talk like a pirate.
[11:41]
A
No wonder why I didn't bring that up.
[11:43]
D
Only one time.
[11:44]
F
Only one time. I got to keep trying.
[11:46]
D
Do you have any other voices?
[11:48]
A
Well, I don't even have that one.
[11:50]
E
Is that something we should emulate now that we're on the block?
[11:53]
F
100%.
[11:54]
E
Hello, guys.
[11:55]
B
People want to stay around after we're done, Richard will do his emulation of a range of voices.
[12:03]
E
Blimey.
[12:05]
B
So really you can get a sense there's a range of podcasts. Let me fill in what we do on the podcast that I host with my co host, John Russell. The podcast up until three days ago was called Diabetes Core Update, and now drumroll. Its name has changed to Diabetes, Obesity and Cardiometabolic Disease. Disease Doc Podcast. Why? Because what we all have evolved to become involved in the diabetes field is a broader range of cardiometabolic disease, including obesity, one of the important precursors of diabetes. In addition, I also host the Patient Facing podcast. Because if we're going to have all these podcasts for our clinician colleagues, we want to make sure that we have a podcast that is patient facing for the people that we take care of. And the core mission of Diabetes Day by Day is a very simple one, and it is to empower patients with knowledge. And with that in mind, we have different topics each month. We like to have a lot of patient voices on the podcast, not just to give it flavor, but to ground it in the reality of patient experience and thereby also have expert clinicians talking to empower patients to go to their clinicians and say, here's what I heard, here's what I need to think about. And for themselves and their families, here's what I need to do. Now we're going to go to the second half of our podcast, which will take two thirds of the time because it ought to be a little more in depth. And we're going to go in reverse order, beginning with Alice, who okay, I know the plan was for you to sneak away unnoticed, but Alice is at the end and going first because you have possibly presented at more than things here than I've heard during the whole week, and you're again needing to leave early in order to be at a presentation that's coming up almost simultaneously with when we end. But so, Alice, do you mind going first and talking about what you found exciting and notable in the meetings?
[14:35]
F
Absolutely. Thank you, Neil. I thought I would also start with what brings me to scientific sessions in the first place and what gets me excited about scientific sessions. I think the biggest thing is an opportunity to reunite with our diabetes family, and I think that is exactly what we are as a community. And the opportunity to support members of our diabetes family to support the science, the ability to speak freely about the science, to learn from each other. And I think that is one of the most beautiful things about scientific sessions and must continue and we must all play our part in making that happen. So that is where brings me to science in terms of one highlight. It's really hard to just Pick one highlight, but I'm going to go with the Achieve Symposium. So the Achieve Symposium is looking at the phase 3 clinical trial program for orfogron. So or 4 glipron, which is a bit of a mouthful but or 4 gliparon is a small molecule non peptide GLP1 receptor agonist that's oral once daily and has the advantage of no food or water restrictions. However, does have some drug interactions we need to be aware of. But I think what's exciting is the possibility of much lower cost given that it's a smaller peptide. But in the symposium we will see the results for three of the clinical trials as well as the summary or independent commentary, which is what I will have the opportunity to provide and talk about where it will fit into this huge toolbox that we now have and will continue to have. I think one of the beautiful things as clinicians is we build this relationship with our patients and it's the ability to help guide them through that toolbox to make decisions. And we need lots of tools in order to help make the right decision for that particular individual. It's not about bigger or better or faster, it's actually about what's the right one for you. And the actual decision points will be different for every person. But I think OR for Glipron will be a lovely addition to the toolbox.
[16:46]
A
And that's what's coming up next at 1:30. So if anyone wants to be sure to catch that, you can just follow Alice on her way to the session hall.
[16:56]
B
So you're up next.
[16:59]
A
All right, so I'll start as well with one of the things that brings me to scientific sessions each year and which was so much fun for me in particular this year is being able to observe current and former students, fellows, postdocs, presenting their science and their work and having the opportunity to mentor individuals at my own institution, other institutions
[17:29]
F
who
[17:29]
A
are here presenting their science, making connections, establishing collaborations and advancing to the next steps in their work. And that's a real fun and exciting part of this conference. And only, I mean the greatest stage in the world for doing that in diabetes. And so that's been terrific. I will highlight one session which I'll try to not put everything that I've written here, but Saturday morning I went to the symposium on harnessing big data to decode immune mechanisms in type 1 diabetes. And so look for this session what really was struck me overall I'll start with is so there is an NPOD program collecting organs and tissues of individuals at risk of and with type 1 diabetes and controls that's evolved into supporting an HPAP program Human Pancreas Analysis Program sponsored by the NIH. This has furthered over the past decade the collection of these very precious materials from organ donors and and their families that have really informed the hope would be why type 1 diabetes develops. And this should inform the current clinical staging that we now understand with when autoimmunity develops far ahead of the presentation of clinical disease. And in this symposium Todd Brusco from University of Florida, he presented work on applying now spatial transcriptomics. This is single cell expression resolution with preserved tissue architecture. You can see what cells are communicating with which how they track and home throughout from draining lymph nodes into pancreatic tissue and really maps the disease unfolding. Klaus Kessner from University of Pennsylvania presented work on evaluation of double stranded rna which forms all the time in transcriptional regulation in our cells but is normally edited or can mimic a viral infection. And really demonstrating how genetic risk for type 1 diabetes is involved with this double strand RNA burden that in the beta cell leads to interferon activation, early inflammation that can be the triggering event for autoimmunity. And then doing work with Juan Alvarez at Penn with inducible pluripotent stem cells from individuals with type 1 diabetes recapitulating this process in vivo. And then we had Kyle Galton at University of California, San Diego. He's taking a genomics approach to all this and understanding the immune response, mapping cell specific changes in gene regulation and its expression as autoimmunity and diabetes develops in the pancreas and really highlights the central role of the beta cell and these initial stress inflammatory responses and changes that occur in cell cell communication. And then Mohammed Haj D Foolian while at Harvard he developed this de novo T cell epitope discovery which Mohammed's now come to University of Pennsylvania where he's applying this tool for understanding T cell receptor and HLA interactions in type 1 diabetes. Doing this with the HPAP program and mapping pancreatic antigens that are recognized by T lymphocytes in the pancreas and the draining lymph nodes to discover novel antigens driving type 1 diabetes. And so this just is an example to me of how investments in these programs more than a decade ago, before the technologies that were used in this symposium did not exist then. But the vision and wisdom to invest in the research and the science so that we could now gain this understanding and develop new possibilities for intervening early in type 1 diabetes was just extraordinary. So recommend everyone take, take A look at that session.
[22:12]
B
That was wonderful, Mike. And it really reminds me of how important basic research is to what we use in the office every day. I want to remind our listeners who might not fully understand when you said, take a look at this, because of course, our listeners who hear this podcast next week aren't here, that all of these programs are available on demand. For those who came to the psy sessions, but are also available, you can go to ada's website and
[22:46]
C
you can
[22:46]
B
purchase the ability to go to any session that is on the on demand schedule, and you'll learn as much. You don't have as much fun as if you were here, but you can learn as much as if you were here in person.
[23:03]
E
Richard well, first, I guess you want me to talk about why I enjoy coming to the ADA scientific sessions. I probably have the most gray hair of anyone on the panel. My first ada was in 1981, and I figure I've been to half of the scientific sessions that ADA has ever held, but it's been an interesting evolution, meeting people in the halls, getting to know people. But the most important thing to me, where my career was really in continuing medical education, was the exposure to people in all the different disciplines that contribute to what the ADA does. The clinicians, the educators, the researchers, the pharmacists, everybody that's in this group comes here. I can learn what they do, listen to their sessions. And it really makes me a lot more rounded in my approach to diabetes and what I'm doing by seeing what other people do. I think the diversity of what we can see is part of why I've loved coming to all these ADAs. Now, in terms of the session that I want to mention, I'm going to be a little bit of a homer, if I might, because this is the first year of the journal Diabetes, Obesity and Cardiometabolic Care. And so I'm going to speak about the journal symposium, which was on the cost of treatment of obesity. And obesity is a really important subject. It's in the center of the journal's name, Diabetes, Obesity and Cardiometabolic Care. And it overlaps with a lot of the disciplines that we're talking about in that journal. So I think it's a very appropriate topic for the first journal symposium. And cost is something that's on everybody's mind these days. Now, the first presentation in the symposium really blew me away because the discussion was on what the actual cost estimates were. And again, any of these cost estimates have to be sort of rough and estimates, and you Know, how do you assume what the cohort is? Is everybody being treated and so on. But the medical cost savings just directly for medical costs was $1.8 trillion. That's with a T. And then they factored in, however, they magically, statistically did this. Labor force gains by not having people get sick, 2.7 trillion. Decreases in absenteeism in the billions. Quality of life gained estimated between 5.6 and 8.5 trillion, for a total of $10.5 trillion saved. And I'm not sure how they even factored in some of the costs of medical support that you need when you're using some of the newer medications, teaching people, nutritionists and educators. So the arithmetic is complex, but the dollars are huge. Another presentation looked at it from the provider perspective, talking about the various factors that go into obesity treatment and the barriers to that treatment. The stigma of weight issues and an interesting stigma that I hadn't heard of, stigma of using the medications to lose weight. Oh, you have to use the medications. I'm doing it with diet and exercise. And that's something else that I hadn't really thought about, but it's an interesting concept. And barriers, of course, the socioeconomic barriers, disparities and so on. And as we move forward in time, these will all evolve as these newer treatments become more ubiquitous. But I think those are things that we think about in the equation. And the final presentation looked at it from the insurer's perspective. And the insurance companies are finally having to realize that the treatment of obesity may make financial sense, but they have to figure out what their cost model is because they're not directly benefiting. Well, maybe, maybe not from people's less absenteeism or their quality of life, or maybe they are or how do they think about it? So it gives us a lot of things to think about going forward. And it was a fascinating, fascinating exploration of all of the perspectives on the cost that we're also cognizant of. Again, to put into a plug. This is available on the ADA webcast. But in addition to that, we conducted a podcast just after the symposium, and I think it's going to be posted fairly shortly. And so there's a special podcast on Points of Care where you can hear the participants speak about their presentations.
[28:09]
B
It's fantastic. And those meta issues drive a lot of what we do. Thanks so much.
[28:14]
D
Yeah. So starting off with why I attend the symposium, I think it, it really heralds back to what has already been discussed on the diversity of work that's presented here and that you can interact with anything from the benchtop all the way up to the bedside, all these different topics. I think there's also the people that are attending. I'm really curious with the audience. How many students might be students, trainees, might be in the audience? Anyone? How many PhDs are in the audience? Just a few. How many MDs, a few people that are working or characterizing themselves more in the basic science, pre clinical research? Anybody? And then how many people might be doing more clinical research? So you have quite a variety of people that are doing various aspects of research, care and treatment of diabetes. And I think this is an excellent opportunity to interact with those people. Another aspect of diversity. Anybody from Louisiana, how many people from the United States? What about international? That's awesome, right? Like this is an international conference and there's opportunities to be able to communicate with your colleagues, your potential collaborators, being able to develop these types of research programs that you want to have, that you can focus in on techniques, research topics, that you can get expertise all around the world. So this is a fantastic venue to get that exposure and to be able to talk to these people. But I have to be honest, you know, this is New Orleans, right? I am here in part because of bread pudding, bananas Foster Po boys, shrimp, Gulf oysters, turtle soup. And I think there's a lot of people here that probably have experienced that. And we've seen people staggering into the convention center after possibly a late night in a specific region of the city. Great music and other things that being characterized as entertainment. So these venues that you can attend these meetings at can also be a driver for being able to sit down and have those conversations, to develop those collaborations and extend the meeting outside of the conference center to really network and get those long term friendships, colleagues, whatever you need for your career development, but also for your independent research programs. And then at the meeting itself, a little bit of a homer as well. The Diabetes Journal has its own symposium that they hold here. And in this symposium they were focusing
[30:59]
A
on
[31:02]
D
less talked about non classical complications of diabetes. And the speakers for this session were Norbert Stefan, John Usher, Julia Critchley and Lorraine Lipscomb. And they talked about how diabetes could be linked to mass, LD or fatty liver disease, diabetes being linked to cancer or infection risk, and then diabetes, also in cardiomyopathy and how you might need to recharacterize or reframe or try and better understand how these different complications are developing. I think these investigators, these presenters should actually be complimented. And I think Jane Kastner and Shannon in the back of the room would appreciate that these investigators submitted a review article to the journal in a timely fashion. Timely enough that they were able to get these articles out for peer review. And these articles are going to be published in the August edition of the Journal of Diabetes. So in addition to the on demand functions of the American Diabetes association that you might be able to watch, listen to these specific talks. You can read more about their articles in the August edition of Diabetes. And as a podcast, we're trying, we're in communication with these authors to get them to come on the podcast and discuss more about these non classical complications so that y' all can learn more about this. And I should say, you know, I'm a neuroscientist, so I study how the brain regulates energy balance and glucose metabolism. Do I have any friends in the audience maybe?
[32:29]
A
No.
[32:29]
D
Nobody raising their hand? Well, you know, this meeting, a lot of neuroscientists might think that they don't have a place. And I want to say to those people that are on the fence about attending a meeting like this, there are a lot of sessions that are focusing on how the brain is involved in regulating energy balance and glucose metabolism, how these pharmacotherapies that have been recently developed, incretin based, dual Incretin, and then as they're getting multiple polypharmacology unimolecular drugs out there and how they're acting in the brain, there's a huge emphasis at this meeting to try and better understand that. There's a symposia coming up just at 1:30, which I would actually like to get to, which is going to have Brad Lowell, Long Long Tu, Sarah Stern and Ziping Peng, which is also being chaired by Quincean Tong, focusing on the plasticity of the brain and regulating energy balance and glucose metabolism. So there is a place for neuroscientists here to try and network and develop those contacts that can be International across PhDs, Maryland and then also the venue of this city. So I really encourage those that might be listening and on the fence to attend these meetings, to definitely look them up and sign up and come join us all.
[33:50]
C
All right, so why do I come? It's a chance, first of all to hear great science, but really it's a chance to meet your mentors and your colleagues and old friends and have those conversations in person that just don't always translate quite as well over zoom. Some of the, the people that were actually missing or one of them is Darlene, my co host. And she sent along actually a symposium that she was sad to miss. And so I guess in her stead, I'll discuss it a bit here. The title was Sexual Dimorphism in Islet Responses in the Settings of Diabetes and Obesity. And, you know, she wanted to communicate that these are things that we've known about for a long time. But it's great, great to see them get a little bit of highlighting and trying to understand the mechanisms driving them. Work that was discussed spans those differences from bench to bedside and has real implications for us understanding mechanisms and future treatments. Now, on my behalf, my favorite session was actually the Scientific Achievement Award Talk. It was given by Dr. Timo Mueller, and Timo and I were postdocs in the same lab at the same time. We had desks right beside each other. I played music he hated.
[35:22]
D
Are you going to share any stories?
[35:23]
C
No, not right now. This is his time. So seeing your friends sort of rise to prominence and being able to enjoy that is really, it's something wonderful. So that was my favorite.
[35:40]
B
That is fantastic. I'm just struck before I share my reasons for coming and what I enjoy and the session I found most compelling. But I'm just struck as I listen, about two things. One, the core reason that we all come is both relationships and the opportunity to access the science. The aspects of science that we're each interested in are remarkably different. And that's why, of course, we're all important in this process. And I'm also struck by just what each of our podcasts offer that is different but makes a cohesive whole. And I find that exciting. And, you know, there are times in life one feels particularly lucky, right? We all have those times. And for me, I'm experiencing one of those moments because the privilege of being here, right? Of spending one of my reasons for common what I enjoy most, actually, it's just walking around, running into people. And what I hate most about it is I keep missing a session that I was planning to go to and wanted to hear about because I run into someone that I haven't seen in a year and end up talking to them. And I have this fantasy that I'll go back to the On Demand and watch each of those, knowing full well I'll have to be very selective, right? Because who has the time? But so for me, it's the people that are so important and that drive me to being here. And the other reason, frankly, I feel lucky is just to be a part of this, right? Like, we live in an age where technology has enabled us as researchers and educators to communicate with our peers In a thoughtful way, using technology, with all these different podcasts. And that's incredibly exciting and fortunate. What did I go to that I found compelling? A bunch of stuff. But the one that stood out to me was the triumph. One study of retatrutide. And retatrutide is of course, the triple g agonist, a GIP GLP1 leukagon receptor agonist. And it was a fascinating trial and its construct because it was a large placebo, usual blinded randomized trial, but it had what they call basket trials in it. It didn't just look at weight loss, which we'll talk about in a moment, but it also included a basket trial on osteoarthritis of the knees and a basket trial looking at an endpoint of obstructive sleep apnea, two very important consequences of obesity. It met all its primary endpoints. The significant decrease in pain for people with osteoarthritis of the knee, a decrease of like 60% in AHI. Apnea hypopnea episodes. The apnea hypopnea index that that reflects the number of episodes of decreased or stopping breathing that someone has per hour during the night went from like 50, 55 down by 60%. And then of course, the primary endpoint, and there were two of them. One was at 80 weeks. So they did a continuation trial with a portion of the population to 104 weeks. At 80 weeks, there was approximately 28% weight loss. And at 104 weeks, there was over 30% weight loss in this cohort of patients. And, you know, we get lost in these percentages. So how much weight is that? It's about £85, if I remember correctly. And then what is £85? I was packing my carry on today and, you know, when I lift, when I lift it to the overhead, it feels heavy. And that's about £25. When you pack one of those massive bags that when you go away on vacation with the family, you swear to yourself you're going to take a smaller bag, it doesn't fit. You then use the larger bag and you push it. And they only allow up to £50. Right? That fits into that. And I know at home when I lift that it is really. It feels really heavy. I can barely lift it. I know one conclusion is that, like, I should work out more. And that might be true. But the other conclusion, that's £50, £85. I couldn't. You can't lift. That's a lot of weight. And many of our patients are walking around carrying that with them every hour of the day as they, they are moving through life. So the opportunity here is an important one. And Alice, you gave the putting it in perspective conclusion to that talk, and you made the point that that's not for everyone. And I agree. And really, what this trial, what this medicine ushers in, is a new responsibility for those of us who are in clinical care to decide which is. And a lot of this is going to be shared decision making, right discussions with our patients, but to decide which is the right medicine for the right patient, because we range now from around 10, 11% to 30% and different people need different medicines. And this is a lot of people who need these medicines. And there's going to be a lot of learning to be done. I think it was on the Lucy showed a lot of explaining to do to patients, to clinicians in order to understand how to tailor our recommendations with shared decision making to the needs of the individual patients. So that was my most exciting study. I want to say we're going to bring this to conclusion a little early for two reasons. One is two of our panel members want to need to get to important symposiums that are coming up and we made the effort to be here in addition to planning to watch the online demand stuff. And then also because as we talked earlier, we recognize that while we were given an hour to talk about things, an hour is probably longer than many people people have concentration for. And I think we said at the beginning, if it ended up not being very good, we better make it short. But if it is very good, keep it short and leave them wanting more. So I want to thank our panel, I want to thank Ada and certainly everyone who joined us today for being a part of it and allowing us to share about our podcasts, individual backgrounds and things we were excited about. Thanks. It was a meeting filled with lots of information. Before we wrap up, a reminder that recordings from the American Diabetes Association's 2026 scientific sessions are still available on demand at ADA2026.org if you registered for PSY sessions, you can access session recordings through August 10, 2026. If you were unable to attend or did not register on demand, access to the recordings may still be purchased through August 7, 2026, with all video content remaining available for viewing through August 10. In addition, eligible attendees can claim continuing education credit for their participation in the scientific Sessions by visiting ADA2026.org. For complete details and access information, visit ADA2026. Till next time, stay safe and keep learning.

Summary9 min read

Diabetes Core Update: Special Edition – Highlights from the ADA’s 2026 Scientific Sessions

Podcast: Diabetes Core Update
Host: American Diabetes Association
Episode Date: July 30, 2026
Location: Recorded live at the ADA’s Scientific Sessions, Exhibit Hall

Episode Overview

This special, live-recorded edition brings together hosts from the ADA’s key diabetes-related podcasts. The episode’s purpose is twofold:

To introduce, compare, and discuss the suite of ADA-hosted podcasts, each targeting different audiences and clinical questions.
To share personal highlights and key insights from the 2026 ADA Scientific Sessions, focusing on new research, landmark symposia, and the evolving landscape of diabetes and cardiometabolic care.

The episode, vibrant with collegial banter and in-depth clinical discussion, aims to bridge deep scientific advancements with everyday treatment and patient empowerment.

Meet the Panelists

Dr. Neil Skolnik
Host of Diabetes Core Update / Disease Doc Podcast; Professor of Family & Community Medicine
Dr. John J. Russell
Co-host; Family Medicine, Thomas Jefferson University
Dr. Kirk Habegger
Co-host of Diabetes Bio; Professor of Nutrition and Medicine
Dr. Kevin Williams
Associate Professor, UT Southwestern; Director, “Sweet Talk” segment on Diabetes Bio
Dr. Richard Rubin
Co-host of Points of Care Podcast for Diabetes, Obesity & Cardiometabolic Care
Dr. Alice Cheng
Co-host of Diabetes Care On Air; University of Toronto
Dr. Mike
Co-host of Diabetes Care On Air (full name not provided)

Section 1: Introducing the ADA Podcast Family

Each host (or co-host) provided a brief overview of their respective podcasts and journal affiliations, highlighting their audience and unique value:

1. Diabetes Bio with “Sweet Talk” Segment

Focus: In-depth discussion of two monthly articles from Diabetes Journal; “Sweet Talk” brings special topics, interviews with award winners (e.g., Outstanding Scientific Achievement Award recipient Timo Mueller), and conversations with authors of classic and current studies.
Unique Feature: Spotlights ADA’s Pathway to Stop Diabetes award, offering career-defining funding to emerging investigators.
Quote [03:23]:
“We try and put a face to the research and personalize it by having these different investigators on to talk about what’s going on.”
— Kevin Williams

2. Points of Care Podcast & Diabetes, Obesity and Cardiometabolic Care Journal

Focus: Translating rigorous scientific research on diabetes, obesity, and cardiometabolic care into practical clinical applications. Brings on authors for discussion and overviews of new articles.
Audience: Multidisciplinary—primary clinicians, educators, nutritionists, pharmacists, behavioral health professionals.
Quote [06:44]:
“The vision for this journal really is to integrate all of these areas of expertise and translate it…so that people out there in the real world can understand the science and use it in their daily lives.”
— Richard Rubin

3. Diabetes Care on Air

Focus: Interviews with authors of “feature articles” from Diabetes Care (publicly accessible), followed by the “Rapid Exchange” segment for quick overviews and discussion of additional articles.
Distinctive Style: Lighthearted banter, fun facts, and humor set the tone.
Quote [11:40]:
“The latter part of our podcast episode is what we call the Rapid Exchange, where we each pick about three articles and just chat about them briefly with our thoughts.”
— Alice Cheng

4. Diabetes Core Update / Disease Doc Podcast (with recent rebranding)

Focus: Previously centered on diabetes, now expanded to full Cardiometabolic Disease (including obesity). Summarizes recent, clinically relevant journal articles for practicing clinicians.
Patient-Facing Version: “Diabetes Day by Day,” empowering patients with expert insights and real voices.
Quote [13:24]:
“The core mission of Diabetes Day by Day is a very simple one, and it is to empower patients with knowledge…to ground it in the reality of patient experience.”
— Neil Skolnik

Section 2: Reflections & Research Highlights from ADA Scientific Sessions

(Format: Each panelist shares: “Why I attend Scientific Sessions” + Memorable Symposium or Study)

2.1. Alice Cheng – The Achieve Symposium and the Power of Community

Main Draw:
“Opportunity to reunite with our diabetes family…to support the science, to learn from each other. That is one of the most beautiful things about scientific sessions.” [14:41]
Highlight Session:
- Achieve Symposium: Phase 3 Clinical Trials for Oral GLP-1 (Orforglipron)
  - Small molecule, non-peptide GLP-1RA: Once-daily, no food/water restrictions.
  - Potentially lower cost; may reshape the therapeutic “toolbox.”
  - Notable for bringing more personalized treatment options to the clinic.
Quote [16:19]:
“…it’s actually about what’s the right one for you. And the actual decision points will be different for every person. But I think Orforglipron will be a lovely addition to the toolbox.”

2.2. Mike – Advances in Type 1 Diabetes Research with Big Data

Main Draw:
“Being able to observe students, postdocs, presenting their science and making connections, establishing collaborations—advancing to the next steps in their work.” [17:01]
Highlight Session:
- Saturday: Harnessing Big Data to Decode Immune Mechanisms in Type 1 Diabetes
  - Showcased the NPOD and HPAP programs (Human Pancreas Analysis).
  - Latest techniques: spatial transcriptomics, single-cell analysis to map disease processes and cell-to-cell communication.
  - Seminal discoveries linking genetics, beta cell stress, and immunological triggers for Type 1 diabetes.
- Quote [21:52]:
  “Investments in these programs more than a decade ago, before the technologies that were used in this symposium did not exist then. But the vision and wisdom to invest in research and science so that we could now gain this understanding…”

2.3. Richard Rubin – Symposium on the Cost of Obesity Treatment

Main Draw:
The comprehensive multidisciplinary exposure and CME opportunities.
- “It really makes me a lot more rounded in my approach to diabetes…by seeing what other people do.” [23:14]
Highlight Session:
- Inaugural Diabetes, Obesity and Cardiometabolic Care Journal Symposium: Cost of Obesity Treatment
  - Estimated $10.5 trillion in potential cost savings (medical, labor force gains, quality of life).
  - Explores provider, patient, and insurer perspectives, including stigma and access barriers.
  - Announced a special podcast episode covering the panel’s perspectives.
- Quote [25:17]:
  “The medical cost savings just directly for medical costs was $1.8 trillion…quality of life gained estimated between 5.6 and 8.5 trillion, for a total of $10.5 trillion saved.”

2.4. Kevin Williams – Nonclassical Complications & Brain-Centric Research

Main Draw:
Diversity of attendees and international collaboration; unique scientific breadth.
- “An excellent opportunity to interact with people…from the benchtop all the way up to the bedside.” [28:14]
Highlight Session:
- Symposium: Nonclassical Complications of Diabetes
  - Explored links between diabetes and NAFLD (fatty liver), cancer, infection, and diabetic cardiomyopathy—soon to be detailed in August Diabetes Journal.
  - Upcoming podcast segments will feature these presenters.
- Neuroscience at the ADA:
  - Promoted upcoming sessions on brain plasticity and energy balance/glucose metabolism.
  - Called for greater participation from neuroscientists and interdisciplinary researchers.
- Quote [32:38]:
  “I want to say to those people that are on the fence about attending a meeting like this, there are a lot of sessions focusing on how the brain is involved in regulating energy balance and glucose metabolism.”

2.5. Kirk Habegger – Personal Milestones & Scientific Achievements

Main Draw:
Valuing in-person interactions for relationship-building and mentorship.
Highlight Sessions:
- Darlene Sandoval (in absentia): “Sexual Dimorphism in Islet Responses”
  - Importance of sex differences from bench to bedside in diabetes and obesity.
- Personal Pick:
  - Scientific Achievement Award Talk by Timo Mueller (longtime colleague and friend).
- Quote [35:31]:
  “Seeing your friends sort of rise to prominence and being able to enjoy that is really, it’s something wonderful.”

2.6. Neil Skolnik – The Power of Relationships and the “Triumph-1” Study

Main Draw:
Spontaneous hallway conversations and old connections as core drivers for attending.
- “What I enjoy most, actually, it’s just walking around, running into people…what I hate most about it is I keep missing a session that I was planning to go to.” [35:40]
Highlight Study:
- Triumph-1 Study: Retatrutide (triple G agonist)
  - Explored weight loss, knee osteoarthritis, and sleep apnea endpoints in a large, innovative “basket” RCT.
  - Results: >30% weight loss at 104 weeks (~85 lbs), functional improvements in sleep and joint pain.
  - Emphasized the clinical responsibility of targeting treatment to individual patient needs.
- Quote [38:11]:
  “That’s a lot of weight. And many of our patients are walking around carrying that with them every hour of the day…this medicine ushers in a new responsibility for those of us who are in clinical care to decide which is the right medicine for the right patient, because we range now from around 10, 11% to 30% and different people need different medicines.”

Notable Quotes & Memorable Moments (with Timestamps)

“We try and put a face to the research and personalize it by having these different investigators on to talk about what’s going on.”
— Kevin Williams, [03:23]
“The vision for this journal is to integrate all these areas of expertise and translate it…so that people out there in the real world can understand the science and use it in their daily lives.”
— Richard Rubin, [06:44]
“There is always either a silly question or a silly fact, or we get Mike to talk like a pirate.”
— Alice Cheng, [11:40]
“That is one of the most beautiful things about scientific sessions and must continue and we must all play our part in making that happen.”
— Alice Cheng, [15:04]
“Investments in these programs…before the technologies…did not exist then. But the vision and wisdom to invest in…research and science so that we could now gain this understanding…”
— Mike, [21:52]
“The medical cost savings…was $1.8 trillion…quality of life gained…$10.5 trillion saved.”
— Richard Rubin, [25:17]
“This is an international conference and…an excellent opportunity to interact…develop these types of research programs that you want to have, that you can focus in on techniques, research topics, expertise all around the world.”
— Kevin Williams, [29:01]
“Seeing your friends sort of rise to prominence and being able to enjoy that is really…it’s something wonderful.”
— Kirk Habegger, [35:31]
“We live in an age where technology has enabled us as researchers and educators to communicate with our peers in a thoughtful way, using technology with all these different podcasts. And that’s incredibly exciting and fortunate.”
— Neil Skolnik, [36:20]

Timestamps for Key Segments

| Topic | Timestamp | |-------------------------------------------------------------|--------------:| | (Opening & Welcome) | 00:09 | | Introduction of Podcasts – Diabetes Bio (“Sweet Talk”) | 02:15 | | Points of Care Podcast & New Journal | 05:53 | | Diabetes Care On Air | 09:48 | | Diabetes Core Update / Day by Day podcast | 12:04 | | Start of Highlights Discussion | 14:34 | | Alice Cheng – Achieve Symposium, Orforglipron ("GLP-1") | 14:34 | | Mike – Type 1 Diabetes Big Data Symposium | 16:58 | | Richard Rubin – Obesity Cost Symposium | 23:02 | | Kevin Williams – Nonclassical Complications/Neuroscience | 28:14 | | Kirk Habegger – Sex Differences, Scientific Achievement Talk | 33:50 | | Neil Skolnik – Relationships & “Triumph-1” Study | 35:40 | | Final Reflections & Closing | 40:44 |

Episode Takeaways

ADA podcasts offer a spectrum: from deep science to practical care and patient empowerment.
The breadth of ADA Scientific Sessions is unmatched: basic research, clinical implementation, emerging therapies, cost analysis, and population diversity.
Major research themes: Oral GLP-1 agents (orforglipron), multipurpose incretin agonists (retatrutide), big data in Type 1 diabetes, social/cost factors in obesity care, diverse and global approaches.
Community is cornerstone: Across the panel, networking, mentorship, and multidisciplinary connections are seen as essential for progress and personal fulfillment.
Innovation & collaboration drive the future: Encouragement for young investigators, neuroscientists, and those from underrepresented disciplines to join the ADA community.

Closing Thought (from Neil Skolnik) [36:20]

“We live in an age where technology has enabled us as researchers and educators to communicate with our peers in a thoughtful way, using technology with all these different podcasts. And that’s incredibly exciting and fortunate.”

For on-demand access to ADA 2026 Scientific Sessions recordings and CME, visit ADA2026.org.

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[00:08]
A
Right.
[00:09]
B
I'm so glad everybody is here today. And this is being recorded live. So for our home audience, everyone should know this is not an ordinary podcast. This podcast is being recorded live on the floor of the exhibit hall of the American Diabetes Association's Scientific Sessions 2026. And you can feel the sense of excitement. Good idea. A little clap. And that was a collective clap for all of the incredible information and relationships that are shared when you come to ada. I don't want to take much time with introduction. I'm Dr. Neal Skolnick. I'm a professor of Family and Community Medicine at the Sidney Kimmel Medical College at Thomas Jefferson University. And we are really fortunate at the American Diabetes association to have a number of superb podcasts now that represent different ways of looking at information and. And give different voices to different views of the information, different slices of information, deep pathophysiology, not as deep, but important clinical approaches. And what we're gonna do, the way we're gonna organize things, is we're gonna each introduce ourself who we are one host. We are all hosts of the different podcasts. We, one host from each podcast will describe what their podcast does, the intention, whether we meet our intentions. That is for our viewers to decide. And then we will go around a second time in reverse order. So you keep you on your toes and say what it is we like most about Scientific Sessions and something that we went to that was particularly notable. Your call.
[02:16]
C
All right. Thanks, Neil. I'm Kirk Hawbager. I'm a professor of nutrition and medicine at the University of Alabama at Birmingham. I'm one of the co hosts of Diabetes Bio. We cover two articles from each month's Diabetes Journal. And my co hosts are Darlene Sandoval, who's not here today, and Kevin Williams, who actually has an additional segment that we cover each month. And that's Sweet Talk, right?
[02:43]
D
Correct. I'm Kevin Williams. I'm an associate professor at UT Southwestern Medical center in Dallas, Texas. And the segment that I kind of direct is the Sweet Talk segment, which we're quite proud of in that name of Sweet Talk in a diabetes podcast. But that segment is really for special topics. We try and highlight different aspects of what's going on here at the scientific session. So we might interview the chair of the program or planning committee. Mark Atkinson's been on a couple times to try and discuss what's going on at this meeting. It's a way to get advanced information as to what you might be expecting every year. We also interview authors that have contributed articles to the Journal of Diabetes that are on classic topics, Maybe some topics that you might have read as you were a graduate student, as a postdoc, you might be referring to them now as an independent investigator. And you're building your hypotheses on these really seminal studies. So we try to bring on some of those investigators that perform those studies, but also the people that are highlighting that work. And then I think another aspect is that we interview award winners. So the Outstanding Scientific Achievement Award winner that was recipient this year, Timo Mueller, was just on about a month or two ago, and we've interviewed many other award winners. And then a final topic is how many people here know that the American Diabetes association, in addition to the scientific sessions, all of the vendors that are here and the works that are presented, how many know that the ADA is actually funding science? Do you all know? Okay, about half of y' all have raised your hands. But the ADA has different mechanisms. One of them is the Pathway to Stop Diabetes award or initiative. And these initiatives really go out to quite commonly those investigators are there trying to transition from their junior positions as a postdoc onto a faculty position. So any trainees in the audience, you all should be aware of this. And their seven year award mechanisms really get you a anchor, a footprint into your independent career. This Mechanism started in 2013, has been going on for now about 13, 14 years. They are seven year awards. So we've had several investigators that have completed their funding mechanism, and so we have them on to try and discuss what the impetus of their award was, what was our hypothesis, what happened during that award mechanism, and what are they doing now with it. So I think it's pretty exciting. I think we try and put a face to the research and personalize it by having these different investigators on to talk about what's going on. So definitely tune in.
[05:20]
B
What I love about what you just described is how we really span all the way and you just talked about deep science and research and for people who are interested in that and also the personalities behind who does that deep science and research. That is the perfect podcast and it's the perfect introduction for our newest podcast, which takes us all the way to the other side of not the other side of clinic care, but to where that basic research is used and implemented.
[05:53]
C
Richard?
[05:54]
E
Thank you, Neil. It's very exciting. You talk about excitement. I'm very excited to be the new kid on the block here. And, you know, I feel like I've come a full circle. When I was a resident, I thought I was subscribing to Diabetes, but instead I got sent this brand new journal called Diabetes Care. And I didn't know what that was. And that was the birth of that journal. And here I am with a little more gray hair and being involved in the birth of a brand new journal, Diabetes, Obesity and Cardiometabolic Care. And it's great. And thank you for giving me a couple minutes. Talk a little bit about this journal, Diabetes, Obesity and Cardiometabolic Care. The mission is to advance the care and management of diabetes, obesity and cardiometabolic diseases, of which there's lots of overlap, by providing health professionals with the latest evidence based, rigorous, objective scientific research, clinical insights and practical applications. And that's sort of the mission statement stated by our editor in chief, Dr. Eliza Siegel. And the vision for this journal really is to integrate all of these areas of expertise and translate it, transmit it, transpose it to practical terms so that people out there in the real world can understand the science and use it in their daily lives, whether they're in practice or research. And so far, we've gotten a lot of very positive feedback. The focus really is being on treatment, education and research. We target a whole lot of providers, primary clinicians, weight management clinicians, diabetes educators, pharmacists, behavioral health professionals, nurse practitioners, nutritionists. I hope I got everybody in there and all professionals really dedicated to developing care for people with diabetes. So that's what the journal is. And I think it's a very exciting journal. It's exciting to see it evolve and cover these overlapping areas for overlapping types of interests. Now, the Points of Care podcast, which evolved from that, is the American Diabetes association podcast relating to this journal. And I'm one of the co hosts along with Jane Rouch, who unfortunately couldn't be here today. And we've really had a good time. We've done three podcasts so far, plus a special one based on the symposium for the journal that was just held a couple of days ago. And the podcast mission really is to provide authors of key articles within the journal the opportunity to speak about their work, what the work's relevance is to people out there in the real world, and just have a dialogue about where the research that they've done or the observations that they've made should be going in the future. And it's very exciting to get the authors involved in this dialogue. Why is the information important, the impact and the future. And then Jane and I, for the second part of the podcast, will go through a number of the other articles in the current edition and talk about them briefly. Give people a sort of tantalizing taste of what's in the journal so that they can see how these articles could be very relevant to their daily practice.
[09:30]
B
I'm going to work on my language because tantalizing taste is just an incredible. It just flows. And I'm going to use that next podcast.
[09:38]
E
You're welcome to, but I won't charge royalties.
[09:40]
A
All right, so thanks, Neil and Richard reminded me where Diabetes Care started, which was Jay Skyler, who was the first editor in chief.
[09:48]
E
Exactly.
[09:49]
A
During your residency. And it's come a long way since then. And what Alice and I attempt to do in our podcast is first highlight feature articles. So the deputy editors of Diabetes Care pick three articles in each month's issue that are available for public access. So when they're. While everyone here has. I hope ADA members has access to the whole issue. Everyone who has access to podcasts can hear about two of the feature articles, but they have access to all of them free of charge. And so Alice and I will each pick one of the articles to interview one or more of the authors to hear about their insights, motivations, and key implications that we hope our listeners can take back to their own research, clinical practice, and teaching. And then, similarly, we have a second segment of the podcast that I'll let Alice introduce to you that we call our Rapid Exchange.
[11:00]
F
Yeah, absolutely. So, thank you, Mike. So, I'm Alice Chang, University of Toronto, and it's been my honor to co host Diabetes Care on air with my friend here, Mike. And the latter part of our podcast episode is what we call the Rapid Exchange, which is where we each pick about three articles and we just chat about them briefly with our thoughts. But Mike left out probably the funnest part of our podcast, which is at the intro, there is always either a silly question or a silly fact, or we get Mike to talk like a pirate. So if you haven't heard that episode, you can go back to. I think it was the first year we did this, and I think I managed to get Mike to talk like a pirate.
[11:41]
A
No wonder why I didn't bring that up.
[11:43]
D
Only one time.
[11:44]
F
Only one time. I got to keep trying.
[11:46]
D
Do you have any other voices?
[11:48]
A
Well, I don't even have that one.
[11:50]
E
Is that something we should emulate now that we're on the block?
[11:53]
F
100%.
[11:54]
E
Hello, guys.
[11:55]
B
People want to stay around after we're done, Richard will do his emulation of a range of voices.
[12:03]
E
Blimey.
[12:05]
B
So really you can get a sense there's a range of podcasts. Let me fill in what we do on the podcast that I host with my co host, John Russell. The podcast up until three days ago was called Diabetes Core Update, and now drumroll. Its name has changed to Diabetes, Obesity and Cardiometabolic Disease. Disease Doc Podcast. Why? Because what we all have evolved to become involved in the diabetes field is a broader range of cardiometabolic disease, including obesity, one of the important precursors of diabetes. In addition, I also host the Patient Facing podcast. Because if we're going to have all these podcasts for our clinician colleagues, we want to make sure that we have a podcast that is patient facing for the people that we take care of. And the core mission of Diabetes Day by Day is a very simple one, and it is to empower patients with knowledge. And with that in mind, we have different topics each month. We like to have a lot of patient voices on the podcast, not just to give it flavor, but to ground it in the reality of patient experience and thereby also have expert clinicians talking to empower patients to go to their clinicians and say, here's what I heard, here's what I need to think about. And for themselves and their families, here's what I need to do. Now we're going to go to the second half of our podcast, which will take two thirds of the time because it ought to be a little more in depth. And we're going to go in reverse order, beginning with Alice, who okay, I know the plan was for you to sneak away unnoticed, but Alice is at the end and going first because you have possibly presented at more than things here than I've heard during the whole week, and you're again needing to leave early in order to be at a presentation that's coming up almost simultaneously with when we end. But so, Alice, do you mind going first and talking about what you found exciting and notable in the meetings?
[14:35]
F
Absolutely. Thank you, Neil. I thought I would also start with what brings me to scientific sessions in the first place and what gets me excited about scientific sessions. I think the biggest thing is an opportunity to reunite with our diabetes family, and I think that is exactly what we are as a community. And the opportunity to support members of our diabetes family to support the science, the ability to speak freely about the science, to learn from each other. And I think that is one of the most beautiful things about scientific sessions and must continue and we must all play our part in making that happen. So that is where brings me to science in terms of one highlight. It's really hard to just Pick one highlight, but I'm going to go with the Achieve Symposium. So the Achieve Symposium is looking at the phase 3 clinical trial program for orfogron. So or 4 glipron, which is a bit of a mouthful but or 4 gliparon is a small molecule non peptide GLP1 receptor agonist that's oral once daily and has the advantage of no food or water restrictions. However, does have some drug interactions we need to be aware of. But I think what's exciting is the possibility of much lower cost given that it's a smaller peptide. But in the symposium we will see the results for three of the clinical trials as well as the summary or independent commentary, which is what I will have the opportunity to provide and talk about where it will fit into this huge toolbox that we now have and will continue to have. I think one of the beautiful things as clinicians is we build this relationship with our patients and it's the ability to help guide them through that toolbox to make decisions. And we need lots of tools in order to help make the right decision for that particular individual. It's not about bigger or better or faster, it's actually about what's the right one for you. And the actual decision points will be different for every person. But I think OR for Glipron will be a lovely addition to the toolbox.
[16:46]
A
And that's what's coming up next at 1:30. So if anyone wants to be sure to catch that, you can just follow Alice on her way to the session hall.
[16:56]
B
So you're up next.
[16:59]
A
All right, so I'll start as well with one of the things that brings me to scientific sessions each year and which was so much fun for me in particular this year is being able to observe current and former students, fellows, postdocs, presenting their science and their work and having the opportunity to mentor individuals at my own institution, other institutions
[17:29]
F
who
[17:29]
A
are here presenting their science, making connections, establishing collaborations and advancing to the next steps in their work. And that's a real fun and exciting part of this conference. And only, I mean the greatest stage in the world for doing that in diabetes. And so that's been terrific. I will highlight one session which I'll try to not put everything that I've written here, but Saturday morning I went to the symposium on harnessing big data to decode immune mechanisms in type 1 diabetes. And so look for this session what really was struck me overall I'll start with is so there is an NPOD program collecting organs and tissues of individuals at risk of and with type 1 diabetes and controls that's evolved into supporting an HPAP program Human Pancreas Analysis Program sponsored by the NIH. This has furthered over the past decade the collection of these very precious materials from organ donors and and their families that have really informed the hope would be why type 1 diabetes develops. And this should inform the current clinical staging that we now understand with when autoimmunity develops far ahead of the presentation of clinical disease. And in this symposium Todd Brusco from University of Florida, he presented work on applying now spatial transcriptomics. This is single cell expression resolution with preserved tissue architecture. You can see what cells are communicating with which how they track and home throughout from draining lymph nodes into pancreatic tissue and really maps the disease unfolding. Klaus Kessner from University of Pennsylvania presented work on evaluation of double stranded rna which forms all the time in transcriptional regulation in our cells but is normally edited or can mimic a viral infection. And really demonstrating how genetic risk for type 1 diabetes is involved with this double strand RNA burden that in the beta cell leads to interferon activation, early inflammation that can be the triggering event for autoimmunity. And then doing work with Juan Alvarez at Penn with inducible pluripotent stem cells from individuals with type 1 diabetes recapitulating this process in vivo. And then we had Kyle Galton at University of California, San Diego. He's taking a genomics approach to all this and understanding the immune response, mapping cell specific changes in gene regulation and its expression as autoimmunity and diabetes develops in the pancreas and really highlights the central role of the beta cell and these initial stress inflammatory responses and changes that occur in cell cell communication. And then Mohammed Haj D Foolian while at Harvard he developed this de novo T cell epitope discovery which Mohammed's now come to University of Pennsylvania where he's applying this tool for understanding T cell receptor and HLA interactions in type 1 diabetes. Doing this with the HPAP program and mapping pancreatic antigens that are recognized by T lymphocytes in the pancreas and the draining lymph nodes to discover novel antigens driving type 1 diabetes. And so this just is an example to me of how investments in these programs more than a decade ago, before the technologies that were used in this symposium did not exist then. But the vision and wisdom to invest in the research and the science so that we could now gain this understanding and develop new possibilities for intervening early in type 1 diabetes was just extraordinary. So recommend everyone take, take A look at that session.
[22:12]
B
That was wonderful, Mike. And it really reminds me of how important basic research is to what we use in the office every day. I want to remind our listeners who might not fully understand when you said, take a look at this, because of course, our listeners who hear this podcast next week aren't here, that all of these programs are available on demand. For those who came to the psy sessions, but are also available, you can go to ada's website and
[22:46]
C
you can
[22:46]
B
purchase the ability to go to any session that is on the on demand schedule, and you'll learn as much. You don't have as much fun as if you were here, but you can learn as much as if you were here in person.
[23:03]
E
Richard well, first, I guess you want me to talk about why I enjoy coming to the ADA scientific sessions. I probably have the most gray hair of anyone on the panel. My first ada was in 1981, and I figure I've been to half of the scientific sessions that ADA has ever held, but it's been an interesting evolution, meeting people in the halls, getting to know people. But the most important thing to me, where my career was really in continuing medical education, was the exposure to people in all the different disciplines that contribute to what the ADA does. The clinicians, the educators, the researchers, the pharmacists, everybody that's in this group comes here. I can learn what they do, listen to their sessions. And it really makes me a lot more rounded in my approach to diabetes and what I'm doing by seeing what other people do. I think the diversity of what we can see is part of why I've loved coming to all these ADAs. Now, in terms of the session that I want to mention, I'm going to be a little bit of a homer, if I might, because this is the first year of the journal Diabetes, Obesity and Cardiometabolic Care. And so I'm going to speak about the journal symposium, which was on the cost of treatment of obesity. And obesity is a really important subject. It's in the center of the journal's name, Diabetes, Obesity and Cardiometabolic Care. And it overlaps with a lot of the disciplines that we're talking about in that journal. So I think it's a very appropriate topic for the first journal symposium. And cost is something that's on everybody's mind these days. Now, the first presentation in the symposium really blew me away because the discussion was on what the actual cost estimates were. And again, any of these cost estimates have to be sort of rough and estimates, and you Know, how do you assume what the cohort is? Is everybody being treated and so on. But the medical cost savings just directly for medical costs was $1.8 trillion. That's with a T. And then they factored in, however, they magically, statistically did this. Labor force gains by not having people get sick, 2.7 trillion. Decreases in absenteeism in the billions. Quality of life gained estimated between 5.6 and 8.5 trillion, for a total of $10.5 trillion saved. And I'm not sure how they even factored in some of the costs of medical support that you need when you're using some of the newer medications, teaching people, nutritionists and educators. So the arithmetic is complex, but the dollars are huge. Another presentation looked at it from the provider perspective, talking about the various factors that go into obesity treatment and the barriers to that treatment. The stigma of weight issues and an interesting stigma that I hadn't heard of, stigma of using the medications to lose weight. Oh, you have to use the medications. I'm doing it with diet and exercise. And that's something else that I hadn't really thought about, but it's an interesting concept. And barriers, of course, the socioeconomic barriers, disparities and so on. And as we move forward in time, these will all evolve as these newer treatments become more ubiquitous. But I think those are things that we think about in the equation. And the final presentation looked at it from the insurer's perspective. And the insurance companies are finally having to realize that the treatment of obesity may make financial sense, but they have to figure out what their cost model is because they're not directly benefiting. Well, maybe, maybe not from people's less absenteeism or their quality of life, or maybe they are or how do they think about it? So it gives us a lot of things to think about going forward. And it was a fascinating, fascinating exploration of all of the perspectives on the cost that we're also cognizant of. Again, to put into a plug. This is available on the ADA webcast. But in addition to that, we conducted a podcast just after the symposium, and I think it's going to be posted fairly shortly. And so there's a special podcast on Points of Care where you can hear the participants speak about their presentations.
[28:09]
B
It's fantastic. And those meta issues drive a lot of what we do. Thanks so much.
[28:14]
D
Yeah. So starting off with why I attend the symposium, I think it, it really heralds back to what has already been discussed on the diversity of work that's presented here and that you can interact with anything from the benchtop all the way up to the bedside, all these different topics. I think there's also the people that are attending. I'm really curious with the audience. How many students might be students, trainees, might be in the audience? Anyone? How many PhDs are in the audience? Just a few. How many MDs, a few people that are working or characterizing themselves more in the basic science, pre clinical research? Anybody? And then how many people might be doing more clinical research? So you have quite a variety of people that are doing various aspects of research, care and treatment of diabetes. And I think this is an excellent opportunity to interact with those people. Another aspect of diversity. Anybody from Louisiana, how many people from the United States? What about international? That's awesome, right? Like this is an international conference and there's opportunities to be able to communicate with your colleagues, your potential collaborators, being able to develop these types of research programs that you want to have, that you can focus in on techniques, research topics, that you can get expertise all around the world. So this is a fantastic venue to get that exposure and to be able to talk to these people. But I have to be honest, you know, this is New Orleans, right? I am here in part because of bread pudding, bananas Foster Po boys, shrimp, Gulf oysters, turtle soup. And I think there's a lot of people here that probably have experienced that. And we've seen people staggering into the convention center after possibly a late night in a specific region of the city. Great music and other things that being characterized as entertainment. So these venues that you can attend these meetings at can also be a driver for being able to sit down and have those conversations, to develop those collaborations and extend the meeting outside of the conference center to really network and get those long term friendships, colleagues, whatever you need for your career development, but also for your independent research programs. And then at the meeting itself, a little bit of a homer as well. The Diabetes Journal has its own symposium that they hold here. And in this symposium they were focusing
[30:59]
A
on
[31:02]
D
less talked about non classical complications of diabetes. And the speakers for this session were Norbert Stefan, John Usher, Julia Critchley and Lorraine Lipscomb. And they talked about how diabetes could be linked to mass, LD or fatty liver disease, diabetes being linked to cancer or infection risk, and then diabetes, also in cardiomyopathy and how you might need to recharacterize or reframe or try and better understand how these different complications are developing. I think these investigators, these presenters should actually be complimented. And I think Jane Kastner and Shannon in the back of the room would appreciate that these investigators submitted a review article to the journal in a timely fashion. Timely enough that they were able to get these articles out for peer review. And these articles are going to be published in the August edition of the Journal of Diabetes. So in addition to the on demand functions of the American Diabetes association that you might be able to watch, listen to these specific talks. You can read more about their articles in the August edition of Diabetes. And as a podcast, we're trying, we're in communication with these authors to get them to come on the podcast and discuss more about these non classical complications so that y' all can learn more about this. And I should say, you know, I'm a neuroscientist, so I study how the brain regulates energy balance and glucose metabolism. Do I have any friends in the audience maybe?
[32:29]
A
No.
[32:29]
D
Nobody raising their hand? Well, you know, this meeting, a lot of neuroscientists might think that they don't have a place. And I want to say to those people that are on the fence about attending a meeting like this, there are a lot of sessions that are focusing on how the brain is involved in regulating energy balance and glucose metabolism, how these pharmacotherapies that have been recently developed, incretin based, dual Incretin, and then as they're getting multiple polypharmacology unimolecular drugs out there and how they're acting in the brain, there's a huge emphasis at this meeting to try and better understand that. There's a symposia coming up just at 1:30, which I would actually like to get to, which is going to have Brad Lowell, Long Long Tu, Sarah Stern and Ziping Peng, which is also being chaired by Quincean Tong, focusing on the plasticity of the brain and regulating energy balance and glucose metabolism. So there is a place for neuroscientists here to try and network and develop those contacts that can be International across PhDs, Maryland and then also the venue of this city. So I really encourage those that might be listening and on the fence to attend these meetings, to definitely look them up and sign up and come join us all.
[33:50]
C
All right, so why do I come? It's a chance, first of all to hear great science, but really it's a chance to meet your mentors and your colleagues and old friends and have those conversations in person that just don't always translate quite as well over zoom. Some of the, the people that were actually missing or one of them is Darlene, my co host. And she sent along actually a symposium that she was sad to miss. And so I guess in her stead, I'll discuss it a bit here. The title was Sexual Dimorphism in Islet Responses in the Settings of Diabetes and Obesity. And, you know, she wanted to communicate that these are things that we've known about for a long time. But it's great, great to see them get a little bit of highlighting and trying to understand the mechanisms driving them. Work that was discussed spans those differences from bench to bedside and has real implications for us understanding mechanisms and future treatments. Now, on my behalf, my favorite session was actually the Scientific Achievement Award Talk. It was given by Dr. Timo Mueller, and Timo and I were postdocs in the same lab at the same time. We had desks right beside each other. I played music he hated.
[35:22]
D
Are you going to share any stories?
[35:23]
C
No, not right now. This is his time. So seeing your friends sort of rise to prominence and being able to enjoy that is really, it's something wonderful. So that was my favorite.
[35:40]
B
That is fantastic. I'm just struck before I share my reasons for coming and what I enjoy and the session I found most compelling. But I'm just struck as I listen, about two things. One, the core reason that we all come is both relationships and the opportunity to access the science. The aspects of science that we're each interested in are remarkably different. And that's why, of course, we're all important in this process. And I'm also struck by just what each of our podcasts offer that is different but makes a cohesive whole. And I find that exciting. And, you know, there are times in life one feels particularly lucky, right? We all have those times. And for me, I'm experiencing one of those moments because the privilege of being here, right? Of spending one of my reasons for common what I enjoy most, actually, it's just walking around, running into people. And what I hate most about it is I keep missing a session that I was planning to go to and wanted to hear about because I run into someone that I haven't seen in a year and end up talking to them. And I have this fantasy that I'll go back to the On Demand and watch each of those, knowing full well I'll have to be very selective, right? Because who has the time? But so for me, it's the people that are so important and that drive me to being here. And the other reason, frankly, I feel lucky is just to be a part of this, right? Like, we live in an age where technology has enabled us as researchers and educators to communicate with our peers In a thoughtful way, using technology, with all these different podcasts. And that's incredibly exciting and fortunate. What did I go to that I found compelling? A bunch of stuff. But the one that stood out to me was the triumph. One study of retatrutide. And retatrutide is of course, the triple g agonist, a GIP GLP1 leukagon receptor agonist. And it was a fascinating trial and its construct because it was a large placebo, usual blinded randomized trial, but it had what they call basket trials in it. It didn't just look at weight loss, which we'll talk about in a moment, but it also included a basket trial on osteoarthritis of the knees and a basket trial looking at an endpoint of obstructive sleep apnea, two very important consequences of obesity. It met all its primary endpoints. The significant decrease in pain for people with osteoarthritis of the knee, a decrease of like 60% in AHI. Apnea hypopnea episodes. The apnea hypopnea index that that reflects the number of episodes of decreased or stopping breathing that someone has per hour during the night went from like 50, 55 down by 60%. And then of course, the primary endpoint, and there were two of them. One was at 80 weeks. So they did a continuation trial with a portion of the population to 104 weeks. At 80 weeks, there was approximately 28% weight loss. And at 104 weeks, there was over 30% weight loss in this cohort of patients. And, you know, we get lost in these percentages. So how much weight is that? It's about £85, if I remember correctly. And then what is £85? I was packing my carry on today and, you know, when I lift, when I lift it to the overhead, it feels heavy. And that's about £25. When you pack one of those massive bags that when you go away on vacation with the family, you swear to yourself you're going to take a smaller bag, it doesn't fit. You then use the larger bag and you push it. And they only allow up to £50. Right? That fits into that. And I know at home when I lift that it is really. It feels really heavy. I can barely lift it. I know one conclusion is that, like, I should work out more. And that might be true. But the other conclusion, that's £50, £85. I couldn't. You can't lift. That's a lot of weight. And many of our patients are walking around carrying that with them every hour of the day as they, they are moving through life. So the opportunity here is an important one. And Alice, you gave the putting it in perspective conclusion to that talk, and you made the point that that's not for everyone. And I agree. And really, what this trial, what this medicine ushers in, is a new responsibility for those of us who are in clinical care to decide which is. And a lot of this is going to be shared decision making, right discussions with our patients, but to decide which is the right medicine for the right patient, because we range now from around 10, 11% to 30% and different people need different medicines. And this is a lot of people who need these medicines. And there's going to be a lot of learning to be done. I think it was on the Lucy showed a lot of explaining to do to patients, to clinicians in order to understand how to tailor our recommendations with shared decision making to the needs of the individual patients. So that was my most exciting study. I want to say we're going to bring this to conclusion a little early for two reasons. One is two of our panel members want to need to get to important symposiums that are coming up and we made the effort to be here in addition to planning to watch the online demand stuff. And then also because as we talked earlier, we recognize that while we were given an hour to talk about things, an hour is probably longer than many people people have concentration for. And I think we said at the beginning, if it ended up not being very good, we better make it short. But if it is very good, keep it short and leave them wanting more. So I want to thank our panel, I want to thank Ada and certainly everyone who joined us today for being a part of it and allowing us to share about our podcasts, individual backgrounds and things we were excited about. Thanks. It was a meeting filled with lots of information. Before we wrap up, a reminder that recordings from the American Diabetes Association's 2026 scientific sessions are still available on demand at ADA2026.org if you registered for PSY sessions, you can access session recordings through August 10, 2026. If you were unable to attend or did not register on demand, access to the recordings may still be purchased through August 7, 2026, with all video content remaining available for viewing through August 10. In addition, eligible attendees can claim continuing education credit for their participation in the scientific Sessions by visiting ADA2026.org. For complete details and access information, visit ADA2026. Till next time, stay safe and keep learning.