American Diabetes Association, June 20-23

The annual meeting of the American Diabetes Association was held this year from June 20 to 23 in Chicago, drawing more than 15,000 participants, including clinicians, academicians, allied health professionals, and others interested in diabetes. The conference highlighted the latest advances in diabetes research and improving patient care, with presentations focusing on treatment recommendations and advances in management technology.

As part of the INHALE-1 study, Michael J. Haller, M.D., of the University of Florida in Gainesville, and colleagues found that inhaled insulin is safe and effective for use among children with type 1 diabetes.

The authors randomly assigned 230 children with type 1 diabetes using basal injected insulin to either placebo or inhaled insulin (Afrezza) as a replacement for rapid-acting meal insulin. The researchers found that Afrezza was no different than rapid-acting analogue (RAA)-injected insulin with regards to hemoglobin (Hb)A1c at 26 weeks, with no concerning safety signals. In addition, children on Afrezza experienced less weight gain compared with those on RAA. Both children and their parents indicated higher satisfaction scores with Afrezza compared with RAA insulin.

“Following what will hopefully be U.S. Food and Drug Administration approval for the use of Afrezza in pediatrics, I expect use of Afrezza in youth with type 1 diabetes will increase markedly. Once [it is] labeled and FDA-approved, we will have more meaningful opportunities to explore the many anecdotal use cases for inhaled insulin,” Haller said. “As just a few examples, use of inhaled insulin in new-onset diabetes, use of Afrezza to optimize management with exercise, and use of inhaled insulin in collaboration with automated insulin delivery systems are all opportunities in which inhaled insulin may offer important advantages and provide additional important options to optimize control for youth with diabetes.”

The study was funded by MannKind, the manufacturer of Afrezza.

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In another study, Nestoras Mathioudakis, M.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues found that a fully automated artificial intelligence (AI)-based Diabetes Prevention Program (DPP) is just as effective as human-delivered DPP in reducing type 2 diabetes risk among adults with overweight/obesity and prediabetes.

In a randomized controlled trial, the authors evaluated a fully autonomous AI-based behavioral intervention (i.e., no human coaching or oversight) against an established gold standard in medicine. They also assessed an AI-based lifestyle intervention and an active comparator representing the current standard of care for diabetes prevention: the human-coach-based DPP. The AI-based DPP tested in this trial was fully automated, incorporating a reinforcement learning algorithm to deliver hyperpersonalized just-in-time adaptive interventions based on user behavior and context.