As SARS-CoV-2 and its prolific progeny of variants continued to colonise the globe the American Diabetes Association (ADA) trialled what is becoming the ‘new normal’ for large meetings and hosted a hybrid event with both actual and virtual presenters and dele- gates. Watching online, and interacting via a screen and chat rooms or Twitter, spares us the torture of air travel and jetlag, but lacks the experiential impact of brushing shoulders with colleagues from overseas, exchanging news and views, both professional and personal, and absorbing a more holistic view of the world and the congress topics considered ‘hot’ by the professionals (rather than the media).
Several of the 2022 sessions commenced with upbeat music and razzamatazz reminiscent of a political convention, followed by all the presentations in the session on the same webcast (encourages serendipity), so it is helpful to have a programme when seeking a specific lecture.1 Some sessions were streamed live whereas others became available up to 24 hours later (all are available now on the ‘Watch Again’ option). Links to this year’s scientific sessions can be found on the ADA website.2 Registered delegates (www. ada2022.org) have a Quick Links option leading to the sessions, e-posters, corporate symposia, product theatres etc. For non-registrants there is ample opportunity to peruse reports of issues considered noteworthy: ADA TV can be viewed on YouTube, and 2022 Highlights (www.adahighlights.com) also supplies daily conference summaries, expert overviews and commentaries plus interviews with key speakers and the ADA leadership, as well as poster podcasts and downloadable slides. ADA News reported on the daily events at the meeting and continued to publish session coverage until the end of August 2022.3 For those who wish to read original material, the Scientific Sessions Abstracts (including late breakers and published only abstracts) are available as a supplement to the journal Diabetes.4
As always, the award lectures were high-points of the meeting, particularly as this year’s recipient of the Banting Medal and Outstanding Scientific Achievement Award was Oxford’s Professor Frances Ashcroft (Table 1). Interestingly, most awardees at this year’s event were women – even when discounting a ‘ladies only’ prize. Notwithstanding the award lectures, the New Orleans meeting provided a brobdingnagian buffet of presentations to cater to all tastes, including plenty of old chestnuts (occasionally with minor embellishments) headlined as major innovations and data dredging with sub-analyses of familiar trials and meta-analyses.
The only real novelty at the meeting was supplied by studies of the once-weekly GIP/GLP-1 receptor agonist tirzepatide. A symposium was dedicated to the results of the first phase 3 clinical trial with this dual receptor agonist (SURMOUNT 1) in obese people (mean BMI 38 kg/m2, 104.8kg) with related complications, excluding diabetes. The 72-week trial included 20 weeks of dose escalation to achieve the target dose (5/10/ 15mg sc once-weekly). All doses resulted in significant weight loss compared to placebo and at least 85% of treated subjects experienced a 5% decrease in body weight (vs 35% on placebo); a >20% reduction in body weight was achieved by 50% and 57% of people receiving 10mg and 15mg, respectively. The commonest adverse events with tirzepatide were gastrointestinal. Trial discontinuation occurred in 4.6-7.1% of those receiving tirzepatide and 2.6% of people on placebo.5 SURPASS 1,2,3 and 5 investigating tirzepatide in people with T2DM were presented at ADA 2021. This year SURPASS 4 (in patients at high cardiovascular risk, of whom 87% had had an event and nearly 55% had poor renal function: eGFR<60mL/min/1.73m2, microalbuminuria or macroalbuminuria) showed that tirzepatide reduced the decline in eGFR, new-onset macroalbuminuria, progression to endstage renal disease and renal death compared to patients treated with insulin glargine.6 The SURPASS studies have been reviewed by De Block et al.7 A session devoted to the ADA-EASD guidelines discussed potential alterations, but decisions were deferred to permit further discussion prior to presentation at EASD 2022.
Now is the time to plan for some California dreaming and book your annual leave to include 23-26 June, 2023, when the ADA meeting will take place at the San Diego Convention Center. It is in the Marina District of downtown San Diego with stunning views across San Diego Bay and the city offers access to diverse geography within a few hours’ drive (I should have been a tour guide), or if you’re not feeling too adventurous, perhaps a trip to the city’s famous zoo? January 9th is the deadline for abstract submission.
Correspondence: Dr Caroline Day, Visiting Fellow, Diabetes Group, Aston University, Birmingham B4 7ET, UK
E-mail: cday@mededuk.com
https://doi.org/10.15277/bjd.2022.391
Br J Diabetes 2022;22:147-148