#diabetesmatters - what’s in the pipeline for diabetes care? - adams

What’s  in  the  Pipeline  for  Diabetes  Care?  

Lenley  Adams,  MD  FRCPC  FACP  Diabetes  Ma>ers  May  12,  2017  

Presenter  Disclosure  

•  Presenter:  Lenley  Adams,  MD  FRCPC  FACP  

•  Rela,onships  with  commercial  interests:  –  Advisory  Board:  NovoNordisk,  Sanofi,  Medtronic,  Merck  –  Speakers  Honoraria:  AstraZeneca,  NovoNordisk,  Sanofi,  Medtronic,  

Merck,  Boehringer  Ingelheim/Lilly,  Janssen,  Valeant  

ObjecGve  

•  Review  upcoming  diabetes  treatment  and  technologies  

Evidence  

•  Ongoing  CV  outcome  trials  

Insulin  

•  longer  acGng  insulins    –  Insulin  degludec-­‐  fall  2017  

•  faster  acGng  rapid  analogs  – Faster  acGng  insulin  aspart-­‐  Fiasp-­‐  available  

•  SEB/  biosimilars  

Insulin  

•  oral  insulins  

•  glucose  dependent  insulins  

GLP1  Receptor  Agonists  

•  Currently  injectable  once  daily  or  weekly  •  Oral  GLP1-­‐  RA    •  GLP-­‐1/GIP  dual-­‐agonist    

CombinaGon  therapy  

•  Long  acGng  insulin  with  GLP1  receptor  agonist  –  Insulin  degludec  and  LiragluGde  –  Insulin  glargine  and  LixisenaGde  

Type  2  Diabetes  Remission  

•  Early  insulin  for  inducGon  of  remission  

Monitoring    

•  CGM/  Libre  

Insulin  Pumps  

•  Patch  pumps  •  Hybrid  pumps  

ArGficial  Pancreas  •  Dual  hormone  pumps  with  sensor-­‐    bionic  pancreas  

Glucagon  

•  Glucagon-­‐  intranasal,  analogs  

The  near  future  •  Stem  cell  derived  islet  cell  replacement    

•  Diabetes  Canada  2018  Guidelines  

What’s  coming?