The ADA Scientific Sessions is an opportunity to catch up on the most important advances in diabetes research, prevention, and care of the past year. And a blockbuster year it has been with major advances building on the growing understanding of diabetes as more than a glycemic disorder.

“I’m 20 years out of training, and diabetes is not the same disease I met in medical school,” said Vanita R. Aroda, MD, Director of Diabetes Clinical Research at Brigham and Women’s Hospital and Associate Professor of Medicine, Harvard Medical School. “Elevated A1C isn’t diabetes, it is just the tip of an iceberg of deeper, more complex metabolic disorders. What we are seeing is that glycemia is a manifestation of a metabolic system gone awry within the body and affecting the whole body.”

Dr. Aroda will discuss the key clinical science discoveries of the past year during ADA Symposium—Major Advances and Discoveries in Diabetes—The Year in Review on Monday, June 24, from 8:00 a.m. – 9:30 a.m. ET in Room W415C, the Valencia Ballroom, of the Orange County Convention Center. The session will be livestreamed on the virtual meeting platform for registered meeting participants. It also will be available on-demand following the 84^th Scientific Sessions.

Discoveries around glucagon-like peptide-1 (GLP-1) receptor agonists and other incretin mimetics have been in the headlines virtually nonstop since the 83^rd Scientific Sessions in 2023.

“New findings in incretins have revolutionized how we think about diabetes, how we can best support patients in achievement of their goals,” Dr. Aroda said. “These insights are giving us the potential of being able to modify the underlying metabolic processes that contribute to the development and progression of diabetes. If you understand diabetes, you have unique insight into all of medicine, because diabetes provides a window into what is going on metabolically within the body and what can be addressed to improve overall health.”

Bruce Verchere, PhD, Professor in the Departments of Pathology & Laboratory Medicine and Surgery, University of British Columbia, Canada, will highlight the latest basic science research related to diabetes.

Ongoing development of incretin-based therapies for diabetes, cardiovascular disease, renal disease, weight loss, and more is the most visible step in the long, often-twisting journey from basic to translational to clinical science.

“One of the most important developments is the growing understanding of the role hormones made by the intestine play and determining their function in other tissues,” said Mary-Elizabeth Patti, MD, Senior Investigator and Director of the Hypoglycemia Clinic at Joslin Diabetes Center and Associate Professor of Medicine at Harvard Medical School, who will discuss breakthroughs in the translational science of diabetes.

“For example, we know that gastric inhibitor polypeptide (GIP) is one of the hormones released in response to food,” she continued. “We are learning more about how GIP is important in other tissues, not just in the pancreas but also in adipose and other tissues. There are additional hormones coming from the intestine that affect metabolism that are being identified.”

Hormonal discoveries are just the beginning, Dr. Patti said. New genetic data and novel analyses suggest there are more genes influencing diabetes risk than have been appreciated in the past. New genes and new regulatory pathways suggest new opportunities to alter gene and protein activity as future therapeutic targets.

Other emerging data suggest that major sex differences in metabolism may trigger different mechanisms responsible for diabetes in men and women.

New findings in gut-brain signaling appear to involve the microbiome, which may influence communication between the gut, brain, liver, and other organs to help regulate metabolic activity. All of these novel pathways could offer potential therapeutic targets.

“This session can help all of us think outside the box when we are looking for new insights into diabetes pathophysiology,” Dr. Patti said. “Translational research is critical to developing and testing exciting new hypotheses. This science may ultimately transform clinical care.”