Diabetes Dialogue: ADCES 2025 Recap Part 2

Welcome back to Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!

In this episode, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, highlight key advancements in diabetes management, particularly in continuous glucose monitoring (CGM) during pregnancy and the anticipated future of continuous ketone monitoring, from Association of Diabetes Care and Education Specialists (ADCES) 2025 annual meeting.

Their second ADCES 2025 episode, the discussion on CGM in pregnancy underscores the increasing availability and utility of these devices, with devices like the Dexcom G7 and the Libre 2, Libre 3, Libre 2 Plus, and 3 Plus are now cleared for use in pregnant individuals. Hosts also explored the potential role of over-the-counter devices, such as Stelo, for gestational diabetes managed through diet and exercise, noting its shared technology with FDA-approved sensors and suitability for short-term use. Hosts pointed out the DipGluMo study on CGM in gestational diabetes did not demonstrate improved clinical outcomes, but it revealed strong patient preference for CGM over traditional finger-stick methods, indicating a significant improvement in patient burden and quality of life.

A smaller randomized controlled trial further supported CGM's benefit by showing greater time in range in the group using CGM for gestational diabetes. The hosts emphasized practical clinical tips, including adjusting CGM targets for pregnancy to 63-140 mg/dL (from the default 70-180 mg/dL) within AGP reports and mobile apps. A critical message for pregnant patients is the necessity of adequate carbohydrate intake for fetal development, with emphasis on spreading out consumption rather than restriction to prevent ketosis.

Looking ahead, the podcast detailed the expected launch of continuous ketone monitoring around 2026. This integrated glucose and ketone device aims to provide earlier alerts for ketosis, facilitating more timely interventions, especially given the variable glucose levels at which ketones can develop and the influence of certain medications like SGLT2 inhibitors.

The episode also touched upon innovative educational approaches at the ADCES meeting, noting a trend toward engaging game show-style product theaters to make learning more dynamic. Finally, hosts spotlight a pre-conference workshop on implicit bias for its focus on ensuring equitable access to the latest therapies and technologies for all individuals with or at risk for diabetes.

Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.