Diabetes Dialogue: Orforglipron Topline Results & ADCES 2025 Part 1

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

This episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives features 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. They share key insights and takeaways from the Association of Diabetes Care and Education Specialists (ADCES) 2025 annual meeting.

Before the discussion on ADCES 2025, hosts discussed new topline data on orforglipron in patients with overweight or obesity, an investigational oral, non-peptide glucagon-like peptide-1 (GLP-1) receptor agonist. The ATTAIN-1 study, a 72-week trial involving over 3000 adults with obesity or overweight and related medical conditions, demonstrated an average weight loss of 12.4% (27.3 lbs), significantly greater than the 0.9% (2.2 lbs) observed with placebo. A key distinction of orforglipron and oral semaglutide is its non-peptide nature, which removes the stringent administration requirements typically associated with peptide-based oral GLP-1 agonists, potentially enhancing patient adherence. The hosts anticipate this agent could revolutionize weight management pharmacotherapy and foresee its potential approval for both diabetes and obesity indications.

Insights from the ADCES meeting highlighted the expanding therapeutic scope of incretin-based therapies. During the "Incredible Incretins" session, phase 3 and emerging data were presented on GLP-1 receptor agonist applications beyond the traditional management of type 2 diabetes and obesity. Conditions for which therapeutic potential was discussed included obstructive sleep apnea, metabolic dysfunction-associated steatohepatitis, osteoarthritis, heart failure, kidney disease,and even Alzheimer’s disease. Notably, the ongoing EVOKE study is investigating oral semaglutide for Alzheimer's disease, with results expected in September 2024. These broader indications are considered critical for improving patient access to these transformative medications, particularly given existing coverage challenges for obesity treatments.

The episode also delved into the growing integration of artificial intelligence (AI) in diabetes management. Isaacs emphasized the imperative for clinicians to adopt AI tools, drawing a parallel to the adoption of new insulins or continuous glucose monitoring (CGM) systems. Examples of AI applications cited include retinopathy screening and the Open Evidence tool. While AI is advancing rapidly, the hosts stressed the importance of verifying information and references.

The discussion also covered AI integration into mobile apps, such as Dexcom G7 for food recognition, and platforms like GlucoSense providing personalized insights from various patient data points, offering valuable support between clinical visits.

Lastly, the hosts reflected on a pre-conference workshop on implicit bias, led by ADCES President Veronica Brady, PhD, RN. This session aimed to foster awareness and discussion among diverse healthcare professionals about unconscious biases, which may inadvertently impede equitable access to advanced therapies and technologies for 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.