EASD 2021: Integrating and personalising care to improve health outcomes along the diabetes journey
The 57th Annual Meeting of the European Association for the Study of Diabetes (EASD) 2021 took place from 27 September to 1 October as a virtual event due to the ongoing impact of the COVID-19 pandemic. The programme of Europe’s largest and most prominent meeting on diabetes offered healthcare professionals from around the world the opportunity to share ideas about cutting-edge research and studies, treatment, and care in diabetes.
This year's EASD highlight from the company's perspective was certainly the symposium "Personalising diabetes care along the entire patient journey". Hosted by Roche Diabetes Care, internationally renowned experts shed light on the various areas in which Roche is active in the field of diabetes: integrated Personalised Diabetes Management (iPDM), medicines, and diagnostics.
Missed the symposium? Don't sweat it! Here are the three presentations in a nutshell. If you would like to delve a little deeper, check out snippets featuring a few highlights listed below or the entire symposium.
iPDM drives improved patient-reported outcomes
According to Kamlesh Khunti, University of Leicester (UK), people with diabetes are still not receiving optimal care and type 2 diabetes is associated with poor long-term outcomes including mortality. One of the key factors that may lead to fluctuating blood glucose levels, as well as macrovascular and microvascular complications is therapeutic inertia. It can be caused by lack of patient adherence to treatment, financial and resource issues, very complex regimens, lack of education, to name just a few.
"What is it ultimately that people with diabetes want?
Research shows they want to live a long and happy life."
A patient-centred, holistic and personalised approach using digital health solutions addresses these barriers. iPDM is set up to overcome therapeutic inertia, improve outcomes and support all involved in the diabetes care continuum: It supports people with diabetes experiencing true relief and achieving more time in range; health care professionals are enabled to deliver effective care resulting in improved outcomes, and, last but not least, it helps healthcare systems to ensure efficient and sustainable care provision. One of the many benefits of iPDM is that it has been shown to facilitate and strengthen collaboration between health care professionals and patients. It encourages time-efficient interpretation of data and therefore better-informed therapy decisions by the caregiver. Evidence suggests that iPDM can also help to prevent acute and to delay long-term complications.1
Despite much progress in the field of iPDM, further work is needed to automatically integrate diverse therapy-relevant data with people-related outcomes. These are aspects that are most important to people living with diabetes and that only they can assess, such as their views of symptoms, their functional status and their health-related quality of life. Only then will personalised care become a reality in the future and improve patient outcomes in the long term.
- The importance of glycemic control (0:33 -1:51)
- iPDM in diabetes management (13:58-14:52)
- What do people expect from treatments? (33:12-34:21)
Screen, triage, and treat – a digital paradigm for risk stratification in chronic kidney disease (CKD)
Navdeep Tangri, University of Manitoba (Canada), shared remarkable advances that were made using machine learning methods to help in one of the most severe secondary complications related to diabetes. Identifying patients with CKD as early as possible is a key factor in preventing kidney failure.
"Current clinical practice is blind to risk.
We need this stratification method to shine the spotlight on the highest risk patient
so that physicians can focus their energy."
A predictive tool developed by Roche and IBM based on real-world data can help with this. Following the screening, a tailored risk stratification method, such as the so-called Klinrisk model that was co-developed by Roche Diagnostics, can be used to triage CKD patients and identify those most likely to progress. Once the patients at the highest risk are identified, these people have to be treated early and appropriately. Combining all these methods can pave the way to risk-based care. Further information on this topic can be found on the poster that has been published by Roche at the EASD.
- The need for a new approach to CKD (01:23-02:26)
- Applications of artificial intelligence (04:10-04:40)
- Enabling risk-based care (16:33-18:52)
Innovative therapies and future integrated solutions can enhance the management of diabetic eye disease
Praveen Patel, NIHR Biomedical Research Centre at Moorfields Eye Hospital (UK), discussed the current landscape regarding the management of diabetic eye disease with the focus on diabetic retinopathy (DR) and diabetic macular edema (DME). He gave an overview of screening approaches and innovative diagnostics for DR and DME.
"The cornerstone of maintaining good vision in the long term is prevention of diabetic eye disease and
making sure people understand the importance of systemic disease control."
Furthermore, he talked about therapeutic options and future integrated solutions to optimise disease management. New therapeutic strategies are in development to relieve the current treatment burden and address the multifactorial nature of eye diseases. However, there is still a significant opportunity to develop new therapies for patients with diabetic macular edema and retinopathy to make sure that they maintain better vision in the long term.
- Ophthalmic complications of diabetes (01:20 -03:01)
- Limitations of screening programmes (08:55 – 09:49)
- Future solutions to optimise treatment (10:35 – 11:49)
Real-life experiences: DBLG1 with Accu-Chek Insight insulin pump
Right after the Roche symposium at EASD, another exciting session was held by Diabeloop discussing “Time In Range and reducing hypoglycemia among people equipped with Diabeloop DBLG1”. The company presented very promising data from about 1,000 patients in Germany using the automated insulin delivery system including the DBLG1 algorithm and the Accu-Chek Insight insulin pump. One of the main insights unveiled is significantly improved overall Time in Range (70-180 mg/dL) of 73.4% as well as reduced time spent in hypoglycemia for all study participants. In the 5 countries where DBLG1 System is currently available, feedback from equipped patients has been very positive about its impact on TIR and hypoglycemia, in addition to the system’s ease of use and enhancement of quality of life. 2-4
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1 Kulzer B. et al., Diabetes Res Clin Pract. 2018 Oct;144:200-212
2-4 Presentation at 57 EASD Annual Meeting, Diabeloop symposium and meet-the expert session:
- Real-life internal data (YourLoops data extract, September 3 2021): 998 patients from Germany, who gave consent, equipped with DBLG1 System with Accu-Chek Insight insulin pump
- Data from 152 patients equipped with DBLG1 System with Accu-Chek Insight insulin pump in Germany from April to September 2021 with available HbA1c at initiation, based on [Beck and al. 2019] equation for hb1Ac <=9% and hb1Ac>=6%”
- C. Amadou et al., Diabetes Care 2021 Jan; dc201809. doi:org/10.2337-dc20-1809’