Three Emerging Topics Shaping the Future of Diabetes Care
by Christine Craig, MS, RDN, CDCES
The vibrant food, music, and culture of New Orleans, along with networking opportunities, were undoubtedly highlights of ADCES 24 this year. Thought-provoking sessions on health equality, disordered eating in diabetes, and strategies to prevent therapeutic inertia made ADCES 24 an enriching experience for all attendees.
Three key topics emerged on advancements aimed at improving individualized care management and actively shaping the future of diabetes care.
Artificial Intelligence (AI) is here to stay.
Diabetes care and education specialists will benefit from an improved understanding of the applications and integrations available at our disposal. Integrating AI into clinical practice offers significant potential for personalized patient care, especially in managing chronic conditions like diabetes. AI-powered tools can analyze vast datasets to identify patterns and provide tailored recommendations, enhancing the precision of nutritional guidance and diabetes management plans. However, challenges remain, particularly when ensuring the quality of AI systems. These models may lack diversity, leading to biases affecting data accuracy and recommendations.
Addressing AI biases is crucial to ensure AI tools support equitable healthcare delivery and foster better outcomes for all individuals with diabetes.
Whole Person Care – CV Risk Calculator
As our Standards of Care suggest, whole-person diabetes care involves going beyond glucose management and focusing on whole-body systems. Cardiovascular metabolic kidney (CKM) syndrome requires a multifaceted approach, targeting the interconnected risk factors of cardiovascular disease, diabetes, and kidney dysfunction.1 Published in 2023, the PREVENT calculator,2 developed by the American Heart Association Cardiovascular-Kidney-Metabolic Scientific Advisory group, provides a 10-year and 30-year risk estimate for CVD, ASCVD, and heart failure. The PREVENT equation considers cardiovascular and other risk factors such as urine albumin-to-creatinine ratio, A1C, or social determinants of health (zip code). We can utilize this risk calculator, but to address cardio, metabolic, and renal disease we can merge the health care silos and offer integrative, comprehensive care models and treatment plans.
By Christine Craig, MS, RDN, CDCES
Type 1 Diabetes Key Updates
There are exciting advances in type one diabetes management including technology, organizational updates, and a focus on progression prevention. The latest advancements in automated insulin delivery (AID) technologies and new partnerships expand options for individuals with diabetes. These advances and additions to the competitive market are crucial for enhancing patient care and offering personalized management strategies.
On June 4th, 2024, JDRF became Breakthrough T1.3 This name change reflects the breakthroughs in research, access, and education and represents the diversity in the age of those living with type 1 diabetes. Prevention of type 1 diabetes progression is focused on immunotherapy approaches, aiming to preserve beta-cell function and delay the onset of the disease. Clinical trials have shown promise with therapies such as teplizumab-mzwv, an anti-CD3 monoclonal antibody, which has been approved by the FDA to delay the onset of type 1 diabetes in individuals at high risk. Early screening and identification of at risk through genetic and immunological markers are also being integrated into clinical practice, allowing for earlier intervention and more personalized prevention plans.
A new Consensus paper published in June of 2024 provides “Guidance for monitoring individuals with islet autobody-positive pre-stage 3 type 1 diabetes”.4 The paper reviews education, monitoring, and treatment initiation recommendations and discusses psychological support systems. This consensus notes that monitoring of stage 1 Type 1 Diabetes will most likely take place within primary care offices; however, specialists may be needed to support stage 2 monitoring and education. There will be new ICD-10 codes to allow improved monitoring of islet autobody-positive pre-stage individuals to ensure appropriate tracking and treatment when required. These developments reflect an emphasis on not just managing type 1 diabetes but actively working to prevent its progression and improve the quality of life for those at risk.
As diabetes care and education specialists, staying informed and engaged with the latest tools and approaches can improve quality of care. I encourage you to delve deeper into these topics, explore how AI can enhance your practice, integrate comprehensive care models like CKM into management, and keep abreast of the latest developments in type 1 diabetes treatment and prevention.
Together, we can continue to elevate the standard of care and improve outcomes for all individuals living with diabetes.
1. Krentz A, et al. Rising to the challenge of cardio-renal-metabolic disease in the 21st century: Translating evidence into best clinical practice to prevent and manage atherosclerosis. Atherosclerosis. Volume 396, 2024. https://doi.org/10.1016/j.atherosclerosis.2024.118528.
2. PREVENT Calculator: https://professional.heart.org/en/guidelines-and-statements/prevent-calculator
3. Breakthrough T1: https://www.breakthrought1d.org/
4. Phillip M. et al. Consensus Guidance for Monitoring Individuals with Islet Autoantibody–Positive Pre-Stage 3 Type 1 Diabetes. Diabetes Care. July 2024; 47(8):1276–1298. https://doi.org/10.2337/dci24-0042
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