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Congress Report: 2015 International Diabetes Federation (IDF) World Congress

Congress Report: 2015 International Diabetes Federation (IDF) World Congress
  • Cardiometabolic
    Endocrinology and metabolism
  • Diabetes

Resource type

Publication

Tags

Type 2 diabetes mellitus
insulin resistance
mouse studies
new therapies
global burden

The focus of this major meeting (30 November to 4 December 2015, Vancouver, Canada) was the International Diabetes Federation (IDF) goals of the prevention of diabetes and improvement in the quality of life for the millions living with diabetes worldwide. Some of the highlights from the six topic categories are presented:

  • Basic and clinical science

  • Diabetes in indigenous peoples

  • Education and integrated care

  • Global challenges in health

  • Living with diabetes

  • Public health and epidemiology.


There is consistent underestimation of the numbers of people affected by diabetes and the overall global burden imposed by the disease, according to Paul Zimmet, Emeritus Director of Baker IDI Heart and Diabetes Institute, Melbourne, Australia. He posed the question, “Is diabetes the largest epidemic in human history?” and irrespective of the answer, diabetes will remain one of the greatest challenges to human health for many years to come.

Traditional drivers of the disease – genes, lifestyle, behaviour – are well-known, and attention is shifting to the impact of the intra-uterine environment and epigenetics. That the disease can be transmitted transgenerationally creates a vicious cycle, ever feeding the epidemic.

Harriet Kuhnlein from the Centre for Indigenous Peoples Nutrition and Environment at McGill University, Montreal, Canada, highlighted the challenges indigenous peoples face for food security and health.

Colonialism, environmental dispossession, ecological threats and rampant poverty along with the emergence of dietary excess and sedentary behaviour have led and are leading to obesity and chronic disease in traditional homelands. This is despite the treasures of food biodiversity and traditional knowledge that could support well-being. To combat this trend, indigenous peoples need help to build credibility of the benefits of their local food systems and to support the availability of healthy foods through markets. Knowing about, protecting and encouraging the many benefits of local cultural resources are all important.

A new environmental factor not previously given huge consideration in the development of type 2 diabetes mellitus (T2DM) has been identified from mouse studies – the gut microbiome – according to C Ronald Kahn from Harvard Medical School Joslin Diabetes Center, Boston, USA.

The collection of microbes in the gastrointestinal tract, affected by diet, genetics and previous environmental history can influence the production of inflammatory mediators by the gut and the secretion of gut hormones that, in turn, can influence energy intake and metabolic homeostasis.

Genes, the environment and complex interactions between the tissues of the body are all causal for T2DM, obesity and metabolic syndrome. Although multiple genetic loci have been found that contribute to these diseases in humans, their combined effect is small. Mouse models have been used to investigate genetic and environmental influences on T2DM susceptibility, and have shown the importance of the liver, fat, brain and beta cells as sites of insulin resistance and intracellular crosstalk.

The problems with treating T2DM were highlighted by Professor Cliff Bailey of Aston University, Birmingham, UK, in his presentation ‘New therapies for diabetes: Is the future really bright?’

Diabetes has a highly variable aetiology and pathogenesis, compounded by its progressive nature, inherent comorbidities, the required commitment by patients, as well as the need to avoid hypoglycaemia, weight gain and drug interactions. To answer these issues, there are many different-acting glucose-lowering agents available.

New potential therapies in advanced stage of development include depot injections of glucagon-like peptide-1 (GLP-1) analogues which last several months and once-weekly tablets of dipeptidyl peptidase 4 inhibitors.

Hybrid peptides of incretins, glucagon analogues and other peptides are in earlier stages of development, and small non-peptide molecules to activate GLP-1 receptors, prolong insulin receptor signalling and antagonise glucagon receptors show potential.

Developments to improve nutrient metabolism include selective peroxisome proliferator-activated receptor modulators, cellular glucocorticoid inhibitors and sirtuin activators.

For type 1 diabetes mellitus, interventions to counteract early autoimmune beta-cell destruction are being tested, and novel insulin formulations and delivery routes assessed, including oral and buccal spray formulations and skin patches. Improved insulin pumps and artificial pancreas technology, as well as agents to assist islet-cell transplant procedures and potential regenerative approaches, continue to offer attractive therapeutic prospects. Despite these advances and innovations, the benefits anticipated are far from the objective of reinstating a normally functioning beta-cell population, normal insulin action and normal nutrient homeostasis.

People with diabetes should be able to live a great life, not despite but because of their condition, according to Riva Greenberg, from Brooklyn, New York, USA.

Modern treatment is based on coping, focussing on the limitations imposed by diabetes; it aims to solve the problems created by the disease, moving patients closer to ‘normal’ functioning and avoiding complications. The Flourishing Treatment Approach, in contrast, helps people find strengths in the face of their diabetes; it individualizes solutions, enhancing possibilities and personal growth. It offers ways to treat and live with diabetes beyond just coping.

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International conference
Vancouver, Canada
Nov 30 - 4, 2015
Target audience
Endocrinologists, Nurses, diabetologists, General practitioners
Cardiometabolic, Endocrinology and metabolism