We are in Copenhagan - it is gorgeous. Diabetes is MOVING - so much going on. Pretty much, it is a tidal wave. The train is moving - are you on it or under it?! It is so clear that if you are big pharma, you must be playing in this area -- it is fun and warming to watch them all pick up steam. They have to be in it and they have to be good and they have to invest - great for small companies, excellent employees, and above all, for patients.
We will be back tomorrow with DREAM results and some individual company notes but in the meantime, here are a few themes that are crystallizing in our heads.
1. Treatment targets feel on the cusp of change downward, and soon. We think it is when, not if, ADA will revise the 7.0 a1c goal downward -- we think it'll be done sooner than anyone expects. Implications? Positive for everyone in industry and ultimately, for patients.
2. Treatment paths are becoming quickly more aggressive. No more diet and exercise ("do nothing") for seven years - we aren't there yet, but quickly we're becoming all about polypharmacy and combo therapy.
3. With new tools, slowly, we are becoming less accepting of suboptimal results. There is a drive toward physiologic therapy - the more normal the better.
4. We're quickly becoming fascinated by beta cell health. Lots of HOMA this, proinsulin this ...this isn't so easy to measure and we are skeptical about a lot of claims with recently submitted drugs Januvia and Galvus and all the claims.
5. Postprandial glucose is hot. The new drugs reduce it and the reduced variability just sounds right. This is important as the understanding of the dual defects of diabetes - insulin resistance and insulin secretion - emerges.
6. Weight matters. Oh, and does it!
7. There is a growing drive to avoid, not treat, complications.
8. We believe tolerability is key and will add to the armamentarian.
9. Simplicity is more key than ever.
10. Patients much be engaged ... and this too is becoming much easier with the newest tools.