Type 2 Diabetes Mellitus: Beyond the Beta Cell

This symposium took place on 12th September 2016 as a part of the European Association for the Study of Diabetes (EASD) Annual Meeting in Munich, Germany

Chairpersons: Baptist Gallwitz,1 Jiten Vora2
Speakers: Chantal Mathieu,3 Juris Meier,4 Jens Holst,5 Marcus Schindler6

1. Department of Medicine IV, Tübingen University Hospital, Tübingen, Germany
2. Royal Liverpool University Hospital, Liverpool, UK; AstraZeneca, Luton, UK
3. Department of Endocrinology, University Hospital of Leuven, Leuven, Belgium
4. Division of Diabetology, St. Josef-Hospital, Ruhr-University, Bochum, Germany
5. Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
6. Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development, AstraZeneca, UK

Disclosure: Prof Mathieu is or has been consultant for, and KU Leuven has received research support or honoraria from NovoNordisk, MSD, Eli Lilly, Sanofi, Novartis, AstraZeneca, BMS, Boehringer Ingelheim, Janssen Pharmaceuticals, Pfizer, Medtronic, Roche, Servier, UCB, and Intrexon. Dr Meier is a board member or advisory panel member for Astra Zeneca, Boehringer-Ingelheim, Eli Lilly and Company, MSD, Novo Nordisk, and Sanofi-Aventis, and has received research support from Eli Lilly and Company, Boehringer-Ingelheim, MSD, Novo Nordisk, Novartis, and Sanofi-Aventis. Dr Gallwitz has served as a consultant for Amgen, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Janssen, Eli Lilly and Company, MSD, and Novo Nordisk, and has received honoraria for lectures from Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly and Company, MSD, Novo Nordisk, and Sanofi-Aventis. Dr Holst is or has been a consultant for NovoNordisk, MSD, Sanofi, Novartis, AstraZeneca, and has received research support from NovoNordisk.
Acknowledgements: Medical writing assistance was provided by Dr Natalie Morris of Oxford
Science Editing.
Support: The symposium was organised and funded by AstraZeneca and speakers received honoraria for preparation and delivery of their presentations. This article was sponsored by AstraZeneca. The views and opinions expressed are those of the author and not necessarily of AstraZeneca.
Citation: EMJ Diabet. 2016;4[1]:36-46.

Meeting Summary

Type 2 diabetes mellitus (T2DM) currently affects >8% of the world population. It is the leading cause of blindness, end-stage kidney disease, and neuropathy, and doubles the risk of developing cardiovascular disease. Until recently, the treatment of diabetes had broadly emphasised the management of hyperglycaemia as the key diagnostic criterion for T2DM. The pathophysiology of T2DM however is now understood to be rooted in the associated metabolic syndrome including intra-abdominal fat deposition, lipid abnormalities, high blood pressure, hypercoagulability, and macrovascular complications occurring in parallel with glucose dysregulation. Accordingly, closer attention to the medical management of these conditions is at the forefront of diabetologists’ treatment rationale in an attempt to prevent and mitigate both micro and macrovascular complications, especially in light of the recent positive data from cardiovascular outcome trials with both sodium-glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists. This symposium included a discussion of the evolution of treatment for T2DM and presented the rationale for the use of novel agents and combination therapies for patients according to their individual disease progression. Several newer drug classes were highlighted, including GLP-1 receptor agonists, dipeptidyl-peptidase-4 inhibitors (DPP-4 inhibitors), and SGLT2 inhibitors. Finally, an overview of the exciting new fields of prevention and treatment for T2DM were discussed; including stem cell proliferation into pancreatic beta cells, the reprogramming of white adipose tissue into brown fat, mimicking physiological effects of bariatric surgery pharmacologically, and other approaches to make the treatment more targeted and personalised.

This article has a correction, made on 16.12.16.
The details of the correction are as follows: Figure 3 has been updated.
The prior version of the paper is available on request, please contact editor@emjreviews.com

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