Weekly Insulin Efsitora Alfa vs Daily Insulin Glargine in Adults with Type 2 Diabetes Treated with Basal and Bolus Insulin 

Presenter: D. Dahl

This Phase 3, 26-week trial compared safety and efficacy of once-weekly basal insulin, efsitora, to daily glargine in 730 adults with T2D on basal-bolus insulin.

Efsitora showed noninferior HbA1c reduction (-11.1 mmol/mol) vs glargine (-11.0 mmol/mol), with similar time-in-range and hypoglycaemia rates. Weekly basal insulin dose was significantly lower for efsitora (392 U vs 427 U). Serious adverse events were comparable between groups. The findings indicate that efsitora may simplify insulin therapy and reduce treatment burden while maintaining glycaemic control and safety in T2D patients.

Association between Prediabetes Phenotypes and Metabolic Dysfunction-Associated Fatty Liver Disease

Presenter: M. He

This cross-sectional study investigated the link between metabolic dysfunction-associated fatty liver disease (MAFLD) and various prediabetes phenotypes. 

Among 1206 prediabetic individuals, 77.1% had MAFLD. Isolated impaired glucose tolerance (IGT) significantly increased MAFLD risk compared with isolated impaired fasting glucose (IFG). HbA1c-defined prediabetes showed lower odds than FPG- and/ or 2h-PG-defned prediabetes. BMI, postprandial glucose, triglycerides, and hyperlipidemia history were independent risk factors; HDL-C was protective against liver fibrosis. The risk of MAFLD rose with prediabetes and the increasing number of glucometabolic defects, partially mediated by insulin resistance. These findings suggest that elevated blood glucose is a stronger predictor of MAFLD than HbA1c, highlighting the heterogeneity of prediabetes in relation to liver disease.

The Effects of Pre-Meal and Post-Meal Exercise on Postprandial Glucose Excursions in Pregnant Women with Type 1 Diabetes 

Presenter: P. Acosta-Manzano

In pregnant women with type 1 diabetes (T1DM), post-meal exercise during early to mid-gestation significantly improves postprandial glycemic control compared to pre-meal exercise. 

A randomized crossover trial with eight participants showed that in early to mid-pregnancy exercising after post meal increased time in euglycemia, reduced hyperglycemia, and lowered glucose variability when compared to premeal exercise. These benefits were independent of insulin, carbohydrate intake or appetite. In late gestation, no significant differences were observed between exercise timings. Thus, timing exercise after meals may be a simple, effective strategy to enhance glycemic control and reduce maternal-neonatal complications in early to mid-pregnancy for women with T1DM.

Early Continuous Glucose Monitoring Data and Overall Glycaemic Control in Gestational Diabetes 

Presenter: K. Zorko

A secondary analysis of a randomized controlled trial evaluated the relation between early (first 14 days) continuous glucose monitoring (CGM) and overall pregnancy data in gestational diabetes.

Early CGM values were strongly associated with full-pregnancy glucose trends. Higher early CGM mean glucose was associated with need for insulin therapy (p = 0.002), increased sensor scanning was correlated with lower HbA1c at baseline (p = 0.003), insulin therapy (p=0.041), lower birthrate percentile (p=0.002) and risk of large-for-gestational-age births (p = 0.005). 

These findings the support the potential CGM use to guide individualized treatment and monitoring strategies for overall glycemic control in women with GDM.

Factors Predicting Adverse Pregnancy Outcomes in Gestational Diabetes: A Retrospective Cohort Study

Presenter: P. R

This large retrospective cohort study of 2401 Indian women with gestational diabetes mellitus (GDM) identified risk factors associated with adverse perinatal outcomes.

The significant risk factors for adverse perinatal outcomes were polycystic ovary syndrome (Adjusted Odds Ratio (aOR) 1.71), gestational hypertension (aOR 1.86), preeclampsia (aOR 3.91), and family history of diabetes (aOR 3.65). Interestingly, early-onset GDM (<24 weeks gestation; aOR 0.58), higher pre-pregnancy BMI (aOR 0.97), and lower gestational age at delivery (aOR 0.84) were significantly associated with decreased odds of adverse perinatal outcomes. These findings highlight the importance of early identification GDM in the Indian context.

Real-world Adherence and Persistence of GLP-1 Based Treatments in Patients with Type 2 Diabetes

Presenter: M.S. Girguis

In this retrospective cohort of 794,702 adults with T2DM initiating GLP-1 therapy (2010–2023), 12-month adherence and persistence were 52% and 42%, respectively. Discontinuation occurred in 58% of patients, with 72% stopping within 6 months. Reinitiation was seen in 34% of those who discontinued, more commonly in early discontinuers and those with higher BMI at time of initiation (31–36%).

Patients with higher baseline BMI showed better adherence (47–53%) and persistence (35–43%). These findings highlight significant real-world challenges in maintaining GLP-1 therapy, emphasizing the need for strategies to improve long-term treatment continuity in T2DM care as established in clinical trials.

Association of Changes in Taste Intensity with Satiety, Appetite and Food Cravings in People with Overweight and Obesity Treated with Incretin-Based Therapies: A Cross-Sectional Exploratory Study

Presenter: O. Moser

This real-world study assessed the impact of incretin-based therapies on taste perception and appetite-related outcomes in 411 adults with overweight or obesity, including 35% with type 2 diabetes. 

Participants received injectable semaglutide or tirzepatide for ~10–12 months, showing comparable weight loss rates (~1 kg/month). Self-reported changes in taste perception were similar across groups. Reduced appetite and increased satiety were also similar between groups. Irrespective of therapy, increased sweet perception was significantly associated with enhanced satiety, reduced appetite, and decreased food cravings while increased salty taste perception was associated with increased satiety. These findings suggest that taste modulation may contribute to favorable appetite related outcomes of incretin based therapies.

Precision Medicine in Type 2 Diabetes: Targeting GLP1 Receptor Agonist and SGLT2-Inhibitor Combination Treatment for Kidney Protection

Presenter: T. Jansz 

This study assessed kidney protective effects of combination of GLP1 receptor agonist (GLP1-RA) with SGLT2-inhibitor (SGLT2i) in type 2 diabetes (T2D) and used the CKD Prognosis Consortium (CKD-PC) risk score for kidney disease progression in identifying benefits from this combination.

GLP1-RA + SGLT2i combination therapy showed lowest incidence of kidney disease progression versus dipeptidyl peptidase-4 inhibitors/sulfonylureas (DPP4i/SU), SGLT2i or GLP1-RA alone (2.8 vs. 5.5, 3.2 or 4.7/1000 patient-years, resp.). This combination therapy lowered the risk by 55% versus DPP4i/SU and 21% versus SGLT2i alone. Using the CKD-PC score to target combination treatment yielded greater absolute risk reduction of 1.1% versus when used with SGLT2i only. This supported GLP1-RA + SGLT2i for enhanced renoprotection and highlighted CKD-PC score as a practical tool for identifying these benefits.

Muscle-to-Fat Ratio Combined with Peripheral Insulin Sensitivity: A Novel Approach for Differentiating Diabetes of Exocrine Pancreas

Presenter: K. Sun

Diabetes of the exocrine pancreas (DEP), often misdiagnosed as type 2 diabetes (T2DM), was compared to T2DM in a matched case-control study (n=40, age 18–75, disease duration <5 years). 

DEP patients, including post-acute pancreatitis diabetes (PPDM-A) and post-pancreatectomy diabetes, showed significantly higher peripheral insulin sensitivity (M-value: 8.54 vs. 6.22 mg/kg/min; F=7.603, P=0.019) and muscle-to-fat ratio (MFR) (3.83 vs. 2.00; F=8.886, P=0.011). PPDM-A and post-surgery subgroups had lower fat content and insulin resistance scores (P<0.05). No significant differences were found in glucose variability metrics (P>0.05). MFR and insulin sensitivity may serve as key discriminative markers for DEP, aiding in accurate diagnosis and tailored treatment strategies.

Sustained Impact of Dapagliflozin on Epicardial Fat Thickness in Type 2 Diabetes: Insights from the DAPAHEART 4-year Experience 

Presenter: C. Morciano

In the DAPAHEART trial, patients with Type 2 diabetes (T2D) and stable coronary artery disease (CAD) treated with dapagliflozin for 4 years showed a sustained 30–35% increase in coronary flow reserve (CFR; p=0.09) and a significant reduction in epicardial adipose tissue (EAT) thickness (p=0.03). The placebo group, after switching to dapagliflozin, had a 28.6% CFR increase (p=0.07) and significant EAT reduction (p=0.04). Body mass index (BMI) also decreased (p=0.001), but EAT reduction was independent of BMI change (R²=0.0662; p=0.50), suggesting a direct effect of dapagliflozin on EAT.

EASD 2025, 15th – 19th Sept 2025, Vienna, Austria.