Impaired Hypoglycemia Awareness in T1DM

Event Details

Invitation to Participate

This meeting is open to the public.

Background

Hypoglycemia remains a limiting factor in the optimal treatment of type 1 diabetes (T1D). Repeated episodes of hypoglycemia result in impaired awareness of subsequent hypoglycemic events, inducing a vicious feed-forward cycle and increasing the risk of morbidity and mortality. New technologies—including continuous glucose monitors (CGM) and artificial pancreas devices—alert patients to declining levels of blood glucose, raising hopes that they can reduce time spent in the hypoglycemic range and improve patient awareness of their hypoglycemic state. However, some data suggest that impaired awareness of hypoglycemia (IAH) persists even with CGM usage. Because individuals with IAH often are excluded from clinical trials in which technologies are tested, our understanding of the factors that contribute to the development of IAH and restoration of awareness of hypoglycemia remains limited. Furthermore, animal and healthy human models that were used to investigate the mechanisms associated with IAH may or may not accurately reflect the human pathophysiology. The purpose of this meeting is to address the obstacles and barriers that have hindered the progress in this clinically important area.

Objectives

• Identify obstacles that have hindered progress in the prevention and treatment of IAH in T1D.
• Discuss the limitations of models of IAH and how they can be improved.
• Discuss identification, measurement, and treatment of IAH in patients with T1D.
• Discuss research gaps that, if addressed, could move the field forward to improved prevention and treatment of IAH.
• Foster interactions between clinical and basic scientists with expertise in T1D, metabolism, and neuroscience.

Organizing Committee

External Members

Elizabeth Seaquist, M.D.
Professor of Medicine
University of Minnesota

Simon Heller, M.B., B.Chir., D.M., FRCP
Professor of Clinical Diabetes
University of Sheffield

Internal Members

Karen Teff, Ph.D.
Program Director
Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Barbara Linder, M.D., Ph.D.
Program Director
Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK

Guillermo Arreaza-Rubin, M.D., Ph.D.
Program Director
Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK

Henry Burch, M.D.
Program Director
Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK

Registration Deadline

October 11, 2021

Abstract Deadline

September 24, 2021

Agenda

October 14, 2021

9:00 a.m. – 9:10 a.m.

Introduction
William Cefalu, M.D.
Director, Division of Diabetes, Endocrinology and Metabolism
National Institute of Diabetes and Digestive and Kidney Diseases

DEFINING THE PROBLEM AND PURPOSE OF MEETING

9:10 a.m. – 9:30 a.m.

Defining the Clinical Problem
Simon Heller, M.B., B.Chir., D.M., FRCP
Professor of Clinical Diabetes
The University of Sheffield, United Kingdom

9:30 a.m. – 9:50 a.m.

Heterogeneity of Response: What Does This Tell Us about Mechanism?
Elizabeth Seaquist, M.D.
Pennock Family Chair in Diabetes Research
Professor of Medicine, Department of Medicine
University of Minnesota

9:50 a.m. – 10:10 a.m.

Animal Models of Hypoglycemia: Relevance and Applicability
Raimund Herzog, M.D., Ph.D.
Associate Professor
Yale School of Medicine

10:10 a.m. – 11:10 a.m.

Panel Discussion
Moderator: Meredith Hawkins, M.D., M.S., Professor of Medicine, Albert Einstein College of Medicine

11:10 a.m. – 11:20 a.m.

Break

11:20 a.m. – 12:20 p.m.

Lightning Talks
Moderator: Janice Hwang, M.D., Assistant Professor of Medicine, Yale University
Junior Investigators

12:20 p.m. – 12:40 p.m.

Lunch Break

MECHANISMS CONTRIBUTING TO IAH: TRADITIONAL AND NOVEL

12:40 p.m. – 1:10 p.m.

Does Impaired Awareness of Hypoglycemia Result from Habituation?
Rory McCrimmon, M.B.Ch.B., M.D., FRCPE, FRSE
Dean and Professor of Experimental Diabetes and Metabolism
University of Dundee, United Kingdom

1:10 p.m. – 1:40 p.m.

Autonomic Plasticity in Response to Hypoglycemia
Matthew Whim, Ph.D.
Professor, Cell Biology and Anatomy
Louisiana State University School of Medicine

1:40 p.m. – 2:10 p.m.

A Habenula-pancreas Axis That Regulates Nicotine-induced Abnormalities in Blood Glucose Homeostasis
Paul J. Kenney, Ph.D.
Professor and Chair, Department of Neuroscience
Icahn School of Medicine at Mount Sinai

2:10 p.m. – 2:40 p.m.

Allostatic Load: Neuronal Adaptations to Glucocorticoids and Chronic Stress
Conor Liston, M.D., Ph.D.
Associate Professor, Neuroscience and Psychiatry
Weill Cornell Medicine

2:40 PM – 3:15 p.m.

Panel Discussion
Moderator: Alan Watts, Ph.D., Professor of Biological Sciences, Physiology and Biophysics, University of Southern California

3:15 PM

Recess Day 1

October 15, 2021

ASSESSMENTS AND OUTCOMES

9:00 a.m. – 9:30 a.m.

Brain Responses to Hypoglycemia: Insights from MRI
Silvia Mangia, Ph.D.
Professor, Department of Radiology
University of Minnesota

9:30 a.m. – 10:00 a.m.

Measures of IAH Assessment
Jane Speight, Ph.D.
Professor of Health Psychology
Foundation Director of the Australian Centre for Behavioural Research in Diabetes, Melbourne, Australia

10:00 a.m. – 10:30 a.m.

CGM: What We Know and Limitations
Pratik Choudhary, M.B.B.S., M.D., FRCP
Professor of Diabetes
University of Leicester, United Kingdom

10:30 a.m. – 11:00 a.m.

Outcomes and Optimal Targets in Type 1 Diabetes with Impaired Awareness of Hypoglycemia
Michael Rickels, M.D., M.Sc.
Professor of Medicine
University of Pennsylvania

11:00 a.m. – 11:30 a.m.

Panel Discussion
Moderator: Ana Maria Arbelaez, M.D., MSCI, Associate Professor of Pediatrics, Washington University in St. Louis

11:30 a.m. – 12:00 p.m.

Lunch Break

INTERVENTIONS

12:00 p.m. – 12:30 p.m.

Addressing Unmet Needs in Cognitive Barriers to Hypoglycemia Avoidance
Stephanie Amiel, B.Sc., M.D., FRCP
Professor of Diabetes Research
King’s College, London, England

12:30 p.m. – 1:00 p.m.

A Hypoglycemia Clinical Trial Based on the Development of an Animal Model of Hypoglycemia Unawareness
Simon Fisher, M.D., Ph.D.
Professor of Medicine
University of Kentucky

1:00 p.m. – 1:30 p.m.

Education/Learning (HypoCOMPASS)
Jim Shaw, M.D.
Professor of Regenerative Medicine in Diabetes
Newcastle University, United Kingdom

1:30 p.m. – 2:00 p.m.

Panel Discussion on Interventions
Moderator: Amir Moheet, M.B.B.S., Associate Professor of Medicine, University of Minnesota

2:00 p.m. – 3:00 p.m.

Next Steps

3:00 p.m.

Adjournment

Abstracts

Abstract Submission Guidelines

To encourage attendance of next-generation researchers, lightning talks of 5 minutes each will be held during the first day of the meeting. Each talk may not include more than 5 slides.

Eligibility for lightening talk presentations includes those scientists who have received their first R01 award or a career development award or are post-doctoral or graduate students working in the area of impaired awareness of hypoglycemia, the topic of the meeting.

A 1-page abstract for the lightning talk along with a cover letter describing the applicant’s scientific background and stage of scientific training as well as a brief justification explaining why the applicant thinks the focus of the presentation would be relevant and contribute to the emphasis of the meeting are required. The cover letter should not be more than 1 page.

It is anticipated that up to 12 abstracts will be accepted for lightning talks.

Submission Deadline

September 24, 2021

Submitting Abstracts

All abstracts must be submitted via email to Rachel Pisarski of The Scientific Consulting Group, Inc. Abstract submissions should be no longer than 1 page (including name and affiliation). Download the Abstract Template (DOCX, 24.67 KB) .

Formatting Requirements

Please follow the instructions below to format an abstract. (Note: Submissions will not be edited for spelling or grammar and will be accepted “as is.”)

• The abstract should be an MS Word document typed single-spaced using Times New Roman font. Everything but the title should be in normal, 12-point font.
  • The abstract’s title should be Bold, 16-Point, Title Case font and should clearly represent the nature of the investigation.
  • On the line after the title, list the author’s first and last names, degree, affiliation, city, state, and country.
  • Separate multiple authors with a semicolon; and underline the primary author’s name (one primary author per abstract).
  • Use one blank line between the title and the body of the abstract and between paragraphs.
  • The abstract file name should follow this format: Last Name of primary author_First Word of Title (e.g., Zucker_Effects).
• Please ensure that your abstract is the correct length and use 1-inch margins.
• Use of standard abbreviations is desirable (e.g., BMI), as well as standard symbols for units of measure (e.g., kg, g, mg, mL, L, and %). Place any special or unusual abbreviations in parentheses after the full word the first time that it appears. Use numerals to indicate numbers except to begin sentences. Do not use subheadings (e.g., Methods, Results).
• Simple tables or graphs may be included; however, they must fit within the designated abstract space of one page.

Acceptance Notification

Applicants will be notified if their abstract has been accepted for a lightning talk by TBD.