This year’s ADA conference provided a wealth of information, including some of the first important clinical data on several drugs. First-in-class Byetta (Amylin, Lilly) emerged as one of the stars of the conference. While a number of doctors we spoke with at the ADA conference were initially hesitant about Byetta (citing they would rather just start insulin), minds were changed as physicians learned more about possible benefits of intervening in the GLP-1 pathway. Byetta showed good long-term efficacy on glycemic control and weight loss. Data on potential competitor MK-0431 (Merck), a DPP-IV inhibitor, was less impressive, though preliminary. Also somewhat disappointing was data presented for the dual PPAR agonists, Pargluva (Bristol-Myers) and Galida (AstraZeneca). Their antiglycemic effect was not much superior to that of the thiazolidinediones, and their side effects similar or possibly slightly greater. While they showed a beneficial effect on lipids, they will probably need outcomes data to take substantial share from the thiazolidinediones. An intriguing compound in Phase II development, Metaglidasen, showed promise with good efficacy and limited adverse effects. Finally, while not definitively resolving the issue, encouraging information was presented at a symposium on the inhaled insulins, showing good long-term safety data for Exubera.

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