By Terence McManus, Senior Healthcare Portfolio Manager at Bellevue Asset Management
At the American Diabetes Association (ADA) scientific sessions, the focus was no longer just on treatment efficacy, but on patients’ ability to stay on therapy over the long term.
Until a few years ago, the central question around obesity and diabetes was whether new drugs could deliver a meaningful improvement in clinical outcomes. At this year’s American Diabetes Association (ADA) scientific sessions in New Orleans, that question appeared to have been largely settled. Attention has now shifted to another challenge: ensuring that patients can access treatment, remain motivated and continue therapy long enough to reap its full benefits.
More than 12,000 physicians, researchers and industry leaders attended the congress. There, we met leading doctors, researchers and companies to discuss the future of obesity and diabetes care.
Whether it concerned more effective obesity medicines, better-tolerated treatments, simplified dosing regimens or diabetes technologies that improve patient adherence, one common theme ran through the conference: the next phase of innovation will be judged not only by efficacy, but also by treatment adherence.
Eli Lilly remained the standout name at the congress. New data from the TRIUMPH programme strengthened retatrutide’s position as the efficacy leader in obesity treatment. While weight loss of up to 30% can be achieved at higher doses, physicians were particularly enthusiastic about the low 4 mg dose, which showed efficacy comparable to tirzepatide, causing fewer side effects and offering a simpler dosing regimen. Many now view retatrutide as the potential successor to today’s leading obesity treatments.
A second major theme was the rise of amylin-based therapies. Lilly’s eloralintide drew considerable interest after demonstrating weight loss of around 20%, combined with a favourable tolerability profile. Physicians increasingly see amylins as a differentiated therapeutic option, rather than simply an add-on to GLP-1 therapies. Interest in this class was further reinforced by encouraging diabetes data from Novo Nordisk’s CagriSema.
The conference also highlighted the practical challenges facing the next generation of obesity treatments. Physicians reported mixed feedback on real-world use of oral semaglutide (Oral Wegovy). The constraints around how it must be taken, together with the more gradual emergence of perceived benefits, appear to make patient adherence more difficult. By contrast, physicians were upbeat about the potential of once-monthly treatments, such as those being developed by Pfizer, as well as amylin-based therapies, whose more favourable side-effect profile could improve long-term persistence with treatment.
Beyond obesity, diabetes technologies also delivered encouraging results. Dexcom’s CONNECT trial showed that continuous glucose monitoring systems could help people with type 2 diabetes not using insulin to achieve better glycaemic control. These findings could support an expansion of Medicare coverage in the United States and thereby give more patients access to the technology.
Insulet’s STRIVE trial also delivered strong results for Omnipod 5, its automated insulin delivery system. It enabled patients to spend more time within the optimal glucose range while reducing the number of manual insulin doses. Taken together, these studies show how innovation in diabetes care can improve patients’ quality of life while creating new long-term growth opportunities across the healthcare sector.
For investors, the big winners from ADA were Eli Lilly and Dexcom. Lilly further cemented its position as a leader in obesity innovation, while Dexcom highlighted the growing role of technology in the management of chronic disease.
The key takeaway from this year’s edition is that the obesity and diabetes markets are entering a new phase. The first wave rewarded companies that proved it was possible to deliver dramatic weight loss and better glycaemic control. The next wave will likely reward those that can make treatments accessible, sustainable and effective in everyday practice.
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