Welcome to the EASD e-Learning Newsflash, with scientific highlights from Day 3 of the 61st EASD Annual Meeting here in Vienna! Day 3 brought a highly anticipated session: the presentation of the main findings of the SURPASS-CVOT. In a symposium chaired by Professor Tina Vilsbøll, we saw the first release of data comparing the GIP/GLP-1 receptor agonist tirzepatide with the GLP-1 analogue dulaglutide. A huge trial, more than 13,000 patients with type 2 diabetes that were evaluated for a very long time. They were randomised to tirzepatide versus dulaglutide and the primary endpoint, it was a cardiovascular outcome trial looking into the classical MACE, so cardiovascular death, acute myocardial infarction, and stroke. And what they showed was non-inferiority compared to an active comparator, which is dulaglutide, which has previously been proven to improve the cardiovascular outcome in patients with type 2 diabetes. You could say, as expected, it had effects on MACE, but also HbA1c, and bodyweight. And, it was a long trial, the second largest ever. It should be published very, very soon, and I’m looking forward to digging into the full publication, where we will see even more. This year we’ve also seen new evidence on the benefits of CGM and hybrid closed-loop systems in pregnancy. These findings were discussed in the symposium “Pregnant and Digital”, chaired by Professor Adam Tabák. We have strong evidence for type 1 diabetes, all the technologies are working. Much less evidence for type 2 diabetes, but there is some benefits of CGM. And in gestational diabetes, a new randomised trial of the use of CGM in gestational diabetes showed a clear-cut reduction in LGA, large-for-gestational-age, babies. However that was clear-cut, there seemed to be a pay-off with an increased, not significantly, but an increased risk of small-for-gestational-age. And I think that will initiate a huge debate whether we should use CGM in gestational diabetic pregnancies or not. And I think some of the results suggested that it might be important or might have a beneficial effect in people in GDM people treated with insulin, but not in those people just on dietary treatment. The water has to settle before we can decide whether it should be included or how we should include it in our consensus. Next, we’ll welcome a new interactive format to the programme: lab talks. Incoming EASD Board member Professor Miriam Cnop hosted one of these sessions and will tell us more. The lab talks are a new activity that EASD implemented this year in its Annual Meeting, where scientists, directors of labs are asked to talk about what it is like to direct a lab, how to manage research lines, people, etc. What are the challenges that people have faced? What would your advice be to a young researcher interested in starting, establishing a successful lab as yours? Well, something that I didn’t mention is, read the literature, read literature on how to establish your own group, how to become a more senior investigator, and how to manage a lab. And as with everything in science, I think the second advice is persistence. It’s great fun. It’s not always easy. So persistence is important. And then the last advice is recruit good people, because as I mentioned, Steve Jobs recruiting people who are smarter than himself so that they could tell him what they had to do next. When I became a director, one of the things that I modified as compared to the previous directors was that I asked for some help from a human resources expert, and he told me about participative management and this sort of participative management has the advantage that it’s bottom-up, people get involved, and become co-responsible for specific activities that need to be accomplished, be it increasing the networking in the research laboratory, or improving the infrastructure, making it more user-friendly, or obtaining a new equipment. It takes also some of the workload off your shoulders. Thank you, Professor Cnop. That’s it from Day 3. Join us tomorrow for highlights from the final day at the 61st EASD Annual meeting here in Vienna. What we have seen with the surface civility is that it is noninferior compared to the lack of time. So we have another group, one that seems actually to be good in cardio protection in individuals with type two diabetes. A huge trial, more than 13,000 patients with type two diabetes that were evaluated for a very long time. The primary endpoint was a cardiovascular outcome trial looking into the classical Mace. So cardiovascular death, acute myocardial infarction and stroke. As expected, it had effects on Mace, but also HBO on sea and body weight. So and it was a long trial, the second largest ever. It should be published very, very soon. And I am looking forward to digging into the full publication where we will see even more about safety. And I'm sure that those riding with the Ada and the ESD guidelines will do so as well, because already next year the we will have an updated version of the Ada NIST recommendation, and I'm sure they will put in their thoughts about how the surpassing beauty will actually fit into us as clinicians to do personalised medicine in a much better way. So innovation in a lab is not limited to the science only, but also to management. Now we're going to the symposium that you chaired. On novel islet endocrine cell biology in type one type two diabetes. What will the future bring? That was such a superb, symposium. We had a talk by, doctor of all going from Sumerian University. He rightfully posed a question. You know, what do you think is a human islet? He and his team published a paper in 2024 describing one human pancreas. Now they're doing work on many more specimens, including specimens from people with type one diabetes and type two diabetes. And I think that's very important work because it will change the way we see disease pathogenesis. The second talk was given by Patrick McDonald from, Edmonton in Canada. And Patrick McDonald, spoke about the alpha cells looking at the function of the alpha cells using sophisticated, patch clamp techniques and then looking at what happens in that same alpha cell that has been functionally characterised at the level of gene expression and other omics approaches. So I think this is really foundational work. The other thing that must be said, and that is extraordinary, is that, his team has made these data, open access. So this these these are superb resources. Both all and Patrick's, for the whole diabetes field. So the third presentation was given by Hu Zhao rang. Ren from the university, and she gave a beautiful talk looking at how alpha and delta cells, regulates beta. So, oscillations and impacts thereby, function. And she did that quite amazingly in vitro, as has been done by other groups, but also in in vivo models, which is quite, quite impressive. And what I also like very much in her presentation is that, she has a background in mathematics and has used mathematical modelling to then make sense of these data. I think that's, fundamental in much of what we do. And this is something that also, was present in the three talks, actually, it's, it's international, interdisciplinary and sing on human materials, human tissue samples. And I think those things are actually going to make us understand human disease, in the coming years.