Hello, I'm Francesco Giorgino, I'm professor of endocrinology at University of Bari Aldo Moro in Bari, Italy. And I'm the President of European Association for the Study of Diabetes. Here in New Orleans, at the 2026 Scientific Sessions of the ADA, we actually had a lot of very interesting highlights and new releases, but certainly a very important one is the first release of the ADA EASD Consensus on the management of people with type 2 diabetes. So this is a first release. We will have the final release with all the final details and consolidation of the document in Milan at our Annual Meeting. It is important to consider this is a major advancement compared to the previous version of this document, which was in 2022, for at least three reasons: So, first of all, of course there is an important consideration that the management of people with type 2 diabetes should be holistic. This means we have to consider the patient, the needs of the patient and also all the wide array of comorbidities that unfortunately can accompany people with type 2 diabetes, from cardiovascular disease, heart failure, CKD, but also some emerging comorbidities like for example, sleep apnea or, importantly, the metabolic disease of the liver, so MASLD, MASH. So it's important to consider for these different comorbidities now we have some medications that are useful and they are of course able to change the disease trajectory. But I think a very important point of this new document is that we are trying now to prioritise the use of GLP-1 receptor agonists and SGLT2 inhibitors. So they should not be considered second-line drugs, but first-line drugs to be used alone or in combination, potentially since the diagnosis of type 2 diabetes. So of course, when to use them alone or in combination would also depend on the level of risk of the patient, the absolute risk for cardiorenal endpoints and also it should depend on whether we are achieving or not the individualised targets. So this is, I think, a revolution. Metformin remains an important therapy, but it's no longer foundational for the therapeutic approach in the person with type 2 diabetes. And last but not least, we should also consider in this document the reference to multiple other interventions that are very important to achieve the appropriate goals, therapeutic goals, so including lifestyle intervention. There's a lot of attention to exercise, there's also a lot of attention to different types of diets. Now we have different solutions, that we should also try to understand whether they are good or bad for the person with diabetes. And this document helps the physician to understand more also along those lines. So it's, I think, a major achievement. And now the challenge is not only to release the final document, but to all of us to make this happen in our daily practise when we see, we manage people with type 2 diabetes. Hi everyone, my name is Alice Cheng. I'm an endocrinologist from the University of Toronto, and I am filming this here at the ADA 2026 in New Orleans, Louisiana. So for this particular Scientific Sessions, a couple of highlights that I want to share with you. The first one is regarding orforglipron, which is a non-peptide, small-molecule oral GLP-1 receptor agonist. And there was a symposium that I was fortunate to be a part of where the ACHIEVE results were reviewed. So ACHIEVE is the phase III clinical trial programme for orforglipron in type 2 diabetes. We saw the results of orforglipron compared to other active comparators such as dapagliflozin as well as semaglutide oral as well as add-on to insulin. And I provided the independent commentary on it. And bottom line is that the orforglipron has greater efficacy from a glycaemic and weight perspective compared to their comparators as well as it is easier to take. So no food or water restriction, but there are some drug interactions that we need to be mindful of, and hopefully, because of it being a small molecule, it may be produced at a lower cost. So therefore, up to now it would be the most efficacious oral antihyperglycaemic that we have for type 2 diabetes, with tolerability being compareable or maybe slightly worse, however, in-keeping with other GLP-1 receptor agonists, and hopefully at a lower cost. So that was a big take-away from the ACHIEVE symposium. And then the second highlight that I'll mention, and again completely biased, as it was a poster that I was involved in, was actually looking at a US database and taking a look at the incidence of type 1 diabetes after a diagnosis of gestational diabetes. So we identified a large group of women in the database with a diagnosis of gestational diabetes, followed them prospectively, and over about a 10 year period the incidence of type 1 diabetes, depending on the definition, ranged from about 0.5 to maybe just under 1 %. But the main take-home from that, because obviously these data are not going to be perfect, is that we should not assume that every woman with gestational diabetes will go on to develop type 2 diabetes. Some of those women will actually go on to develop type 1 diabetes. And their gestational diabetes was just a warning sign that the pancreas could not quite handle the stress test of pregnancy. So just something to be mindful of. And there were certain characteristics like a lower BMI, the requirement for basal bolus insulin. Those were sort of some predictors of women who might progress to type 1 diabetes. So, an extra little bit of information to think about the next time you're in the high-risk clinic. So those were, for me, a couple of highlights from ADA 2026. Hello everybody, my name is Naveed Sattar. I am professor of cardiometabolic medicine at the University of Glasgow and I'm here in New Orleans at the American Diabetes Association. I'm excited to be here because we have now started to see an even greater shift towards tackling obesity in the context of diabetes. I was pleased to see and chair a session that looked at retatrutide, a phase III trial in people with type 2 diabetes who were predominantly naive to therapies. The baseline haemoglobin A1c in these individuals was 7.9 %. And what was remarkable was that although retatrutide, which is a triple agonist, so also includes glucagon, which we've always thought that glucagon will worsen glycaemic control, but instead what we saw was a really good improvement in glycaemic control of about 1.9 %. So an average of going from 7.9 % down to 6 % in efficacy analysis. This suggests also the triple agonist, which includes the glucagon agonist, still does lower glycaemia to the levels that we have seen with tirzepatide and with higher-dose semaglutide. So that's really encouraging. I suppose the other really notable thing about this trial was the reduction in weight that was seen with retatrutide, which was around of the order of 15 to 16 kilograms, which is much greater than we've seen for several other previous therapies, including semaglutide, and was slightly greater than also we've seen with tirzepatide in the SURPASS programme. That therefore means we will soon have – in the next year – another tool that cannot only improve glycaemia, but substantially improve weight in patients living with diabetes. And that is important because we have for many years underestimated how much impact weight has on our patients’ lives in terms of their other risks, including blood pressure, lipids, but also their ability to do functional things, so their function, physical functionality and how they feel about themselves. so their physical functionality, and how they feel about themselves. I think this is a good result for patients. We need more tools in the toolbox to help tackle diabetes, particularly that tackle weight. And I think retatrutide will be one of those dominant tools going forward in the future. Another trial programme that was presented was the berobenatide data, which was predominantly phase II dose-finding studies in the context of diabetes and people without diabetes. If we concentrate on the data within diabetes, again, it was very encouraging. The data did suggest that berobenatide can lower weight by up to about 10 kilogrammes on average at the higher doses that were trialled in that phase II programme, but also improve glycaemic control to a really good extent, around about 2 %. So, again, very exciting. But perhaps the USP of berobenatide, compared to existing agents including tirzepatide: It has a longer half-life. And within the phase II programme, there was an investigation of tailoring this dose to make it not just once-weekly, but the higher doses to actually make it once-monthly, which is really exciting because once-monthly may well be favoured by some of our patients. Therefore, they only require 12 injections a year rather than the current of every week of 52 injections, which is a big advance. So let's see how this data evolve in the phase III programme. The doses have now been chosen to extend to the phase III programme. The way that they tailor the doses and escalate the doses is also being modified to try and mitigate the side effect profile. And the side effect profile did look really encouraging. It looked at least as good as the other drugs, potentially better. But we will get to the truth in the much larger phase III programme, which is about to start with this class of drugs. So another exciting new tool in the context of patients living with type 2 diabetes.