Incretin Innovation, Metabolic Liver Disease, and Cardiovascular Risk Reduction Dominate ADA 2026

Incretin therapy stole the spotlight at the American Diabetes Association (ADA) 2026 Scientific Sessions, with experts pointing to a wave of novel agents poised to reshape treatment of diabetes, obesity, and related metabolic conditions.

"Incretin therapy was really the big thing of the meeting," Alyson K. Myers, MD, professor at Albert Einstein College of Medicine and associate chair of faculty mentoring and community engagement at Montefiore Einstein, Department of Medicine, said. "A lot of people's lives have changed with the weight loss, improvement in [hemoglobin] A_1C, and improvement in cardiac and renal outcomes from these medications."

Among the most anticipated advances: a triple hormone receptor agonist expected to deliver even greater weight loss than current agents and a once-monthly glucagon-like peptide-1 (GLP-1) receptor agonist formulation that could ease the burden of weekly injections for patients resistant to self-administration.

Phase 3 data from the SYNCHRONIZE program for survodutide (Boehringer Ingelheim) drew considerable attention. The trials enrolled patients both with and without type 2 diabetes, spanning a broad spectrum of obesity severity and metabolic disease—including metabolic dysfunction–associated steatotic liver disease (MASLD) and metabolic dysfunction–associated steatohepatitis (MASH). Lee Kaplan, MD, PhD, director of The Obesity and Metabolism Institute, Massachusetts General Hospital, called the liver disease findings particularly meaningful. "We're seeing—finally—opportunities to not only prevent the disease but also to treat it when it exists," he said, noting that more data from survodutide and other agents are expected in the coming years.

Cardiovascular risk reduction also emerged as a critical theme. Lawrence Leiter, MD, director of the Lipid Clinic; associate director of the Clinical Nutrition and Risk Factor Modification Centre; associate scientist, Li Ka Shing Knowledge Institute at St. Michael’s Hospital; and professor in the departments of Medicine and Nutritional Sciences at the University of Toronto, highlighted results from the VESALIUS-CV (NCT03872401) trial, in which adding evolocumab (Repatha; Amgen) to background lipid-lowering therapy reduced low-density lipoprotein to approximately 45 mg/dL and significantly cut cardiovascular events in high-risk patients with diabetes who had no prior myocardial infarction or stroke.

"We really need to have a comprehensive risk reduction strategy in order to achieve maximal benefit for our patients," Leiter said.

Anne Komé, PharmD, CPP, BCACP, CDCES, a clinical pharmacist practitioner in the Endocrinology Clinic at the UNC Chapel Hill Medical Center and moderator of the session “Perturb & Observe: What Pharmacologic Challenges Reveal about Human Metabolism,” reflected on the breadth of learning the meeting offered.

"I learned a lot about molecules that are in the pipeline, as well as how molecules that are currently available are being used off-label and on-label, and some about the exciting technologies that are underway in the diabetes space," she said.

Taken together, the ADA 2026 meeting underscored an expanding therapeutic toolkit, and a growing mandate to treat obesity and its downstream consequences as a systemic disease.