ADA 2026: From efficacy to adherence

Just a few years ago, the biggest question in obesity and diabetes was whether new medicines could dramatically improve outcomes. At this year’s American Diabetes Association (ADA) Scientific Sessions in New Orleans, that question appeared largely settled. Instead, the focus shifted to a different challenge: helping patients access treatment, stay engaged, and remain on therapy long enough to realise its full benefit.

More than 12 000 physicians, researchers and industry leaders attended the meeting, where Bellevue Asset Management’s portfolio manager Dr. Terence McManus and healthcare analysts Guy Bettschart and Lorenzo Zignani, met with leading physicians, researchers and companies to discuss the future of obesity and diabetes care.

Whether through more effective obesity medicines, better tolerated therapies, simpler dosing schedules, or diabetes technologies that improve patient engagement, a common theme emerged throughout the conference: the next phase of innovation will be measured not only by efficacy, but by adherence.

Eli Lilly remained the standout story of the meeting. New data from the TRIUMPH program reinforced retatrutide’s position as the efficacy leader in obesity. While weight loss of up to 30% can be achieved at higher doses, physicians were particularly encouraged by the low4 mg dose, which delivered tirzepatide-like efficacy with fewer side effects and a simpler titration schedule. Many now see retatrutide as a potential successor to today’s leading obesity therapies.

A second major theme was the emergence of amylin-based therapies. Lilly’s eloralintide attracted considerable attention after demonstrating approximately 20% weight loss alongside a favourable tolerability profile. Physicians increasingly view amylins as a differentiated treatment option rather than simply a combination partner for GLP-1 therapies. Interest in the class was further supported by encouraging diabetes data from Novo Nordisk’s CagriSema.

The meeting also highlighted practical challenges facing the next phase of obesity treatment. Physicians reported mixed real-world experience with oral semaglutide (Oral Wegovy), where administration requirements and a slower onset of perceived benefit appear to be creating adherence challenges. By contrast, physicians were optimistic that once-monthly dosing, as demonstrated by Pfizer’s obesity program, and the lower side-effect burden observed with amylin therapies could improve long-term treatment persistence.

Outside obesity, diabetes technology also delivered encouraging results. Dexcom’s CONNECT trial showed that continuous glucose monitors can help people with type 2 diabetes who do not use insulin achieve better blood sugar control. These data could support broader Medicare coverage in the United States, helping more patients access this technology. Insulet’s STRIVE

trial also delivered strong results for Omnipod 5, its automated insulin delivery system, helping patients spend more time in a healthy glucose range with fewer manual insulin doses. Together, these studies demonstrate how innovation in diabetes care can improve patients’ lives while expanding long-term opportunities across the healthcare sector.

For investors, the clearest winners from ADA were Eli Lilly and Dexcom. Lilly further strengthened its position at the forefront of obesity innovation, while Dexcom highlighted the growing role of technology in chronic disease management. However, the most important takeaway may be that the obesity and diabetes markets are entering a new phase. The first wave rewarded companies that proved dramatic weight loss and glucose control were possible. The next wave is likely to reward those that make treatment accessible, sustainable and effective in the real world.