The 2026 American Association of Clinical Endocrinology (AACE) just concluded in Las Vegas, Nevada. The AACE 2026 meeting was three days packed with networking opportunities, educational sessions, and informative research presentations on all topics related to endocrinology.

Today, we have a curated selection of abstracts focusing on topics related to diabetes. Some descriptions and conclusions were edited for clarity and brevity. AACE publishes abstracts accepted for the annual meeting into a supplement issue of Endocrine Practice. This year's abstracts appear in the April 2026 supplement issue. View the full issue for a complete look at all of the abstracts that were accepted.

Diabetes Abstracts from the 2026 AACE Annual Meeting

Impact of GLP-1 Receptor Agonists on End-Organ Complications in Type 1 Diabetes: A Retrospective Cohort Analysis

  • Description: Although emerging evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1RAs) protect against end-organ complications in type 2 diabetes, their potential role in type 1 diabetes (T1D) remains understudied. This study utilizes a retrospective cohort study design to assess whether GLP-1RA use in T1D reduces microvascular and macrovascular complications.
  • Conclusion: These findings indicate that GLP-1RAs may help slow T1D progression and reduce the risk of end-organ damage. Although insulin monotherapy remains the cornerstone of treatment for T1D, [the researchers'] results suggest that GLP-1RAs could serve as a valuable adjunct to mitigate disease progression.

Idiopathic Diabetic Myonecrosis With Concurrent Staphylococcus Bacteremia in a Patient with Type 2 Diabetes

  • Description: Diabetic myonecrosis is a rare microvascular complication associated with poorly controlled type 1 or type 2 diabetes mellitus (T2DM), presenting with acute-onset localized muscle pain, swelling, and tenderness involving thigh or calf. Diagnosis is missed due to overlap with other conditions such as deep vein thrombosis, cellulitis, or trauma. This case demonstrates idiopathic diabetic myonecrosis in a 68-year-old man with T2DM.
  • Conclusion: Although diabetic myonecrosis usually resolves spontaneously with supportive care and improved glycemic control, recurrence occurs in ≤50% of cases. This is a unique case with its association with S. aureus bacteremia in the absence of infection or trauma. It remains unclear whether myonecrosis predisposed to bacteremia through microvascular disruption or bacteremia precipitated the myonecrosis. The absence of abscess or necrotizing features on imaging supports a diagnosis of primary diabetic myonecrosis complicated by secondary bacteremia. Early recognition prevents unnecessary invasive procedures and timely treatment.

Thirty-Year Misdiagnosis of Maturity-Onset Diabetes of the Young Type 3 (MODY3) as Type 1 Diabetes: Novel Therapeutic Approach with Glyburide and Adjunctive Tirzepatide

  • Description: Maturity-onset diabetes of the young type 3 (MODY3) is often misclassified as type 1 or type 2 diabetes. Because individuals with MODY3 respond to sulfonylureas, misdiagnosis can lead to unnecessary insulin use. Glucagon-like peptide-1 (GLP-1) therapies may help as well, though only one case has been reported using the dual GLP-1/gastric inhibitory polypeptide receptor agonist, tirzepatide.
  • Conclusion: This case shows how delayed recognition of MODY3 can postpone effective therapy for decades. The patient’s robust response to glyburide reflects the known sensitivity in HNF1A-MODY, allowing substantial insulin reduction even after >30 years of high-dose insulin therapy. Tirzepatide further decreased insulin needs and supported weight loss.

Comprehensive Metabolic and Hepatic Benefits of Tirzepatide in Type 2 Diabetes: A 4-Month Real-World Evaluation in 132 Patients

  • Description: Tirzepatide, a dual GIP/GLP-1 receptor agonist, has demonstrated substantial glycemic and weight-lowering effects, with emerging evidence of hepatic benefit through reductions in steatosis and fibrosis markers. This study aimed to evaluate the 4-month effects of tirzepatide on anthropometric, glycemic, lipid, hepatic, and fibrosis indicators in adults with type 2 diabetes mellitus (T2DM) treated in routine clinic.
  • Conclusion: In this real-world cohort of 132 adults with T2DM, 4 months of tirzepatide therapy resulted in robust improvements in weight, BMI, glycemic control, lipid profile, hepatic transaminases, GGT, and FIB-4 index. The observed reductions in steatosis- and fibrosis-related markers suggest early hepatic benefit, supporting tirzepatide’s potential as a comprehensive metabolic and hepato-protective therapy for patients with diabetes and associated metabolic dysfunction.

Challenges in Diabetes Classification: A Case Exhibiting Autoimmune and Metabolic Features 

  • Description: Classifying diabetes mellitus (DM) is crucial in determining the most effective treatment, yet it can be challenging in certain cases. Whereas type 1 DM is characterized by an autoimmune process, leading to absolute insulin deficiency, type 2 DM is associated with insulin resistance. This case highlights how some patients present with overlapping features that make the diagnosis more nuanced.
  • Conclusion: This case underscores the challenges of accurately classifying diabetes in certain individuals. A combination of characteristics that indicate both type 1 and type 2 DM in this patient were present. An episode of diabetic ketoacidosis and persistently high glutamic acid decarboxylase-65 antibody levels suggest an autoimmune component aligning with a type 1 DM, whereas the absence of insulin autoantibody, a measurable C-peptide level, signs of insulin resistance, and positive response to noninsulin treatments, such as semaglutide injection and previously used metformin, further complicates classification.

Catching the Second Wind: Dual Metabolic Challenges in McArdle Disease and Type 1 Diabetes

  • Description: [The researchers reported] the case of a 21-year-old man with T1DM and genetically confirmed McArdle disease who presented with acute, severe left shoulder pain after overhead lifting at work. 
  • Conclusion: This case highlights the management challenges in patients with both McArdle disease and T1DM, especially regarding diet. Evidence for nutrition in McArdle disease is limited to small trials. Studies show pre-exercise sucrose or high-carbohydrate diets can improve exercise tolerance, whereas a 6-month ketogenic diet trial improved aerobic metrics but not quality of life. [...] Ultimately, finding the right carbohydrate balance is key for managing both conditions.

Beyond Hemoglobin A1C: Managing Type 2 Diabetes in a Patient With Human Immunodeficiency Virus on Antiretroviral Therapy

  • Description: Patients with HIV on antiretroviral therapy (ART) present a unique challenge in diabetes management due to drug-drug interactions (DDI) that can limit antihyperglycemic options. In addition, A1C measurements can be unreliable in these patients. [The researchers presented] a case highlighting these challenges and an approach that considers DDI and metabolic benefit.
  • Conclusion: The discrepancy between A1C and fructosamine demonstrated the need for alternative glycemic markers. GLP-1 receptor agonists provide cardiovascular, renal, glucose lowering, and weight reduction benefits and have little interactions with ART making them effective options. Overall, patients with HIV on ART require an approach that considers DDI, reinforcement of medication adherence, and alternative glycemic markers for safe and individualized care.

Does the Use of GLP-1R or Dual GLP-1R/GIPR Agonists for Management of Patients With Type 2 Diabetes Mellitus Have an Effect on Thyroid Hormone Replacement Therapy?

  • Description: Incretin analogs (GLP-1RA and GIPR/GLP-1R) are mainstay therapy for type 2 diabetes mellitus treatment. Studies suggest these drugs may alter thyroid hormone dynamics by altering cellular sensitivity, levothyroxine absorption or DIO-3-mediated metabolism. [The researchers] retrospectively analyzed patients with type 2 diabetes on incretin analogs and levothyroxine to assess their impact on thyroid hormones.
  • Conclusion: Although studies have demonstrated that there are incretin analogs (GLP1 RA and GIPR/GLP1RA) which may have direct effects on the thyroid, hormone absorption or hormone metabolism, [researchers] did not find any effect of these analogs on changes in weight adjusted levothyroxine dose requirements. Therefore, clinicians must continue to monitor and adjust the levothyroxine replacement requirements in cases of significant weight loss.

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