Diabetes Basics.

Last updated Thursday, February 10, 2005

Research

Is there research studying how to cure, prevent, or treat diabetes basics? Is there research studying the causes, mechanisms, or risk factors of diabetes basics?

For both type 1 and type 2 diabetes, research is focusing both on prevention and cure. Another major focus of research is improvements in current therapies.

For type 1 diabetes, a large study asking if small doses of insulin could prevent type 1 diabetes in high-risk individuals showed this strategy did not work. Scientists are now looking at other strategies, perhaps an "immunization". For example, a group from Israel showed that injecting a small protein could slow the progression of diabetes in newly diagnosed individuals with type 1 diabetes. More research on this is anxiously awaited. As far as a cure in concerned, some progress has been made with islet cell (the cells that make insulin) transplants. Newer ways to prevent rejection of the transplanted tissue are now being studied.

For type 2 diabetes, a large prevention study showed that intense diet and exercise could reduce the risk of diabetes by 59% in high-risk people. The drug metformin could also reduce this risk, but by only 31%. This makes sense since weight loss and metformin also improve insulin resistance, one of the main mechanisms for type 2 diabetes.

Research has also resulted in an explosion of new drugs and technologies for the treatment of diabetes. This explosion shows no sign of a slow-down, as we expect more new pharmaceutical agents to be released over the next five years. This will include new classes of oral agents to improve both insulin resistance and insulin secretion in type 2 diabetes, and new insulins for those both with type 1 and type 2 diabetes. It is also hoped there will be better weight-loss drugs as our understanding of obesity improves. It is also likely glucose sensors will become more often used as telemetry-based glucose sensors should be available by 2003. This would allow a sensor, placed under the skin, to relay "real-time" blood glucose readings to you on a monitor you could wear on your belt or like a watch. Another development, the "Glucowatch" by Cygnus will work similar to this and should be available in the near future. It is hoped that the sensors will progress to the point they can be attached to an implantable pump, and thus work like a normal pancreas.

Is there research studying non-surgical treatments for diabetes basics (therapy, lifestyle issues, etc.)?

The study of exercise and its effects on blood glucose is one of the earliest types of diabetes research. Dietary research also continues to evolve, especially as we learn more about heart and kidney disease. There have been tremendous advances in our understanding in dietary recommendations as mentioned above.

There is also better understanding on the impact of anxiety and depression on the impact of diabetes. People with diabetes tend to have more mental health challenges than those without diabetes, and effective management of these often tends to improve diabetes care. For example, some people when stressed or depressed tend to eat more. Others find it difficult to measure their blood glucose during these times. Treating any mental health problems often makes diabetes management easier.

Since diabetes is treated surgically only in a very small minority of patients, treatment programs are based on many other factors: appropriate diet, regular exercise, and a variety of medications, which often includes insulin. As opposed to many other conditions, diabetes is a chronic medical condition that first and foremost requires active patient participation to result in good outcomes (blood glucose control).

Is there research studying surgical treatment for diabetes basics?

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