New Developments In The Treatment Of Diabetes

By Steve Bigham

Danbury physician Robert Savino returned from an Endocrine Society Conference in Toronto late last month with renewed excitement about the latest breakthroughs in the treatment of diabetes.

There are several new treatments on the horizon that are designed to extend and improve the lives of those suffering from Diabetes I and II.

“A lot has happened in the last five years,” Dr Savino explained.

Dr Savino, a specialist in endocrinology (having to do with glands that make hormones), said that  since 1995 a lot has been learned regarding both treatment and prevention.

 That’s the good news. The bad news is that more and more Americans are losing the fat battle. Today, nearly 50 percent of the American population is overweight. Obesity is a major cause of diabetes.

“Diabetes is increasing in epidemic proportions due to obesity,” the doctor said. “Kids are getting fatter and fatter. Kids these days are more inactive than in years past.”

Diabetes is a disease caused by the inability of the pancreas to produce insulin (type 1) or use the insulin it does produce in the proper way (type II).

Normally, when we eat, food is digested and converted to sugar or glucose (the body’s food) which enters the bloodstream. The sugar in the bloodstream must then make its way to the body’s cells for energy.

According to Dr Savino, insulin is the “key” to unlocking the cells’ “doors” and allows the sugar to move from the bloodstream into the cells. Without insulin (as in type 1) or when cells become insulin resistant (type II), the sugar stops in the bloodstream, gluing up the vessels that go to the heart, brain, kidneys, eyes, and limbs. This can cause blindness, loss of limbs, and other problems.

Topping the list of medical breakthroughs is a successful cell transplant technique called the Edmonton Protocol, which has been developed to assist those with type I diabetes. Researchers have taken islets (insulin producing cells in the pancreas) and successfully transplanted them into 11 diabetes patients. The cells reportedly took up residence in the liver and began producing the insulin that controls blood-sugar levels.

So what does all this mean? According to Dr Savino, if the results are confirmed, it could mean the end of insulin-dependent diabetes. The results of this test were so striking that the New England Journal of Medicine released the University of Alberta study two months early.

Type I diabetes, also known as juvenile onset diabetes, affects 500,000 to 1 million Americans.

Other Developments

Coming soon: The Gluco-Watch, a state-of-the-art wrist-watch that provides not only the time, but also a glucose reading every 20 minutes for 12 hours. Diabetic patients have to check their blood-sugar levels frequently; the watch would eliminate the finger-prick test. The watch has been approved and is expected out sometime this year.

The Hope Study is testing an ace inhibitor drug designed to protect the cardiovascular system, which often malfunctions as a result of the diabetes.

Researchers are also looking at insulin inhalers for diabetics. Currently, many diabetics are forced to give themselves insulin shots at least twice a day.

Today’s medicine also allows doctors to measure the antibodies that cause the disease to determine if a patient is a candidate.

The biggest breakthrough, however, may be the overall knowledge that physicians have gathered in working to prevent diabetes. More and more studies are showing that, in certain cases, diabetes can be prevented with a few lifestyle modifications. One study by the American Diabetes Association (ADA) proved this point. The study, called the Finnish Diabetes Prevention Study, took 523 adults (average age of 55) who suffer with what is known as impaired glucose intolerance – the state between “normal” and “diabetes.”

According to Dr Savino, the patients were split into two groups; 265 received intervention (dietary counseling, etc), while the 257 people in the controlled group received limited intervention. The results showed that of the 83 cases in which patients became diabetic, 57 were from the controlled group and only 26 from the intervention group.

Currently, there are 8 million Americans suffering from Type 2 Diabetes, including 6 to 7 percent of people between the ages of 45 and 64. That figure rises to 10 to 12 percent of those 65 and older. Doctors figure an additional 8 million Americans do not even realize they have diabetes. An estimated 35 to 40 million Americans have impaired glucose intolerance – a slight impairment, but not nearly as serious as diabetes.