Future of Diabetes

Diabetes is a topic that is getting a lot more attention than it did even 10 years ago. You can find dozens of reports projecting phenomenal growth in the numbers of people with diabetes over the coming decades.  One study reported that between the years 2009 and 2034 the total number of people in the United States with undiagnosed and diagnosed diabetes will swell to 44.1 million and spending on the disease will increase 197% in the same time period.1

The growth in the number of diabetes patients will no doubt spark a marketing frenzy that consists of new drugs, revised insulin injection methods, assistive devices and much more. As a diabetic, it will be necessary to use a lot of caution in the face of intense marketing pressure. Your medical team can provide a lot of support and information as research leads to new ways to deal with diabetes that are more effective.

The real question many people have now, and will have in the future, is: Will there ever be a cure?

Hoping for a Cure

Just about anything you read on diabetes points out that living with the disease requires many lifestyle changes. It’s not easy to change a diet that requires you to avoid sugar and to severely limit fat intake. Except for fresh fruits and vegetables, you may find yourself asking: What can I eat?  Wouldn’t it be much better if medical science found a cure?

Diabetes, at this point, is for life. Right now the closest thing to a cure is the islet of Langerhan beta cell transplant for type 1 diabetes patients, but even that will require taking immunosuppressive drugs the rest of your life. For type 2 diabetics, it’s diet that offers hope of a cure, like a recent study that used a calorie restricted diet for 2 months with enormous success. Right now type 2 diabetes is considered a lifelong disease even when blood glucose levels are currently normal through diet. Weight loss surgery is the only treatment that has “cured” type 2 diabetics, and that does not cure all people. Unfortunately, the disease can return at any time. There are clinical trials in progress, of course, that are testing new drugs using state-of-the-art technology, but once again you are looking at controlling diabetes with drugs for the rest of your life.

What is the future of diabetes management? With millions of people living with this disease, the one thing you can count on is that innovative research will be ongoing. Innovative research takes research efforts into startling new directions as opposed to research that relies on tried and true methods. Technology and genetic studies have opened up new possibilities that have never existed before, and it is hoped the more radical research efforts will lead to a breakthrough which will lead to a cure.

Following is an unusual approach to a diabetes discussion. It is a glimpse into the future.

Breakthrough Research of the Future

Future research efforts will certainly be working on expanding current ideas like islet of Langerhan cell transplants , but more radical research is investigating the possibility of implanting an artificial pancreas for type 1 diabetes patients. The artificial pancreas is an automated system that could read blood sugar levels and deliver insulin on an as-needed basis. There is a big push in the medical research community to develop reliable equipment and software that can free type 1 diabetics from a lifetime of insulin shots  and insulin management.2

Also on the horizon are a variety of new methods of insulin delivery. You can expect one day to see insulin sprays for the throat and insulin patches you wear on the skin. Also, there is hope that in the future an insulin pill will be developed that the body is able to absorb. Insulin is a protein and, so far, the researchers have not been able to come up with a form of it that can make it through the digestive system intact.

The future may also hold inoculations to prevent the autoimmune system from stopping beta cell action. The key is to create an inoculation that won’t harm the immune system and will only shut down the immune system’s attack cells that focus on the beta cells.

Technology for a Diabetic Lifestyle

Technology touches everything today, and diabetes is no different. Currently there are several research approaches on diabetes management that rely on technology.3

  • Cell phone with a glucose meter, recorder and transmitter
  • Wireless transmission of glucose meter readings to health professionals
  • Insulin pumps operated via wireless meters
  • A glucose sensing car that gets information from the driver’s implanted skin sensor and warns of falling blood glucose levels

The glucose sensing car technology would enable diabetics to obtain commercial driving jobs with greater ease. One of the concerns now is that a diabetic will experience hypoglycemia and become unconscious while driving. A warning system would give the driver plenty of time to take appropriate measures to bring the blood glucose back up long before that happens.

It is expected that technology will lead more and more to continuous monitoring devices, wireless data transmissions, and wireless pump and injection systems for insulin. For example, researchers are working on the continuous glucose monitoring as a component of the closed loop artificial pancreas system.3

There is a word that diabetics should get familiar with too: telemedicine. The technology advances will make telemedicine the standard for long-term patient care. Telemedicine is not a new concept, but it has not really been fully developed or utilized. As technology advances and new devices and capabilities are designed, healthcare delivery will be transformed. The long term care of diabetics will rely more and more on technology for maintaining access to physician care, dietary advice, glucose monitoring, and monitoring of symptoms of diabetic complications.

Will There Be a Cure?

The question as to whether there will ever be a cure for diabetes cannot be answered at this point. Genetics and stem cell research seems to hold the most promise for a cure. Perhaps one day they will be able to genetically alter cells so that they won’t be rejected by the immune system after transplant. Maybe one day they will be able to restore pancreas functioning after the organ stops working.

Until a cure is found, diabetics can take hope in the fact that there are many research efforts on the brink of success.

References

1 Huang, Elebert S; Anirban Basu; Michael O’Grady; James C. Capretta. (December 2009) Projecting the Future Diabetes Population Size and Related Costs for the U.S., Diabetes Care, v32:12, 2225-2229.

2 Artificial Pancreas System (2011) Retrieved from U.S. Food and Drug Administration at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/ArtificialPancreas/default.htm

3 Keenan, D. Barry, Benyamin Grosman,  Harry W. Clark,  Anirban Roy, Weinzimer .D., Rajiv V. Shah, John J. Mastrototaro. (November 2011) Continuous Glucose Monitoring Considerations for the Development of a Closed-Loop Artificial Pancreas System. Journal of Diabetes Science and Technology, v5:6, p 1357+.

This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.