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Advances in Diabetes Care

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Updated November 07, 2007

Horror stories abound concerning the worst of what people with diabetes can expect: amputations, blindness and other serious complications. But, thanks to advances in diabetes care in the past 40 years, these stories can remain just that -- stories.

It’s possible for the person with diabetes today to live a full and healthy life. Advances in treatment have made control and management of the disease easier, and have taken much of the guesswork out of it.

Advances Help Patients With Diabetes Management

Diabetes research has led to such major advances as faster-acting and longer-acting insulin, oral diabetic agents, blood glucose meters and insulin pumps to help patients with their diabetes management.

Here is a timetable of some of the major developments of the last four decades:

  • In 1967, a laser treatment for retinopathy was developed. This revolutionized the care of retinopathy -- a complication of diabetes that sometimes causes blindness. The laser accurately targets damaged parts of the retina and helps control the complication, thus saving a person’s sight.
  • Before 1969, there was no way for a person with diabetes to test his or her own blood sugar level. Then the Ames Company devised the Eyetone meter. The device weighed 3 pounds, cost $650 and initially was only available to physicians. A year later, patients could buy their own. Now the blood glucose meters are far less expensive, far lighter in weight and more readily available.
  • A decade later, in 1979, the hemoglobin A1C test was developed. This test allowed doctors and patients to track average blood sugar levels, giving a much clearer understanding of how well the treatment was working.
  • Also in 1979, the first insulin pump was introduced, but it was inconvenient for most people because of its size, which required it to be carried around in a backpack. Today insulin pumps are about the size of a deck of cards.
  • In the 1980s and 1990s, genetic engineers created new types of insulin to replace the pig or cow insulin that had been standard treatment until then. These “monocomponent” insulins were considered superior to earlier types, because they were more apt to mimic human insulin.
  • Also in the 1980s and 1990s, the very-short-acting insulins were developed. These could be injected just 15 minutes before a meal, giving those who used it more freedom in timing their meals.
  • In the 1990s, people with type 2 diabetes got a boost with the approval of metformin, a drug used to treat insulin resistance. This drug has additional benefits, such as low blood sugar reactions, which are extremely rare, and this drug helps to prevent cardiovascular disease. In rare cases, this drug may cause a serious, life-threatening condition called lactic acidosis.
  • At the beginning of this century, a new, long-acting insulin was introduced called glargine. This insulin has a 24-hour action period, but no peaks and valleys, making more stable blood sugar control possible for some.

Advances in Diabetes Care

Perhaps the biggest development in diabetes care over the past several decades was the Diabetes Control and Complications Trial that began in 1983 and lasted 10 years. This was the first time that researchers were able to confirm a relationship between levels of blood sugar and the development of diabetic complications. This realization has formed the basis of much current and ongoing research aimed at finding ways to help reduce the number of people who suffer diabetes-related complications.

Those interested in learning more about advances in diabetes care can listen to people with diabetes tell their own stories at the Diabetes Stories Web site, a project of Great Britain’s Oxford Centre for Diabetes, Endocrinology and Metabolism.

More Hope for Future Advances

In 2006, the U.S. government spent $1.1 billion on diabetes research. Organizations and foundations such as the Juvenile Diabetes Research Foundation and the American Diabetes Association also commit funds and resources to research. The work currently under way holds great promise for finding even more new and improved treatments for the disease.

Specific avenues researchers are exploring include the following:

  • Prevention, early detection and early intervention
  • Islet cell transplantation
  • Immunology and immunogenetics to aid in risk identification and potential new treatments
  • New treatments to prevent vascular and cardiac damage
  • Continuous glucose meters to minimize the need for so many finger pricks to test blood sugar levels
  • Implantable glucose meters along with implantable pumps
Keep up-to-date with research by visiting the American Diabetes Association website, which provides summaries of current research on diabetes and related conditions, and by coming back to About.com.

Sources:

“Diabetes Research.” eMedTV.com. 2006 Clinaero, Inc. 22 Sept. 2007.<http://diabetes.emedtv.com/diabetes/diabetes-research.html>.

“Diabetes Stories: Personal Tales of Diabetes Through the Decades.” Oxford Centre for Diabetes, Endocrinology & Metabolism. 2005 Oral History of Diabetes. 21 Sept. 2007 <http://www.diabetes-stories.com/>.

Einhorn, D. “Advances in Diabetes for the Millennium: Insulin Treatment and Glucose Monitoring.” Medscape.com. 2004. Medscape. 21 Sept. 2007. (subscription) <http://www.medscape.com/viewarticle/488996>.

“History of Diabetes.” 2005. 22 Sept. 2007. <http://64.233.169.104/search?q=cache:jKrohtAORHsJ:www-unix.oit.umass.edu/~abhu000/diabetes/timeline.html+history+of+diabetes&hl=en&ct=clnk&cd=14&gl=us>.

Irbina, I. “Rising Diabetes Threat Meets a Falling Budget.” NYtimes.com. 2006. The New York Times. 22 Sept. 2007. <http://www.nytimes.com/2006/05/16/health/policy/16diabetes.html?_r=1&ei=5070&en=d21a8a15b8a4d553&ex=1189569600&pagewanted=print&oref=slogin>.

Kalayoglu, M. “Laser Photocoagulation Systems for Diabetic Retinopathy and Other Retinal Disorders.” Medcompare.com. 2007. Medcompare. 21 Sept. 2007. <http://www.medcompare.com/spotlight.asp?spotlightid=224>.

Metformin. Medscape.com. 2007. Medscape. 6 Oct. 2007. <http://search.medscape.com/drug-reference-search?queryText=metformin>.

Satley, M. “History of Diabetes.” DiabetesHealth.com. 1996. 21 Sept. 2007. <http://www.diabeteshealth.com/read/1996/11/01/715.html>.

“Joslin Research Sections.” Joslin Diabetes Center. 2007. Joslin.org. 22 Sept. 2007 <http://www.joslin.org/732_1206.asp>.

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