If one considers that the treatment of type 1 diabetes became possible in 1922 with the discovery of insulin, one must admit that for many new features have greatly increased the quality of life of these patients ( eg 1 meter in 1969, portable pumps late 70s, the insulin analogues and continuous measurement of blood glucose in the late 90s ...
New level of insulin.
The first inhalable insulin appeared on the market in 2005, intended primarily for people with type and type 1 diabetic adults. Because of its high price, lack of long-term studies on possible effects on the airways, difficulty of a precise dosage, this insulin has been very little interest and was withdrawn in in 2008. In late November 2007, the first oral insulin spray form has been marketed in Equador. Probably intended for people with type 2 diabetes or prediabetes, it has not yet been approved in Europe and long-term studies are not yet available. United States, a study began in 2006 trying to treat patients at high risk of diabetes with insulin capsules. The goal is to see if we can delay or prevent the onset of disease by administering insulin by the digestive tract to create a kind of tolerance and thus calm the immune system. Prevention of type 1 diabetes is not so far, the results of this study (in a few years) are eagerly awaited. However, it has already been proven that these insulin capsules will not be used to treat diabetes already said.
Vaccination
A hot topic in diabetes research for GAD65 vaccination. The GAD65 protein is beta cells. Diabetic type 1 there are antibodies that destroy certain proteins, often also GAD65. The idea of this vaccine is to keep as long as possible the production of insulin by beta cells by deflecting action of immune antibodies to the injected proteins. First results seem promising in Sweden and large-scale studies are planned in Europe in 2008. The Swedish study suggests that most are vaccinated sooner a person in whom diabetes has just been declared, the more we come to preserve beta cell.
Prevention (of disease onset)
These measures include also studies of oral insulin (see "insulin") In Europe, several countries are currently involved in "the study pre Point", in which we try to prevent the formation of destructive beta-cell antibodies by administration of insulin as a spray or powder in the diet of children at high risk of diabetes (which could have a hypoglycemic effect in those already diabetic). The hypothesis is that insulin may stimulate the immune system by inducing an immune response designed to protect cells against beta-destruction. The study has just begun, but similar studies in the U.S. seem promising.
Transplants
We are in the hot topic of stem cell therapy. The goal of research in the field of transplantation is a cure for diabetes by transplanting functional beta cells, the major problem is however the lack of organ donors. In recent years, a new method was developed: the culture of Beta cells from stem cells (= cells that can renew themselves indefinitely and give specialized cells by cell differentiation). We distinguish embryonic stem cells and adult stem cells. Studies in mice have allowed to grow insulin-producing cells from embryonic or adult stem cells which, transplanted into diabetic mice, have improved even normalization of blood glucose. Unfortunately, these experiences are only a stage animal and research on human embryonic cells still raises many ethical issues well justified. Similarly, studies of autologous stem cells (in Germany, Brazil) are very interesting. In this case, is transplanted to the patient's own stem cells that will be responsible for insulin production and replace insulin injections. The initial results seem positive, but research is still needed.
Measurement of continuous glucose
In 2006, the techniques of continuous glucose measurement have become increasingly efficient and allow the patient to directly read glucose values measured
in the subcutaneous tissue that appear on the device using a transmitter without cable, whose size has also fallen sharply, which enhances comfort, especially in children. The sensors can remain in place 3-6 days. Recently, the RealTime Paradigm insulin pump was also placed on the market in Luxembourg, (not yet repaid). This pump is combined with a continuous glucose monitor, the patient must wear two subcutaneous catheters (one for the administration of insulin to a glucose sensor). He can see glucose values on the pump which also warns if glucose is trying to climb or fall and emits alarm signals in case of hypo-or hyperglycemia. All these study results and progress in research lead us slowly towards the dream of a cure diabetes, but the road is still long! However, we can also see that all these small steps since the discovery of insulin allows diabetics to continuously improve their quality of life.
The first inhalable insulin appeared on the market in 2005, intended primarily for people with type and type 1 diabetic adults. Because of its high price, lack of long-term studies on possible effects on the airways, difficulty of a precise dosage, this insulin has been very little interest and was withdrawn in in 2008. In late November 2007, the first oral insulin spray form has been marketed in Equador. Probably intended for people with type 2 diabetes or prediabetes, it has not yet been approved in Europe and long-term studies are not yet available. United States, a study began in 2006 trying to treat patients at high risk of diabetes with insulin capsules. The goal is to see if we can delay or prevent the onset of disease by administering insulin by the digestive tract to create a kind of tolerance and thus calm the immune system. Prevention of type 1 diabetes is not so far, the results of this study (in a few years) are eagerly awaited. However, it has already been proven that these insulin capsules will not be used to treat diabetes already said.
Vaccination
A hot topic in diabetes research for GAD65 vaccination. The GAD65 protein is beta cells. Diabetic type 1 there are antibodies that destroy certain proteins, often also GAD65. The idea of this vaccine is to keep as long as possible the production of insulin by beta cells by deflecting action of immune antibodies to the injected proteins. First results seem promising in Sweden and large-scale studies are planned in Europe in 2008. The Swedish study suggests that most are vaccinated sooner a person in whom diabetes has just been declared, the more we come to preserve beta cell.
Prevention (of disease onset)
These measures include also studies of oral insulin (see "insulin") In Europe, several countries are currently involved in "the study pre Point", in which we try to prevent the formation of destructive beta-cell antibodies by administration of insulin as a spray or powder in the diet of children at high risk of diabetes (which could have a hypoglycemic effect in those already diabetic). The hypothesis is that insulin may stimulate the immune system by inducing an immune response designed to protect cells against beta-destruction. The study has just begun, but similar studies in the U.S. seem promising.
Transplants
We are in the hot topic of stem cell therapy. The goal of research in the field of transplantation is a cure for diabetes by transplanting functional beta cells, the major problem is however the lack of organ donors. In recent years, a new method was developed: the culture of Beta cells from stem cells (= cells that can renew themselves indefinitely and give specialized cells by cell differentiation). We distinguish embryonic stem cells and adult stem cells. Studies in mice have allowed to grow insulin-producing cells from embryonic or adult stem cells which, transplanted into diabetic mice, have improved even normalization of blood glucose. Unfortunately, these experiences are only a stage animal and research on human embryonic cells still raises many ethical issues well justified. Similarly, studies of autologous stem cells (in Germany, Brazil) are very interesting. In this case, is transplanted to the patient's own stem cells that will be responsible for insulin production and replace insulin injections. The initial results seem positive, but research is still needed.
Measurement of continuous glucose
In 2006, the techniques of continuous glucose measurement have become increasingly efficient and allow the patient to directly read glucose values measured
in the subcutaneous tissue that appear on the device using a transmitter without cable, whose size has also fallen sharply, which enhances comfort, especially in children. The sensors can remain in place 3-6 days. Recently, the RealTime Paradigm insulin pump was also placed on the market in Luxembourg, (not yet repaid). This pump is combined with a continuous glucose monitor, the patient must wear two subcutaneous catheters (one for the administration of insulin to a glucose sensor). He can see glucose values on the pump which also warns if glucose is trying to climb or fall and emits alarm signals in case of hypo-or hyperglycemia. All these study results and progress in research lead us slowly towards the dream of a cure diabetes, but the road is still long! However, we can also see that all these small steps since the discovery of insulin allows diabetics to continuously improve their quality of life.
