DIABETES
DIABETES: the current situation
As THe INCIDeNCe OF DIABeTes – BOTH TYPe 1 AND TYPe 2 – CONTINUes TO INCReAse, PIF LOOKs AT NeW ReseARCH THAT’s PROVIDING HOPe FOR THOse AFFeCTeD…
D
iabetes mellitus is a condition caused by a lack of insulin, or by a resistance to its action.
While there are many subtypes of the condition, the two main classes of diabetes are Type 1 and Type 2.
Type 1 is caused as a result of insulin deficiency following auto-immune destruction of pancreatic beta cells, and so Type 1 patients require the administration of insulin for survival. Type 2, on the other hand, is caused by a reduced secretion of insulin, or by peripheral resistance of its action.
While Type 2 diabetes can be controlled by diet alone, the majority of patients will still require oral antidiabetic drugs or insulin (or both) to maintain adequate control. With the incidence of both types still rising, research is being done in both areas to either find a cure, or to change the way the condition is treated.
Type 1: what’s happening With around ten per cent of people with diabetes in the UK affected by Type 1 diabetes, the pharmacist is frequently call on to ensure adherence to treatment to avoid complications.
If Type 1 diabetes is to be stopped, then scientists need to disrupt the immune system’s attacks on beta cells. Diabetes UK have said that their scientists are currently working on doing this and are aiming to ‘develop
56 - PHARMACY IN FOCUs
and test treatments – immunotherapies – that target the immune system to stop it destroying beta cells.
According to the charity, immunotherapies that have already been tested in trials have been able to delay the onset of the condition for a few months, and scientists are now exploring whether giving treatments earlier on, in younger children, could have better success at preventing Type 1 entirely. Researchers already appear to have been able to slow down or halt the immune attack to protect surviving beta cells.
Treatments that have been tested so far have been proven to preserve the amount of insulin people make and improve their blood glucose control, but, unfortunately, the protective effects appear to dwindle over time. Now, work is being done to look at how scientists can combine immunotherapies to target different parts of the immune system, and have a greater impact.
New insulin compound discovery In Australia, meanwhile, scientists have made a promising discovery that could improve the clinical delivery of insulin for people living with diabetes. scientists from the Florey Institute of Neuroscience and Mental Health at the University of Melbourne, have developed a non-fibrillating form of human insulin called glycoinsulin. The team say glycoinsulin could
prevent the formation of fibrils (clumps of insulin) and improve the delivery of insulin for people who rely on pump infusions.
Fibrils can arise when insulin compounds aggregate together forming clumps. For people with diabetes who rely on pump infusions to administer insulin, fibrils pose serious risk in blocking the delivery of insulin which can potentially lead to life threatening under-dosing.
Associate Professor Hossain said that the discovery of glycoinsulin presents a promising solution for patients. ‘Not only did our research demonstrate that glycoinsulin does not form fibrils,’ he said, ‘even at high temperature and concentration, but also that it is more stable in human serum than native insulin. Together these findings could position glycoinsulin as an excellent candidate for use in insulin pumps and a way to improve the shelf life of insulin products,” said A/Prof Hossain.
‘We now hope to streamline the manufacturing process for glycoinsulin so this compound can be further investigated in larger, clinical studies.’
Type 2: new advances In the past, Type 2 diabetes was thought to be a lifelong condition. Now, however, there is increasing evidence to say that, while it can’t be cured, it can be put into remission
through weight loss, leading to benefits for both patients and the NHs.
Reversing type 2 diabetes: a new approach There is no doubt that Type 2 diabetes is a national crisis and a massive challenge to the NHs. One in ten people over 40 is now living with diabetes and new figures from Diabetes UK suggest that, by 2030, around 5.5 million British people will have the condition.
But new research has shown real hope of turning the clock back and reversing Type 2 using a revolutionary diet.
The diet, which was developed by Professor Roy Taylor from Newcastle University in conjunction with colleagues from the University of Glasgow, sees participants live on a diet of just 800 calories per day for four weeks in order to see if they can shed more than two stones (15kg).
What is diabetes remission? Type 2 diabetes means that the body can no longer maintain healthy blood sugar levels through production of the hormone insulin. When blood sugar levels rise to harmful levels (ie, 6.5 per cent or 48mmol/moll HbA1c), people are diagnosed with diabetes.
Although many factors affect the development of type 2 diabetes, it is often accompanied by weight gain.
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