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More than two million Canadians have diabetes. Approximately 10% of those have type 1 diabetes, where the body stops producing insulin, which is required to convert sugar into energy. The remaining 90% have type 2, where the body either does not produce enough insulin or does not properly use the insulin it produces.
Both type 1 and type 2 diabetes can take a toll on sufferers, from decreased quality of life to a higher risk of heart disease, stroke, kidney disease, blindness, amputation and other complications that may lower life expectancy. But research advances are making life for people with diabetes easier - both in terms of day-to-day management of their condition and with regards to long-term care.
For example, people who have type 1 diabetes (and some type 2 sufferers) must be treated with insulin as a means of controlling blood glucose. For years, this meant injections several times a day. But now there are many different options for people who require insulin, from different forms of delivery to different numbers of dosages per day.
Health Canada recently approved the sale of a new form of long-acting insulin, several years after it was made available in the U.S. and elsewhere. This new form of insulin needs only to be injected once a day and results in more stable insulin levels than previously available long-acting versions.
There are also a wide variety of forms of administering insulin that go above and beyond the traditional syringe and needle. Newer delivery methods include insulin pens and pumps that deliver a constant stream of insulin for people who require more intensive therapy. And there are even more delivery systems in the pipeline. Currently there is research on a new type of skin patch which could be used for insulin delivery, while pumps that can be implanted in the skin, inhalation sprays, oral sprays and pills are also being developed or investigated.
Scientists are also making leaps and bounds in the long-term management of diabetes, with some treatments that could yield a virtual cure. One example is a review of 136 studies, which found that obesity surgeries, such as stomach stapling, eliminate type 2 diabetes in nearly 77% of patients.
Meanwhile, much of the efforts surrounding type 1 diabetes have focused on cell and organ transplants that may reduce or eliminate the need for insulin injections. In type 1 diabetes, the body's immune system attacks the cells in the pancreas that produce insulin. As a result, research has focused on ways to restore levels of insulin-producing "beta cells," whether through pancreas transplants or the insertion of these specialized cells.
The first pancreas transplant took place in 1966, but initial success rates were low. While many people who have undergone a pancreas transplant no longer require insulin, many need to take immune-suppressing drugs for the rest of their lives to reduce the risk that their body will reject the new organ, and on older immune-suppressing drugs, the risk of rejection was still high. Advances in these drugs have increased the number of successful transplants performed each year. But because pancreases used for transplants come from donors who have just died, these organs are in limited supply, which limits the number of transplants that can be performed.
As a result, researchers have had to look for other ways of delivering the same benefits. This includes efforts to develop a transplantable artificial pancreas, which contains a computer to measure blood glucose levels along with an insulin pump.
Researchers are also focusing on the insulin-producing cells themselves. Doctors at the University of Alberta in Edmonton have successfully implanted these cells into patients with type 1 diabetes. But again, this procedure has limits: About 1 million insulin-producing cells are required for a successful transplant, which means doctors generally need two pancreases to obtain the cells.
But researchers are aggressively searching for a more plentiful source of these cells, including from animal donors or stem cells that could possibly be adapted to produce insulin. A recent study also showed early success for the possibility of such transplants using cells from just one pancreas, though further research must be done. Japanese researchers are also studying the possibility of using live donors.
With so many leaps and strides in diabetes research, is it possible that this condition can one day be eliminated? Don't hold out hope for that sweet news just yet - especially where type 2 diabetes is concerned. For now, the emphasis is still on management and prevention.
While at the moment there is no means to prevent type 1 diabetes, there is fear among experts that today's super-sized, sedentary lifestyles could lead to an explosion in type 2 diabetes cases. If you don't have type 2 diabetes, remember that being overweight and not exercising are two of the main risk factors for developing it.
And whether you have type 1 or type 2 diabetes, remember that your best way to lower your chance of complications is by controlling your blood glucose through diet, exercise and, for people with type 1 diabetes and some people with type 2, medication.
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