New Diabetes Approaches: Can We Lift The Global Burden?

The World Health Organization (WHO) already considers diabetes an epidemic and predicts that in the not-so-distant future it will be the seventh leading cause of death at a global scale. So when a piece begins with a statement about the ‘diabetes epidemic’ know that writers are not being dramatic for the sake of keeping your attention.

The numbers are scary as you can see for yourself and though environmental factors like diet and physical activity have a significant role to play, type I diabetes is still unpreventable as its cause is currently unknown.

You can prevent type II diabetes or at least delay its onset by maintaining a healthy body weight and leading a generally healthy cigarettes-free, physically active, lettuce-loving lifestyle. And that’s good news because it is type II diabetes that makes up the majority of the global diabetes burden.

However, you can only do so much to control an autoimmune disease like type I diabetes and to make a big difference there, we’ll have to rely on research and medical advancements – both when it comes to prevention, and when we look for better treatments.

The medical world has taken the incentive to heart and we at FindMeCure are excited about all the opportunities being researched or given the green light for testing in just the recent few months. From a new classification of diabetes that allows for personalized treatment to artificial pancreases and developments that sound so futuristic, we can hardly believe they’re being tested right now, the road ahead looks interesting, to say the least. Let’s take a look.

Cell therapy in type I diabetes

Transplantation of healthy insulin-producing cells has failed time and time again in its early attempts due to the patient’s body rejecting the foreign cells. Cell donors are another variable that has to be taken into account – if a therapy depends on volunteers to donate the material needed, a patient can never be guaranteed to receive it.

An alternative to this treatment comes from the Diabetes Research Institute (DRI) that came up with the clever idea of encapsulating insulin-producing cells in a sort of a bio-engineered mini-organ. This treatment is also not purely hypothetical – it’s been two years since the first patient to receive it in a phase II clinical trial, and it seems to be a success because she reports no longer needing insulin injections.

Still, can a patient’s own cells be used to ‘hack’ their pancreas into producing insulin? Maybe they can and that could be a viable alternative to transplantation, according to Orgenesis – a big company in the field of cell therapy in type I diabetes, and the UK company Islexa. They’re both looking into the possibility of extracting cells from the patient’s own liver or pancreas and then reprogramming them to produce insulin. That would be a way around the limitation of searching for donors and the patient’s body rejecting the new cells later.

These therapies will have to go through clinical trials to confirm their potential to treat and possibly even cure diabetes. However, we shouldn’t be quick to celebrate even if the results of the clinical trials confirm our boldest hopes. Prices of cell therapies can be so high that they never reach the general population. So, maybe better insurance policies are in order before the newest treatments are widely available.

New classification of diabetes

ANDIS (All New Diabetics In Skåne) – a study of newly diagnosed diabetics from the Lund University in Sweden suggests there are in fact more than two types of diabetes. What this could mean about treatment is the possibility of personalizing drugs to target the specific cause of the issue, instead of going by a ‘one treatment fits all’ approach.

“Current diagnostics and classification of diabetes are insufficient and unable to predict future complications or choice of treatment”, says the initiator of the study, Professor Leif Groop.

Researchers took into account not only blood sugar levels but also insulin resistance, secretion, and age of onset and five distinct groups emerged. These groups include SAID (severe autoimmune diabetes), corresponding to type I diabetes, SIDD (severe insulin-deficient diabetes), in which insulin secretion is impaired, SIRD (severe insulin-resistant diabetes), in which the body is resistant to the insulin produced, MOD (mild obesity-related diabetes) and MARD (mild age-related diabetes), which affects elderly patients.

By dividing patients into five groups according to these measurements, researchers were able to predict what secondary diseases diabetics were at risk of developing later on. This allows for a new approach, aimed at preventing complications.

Immunotherapy for newly diagnosed patients

In type I diabetes, the immune system attacks insulin-producing cells until none of them are left in the body. But what if the immune system could be ‘persuaded’ to stop doing that?

This is the question researchers in a recent clinical trial are trying to answer by giving treatment to newly diagnosed patients. The treatment under investigation is designed to get the immune system to destroy the immune cells attacking the insulin-producing ones. They hope this way the remaining insulin-producing cells will be preserved and the offending immune cells will be eliminated, so there’ll be none left to cause trouble.  

The artificial pancreas can be among the solutions   

This one can be a game changer for type I diabetes patients whose insulin-producing cells cannot be saved. They have to rely on insulin injections but as professor Roman Hovorka from the Cambridge University points out – the insulin demands of those patients vary from day to day and throughout the day as well.  

The artificial pancreas can be an effective, low-maintenance alternative to the insulin injections. Equipped with a glucose sensor and an insulin pump the artificial pancreas aims at delivering just the right amount of insulin to meet the demands of the body as they arise. This allows for the sustenance of healthy blood sugar levels, which in turn reduces the risk of complications.

The artificial pancreas is probably closest to being commercially available, compared to all the other advancements we talked about here. It’s already showing promising results in clinical trials, as reported by 17-year old Jack Newman who recently shared his story in hopes of encouraging others with his diagnosis to participate in clinical trials.

As Diabetes Awareness Month is gradually coming to an end making way for the Hollyday season, we at FindMeCure are counting all of the exciting new paths in the fight against the epidemic.

New devices and drugs entering clinical trials mean new, better treatments in the years ahead. If you want to make a contribution to the world of medical advancements and be part of the efforts to lift the global burden, while at the same time receiving the most innovative treatment a patient can have access to, you might want to take a look at the clinical trials available in your area.