Diabetes Views - Towards a brighter future with and without diabetes

I am particularly pleased to greet Diabetes Voice readers in the pages of this special issue dedicated to potential, novel, newly implemented and recently investigated approaches to diabetes care and prevention. A collection of international authors reporting on their achievements and work in progress either originate from or are working in countries representing all seven IDF regions. The multiethnic cohort of experts is drawn from a variety of fi elds and refl ects the complex and multifaceted and now sadly global nature of the incipient diabetes epidemic – for it is a reasonably new epidemic, and no magic bullet for a cure (yet) exists. All of the emerging therapies and interventions showcased in this magazine – be they lifestyle-related or in search of a pharmacological (or bionic!) solution – describe achievements and achievements in the making made through a great deal of hard work carried out within the rigorous framework of scientific research.

Articles in the ‘Science at the cutting edge’ section explore just that – progress towards a state-of-the-art response to diabetes. Or, in the case of the article on IDF’s position statement on the use of bariatric surgery, towards preventing type 2 diabetes or reversing its disease process. Long-term studies have demonstrated that weight-loss surgery procedures, such as gastric banding, sleeve gastrectomy or gastric bypass, lead to improvements in cardiovascular risk factors and even 'recovery' from diabetes in obese people. Th e psychological eff ects of such interventions appear to be positive also. However, some emotional trauma can occur due to the transformation of a person’s appearance – loose skin and facial changes, for instance – and the IDF consensus recommends immediate post-op counselling and life-long follow-up.

A team of UK-based researchers debates the merits o f two potential paths to restoring insulin secretion in people with diabetes, bringing their blood glucose levels and control back to normal with no risk of hypoglycaemia. Theirs is an informative piece, which manages to demystify some highly specialized science.

In the other two sections of this special issue, a number of articles provide an update on research supported by BRIDGES, a major IDF grant programme funded by Lilly Diabetes, whose overarching goal is to improve diabetes care and prevention in the neediest of communities around the world. People living in developing countries face a disproportionate risk from the disturbing, disabling and potentially lethal complications of diabetes. Over the coming decades, the greatest increases in the numbers of people with diabetes are set to occur in sub-Saharan Africa and East and South-East Asia. Latina America and the Caribbean already have worryingly large diabetes populations. For those people, the physical and emotional challenges of managing a complex and life-long disease like diabetes are compounded by daily life in an unhealthy and oft en unsanitary environment, including a lack of access to healthy food, and a devastating inability to pay for life-saving medications, including insulin.

Investigators working on the BRIDGES-supported projects, like those described in this issue, are striving to translate knowledge gleaned through clinical research and randomized controlled studies into cost-eff ective clinical practice in order to implement long-term behavior modifi cation strategies to tackle diabetes and prevent its complications. Th ese are examples of translational research in motion and show the real-world results of IDF’s work, in partnership with public health services and the private sector, to make a diff erence to the health and wellbeing of vulnerable people with diabetes everywhere.