Building bridges for diabetes prevention and treatment

Linda Siminerio, Diabetes Voice Guest Editor:

I have had the opportunity to observe advances in diabetes over the course of 50 years. Looking backward and forward, the process tells a story of promise. 

In the 1960s, I recall watching my father who struggled with the crude treatments and tools available to people with diabetes at the time. He was prescribed a strict diet, urine testing, and a dose of insulin delivered through a glass syringe with a very long needle. There were no tests for monitoring. All of his care decisions were based on guesses. Despite his best efforts, his diabetes led to a series of complications and a tragic end.  

Years went by in the diabetes community with little advancement. New medications, insulin products and better delivery tools were introduced in the 1970s and there was a sigh of relief in the diabetes community. Yet people living with diabetes still had no way of knowing when their glucoses were high or low. As a result, people still suffered the serious complications of the disease.

Methods for monitoring blood glucose finally became available during the 80s. Tools to perform blood glucose and hemoglobin HbA1c testing provided the needed information to people with diabetes and healthcare providers. The diabetes community yet again breathed a sigh of relief. If there was a way to monitor glucose, of course complications could be prevented.

When monitoring became available, scientists and governments from around the world in the 1980s and 90s were finally able to invest time and funds to find answers to pending questions. Does blood glucose control really prevent the complications of diabetes? If people are at risk, can we prevent diabetes from happening? From major studies, we learned that good glucose control could prevent complications in people with type 1 diabetes. Blood pressure and glucose control are very important for people with type 2 diabetes. For people at risk, several large studies showed that lifestyle interventions help lower the chance of getting diabetes. The diabetes community breathed yet another sigh of relief, until they realized that these important scientific findings were sitting on shelves in universities.

To everyone’s relief...investigators, health decision makers and funding agencies realized that there was more work to do on the diabetes journey.  Bridges were built to translate important findings from the research world to communities where people either with diabetes or at risk for the condition live.

In this issue of Diabetes Voice, you will get a peek into the world of translational research. Through an educational grant from Lilly Diabetes, BRIDGES (Bringing Research in Diabetes to Global Environments and Systems), is an International Diabetes Federation’s (IDF) programme dedicated to translational research projects. BRIDGES takes lessons learned in research into communities. In this issue you can learn more about real-world projects that investigators from around the world are currently working on in the fight to prevent and treat diabetes.

In Tunisia, a lifestyle intervention is being tested in schoolchildren. Project leaders in Pakistan are partnering with prevention experts from Finland. They are adapting the effective Finnish Diabetes Prevention into a culturally specific lifestyle intervention for the prevention of type 2 diabetes in Pakistan.

In looking at ways to provide better care and education to people in their respective countries, care models, education and peer programmes are being developed and tested in Austria, Brazil, Caribbean Islands, China and Denmark.

Other projects are relying on technology. For example, a mobile phone self-management system is being used to help people with diabetes in the Democratic Republic of Congo, Cambodia and the Philippines. A DVD on gestational diabetes is being piloted with expectant mothers in the United Kingdom.

Much effort has gone into testing strategies to prevent and treat diabetes.  We need to work together, learn from each other, adapt to our own communities and rely on tested approaches. I hope that you agree, after reading this issue that highlights BRIDGES translational research, that there is promise for the future in reaching out to the world of people affected by diabetes.

In closing, I would like to thank Lilly Diabetes for their continued support. I would also like to thank the members of BRIDGES Executive Committee, BRIDGES Review Committee and IDF Executive Office for their dedication and hard work to make this programme a success.