Insulin

For many people with diabetes insulin is essential to health. Indeed, there are few other conditions where the replacement of a hormone that the body has ceased producing can make an acute difference between life and death. Nevertheless, a recent data-gathering project in Central and Eastern Europe illustrated that, almost 80 years after its discovery, access to insulin supplies is still problematic.

When he left home to attend his regular diabetes clinic, Ray Msengana was already feeling unwell. But when he was told that the treatment of his Type 2 diabetes was to change from tablets to insulin therapy, he rapidly felt a lot worse. In this candid account of life with diabetes, Ray Msengana describes the affective impact of the condition, and makes a call for changes in the way diabetes is managed.

The insulin pump offers advantages to some people with Type 1 diabetes, freeing them from the chore of administering a number of injections every day. However, the high cost of the pump and the need for careful supervision will limit its use to wealthy patients who can count on sophisticated medical support. This article proposes the use of "beta cell therapy" in order to create surrogate insulin-producing cells.

Insulin for Life (IFL) is a non-profit, Australian-based organization established in 1999. This unique initiative evolved from the 20-year programme at the International Diabetes Institute in Melbourne.

We usually assume that the ups and downs of blood glucose are solely responsible for changes in the release of insulin into the circulation, such as in response to a meal. However, the release of insulin from the pancreas is supported by signals from the alimentary canal (gut). When food is transported from the stomach into the small intestine, from which glucose, fat and proteins are absorbed into the blood, gut hormones are released into the circulation. Around 50%

Over 80 years after the discovery of insulin, access to it is still problematic for people in many parts of the developing world. In February 2001, at a meeting between the International Diabetes Federation (IDF) and the World Health Organization (WHO), a call was made for the establishment of a non-governmental organization to improve the sustainable, affordable and uninterrupted supply of quality insulin for people with Type 1 diabetes in areas of need.

For the safety of the passengers and crew of an aeroplane, it is imperative that an airline pilot maintain a high level of fitness. There are a number of medical conditions which, once diagnosed, may prevent a pilot being allowed to fly a plane. If they can be stabilized, some conditions may allow a return to work. Other conditions are classed as 'non-medically certifiable'. Upon diagnosis of a non-medically certifiable condition, a pilot's medical certificate will be denied, and if already issued, it will be revoked.

There is still a widespread misconception that non-communicable diseases such as diabetes are not relevant to poor people in developing countries. For these people, medicines for the treatment of such conditions are regarded almost as a luxury. Scientific evidence testifies to the contrary. Non-communicable diseases such as diabetes are escalating in developing countries. This is giving rise to severe economic as well as human consequences. An effective public health strategy for poor countries requires continued access to low-cost, high-quality generic medicines.

In the last 10 years, genomic and proteomic technologies have been applied to identify and develop a new generation of diabetes treatments. While these technologies have become increasingly automated, producing a deluge of potential therapeutic targets and biological insights, projections estimate that individual drug development time and cost will continue to rise and soon exceed 1 billion USD. A significant contributor to this rising cost is the large

Despite major fluctuations in supply and demand, sophisticated mechanisms in the body maintain levels of blood sugar (glucose) within narrow limits. Although under normal conditions, insulin is the major regulator of blood glucose levels, growth hormone (GH) and insulin-like growth factor-1 (IGF-1) play an important contributory role. Both of these hormones have potent effects on glucose metabolism which may be utilized in diabetes management. Richard Holt explains the growing interest in exploiting the effects of GH and IGF-1 for people with diabetes.