Research and studies

Recently, two clinical trials addressed the role of tight blood glucose control on cardiovascular risk in people with type 2 diabetes: the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study and the Action in Diabetes and Vascular Disease (ADVANCE) trial. The ACCORD study included 10,251 people with type 2 diabetes and was designed to determine whether intensive blood glucose control (HbA1c below 6%) as compared to a conventional approach (HbA1c between 7% and 7.9%) would result in favourable cardiovascular outcomes in people with type 2 diabetes at high vascular risk.

In 2001, the Diabetes Attitudes, Wishes and Needs (DAWN) study interviewed more than 5400 adults with diabetes and more than 3800 diabetes care professionals in 13 countries. The main purpose of  that research was to identify new ways to overcome the psychosocial barriers to the optimal health and quality of life of people with diabetes and those at risk.

Because their condition affects every aspect of their daily  life, children and adolescents with diabetes are faced with more problems than are many of their peers without diabetes. The greater part of their day is spent at school, and this is where many of the greatest problems lie. Dealing with diabetes in school is one of the most important topics in the daily life of many families. The 2007 online WebTalk survey, conducted in eight countries as part of the DAWN Youth survey, has contributed to an increased understanding of the issues faced by children and adolescents with diabetes.

The high expectations that stem cells will cure diabetes have been met with a considerable degree of scepticism, particularly from people who have been hearing for decades that a cure is ‘just around the corner’. The conclusion of this article is that stem cell biology is promising and might deliver the advances the diabetes community has been waiting for. But no one knows how long this will take; no timetables for expected success will be presented – which might be a disappointment to some.

The BRIDGES grant programme is dedicated to supporting translational research in diabetes worldwide. The structure of BRIDGES is in place and the programme has taken the first steps towards accomplishing its overarching objective: to bridge the gap between science and people with diabetes – between clinical research and clinical practice – by supporting cost-effective and sustainable interventions to prevent and control diabetes.

The lack of access to scientific and medical literature has historically been a major challenge in developing countries. In a world that is increasingly digital, effective opportunities now exist for connecting healthcare providers, researchers and policy-makers with online research and clinical information. The authors report on HINARI, AGORA and OARE programmes built on partnerships between publishers and UN organizations which provide researchers from developing countries with access to the world’s latest scientific literature.

The International Diabetes Federation estimates that approximately 246 million people around the world have diabetes. Of this number, around 90% are people with type 2 diabetes. The consequences for public health worldwide are devastating. The World Health Organization estimates that one in 20 deaths in the world is caused by diabetes, and that up to 15% of the annual budget for healthcare is devoted to the disease.

There are thousands of medical journals worldwide, many of them publishing articles that report diabetes-relevant research. The growth of Internet publishing has made this knowledge universally available – in theory. However, the contents of peer-reviewed medical journals are beyond the reach of most of the world’s healthcare providers and indeed most people with diabetes. Publishers limit access to the latest research findings to those institutions and individuals that can afford to pay for it.

Diabetes is now the world’s fourth leading cause of death by illness, and the global epidemic shows no signs of abating. In recent decades, a revolution in science has contributed to a greater understanding of diabetes and the development of new cutting-edge therapies. However, diabetes prevalence, and diabetes-related death and disability have continued to grow rapidly.

The onset of coeliac disease, together with type 1 diabetes, influences glycaemic control, and more precisely the development of hypoglycaemia. These conditions share a similar genotype. The main problem of coeliac disease is intolerance to gliadin, a gluten protein found in cereals such as wheat, rye and barley; the only treatment is a gluten-free diet. Spomenka Ljubic and Zeljko Metelko report on the growing body of evidence linking coeliac disease and other autoimmune disorders, including type 1 diabetes, and describe recommended procedures for its diagnosis and treatment.