Diabetes treatment > Latest advances

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Back to the future: investigating new treatments for type 1 diabetes using old inexpensive drugs

"Great disappointments in medicine frequently give rise to great innovation – so the saying goes – but who expected a 20-year detour?" Denise Faustman and her team were disappointed by their findings from human islet cell transplantation trials and felt compelled to return to the bench for 20 years to understand why the trials had been less successful than had been hoped. They first turned to an animal model of type 1 diabetes, which,

Biosimilar insulins

Insulin is a complex protein, manufactured to a high standard, and requiring special expertise. As modern insulins come offpatent, many companies are expected to try to enter the market with copies of current branded insulins, termed 'biosimilar insulins'. Philip Home discusses the issues in development and production of such biosimilars, and the regulatory hurdles and likely consequences for the insulin market.



Diabetes and the promise of a preventive and therapeutic role for vitamin D

Vitamin D is naturally present in a few foods and produced in the body when ultraviolet rays from sunlight come into contact with the skin. This fat-soluble vitamin is also available as a dietary supplement. The principal biological function of vitamin D is to maintain levels of calcium and phosphorus in the blood, aiding the absorption of calcium, and helping to form and maintain strong bones. Recent research findings have suggested that vitamin D also may provide protection from osteoporosis, high blood pressure, some cancers, and several autoimmune diseases, including diabetes.

New findings in gestational diabetes - the HAPO Study

The diagnosis of gestational diabetes has for decades been based either on criteria that predict a mother’s risk for developing type 2 diabetes in the future, or those used for non-pregnant women. But gestational diabetes also carries a risk for the baby. Moreover, the level at which maternal blood glucose provokes risk for the foetus remains unclear.


The results and implications of the ACCORD and ADVANCE trials

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.

HbA1c results in relation to familiar every-day measurements - the near future

Haemoglobin A1c (HbA1c) is widely used to determine levels of long-term blood glucose, judge the adequacy of diabetes management, and adjust therapies. HbA1c results are expressed as the percentage of haemoglobin that is exposed to glucose (glycated). People’s day-to-day diabetes management is guided by self-monitoring of  capillary glucose concentrations, which are measured  in mmol/l or mg/dl.

Sharing future hopes

Editor-in-Chief's editorial

Do stem cells hold the key to a future cure for 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.

Global standardization of the HbA1c assay - the consensus committee recommendations

Since the late 1970s, HbA1c test results have been used to guide diabetes care. The International A1c-AG Study, under way in 10 centres in North America, Europe, and Africa, aims to explore the relationship between HbA1c and average blood glucose. Martin Silink and Jean-Claude Mbanya, who represent IDF on a consensus committee working towards the standardization of the HbA1c assay, report on developments in the measurement and reporting of long- term average blood glucose levels.

Insulin pump therapy in children and adolescents: risks and benefits

During the last decade, insulin pump therapy has gained widespread acceptance in the treatment of children and adolescents with type 1 diabetes. In some of the European and North American paediatric diabetes centres, more than half of the young people with diabetes try to simulate a normal pattern of insulin secretion by means of an insulin pump (continuous subcutaneous insulin infusion).

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