Tomorrow Belongs to Us

Every one of us who has diabetes, and the people who love us, hope for the day when science finds a way to cure our disease.

Not just kick it into remission, but cure.

In the meantime, until that great day, it’s good to remember just how far the struggle to control diabetes has come over the past few decades. It makes sense to hold out hope for things we know are just on the horizon thanks to incredible new technology:

Surgical Advances

There’s no denying that gastric bypass surgery has come the closest to a “cure” for type 2 diabetes among any of the therapies now available. The problem is that it’s an expensive weight-control procedure restricted (for now) to obese people. Its wonderful effects on type 2 have been a great unanticipated bonus, but it has yet to become an accepted primary way to treat type 2 .

Could outpatient bariatric surgery become commonplace? Hard to say. Surgeries like it are a “practice-makes-perfect” affair. The more they’re done, the faster, better, and cheaper they become. If/when that happens, they could become a viable treatment for many overweight type 2s.

New Drugs

Insulin

A new basal insulin analog being developed by Eli Lilly and Co. has shown advantages over insulin glargine in Phase II trials. The insulin, dubbed LY2605541, matched glargine in terms of glycemic control, with the additional benefits of collateral weight loss, lower rates of nocturnal hypoglycemia, and fewer variable blood glucose readings through the day.

Oral Insulin

This may be closer than we think. The trick is to smuggle delicate insulin molecules past the destructive acidity of the digestive system. An Israeli company, Oramed, has been at the forefront of developing insulin you swallow rather than shoot.

Other Drugs

A steady stream of new drugs is appearing to treat type 2 symptoms, most of them as add-ons to drugs currently on the market. For example, Poxel’s imeglimin, now in Phase II tests, when added to sitagliptin reduced diabetes patients’ A1c’s by 0.73 percent over a 12-week period.

Another drug, dulaglutide, from Eli Lilly & Co., is a once-weekly injectible drug that  outperformed three other widely taken diabetes drugs in just-concluded Phase III studies. (Those drugs were metformin, Januvia [sitagliptin], and Byetta [exenatide].)

Improved Monitoring Devices

Over the past few years, manufacturers have added features to blood glucose meters that make life easier for type 2s, including the need for smaller blood samples and meters that can wirelessly send and receive data—a boon for healthcare workers and recordkeeping.

The next advance will be successful optical blood glucose measuring systems that do away with the need for needle sticks. Devices currently under development all work on the same principle: A beam of light is shone on the skin, which causes glucose molecules to vibrate. This indicates how much glucose is in the bloodstream.

There are drawbacks: Optical monitoring probably won’t be recommended as a total replacement for needle sticks or use by very light or dark-skinned individuals. Also, pregnant women, people under 18, smokers, and people with peripheral vascular disease. 

A California company, C8 MediSensors, has an interesting discussion of the technology here.