21 Aug New Developments in the field of Diabetes
World Diabetes Day is the primary global awareness campaign of the Diabetes Mellitus around the world and is held on November 14 of each year. It was introduced in 1991 by the International Diabetes Federation and World Health Organization in response to the alarming rise of Diabetes around the world. It engages millions of people worldwide in Diabetes advocacy and awareness.
World Diabetes Day is a campaign that features a new theme chosen by the IDF each year to address issues facing the global diabetes community. While the campaigns last the whole years, the day itself is celebrated on November 14, to mark the birthday of Frederic Banting who, along with Charles Best, first conceived the idea which led to the discovery of Insulin in 1922.
World Diabetes Day is celebrated worldwide by the over 200 member associations of the International Diabetes Federation in more than 160 countries, all member states of the United Nations, as well as by other associations and organizations, companies, healthcare professionals and people living with diabetes and their families. IDF member associations and partners develop an extensive range of activities, tailored to a variety of groups. WDD became an official United Nation day in 2007 with the passage of United Nation Resolution 61/225. On 20 December 2006, the UN General Assembly passed Resolution 61/225, which designated the existing World Diabetes Day as an official world day beginning in 2007. This landmark resolution also recognized Diabetes as “a chronic, debilitating and costly disease associated with major complications that pose severe risks for families, countries and the entire world.”
Activities that are organized every year include: lighting buildings and monuments in blue—the color of the Diabetes circle, walks and cycle rides, radio and television programmers, sports events, free screenings for Diabetes and it’s complications, public information meetings, poster and leaflet campaigns , Diabetes workshops and exhibitions, press conferences, newspaper and magazine articles, events for children and adolescents and activities and lesson in schools.
Each year World Diabetes Day is centered on a theme related to Diabetes. Topics covered in the past have included Diabetes and human rights, Diabetes and lifestyle, and the costs of Diabetes.
Recent themes include:
2005: Diabetes and foot care
2006: Diabetes in the disadvantaged and the vulnerable
2007-2008: Diabetes in children and adolescents
2009-2013: Diabetes education and prevention.
The campaign calls on all those responsible for Diabetes care to understand Diabetes and take control. For people with Diabetes, this is a message about empowerment through education. For governments, it is a call to implement effective strategies and policies for the prevention and management of Diabetes, to safeguard the health of their citizens with risk of Diabetes. For healthcare professionals, it is a call to improve knowledge so that evidence based recommendations are put into practice. For the general public, it is a call to understand the serious impact of Diabetes and know, where possible, how to avoid or delay Diabetes and its complications.
New innovations in the field of Diabetes
Treatment of Diabetes has changed considerably over years as a result of technological advances. From the discovery of Insulin to the development of less painful ways to deliver it, the lives of people with Diabetes have been improved and extended, by both Diabetes focused research and broader improvements in medical care There are several exciting developments on the horizon that may soon significantly change how people with Diabetes receive medical care or manage the condition on their own.
Let us review some innovations that are likely to change the way medical care is delivered.
CONTINOUS GLUCOSE MONITORING:
Technology of continuous glucose monitoring is completely revolutionary for its potential to change Diabetes care.
Compared with relying on urine glucose test strips and a single blood glucose measurement at the time of visit to the doctor, home blood glucose monitoring and the glycosylated Hb test, which provides information about the level of blood glucose control over the past three months have allowed a degree of blood glucose control that was unimaginable at their inception. Continuous glucose monitoring is just another advancement that is changing the rules of what we use for control.
Continuous glucose monitoring uses a sensor inserted under the skin, to provide a glucose reading every 1-5 minutes, that is displayed on a monitor; the monitor also shows whether the glucose level is raising or falling and can sound an alarm if it gets too high or too low. Numbers are stored and can be viewed as graphs, which lets the user see his glucose trends throughout the day or across several days.
Creating a device that would regulate blood glucose levels on its own, in effect creating an artificial Pancreas, has long been a goal of Diabetes researchers. Now, however, such devices are actually being built and undergoing testing. The advent of continuous glucose monitoring has been crucial to this process, since an artificial Pancreas is basically a unique combination of an Insulin pump, a continuous glucose monitor and a computer program that calculates how much Insulin the user needs at any moment based on his blood glucose level.
Technology is also poised to improve Diabetes education, especially for young people. A well designed Diabetes self management game could change health behaviors and outcomes. Highly rated Diabetes education computer games that are widely available include dbaza’s Diabetes education for kids, a CD ROM for windows operating systems like ” it’s time to learn about Diabetes,” a CD-ROM for both windows and mac. Two more graphically complex nutrition-themed video games, “escape from diabetes” and “nanoswarm: invasion from inner space” are set to be released this year. Both were developed through a partnership between Achimage , Inc, and a Children Nutrition Research Center at Houston’s Baylor College of Medicine. A varitey of free online games can also be found at the American Diabetes Association’s youth zone, located at www.diabetes.org/youthzone/fun-games.jsp
LONG DISTANCE PATIENT CARE:
Soon, you may not need to live in or travel to a major city to receive big-city medical care. Organizations, for example, the American Telemedicine Association paints a picture of having your blood pressure read while you’re at home and the nurse is in the office, of a radiologist reading your medical images from his home in another town, even of a surgeon operating on you from 300 miles away.
This isn’t a dream: It’s happening right now. In the past, to examine the heart, the Cardiologist could not be no farther from the patient than his or her stethoscope (the instrument to examine heart) allowed, and data gathering required face to face discussions with patients and sifting through paper files. But as health care becomes digitized, many activities, ranging from diagnostic imaging to the manipulation of laparoscopic instruments, are rendered borderless.
What does this mean for you? It may lower the cost of your care, or even save your life. Say you’re in a serious accident in the middle of the night. Your life depends on having the correct diagnosis fast, and the diagnosis involves having a radiologist read your x-rays.
However, radiologist available in the hospital you’ve been taken to, and calling one in would take too much time, luckily for you, the hospital has a relationship with a radiologist in another part of the world where it’s the middle of the day so the doctor is in. The image (taken by technician) is transmitted to the radiologist by computer, and he reads it and sends back the findings.
Telemedicine may also provide more opportunities for people with a chronic illness or condition, such as Diabetes, to interact with medical professionals. This in turn, may lead to improved outcomes.
Could gene therapy cure Diabetes?
New research into Diabetes holds out hope of a cure from this disabling condition. Experimental gene therapy has cured mice of Diabetes, and although work is at early stage, scientists hope the technique will one day free people from Diabetes.
Scientists introduced a gene to the mice that enabled their livers to generate Insulin.
Professor Lawrence Chan, who led the research at the Baylor College of Medicine in Houston, Texas, said: “it is a proof of principle. The exciting part of it is that mice with Diabetes are ‘cured’”.
Liver cells were induced to become beta cells that produce Insulin and three other hormones.
Beta cells are normally found within small bodies embedded in the Pancreas, called “islets”
Transplanting islet is one of the ways Diabetes can be treated, but a compatible donor must be found and the patient has to take powerful immunosuppressive drugs.
People with type 1, or Insulin Dependent Diabetes, produce virtually no Insulin because their islets have been destroyed by their own immune system. In the case of type 2 Diabetes, the body does not produce enough Insulin or respond to the hormone normally. Professor Chan’s team used a doctored virus to carry the beta cell gene into the mouse liver cells.
On its own, the gene partially corrected the disease. Combined with a beta cell growth factor, a biochemical which promotes growth; the Diabetic mice were completely cured for at least four months. An added benefit was that the modified liver cells also produced glucagon, somostatin and pancreatic polypeptide. These three hormones are thought to play a role in controlling Insulin production and release. The main obstacle to using the treatment on humans was concern about the safety of the virus “vector”
Transplant of Pancreas:
Some patients with type 1 Diabetes have experienced positive results from Pancreas transplants. Typically, part or all of a new Pancreas is surgically implanted. The old Pancreas is left alone; it still makes digestive enzymes, even though it doesn’t make Insulin. Most organs are obtained from someone who has died but has decided to be an organ donor.
A transplant of the Pancreas usually reserved for those with serious complications. Pancreas transplant are most often done when a patient also receives a new kidney The Pancreas transplant adds little further risk in this situation and offers big benefits. However, transplant surgery is risky. Each person needs to carefully weigh the potential benefits and risks.
BENEFITS OF PANCREAS TRANSPLANTS
— You may b able to maintain a normal blood glucose level without taking Insulin.
— Many of the Diabetes-related side effects are prevented or delayed.
— Most people with nerve damage who receive a Pancreas transplant do not get worse and sometimes show improvement.
DOWNSIDES TO PANCREAS TRANSPLANTS
— The body treats the new Pancreas as foreign and the immune system attacks the transplanted Pancreas.
— Transplant patients must take powerful immunosuppressant drugs to prevent rejection of the new Pancreas. Drugs that suppress the immune system can lower resistance to other diseases, such as cancer, and to bacterial and viral infections.
All signs are that technological developments will continue and probably even accelerate, given the expected increase in the number of people with Diabetes. While a miracle cure is unlikely, advances in medical technology can make Diabetes control easier, more convenient, and more accurate for everyone.