If you are living with diabetes, you may often wonder if the future holds more than sugar-free desserts and insulin injections. Doctors understand the importance of finding treatment plans that are easy for patients to follow and relatively free of unwanted side effects, so research is ongoing to find novel approaches to managing this life-altering disease.
Oral Insulin
Insulin has been a mainstay of therapy for diabetes for years because it's extremely safe when taken as directed, and its flexible dosing allows doctors to adjust regimens as often as needed to achieve target glucose levels. But even with these positive features, doctors and patients often hesitate to start injectable insulin therapy because of the wide array of oral drugs available. These drugs carry their own downsides, however---most notably an increased risk for weight gain and hypoglycemic episodes in which blood sugar levels can dip perilously. In an effort to give patients the benefits of insulin without needles, researchers are trying to determine whether oral insulin can be as effective as the conventional injectable type. In a 2010 review that appeared in the journal "Diabetes, Obesity and Metabolism," lead author Harish Iyer reported that two oral insulin products are showing early promise for reaching the market, and long-awaited data from long-term patient trials will be available in the second half of 2010.
Vitamin D Supplementation
Some studies are showing that vitamin D deficiency may be linked to diabetes risk, so research is underway to determine whether supplementation might be useful for preventing the disease. Elena Barengoltz, MD, chief of the endocrinology section at the University of Illinois Medical Center in Chicago, reported that researchers are showing that long-term supplementation with vitamin D and calcium may be as effective as metformin (a common diabetes drug) for reducing blood glucose levels. But before you rush out to your local health food store, consult your doctor to find out whether you could benefit from supplementation---excess intake of this fat-soluble vitamin can lead to bone loss and, in extreme cases, kidney failure.
Gastric Electrical Stimulation
Gastric electrical stimulation is a new technology under investigation that may benefit obese patients with type 2 diabetes. MetaCure is the manufacturer of one such system, the Tantalus stimulator, which uses implanted electrodes to monitor the natural activity of your stomach and applies gentle electrical pulses to enhance your sensation of fullness. According to a 2009 report in "Journal of Diabetes Science and Technology," a six-month study of the Tantalus stimulator in 14 patients resulted in significant decreases in hemoglobin A1c (a measure of blood glucose control) and blood pressure, as well as reductions in blood triglyceride and LDL ("bad") cholesterol levels. The device also appeared to induce weight loss---patients lost, on average, 11 to 12 pounds during the study period. These early results are promising, but studies of more patients are necessary before the U.S. Food and Drug Administration will be able to approve this type of device for widespread use.
References
- "Diabetes, Obesity and Metabolism"; Oral Insulin -- A Review of Current Status; Harish Iyer; January 2010
- "Endocrine Practice"; Vitamin D Role and Use for Pre-Diabetes; Elena Barengolts; February 2010
- "Journal of Diabetes Science and Technology"; Gastric Electrical Stimulation with the TANTALUS System in Obese Type 2 Diabetes Patients: Effect on Weight and Glycemic Control; Claudia P. Sanmiguel; July 2009
