Diabetes is incurable but can be managed

Although some of the world’s best scientists have been working on it for decades, a permanent and complication-free cure for type 1 and type 2 diabetes mellitus has yet to be developed.

Pancreas transplant can be performed on type 1 diabetes patients who have developed serious complications. The healthy pancreas is taken from a brain-dead donor on life support. Pancreas transplant is usually done in conjunction with a kidney transplant. Like any major surgery, it carries a high risk of surgical complications. Transplant patients need to take medicines in order to prevent organ rejection; these medicines suppress the immune system and make patients vulnerable to infections.

Another potential cure is beta cell transplantation. The beta cells of the pancreas are progressively damaged in patients with diabetes. Once transplanted, the healthy beta cells from the donor begin to make and release insulin that keeps blood glucose within normal levels. Like all organ transplant procedures, beta cell transplantation is associated with surgical complications, organ rejection and immune suppression caused by antirejection medicines. It has yet to be performed in the Philippines.

Scientists are experimenting on stem cell therapy for type 1 diabetes in mice. Stem cells are cells that can develop into other types of cells, including beta cells. Scientists of a California biotech company prepped human embryonic stem cells to develop into beta cells. After prepping the cells, they grafted them onto the abdominal fat of mice. Two months later, the implanted cells began producing insulin. Although promising, stem cell therapy for diabetes is still a distant reality.

Bariatric surgery or weight-loss surgery can be considered in obese patients with type 2 diabetes. It involves making changes to the stomach and/or small intestine in order to restrict food intake or interrupt digestive processes. Many type 2 diabetes patients who underwent bariatric surgery lose significant amounts of weight and achieve near-normal blood glucose levels. The diabetes of patients who lose the most weight after bariatric surgery often goes into remission, i.e., they no longer need to take antidiabetes medications. Unfortunately, many patients regain the weight they shed after bariatric surgery and their diabetes returns.

The good news is the root causes and mechanisms behind both forms of diabetes are becoming more clearly understood all the time. We now know that early optimal blood glucose control is key in preventing serious diabetes-related complications. Eating a healthy diet, engaging in regular physical activity and taking the right antidiabetes medications are critical in diabetes management. Weight loss and maintaining a healthy weight are likewise very important in managing diabetes.

Liraglutide is a once-daily injectable medication for adults with type 2 diabetes mellitus. It mimics the action of an intestinal hormone called GLP-1, which stimulates the pancreas to release insulin that lowers blood glucose levels while suppressing the release of glucagon, a hormone that increases blood glucose levels. Aside from providing good blood glucose control, liraglutide has the added benefit of causing weight loss.

DIABETES TRIVIA

CONTEST: Liraglutide stimulates insulin release while suppressing glucagon production. True or False? E-mail your answer to [email protected] and get the chance to win a prize! Congratulations to Vergel Macalino! Your correct answer to the question in the July 6, 2013 column was chosen as this week’s winner in the Diabetes Trivia Contest. You will receive an e-mail on how to claim your prize.

Dr. Michael L. Villa is an endocrinologist. The “Changing Diabetes” column commemorates the 92nd anniversary of insulin’s discovery. It aims to increase awareness on diabetes prevention, diagnosis and management. Novo Nordisk supports “Changing Diabetes.” Headquartered in Denmark, Novo Nordisk is a global healthcare company with 90 years of innovation and leadership in diabetes care. For questions or comments, e-mail [email protected] or follow us at www.facebook.com/ChangingDiabetesPH.