Advances in Diabetes Treatment

Medically Reviewed by Michael Dansinger, MD on February 21, 2015
3 min read

Diabetes treatment is getting better every day. Scientists may be just a few years away from making an artificial pancreas that can safely detect and adjust blood sugar (glucose) levels. In the meantime, new medications and insulin devices can make living with diabetes easier and safer now.

"We're getting more and more options," says Michael German, MD, clinical director of the Diabetes Center at the University of California, San Francisco. "That's good because no two people with diabetes are the same. It helps us get the right medicine for each person."

These treatments are or will soon be available in the U.S.

  • Afrezza. This insulin inhaler for adults with type 1 and type 2 diabetes hit the market in February 2015. You use it at the beginning of a meal for a boost of short-acting insulin. Unlike an older inhaler, which was the size of a can of shaving cream, Afrezza is easier to use and not as clunky to carry around. "It's quite small – a little bigger than a whistle," says Sethu K. Reddy, MD, chief of adult diabetes at Joslin Diabetes Center at Harvard Medical School in Boston. It's probably not for you if you smoke or have a lung condition like asthma or emphysema.
  • Medtronic MiniMed 640G. This combined insulin pump and continuous glucose monitor is a step toward the artificial pancreas. It automatically stops pumping insulin when your blood sugar levels are trending down and starts again when they're back up. "Hypoglycemia [low blood sugar] is a real problem, particularly for people with type 1 diabetes," German says. It could be especially useful for people who have hypoglycemia but feel no symptoms. The device isn’t available in the U.S. yet, but it may come to the FDA for approval soon. 
  • Lucentis. Doctors already use this drug to treat the eye disease macular edema in people who don't have diabetes. But in February 2015, the FDA made it the first eye medication for diabetic retinopathy, a serious eye problem linked to diabetes and a leading cause of blindness among U.S. adults.

If you use insulin many times a day for type 1 diabetes, you might long for a device that could take the burden of blood sugar control off you. A portable artificial pancreas could do the work of both an insulin pump and a continuous glucose monitor, measuring doses and pumping insulin based on its own readings. Scientists are working on a few different models of the device. Some have a second pump for glucagon, a medication that treats severe hypoglycemia.

Experts say there’s a good chance one of these models will be on the market before 2020. But it will likely take a while to work out all the kinks in real-life situations.

"I'm guessing that it will not be used for tight control right away," Reddy says. "It's like a regular car versus a race car. With a regular car, slight variations in control may not be a problem. But if you're driving 110 miles an hour, they are. Avoiding the severe low blood sugars is critical." 

"There is a lot of research into developing more predictable and consistent longer-acting insulin," Reddy says.

Scientists are also trying to come up with more concentrated forms of this type of insulin to cut down on the number of injections people have to give themselves. "A syringe holds 100 units of insulin," Reddy says. "So if you need to take a higher dose, you have to give yourself a second injection. For people with type 2 diabetes who may need to take high doses, getting it down to one injection would be good."

Researchers also continue to explore how to direct stem cells to make insulin that can respond to the ups and downs in the body's blood sugar levels. Stem cell research could lead not only to better treatments, but also to a cure for diabetes. "More work needs to be done," Reddy says, "but it's not just a pie-in-the-sky concept."