New Treatment Trends

 

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

"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."

The Latest Choices

 

Afrezza. This insulin inhaler for adults with type 1 and type 2 diabetes hit the market in February 2015. You use it at the start of your meal for a boost of short-acting insulin.

Unlike an older inhaler, which is 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.

It's probably not for you if you smoke or have a lung condition like asthma or emphysema.

Medtronic MiniMed 640G. This device isn't sold in the U.S. yet, but it may go to the FDA for approval soon. It's a combined insulin pump and continuous blood sugar monitor -- and it's a step on the road toward an artificial pancreas. It automatically stops pumping insulin when your blood sugar levels trend 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. If you have it but don't feel any symptoms, this device could be especially useful.

Ranibizumab (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 problem linked to diabetes and a leading cause of blindness among U.S. adults.

Continued

Progress on the Artificial Pancreas

If you use insulin many times a day for type 1 diabetes, you might wish for a device that could relieve you of the burden of blood sugar control. A portable artificial pancreas could someday do the work of both an insulin pump and a continuous glucose monitor. The device might be able to measure doses and pump insulin based on its own readings.

Scientists are working on a few different models. Some have a second pump for glucagon, a medication that treats severe hypoglycemia.

Experts say there's a good chance one of these will be on the market before 2020. But it will probably 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."

Other Advances in the Pipeline

"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 shots you need.

"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 are also checking to see if stem cells can treat or even cure diabetes. Unlike other types of cells, stem cells have the potential to take on new roles. Scientists hope to direct them to make insulin that can respond to the ups and downs in the body's blood sugar levels. "More work needs to be done," Reddy says, "but it's not just a pie-in-the-sky concept."

WebMD Feature Reviewed by Michael Dansinger, MD on January 22, 2017

Sources

SOURCES:

American Diabetes Association: "What Are My Options?" "Stem Cell Research," "Preventing and Treating Hypoglycemia through Automated Glucagon Delivery." 

Boehringer Ingelheim: "U.S. FDA approves first-in-class Glyxambi® (empagliflozin/linagliptin) tablets for adults with type 2 diabetes."

Diabetes Forecast: "The Artificial Pancreas Aces New Tests."

FDA: "FDA approves Lucentis to treat diabetic retinopathy in patients with diabetic macular edema."

Michael German, MD, clinical director, Diabetes Center; director, UCSF NIH Diabetes Research Center; University of California, San Francisco.

Medical News Today: "Sanofi and MannKind announce Afrezza, the only inhaled insulin, now available in the U.S."

Medtronic: "Medtronic Launches MiniMed 640G System, Breakthrough in Artificial Pancreas Technology, Outside the U.S."

Sethu K. Reddy, MD, chief of adult diabetes, Joslin Diabetes Center, Harvard Medical School, Boston.

National Institutes of Health: "Stem Cell Basics."

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