What Will the Future Bring?

In the future, it may be possible to administer insulin through inhalers,
a pill, or a patch. Devices are also being developed that can monitor
blood glucose levels without having to prick a finger to get a blood sample.

Researchers continue to search for the cause or causes of diabetes and
ways to prevent and cure the disorder. Scientists are looking for genes
that may be involved in type 1 or type 2 diabetes. Some genetic markers
for type 1 diabetes have been identified, and it is now possible to screen
relatives of people with type 1 diabetes to see if they are at risk.

The Diabetes Prevention Trial–Type 1, sponsored by NIDDK, identifies
relatives at risk for developing type 1 diabetes and treats them with
low doses of insulin or with oral insulin-like agents in the hope of preventing
type 1 diabetes. Similar research is under way at other medical centers
throughout the world. For more information about this trial, call 1-800-HALT-DM1

Transplantation of the pancreas or insulin-producing beta cells offers
the best hope of cure for people with type 1 diabetes. Some pancreas transplants
have been successful. However, people who have transplants must take powerful
drugs to prevent rejection of the transplanted organ. These drugs are
costly and may eventually cause other health problems.

Scientists are working to develop less harmful drugs and better methods
of transplanting beta cells to prevent rejection by the body. Using techniques
of bioengineering, researchers are also trying to create artificial beta
cells that secrete insulin in response to increased glucose levels in
the blood.

Recently, researchers at the University of Alberta in Edmonton, Canada,
announced promising results with islet transplantation in seven patients
with type 1 diabetes. At the time of the report in the New England
Journal of Medicine,
all seven patients who had received the transplant
remained free of insulin injections up to 14 months after the procedure.

A clinical trial funded by the NIH and the Juvenile Diabetes Foundation
will try to replicate the Edmonton advance. With the insights gained from
this trial and other studies, scientists hope to further refine methods
of islet harvesting and transplantation and learn more about the immune
processes that affect rejection and acceptance of transplanted islets.

For type 2 diabetes, the focus is on ways to prevent diabetes. Preventive
approaches include identifying people at high risk for the disorder and
encouraging them to lose weight, be more physically active, and follow
a healthy eating plan. The Diabetes Prevention Program, another NIDDK
project, focuses on preventing the disorder in high-risk populations,
such as people with impaired fasting glucose, African Americans, Alaska
Natives, American Indians, Asian and Pacific Islander Americans, Hispanic
Americans, or women who have had gestational diabetes.

Several new drugs were recently developed to treat type 2 diabetes. By
using the oral diabetes medications now available, many people can control
blood glucose levels without insulin injections. Studies are under way
to determine how best to use these drugs to manage type 2 diabetes. Scientists
also are investigating strategies for weight loss in people with type
2 diabetes.

References and Sources: Medline, Pubmed, National Institutes of Health.

last update: December 2008

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