The future of diabetes

What is the future for diabetes? Is there a cure? Will there be a cure soon?

There is no cure for diabetes at this time but with continual research and technology, things are only getting better and more hopeful for diabetes.

A device that has been out for some time is called a continuous glucose monitor(CGM).

The CGM is on the left and the insulin pump and insertion site is on the right. 

CGM measures glucose levels 24/7 via a tiny electrode called a glucose sensor. This sensor is inserted under the skin to measure glucose levels in tissue fluid. It is connected to a transmitter that sends the information via wireless radio frequency to a monitoring and display device. The device then lets you know if your glucose is reaching a high or low limit.

This does not replace finger sticks.  The device requires 3-4 finger sticks per day to calibrate the sensor.  This is an especially great tool for small children who have labile glucose readings or for people who don’t feel their highs and lows.

Bionic pancreas

Below is a video that talks a little bit about the bionic pancreas.  The bionic pancreas is a device that continuously measures the blood glucose in a diabetics body and then automatically delivers as much insulin or glucagon needed to keep the blood glucose in a normal range.

Pancreas transplants

Although pancreas transplants or islet cell transplant seem like the best option for curing diabetes, it is not so easy as it seems.

Although islet cell and pancreas transplants are possible, they are not the first line treatment for a few reasons:

·      There are not enough human islets

·      The medications needed to prevent rejection cause side effects

·      The rejection medications are costly and have to be taken for the rest of the person’s life.

·      Increased possibility of infections

·      Low white blood cell count

·      Increase in cancer risk

My cousin who was diagnosed with Type 1 Diabetes at a very young age received a pancreas transplant almost a year ago.  It was the first one performed at Univeristy of Utah.  The link to read about it is here: First ever pancreas transplant at U of U

Sources:

http://www.medtronicdiabetes.com/treatment-and-products/continuous-glucose-monitoring

Understanding Diabetes

Diabetes burnout

Diabetes burnout is something that happens when a diabetic stops managing their diabetes for either a period of time or in worst case, forever. 

Diabetes is a disease that requires constant monitoring and treatment so it is no wonder why burnout can happen.  Imagine pricking your finger 5-6 times a day and not putting anything in your mouth without  counting how many carbs it has and giving yourself a shot of insulin if necessary.  If there is one thing I learned when I went and worked at the diabetes camp, it was that young kids with diabetes grow up quickly.

Diabetes burnout is not the same thing as depression, it is something that takes place when a person is either unwilling to change or just tired of endless attention to diabetes care.

This can obviously be very dangerous as it increases risk for diabetes complications.

Joslin Diabetes gives two approaches to help prevent diabetes burnout.  These are things you can share with your diabetic patient:

1) Stay motivated, not “perfect”

            Often, diabetics feel that their blood glucose readings must be perfect and become frustrated if their readings are off.  Helping the patient understand that although, good blood glucose control is important, they do not have to be perfect.  This can relieve some stress that comes with a diabetic feeling they have to be perfect and eventually becoming burned out with caring for themselves.            

2) Identify barriers to good diabetes care:

            What is preventing the patient from taking good care of themselves? Are there obstacles that are causing them to stop caring for their diabetes? If so, have the patient make a list of these obstacles and being creating new options to face the obstacles.  For example, if the patient is finding difficulty making it to the gym, another option could be a workout on dvd in the home or buying a treadmill. 

What can also be a huge help is having a good support system.  Educating family and friends and letting them help motivate the patient is a good way to avoid burnout.  When the patient is educating their family and friends, they can be specific in how they would like the family or friend to support or help them manage their diabetes better.   

Diabetes complications

We are always teaching patient’s that having high blood glucose readings often is bad for them…but are we educating them on why? The long term effects of hyperglycemia can be detrimental to a diabetic. Below are some of the longterm effects:

Some facts about long term effects:

Long term complications do not occur in young children. In fact, the greatest risk for complications seem to start after puberty. *In young diabetics (under 5 years of age) the recommended BG is 80-200 and for ages 5-11, the recommended range for BG is 70-180*  This is because the young diabetic’s brain is still developing and a high BG is less detrimental at this age than hypoglycemia.

After puberty, the blood vessels usually stay normal in diabetics with good BG control.  In those that do not have good BG control, blood vessels may change.

Around the time of puberty, growth hormone, sex hormones and other hormones increase and cause BG levels to increase making it more difficult to manage BG levels.

Complications:

Eyes- Cataracts, retinal changes or retinopathy

Kidneys – kidney disease or diabetic nephropathy

Neuropathy(nerve damage)

Coronary and other blood vessel narrowing

Joint contractures

Birth defects(to babies born with diabetic mother)

Foot problems

This information was found in Understanding Diabetes