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Report on Diabetes Treatment
Introduction
Diabetes is the name of a group of metabolic diseases which results in the presence of high glucose in the blood, either due to inadequate production of insulin or the insufficient response of the body cells to such insulin, and often due to both. Typically, individuals suffering from diabetes experience, heightened hunger and thirst, general fatigue, need for frequent urination etc. Typically, diabetes is of two types – Type I where the body does not produce adequate insulin and Type 2 where, the insulin thus produced do not properly function (Adeghate, Schattner, & Dunn, 2006). Apart from these two, two other variants of diabetes exist; Gestational Diabetes which impacts pregnant females and congenital diabetes, a condition affecting infants since birth.
The purpose of this paper is to investigate on the present, innovative and alternative treatment solutions for Diabetes. The main article considered for this essay is – the study by McInnes et al, in 2017, the aim of which was to explore the feasibility, safety as well as potential for bringing about remission from T2D (Type 2 Diabetes) through a limited intensive metabolic treatment . Along with this, other modern means of diabetes treatment would also be explored upon.
The purpose of this paper is to investigate on the present, innovative and alternative treatment solutions for Diabetes. The main article considered for this essay is – the study by McInnes et al, in 2017, the aim of which was to explore the feasibility, safety as well as potential for bringing about remission from T2D (Type 2 Diabetes) through a limited intensive metabolic treatment . Along with this, other modern means of diabetes treatment would also be explored upon.
Analysis
The applicability of genetic tests in determining Diabetes has been in wide speculation in the last decade (Singer, 2007). Genetic screening can help individuals understand whether they are prone to which type of diabetes and based on that individuals can make informed decisions about their lifestyles. In 2016, FDA approved the marketing of a new ZnT8Ab test to help in the diagnosis of T1D. This test which is more commonly known as ZnT8Ab ELISA ASSAY, effectively measures the presence of auto-antibodies to the ZnT8 which acts as the insulin secretor granule of Zinc, and is a product of the SLC30A8 gene. Individuals having Type 1 diabetes makes ZnT8ab and for others (T2D or Gestational) such antibodies are absent (Volpe, 2016).
It is now an established fact that T2D is a resultant of heredity and environmental factors. Environmental factors like, sedentary lifestyle, and a heavy carbohydrate dependent diet results in the creation of T2D. Bariatric surgeries (Roux-en-Y bypass/ Duodenal Switch/ Gastric Banding etc) also acts as an alternative treatment, which reduces the hypertension, incidence of diabetes etc (Kashyap, Gatmaitan, Brethauer, & Schauer, 2010).
Diabetes is known to impact the kidneys, the eyes and one such complication is diabetic retinopathy, which can be corrected however, through surgery. Pancreas surgery is also possible which keeps the level of insulin adequate in T1D patients. Pancreatic Islet Cell Surgery is another option, which is relatively less complex and gives sufficiently adequate results. Apart from surgery, certain high technological interventions are present which help the patients to consistently monitor the diabetes – CGM, insulin pumps etc.
As per the study by McInnes et al, it was found that a short but crisp course on lifestyle changes and drug therapies achieved normo-glycemia and promoted weight loss. It achieved prolonged, remission of diabetes and is in alignment with the present studies of novel regimens aimed at complete remissions. In this study by McInnes et al, it was found that patients suffering from T2D for 3 years and up, were subjected to three types of treatment – 8 week long intensive medical based interventions; a 16 week long such procedure and thirdly, standard diabetes care which is the norm today. It was found that, weight-loss occurred and normoglycemia was reached. Diabetic drugs like Metformin, Insulin glargine and acarbose were used along with conscious lifestyle changes. The drugs were then discontinued and repeated follow up were done to find relapse of hyperglycemia, but the primary outcome was a normal blood glucose level (McInnes, et al., 2017). Though this study gave very promising results, further and repeated trials has to be continued to bring about an effective treatment strategy and then patients all around the globe can reap its benefits (Bernstein, 2017).
It is now an established fact that T2D is a resultant of heredity and environmental factors. Environmental factors like, sedentary lifestyle, and a heavy carbohydrate dependent diet results in the creation of T2D. Bariatric surgeries (Roux-en-Y bypass/ Duodenal Switch/ Gastric Banding etc) also acts as an alternative treatment, which reduces the hypertension, incidence of diabetes etc (Kashyap, Gatmaitan, Brethauer, & Schauer, 2010).
Diabetes is known to impact the kidneys, the eyes and one such complication is diabetic retinopathy, which can be corrected however, through surgery. Pancreas surgery is also possible which keeps the level of insulin adequate in T1D patients. Pancreatic Islet Cell Surgery is another option, which is relatively less complex and gives sufficiently adequate results. Apart from surgery, certain high technological interventions are present which help the patients to consistently monitor the diabetes – CGM, insulin pumps etc.
As per the study by McInnes et al, it was found that a short but crisp course on lifestyle changes and drug therapies achieved normo-glycemia and promoted weight loss. It achieved prolonged, remission of diabetes and is in alignment with the present studies of novel regimens aimed at complete remissions. In this study by McInnes et al, it was found that patients suffering from T2D for 3 years and up, were subjected to three types of treatment – 8 week long intensive medical based interventions; a 16 week long such procedure and thirdly, standard diabetes care which is the norm today. It was found that, weight-loss occurred and normoglycemia was reached. Diabetic drugs like Metformin, Insulin glargine and acarbose were used along with conscious lifestyle changes. The drugs were then discontinued and repeated follow up were done to find relapse of hyperglycemia, but the primary outcome was a normal blood glucose level (McInnes, et al., 2017). Though this study gave very promising results, further and repeated trials has to be continued to bring about an effective treatment strategy and then patients all around the globe can reap its benefits (Bernstein, 2017).
Conclusion
Diabetes has now been given the status of a worldwide epidemic (Ali, 2013). Even in developing nations, the problem of diabetes is spreading like wildfire. Experts have highlighted a number of strategies which in combination can help in treating and dealing with diabetes effectively – proper nutrition and control on intake of carbohydrates, modification of lifestyles, reducing sedentary lifestyles and increasing aerobic and resistance based exercises, regular monitoring of blood pressure and blood sugar levels, specialized eye, foot, cardiac and renal care for diabetic patients, behavioral support on physical and mental health, motivation and regular support from peer groups and families and lastly, prevention and control on complications resulting from diabetes (Bernstein, 2017).
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Adeghate, E., Schattner, P., & Dunn, E. (2006). An Update on the Etiology and Epidemiology of Diabetes mellitus. Ann N Y Acad Sci , 1084 (1), 1 - 29.
Ali, O. (2013). Genetics of Type 2 Diabetes. World J Diabetes , 4 (4), 114 - 123.
Bernstein, S. (2017). High Tech Tools to Help You Handle Diabetes. US: WebMD https://www.webmd.com/a-to-z-guides/condition-15/diabetes/gadgets.
Kashyap, R., Gatmaitan, P., Brethauer, S., & Schauer, P. (2010). Bariatric Surgey for Type 2 Diabetes - Weighing the impact for obese patients. Cleve Clin J Med , 77 (7), 468 - 476.
McInnes, N., Smith, A., Otto, R., Vandermey, J., Punthakee, Z., Sherifali, D., et al. (2017). Piloting a Remission Strategy in Type 2 Diabetes : Results of a Randomized Controlled Trial. The Journal of Clinical Endocrinology & Metabolism , 102 (5), 1596 - 1605.
Singer, E. (2007). A Genetic Test for Diabetes Risk. US: Technology Review - MIT.
Volpe, D. (2016). FDA Approves Marketing of First ZnT8Ab Auto antibody Assay for Type 1 Diabetes Diagnosis. US: Endocrinoweb https://www.endocrineweb.com/professional/type-1-diabetes/fda-approves-marketing-first-znt8ab-autoantibody-assay-type-1-diabetes-.
Ali, O. (2013). Genetics of Type 2 Diabetes. World J Diabetes , 4 (4), 114 - 123.
Bernstein, S. (2017). High Tech Tools to Help You Handle Diabetes. US: WebMD https://www.webmd.com/a-to-z-guides/condition-15/diabetes/gadgets.
Kashyap, R., Gatmaitan, P., Brethauer, S., & Schauer, P. (2010). Bariatric Surgey for Type 2 Diabetes - Weighing the impact for obese patients. Cleve Clin J Med , 77 (7), 468 - 476.
McInnes, N., Smith, A., Otto, R., Vandermey, J., Punthakee, Z., Sherifali, D., et al. (2017). Piloting a Remission Strategy in Type 2 Diabetes : Results of a Randomized Controlled Trial. The Journal of Clinical Endocrinology & Metabolism , 102 (5), 1596 - 1605.
Singer, E. (2007). A Genetic Test for Diabetes Risk. US: Technology Review - MIT.
Volpe, D. (2016). FDA Approves Marketing of First ZnT8Ab Auto antibody Assay for Type 1 Diabetes Diagnosis. US: Endocrinoweb https://www.endocrineweb.com/professional/type-1-diabetes/fda-approves-marketing-first-znt8ab-autoantibody-assay-type-1-diabetes-.
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