Intense research into the causes, treatment, and prevention of type 2 diabetes is underway right now throughout the world and medical studies on this disease are published daily. The sheer volume of information can be overwhelming. Below is an overview of some of the recent medical developments in type 2 diabetes research and treatments and links to sites with news stories about the developments in type 2 diabetes.
Diabetes treatments
There are currently several new drugs under development for type 2 diabetes and there surely will be several more in the coming years. The prevalence of obesity in the United States makes diabetes drugs in high demand: a lot of us have type 2 diabetes and if things don’t change, a lot more of us are going to get it. Drug companies have an interest in helping people with diabetes and can be pretty secure that a market for newly developed type 2 diabetes drugs will exist as long as they are effective.
GLP-1 agonists
There is a body molecule called glucagon-like peptide 1 (GLP-1) that naturally reduces blood glucose levels in the body. Unfortunately, it does not make a good medication itself because it gets broken down quickly in the body. GLP-1 agonists are like synthetic versions of GLP-1 that last longer the body. These drugs lower glucose levels by inhibiting the pancreatic production of glucagon, the hormone that normally opposes insulin by increasing blood sugar. Byetta, given by injection, is the only GLP-1 agonist approved by the FDA but others are undergoing clinical trials.
DPP-4 Inhibitors
Part of the reason for its short life of GLP-1 in the body (see previous paragraph) is the enzyme dipeptidyl peptidase 4, or DPP-4, which breaks down GLP-1. DPP-4 inhibitors slow the breakdown of GLP-1 and allow it to remain active in the body longer, which lowers blood glucose levels when they are too high. Currently, sitagliptin (Januvia) is the only DPP-4 available in the U.S. but others are on the way.
Genetics of diabetes
About 25% of people with type 2 diabetes have a family history of the disease. While it is not known exactly what genes confer this hereditary susceptibility to developing diabetes, candidate genes have been identified including a gene for a potassium channel called KCNJ11 and a gene called TCF7L2 which regulates the production of glucagon-like peptide-1 (GLP-1). Research is ongoing into how these or other genes might lead to the development of diabetes.
Epidemiology of diabetes
While research into the causes of type 2 diabetes is underway in the laboratory, much of what we are learning about the disease comes from studies of people. Epidemiology is the study of who gets diseases and when. A strong argument for the importance of genetic factors in the development of diabetes comes from studies in identical twins. The concordance rate for Type 2 diabetes in identical twins is close to 90%, meaning if one twin has type 2 diabetes there is a 90% chance that the other will have it as well. In addition, the fact that obesity, a major risk factor for type 2 diabetes, is strongly hereditary suggests that inherited obesity may be part of the reason that type 2 diabetes runs in families.
But genetics is not the whole story. Some research suggests that environmental factors in the womb are important for the development of Type 2 diabetes. If a mother has diabetes while pregnant, that child is much more likely to develop type 2 diabetes later in life that if the mother develops diabetes sometime after her pregnancy. This suggests that the uterine environment may directly affect the development of type 2 diabetes. Further, low birth weight babies have a higher risk of developing type 2 diabetes, as do babies fed with formula (instead of being breastfed).
There is also a clear difference among different ethnic groups in the risk of having type 2 diabetes. Native Americans and Alaska Natives seem to have the highest risk, followed by African Americans, and then Hispanic/Latinos. Asian Americans and Pacific Islanders also have an increased risk but the degree of risk is difficult to determine. While research is ongoing to figure out exactly why these groups differ, knowing that they all have increased risk of diabetes helps direct funding and resources for educational campaigns and screening programs to help lower the impact of the disease among these peoples.
Links to recent type 2 diabetes developments
Access: Diabetes Research; summaries of late-breaking research published in journals
http://www.diabetes.org/patientinform/default.jspAmerican Diabetes Association current research database
http://www.diabetes.org/diabetes-research/research-database-intro.jspIn Diabetes Today: recent diabetes news
http://www.diabetes.org/indiabetestoday.jspDiabetes news on Science Daily, a digest of recent science research news.
http://www.sciencedaily.com/news/health_medicine/diabetes/Medline Plus: latest news on diabetes
http://www.nlm.nih.gov/medlineplus/diabetes.html#cat57PubMed is a U.S. National Institutes of Health search engine that covers all research published in medical and bio-scientific journals.
http://www.ncbi.nlm.nih.gov/PubMed/PubMed Central is the National Institutes of Health free digital archive of biomedical and life sciences journal literature.
http://www.pubmedcentral.nih.gov/The U.S. Food and Drug Administration Center for Biologics Evaluation and Research is the government agency charged with reviewing and approving applications for new drugs and medical devices and their website ahs information about recent developments in these areas.
http://www.fda.gov/Cber/index.html
Information about clinical trials
If you are interested in finding out more about clinical trials for diabetes the National Institutes of Health has a clinical trials website at http://clinicaltrials.gov/.
To find a clinical trial being conducted in your area, visit the Healia clinical trials search page: /healia/en/index.jsp?&mSp=ct