5 Future Treatments for Type 2 Diabetes
I am 38 years old and I have type 2 diabetes. I was diagnosed when I was 33 years young, and though I’m not the youngest of people (by far) to ever be diagnosed with this disease, I still could potentially live another 40-50 years with this condition, if I play my cards right.
With this in mind, I often ponder upon the future of type 2 diabetes management, and what’s around the corner. There are always new studies outlining potential treatments and avenues of exploration for studying, treating and even potentially curing this disease. While every day we might see FDA approval for a new drug, or a new gastric bypass surgery method, these are potential treatments which are quietly etching themselves onto the surface of type 2 diabetes research, and show fresh and renewed promise for a brighter future with the condition:
- Oral Insulin: Current type 2 diabetes management entails an attempt to slow progression of the condition, while reserving insulin as a medication for the last stages, when a person’s pancreas will stop producing insulin. This is generally, not the greatest approach because one of the best ways of slowing down progression of diabetes is by introducing insulin early in order to give the pancreas a rest, and delaying a full dependency on insulin. An oral insulin medication would eliminate the need for injections in persons with type 2, be able to be introduced much earlier in the treatment, and possibly greatly reduce injection needs for patients with type 1 diabetes. Oral insulin has one obstacle: our stomach’s digestive juices. However, there are several giants in the race to bring us Oral insulin, and at various trial stages, with Israeli pharmaceutical, Oramed, claiming to be at Phase 2 clinical trials.
- Brown Fat Power: People apparently make two kinds of fat, your regular ol’ white fat, which can be bad for us, especially when accumulated around our mid section, and brown fat. And brown fat apparently has a lot of wonderful, useful purposes, such as body temperature regulation which necessitates that it process glucose and burn it as fuel. In fact, brown fat can produce 10 times the amount of glucose transporters than insulin. Finding treatments that activate brown fat could lead to better management of obesity, cardiac health, and help manage glucose levels without need for insulin.
- Amylin Toxic Clump Therapy: Extensive research is beginning to show that type 1 and type 2 diabetes are both the result of the formation of toxic clumps of a hormone called amylin. Normally amylin works together with insulin order to regulate the body’s response. But when some of this amylin that IS produced starts to clump up around beta cells (which are the cells that produce insulin), these clumps can be toxic to the beta cells, and result in diabetes. Researchers expect to have potential medicines in clinical trials to target this toxicity in the next few years.
- Autoimmune Therapy – anti-CD20: Some research is showing that more than a metabolic disorder, type 2 diabetes is also an autoimmune condition which occurs resulting out of the inflammation caused from the dying of adipose tissue and its auto immune-inhibited ability to handle insulin. Some autoimmune therapies such use of the antibody anti-CD20 have shown promise in eliminating diabetes in laboratory mice, and the advantage is that this medication is already approved for use in humans to treat some types of blood cancers and autoimmune disorders.
- Fecal Microbiota Transplant: Some time ago, research started pointing to a connection between people who had the peptic ulcer causing bacteria pylori, and a potential link to type 2 diabetes. How could it be? At the time, it was speculated that this was probably an association between how H. pylori might change conditions in the gut, and how it might promote inflammation. Other studies independent of H. pylori have seemed to support how a change in gut health could also lead to type 2 diabetes, and others to an increase in obesity. But probably the most compelling factor has been the role of gastric bypass in gut health: You see, while there have been many overstated claims on the benefits and remission rates of weight loss surgeries, only about 41% of people have had lasting remission by stringent criteria (more normalized blood glucose levels), and only with one type of surgery: Roux-en-Y. What is different about Roux-en-Y? This type of gastric bypass surgery shrinks the stomach, and bypasses the upper portion of the small intestine, reconnecting it at the middle. Some scientists suspect this ‘resets’ the gut, and some studies have shown doing this could change gut bacteria composition, as well as make it more efficient at burning sugars … which makes the future of gastric bypass probably a thing of the past! Why get such a risky surgery, for the benefits of weight loss and better blood glucose control, when a safer fecal microbiota transplant could provide similar benefits? The procedure is already undergoing clinical trials with type 2 diabetes patients.
With 2015 looming and beyond, I am EXCITED about what the future may bring for type 2 diabetes management, and perhaps real cure. A person with diabetes can only dream!