Type 1 Diabetes
The discovery of insulin in 1921 was the most notable event in diabetes research. Prior to the discovery of insulin, an individual diagnosed with type 1 diabetes had a life expectancy of less than a year. The availability of insulin, although not a cure for diabetes, has allowed millions of people affected by diabetes to live a long and productive life.
More recent research achievements have identified type 1 diabetes as an autoimmune disease. This finding may allow suppression of the immune system and prevention of the destruction of beta cells.
In 1993, a 10-year study named the Diabetes Control and Complication Trial (DCCT) proved what researchers believed all along - that intensified care and tight glucose control can go a long way in reducing the long-term complications of diabetes.
Newer, more effective systems for delivering insulin are constantly being studied. One day, continuous and noninvasive glucose monitoring devices could eliminate the need for finger sticks to check glucose levels.
At the American Diabetes Association's 62nd annual meeting, there were reports of new technologies for insulin delivery. There has been successful research for a pill, a transdermal skin patch, a mouth spray and several versions of pulmonary inhaled insulin. That could make life easier for the 3.7 million patients in America who, on average, must take one to five insulin shots daily to control their disease.
Research shows that a drug (an antibody) (in a single 2-week treatment) may stop type 1 diabetes in people newly diagnosed with the disease, decreasing their need for insulin shots. The most important finding of this study is that there can be effective intervention even after onset of the disease. The drug targets specific immune cells and so protects beta cells and pre-insulin production.
The first successful pancreas transplant was performed in 1966, but survival rates for this procedure were until improved anti-rejection drugs became available. By the end of 1997, nearly 10,000 pancreatic transplants were recorded in the International Pancreas Transplant Registry. Most pancreatic transplantations in patients with diabetes are offered to people with end-stage renal disease and are performed at the same time as or after kidney transplantation. The success rates for pancreas transplants alone are not as good as when both kidney and pancreas are transplanted together. Pancreas transplant is, therefore, usually only offered to a patient who has end-stage renal failure and requires a kidney transplant.
Some of the most promising diabetes research appears to be in the area of islet cell transplants. In this procedure, instead of transplanting most of or the entire pancreas, only the islet cells (those cells responsible for insulin production) are transplanted. This procedure does not involve the surgical risks associated with organ transplantations. Many researchers believe that the cure for diabetes will evolve when improved methods are perfected for preventing rejection of the transplanted islet cells.
The ability to use engineered islet cells, using recombinant DNA to create new islet cells, is another area of diabetes research that could some day lead to a cure for diabetes.
The future for those affected by diabetes looks hopeful. Research efforts during the past 80 years have led to improved management and treatment of diabetes today. Although a lot of work remains in diabetes research, the road to the cure for diabetes is getting shorter.
How common is Type 1 Diabetes?
Of the 16 million people with diabetes in the United States, about 5 percent to 10 percent have type 1 diabetes. Type 1 diabetes usually begins in childhood or adolescence but may begin at any age. It is a lifelong disease because there is no cure for type 1 diabetes.
Type 1 diabetes is an autoimmune disease, meaning that the body stages a war against itself by attacking its own cells. Researchers do not know exactly what causes the immune system to attack and destroy the beta cells within the pancreas, but the end result is the inability of the pancreas to produce the hormone insulin.
Before the discovery of insulin in the 1920s, people with type 1 diabetes usually died within a year of diagnosis. All of that has changed. Although people with type 1 diabetes require insulin injections multiple times each day to balance their blood glucose levels, they can expect to live a long life despite the disease.
