viernes, 12 de junio de 2015

Experts reflect on the past, present and future of diabetes

Over r the past 50 years, treatment and outcomes for diabetes have changed dramatically. At a recent symposium, experts looked back at how lives have changed over the past 5 decades and what remains to be addressed over the next 5.

The symposium was held at the American Diabetes Association's (ADA) 75th Scientific Sessions.
"There are things that have happened over the past 50 years that clearly make life a lot better for people," says Dr. Fred Whitehouse, of the Henry Ford Health System in Detroit, MI. "There's been a lot of change, most of it for the better, but what people want is a cure and we don't have that yet."
Dr. Whitehouse has overseen many changes in how people with diabetes have been treated. When he first started treating people with the condition, the only form of treatment was the injection of animal insulin, obtained from cows or pigs, which could sometimes cause adverse reactions.
Nowadays, human insulin is used, produced by microorganisms and delivered through a variety of different systems including insulin pumps. There are now fewer adverse reactions and no fear of supplies running out, Dr. Whitehouse says, with methods of delivery that are more accurate than ever before.
Glucose levels can also be tracked more accurately. Previously, diabetes control could only be assessed by analyzing the levels of sugar in urine. There are many more options available to patients now, including the noninvasive A1C test that measures average levels over 3 months, "showing whether a person is on the right road or not," states Dr. Whitehouse.
As methods for treating and tracking the disorder have improved for patients, so too has the collective understanding of diabetes shared by researchers and clinicians. It takes a long time for research to make a clinical impact and recent years have seen the results of 50 years of hard work.
Dr. Daniel Porte, Jr., a professor at the University of California-San Diego, describes one of the most recent discoveries in the field:
"This year, amazingly enough to me, it was discovered that insulin sent to the central nervous system not only feeds back to the brain, it also affects glucose production. It regulates the islet cells, so there is a complete integration of the endocrine system and the nervous system. It took 40 years to discover this."
Originally, the endocrine and nervous systems were believed to function completely independently of each other, with glucose the sole regular of insulin.

In 50 years, 'complications of diabetes should become historical memories'

Dr. Porte states that with diabetes research, it is crucial to be patient. "For example, the drugs we use now to treat diabetes were first studied 30 to 40 years ago. And there are many more than the one or two that were being used back in the 1970s."
Such research not only leads to an improved understanding of diabetes but of other conditions as well. "We now believe that perhaps impaired insulin action in the central nervous system leads to the behavioral changes we see in Alzheimer's patients," Dr. Porte explains.
Dr. Michael Brownlee, associate director for biomedical sciences at the Albert Einstein College of Medicine's Diabetes Research Center in New York City, NY, states that diabetes is such a serious health problem due to its complications. His research on the mechanisms that cause complications such as eye and kidney disease has led to great change.
"Prior to the Diabetes Control and Complications Trial (DCCT) study that was published [in 1993], the general dogma was that diabetes caused both metabolic changes and complications, which had nothing to do with each other. They were just two parallel manifestations of the disease," he says.
"Now it's known that prolonged high glucose levels increase the risk for eye and kidney complications associated with diabetes, and maintaining tighter control of blood glucose levels reduces that risk."
Although the landscape of diabetes treatment and research has changed radically over the past 50 years, physicians are still only able to manage the disease rather than cure it. Dr. Robert Ratner, chief scientific & medical officer for the ADA, outlines what needs to be done:
"The next 50 years must elucidate the mechanisms by which both type 1 and type 2 diabetes occur, along with those critical steps at which we might intervene to prevent disease. Treatments must provide optimal glucose and metabolic control, without the risk of hypoglycemia, and complications of diabetes should become historical memories."
If research and treatment can progress at the same rate over the next 5 decades as it has over the past 5, who is to say what can be accomplished?
Tomado de McIntosh, J. (2015, June 8). "Experts reflect on the past, present and future of diabetes." Medical News Today. Retrieved from
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6 comentarios:

  1. La investigación en diabetes ha tenido un gran avance en los últimos años, a pesar de la variedad de medicamentos para llegar al control, sólo se queda en eso: control. La curación aún no ha llegado a ser descubierta, pero finalmente no les ayudará mucho a los pacientes ya que la mayoría de ellos lleva un estilo de vida poco saludable por lo que el riesgo persiste.
    La diabetes desaparecerá no con un tratamiento curativo sino con una cultura de prevención, ya que una dieta balanceada, ejercicio es algo que necesitamos todos, no es imposible, mantener un equilibrio es lo ideal, y cuando el equilibrio se rompe es natural que el cuerpo se enferme.
    Este comentario no aplica para los pacientes con Diabetes Mellitus tipo 1, ya que un importante porcentaje de ellos se cuida de forma adecuada y llevan su enfermedad de forma responsable, lo cual en un bajo porcentaje ocurre con los pacientes con Diabetes Mellitus tipo 2.
    Realmente la prevención es la mejor solución.

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  2. Suena esperanzador un mundo con la cura a una de las enfermedades mas importantes del siglo, pero tal vez esto sea una realidad actual, que no necesita de una vacuna o una píldora curadora.
    A lo largo de la carrera hemos visto pacientes que con una dieta adecuada, ejercicio adecuado, un buen apego a tratamiento medico y la motivación suficiente , logran evadir toda complicación de esta enfermedad.
    Sin embargo también hemos visto pacientes mal diagnosticados mal tratados y con 0 motivación que algunos vemos con todas las complicaciones y sin saber que son diabeticos.
    En conclusión aunque se tengan todas las armas del universo para matar una cucaracha no sirven de nada ante alguien que no sabe ni como ni cuando usarlas

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  3. Pase lo que pase con los avances en cuanto a tratamiento o cura de la diabetes, no servirá de mucho en nuestro país, estamos en uno donde nuestro entendimiento y cultura general en cuanto a la alimentación y cuidado de la salud está reprobable. Suele pasar que hasta que no enfermamos nos cuidadossintiéndonos bien, nos sobrepasamos, sería una redundancia, quizá en el oriente sea de provecho.

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  4. Indudablemente la investigación y el tratamiento tanto de la enfermedad como de sus complicaciones ha ido progresando bastante en los últimos años, ojalá en años venideros esto mejore aun más.
    Aunque también creo que es necesario hacer consciente al paciente acerca de la necesidad de compromiso de su parte para llegar a mejores resultados.
    Y pues no queda mas que consolarse por el momento solo con el control de la enfermedad, esperando que el paciente comprenda lo grave que puede llegar a ser y se apegue al tratamiento

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