Considering the rising rates of diabetes and its potentially serious consequences, treatment of diabetes is important. So, can diabetes be cured or treated?
Diabetes mellitus, also referred to as diabetes, is one of the most common disorders experienced worldwide, with rates expected to increase over time. This chronic disorder is often a top cause of death in North America.
Diabetes is also known for various long-term complications developing as the disorder progresses. Some of these complications include
- neuropathy leading to amputations,
- retinopathy leading to blindness,
- and nephropathy leading to kidney failure.
Individuals with unmanaged diabetes are also likely to develop cardiovascular and cerebrovascular disease, potentially resulting in death.
What is diabetes mellitus?
Diabetes mellitus describes a metabolic disorder in which an individual’s blood glucose levels are abnormally high. This chronic abnormal high blood glucose is called hyperglycaemia. The hyperglycaemia is due to issues with a product of the pancreas called insulin which allows cells to take-in glucose either for storage or energy use. The impaired ability of the body’s cells to store or use glucose causes a build-up of the glucose circulating in the blood. The excess sugar in the blood will circulate looking for a place to settle in even when it shouldn’t be there causing a series of uninvited issues.
History of diabetes mellitus
The first known documentation of diabetes was by ancient physicians who noted symptoms of excessive urination that lead to emaciation – extreme thinness due to a lack of nutrition – and eventually, death. Later, the disorder was recognized for causing sweet urine and so, it was termed “diabetes mellitus”; diabetes meaning “to pass through” and mellitus meaning “sweet”. Since then, numerous scientific discoveries and research studies have increased our understanding of the disorder.
Type 1 vs type 2 diabetes
There are many different categories of diabetes mellitus; however, the main ones are type 1 diabetes mellitus and type 2 diabetes mellitus. While type 1 and type 2 diabetes are both characterized by hyperglycaemia, the causes of the elevated blood sugar levels differ.
Type 1 diabetes mellitus
People with type 1 diabetes have a complete absence or extremely low level of insulin production, impairing the body’s cells’ ability to take-up glucose from the blood due to an insufficient amount of insulin. This severe insulin deficiency is often caused by an attack from the immune system on its own beta cells in the pancreas, which produce insulin.
The onset for this type of diabetes is often in younger children or adolescents, peaking around 4 to 6 years old and then again between 10 to 14 years old. Overall, type 1 diabetes represents about 5% to 10% of all diabetes diagnoses, although it represents approximately 80% to 90% of the diabetes diagnoses for children and adolescents.
Genetic predisposition is one factor that impacts the development of type 1 diabetes. Certain environmental factors are thought to be involved in the development of type 1 diabetes, such as viral infections like congenital rubella.
Type 2 diabetes mellitus
People with type 2 diabetes have insulin resistance – diminished tissue response to insulin – resulting in less glucose uptake by the targeted tissues. Insulin resistance is combined with some degree of insulin deficiency. Together, the resistance to insulin action and inadequate insulin production to compensate for such insulin resistance result in hyperglycaemia.
Often, type 2 diabetes develops later in adulthood and is associated with older age, obesity and a lack of physical activity. Rates of type 2 diabetes are increasing in adolescents, likely due to the rise in obesity in this age group. Overall, approximately 90%-95% of diabetes diagnoses are type 2 diabetes.
Other than lifestyle factors, genetic risk factors play an important role in the development of type 2 diabetes. They are thought to be more prominent in the development of type 2 diabetes than in type 1 diabetes.
Other types of diabetes mellitus
Types of diabetes mellitus develop differently. For example, diabetes can develop from genetic defects of beta cell function or insulin action, or by diseases of the pancreas and endocrine (hormone) gland dysfunction. Diabetes development may also be induced by drugs or chemicals if an individual was already insulin resistant.
Gestational diabetes refers to diabetes that develops during a pregnancy. Most cases end once the pregnancy is over, although the mother’s glucose intolerance may continue even after birth. It is not clear what causes gestational diabetes to develop. However, risk factors include obesity, family history of diabetes, and maternal age.
Can diabetes be cured?
Treatment may differ depending on an individual’s classification of diabetes. Often, in order to manage diabetes, a combination of interventions is required. The goal of diabetes treatments is to keep blood glucose levels within the desired range to prevent undesirable complications. Key factors to successful diabetes management are patients engaging in education on their disorder and their prescribed interventions.
Lifestyle changes is a common intervention prescribed to diabetes patients, especially those with type 2 diabetes. Restricting carbohydrates and overall caloric intake may be suggested. Also, meeting physical activity guidelines of a 150 to 300 minutes of exercise a week will help to manage the disorder. The diet and physical activity changes often result in weight loss and body composition changes that are necessary for diabetes and cardiovascular disease management.
For type 1 diabetes, where there is an absolute or severe deficiency of insulin, daily injections of insulin is the primary treatment. For type 2 diabetes, other than diet and physical activity, diabetes medications can be prescribed, such as metformin. Metformin works to lower the bodily production of glucose and the breakdown of stored glycogen into glucose. This helps manage blood glucose levels. Some people with type 2 diabetes may require insulin injections, especially if they are in advanced stages of the disorder and previous interventions have not managed the disorder.
A recent treatment that has shown promising results in clinical trials is transplanting stem cells in people with diabetes. Stem cells have the ability to develop into insulin-producing cells, which can increase insulin production and lower blood glucose levels. For people with insulin-dependent diabetes, this may reduce or remove the need for daily insulin injections. More clinical trials are required to validate the efficacy and safety of stem cell therapy for diabetes, as well as to establish the best type of stem cells to use for each type of diabetes.
References
American Diabetes Association (2010). Diagnosis and classification of diabetes mellitus. Diabetes Care, 33(Suppl 1), S62–S69. https://doi.org/10.2337/dc10-S062
Blaslov, K., Naranđa, F. S., Kruljac, I., & Renar, I. P. (2018). Treatment approach to type 2 diabetes: Past, present and future. World Journal of Diabetes, 9(12), 209–219. https://doi.org/10.4239/wjd.v9.i12.209
Kharroubi, A. T., & Darwish, H. M. (2015). Diabetes mellitus: The epidemic of the century. World Journal of Diabetes, 6(6), 850–867. https://doi.org/10.4239/wjd.v6.i6.850
Sapra, A., & Bhandari, P. (2020). Diabetes mellitus. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK551501/
Zhang, Y., Chen, W., Feng, B., & Cao, H. (2020). The clinical efficacy and safety of stem cell therapy for diabetes mellitus: A systematic review and meta-analysis. Aging and Disease, 11(1), 141–153. https://doi.org/10.14336/AD.2019.0421
