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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
Introduction
Diabetes mellitus is a disease that occurs as a result of a collection of related metabolic
disorders. This group of disorders ultimately led to the insufficient utilization of glucose.
Estimates show that about 5% of the American population is affected by Diabetes mellitus. The
disease results in hyperglycemia as a consequence of the insufficient activity of a hormone called
insulin. Diabetes mellitus occurs as results of two insulin associated factors; inadequate
production of insulin by the pancreatic beta cells or due to the body’s resistance to insulin. There
is, therefore, two types Diabetes mellitus; type 1 and type two respectively. Type 1 Diabetes
mellitus is caused by the destruction of the insulin-producing islet beta cells by the body’s
immune due to a genetic predisposition while type 2 is majorly associated with obesity. It
should, however, be noted that the disease can also result from overproduction of hormones. This
encourages metabolic pathways that lead to the formation of glucose from other organic
compounds in the body such as glycogen and amino acids. Laboratory diagnosis of Diabetes
mellitus is important as it should understood that only a half of people suffering from the disease
have been diagnosed, and most of those who have been diagnosed have developed the disease
over seven years before the diagnosis.
Diabetes mellitus is a chronic disorder that should be given continuous medical attention
integrated risk reduction techniques in addition to glycemic regulation. The on-going education
to patients on self-management and support are vital to avoiding acute illnesses and alleviating
some of the long-term risks. Considerable evidence has been found that points to some
intervention strategies that may lead to better outcomes of Diabetes mellitus.
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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
Annotated Bibliography
Diagnosis:
Holstein, A., Thiessen, E., Kaufmann, N., Plaschke, A., & Egberts, E. H. (2012). Blood glucose
Self-Monitoring from abdominal skin: a precise and virtually pain-free method. Acta
diabetologist, 39(2), 97-104.
Pain-Free Glucose Tests
Diabetes patients usually have to endure pain every time they test for their blood sugar
using the conventional method involving lancelets. Blood is often drawn from the fingertips of
diabetics, and these inflict pain. To make it comfortable for patients, it is important that scientists
come up with less painful procedures to diagnose diabetes mellitus. Such advancements are
increasing of recent years with scientists from all over the globe coming up with more
technological and less invasive means of withdrawing samples from patients for subsequent
assaying. Examples of these procedures are such as the one involving amplitude modulated
ultrasound with infrared techniques and the iQuickIt method that includes saliva instead of blood
samples.
Podoleanu, A. G. (2014). Optical coherence tomography. The British journal of radiology.
Optical Coherence Tomography:
The introduction of Optical Coherence Tomography (OCT) has enhanced the possibility
to test and quantify diabetic macular edema. For physicians who are not used to viewing macular
edema, OCT technology is a great confidence booster as it shows the thickened tissue, and the
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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
doctor can test result to the clinical exam. OCT has been of great help in quantifying intensity of
thickening and hence helps assess its stability, progression or improvement. Before the
introduction of OCT, estimating efficacy was hard in patients with diffuse thickening as it was a
subjective test by the doctor. OCT has been able to quantify these changes for the doctor and
hence assists in determining whether the patient should continue with the treatment schedule or
change the strategy. OCT is one of the painless but efficient methods that have been introduced
recently. The lack of pain and specificity of OCT, therefore, gives it an advantage over other
methods previously used that largely depended on the doctor’s opinion.
Chowdhury, M. K., Srivastava, A., Sharma, S., & Sharma, N. (2014). The potential application
of amplitude modulated ultrasound with Infrared Technique for blood glucose level
determination in anon-invasive manner. Biomedical and Pharmacology Journal, 7(1),
195-206.
This method involves new non-invasive methods for testing blood glucose that could
change the management of Diabetes mellitus. This is expected to reduce a load of a medical
emergency, compliance of the patients and make treatment and diagnosis of the disease easier.In
the study, the researchers have experimented possibility of using amplitude modulated
ultrasound accompanied by infrared technology for blood glucose level checks in a non-invasive
method. This new system according to Chowdhury et al. operates at the wavelength of 940 nm
and has an ultrasound transmitter of 40nm. The pilot study involved five volunteers who had
their blood glucose successfully checked. Oral glucose tolerance tests were used as standards to
monitor the variations. The novel technique showed increased sensitivity and specificity close to
that of the infrared techniques of non-invasive glucose determinations. These studies indicated
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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
the likelihood of the use of the ultrasound combined with infrared methods for non-invasive
blood glues tests glucose determinations in human volunteers. The licensing followed by use of
this new method would increase the efficiency and speed of blood glucose determination
especially in emergency incidents hence saving a good number of patients.
Berard, L., & Blumer, I. (2015). Diabetes and Technology: A Revolution on Our Doorstep, but
Let's Keep Humanity at the Bedside.Canadian Journal of Diabetes, 39(3), 173.
The saliva test kit:
iQuickit is a new painless technology that does not involve pain like the traditional blood
test techniques. iQuickIt is a novel method that involves the testing of blood glucose
concentration in the saliva using an iQuickIt analyzer. This is in contrast to the use of blood as in
the case of traditional blood sugar tests involving the use of lancelets to draw blood. In essence,
it works like a conventional blood meter. One would draw specimen from the mouth and put into
a strip that they would insert into a white reading gadget. Results produced would be shared by
wireless technology with a smartphone or a tablet. The patient would place a Draw Wick strip
into their mouth to fetch sample for several seconds and insert the strip into the iQuickit Saliva
Analyzer to get the glucose concentration. Like other developing diabetes testing gadgets, the
scientists think it would change diabetes diagnosis. This is however a new invention and further
research would need to conducted to make improvements shortly.
Preventive diagnosis is also vital to prevent late detection and hence enhance preventive
measures. Of recent years, scientists have been studying novel methods of prognosis to alleviate
the pathological effects of delayed diagnosis. Advances in studying diabetes prediction will
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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
result in physicians being able to tell the likelihood of a person developing either type 1 or type 2
diabetes mellitus. Such techniques although available currently, involve very complicated
procedures that lead to them not being carried out. They are also so expensive that most people
would not afford. The invention of new and better alternatives will go a long way to ensuring
correct prognosis and application of preventive measures. Miao et al. in their study on the
efficiency of ECL, GABA, and AAI validated the use of such methods.
Miao, D., Steck, A. K., Zhang, L., Guyer, K. M., Jiang, L., Armstrong, T., ... & Yu, L. (2015).
Electrochemiluminescence assays for insulin and glutamic acid decarboxylase
autoantibodies improve prediction of type 1 diabetes risk. Diabetes technology &
therapeutics, 17(2), 119-127.
Scientists lately developed new assays to check and differentiate high-affinity high-risk
diabetes-specific autoimmune antibodies from the low affinity, low-risk islet autoimmune
antibodies. These tests include ElectroChemiLuminescence (ECL), Glutamic Acid
Decarboxylase 65 Autoantibody (GADA) and Insulin AutoAntibody (IAA) assays. In the study
by Miao et al., they did more validation of these tests. This research proved that both ECL-IAA
and GABA are more accurate and have a better ability to foretell the possibility of progression to
Diabetes type 1 as compared to the current standard RADs. This further gives a better ability to
control the occurrence of type 1 diabetes mellitus. With this validation, implementation of IAA
in conjunction with ECL and the use of GABA will increase the efficiency and precision of
prognoses of type-1 before it shows any pathological signs resulting to the control of its
complications. Such efficient methods would lead to a reduction of mortality rates caused by
Diabetes mellitus.
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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
New Advances in Prevention of Diabetes Mellitus
Salas-Salvadó, J., Bulló, M., Estruch, R., Ros, E., Covas, M. I., Ibarrola-Jurado, N., ... &
Martínez-González, M. A. (2014). Prevention of diabetes with Mediterranean diets: a
subgroup analysis of a randomized trial. Annals of internal medicine, 160(1), 1-10
As a result of the relationship between food intake and weight gain, researchers have seen
it relevant to find dietary combinations that lead a minimum increase in weight. Also, those that
.do not result in the deposition of the low-density lipoproteins that are considered to be bad fats.
Salas-Salvadó, et al., did a study to establish these dietary combinations. The study focused on
dietary changes involving the use of Mediterranean diet supplemented with extra-virgin olive oil
without caloric restrictions. Interventions that encourage weight loss reduce the occurrence of
type 2 diabetes mellitus. Dietary changes that do not have calorie restrictions were studied to find
out if they offered any protection against type 2 Diabetes mellitus. Interventions that promote
weight loss can decrease the incidence of type 2 diabetes mellitus. Whether dietary changes
without calorie restriction also protect from diabetes has not been evaluated. The study was done
to find out whether Mediterranean diet without calorie restrictions supplemented with extravirgin olive oil has any effect on prevention of type 2 Diabetes mellitus. In the assessment,
results showed that Mediterranean diet complemented with extra virgin olive oil without calorie
restrictions could reduce the risk of developing type 2 Diabetes mellitus in people with
cardiovascular predisposition. This shows that eating Mediterranean diets supplemented with
extra virgin olive oil can be used as a primary preventive measure for type two diabetes mellitus
that develops due to the patient's insulin sensitivity as a result of obesity.
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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
Halban, P. A., Polonsky, K. S., Bowden, D. W., Hawkins, M. A., Ling, C., Mather, K. J., ... &
Weir, G. C. (2014). Β-Cell failure in type 2 diabetes: postulated mechanisms and
prospects for prevention and treatment.Diabetes care, 37(6), 1751-1758.
Targeting beta cells in diabetes treatment and prevention:
The targeting of beta cells of islets is also of interest in the early prognosis, prevention
and treatment of DiabetesMellitus type 1. This arises from the fact that the beta cells of the
pancreas are the ones targeted by genetically coded autoimmune antibodies leading to the
subsequent destruction and insufficiency of insulin in the cases of type 1 diabetes mellitus. In
fact, researchers search as Halban et al. have come up with compelling evidence that would lead
to further studies into the pancreatic beta cells and subsequent discoveries about type one
diabetes mellitus management practices.
The article by Halban et al. examines the basis of the failure of beta cells in the cases of
type 2 diabetes mellitus. The study also gives suggestions of the target fields for future studies on
the causal mechanisms that may lead to treatment and prevention. Due to genetic predisposition
to the beta cells failure, Halban et al., suggested the use of genetic studies to determine the
susceptibility of individuals to type-1 Diabetes mellitus. Additionally, the study involved the use
of gene therapy to prevent the subsequent occurrence of the condition due to the familial nature
of the disorder.
Ledet, G., Graves, R. A., Bostanian, L. A., & Mandal, T. K. (2015). Second-generation inhaled
insulin for diabetes mellitus. American Journal of Health-System Pharmacy, 72(14),
1181-1187.
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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
Inhalable insulin:
Afezza is a novel lung delivered insulin instead of injection delivery. It is therefore
anticipated that this discovery will hasten developments towards the reduction of diabetes
mellitus related mortality. Afrezza is a new fast-acting insulin formulation designed for use in
increasing glycemic control in some patients with diabetes mellitus types 1 or 2.Afezzais not
intended for usage in place of traditional long-acting insulin but to complement the insulin. It is
therefore that it is used in combination with long-acting insulin. Rates of patients in clinical trials
with hypoglycemia were lower for Afezza treated patients as compared with those treated with
the insulin. However, Afezzahas a limitation that lies in its induction of coughing a few moments
after inhalation. Owing to this, it is not recommended for patients with smoking habits and other
chest and lung related problems such as asthma. The coughs are however mild and subside after
a short time. Studies have shown Afezza to be safe for use. Also, this novel drug is not
recommended for patients with ketoacidosis.
Espes, D., Lau, J., & Carlsson, P. O. (2014). Increased circulating levels of betatrophin in
individuals with long-standing type 1 diabetes.Diabetologia, 57(1), 50-53.
Betatrophin as a future prospect for the treatment of type 1 diabetes mellitus:
Betatrophin is a hormone derived from liver and fat. The Harvard Stem Cell Institute recently
uncovered that Betatrophin has a role in the production of insulin the beta cells of mice. The
scientists from this study are advancing in finding out whether similar studies in human subjects
will show the same results as observed in laboratory mice. If the result become positive, then this
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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
would give a substantial leap towards the treatment of type 1 diabetes mellitus that requires
inadequate synthesis of insulin by the beta cells of the pancreas. Betatrophin is an example of
other hormone-like molecules that are suspected of taking part in the development of insulin
resistance and other diabetes mellitus pathological factors. The studies on betatrophin are of
interest because they give another dimension of treating type-1 diabetes that has not been tried
before. This would involve the repair or replacement of the damaged beta cells of islet by
treatment with betatrophin.
Conclusion
In conclusion, advances in the treatment, prevention, and diagnostic technology for both
type one and two diabetes mellitus are still a long way to perfection. However, there is hope that
diabetes will soon be more manageable and less life-threatening as a result of the continuous
scientific studies being pursued to alleviate the problem. It is, therefore, important that enough
support is given to the scientists involved in these studies. This can be in terms of monetary
assistance and infrastructure as this would increase the welfare of patients and save governments
a lot of billions of revenue participating in the treatment diabetic patients. It is also necessary that
scientists explore all potential area of interest in tackling this burden of diabetes mellitus. This
will require goodwill and thinking on the part of scientists, public, and the relevant governments.
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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
References
Berard, L., & Blumer, I. (2015). Diabetes and Technology: A Revolution on Our Doorstep, but
Let's Keep Humanity at the Bedside.Canadian Journal of Diabetes, 39(3), 173.
Chowdhury, M. K., Srivastava, A., Sharma, S., & Sharma, N. (2014). The potential application
of amplitude modulated ultrasound with Infrared Technique for blood glucose level
determination in anon-invasive manner. Biomedical and Pharmacology Journal, 7(1),
195-206.
Espes, D., Lau, J., & Carlsson, P. O. (2014). Increased circulating levels of betatrophin in
individuals with long-standing type 1 diabetes.Diabetologia, 57(1), 50-53.
Halban, P. A., Polonsky, K. S., Bowden, D. W., Hawkins, M. A., Ling, C., Mather, K. J., ... &
Weir, G. C. (2014). Β-Cell failure in type 2 diabetes: postulated mechanisms and
prospects for prevention and treatment.Diabetes care, 37(6), 1751-1758.
Holstein, A., Thiessen, E., Kaufmann, N., Plaschke, A., & Egberts, E. H. (2012). Blood glucose
elf-Monitoring from abdominal skin: a precise and virtually pain-free method. Acta
diabetologist, 39(2), 97-104.
Ledet, G., Graves, R. A., Bostanian, L. A., & Mandal, T. K. (2015). Second-generation inhaled
insulin for diabetes mellitus. American Journal of Health-System Pharmacy, 72(14),
1181-1187.
Miao, D., Steck, A. K., Zhang, L., Guyer, K. M., Jiang, L., Armstrong, T., ... & Yu, L. (2015).
Electrochemiluminescence assays for insulin and glutamic acid decarboxylase
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New Advances in Diagnosis, Prevention, And Treatment of Diabetes Mellitus
autoantibodies improve prediction of type 1 diabetes risk. Diabetes technology &
therapeutics, 17(2), 119-127.
Podoleanu, A. G. (2014). Optical coherence tomography. The British journal of radiology.
Salas-Salvadó, J., Bulló, M., Estruch, R., Ros, E., Covas, M. I., Ibarrola-Jurado, N., ... &
Martínez-González, M. A. (2014). Prevention of diabetes with Mediterranean diets: a
subgroup analysis of a randomized trial. Annals of internal medicine, 160(1), 1-10