Diabetes mellitus is a chronic metabolic disease and is recognized as a global public health concern. With over 72.96 million people affected with diabetes in India, this disease is one of the leading causes of heart diseases and blindness. Though a cure for the condition remains yet to be found, the invention of a variety of technological devices and medical therapies has its management rather smooth and easy as compared to earlier times. As November 14th is observed as World Diabetes Day, let us look at some of the treatment advances being worked upon in order to manage diabetes.
- Newer oral hypoglycaemic agents and Newer Insulins
Insulin has been in use for many years for the treatment of diabetes. However, as opposed to older insulins derived from animal sources, newer insulins manufactured using recombinant DNA technology provide better control of blood sugar with fewer risks of hypoglycaemia complications. The invention of new drug molecules also helped to adopt a multidrug approach which helps to control diabetes through the various mechanism of action, thereby reducing the risk of adverse effects associated with high dose monotherapy. Some of these new oral hypoglycaemics lower blood glucose levels stopping the kidneys from absorbing the glucose in the body or by boosting the pancreas to produce insulin. The management of diabetes has highly evolved as a personalised treatment as opposed to one treatment that fits all in the past. Management now encompasses lifestyle changes, oral medications and insulin based on patient condition and severity of complications.
- Multi-systemic integrated approach
Diabetes is a condition that affects your entire body along with all organs and systems. A collaboration between general physicians, endocrinologists, cardiologists, dietitians, and nephrologists helps in managing the diabetic patient better. The new ‘chronic care model’ has been brought into practice where the diabetic patient is managed by a proactive doctor’s team that focuses on tackling all complaints of the patient. Patient education about diabetes care and managing the condition has become the new way forward.
Technological advances in Diabetes Management
- Glycated Hemoglobin
Glycated Hemoglobin (HbA1c) is now considered a better measurement of optimal blood sugar levels as compared to fasting and random blood glucose levels. This test helps the physicians to understand a patient’s overall blood sugar levels over the past 3 months and helps to better tract treatment and risk of complications and make necessary management modifications.
- Continuous glucose monitors (CGMs) and CGM-insulin pumps
CGMs are devices with tiny sensor that is attached to the surface of the patient’s skin. This sensor measures the glucose levels in the fluid between your cells every few minutes. The data is then transmitted wirelessly to a device or the patient’s smartphone. CGMs helps monitor sugar levels at various times during the day. Unlike regular glucose meters which requires pricking yourself each time for blood, CGMs give you more results throughout the day with just 1 prick. The CGM-insulin pump is a gadget that allows the pump to use data given by the CGM to change the insulin dosage and make necessary adjustments as required.
- Insulin therapies
The recent technological advances in insulin pen devices can remember your last dose and the time when you took it. This is helpful for patients who are forgetful or too busy to take their dose on time. The new insulin pens are also connected to a smartwatch or smartphone to help you track your blood sugar levels and calculate the required dose. These devices also remind you about your dose, the time, and the expiry date of your insulin pen.
- Insulin pumps
If you are someone who requires multiple doses of insulin throughout the day, then the insulin pumps are your go-to gadgets. The pump injects insulin directly into your body’s tissue just below the skin. This device can be worn around your waist and kept in your purse or pocket. Secure it with an armband or attach it to your belt or bra for easier use. Some pumps administer insulin at mealtimes or snack times and others deliver it continuously. This can be decided based on your condition and need for blood sugar regulation. All you need to do is push the button and insulin gets delivered directly without you needing to prepare a syringe.
- Smartphone apps
The biggest tech innovation of all time has been the invention of smartphones. The add-on to that is the apps. Yes, you have an app to manage your diabetes. You can track your blood sugar levels, observe graphical trends of your blood sugar levels and monitor your diet on the app.
With the therapeutic and technological advances in the management of diabetes, the treatment protocol has been changing shape accordingly. The availability of these various treatment options helps maintain individualised patient care based on the patient’s preference of cost, disease prognosis, and compliance.
This article has been contributed by Dr Abhijit Bhograj, Consultant- Endocrinology, Manipal Hospital- Hebbal, Bengaluru. With more than 13 years of experience, Dr Bhograj’s expertise lies in Diabetes complication management, gestational diabetes mellitus, goitre, thyroid disorders, hormonal therapy and weight loss programs for Polycstic Ovarian Syndrome (PCOS).
