Research for Diabetes

Although the NICHD studies different aspects of all types of diabetes, the NICHD is not the primary resource for patient information about type 1 or type 2 diabetes. The National Diabetes Information Clearinghouse at http://diabetes.niddk.nih.gov and the National Diabetes Education Program at http://ndep.nih.gov provide detailed patient information about type 1 and type 2 diabetes, including their symptoms.

Source: NICHD (NIH)1

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Back to: « Diabetes

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The AIHW undertakes national surveillance and monitoring of a number of prominent chronic conditions, including diabetes, along with their comorbidities and associated risk factors. The AIHW seeks to enhance the evidence on the impact of chronic conditions, including diabetes, through these monitoring activities by providing information and advice, addressing key policy priorities and filling key information gaps.

Source: Australian Institute of Health and Welfare2

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Accelerating Medicines Partnership (AMP—Part 3 of 4)

Type 2 Diabetes

The NIH, pharmaceutical companies, and nonprofit organizations have together created the Accelerating Medicines Partnership (AMP) to develop new models for identifying and validating promising biological targets for new diagnostics and drug development. The partners have designed a project plan to address relevant challenges for type 2 diabetes.

Source: MedLinePlus Magazine (NIH)3

Treatment Research for Diabetes

Are there research studies for type 2 diabetes that show promise in preventing and/or treating the disease more effectively in the future?

The NIDDK funds many studies examining better ways to prevent and treat type 2 diabetes, including:

  • Look AHEAD (Action for Health in Diabetes)—This study looks at people who already have type 2 diabetes. It has shown that a lifestyle intervention that helps participants lose weight reduces the need for medications to control diabetes, and improves mobility and quality of life.
  • Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study, the first large-scale study to compare treatments for young people with type 2 diabetes.
  • The Restoring Insulin Secretion (RISE) study is looking at ways to preserve beta cell function in people early in the course of type 2 diabetes.
  • The ACCORD, DPP/DPPOS, and DCCT/EDIC studies continue to follow participants so we can learn more about the long-term outcomes of people with and at risk of diabetes.

Source: MedLinePlus Magazine (NIH)4

Research for Diabetes

Artificial Pancreas: Points to Remember

  • Glucose monitoring helps people with diabetes manage the disease and avoid its associated problems.
  • The most common way to check glucose levels involves pricking a fingertip to obtain a blood sample and using a glucose meter to measure the glucose level in the sample.
  • Continuous glucose monitoring (CGM) systems use a tiny sensor inserted under the skin to check glucose levels in tissue fluid. A transmitter sends glucose measurements to a wireless monitor.
  • An artificial pancreas based on mechanical devices will consist of a CGM system, an insulin delivery system, and a computer program to adjust insulin delivery based on changes in glucose levels.

Source: NIDDK (NIH)5

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Cone snail insulin: Cone snail reveals insulin insights

Many people with diabetes rely on injections of synthetic insulin to keep their blood sugar levels in check. However, human insulin molecules take time to act on blood glucose levels. Researchers have found that a fast-acting insulin from the cone snail can bind and activate the human insulin receptor. The 3-D structure and other findings from the study provide insights for designing rapid-acting insulins to better manage diabetes.

https://medlineplus.gov/magazine/issues/spring17/articles/spring17pg4-7.html

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Glucose-Sensing Contacts: Glucose-Sensing Contacts

Glucose-sensing contacts could provide a non-invasive solution for continuous blood sugar monitoring.

https://medlineplus.gov/magazine/issues/fall14/articles/fall14pg24-25.html

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Tailored goals: How has NIH research led to changes in the guidelines that tailor them to individual patients?

The guidelines focus on tailoring goals to the individual, based on potential risks and benefits of blood sugar control as measured by the A1C test. That is a lab test that measures average blood glucose level over the last two to three months. These new guidelines call for better control of diabetes in people who are newly diagnosed, do not have many other health problems, and can expect to live a long time. Other people should have less strict A1C goals. Those include people with severe low blood sugar, other serious health problems—such as heart disease—or longstanding or hard to control diabetes.

These guidelines are consistent with findings in the NIH-funded Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. This study found that lowering blood glucose to a goal of near normal, or non-diabetic levels, increased the risk of death; the study participants had longstanding type 2 diabetes and either had heart disease or were at high risk for it.

Two other studies, the Diabetes Control and Complications Trial (DCCT) and the Epidemiology of Diabetes Complications (EDIC)—studied patients treated intensively early in the course of type 1 diabetes. These studies showed that tight blood glucose control lowers the risk of diabetes complications, and that the benefits continued years after the trial ended.

These trials tell us that treatment should be tailored for the individual patient. For some people with diabetes, intensive glucose control might not be best. For other people, it may be the right thing to do. We've learned that a one-size approach does not fit all in treating diabetes. It is important to remember that it's not just glucose control that is important. Controlling blood pressure and taking cholesterol-lowering statin drugs have a huge effect in preventing heart disease in people with diabetes.

https://medlineplus.gov/magazine/issues/fall12/articles/fall12pg14.html

Cure Research for Diabetes

Is there a cure for diabetes?

In response to the growing health burden of diabetes, the diabetes community has three choices: prevent diabetes; cure diabetes; and improve the quality of care of people with diabetes to prevent devastating complications. All three approaches are actively being pursued by the US Department of Health and Human Services.

Both the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) are involved in prevention activities. The NIH is involved in research to cure both type 1 and type 2 diabetes, especially type 1. CDC focuses most of its programs on making sure that the proven science to prevent complications is put into daily practice for people with diabetes. The basic idea is that if all the important research and science are not applied meaningfully in the daily lives of people with diabetes, then the research is, in essence, wasted.

Several approaches to "cure" diabetes are currently under investigation:

  • Pancreas transplantation
  • Islet cell transplantation (islet cells produce insulin)
  • Artificial pancreas development
  • Genetic manipulation (fat or muscle cells that don’t normally make insulin have a human insulin gene inserted — then these "pseudo" islet cells are transplanted into people with type 1 diabetes).

Each of these approaches still has a lot of challenges, such as preventing immune rejection; finding an adequate number of insulin cells; keeping cells alive; and others. But progress is being made in all areas.

Source: CDC6

Prevention Research for Diabetes

Lifestyle changes worked just as well for men and women and all ethnic groups. Nearly half the DPP participants were from minority groups who suffer disproportionately from type 2 diabetes: African Americans, Hispanic Americans, American Indians, and Asian Americans and Pacific Islanders. In the study, people age 60 and older who made the lifestyle changes lowered their chances of developing diabetes by 71 percent.

When these results were announced, they surpassed even researchers’ expectations. Study chair Dr. David Nathan of Massachusetts General Hospital said, “They came as close to qualifying for "the gold’ as any diabetes finding of the last decade.”

Source: NIH News in Health (NIH)7

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Building on this research, CDC’s National Diabetes Prevention Program supports establishing a network of community-based, group lifestyle intervention programs for overweight or obese people at high risk of developing type 2 diabetes. As of early 2011, it was anticipated that 33 U.S. sites will offer group lifestyle interventions in 2011, with plans to expand to other communities.

Source: CDC8

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Can insulin resistance and prediabetes be reversed?

Yes. Physical activity and weight loss help the body respond better to insulin. The Diabetes Prevention Program (DPP) was a federally funded study of 3,234 people at high risk for diabetes.

The DPP and other large studies proved that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity—for example, walking 30 minutes a day, 5 days a week.

People at High Risk for Diabetes

DPP study participants were overweight and had prediabetes. Many had family members with type 2 diabetes. Prediabetes, obesity, and a family history of diabetes are strong risk factors for type 2 diabetes. About half of the DPP participants were from minority groups with high rates of diabetes, including African Americans, Alaska Natives, American Indians, Asian Americans, Hispanics/Latinos, and Pacific Islander Americans.

DPP participants also included others at high risk for developing type 2 diabetes, such as women with a history of gestational diabetes and people ages 60 and older.

Approaches to Preventing Diabetes

The DPP tested three approaches to preventing diabetes:

  • Making lifestyle changes. People in the lifestyle change group exercised, usually by walking 5 days a week for about 30 minutes a day, and lowered their intake of fat and calories.
  • Taking the diabetes medication metformin. Those who took metformin also received information about physical activity and diet.
  • Receiving education about diabetes. The third group only received information about physical activity and diet and took a placebo—a pill without medication in it.

People in the lifestyle change group showed the best outcomes. However people who took metformin also benefited. The results showed that by losing an average of 15 pounds in the first year of the study, people in the lifestyle change group reduced their risk of developing type 2 diabetes by 58 percent over 3 years.

Lifestyle change was even more effective in those ages 60 and older. People in this group reduced their risk by 71 percent.

People in the metformin group also benefited, reducing their risk by 31 percent. More information about the DPP, funded under NIH clinical trial number NCT00004992, is available at www.bsc.gwu.edu/dpp .

Lasting Results

The Diabetes Prevention Program Outcomes Study (DPPOS) has shown that the benefits of weight loss and metformin last for at least 10 years. The DPPOS has continued to follow most DPP participants since the DPP ended in 2001. The DPPOS showed that 10 years after enrolling in the DPP

  • people in the lifestyle change group reduced their risk for developing diabetes by 34 percent
  • those in the lifestyle change group ages 60 or older had even greater benefit, reducing their risk of developing diabetes by 49 percent
  • participants in the lifestyle change group also had fewer heart and blood vessel disease risk factors, including lower blood pressure and triglyceride levels, even though they took fewer medications to control their heart disease risk
  • those in the metformin group reduced their risk of developing diabetes by 18 percent

Even though controlling weight with lifestyle changes is challenging, it produces long-term health rewards by lowering the risk for type 2 diabetes, lowering blood glucose levels, and reducing other heart disease risk factors.

More information about the risk of developing diabetes; the DPP, funded under NIH clinical trial number NCT00004992; and the DPPOS, funded under NIH clinical trial number NCT00038727, is provided in the NIDDK health topics:

  • Diabetes Prevention Program
  • Am I at risk for type 2 diabetes? Taking Steps to Lower Your Risk of Getting Diabetes

Source: NIDDK (NIH)9

Prevention Research for Diabetes

Chocolate: But the evidence that chocolate can reduce cancer or death rates in people is still weak. “There are a few studies that show some effect,” Su says, “but the findings so far are not consistent.”

Some research also suggests that chocolate might help prevent diabetes. However, the challenges in proving this link are similar to those of heart disease and cancer.

Source: NIH News in Health (NIH)10

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Weight loss: People can sometimes reverse prediabetes with weight loss that comes from healthy eating and physical activity. Even a small weight loss can prevent or delay progression to type 2 diabetes. We learned in the Diabetes Prevention Program (DPP) study that losing just 5-7 percent of your body weight (about 15 pounds for many people) can help prevent or delay the chances of getting type 2 diabetes. That's true even if you don't get down to your ideal body weight. A diet low in fat and calories and regular physical activity, such as walking 30 minutes for five days a week, can reduce the risk type 2 diabetes by more than half.

It is important to note that these proven benefits of weight loss are for delay or prevention of type 2 diabetes in people who have been diagnosed with prediabetes or have risk factors for developing type 2 diabetes.

Source: MedLinePlus Magazine (NIH)11

Diagnostic Research for Diabetes

Another emerging issue is the effect on public health of new diagnostic criteria, such as introducing the use of HbA1c for diagnosis of diabetes and high risk for diabetes, and lower thresholds for gestational diabetes. These changes may impact the number of individuals with undiagnosed diabetes and facilitate the introduction of diabetes prevention at a public health level.

Source: Healthy People (DHHS)12

Causal Research for Diabetes

School Environment Affects Diabetes Risk

The new study was conducted at 42 middle schools where many students are minorities or from low-income families. Half the schools were randomly chosen to use the study’s “intervention” program: longer gym classes, more nutritious foods and education in healthy behaviors.

About 4,600 students were tracked from the beginning of 6th to the end of 8th grade. At the start, nearly half were overweight or obese. Many had other signs of high diabetes risk.

At the end of the study, kids who had been overweight or obese at the intervention schools had a 21% lower obesity rate than those at the comparison schools. Other diabetes risk factors, like larger waist size, also fell more at the intervention schools.

“The study shows that a school-based program can help lower obesity and certain risk factors for type 2 diabetes in youth at high risk for the disease,” says Dr. Griffin P. Rodgers, director of NIH’s National Institute of Diabetes and Digestive and Kidney Diseases.

Source: NIH News in Health (NIH)13

Causal Research for Diabetes

Insufficient sleep: Lack of Sleep May Increase Diabetes Risk

A lack of sufficient sleep reduces the body's sensitivity to insulin, impairing its ability to regulate blood sugar and increasing the risk for diabetes, according to researchers from the University of Colorado. Their new study adds to a growing body of information linking a lack of sleep to a range of ailments including obesity, metabolic syndrome, mood disorders, cognitive impairment, and accidents.

"We found that when people get too little sleep it leaves them awake at a time when their body clock is telling them they should be asleep," said the study's lead author, Kenneth Wright Jr., PhD, professor of integrative physiology at CU-Boulder. "And when they eat something in the morning, it impairs their ability to regulate their blood sugar levels."

Diabetes rates are skyrocketing nationwide, noted study co-author Robert Eckel, MD, an endocrinologist and professor of medicine at CU-Anschutz. By 2050, he noted in a press release about the study (bit.ly/1RRJ3kI), as many as 33 percent of all Americans may have type 2 diabetes.

The study, funded in part by NIH, appeared online in the journal Current Biology (bit.ly/1lgXHaR).

Source: MedLinePlus Magazine (NIH)14

Prevalence Research for Diabetes

Researchers have collected data on diabetes for several decades as part of the National Health and Nutrition Examination Survey. For this survey, people were given a 2-hour oral glucose tolerance test during 2 time periods—from 1988 to 1994 and again from 2005 to 2006. This test is more sensitive in detecting diabetes and pre-diabetes than a more common and less expensive test called fasting plasma glucose.

By comparing data from the 2 time periods, scientists found that the percentage of people with diabetes rose from about 5% in 1988-1994 to nearly 8% a decade later. By 2006 more than 40% of adults had either diabetes or pre-diabetes.

“It’s important to know if you have diabetes or pre-diabetes, because there’s so much you can do to preserve your health,” said Joanne Gallivan, director of NIH’s National Diabetes Education Program. “Talk to your health care professional about your risk.”

Source: NIH News in Health (NIH)15

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In a new analysis of national survey data, researchers found that the prevalence of diabetes in U.S. adults is continuing to rise. And despite efforts to raise awareness of the problem, about a third of adults with diabetes still don’t know they have it.

Researchers at NIH and the Centers for Disease Control and Prevention (CDC) analyzed data from a national sample of U.S. adults 20 years old and over who took part in the National Health and Nutrition Examination Survey. Participants were interviewed in their homes and given a physical exam with a blood test, including a glucose reading taken after an overnight fast.

The researchers found that the prevalence of diagnosed diabetes in U.S. adults rose from about 5.1% in the years 1988-1994 to 6.5% in 1999-2002. About 2.8% of U.S. adults, a third of those who have diabetes, don’t even know they have it.

Source: NIH News in Health (NIH)16

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References

  1. Source: NICHD (NIH): nichd.nih.gov/ health/ topics/ diabetes/ conditioninfo/ Pages/ symptoms.aspx
  2. Source: Australian Institute of Health and Welfare: aihw.gov.au/ reports-statistics/ health-conditions-disability-deaths/ diabetes/ about
  3. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall14/ articles/ fall14pg17.html
  4. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall12/ articles/ fall12pg14.html
  5. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ managing-diabetes/ continuous-glucose-monitoring
  6. Source: CDC: cdc.gov/ diabetes/ basics/ diabetes.html
  7. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2005/ November2005/ docs/ 01features_01.htm
  8. Source: CDC: cdc.gov/ diabetes/ basics/ diabetes.html
  9. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ what-is-diabetes/ prediabetes-insulin-resistance
  10. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ issue/ aug2011/ feature1
  11. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall12/ articles/ fall12pg14.html
  12. Source: Healthy People (DHHS): healthypeople.gov/ 2020/ topics-objectives/ topic/ diabetes
  13. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ issue/ sep2010/ capsule1
  14. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ winter16/ articles/ winter16pg28.html
  15. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2009/ March/ capsules.htm
  16. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2006/ July/ docs/ 01features_02.htm

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Note: This site is for informational purposes only and is not medical advice. See your doctor or other qualified medical professional for all your medical needs.