The Future and Prospects of Type 2 Diabetes Therapy: Can We Fully Cure It with Endoscopy or Genetics?
Diabetes mellitus (DM) cannot be cured, but it can be successfully treated... Will we rewrite this textbook fact passed down for years in the future? Will we be able to completely cure type 2 diabetes mellitus (T2DM) one day? The Prague Institute for Clinical and Experimental Medicine (IKEM) sees endoscopic procedures as one of the promising paths and is preparing to test this groundbreaking method of therapy.
Number of Diabetics in 2045? An Increase of 200 Million
According to data from the World Health Organization (WHO), DM occurs globally in every population, and the number of diabetics worldwide is constantly increasing. While in 2014, WHO estimated the global number of adults with DM at 422 million, by 2045, the number is expected to rise to 629 million, meaning approximately one in ten individuals would suffer from this disease.
Endoscopic Treatment of DM
Thanks to insights from bariatric surgery, the duodenum has become the target of modern diabetes treatment. It has been found that certain nerve cells in the duodenum directly affect the further metabolic processing of sugars, and a specific endoscopic intervention into the duodenal mucosa has favorable metabolic impacts by improving glycemic control in patients with T2DM. If 50-80% of these nerve cells are blindfolded with a laser, the human body is confused and fundamentally changes its metabolic setting, reducing blood sugar levels, which in turn improves type 2 diabetes, and in some cases, may completely cure it. This method was developed by scientists in Israel, and thanks to IKEM, the Czech Republic could join this project as the first European country. The advantage of the procedure is its permanence, it is performed outpatient and takes about 15 minutes.
Repairing a Defective Gene or Artificial Pancreas
Some expert considerations suggest that in the future, genetic testing can be expected to determine whether a specific individual will develop diabetes, and if so, which of the predisposing genes it involves. Diagnosing the exact gene subtype will then help the doctor choose the most appropriate treatment and also examine other family members. It is considered that in the future, repairing a defective gene or targeted pharmacotherapy that would compensate for the defect in the given gene subtype might be the solution. Sophisticated methods of insulin delivery via an artificial pancreas are also being researched.
(tich)
Sources:
1. Classification of diabetes mellitus 2019. WHO, 2019 Apr 19. Available at: www.who.int/publications/i/item/classification-of-diabetes-mellitus
2. Beneš M. A world-unique way of treating type 2 diabetes at IKEM. IKEM, May 25, 2017. Available at: www.ikem.cz/cs/svetove-unikatni-zpusob-lecby-diabetu-2-typu-v-ikem/a-3073
3. van Baar A. C. G., Holleman F., Crenier L. et al. Endoscopic duodenal mucosal resurfacing for the treatment of type 2 diabetes mellitus: one year results from the first international, open-label, prospective, multicentre study. Gut 2020 Feb; 69 (2): 295–303, doi: 10.1136/gutjnl-2019-318349.
4. The future of diabetes. Diabetes UK, 2017. Available at: www.diabetes.org.uk/get_involved/campaigning/the-future-of-diabetes
5. Shomali M. Diabetes treatment in 2025: can scientific advances keep pace with prevalence? Ther Adv Endocrinol Metab 2012; 3 (5): 163–173, doi: 10.1177/2042018812465639.
6. The future of diabetes management. The Medical Futurist, 2017 Jun 1. Available at: https://medicalfuturist.com/the-future-of-diabetes-management-8-reasons-why-we-face-extraordinary-times
Did you like this article? Would you like to comment on it? Write to us. We are interested in your opinion. We will not publish it, but we will gladly answer you.
