New Delhi, Jul 23 (IANS): From small reliable insulin pumps to wearable glucose monitors and even pancreatic transplantation, treatment options for diabetes have undergone a significant change in the last decade, and the future looks hopeful for better outcomes for people with diabetes, said health experts.
According to the World Health Organisation (WHO), about 422 million people worldwide have diabetes, the majority living in low-and middle-income countries, and 1.5 million deaths are directly attributed to diabetes each year.
Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades and are predicted to rise further.
The chronic, metabolic disease is characterised by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves.
From the Glyptase routinely used in the last 10 years for the treatment of diabetes, the treatment of Type 2 diabetes has undergone a change facilitated by the discovery in widespread clinical use of two groups of drugs: SGLT2 inhibitors and GLP-1 receptor agonists.
“SGLT2 inhibitors are drugs that act on the kidney and help control the blood sugar along with helping some weight loss without low blood sugar levels. GLP1 is a molecule that is circulating in the blood secreted from the intestine and actually improves insulin secretion and does many other things including controlling appetite,” Dr. Ambrish Mithal, Chairman & Head – Endocrinology & Diabetes, Max Hospital, Saket, told IANS.
The effects of these drugs are way beyond glucose control and are remarkable editions to our tools in combating diabetes.
“The oral tablet of SGLT2 can not only control diabetes and help weight loss but can also reduce the risk of progression of renal disease and also partially reverse that including reduction in urinary protein,” Dr Mithal said. These drugs have also shown to prevent heart failures and cardiac related deaths.
Similarly, the GLP1 available in two forms — oral or injectable once a week — which started as an anti-diabetic is now also an anti-obesity drug.
Further, technology is also playing a great role in managing diabetes.
Monitoring diet has now become much easier and personalised with several apps, based on artificial intelligence (AI) enabling people to regularise their diet and their glucose.
There has also been an increase in the availability of continuous glucose monitors (CGM), that are attached on the skin and can actually monitor sugar continuously for up to 2 weeks.
“From the conventional way of monitoring blood glucose by finger pricking once-twice a day or once a week, the new continuous glucose monitor device comes in the form of a patch, which when inserted on the patient’s arm or the abdomen, records the blood glucose from the interstitial fluid under the skin, and it provides real time data about the blood glucose in the user,” Dr Sonali Kagne, Deputy Consultant, Department of Endocrinology, Sir HN Reliance Foundation Hospital, Mumbai, told IANS.
“This CGM system can record the data for up to seven days, or in some devices, it can record the data of 14 days and it takes one blood glucose reading every five minutes, thereby giving us a graph of how your blood sugar is behaving throughout the day for the 7 to 14 days,” she added.
Another advancement is in the form of new insulin pumps, particularly helpful for people with Type-1 diabetes, which can automatically adjust insulin delivery based on real-time glucose levels.
“Called a closed loop system, the CGM device that collects data about the blood glucose is combined with the insulin pump to deliver the insulin. The system acts like an artificial pancreas by assessing the high or low levels of blood sugar in a person at a given point in time and accordingly, adjusts the dose of insulin on its own and delivers that dose based on the meal that they are taking and how the sugars are behaving,” Dr Kagne said.
The health expert said the future is for personalised medicine.
“When we talk about the future options of the treatment of diabetes, much research is going on as to how we can identify how much is the role of genetics in a person’s diabetes levels and how we can use that data for the treatment. So, now there is an era of personalised medicine, so that we can tailor the treatment as per the individual needs, considering the factors such as genetics, lifestyle and glucose variability,” Dr Kagne said.
She explained that the pancreatic transplant for the treatment of Type-1 diabetes and Type -2 diabetes, are not very common currently.
“But in future with the advancement of the broader availability of the pancreatic transplant, it can be used for the control of the blood sugar level and better measurement of the diabetes in people who have diabetes and very fluctuating blood sugar levels, as well as those with underlying associated comorbidities like the infection of the kidneys,” Dr Kagne said.
Further, with ongoing research on microchips that can diagnose Type 1 diabetes, even before the symptoms appear; nanorobots travelling in the bloodstream while they measure glucose and deliver insulin, the future looks hopeful for people with diabetes.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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