One of the very recent innovations in glucose control is the continuous glucose monitor (CGM). CGMs are tiny wire sensors that go below the skin and send details about blood sugar levels via a radio transmitter to a pager-sized receiver; they relay your glucose level every few minutes, thus helping you to see trends and patterns. This helps wearers respond almost immediately to rising or dropping blood sugars. Most people who use CGMs wear an insulin pump, but a pump is not required to use a CGM.
Another breakthrough on the horizon may be the artificial pancreas now in clinical trials. An artificial pancreas involves a continuing glucose monitor, an insulin pump, and a control system, all working together to automatically sense and dispense the correct amount of insulin - without patient administration. Researchers project that in just a few years, the artificial pancreas will be a viable option to insulin pumps and multiple daily injections of insulin for patients.
Inhalable insulin was short-lived when, in 2006, Pfizer released probably the most revolutionary delivery option for insulin since its discovery, an inhalable insulin called Exubera. Unfortunately, these devices was unwieldy, similar to the size of a can of tennis balls, and doctors were concerned about long-term lung function. Pfizer abandoned the product, and 2 other pharmaceutical companies that were conducting trials with inhalable insulin put on the brakes.
However, in a brand new York Times November 2007 report titled "Betting an Estate on Inhaled Insulin," entrepreneur Alfred E. Mann is so certain he is able to succeed with an inhalable insulin that he's putting $1 billion of their own money into redeveloping it. Mr. Mann says his insulin device is going to be slightly bigger than a cell phone and has not far caused lung problems, although more testing is required.
Other insulin-delivery devices are in the prototype stage, including an insulin patch that administers insulin with the skin (just like a nicotine patch), insulin nasal and cheek sprays, and what's been a long-awaited dream, insulin in a pill - which is now in clinical trials with patients who have type 2 diabetes. Thus far the results show early success, having a reduction in blood sugar levels as well as an increase in insulin levels.
"Until 1995, there had been no substantial advance in drug management of diabetes because the 1950s," said John Buse, an endocrinologist in the University of North Carolina at Chapel Hill and president from the American Diabetes Association. In the last few years, however, several new diabetes medications have come to market.
An extremely recent class of medication, incretin mimetics (drugs that mimic the result of certain gut hormones), enhance the body's capability to manage glucose levels by stimulating insulin secretion when food is eaten, slowing stomach emptying, and inhibiting the liver from secreting glucagon, a hormone involved in carbohydrate metabolism.
These drugs have been proved useful in weight reduction, and they improve blood sugar levels control before and after meals. Progressively more endocrinologists believe that post-meal blood sugar control is more significant than was previously thought in an effort to prevent diabetic complications.
Byetta is one such drug. In trials, more than 4 times as numerous patients using Byetta as well as other medications reached the ADA's recommended A1C level of under 7 percent, and a majority of patients lost an average of eight pounds in thirty weeks. Symlin, another new medication, replaces the hormone amylin, that is made by beta cells and lost as beta cells degrade.
Symlin suppresses the release of glucagon in the liver, flattening post-meal blood sugars, which researchers now know is important to help prevent diabetes complications and decelerates the absorption of carbohydrates, promoting satiety and weight reduction.
Januvia is a pill that cuts down on the quantity of glucose produced by the liver and stimulates the release of insulin only if you will find available carbohydrates, decreasing the incidence of hypoglycemia. Januvia is well tolerated by most patients and causes neither weight reduction nor weight gain. Insulin has been around since 1921, but in the recent years newer kinds of insulin have been developed that help control blood sugar more effectively because of their quicker onset, less pronounced peak, and quick degradation.
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