With the number of people being diagnosed with diabetes on the rise and set to top 1.31 billion by 2050, we take a closer look at some of the major treatment and research breakthroughs that have been made this year.

Advances in insulin treatments

In recent years, a key advancement has been the development of insulin pumps.

Alongside this has been research into new ways to deliver insulin, including the use of nanomaterials so it can be administered orally.

This year saw developments in insulin formulations and the provision of more affordable options for Americans living with the condition.

The role of technology in managing diabetes

The last few years has seen the development of wearable and implantable devices to administer insulin.

As well as removing some of the pressure on people with diabetes, this technology can also help improve control of the condition.

Insulin pumps involve a catheter placed under the skin which delivers rapid-acting insulin and mimics the release of natural insulin throughout the day.

Closed-loop systems deliver insulin based on glucose levels, so they feature a continuous glucose monitor (CGM) system, an insulin pump and an algorithm which measures blood glucose levels to deliver the right amount of insulin at the right time.

The development of these algorithms means that some can predict future blood sugar levels, meaning individuals receive bespoke recommendations for insulin dosing or lifestyle tweaks.

However, the role of technology has also come into question with software glitches causing alarm among people with diabetes.

The discovery of genetic variations

Breakthroughs have been made in identifying specific genetic variants in genes associated with the development of diabetes.

For example, in the rare neurodegenerative disorder Wolfram syndrome, which can present diabetes, the maternally inherited c.1369A > G; p.Arg457Gly variant of the WSF1 gene was found.

In addition, scientists found that the missense rs2234970 SNP in SCD1 can contribute to the development of obesity-related metabolic disorders, including type 2 diabetes.

While these findings may help to predict the risk an individual faces in developing diabetes, they cannot always be applied universally as they are often specific to certain population groups.

Alternative therapies

Recently, a potential therapy for diabetic ketogenesis has been explored.

The method aims to supress ketogenesis by targeting the hepatic S100A9-TLR4-mTORC1 axis in non-parenchymal cells.

Teplizumab became the first drug to be approved by the FDA for delaying the progress of type 1 diabetes.

It is believed the therapy may partially activate signalling and deactivate autoreactive T lymphocytes that target pancreatic beta cells.

Working towards a cure

Promising treatments for diabetes involve β cell regeneration and immunotherapy. Central to the treatment of the condition is the restoration of the function and number of beta cells.

Potential for this regeneration has been shown in self-duplication and regeneration from stem cells, although there are still hurdles to overcome in β cell regeneration in clinical practice.

Immunotherapy offers a potential for the treatment of diabetes, with the aim of regulating the immune response and stopping the β cell destruction that is seen in type 1 diabetes.

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