Researchers continue to search for the cause or causes of diabetes and for ways to prevent and cure the disorder.
For example, scientists are looking for genes that may be involved in type 1 or type 2 diabetes. Some genetic markers and other indicators for type 1 diabetes have been identified, so it is now possible to check relatives of people with type 1 diabetes to see if they are at risk. Scientists are also researching ways to prevent or delay many of the complications associated with diabetes.
Many drugs are now available to treat type 2 diabetes. These include, for example, drugs that help the pancreas produce more insulin, make tissues more sensitive to insulin, or improve the liver's response to insulin.
By using the oral diabetes medications now available, many people with type 2 diabetes can control blood glucose levels without insulin injections. Studies are underway to determine how best to use these drugs to manage type 2 diabetes.
Much of diabetes research is conducted through clinical trials, which are research studies conducted with human volunteers to find out if a new experimental drug, therapy, medical device, lifestyle change, or test will help treat, find, or prevent a disease. New therapies are tested on people only after laboratory and animals studies have shown promising results.
Findings on Blood Glucose Control
- The Diabetes Control and Complications Trial, sponsored by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), between 1983 and 1993, showed the importance of tight control of blood glucose in slowing or preventing complications of diabetes such as eye, kidney, and nerve damage.
- A trial conducted in the United Kingdom from 1977 to 1997 (the U.K. Prospective Diabetes Study) showed that intensive therapy to control blood glucose and lower A1c levels to target goals could reduce the risk of diabetes complications.
Findings on Weight Loss and Exercise
In 1996, the NIDDK launched its Diabetes Prevention Program, or DPP. The goal of this research effort was to learn if type 2 diabetes could be prevented or delayed in people at high risk for the disease.
DPP researchers found that people at high risk for type 2 diabetes could lower their chances of developing the disease by half by losing a small amount of weight (achieved by a low-calorie, low-fat diet) and participating in regular physical activity.
Older adults participating in the study saw even greater benefits of diet and exercise; some people over 60 reduced their diabetes risk by even more 71 percent. The DPP also suggests that metformin can help delay the onset of diabetes. It was, however, least effective in people aged 45 and older.
A DPP follow-up study known as the DPP Outcomes Study, or DPPOS, built on those findings. Although researchers acknowledged the challenges of keeping pounds off, they found that even modest weight loss produced major long-term health rewards by lowering the risk of type 2 diabetes and reducing other cardiovascular risk factors in people at high risk of developing diabetes POS participants who kept off the weight they had shed through healthy eating and by exercising regularly also lowered their heart disease risk.
Current Clinical Trials
Currently, the National Institutes of Health is conducting three clinical trials to find the best strategies to prevent and treat heart disease, the leading complication of diabetes. All three are jointly sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute.
- Look AHEAD (Action for Health in Diabetes). Look AHEAD is the largest clinical trial to date to examine the long-term health effects of voluntary weight loss in people with type 2 diabetes. Researchers are studying how lifestyle changes such as eating better and getting regular exercise over the long term affect people with diabetes and their risk for heart disease. Preliminary findings from 2010 show intensive lifestyle changes improved diabetes control and lower cardiovascular disease risk in overweight and obese individuals with type 2 diabetes.
- ACCORD (Action to Control Cardiovascular Risk in Diabetes). The ACCORD study was conducted to examine at various approaches to preventing heart disease and strokes in individuals with type 2 diabetes. Study results reported in 2010 confirmed the importance of individually tailoring diabetes treatment and goals, especially those with cardiovascular or other diseases, severe hypoglycemia, and with long-standing diabetes.
- BARI2D (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetics). BARI 2D, a 5-year clinical trial, is comparing various treatment strategies for diabetes and heart disease to prevent early death, heart attack and stroke.
For More About Clinical Trials…
The U.S. National Institutes of Health maintains an online database of clinical trials at ClinicalTrials.gov. Here you will find information about a trial's purpose, who may participate, locations, and phone numbers. Visit www.clinicaltrials.gov for more information. Type “diabetes” in the search box to see a list of the current clinical trials on diabetes.