The drive to discover new and innovative solutions for managing diabetes is international. The Diabetes UK Professional Conference, held in Glasgow in March 2016, presented many of these advances and developments, including new insights into diabulimia; the role of mindfulness in diabetes management; risk factors for Type 2 diabetes in the younger generations; and new discoveries in glucose monitoring and management. Through interviews conducted with the presenters of these topics, Dr. Nicola Davies explores the latest innovations in diabetes research.
In this installment, we look at blood glucose monitoring and control.
Dr. Steve Bain, clinical lead for the Diabetes Research Network in Wales, is working on an oral medication for stabilizing glycemic levels that is currently in the trial stages. The medication, semaglutide, is an investigational glucagon-like peptide-1 analog that is showing promising results in the treatment of Type 2 diabetes. One weekly dose of semaglutide significantly improved glycemic control in trial participants compared with previous treatments, outperforming even the most widely used Type 2 diabetes treatment, metformin.
For the latest technology in glucose monitoring, Dr. Bain recommends the Abbot Freestyle Libre, a flash glucose monitor that scans blood glucose measurements rather than relying on the painful and inconvenient method of frequent pinpricks. A sensor is affixed to the skin, and a person needs only wave the glucose reader within an inch and half of it to check blood sugar levels. The device works through clothing and is water resistant, so the wearer can swim, exercise, shower, or bathe. Bain says, “If the Abbott Freestyle Libre device is available on prescription, it will become hugely popular.”
Dr. Brian Frier, honorary professor of diabetes at the University of Edinburgh, also sees tremendous potential in the Freestyle Libre. He considers it a more practical alternative to the trendy continuous glucose monitoring (CGM) systems on the market. According to Frier, the Freestyle Libre “relies on flash glucose testing at five-minute intervals. This is not the same as CGM, but enables frequent testing of glucose so that the individual can see the direction of travel of their glucose, such as whether it is stable, rising or falling. The reports I have heard from patients is that they find this method of monitoring to be very valuable.”
This new form of glucose monitoring provides greater flexibility in lifestyles and glycemic targets. Frier notes, “Guidelines [regarding individualizing targets for people with diabetes] have now abandoned the previous impractical (and frankly dangerous) blanket approach to glycemic targets in that everyone was to aim for very strict control, irrespective of age and co-existing medical disorders. Sensible targets are now being advocated for frail elderly people, very young children with Type 1 diabetes, and other groups, while promoting very strict control where this is essential, such as in pregnancy.”
Looking to the future
Researchers continue to develop new treatments to assist the almost 620 million people worldwide with various forms of diabetes. The Diabetes UK Professional Conference kept attendees abreast of current developments in the field. The sessions were invaluable for increasing awareness regarding troubling trends in the diabetes community or developing new methods or technologies to help people with diabetes manage and monitor their condition. The insights provided predict a future with greater public awareness of the risk of unhealthy lifestyles, a higher standard of care that can be provided by practitioners and a higher quality of life for people with diabetes.