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The latest therapeutic techniques are presented by prof. dr hab. n. med. Waldemar Karnafel, head of the Department and Clinic of Gastroenterology and Metabolic Diseases at the Medical University of Warsaw.
Pancreatic islet transplant
The rescue for patients with unstable sugar levels may be transplantation of isolated pancreatic islets – taken from a deceased donor. They are injected into the portal vein where islet cells settle and begin to produce enough insulin to maintain normal blood sugar levels. The patient does not need to use insulin, but takes medications for the rest of his life to prevent rejection of the transplanted cells. Such treatments are not performed in Poland.
Insulin analogs
Animal insulins used years ago have been replaced by genetically engineered human insulin molecules. The latest achievement of insulin therapy are new insulin preparations, the so-called analogues that effectively lower sugar after a meal, allow you to adjust the intake of the analogue to the time of meals, and prevent hypoglycaemia.
Insulin pumps
Electronic device for self-administration of insulin. The patient wears them attached to a belt around the clock. Insulin from the pump passes through the catheter and enters the subcutaneous tissue through the needle. Thanks to the pump, the patient’s comfort of life increases, but the patient must check the device – there is a risk of bending the tube or clogging the needle. Discontinuation of insulin administration may result in the development of ketoacidosis.
Oral hypoglycaemic drugs
Incretin hormones have been registered in the European Union. These substances stimulate insulin secretion and reduce the secretion of glucagon from A cells, thus inhibiting the excessive secretion of glucose by the liver. On this basis, new drugs were developed: liraglutide, exendine and dipeptidase IV inhibitors (sitagliptin, vildagliptin).
Inhaled insulin
At the time of diagnosis of type 2 diabetes, only half of the pancreatic islets are functional. Another 5% of them disappear every year. Eventually, the patient has to start taking insulin. Patients are afraid of this, they believe that they will have to take insulin for the rest of their lives. It’s not true. Work on a different route of insulin administration is advanced. The inhalation form, administered through a bronchial inhaler, turned out to be the best. Patients will be able to use this method in just a few years.
interviewed by Ryszard Sterczyński
Source: Domowe Kuracje, Live for Life, 6/2008