Diabetes: From Research to Clinical Practice
The number of people living with diabetes, the number of deaths attributable to it, and the cost of treating the disease and its complications are increasing exponentially. Centuries of research led to the discovery of insulin and other drugs based on pat
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Diabetes: From Research to Clinical Practice Md. Shahidul Islam
Abstract
The number of people living with diabetes, the number of deaths attributable to it, and the cost of treating the disease and its complications are increasing exponentially. Centuries of research led to the discovery of insulin and other drugs based on pathophysiology from “the triumvirate to ominous octet”. The agonists of the glucagon-like peptide-1 (GLP-1) receptor, and the inhibitors of the sodium-glucose transport protein 2 (SGLT2) are the new drugs that improve cardiovascular outcomes and provide renal protection, and they are being used increasingly for evidence-based treatment of type 2 diabetes. Bariatric surgery, when indicated, results in excellent weight- and metabolic-control, and in many instances even remission of diabetes. Technological advances like Flash glucose monitoring, continuous subcutaneous insulin infusion (CSII), and continuous glucose monitoring (CGM) have improved glycemic control, reduced episodes of severe hypoglycemia, and improved quality of life. For the treatment of diabetic macular edema intravitreal injection of M. S. Islam (*) Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Research Center, Stockholm, Sweden Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden e-mail: [email protected]
several anti-VEGF agents are being used. Numerous people living in the middle- and low-income countries cannot afford the costs of care of diabetes. Institutions like the World Health Organization, the World Bank and the International Monetary Fund should roll out plans to convince the politicians to invest more in improving the diabetes care facilities. Keywords
Anti-VEGF · Cardiovascular outcomes · Diabetes and GLP-1 receptor agonists · Diabetes and SGLT2 inhibitors · Diabetic keto-acidosis · Diabetic macular edema · Euglycemic diabetic keto-acidosis · Gestational diabetes · Hyperglycemic hyperosmolar comma · Hypoglycemia · Renal protection · Type 1 diabetes · Type 2 diabetes In 2019, 463 million adults in the world were living with diabetes, and about half of them were unaware of their condition (Saeedi et al. 2019). About 80% of them were living in the middle- and low-income countries. Number of children and adolescents living with type 1 diabetes was 1.1 million (Patterson et al. 2019). The estimated global healthcare expenditure for diabetes in the world was 760 billion USD (Williams et al. 2020). In 2019, 2.4 million of deaths among adults (20–79 year) were attributed to diabetes (Saeedi et al. 2020).
M. S. Islam
Research in the past decades have increased our understanding of the different types of diabetes and their treatment. In addition to the type 1 diabetes, type 2 diabetes, and gestational diabetes, there are other forms of diabetes that include diabetes of cystic fibrosis, fibro-calculous pancreatopath
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