Redefining Diabetes Care and Prevention

Redefining Diabetes Care and Prevention: What if the key to curing diabetes was simply a matter of fine-tuning your metabolism? What if science could develop a proactive approach to managing individuals at risk for diabetes? Data presented recently at the American Association of Clinical Endocrinologists (AACE) 18th Annual Meeting & Clinical Congress seems to indicate these two objectives may be possible.

Dr. Francesco Rubino of Weill Cornell Medical College said, “Metabolic surgery is one of the most important research opportunities for the next decade in medicine.”

A press release from the AACE indicates, “A growing body of evidence suggests that the mechanisms of diabetes resolution after surgery involve intestinal signals.” In other words the bowel may be a key control mechanism in the prevention and treatment of diabetes.

We reported in recent months that bariatric surgery has allowed many diabetics to effectively reverse the development of their disease. In most cases medical science has been unable to say with certainty why this surgery allowed a remission or possible cure for diabetics in their care. What they were certain of is that it worked. This type of surgery has been typically reserved for those who are morbidly obese. In fact, government health programs have even paid to have this surgery completed on patients in their programs.

The AAEC said, “Dr Rubino’s personal research showed for the first time that the effects of bariatric surgery on diabetes cannot be entirely explained by weight loss, and are intrinsic with the change of intestinal anatomy characteristic of these procedures. As a result, experts have been studying the biological impacts of the surgery on mechanisms of glycemic control, and are exploring the possibility to use gastrointestinal surgery to treat diabetes.”

This line of thinking has allowed Rubino and others to consider the metabolic significance associated with the procedure and how it affects patients. Rubino claims, “It would be premature at this point to argue every diabetes patient is a candidate for gastrointestinal surgery. However, there is enough evidence that surgery should be considered as an option to endocrinologists in the treatment of type 2 diabetes.”

A synergistic approach is taking place within this approach to diabetes care. Endocrinologists and surgeons are working together to bring specialized skills and insight to the interventions associated with this field of diabetes care. Rubino said, “Recognizing the need to work as a team across disciplines that includes endocrinologists and surgeons is the first critical step to address the issues and opportunities that surgery offers to diabetes care and research.”

The AAEC is also pursuing preventative measures related to prediabetes that include both pharmaceutical approaches along with treatment aimed at assisting in solution development for metabolic challenges faced by those on a collision course with diabetes.

While lifestyle alterations have always been a primary key in keeping diabetes at bay, new approaches being discussed include the use of medications such as, “Metformin, acarbose, glucagon-like peptide 1 agonists and thiazolidinediones.” quoted Daniel Einhorn, MD in a recent report when he claimed, “These medications illustrate a specific ‘plan of attack’ for treating prediabetes. But it’s important that caution is exercised.”

It should be noted that there is no current FDA approved program to treat prediabetes, but scientists remain interested in pursuing this course of action in an attempt to put a proactive plan together to turn the tide of onset diabetes in America.