Poxel (PP:POXEL) is a French pharmaceutical company that recently received $30.1 million in post-IPO equity in 2016. The company has developed an orally active medication called Imeglimin, which targets all three organs and body systems that are affected by diabetes simultaneously: the pancreas, liver, and muscles. The drug is currently undergoing phase 3 clinical work in Japan, and will commence phase 3 trials in the European Union and the United States that will be completed by 2019. The company is also concurrently working on several other pharmaceutical agents in various stages of the development pipeline.
If the amount of insulin available is insufficient, or if cells respond poorly to the effects of insulin (insulin insensitivity or insulin resistance), or if the insulin itself is defective, then glucose will not be absorbed properly by the body cells that require it, and it will not be stored appropriately in the liver and muscles. The net effect is persistently high levels of blood glucose, poor protein synthesis, and other metabolic derangements, such as acidosis.
Around 75% of people with diabetes have type 2 diabetes mellitus. This was earlier termed non-insulin dependent diabetes mellitus (NIDDM) or maturity-onset diabetes mellitus. The number of people with type 2 diabetes is rapidly increasing. In type 2 diabetes, not enough insulin is produced or the insulin that is made by the body is insufficient to meet the needs of the body. Obesity or being overweight predisposes to type 2 diabetes.
I bring this up because sleep apnea increases a person’s risk for developing type 2 diabetes. Also, sleep-disordered breathing is also related to proper nutrition throughout life. And perhaps most importantly, the first line of defense in catching sleep-disordered breathing in patients early, are dentists. This is another area where dentists must get involved if we want to tackle the issue of pervasive type 2 diabetes with any success.
Exposure to certain viral infections (mumps and Coxsackie viruses) or other environmental toxins may serve to trigger abnormal antibody responses that cause damage to the pancreas cells where insulin is made. Some of the antibodies seen in type 1 diabetes include anti-islet cell antibodies, anti-insulin antibodies and anti-glutamic decarboxylase antibodies. These antibodies can be detected in the majority of patients, and may help determine which individuals are at risk for developing type 1 diabetes.
Ariana Shakibinia decided to study public health in large part because she lives with T1D. She had always been interested in public policy, but she says living with this disease has made her more vested in the healthcare conversation. “I am living with what is essentially a pre-existing condition. I’m fortunate enough to have good health insurance, but it makes the potential financial burden of T1D management much more visible and relatable.”
Though not routinely used any longer, the oral glucose tolerance test (OGTT) is a gold standard for making the diagnosis of type 2 diabetes. It is still commonly used for diagnosing gestational diabetes and in conditions of pre-diabetes, such as polycystic ovary syndrome. With an oral glucose tolerance test, the person fasts overnight (at least eight but not more than 16 hours). Then first, the fasting plasma glucose is tested. After this test, the person receives an oral dose (75 grams) of glucose. There are several methods employed by obstetricians to do this test, but the one described here is standard. Usually, the glucose is in a sweet-tasting liquid that the person drinks. Blood samples are taken at specific intervals to measure the blood glucose.
Many herbal remedies have been used to reduce inflammation and pain. Writing in the online publication U.S. Pharmacist, Antoine Al-Achi, PhD, a Professor of Pharmaceutics at the Campbell University School of Pharmacy in North Carolina, reported that bromelain (pineapple enzyme), curcumin (an antioxidant found in turmeric), echinacea, chamomile, ginger, and arnica have shown anti-inflammatory effects. Preparations of these plant-based supplements are widely available at health-food stores. If you would like to try one or more of these supplements, speak to your doctor first about possible side effects and drug interactions.
Electrical stimulation can sometimes block pain signals from traveling up the nerves. The most commonly used system is called TENS, which stands for transcutaneous electrical nerve stimulation. TENS works by sending electrical pulses across the surface of the skin into the nerves. The stimulating pulses help prevent pain signals from reaching the brain. They also help stimulate your body to produce higher levels of its own natural painkillers, called endorphins.
Capsaicin cream (Arthricare, Zostrix) can block pain signals using an ingredient found in hot peppers. Studies haven’t shown this to be helpful in diabetic neuropathy. Capsaicin products cause skin irritation in some people. Capsaicin cream, which is also available as a lotion, jelly, or patch, can be applied to the skin where diabetic nerve pain is strong and temporarily relieve pain.