Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin. In the past three decades the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. There is a globally agreed target to halt the rise in diabetes and obesity by 2025.
For over a decade, Cummings and others have tried to reframe the very concept of bariatric surgery (they prefer “metabolic surgery”). Their work has shown these procedures just don’t change how much food the stomach can fit; they trigger a cascade of metabolic and bodily changes, many of which help people with type 2 diabetes naturally get their blood sugar under control. Some changes even start happening before a patient loses weight, such as higher levels of peptide production in the gut that seem to restore a patient’s sensitivity to insulin.
Without insulin, that extra sugar starts to hang out in your blood with nowhere to go. Just like with honey or sweet syrup, high concentrations of sugar causes the blood to thicken. Physiologically, this pulls fluids and water from other parts of the body into the bloodstream, causing swelling and dryness. Early symptoms of diabetes are relatively mild, including excessive peeing, dry mouth, itchy skin, hunger, fatigue, and blurred vision.
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.
One of the most advanced alternatives comes from the Diabetes Research Institute (DRI) in the US, which is developing a bioengineered mini-organ where insulin-producing cells are encapsulated within a protective barrier. Two years ago, the DRI announced that the first patient treated in an ongoing Phase I/II trial no longer requires insulin therapy.
Type 2 diabetes is by far the most common form (around 90% of all cases) and the one which is increasing the most. It primarily affects overweight people in middle age or later. It’s not uncommon for the affected person to also have a high blood pressure and an abnormal lipid profile. Gestational diabetes is a temporary special case of type 2 diabetes.
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