Diabetes has always intrigued me, especially as it's so widespread—almost everyone knows someone affected by it. For me, it was a high school friend with diabetes. I’d watch her carry a sugar bar for emergencies or see her self-administer insulin, but I didn’t fully understand the reason for these actions. It wasn’t until medical school that I found answers to my questions and realized the complexities of diabetes. It’s remarkable how something as seemingly harmless as sugar can lead to such serious health consequences.
Diabetes as a Growing Health Crisis Type 2 diabetes is notably intertwined with other metabolic conditions, like obesity. Both are seeing alarming increases, particularly among adolescents worldwide. In the Middle East and North Africa (MENA) region, where I reside, diabetes prevalence reached 12.2% in 2019—the highest globally.
With the introduction of newer drugs, type 2 diabetes treatment has changed significantly. For example, GLP-1 agonists and SGLT-2 inhibitors have demonstrated significant advantages. These medications are especially helpful for people with these issues since they not only help regulate blood sugar levels but also have heart and kidney protective properties. But SGLT-2 inhibitors may make stroke patients who use urinary catheters more susceptible to UTIs.
"Smart Insulin": A Future Innovation in Diabetes Care One promising advancement in diabetes care is "smart insulin," a glucose-responsive formulation that adjusts its activity based on real-time blood glucose levels. In contrast to regular insulin, which is given in set doses regardless of fluctuating glucose levels, smart insulin is designed to activate when glucose levels rise and deactivate as they fall. This real-time precise measurements and administration makes this upcoming technology promising.
One such innovation, known as NNC2215, includes a “glucose-responsive switch” that senses blood glucose concentrations and adjusts insulin activity accordingly. Animal studies have shown that NNC2215 responds up to 3.2 times more effectively than traditional insulin, closely mimicking the body's natural insulin response. However, human trials are essential to validate its effectiveness and safety before it becomes a widely available treatment option.
In the end, a customised strategy is necessary for effective diabetes care. Improving results in diabetes management will depend on healthcare providers keeping up with the most recent developments and customising therapies to meet the needs of each individual patient.
1-El-Kebbi et al. in World Journal of Diabetes (2021) and related studies on SGLT-2 and GLP-1 agonists in recent reviews.
2- Kalra S. Smart insulins. J Pak Med Assoc. 2014 Jan;64(1):95-7. PMID: 24605725.
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