latest research

Researchers continue to search for the cause or causes of diabetes and for ways to prevent and cure the disorder. For example, scientists are looking for genes that may be involved in type 1 or type 2 diabetes. Some genetic markers and other indicators for type 1 diabetes have been identified, so it is now possible to check relatives of people with type 1 diabetes to see if they are at risk. Scientists are also researching ways to prevent or delay many of the complications associated with diabetes.

Many drugs are now available to treat type 2 diabetes. These include, for example, drugs that help the pancreas produce more insulin, make tissues more sensitive to insulin, or improve the liver's response to insulin. By using the oral diabetes medications now available, many people can control blood glucose levels without insulin injections. Studies are underway to determine how best to use these drugs to manage type 2 diabetes.

For people with type 1 diabetes, researchers have also been experimenting with pancreatic islet transplantation, a procedure to help the body produce insulin. The pancreas is an organ located behind the lower part of the stomach, and it makes insulin and enzymes that help the body digest and use food. Spread all over the pancreas are clusters of cells called the islets of Langerhans where insulin is made. In this experimental procedure, islets are taken from the pancreas of a deceased donor and transferred into another person. Once implanted, islets may begin to make and release insulin. A person who receives islet transplantation must take strong medications to prevent the immune system from rejecting the donated islets.

Researchers are now working on ways to reduce the need for immune-suppressive drugs, which cause serious side effects. They are also trying to develop a reliable source of islets, since only about 6,000 pancreases a year are available for transplantation. Researchers hope that islet transplantation will help people with type 1 diabetes live without daily injections of insulin.

Much of diabetes research is conducted through clinical trials, which are research studies on people to find out if a new drug or treatment is both safe and effective. The findings of the Diabetes Control and Complications Trial, sponsored by the National Institute of Diabetes and Digestive and Kidney Disease or NIDDK, showed the importance of tight control of blood glucose in slowing or preventing complications of type 2 diabetes.

In 1996, the NIDDK launched its Diabetes Prevention Program, or DPP. The goal of this research effort was to learn how to prevent or delay type 2 diabetes in people with impaired glucose tolerance, or IGT. IGT is a strong risk factor for type 2 diabetes. The findings of the DPP, which were released in August 2001, showed that people at high risk for type 2 diabetes could sharply lower their chances of developing the disease through diet and exercise. Treatment with the oral drug metformin also reduced diabetes risk, though less dramatically.

Currently, the National Institutes of Health is conducting three clinical trials -- Look AHEAD, ACCORD, and BARI 2D -- to find the best strategies to prevent and treat heart disease, the leading complication of diabetes. These studies are all joint efforts of the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute.

The Look AHEAD: Action for Health in Diabetes study is the largest clinical trial to date to examine the long-term health effects of voluntary weight loss in people with type 2 diabetes. This clinical trial will examine how lifestyle changes designed to achieve and maintain weight loss over the long term through healthy eating and increased physical activity affect people with diabetes and their risk for heart disease.
The Action to Control Cardiovascular Risk in Diabetes, or ACCORD study, is looking at three key approaches to preventing heart disease and strokes in individuals with type 2 diabetes.
The Bypass Angioplasty Revascularization Investigation in Type 2 Diabetics Trial, or BARI 2D, a 5-year clinical trial, will compare medical versus early surgical management of patients with type 2 diabetes who also have various forms of heart disease. The BARI 2D trial is also studying how different strategies used to control blood glucose affect a patient's risk of developing heart disease.

The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov. Here you will find information about a trial's purpose, who may participate, locations, and phone numbers for more details. View a list of the current clinical trials on diabetes. A separate window will open.

NIH SeniorHealth
National Institute of Diabetes and Digestive and Kidney Diseases

Last updated: 08 December 2004