Eradicating Diabetes by 2050 – Mission (Im-)Possible?

Improved sanitation and hygiene practices, vaccination, antibiotics and other antimicrobial medicines have to be thanked for eradicating many deadly diseases. In the future, experts expect even faster progress in curing many conditions endured by a large portion of the world population. Major bets are placed on digital health technologies. Diabetes is no exception. 

Manage vs. eradicate: ongoing scientific and technological (re-)volution 

While there is no real cure for either type at the moment, there are grounds for optimism. In the last several decades significant progress has been achieved in the fields of immunotherapy and stem cell research. 

“While a complete cure is still many decades away, changes in lifestyle can make diabetes manageable. Since the FDA (U.S. Food and Drug Administration) approval of CGM (continuous glucose monitor) in 1999, patients no longer need to prick their fingers every time they need to measure their insulin levels. Still, the CGM sensor needs to be replaced every two weeks,” shares Kasparas Aleknavicius, MD, Head of Medical Affairs at Kilo Health. 

In Kasparas’ opinion, the CGM technology will be improved to lengthen the time between CGM replacements. In time, with advancing sensor technology, researchers should find a solution to eliminate the need to replace CGMs altogether. 

“In this respect, the company Eversense has made the most considerable progress thus far,” says Kasparas. “Since 2018 they have been selling an implantable glucose sensor that can be kept under the skin for as long as 90 days. The only drawback is that the small surgical procedure that is required to implant the sensor carries with itself a risk (albeit very small) of infection.”

Anticipated advancements in combined use of CGMs and insulin pumps

Meanwhile, another notable solution involves combining the use of CGM technology with insulin pumps. It allows creating a so-called closed-loop system, or artificial pancreas. “This technology gets developed and improved as we speak. I am talking about such features as built-in bolus (a single dose of a drug administered automatically, as needed) calculators, personal computer interfaces, and alarms.”

In terms of type I diabetes management, the other field that looks highly  promising is immunotherapy. “This type of diabetes is commonly caused by an autoimmune reaction (the body attacking itself by mistake). Therefore, reprogramming the immune system to recognize and refuse to attack insulin producing beta cells could be the answer. At this time the treatment is only experimental, but the future’s looking bright. Once perfected, it could stop type I diabetes in its tracks or prevent the condition entirely. There is no drug approved by the FDA yet, but there are already several submissions pending approvals.” 

Are you at greater risk? Prevalence and link to lifestyle choices

According to various sources, you are about 15 times less likely to suffer from type I diabetes than its type II counterpart. Type I usually manifests itself in children, teens, and young adults. Type II is more often diagnosed for patients aged 45 and above. Type II diabetes is also directly linked to being overweight and inactive. For both types, family health history plays an important role. 

Both types of diabetes can start with only mild symptoms that often go unnoticed for quite some time.  

“Unfortunately, some people do not experience any noticeable symptoms apart from minor changes in their energy levels, allowing the condition to progress for years,“ explains Kasparas. „In case of type II diabetes, an improvement in lifestyle, such as taking up a sport or changing a diet, can reverse the effects of an early onset condition.”

No one-size-fits-all and the need for individualized solutions

The biggest obstacle to developing a cure for type I diabetes is the fact that humans differ in their  genotypes and physiology. In the meantime, type II diabetes can be rather easily reversed or even  eradicated. We just have to individualize the treatment to the finest details.

“We say “easily”, but changing an individual’s behavior is anything but easy,” says Kasparas. “Luckily, digital healthcare technologies have gone a long way to make these changes easier to make.” 

According to Kasparas, the main advantage of modern technology is that it helps humans make more informed, data-driven changes based on more precise individual needs. “I am talking about remote synchronous and asynchronous communication with diabetes and nutrition specialists, mobile apps to readjust drug dosage on their own, and others.”

There is also a growing spectrum of digital solutions that is currently not fully utilized. It is aimed at satisfying the unmet needs of diabetes patients, like mental health and personal quality of life.

The verdict: mission possible, but healthy lifestyle will remain key

There is a reason why Kasparas, like most medical professionals, is skeptical about the so-called “miracle cures” that have been flooding the Internet for many years. Not unlike magical weight loss recipes, these are neither realistic nor sustainable. In many cases, they are harmful and dangerous.   

Yet, there is a bright silver lining. Companies continue investing big into digital solutions to facilitate our efforts to prevent, cure, or manage a wide spectrum of conditions. And, diabetes is no exception. They address what traditional medicine tends to overlook or underestimate – personalized behavioral change based on accurate data of how a diabetic body reacts to different stimuli.