9 Innovations in Type 2 Diabetes Treatment
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In a few short decades, type 2 diabetes research and technological breakthroughs have brought about significant advancements in how the condition is treated and managed. Here are some of the top innovations that are helping people with type 2 diabetes better manage the condition today.
1. Insulin Pumps The first insulin pump came on the market in 1974. Previously, insulin pumps were only approved for use in those with type 1 diabetes. But if you have type 2 diabetes and have to inject insulin multiple times a day, a pump is an alternative to self-injection. “An insulin pump is a medical device that delivers insulin into the tissue just underneath the skin,” says Megan Porter, RD, CDCES, a certified diabetes educator in Portland, Oregon.
This computerized device, which is about the size of a deck of cards, can be worn around your waist, put in a pocket, secured with an armband, or attached to a belt or bra. “Some pumps deliver the insulin continuously, and others only deliver the insulin at meals or large snacks,” adds Porter. An insulin pump can also be more convenient if you’re out or at work, because all you may need to do is push a button to deliver the insulin instead of giving yourself a shot.
2. Continuous Glucose Monitors (CGMs) These devices have a tiny sensor that is placed below the surface of the skin to measure the amount of glucose in the fluid between cells every few minutes and transmit the data wirelessly to a device or your smartphone.
CGMs are a game-changer: Unlike glucose meters that require a drop of blood to check what your blood glucose levels are at that moment, CGMs monitor your levels at set times throughout the day, such as every five minutes. This can help you and your doctor identify patterns and trends that may be helpful in fine-tuning your type 2 diabetes treatment plan to optimize management, according to the American Diabetes Association (ADA). These devices can also alert you when your glucose level is too low or too high.
The first CGM, which involved wearing a device provided by the doctor for two weeks or less and then returning it to the clinic or hospital, was approved by the U.S. Food and Drug Administration (FDA) in 1999. Since then, CGMs have become increasingly accurate and much more widely available for home use. In the past five years, there have been even more advances in CGM therapy. In 2018, the FDA approved the first implantable CGM device, which can be worn up to three months without changing the sensor, for people with type 1 or 2 diabetes.
“The benefit of using a CGM is that it can be worn for seven or more days, which means one poke to insert the monitor [during that time frame] replaces checking blood sugars via a finger poke three or more times per day,” Porter notes. CGMs make it easier to check your blood sugar before and after meals, and they can help you understand how your diet, activity, and lifestyle affect your blood sugar levels.
3. Connected CGM-Insulin Pumps Another option available is a combination CGM-insulin pump, which enables the pump to use the data from the CGM to suggest changes in medication dosing or make necessary adjustments on its own. In 2020, the FDA approved an integrated CGM, which allows it to be connected to other diabetes management devices, such as insulin pumps and blood glucose monitors.
This integration of devices can help improve type 2 diabetes management by quickly reducing blood sugar and minimizing the amount of time you experience unsafe and unhealthy blood sugar levels.
4. Diabetes Medications Although insulin has been used in the United States since the 1920s, according to the FDA, today’s medications can be far more targeted for specific diabetes issues.
Metformin, which belongs to a class of medications called biguanides, is often the first medication prescribed for type 2 diabetes. “Metformin decreases glucose absorption from food and decreases liver production of insulin,” says Porter. Other options, including oral medications and noninsulin injectables:
- Sodium-glucose cotransporter-2 (SGLT2) inhibitors are oral medications that lower blood sugar levels by preventing the kidneys from absorbing glucose.
- Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are injectable medications that help you control appetite and blood sugar levels.
- DPP-4 inhibitors, also called gliptins, are oral medications that help manage diabetes in several ways, such as by enhancing insulin secretion, slowing down digestion, and decreasing appetite, which can help with weight loss.
- Thiazolidinediones, also called glitazones, are oral medications that help make your body’s tissues more sensitive to insulin.
- Sulfonylureas are oral medications that increase the release of insulin from your pancreas.
- Meglitinides are oral medications that help your body make more insulin around mealtimes.
- Alpha-glucosidase inhibitors are oral medications that help your body digest sugar more slowly.
- Combination therapies join multiple drug classes in a single medication. They may be injected or taken orally.
“And, of course, insulin is still used as a replacement when a person’s body does not create enough insulin on its own,” Porter adds.
5. Insulin Innovations Insulin has come a long way since it was first discovered. It now comes in a variety of forms, including rapid-acting, long-lasting, and premixed formulas, and can be delivered via a number of methods, such as syringes, pumps, and pens. And innovations are still coming. For instance, there are now insulin pen devices that can remember the last dose and the time that it was given, which is especially helpful if you’re busy or tend to forget to take it. Smart insulin pens have many of the features of insulin pumps but cost less and don’t have to be attached to your body.
According to the ADA, smart insulin pens can connect to your smartphone or watch and link to diabetes data-tracking platforms to help you accurately calculate each dose based on factors such as your blood sugar level, carb amounts, meal size, and other parameters prescribed by your doctor. These devices can also remind you to take your dose, keep track of the amount of each dose, and tell you when your insulin has expired.
6. Easier-to-Use Glucagon Glucagon is used in emergencies to treat very low blood sugar, or hypoglycemia, a dangerous condition that can lead to confusion, loss of consciousness, seizures, and even death, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Glucagon injections have been available for more than 20 years, but in the past few years, devices such as injectable pens and glucagon that can be inhaled have made it much easier for you — or your family or friends — to administer glucagon in the event of an emergency.
7. Better Support for People With Diabetes In the past, many people with type 2 diabetes were treated by their primary care physician — rather than an endocrinologist, who is trained to treat diabetes — who may not have had any special training in the complexities of type 2 diabetes management. Today, there are many specialists who can help. Since the 1980s, certified diabetes educators have transformed diabetes management, according to the ADA. These professionals, who are now called certified diabetes care and education specialists (CDCES), take a comprehensive approach to teaching diabetes management and specialize in educating and supporting those with diabetes to optimize their health.
Diabetes educators can also connect you to dietitians, physical therapists, and mental health experts trained to help with the condition. “Hopefully, over time, more people with chronic conditions, such as diabetes, will be referred out to other healthcare professionals who can help them manage their condition physically and mentally,” Porter says.
8. Diabetes Smartphone Apps Yes, there’s an app for that — many of them, in fact. Nowadays, diabetes apps can track your blood sugar levels and show trends; monitor your diet and suggest recipes; log your exercise; and provide support from other people with diabetes. “Coaching apps can also give you access to highly trained diabetes educators and fitness coaches,” Porter says.
But it’s important to check with your doctor, CDCES, or other trusted diabetes health professional before you choose an app. An article in the journal Diabetes Care noted that there isn’t sufficient evidence to back up the effectiveness, accuracy, and safety of many apps, and many are plagued by technical problems. The authors noted that regulatory agencies and app companies urgently need to work with diabetes health professionals and researchers to ensure the safety and effectiveness of diabetes apps.
9. Meal Delivery Services While they weren’t developed specifically for diabetes, meal delivery companies that offer healthy foods and recipes have become very popular over the past several years. Now, many companies provide diabetes-friendly meal kits if you want to eat healthy but don’t want to do a lot of food shopping and planning.
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