Diabetes Therapy
Significant advances have been made in diabetes therapy in recent years. People with either type 1 diabetes or type 2 diabetes can now be treated much more precisely than in the past.
Through the identification of subtypes of diabetes, clinical studies in particular are delivering new insights into how diabetes can be managed as effectively and precisely as possible.
New types of insulin that only have to be injected once a week, such as basal insulin, are now available for people with type 1 diabetes. Closed loop systems (“artificial pancreas”) allow for insulin therapy in which blood glucose monitoring and insulin administration are largely carried out automatically.
The transplantation of insulin-producing beta cells is being tested for patients with type 1 diabetes who do not achieve a satisfactory treatment outcome despite optimal diabetes management.
There are also several developments and new approvals in the drug therapy of type 2 diabetes, especially regarding so-called receptor agonists. These synthetically produced peptides mimic the function of natural peptide hormones from the intestines and pancreas, thus promoting the release of insulin. Additionally, they slow down gastric emptying and enhance the feeling of satiation. This facilitates weight loss for people who already have overweight, which is commonly associated with type 2 diabetes.
Therapy of Type 1 Diabetes
In people with type 1 diabetes, endogenous insulin production decreases until it stops altogether. Because very little or no insulin is produced if diabetes is manifest, this type of diabetes requires the exogenous administration of the missing insulin. There are multiple ways to do this: by injection, pen or insulin pump. Furthermore, various types of insulin are available, which have different effects and are used in an individual manner.
Hybrid closed loop systems are a relatively new development in the treatment of type 1 diabetes. Here, a continuous glucose monitoring (CGM) system measures the glucose levels in the tissue, while an algorithm automatically calculates the amount of insulin to be delivered to an insulin pump based on the values.
Therapy of Type 2 Diabetes
Unlike people with type 1 diabetes, individuals with type 2 diabetes still produce insulin for many years after developing the disease. Nevertheless, due to the presence of insulin resistance, the insulin does not act properly on the body’s cells, meaning that they do not absorb glucose. Insulin production continues to decline over time with the condition, while insulin resistance usually remains present.
Change in Diet and Increased Physical Activity
Basic therapy for type 2 diabetes initially consists of a change in diet and regular exercise. Training for affected individuals is another important part of diabetes therapy.
Drugs to Treat Diabetes
If lifestyle changes are insufficient to treat type 2 diabetes, drugs can generally be used to lower blood sugar. They can be taken as tablets (oral antidiabetics) or injected into the subcutaneous fatty tissue (e.g., GLP-1 receptor agonists).
Insulin therapy may also become necessary to treat type 2 diabetes as the disease progresses. The appropriate type of therapy should be determined on an individual basis together with the patient. Recommendations for this can be found in the guidelines of the German Diabetes Association (DDG).
Type 2 diabetes: Treatment (diabinfo.de)
Digital Health Applications (DiGA)
People with diabetes can now also be supported by digital health applications (DiGAs). These are smartphone apps that are prescribed by the physician and are reimbursed by health insurance providers.
Everyday life with diabetes (diabinfo.de) (in German)