Advancements in medical science over the years have made many enigmatic diseases treatable. However, at present, there is a paradigm shift in treating diabetes not only to fight the pathology of a disease but also the gene-environment-induced physiological implications of the disease.

Gone are the days when infections caused septic shocks and sudden deaths. Today, lifestyle-induced chronic diseases like hypertension and diabetes are major killers that debilitate the majority of the adult population.

From the point of view of pharmacological companies investing in diabetes (diabetes mellitus and diabetes insipidus), research makes sense. Chronic disorders require long-term medication, translating into long-term revenue that reaps excellent dividends on the R&D investment.

Diabetes: cause and effect

Lack of insulin production or insensitivity to it is the primary culprit when it comes to diabetes. Elevated blood glucose levels that result in a plethora of complications like retinopathy, neuropathy, and increased risks of cardiovascular diseases are the hallmarks of Type II Diabetes.

Conventional treatment and side effects

Straightforward diabetes treatment paradigms try to counter common diabetes symptoms by medicine or by following a diabetes diet chart. Standard diabetes medicine like metformin or phenformin to restore normal blood sugar levels (diabetes range).

However, the severe side effects of biguanides (phenformin), like fatal lactic acidosis, have led to country-wide bans for these classes of drugs. The ban (on phenformin), together with the industrial production of insulin, was the next line of treatment. But now researchers have gone beyond the insulin pen shots you had to take before eating a meal. Advanced research on Diabetes is focussing on the “legacy effects of diabetes”.

The Paradigm Shift in Treating Diabetes

“Legacy effects of diabetes” posits that short-term and quick interventions post-diagnosis help reduce the potential long-term impact of diabetes. HbA1c (a glycated Haemoglobin used as a measure for diabetes) levels, if curbed early, reduce the risk of cardiovascular diseases. Studies on the legacy effect of metabolic memory are valuable as they prove that metabolic control in the early natural history of illness influences prognosis in later life.

Diet and weight control in early life (young children) have opened up new dimensions in diabetes prevention and control. Studies are now focussing on why young obese (pre-diabetic) children cannot overcome their hunger pangs despite strictures. In obese children, the brain’s satiation center most likely works differently, making them eat even when their stomachs are full, predisposing them to diabetes.

Obesity and lifestyle choices have long been blamed for the ever-increasing burden of chronic disease, but it is only now that treatments are focused on the root cause of the disease. Another interesting link with the increasing burden of diabetes is its linkage with a molecule called Bisphenol A. Bisphenol A, often found in polycarbonate plastics (bottles, food can coatings, water supply pipes), is an endocrine disruptor that is implicated in the development of diabetes.

In short, the past decade has seen a paradigm shift in treating diabetes and its control. The top-down approach of using a drug that relieves the most easily measurable symbol (glucose levels) has been done away with. Now treatment measures are becoming more wholesome where the physiology, behavior, genetic, and environmental interaction are considered to deal with this life-threatening long-term disease.