Health Insights: Diabetes Cure? | HealthiNation

Uploaded by HealthiNation on 12.04.2012

DR. HOLLY ATKINSON: Welcome to HealthiNation! I'm Doctor Holly Atkinson. There is a lot
of promising research that's happening in the diabetes world; but will any of it lead
to a cure? Dr. Derek LaRoith, Chief of the Endocrinology, Diabetes and Bone Disease Department
at the Mt. Sinai School of Medicine, shares his insights. Why is diabetes so bad?
DOCTOR DEREK LeROITH: Because diabetes affects virtually every organ of the body, every tissue's
affected. Patients with diabetes develop complications which can affect the eyes, the kidneys, the
heart, they can develop more cancer than in the normal population. And since this is a
growing epidemic throughout the world, we're gonna see more 'n' more of these complications.
DR. HOLLY ATKINSON: Do you think patients really understand how severe the complications
can be? Have we gotten that word out?
DOCTOR DEREK LeROITH: No, I don't think so; I think patients actually, uh, try to avoid
thinking about these complications 'cuz if they were aware of them and we're able to
educate them about them, perhaps they would take better care of themselves.
DR. HOLLY ATKINSON: Let's say you have an ideal patient who does absolutely everything
right, can they reverse their diabetes?
DOCTOR DEREK LeROITH: Reversing diabetes, uh, is an interesting term. Can you change
things? No, you will always be a diabetic but your blood sugar can be perfectly normal.
So we have individuals who are so particular about their diet and their weight that they
in fact don't take medication because their weight is perfectly normal and they don't
eat simple sugars that raise their blood sugar after their meal and if you measure the hemoglobin
A1C over a year or two, it's always in the normal range, so there are some patients like
that, but it's the exception.
DR. HOLLY ATKINSON: We've heard a lot about the effects of bariatric surgery and some
people even suggest that it's a cure.
DOCTOR DEREK LeROITH: Bariatric surgery has been shown to be very helpful in reversing
the high blood sugars and bringing the A1Cs down into the normal range, in fact, even
taking patients off medication because their blood sugars are now normal. So, it reverses
the diabetic state but it doesn't cure diabetes because in fact, if you wait five or six years
and you watch the outcomes of many of those patients, some of them either put on work
and some of them, the high blood sugar returns. And the reason for that we believe is even
if you keep your weight off, years later the beta cell, the insulin-producing cells, may
in fact, still deteriorate, and so, in many of those cases, the diabetes will come back
and it will require medication. So I don't like to call it a cure.
DR. HOLLY ATKINSON: We got some questions from some people with diabetes; Sara asks,
we've heard a lot about islet cells, stem cell research, et cetera, but are we any closer
to finding a real cure for Type I diabetics?
DOCTOR DEREK LeROITH: The cure by finding stem cells which will develop into islet cells
is a long way off; the main reason is to get a supply of stem cells which we can then give
to the Type I diabetic by injecting say, into the liver where it'll produce insulin and
then come off their insulin needs. The problem with those is the rejection by the patient;
we really have to find good preventative medication that will prevent the rejection and people
are working on both: developing the islet cells, either through stem cells or other
means and there are people who are testing the prevention side. When those two come together,
we'll be able to say we've cured diabetes.
DR. HOLLY ATKINSON: What are the burning questions that you would love to have answered about
diabetes that you don't have right now?
DOCTOR DEREK LeROITH: Well, I don't know what causes diabetes. We know it's genetic, we
know that people have found certain genes. But what we'd really like to know is how do
these genes interact because if we understand more about the genetic background, and we
certainly understand a lot about the environmental effect of overweight, obesity driving the
diabetes, but if we know more about the genetics, we'd understand more about where to target
the new therapies. I'm looking for the gene targets that can improve the medications that
we could derive in the future for our diabetic patients.
DR. HOLLY ATKINSON: And how far off do you think success is in that area?
DOCTOR DEREK LeROITH: I hope in my lifetime we'll, uh, have some success.
DR. HOLLY ATKINSON: So, here's the insight: the complications of not treating your diabetes
properly can be severe; so hopefully, this knowledge will help you take control of your
health by committing to keeping your blood sugars under good control. And while bariatric
surgery is not a cure for diabetes, it is an important treatment option for those who
are having difficulty losing weight and lowering their blood sugar. A cure for diabetes may
be a long way off but there is promising research being done every day.