Recent research has highlighted some positive news regarding both the control and the consequences of diabetes - but experts are cautious about the full implications and continue to emphasise that simple lifestyle choices are still the best method to moderate the risks of contracting Type 2 diabetes.
Diabetes is a condition whereby the body's natural process for managing the production of glucose either never worked (Type 1 diabetes) or became inadequate or inefficient at some point (Type 2 diabetes). It is a condition that is seen as reaching epidemic proportions across the world.
In the UK, the number of people diagnosed with the condition has doubled to some three million in only twenty years. Treatment of the disease itself and its grave consequences including cardiac arrest/failure, stroke and kidney disease are major challenges for health services across the world.
Diabetes, combined with these very serious complications has meant that people with the disease have experienced higher mortality rates than their peers . However, research in Canada has suggested that these heightened mortality rates may have become less marked in the recent past.
In the mid 1990s the data indicated that people with diabetes were, in a given time period, almost twice as likely to die as were those without it. By 2009, although the raised mortality rate was still present, it has fallen to an increased risk of about 50%. The data consisted of statistics from some 3 million people with diabetes in the UK and some 10 million in Canada. In the UK alone, the 'excess' death rate fell from 114% to 65% and from 90% to 51% in Canada. This narrowing of the death rate gap was consistent across all age groups and for both men and women.
However, while acknowledging the positive aspects of the research results, clinicians emphasised that the full interpretation of the data required some caution and that the deep underlying causes needed further research before they could be fully understood.
Data may reflect more comprehensive treatment of the disease in particular relating to management of both blood pressure and of levels of sugar in the blood. Other factors however, included improved screening for a wide range of illnesses which meant that diabetes was actually being identified at a much earlier stage in its development in patients and that this was having some impact on these reported mortality rates.
The other intriguing development with regard to diabetes care came from a wholly unexpected quarter with people who have undergone a gastric bypass to counteract problems of obesity also finding that their Type 2 diabetes had been eradicated.
Loss of weight will, of itself, impact on diabetes but the evidence has been that some people undergoing the bypass treatment have had their diabetes cured even before they have actually experienced any weight loss.
Research into this phenomenon was undertaken at the Boston Childrens Hospital and used rats to model the processes that may be set in motion by a gastric bypass. The rats underwent an operation that connected the opening of the stomach to the small intestine - bypassing the stomach in the digestive process - and then scanning techniques were used to track the progress of food through the rats' system.
Research suggested that the process of digestion within the intestine itself used up the diabetes causing 'excess' sugar as the body had to work harder in the absence of the contribution made by the stomach. In addition there is, in effect, some redesign of the intestine itself to adjust for the new arrangements which also absorbs some excess sugar. Overall the research concluded that around 64% of the reduction in sugar levels that a gastric bypass brings about is due to the additional activity taken place as a consequence within the intestine.
There is no suggestion that people should go through the highly invasive process of gastric bypass as a means of 'curing' diabetes but the researchers in Boston are hopeful that further investigation of the process they have uncovered may have more general benefits to those with diabetes - possibly through some activation of the intestine to produce the same effect without recourse to surgery.
Diabetes UK, the charity which funds and leads research into the condition in the UK, has noted the results of this research but counsels that any new treatment that results from this work is still probably many years away.
Globally, researchers continue to stress the benefits that modification to lifestyle can have in preventing the onset of type 2 diabetes and underline the benefits of a healthy and balanced lifestyle, combined with regular exercise.