A study published in 'The Faseb Journal' has discovered a dual peptide (PGLP-1) that could inhibit gluconeogenesis, improve glycemic control and increase insulin resistance in type 2 diabetes. Experts consulted by CF are cautiousin an animal experimentation phase and analyze the most promising treatments that will mark a before and after in the approach of diabetes and are already close.

A study published last week at The Faseb Journal, carried out in rodents, has discovered a dual peptide (PGLP-1) that could inhibit gluconeogenesis, improve glycemic control as insulin therapy in type 1 diabetes and increase theInsulin resistance in type 2 diabetes. Although it is a relevant finding, experts consulted by CF, they are cautious because they are "one more molecule of the many that are in the phase of animal experimentation and continue to point to prevention as the best treatmentFor this disease.

In any case, Rebeca Reyes García, coordinator of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN), highlights the capacity of the peptide to "stimulate and/or regenerate the beta cell", something for which not which does notThere are drugs today.His opinion is endorsed by Albert Goday, president of the Catalan Diabetes Association, which highlights the decrease achieved in gluconeogenesis mice, which in "many patients is the most important factor of hyperglycemia."

some 'buts'

However, Goday points out two adverse effects that can be seen in essays with mice.On the one hand, the weight gain, which would be "an inconvenience" for type 2 diabetes, so that the advantage that is achieved with other analogues of the LPG-1 of weight decrease would be lost.On the other, the proliferation effect of beta cells, which "is interesting because it would avoid the exhaustion of these", but could have oncogenic effect. "

In the treatment for type 1 diabetes, José Ramón Calle, of the Endocrinology Service of the San Carlos Clinical Hospital (Madrid), highlights the development of the analogues of insulin of ultra-ultra rapid action, which throughout this year is expectedThat they are already available in some countries and that, according to street, they look great in their action profile "to the insulin that secrete non -diabetics".

Antonio Pérez Pérez, vice president of the Spanish Diabetes Society (SED), also mentions the development of "smart insulins", which could be prescribed in type 1 diabetes such as 2 and that, unlike those of todayWhat the patient does, adapt the dose to the circumstances of each one.

Another expected advance in type 1 diabetes, according to both experts, is the artificial pancreas, which adapts to the daily life of patients without having to monitor or make adjustments."If for many years this was something very distant, now it is getting closer," says Pérez Pérez.So much so that, according to street, today this artificial pancreas "already works wonderfully" at night.During the day, however, physical activity and food intake cause current technology "not yet to take changes in insulin levels" to create an "totally reliable" artificial pancreas.

The experts consulted agree that the biggest challenge in type II diabetes is prevention."In the most immediate future, the challenge is to stop the exponential increase in obesity to, secondarily, prevent diabetes in a percentage that will never get any drug," says Pérez Pérez, which figure between 70 and 80 percent theCases of type 2 diabetes that would not exist if obesity was eliminated.

wide therapeutic arsenal

Developed theDisease, Street is committed to "intensify the treatment, take advantage of the many families of existing drugs without falling into therapeutic inertia and marking and fulfilling rigorous control objectives."

Goday concludes that the challenge would be based on treatments "that reduce excess weight in a safe and effective way, without side effects on the cardiovascular system; and delaying or avoiding the deterioration and exhaustion of beta cells."

administrative obstacles

More and more effective therapies for diabetes develop.However, Albert Goday, of the Catalan Diabetes Association, criticizes "existing administrative limitations to prescribe many of these drugs, which are authorized, have a technical file to use them, all regulations have passed, but which are simply more expensive"

In his opinion, "institutional guides are very restrictive to the oldest drugs, which work, but do not have the advantages of the new ones."His vision is shared by Antonio Pérez, of the Spanish Diabetes Society, who points out that in the crisis situation, with the attempt not to increase health spending, there are "important obstacles."

José Ramón Calle, of the San Carlos Clinic (Madrid), also regrets that in Spain innovation usually comes "with delay" or with "bureaucratic pegas".

in five ideas

1. Prevalence
According to the seventh edition of the Atlas de la Diabetes (2015), of the International Diabetes Federation, in Spain the prevalence of 14 percent in over 18 years.

2. Health challenge
For professionals and for the authorities the exponential increase in the number of diabetics makes the disease a challenge for health systems.

3. Obesity
From the Spanish Diabetes Society it is claimed that between 70 and 80 percent of the cases of type 2 diabetes
They would not existed if obesity was eradicated.

4. Pharmacological therapy
In the field of pharmacology, a challenge for medications that are yet to come through delaying or avoiding the deterioration and exhaustion of beta cells.

5th near future
According to experts, the development of an artificial pancreas is increasingly a reality.This would be a great advance for the treatment of type 1 diabetes.