Diabetes prevention in the works at NIH


“I had no idea I could be diabetic or have anything like that,” said Andy Streich, a Type 2 diabetes research participant.

Streich was in the hospital for something totally unrelated when his doctor discovered his condition.

“He said, ‘Well, you are diabetic and if you don’t pay attention to that, you’re going to go blind and have your feet amputated,’” Streich said.

Sound extreme? It’s not.

Untreated diabetes can also lead to kidney or heart disease.

A little over 9 percent of Americans have diabetes.

Both Type 1 and 2 diabetes are genetic and involve high blood sugar levels, but the reasons for these levels are different.

“Type 1 diabetes is an autoimmune disease, which means that the immune system mistakenly attacks the cells in the pancreas that produce insulin,” said Dr. Judith Fradkin, director of the division of diabetes, endocrinology, and metabolic diseases at NIDDK.

So, Type 1 patients need to inject insulin.

“Type 2 diabetes usually starts off with people becoming resistant to the action of insulin, which helps blood sugar get into the muscles and the other organs,” Fradkin said.  “Then gradually, the cells and the pancreas that make insulin aren’t able to produce enough insulin to overcome the body’s resistance to it.”

Type 2 is treated with drugs like metformin.

Diabetes treatment is demanding.

“They have to think about what they eat. They have to think about a treatment, they have to take the treatment as prescribed as scheduled,” said Heidi Krause-Steinrauf, GRADE Coordinating Center.

New research studies are looking to make living with diabetes easier.

“I want to do my part,” Streich said.  “I’m diabetic. I want to contribute to the research.”

Andy is one of thousands of participants in a study nicknamed GRADE, which is looking at the most effective, long-term drug combinations for when metformin is not enough.

“This question of what’s the long-term benefit of each of these given treatments was probably the number one unanswered questions facing physicians that are trying to treat subjects with diabetes today,” said John Lachin, Sc.D., GRADE Coordinating Center.

When it comes to Type 2 prevention, Dr. Fradkin said an ongoing study is looking at Vitamin D.

But both types can be triggered by environmental factors.

“Making a change and losing about seven percent of your body weight can reduce your chances of developing Type 2 diabetes by more than half,” Fradkin said.

With a few lifestyle changes, like regular exercise and eating right, Andy said he feels better all around.

For Type 1 diabetes, the road to prevention is longer.

Researchers are currently studying 8,000 kids for a 15 year span

“We’re gonna measure all of the different chemicals in their blood, all of the viruses and bacteria in their stool, and hope that something pops up that we had no idea was either associated with increased risk or that was associated with protection,” Fradkin said.

Meanwhile, Dr. Fradkin said routinely controlling your blood glucose levels will dramatically decrease complications with the disease.

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