A continuous search for new ways to treat diabetes has explored multiple scientific areas that include gene therapy, medical nutrition and herbs, stem cells, and the development of various new drugs. The effectiveness of the new therapeutics depends on their ability to treat or relieve one or more of the metabolic issues. They may increase the production of insulin or enhance glucose uptake and utilization by the body tissues. In addition to new generations of therapeutics, several other classes are also considered as alternative strategies for diabetes treatment.
Mesenchymal stem cell therapy is considered a promising therapy in treating type 1 diabetes due to its ability to inhibit the activity of the immune system. The hematopoietic stem cells are the cells that can give rise to all types of blood cells and also have an effect on the functioning of the immune system. Therefore, the transplantation of hematopoietic stem cells has shown improvement in the function of the pancreas β cells in patients newly diagnosed with type 1 diabetes.
Nevertheless, the research has various limitations due to the absence of reliable methods for generating specific cell types, difficulty in the purification of particular cell lineages, and immunological rejection of the transplanted cells. Still, the application of stem cell technology is thought to be a promising approach in treating diabetes.
Gene therapy involving the somatic cells of the body has two methods of gene delivery. The first one is known as ex vivo gene therapy. In this case, the therapeutic gene is inserted into the removed tissue, which is then reimplanted back in the body. This method aims at the generation of cells possessing the properties of insulin-producing cells. However, there exist some concerns about surgically removing and reimplanting modified tissues.
On the other hand, in vivo therapy involves inserting gene therapy vectors directly into the organism by injection. It is the method of choice because the procedure is simpler, but the development of safe and effective vectors remains a challenging task for gene therapists. Currently, strategies for in vivo therapy include the transfer of glucose-lowering genes, enhancing glucose utilization by the liver or skeletal muscles, and inhibiting glucose production.
Medical nutrition therapy
The goals of nutritional therapy for diabetes are to regulate sugar and lipids levels in the blood and maintain healthy body weight. Such treatment depends on certain factors such as the patient’s age-based nutritional requirements, food preferences, exercise regime, and abilities, considering any other medical conditions. Protein intake should constitute about 10–20% of all calories; total fat intake should be restricted to <30% of all calories. Diet should include high fiber consumption and restriction of sodium (2400–3000 mg/day) and alcohol (≤2 drinks/day in men, ≤1 drink/day in women). Multivitamins should also be included in the diet.
Many bioactive drugs isolated from plants with glucose-lowering effects demonstrate sufficient antidiabetic activity. Some plant species rich in bioactive components (like terpenoids, phenolics, flavonoids) have shown a reduction in blood sugar levels. Several plants like garlic, onion, curry tree, ashwagandha, asafoetida possess antidiabetic properties that were demonstrated in experimental models of diabetes.
Leptin therapy is one of the emerging trends in diabetes treatment. Leptin is a hormone secreted by fat cells, which acts on the neurons of the central nervous system. The multiple functions of this hormone include control of excessive weight gain by suppressing the food intake and increasing the expenditure of energy. It also regulates glucose homeostasis by activating leptin receptors. Leptin therapy improves type 1 diabetes characterized by insulin deficiency through central nervous system-dependent mechanisms in mice.
Relatively recently, a new target in diabetes treatment research was found: insulin inhibitory receptor called inceptor. In experiments with mice models, it was shown that the function of the inceptor is to shield the insulin-producing beta cells from the activation pathway. Inceptor is upregulated in diabetes, and blocking insulin signaling might contribute to insulin resistance. However, if the function of the inceptor is inhibited, insulin signaling and beta-cell functioning are increased. This property opens more possibilities for new ways to treat diabetes in the future.
Research on new antidiabetic therapeutics is constantly being conducted. And regulatory authorities must prove any new therapy before it is put on the market. It is also essential to get a consultation with a doctor before any experimental treatment is started.