REVIEW – August 2007

New treatment options for type 1 diabetes


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The increasing prevalence of diabetes worldwide is the cause of concern both in terms of associated morbidity and increasing health costs. This review aims to focus on new treatment options for type 1 diabetes: insulin pump therapy, inhaled insulin, pancreas and islet transplantation. Many studies have shown benefits for improved glycaemic control and reduced rates of hypoglycaemia with insulin pump treatment compared with multiple daily injections. Inhaled insulin is short-acting insulin which can be used at mealtimes in combination with injected basal  insulin. Studies have shown that the efficacy of inhaled insulin is comparable with that of subcutaneously injected prandial human insulin. Pancreas transplantation has been accepted as preferred treatment for patients with type 1 diabetes mellitus and advanced diabetic nephropathy with end-stage renal disease. Islet transplantation offers the potential to improve glycemic control in a subgroup of patients who are disabled due to refractory hypoglycemia. Transplantation patients require lifelong immunosuppressive treatment. The main limitation of this method is lack of availability of donor pancreas.