As oncologists race forward with new treatments verging on science fiction and biotech companies press on with drugs for once-hopeless rare disorders, one of the world’s most pervasive diseases looks like it’s been left behind.

There are few new drugs on the horizon for diabetes, which affects about 29 million Americans. Most of the treatments in late-stage development are simply improved versions of what’s out there — taken weekly versus daily, or orally instead of by injection.

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  • This is a very poor quality article, there are many exciting diabetes projects underway. Also, people saying T2D is solely the cause of “bad lifestyle” is a nonsense. Olympic athletes have experience elevated blood sugars!

    • You are equating physical fitness with health. They generally go hand-in-hand, but not always. In the same way, diabetes is not always caused by lifestyle choices, but usually, and one will never know for sure until one fixes one’s lifestyle.

  • PW, my comment does NOT include T1D. I sure wish they weren’t both called the same thing. They may both be about blood sugar, but T2D is about too much insulin and T1D is about too little insulin. So they are completely different diseases at their causal level. Sorry about that.
    95% to 100% of T2D is caused by human behavior. Probably 0% of T1D is caused by human behavior. (:->)

    • I think again T2D causes are being generalized. For everyone it is not lifestyle. I have it and all my life I have maintained a healthy lifestyle however as I am getting older it is getting harder to control. Please do not generalize so much due to stereotypes. Just because you see obese people with diabetes it does not mean all of them have bad lifestyle.

    • Patty, what I am trying to say is that the conventional definition of “healthy” is not healthy. I also was living what I thought and was told was a healthy lifestyle, with large plates of fettuccine alfredo, tacos, and other non-paleo foods. Then I got diabetes and some intense pain. Now I am doing much different and much better with a paleo diet with a strong emphasis on fresh veggies and DIY sprouts. My heart rate is regularly below 50 with a low of 47.2. Almost all of my diabetes symptoms are completely gone. I sleep really good. And I wake up with my male morning libido indicator indicating. (:->) And I am 71 years old, just like Arnold S.

      Conventional health advice is lame at best, certainly not optimal.

    • Actually Roger, your explanations of T1DM and T2DM are incorrect. They both deal with not enough insulin. i.e T2DM is not too much insulin.
      Here’s the difference.
      T1DM: Condition where patients lose their ability to make insulin. Beta cells in pancreas makes insulin, for a multitude of reasons – genetic and environmental. These cells stop working and hence can’t produce insulin. ~90% of T1DM is autoimmune in nature. In this case, patients make very little to no insulin. This is considered insulin deficiency.
      T2DM: In this type of diabetes, patients often times can make enough insulin. Their bodies just aren’t sensitive to the insulin and so insulin has almost no effect in such individuals. This is known as insulin resistance. At its worse, a T2DM patient produces more insulin than a T1DM patient at its best. At some point however, these patients can also lose their beta cells, thereby losing ability to make insulin. This type of diabetes is also linked with multiple genes and environmental causes.

      In either case, you end up with a lot of sugar in your blood rather than in your cells and muscles for use as energy and in your liver to start the process of storing.

  • “Where are all the new diabetes drugs?” I say, “Where are all of those people with diabetes taking responsibility for the mess that they got themselves into and doing something constructive about it, like intermittent fasting, ketogenic dieting, and exercise?” That will work much better than any drug.

    • Some of these comments illustrate that type 1 is misunderstood or left out entirely. Type 1 is an autoimmune disorder. A trigger, such as a virus, causes the body to attack its own pancreas. Without insulin, type 1’s would die quickly. Other meds aren’t relevant. Type 1 requires an enormous amount of work each day- and overnight- straddling the lows from insulin and highs from the disease. I hope comments will include type 1.

  • We need to figure out the cause, not treat symptoms. And who’s doing that? Academia wants to develop technologies without understanding the questions. Industry wants to create money from shorter-term projects. Without groups willing/able to dig deep, how will we move past this impasse?

  • This article gives the illusion that Norvo Nordisc is struggling financially: profits are about 6 billion, 6% up. Meanwhile, the cost of insulin (which for type 1 diabetics is not a choice–its a necessity) has tripled in the last decade. Do we need new diabetes medicines? No. We need less expensive diabetes medicines. What good is new innovation if no one can afford it? And by the way, the CURE for type 2 diabetes is diet and exercise. Innovation for that? Sidewalks and bikepaths; affordable healthy food; tax processed food.

    • Amen, Dr. Jones! I’ll add just one addendum: Unlike the risky side effects that accompany most diabetic meds, the “side effects” of lifestyle health interventions — exercise and a whole foods plant-centered diet– are all GOOD and health promoting!

    • Bravo Dr. Jones. We have Corporate profit making machines (drug and processed food producers) against humanity where it is becoming slave of lethargy and convenience. Points made in the conversation are great but we are just at the verge of forgetting how to walk and talk as we want to get there yesterday.

      There will be NO new drugs that can be mass produced and/or used as they WILL BE expensive and less affordable than every current drug we have. Advertising is going to blind us and company profits will be higher. That is life.

  • One of the issues or threats facing pharmaceutical firms is stem cell research. It’s quite possible at some point in the next, say, 10 years, that pancreas, at least the islet cells, of a diabetic can be “regrown” , implanted somehow in the patient and obviate the need for insulin. This could work for type 1 and 2 diabetics. (Type 2 diabetes is metabolically more complicated but, in the end, many end up on insulin)

    With this technology out there in the not too distant future it just might not make sense for drug companies to make risky long term R&D investments in new drugs, which are even now “half-way technologies”.

    • Of course they don’t want to actually “Cure” these chronic diseases! That would kill their revenue streams. Let’s be honest, the permanent cure for diabetes, heart disease, etc… will need to come from outside the pharmaceutical industry because there is NO incentive to Cure anyone!

    • Not too distant future? I’ve been hearing that crap for 40 years! It will be many more years before there is a cure! And by the way most primary care physicians don’t know a thing about JD. Be sure you see a endocrinologist who works with patients with JD everyday.

  • It would be nice if this article explained the two types of diabetes and had content organized by type. It is hard to keep track of which new approach is for type 2 and which for type 1 as it is written.

    • Thank you for this comment. I agree, differentiating the very distinct pathophysiology of Type 1 and Type 2 is important for readers. It is similarly important in highlighting that the majority of the above-mentioned interventions would not be applicable to a patient with Type 1. Outlining this differences is important to bring public knowledge and attention to the difference between the two forms of the disease — namely that Type 1 cannot be prevented and the types of breakthroughs that will improve management for that population are distinct.

    • Novo Nordisk probably didn’t want to make the investment because there aren’t enough Type 1’s to make it profitable. Also, type 1’s are doing insulin doses with tiny increments (.025) and inhaled insulin sounds, um, rather approximate.

      I want to know where the diabetes advocacy groups are when clarification of type 1 versus type 2 is needed. My theory is that type 1 groups don’t want to do this because they then lose the numbers (total diabetes population is 95% type 2) and perhaps the type 2 groups don’t want to lose the p.r. value of the kids. All I now is that I contact media every time I see an article on “diabetes” with info on lifestyle changes that are not causative for a type 1, which is an autoimmune disorder. And I am almost always told there was not room or time for inclusion of info on type 1. Medical and nursing training apparently must have a sidebar in the text on type 1, because they don’t know much about it either. Try being in an ICU with type 1!

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