The Daily Burden of Living with Type 1 Diabetes
Current Methods of Blood Glucose Control Are Inadequate
Living with type 1 diabetes is a 24/7 job — patients must constantly think about how they are managing the disease.
Despite significant advances in the treatment of type 1 diabetes, particularly over the past 30 years, including the development of blood glucose (sugar) monitors, insulin analogs, insulin pumps and continuous glucose monitors, glucose control remains a tremendous challenge.
In the United States less than 50% of people with type 1 diabetes achieve target-recommended A1c levels. Furthermore, even at target A1c (7%), recent data demonstrates a person with diabetes spends a very significant portion of the day hyperglycemic (too high blood sugar levels) and over an hour every day hypoglycemic (too low blood sugar levels). Hypoglycemia remains the major barrier to normal blood glucose levels and severe episodes still prove fatal.
The Diabetes Control and Complications Trial (DCCT) and the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) have demonstrated the association between glucose control and both onset and progression of diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. Surprisingly, recent data from the EDIC cohort has shown a strong metabolic memory effect of glucose control and that poor blood glucose control can have negative impact well into the future. The duration of this metabolic memory is unknown and is the focus of intense research. The direct link between sustained elevated glucose and macrovascular disease is not as clear. However, the longer-term follow-up of the EDIC cohort has shown significant benefit of intensive glucose management in reducing cardiovascular events by over 40% and severe events (including nonfatal myocardial infarction, stroke, or death from cardiovascular disease) by approximately 57% based on these study results.
Fortunately, the risk of developing diabetes complications continues to decrease. However, normal blood glucose level control is currently very difficult to achieve and the management of diabetes remains a grueling daily task for the individuals with type 1 diabetes as well as their loved ones. The Treat Research Program at JDRF aims to drive the discovery, development and delivery of devices and drugs that improve glucose control, reduce diabetes burden and improve health-related quality of life, and prevent diabetic complications.
Artificial Pancreas Project
A Technology Driven Solution to Blood Sugar Control
JDRF’s artificial pancreas project will link continuous blood sugar readings to an insulin pump through a sophisticated computer program that automatically calculates and directs the delivery of the necessary amount of insulin just like a normal pancreas.
Novel Blood Sugar Control Therapies
Next Generation Drugs and Delivery Products
JDRF is reinventing insulin to do extraordinary things, such as responding to sugar levels in real time. Glucose-responsive insulin would be released in
the amount the body needs. JDRF is also researching drugs to work with insulin for better blood sugar control.
T1D Complications Prevention and Treatment
Novel Approaches to Resisting and Reversing Complications
JDRF is discovering why certain individuals develop T1D complications more rapidly than others. This knowledge is supporting development of new therapies for complications and targeting them to the right individuals as early as possible.