Take the Sting Out

With new advances, life with diabetes can be sweeter.

If you have diabetes and depend on insulin to control your blood glucose, then you know the drill: daily finger-stick tests, insulin injections, carb counting, oral medication. It's not easy, but you do it because it's important to maintain tight control of blood glucose to avoid serious complications. Still, wouldn't it be nice if diabetes care could be a little less intense? It can be.

High-tech, Low-touch
Smaller and more portable, today's blood glucose monitors make needle-sticks more comfortable. Some can work with a smaller blood sample taken from the forearm, sparing sensitive fingertips.

When it comes to infusing insulin, technology has advanced beyond the syringe. Insulin pens are now available, and insulin pumps, pager-size devices worn underneath the clothes, inject insulin through a port on the skin. They deliver insulin in short bursts around the clock and can deliver booster doses at mealtimes.

"By pushing a few buttons, you can program a pump to increase your basal insulin rate overnight or administer a dose every three hours—all without a needle stick," says Darren Lackan, M.D., an endocrinologist on the medical staff at Baylor Medical Center at Southwest Fort Worth.

Take a Breath
Needle-phobes should know there is another way to get insulin into the body—through the lungs. "Inhalable insulin in powder form doesn't eliminate the need to inject long-acting insulin, but it can be a welcome alternative to injections at every meal," says Jason Nordstrom, M.D., an internal medicine specialist on the medical staff at Baylor Medical Center at Waxahachie.

However, "It's not for people with asthma, emphysema or COPD, and pulmonary function testing is required," says Terry Exstrum, M.D., an endocrinologist on the medical staff at Baylor Regional Medical Center at Plano.

On the Horizon
How about eliminating blood glucose monitoring and insulin injections altogether? The solution may be biological or technological—or both.

The biological approach: transplanting insulinproducing islet cells from a donor pancreas. While still rare, such experimental procedures are being performed at the Pancreatic Islet Cell Transplant Program at Baylor University Medical Center at Dallas.

The technological approach is a "closed-loop system," an implantable device under development that performs continuous blood-glucose monitoring, insulin dose calculation and automatic insulin delivery—in short, an artificial pancreas. "It will be a huge step forward, but it's still at least five to 10 years away," Dr. Lackan estimates.

While it's easy to get caught up in these advances, Priscilla Hollander, M.D., medical director of the Baylor Ruth Collins Diabetes Center and a physician on the medical staff at Baylor Dallas, reminds diabetes patients not to lose sight of the essentials. "The key to successful long-term diabetes management still is a healthy lifestyle—weight control, healthy eating and exercise."

By Deborah Paddison

Diabetes education classes are available throughout Baylor Health Care System. Find a class near you. For a referral to an endocrinologist on the medical staff at Baylor, call 1-800-4BAYLOR or use our on-line physician directory.