As a pediatrician, I frequently am asked "When will there be a cure for diabetes?" Ten years ago, with the success of pancreas transplants, I was predicting that in about ten years we would have a cure for diabetes. I am now more cautious in making such predictions, but I do remind parents and teenagers who ask this question how far we have come in the last decade.
Ten years ago, insulin therapy usually consisted of one shot per day of insulin (an intermediate-acting insulin with or without regular). Encouraged by what were then provocative new data, we began recommending conversion from one to two shots per day of insulin to improve blood glucose control throughout a 24-hour period and to prevent progression of diabetic retinopathy. Most parents did not want to subject their children to another shot. However, patients who adopted the new regimen found that it allowed more flexibility in the timing of meals, and they also physically felt so much better that none returned to one shot per day. Today, we routinely prescribe two shots per day for all patients beginning to receive insulin, and sometimes three shots per day. Insulin regimens today can be as varied as the life-styles of the people who use them, including intermediate-acting, regular, and long-acting insulins and, in specific instances, the subcutaneous insulin infusion pump. All of these methods provide good blood glucose control along with more flexibility in life-styles to accommodate the needs of diabetic children with two working parents or diabetic teenagers and college students