More than seventeen million Americans are living with diabetes. They also live with the possibility of complications related to the disease. Blindness, kidney disease, nerve damage, amputations, heart disease, and stroke are everyday fears for people with diabetes. "It's terrible. It's a tragedy. It's a preventable problem," says Tyler Doctor Larry Wiertz. He says the incidence of diabetes in this country is up by 15% in the last 15 years, primarily, because of our lifestyle. But this Internal Medicine and Endocrinology Doctor is optimistic about the next 15 years. He adds, "There is no question we have much better tools and we're doing much better at the treatment." Iris Larssen has lived with the fear, and the reality of diabetes, for 54 years. "I have very little vision in my right eye. I have good vision in my left eye, good enough so I can drive," Iris says. Doctor Lloyd Paul Aiello says nearly every patient with diabetes will eventually develop eye damage. "The two main problems that result in vision loss are either leakage of vessels when they're not supposed to be leaking. Or when vessels grow where they're not supposed to," says Dr. Aiello. Laser therapy is the standard treatment for advanced disease. Dr. Aiello goes on to say, "The laser actually functions by being a destructive treatment. It actually destroys areas of the retina in an attempt to save more vision that would happen otherwise." But it has to be done soon enough and there are side effects, including impaired night vision and peripheral vision loss. A new treatment under study goes to the source of the problem, which is a protein called VEG-F. "It's a protein whose primary actions are to cause blood vessels to grow or blood vessels to leak," explains Dr. Aiello. A drug, eye-001, prevents VEG-F from working. Dr. Aiello says, "This can theoretically give us a way that these patients cannot only prevent the complications in the future or reduce them, but do so in a way with fewer side effects." Dr. Wiertz adds, "Early treatment and prevention of complications is where we're trying to go." He says progress is being made. "Fortunately we've had 3 great new classes of drugs on the market. We've had three new insulins in the last 3 years and we'll probably have two more this year. So we've been moving ahead at great speed which is fortunate," says Dr. Wiertz. Another new drug, a P-K-C inhibitor, targets nerve damage, or neuropathy. "There are 85,000 amputations every year in the united states. About 87 percent of the precipitating factor there is that of neuropathy," says Aaron Vinik, an Internal Medicine Doctor. Most drugs simply help symptoms. P-K-C inhibitors do more. Dr. Vinik says, "This compound improves the blood supply to the nerves so it addresses the basic biology of nerve damage. It not only slowed the progression, but it showed that you could actually get some reversal of the nerve damage." That's important for patients like Greg Stone. He was diagnosed with diabetes in 19-90 and has neuropathy. "I started losing feeling in my toes. It has moved progressively into both feet, up to the ankles and calves in both leg." Greg goes on to say, "One of these days, there's hope that someday again I can regain the feeling that I've already lost." P-K-C inhibitors may also improve vision problems and help patients like Iris. But she wants more than help. "I would like to see a cure. The other thing I would like to do is dance at my grand kids' wedding," Iris says. In the meantime, Dr. Wiertz has some advice. "The prevention is healthy lifestyle, increase exercise, less food. It's simple, it's just hard medicine to follow."
Gillian Sheridan reporting.