My previous posts have heartily reinforced that human biology is an evolving and engaging process. Therefore, the argument regarding whether we know enough to use hormones in the management of diabetes and/or obesity is a complex one. My contention pertains to how well we, as a collective, utilize what knowledge we already have, whilst simultaneously researching and garnering more. I do not believe there is an additional knowledge threshold that currently needs to be obtained in order to contribute in meaningful and helpful ways in the usage of hormones to manage diabetes or obesity.
Specific to the treatment of ‘diabesity’: the combination of type 2 diabetes mellitus (T2DM) and obesity (Tharakan et.al, 2011), bariatic surgery has been deemed “the most successful treatment for this condition, causing durable loss of weight, proven reductions in cardiovascular events and overall mortality, as well as a sustained remission of diabetes in most patients” (L. Sjostrom et al., 2007). This surgical success story has highlighted several gut hormones and their capabilities in increasing insulin secretion, suppressing appetite, and delaying gastric empting, namely glucagon-like peptide-1 (GLP-1). This hormone has inspired research into new non-surgical methods of achieving significant and long-standing weight loss and reduction in diabetes (Tharakan et. al., 2011) through hormone use. The proposed utilization of this particular hormone in the treatment of diabesity illustrates how we are able to utilize knowledge regarding bariatric surgery, thoroughly analyze the mechanisms that contribute to its success, discover specific hormones that are significant, and then extrapolate them from the surgical process.
In addition, the responsibility of controlling diabetes is a multi-faceted and layered dilemma. Ultimately, diabetes is an individual health condition that’s responsibility remains with the individual. Regardless of the amount of public health promotion, medical services, and community support that is given, an individual’s health status remains their own. These services do greatly enhance an individual’s ability to care for themselves (McGill et. al., 2009) and are entirely integral to the success of diabetes control (Littenberg, et. al., 2006).
Johnson, M.D. (2010). Human Biology: Concepts and current issues. San Francisco. CA: Pearson Benjamin Cummings.
Littenberg B., Strauss K., MacLean CD, Troy Ar. (July 2006). The use of insulin declines as patients live farther from their source of care: results of a survey of adults with type 2 diabetes. BMC Public Health. 27;6:198.
McGill, H.C., McMahan Ca., Gidding SS.,(January 2009). Are pediatricians responsible for prevention of adult cardiovascular disease? National Clinical Practice Cardiovasc Med. 6(1):10-11.
Sjostrom L., Narbro K Sjöström D., Karason K., Larsson B., Wedel H., Lystig T., Sullivan M., Bouchard C., Carlsson B., Bengtsson C., Dahlgren S., Gummesson A., Jacobso P., Karlsson J., Lindross A.K., Lönroth H., M.D., Näslund, T., Olbers T., Stenlöf K., Torgerson K., Ågren H., Carlsson L. (August 23, 2007) Effects of bariatric surgery on mortality in Swedish obese subjects, New England Journal of Medicine. 357, pp. 741–752
Tharakan G., Tan T, Bloom S.(January 2011) Emerging therapies in the treatment of 'diabesity': beyond GLP-1. Trends in Pharmacological Science. 32(1):8-15
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