1Vilnius University, Faculty of Medicine
Diabetes mellitus (DM) is a chronic, progressive disease, so it is important to diagnose and treat this disorder as soon as possible in order to prevent the development and progression of DM complications [1-5]. Adverse effects of drug therapy are often reported during the treatment of DM with conventional therapies (oral antidiabetic drugs, insulin therapy). Therefore, new and more effective methods of DM treatment, that can ensure effective glycemic control, are being actively sought. Aim: to review the future treatment methods of DM, described in the literature. Methods: analyzed publications in ,,PubMed”, ,,UpToDate” databases, using keywords ,,diabetes mellitus”, ,,gene therapy”, ,,b-cells regeneration”, ,,stem cells”. Articles are included, which discuss the possible future perspectives of DM treatment – gene therapy, and diabetic therapy targeting β -cells and β – cells regeneration, and the application of stem cells in DM treatment. Results and Conclusions. One of the fastest growing areas for DM treatment is gene therapy. Results from studies in diabetic laboratory animals have shown efficacy of gene therapy in reducing hyperglycaemia [9, 12, 16]. Another, no less important area, is methods of promoting pancreatic β – cell regeneration. One of the possible methods of regeneration is cell trans-differentiation (conversion process from a differentiated cell to other cells). It is thought that the most active β – cell regeneration may occur from pancreatic exocrine cells or pancreatic duct epithelial cells. With this method, the results, while controversial, are encouraging. This requires more detailed research. Also, the stem cell transplantation in the treatment of DM, showed good results. Induced Pluripotent Stem Cells (iPSC) could be used in these studies to avoid ethical concerns. The best results for DM treatment were obtained by transplanting diabetic rats from pancreatic ducts iPSC. Stem cells of other origins, such as those of mesenchymal origin, bone marrow and adipose tissue, are also being studied. Thus, the results obtained in laboratory animal studies offer great hope for the future adaptation of individualized interventions to DM patients using techniques such as gene therapy and stem cell, β – cell regeneration techniques. Of course, further research is needed that would not only use animal models or donor organs, but would take place in a real human micro-environment. However, based on the results of existing studies, it is believed that these methods could potentially lead to better clinical outcomes and are likely to have fewer adverse effects in the treatment of DM.
Keywords: diabetes, gene therapy, stem cells.