Advances In Diabetes Care

There have been remarkable advances in diabetes care and management over the last 80 years. Prior to the discovery of insulin in the 1800’s and early 1900’s the treatments for diabetes was, among others, bleeding, exercise, opium, fad diets including a very strict starvation diet, a diet low in carbohydrates and high in fat and protein. This last treatment was difficult to adhere to but extended the lives of people with diabetes by approximately 1 year. With the discovery of insulin in 1921, people with diabetes had at least a treatment for their condition. Originally extracted from the pancreases of cows and pigs the liquid was very impure, large doses were needed and caused abscesses at the site it was injected. Insulin became readily available in 1923. This insulin was only short-acting so multiple doses were needed throughout the day to control diabetes symptoms. In the 1930’, the first long-acting insulin Protamine Zinc Insulin (PZI) became available.

In the 1940’s Neutral Protamine Hagedorn (NPH) insulin became available and is still widely used today. Also in the 1940’s the first standardized insulin syringe was made. Syringes needed to be sterilized by boiling them and the needle needed to be sharpened regularly. In the 1950’s, adding zinc to insulin produced another type of insulin including Lente, Ultralente (also still used today) and Semilente. In the 1960’s, insulin became more pure. In the late 1970’s and into the 1980’s, many new advances were introduced to help people live better lives and better control their diabetes including blood glucose monitoring, disposable insulin syringes, insulin infusion pumps, insulin pens, Glucagon and Human insulins. The 1990’s continued this trend, in 1993, the Diabetes Control and Complications Trial (DCCT), the longest, largest diabetes study ever undertaken, demonstrated that intensive therapy and excellent diabetes control prevented or delayed the long-term complications associated with diabetes. In 1996, the first rapid-acting insulin analog, Humalog , became FDA approved. The Continuous Glucose Monitoring System (CGMS) became available in 1999. In the year 2000, NovoLog , another rapid-acting analog was introduced. In 2001, Lantus , became the first and currently only long-acting analog available. The GlucoWatch received FDA approval and is the first non-invasive glucose monitoring device. There are also computer programs to download information about blood glucoses, insulin, exercise and other details; at-home and mail-away HbA1c kits, mail-away kits to check kidneys available today.

So while we have come a long way in diabetes, we have in some respects landed where we started, with the trend of treatment being multiple daily injections to control diabetes. Ultimately, our goal now is quite different given the technology at our disposal, specifically, optimal control of blood glucoses levels instead of merely controlling the symptoms and preventing death. Insulin pens are a popular choice among many practitioners as a tool for people with diabetes using multiple injections. They are convenient and discreet and deliver consistent amounts of insulin when prepared and used properly. BD has recently introduced their new insulin pen needle, known as the BD Ultra-Fine III Mini pen needle. It is 5 mm (3/16 of an inch) long and even thinner, 31 gauge, than it’s predecessors. This new needle may make injections even less intimidating and more comfortable for the person with diabetes and the parent or caregiver who needs to do the injection. Also, since this needle does not require the person with diabetes to pinch up the skin, it may make more sites more accessible and easier to use for injections.

Additionally, many practitioners have prescribed insulin doses in * unit increments for a long time for pediatric patients, adult patients requiring small doses of insulin, patients using intensive regimens and those who are using insulin correction and insulin to carbohydrate ratios. Teaching the person to use the spaces between the marked lines on traditional 30 unit and even 50 unit syringes as the area for * unit doses. Each giving tips to patients for how to measure this type of dose most accurately and to use this procedure consistently to help improve blood glucose control. The new BD UltraFine II Short Needle Half-Unit Scale (30 unit) insulin syringe offers people with diabetes a more precise way to measure very small doses of insulin with clear, alternating markings for doses in * unit increments. With the push for multiple daily injections and the use of insulin pens, the new pen needle may make this a more viable option and the new syringe may make small doses more accurately measurable.

So what’s in the future for diabetes? New products and developments are being investigated every day for new technologies to measure blood glucose, new insulins such as analogs and new ways to give insulin such as finding a way to give insulin by mouth but avoid it being digested or even inhaled insulin. The Holy Grail is still to find a cure for diabetes. Researchers continue to pursue a myriad of avenues including developing an artificial pancreas, transplants to cure diabetes and ways to prevent diabetes from happening all together. The possibilities are endless.

  • Register For This Twitter Chat Series

    When you register, we will send you timely reminders about upcoming Twitter chats via email.

    Simply enter your email address below and click on the "Register Me" button.

  • This field is for validation purposes and should be left unchanged.

Constance Brown-Riggs, MSEd, RD, CDE, CDN—an award-winning RD, certified diabetes educator, and past national spokesperson for the Academy of Nutrition and Dietetics, is the author of The African American Guide to Living Well With Diabetes, which received the Favorably Reviewed designation from the American Association of Diabetes Educators, and Eating Soulfully and Healthfully with Diabetes.

Dr. Lori Shemek, PhD, CNC, CLC, the best-selling author of “Fire-Up Your Fat Burn! and leading health and weight loss expert, is also known as “The Inflammation Terminator.” She has made it her mission to educate the public on the toxic effects of certain foods and lifestyle choices and how they create inflammation in the body. She is a leading authority on inflammation and its role in weight loss, preventing disease and optimizing health.

Rebecca Bitzer – MS, RD/LD, CEDRD is an award-winning Registered Dietitian, writer, speaker, blogger, and REBEL Dietitian business owner. Rebecca and her team of six Registered Dietitians have counseled thousands of clients struggling with diabetes for over twenty-five years. They work closely with each other along with internists, endocrinologists, therapists, and families.

Maureen Sullivan – RN, CDE has worked for many years as a Registered Nurse, most of them in emergency and trauma services. She is a Certified Emergency Nurse, Certified Diabetes Educator, and the former manager of a hospital stroke program. Maureen’s wealth of knowledge, passion for nursing and education, and ability to engage people makes her an excellent teacher and a captivating lecturer. Recently, Maureen has been concentrating on writing, speaking and teaching, as well as working on her award-winning weekly podcast, “The Health and Humor Show.”

Lauren Harris-Pincus, MS, RDN is a nutrition communications specialist, registered dietitian in private practice, social media consultant, speaker, spokesperson and corporate consultant. She is currently the owner of Nutrition Starring YOU, LLC and Lauren strongly believes that we should “Think Healthy, not Skinny”, and “EveryBODY is unique, your diet should be too”. Lauren was co-host of the Family Food Experts Kitchen radio show, available for listening on iHeart Radio and iTunes. Also known as one of the “NutritionBabes”, Lauren co-founded, a popular Health and Wellness website in 2009. was voted one of Healthline’s Top 100 Health Blogs in 2011, 2012 and 2013.

Mark Heyman, PhD, CDE is a clinical health psychologist and the director of the Center for Diabetes and Mental Health (CDMH). In addition to treating patients with type 1 and type 2 diabetes, Dr. Heyman provides training for health care providers on how to identify and address the emotional and behavioral aspects of diabetes in their patients. He also works with pharmaceutical and medical device companies to help them understand these issues and incorporate this information into their sales, marketing, and patient education materials. He is particularly interested in empirically supported behavioral interventions that promote behavior change and improve physical and mental health in people with diabetes.

Katie Ferraro, MPH, RD, CDE is a nationally-recognized registered dietitian, certified diabetes educator and author with an expertise in nutrition communications and curriculum development. She is the co-author of “Diet Therapy in Advanced Practice Nursing” (McGraw Hill, 2014) and an Assistant Clinical Professor of Nutrition at the University of California San Francisco and University of San Diego’s graduate schools of nursing.

Dr. Beverly S. Adler, PhD, CDE (aka “Dr. Bev”) is a clinical psychologist and certified diabetes educator, author and speaker. She specializes treating the emotional issues of people with diabetes. In her private practice, she provides individual, family and/or group therapy utilizing a cognitive behavior therapy orientation, combined with a spiritual approach. Her goal is to empower her patients to manage their diabetes.

Dr. Bev is the author of two self-help diabetes books. She has written numerous articles which are published in print and online – always focused on diabetes from the emotional perspective. She also speaks to audiences of people living with diabetes, as well as, to audiences of healthcare professionals and diabetes educators. Dr. Bev, herself, has been living successfully with type 1 diabetes for 40+ years.

In August 2016, Dr. Bev was honored to receive the “CDE Entrepreneur of the Year” Award from her Metropolitan NY Association of Diabetes Educators.

Jill Weisenberger, MS, RDN, CDE, FAND is an internationally recognized nutrition and diabetes expert with more than two decades experience. Through writing, speaking and one-on-one coaching, Jill empowers people to grab control of their health. She has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is known for her practical approach and caring attitude. Her no-nonsense strategies to eating well include foods that both taste good and are good for you.

Marlene Koch (pronounced ‘cook’) is a nationally recognized nutritionist, popular TV personality and New York Times bestselling author. She graduated Magna Cum Laude from UCLA with a Bachelor’s degree in Nutritional Science. She is a registered dietitian and one of a select group of dietitians to hold an advanced certificate in Child and Adolescent Weight Management from the Academy of Nutrition & Dietetics.

Marlene has taught professional chefs from the American Culinary Federation the principles of healthy cooking and eating. She has been adjunct Nutrition professor and cooking instructor for Columbus State College and the Columbus State Culinary Academy, and she is a nationally recognized expert in weight loss, diabetes, child and adolescent nutrition, and sugar substitutes.

Marlene has sold over one million cookbooks, and is a regular guest on QVC.

Barbara Ruhs – MS, RDN is a Registered Dietitian Nutritionist and owner of Neighborhood Nutrition LLC, a consulting firm focused on providing solutions to help food companies and supermarkets improve consumer health & wellness. She’s a former supermarket dietitian and has run a successful business for 17 years. A leader in the field of nutrition, her mission is to help people by impacting the way food is produced, marketed and sold. She’s a strong advocate for supermarket dietitians and believes the retail food industry has the greatest potential to impact public health.

Cheryl Orlansky has over 25 years of experience in health promotion and chronic disease prevention and management. Her first career as a registered dental hygienist led her towards a path of wellness and nutrition! Her expertise is in diabetes, weight management and cardiovascular disease for individuals and groups. She works in a large private practice including endocrinology, internal medicine, rheumatology, neurology and sleep medicine. She is an award winning dietitian with current leadership positions in state and local dietetics organizations.

She has been interviewed and quoted in media outlets for WebMD, Atlanta Sports and Fitness, Georgia Public Broadcasting, and the Atlanta Journal and Constitution. She has partnered with V-103 Radio to lead supermarket tours as part of a community outreach during National Nutrition Month.

Cheryl helps her clients reach balance through lifestyle choices: cooking and eating, activity and purpose in life.

Jackie Newgent, RDN, CDN, is a registered dietitian nutritionist and classically-trained chef. With a passion for helping people (including her father) with diabetes, she’s author of The With or Without Meat Cookbook: The Flexible Approach to Flavorful Diabetes Cooking and the award-winning The All‐Natural Diabetes Cookbook, both published by the American Diabetes Association. Jackie is also author of 1,000 Low-Calorie Recipes and Big Green Cookbook. Her next book, The All-Natural Diabetes Cookbook—2nd Edition, was published in 2015.

Nutritionist Rania Batayneh, MPH is the author of the best-selling book, The One One One Diet. She holds a master’s degree in public health nutrition from the University of Michigan School of Public Health and is also a Wellcoaches Certified Health and Wellness Coach endorsed by the American College of Sports Medicine (ACSM).

OmnichannelHealth Media, publisher of, does not provide medical advice, diagnosis or treatment. See additional information.