Diabetes: Epidemiology Suggests a Viral Connection

Diabetes is a rapidly increasing health problem. The number of diabetics in the United States has burgeoned from 1.2 million in 1950 to an estimated 5 million now, an increase of more than 300 percent while the population has grown only about 50 percent. Treatment with insulin has markedly increased the life expectancy of diabetics. But in spite of treatment with insulin, strict diets, and oral antidiabetic agents, diabetes is still the fifth leading cause of death by disease in this country and the second leading cause of blindness. Progress in research on diabetes seemed to tail off in the 1950's and early 1960's, but there has been a marked resurgence during the last few years. Epidemiologists have produced much evidence that there is a link between viral infection and the onset of diabetes. Virologists have developed several model systems in which viruses appear to produce diabetes in animals. Geneticists have collected evidence suggesting that there are two different forms of diabetes with different methods of initiation. Endorcrinologists have shown that a second hormone, glucagon, is involved in the pathology of diabetes, suggesting that much better control of diabetic symptoms can be accomplished by regulation of the concentrations of both insulin and glucagon. And clinicians and technologists have developed new methods with the potential for providing a more natural regulation of insulin concentration, such as transplantation of pancreases or the islets of Langerhans and implantation of artificial pancreases or cultured beta cells. None of these developments have yet met with any significant clinical application, but they offer much promise for future use. In the next few weeks Research News will present several articles assessing the status of research in diabetes and examining some of the areas where progress has been most apparent.