There was a time when diabetes was defined as a simple lack of insulin, and when 14 year old Leonard Thompson received the first injection of insulin as a treatment for type 1 diabetes in Toronto, Ontario, on January 11, 1922, supposedly the cure was found. We know almost 100 years later that insulin is not the cure but only one treatment. Over the past few years we have made some great strides with SGLT-2 inhibitors, DPP-4 inhibitors and GLP-1 analogs. However, all these treatments revolve around managing glucose as the regulator.
But what about managing all of the metabolites that affect energy consumption and production? The concept of metobolomics is what we are referring to, and this week our clinical text delivers the first part of a whole new way of looking at the over 275 metabolites including tissue amino acids and their derivatives, systemic bile acids, and blood phospholipids, that affect metabolic homeostasis and ultimately glucose control.