NIH Confirms Protocol To Reverse Type 1 Diabetes

FiReaNGeL writes "In 2001, researchers at Massachusetts General Hospital demonstrated the efficacy of a protocol to reverse type 1 diabetes in diabetic mice. New data from a study performed at the National Institutes of Health provides additional confirmation of the ability to reverse type 1 diabetes and on the role of spleen cells in islet regeneration. Spleen cells appear to contribute to islet recovery more in mice who are older and with more advanced diabetes compared with younger mice with less advanced diabetes, in which regeneration of remaining islets may be the dominant mechanism."

Comments

Hype or not?

[El Lobo]

Current investigation, however (both embryonic and adult stem cells), is still in the preliminary stage and several more years remain before they can potentially be used in the clinical setting. Procedures that reduce in vitro manipulation of cells and allow stem cells to develop into islets in vivo are crucial. Furthermore, the regeneration of existing islets is a distinct possibility. Simplistically, it might be hypothesized that down-regulation of autoimmunity may give the pancreas the breathing space to regenerate islets.

Re:Hype or not?

[Anonymous Coward]

I got Type I diabetes as a result of pancreatitis. In this, a stone blocks the pancreatic duct, and digestive enzymes escape the bits that are protected against them. They then digest parts of the pancreas. This is a non-auto-immune cause of Type I diabetes, and while the end of my pancreas which makes insulin is certainly more macroscopically chewed up than auto-immune Type I cases, my pancreas has shown no signs of regenerating any islet cells in 12 years.

itll be years

[crankshot999]

it will be years before this is available to humans!

Re:itll be years

[crankshot999]

They have to go through rats pigs and the new goat/pig cross my company is breeding. They are the closest animals to humans.

Re:itll be years

[Loconut1389]

better than never, and diabetes, though the complications can be gruesome, if managed well is more of a nuisance than a terror. For many, diabetes is a very manageable problem, but instances do occur with circulation problems to the limbs that require amputation. It'll be great when this cure hits the streets, and as with anything, the sooner the better, but rather than complaining that it'll take years before being available to humans, why don't we celebrate the fact that a cure is officially in sight?

Re:itll be years

[crankshot999]

in 4 years it'll be open to small groups of humans and 2 years after that it'll be on the market.

Re:itll be years

[LiquidCoooled]

That just shows, if the protocol had been released under the BSD or even GPL license, we could have ported it to humans by now.

Re:itll be years

[Sinbios]

Until one day, you figure out you're actually just breeding humans!

Re:itll be years

[Anonymous Coward]

They have to go through rats pigs and the new goat/pig cross my company is breeding. They are the closest animals to humans.

I thought that was ManBearPig.

Re:itll be years

[billybob_jcv]

Do you understand the difference between Type 1 & Type 2 diabetes? I do not consider needing to give insulin shots 4 times per day to my 21 month old daughter "manageable". She is now 9 and wearing an insulin pump, which means we change her infusion set (a fairly large needle inserted under the skin on her stomach or back) every three days. Type 1 diabetes cannot be managed by diet, exercise & pills!!!

Re:itll be years

[autophile]

which means we change her infusion set (a fairly large needle inserted under the skin on her stomach or back)

Fairly large? My infusion set has a catheter that's a quarter inch?

--Rob

Re:itll be years

[Loconut1389]

For young children, its burdensome, sure but everybody that has to do it gets used to it, just like anyone who has to take any kind of medicine- regardless whether its IM, IV or PO. I wasn't saying that what people go through isn't troublesome, and everyone needs shots at different intervals- everyone is different. There are exceptions to everything. Anyway, my overall point was that rather than saying, well geeze, it'll be 4-6 years before its available, waah- we should be saying Thank Someone that there's even a chance of a cure, otherwise you and your daughter are guaranteed to be doing those shots for a long time to come- now you may only have to do it a few more years- if even that. Insulin pumps have come a long way and are better than giving shots- maybe something better (transdermal patch?) will come along between now and when the 'cure' is available. I happen to know a relative who is Type 1 diabetic and has received awards for having the disease for longer than the vast majority of people (I think he's around 80 and has had it since he was young)- but he's been giving himself shots several times a day his whole life and still manages to have a pretty good existence- he used to run even up to a few years ago, still walks a lot, etc. Its a part of his life and it doesn't slow him down. On the same token, I know another friend and her husband who are in their late 50's and have nearly had to have legs amputated. There's someone on every end of the spectrum, as I said originally- but just be thankful you can look forward to the day you don't have to give those shots anymore, or she may never have to do it herself.

Re:itll be years

[Loconut1389]

sarcasm aside, I often wonder why people can't voluntarily submit themselves to whatever they want. All these laws we have are designed in large part to prevent involuntary testing- but if someone like Jonas Salk is willing to die to test a vaccine or treatment, why stop them? I'm not a big fan of animal testing as it is- though I accept it as somewhat of a necessary evil- but I really don't see why if we want to have a limb taken off, added on, grow boobs, have them taken off, whatever, that we can't just do what we want as long as we're aware of the consequences and are of sufficient age and sound mind to make the decision. I wonder if when we live in the Star Trek world (hah?) medicines will indeed be under something like the GPL? Feel free to make it better, but give it back to the world?

Re:itll be years

[Dunbal]

I often wonder why people can't voluntarily submit themselves to whatever they want.

      OK, look at it the other way. Just because you're prepared to die to test out a new treatment doesn't mean that I'm prepared to kill you with it. We usually have to be pretty darned sure that something won't be harmful before starting testing on humans.

Re:itll be years

[Dunbal]

Type 1 diabetes cannot be managed by diet, exercise & pills!!!

      Insulin pumps can be pretty darned dangerous, too. Over 25% of diabetes related deaths are actually due to (accidental or intentional) insulin overdose. At least it's nice to know that people are working on the problem though.

Re:itll be years

[Anonymous Coward]

A cure has been "in sight"/"just around the corner"/"a few years away" for at least 20 years.

Re:itll be years

[Score Whore]

I often wonder why people can't voluntarily submit themselves to whatever they want.

Many reasons. Probably the first and foremost are snake oil salesmen. Followed closely by the fact that while people will say they want a particular experimental treatment, what they really want is a cure. If what they end up getting is an experimental treatment that gives them cancer, makes their legs fall off, or just drains their bank account, they'll be suing the researches post haste.

As far as gross surgical procedures go, you can pretty much do any of that that you want. You're a guy and you want breast implants? No problem, just get out the check book. Want your fingers chopped off? Sure thing. You might have a hard time finding a doctor to do it for you, but it's not illegal like it is to start a regimine of experimental drugs.

Re:itll be years

[ScrewMaster]

I'm not a diabetic myself (so far, anyway) but I've had several relatives that were Type II, and I knew a girl who was a Type I that died at thirty from complications from it. And this was an individual that exercised, kept her weight down, monitored her glucose level constantly and took care of herself way better than most. She said once evening, rather sadly, "Diabetes really sucks." My father also died of complications due to his diabetes mellitus, and I took care of him the last three years of his life before the final heart attack took him. Or perhaps it was a stroke, hard to say. At least he still had all of his limbs, although for ten years previously he couldn't feel them because severe neuropathy killed most of the sensory nerves.

My point is that you may indeed know a "successful" diabetic, but for every one of those there are dozens that suffer terribly. It's a degenerative disease ... the girl I mentioned had multiple eye problems requiring surgery (retinal bleeding and so forth, my father had them too), they had to temporarily remove and freeze her eyeballs to fix it. They had to remove part of her intestines at one point. My father had multiple heart attacks, strokes, pacemaker, bone infections, total renal shutdown (home dialysis) and in the end was bedridden for two years before he died. And for about fifteen years he had neuropathic pain that was neverending, and at times was like continuous electric shocks. Yes, he had it worse than most, but there are many who aren't far behind.

So, while I agree with you that it's a wonderful thing that something resembling a "cure" may be on the way, believe me, maintaining a tolerable existence is very difficult for many of those so afflicted. It's a rough disease, it really is, and it affects every aspect of your life. About six months before he died, my father said, "I think I should go off the dialysis." Apparently, renal failure is a fairly decent way to go: you drop into a coma and die shortly afterwards. I talked him out of it then, although if I had it to do over again I wouldn't.

I've also lost relatives to different varieties of cancer, and frankly, if I had to choose one or the other as my way to go ... I think I'd pick a nice fast-growing cancer. Oat-cell carcinoma, maybe.

Re:itll be years

[Anonymous Coward]

No link to the RFC yet though. :(

Re:itll be years

[Slippy.]

Type 1 takes over your life. It's horrible for kids. Steals much joy from being young.

You *must* watch your diet all the time or risk coma/death very quickly in the short term, or bad side effects (blindness, loss of limbs, organ failure) in the long term. Getting drunk can get a person in trouble fast, especially if vomitting occurs.

First time your friends see you get sugar low, you'll get looked on as a freak by many people. A sugar low means you'll lose thinking ability (you look dumb) and won't realize what you're doing or what's going on.

This leads quickly (just a few minutes sometimes) to passing out (possible convulsions, spasms) and possibly coma/death if no one knows what's happening. This is all very disturbing to people, even if they know what's happening...and these are just kids.

One diabetic I know had a reaction while driving and got dumb (talking but no real thinking happening) - had five cop cars chasing him before he crashed. The passenger was pretty much freaking - he'd just been talking to the driver and then he just went off into la-la land. *No one* knew what was happening (he did have a medic-alert bracelet but no one noticed)...the cops assumed he was on drugs.

Lucky for him, they called his dad. One cup of juice and 5 minutes, and he was back. The police were surprisingly understanding. Didn't remember anything, though, and he was pissed cause it was so embarrassing.

It's definitely not appealing for getting dates.

Now picture getting sick. You've taken your insulin shot in the morning...not being able to eat means you might need to go to the hospital. You can't let your blood sugar get too low, and the insulin keeps working whether you eat or not.

Worse yet, you could get sick while camping.

Travelling...having to explain about the needles you have while crossing borders over and over. Keeping the insulin good for long periods when travelling in warm weather.

This list keeps going on. I'm not a diabetic, but I'm closely related to some.

Re:itll be years

[Redlazer]

You're probably right, although i think Al Gore himself would be a better substitute. After all, we have to take care of endangered species, and we must protect the ManBearPig.

So. Who wants to breed with ManBearPig? Im kinda busy this weekend, so i really cant.

-Red

Re:itll be years

[FallLine]

For young children, its burdensome, sure but everybody that has to do it gets used to it, just like anyone who has to take any kind of medicine- regardless whether its IM, IV or PO. I wasn't saying that what people go through isn't troublesome, and everyone needs shots at different intervals- everyone is different.

I respectfully disagree. Having worked for an insulin pump manufacturer and having spoken with hundreds of doctors, patients, and educators, I can tell you that managing diabetes is fundamentally and vastly different than the management of almost any other disease. Diabetes management, whether through shots and pumps, is fundamentally different because it is largely a patient managed disease. The patients or their guardians are required to make important day to day decisions about their treatment and must be able to exercise judgement. Unlike most other diseases, the patient is not just taking a prescribed dose, but is required to to constantly balance their insulin requirements against their carb intake. To achieve even remotely tight control the patient must understand: what they're eating; when they're eating it; how their habits impact their bodies (e.g., exercise, sleep, sex, etc); accurately measure their BGs; and be able to adjust accordingly (which, itself, is not that simple) through-out their waking and sleeping hours. The level of patient awareness and the implications of that awareness (or lack thereof) set diabetes far apart from virtually anything else. This difficulty becomes especially apparent when dealing with less mentally aware, less mature, and less educated parts of society.

Achieving tight control is actually a fairly complicated task. It is difficult to do as well as a non-diabetics (close perhaps, but not quite the same). While I agree that the pump simplifies things dramatically and that most pump users achieve fairly tight control on average such that their complications are much more in line with non-diabetics, most still suffer significant highs and lows with some regularity and they still must structure their life around the disease to some extent. Unfortunately recent research has shown that while average blood sugars (as represented by a1cs) are important, the degree of volatility is perhaps even more a important predictor of long term health complications... In other words, the volatility that virtually all pump users suffer to some extent (non-pump users even more so) or other is still suggests significant complications over the long term.

Re:itll be years

[bigpat]

OK, look at it the other way. Just because you're prepared to die to test out a new treatment doesn't mean that I'm prepared to kill you with it. We usually have to be pretty darned sure that something won't be harmful before starting testing on humans.

Who is this "we" you keep talking about?

Re:itll be years

[witekr]

Thank you for the insightful post. I'm a 19 y/o Type 1 Diabetic, and have had to deal with many of the situations you wrote about in your post.

Type 1 Diabetes is not fun to have, and it's not something to be shrugged off. I'm sure that some diabetics experience less problems than others, but it's not a disease to be shrugged off as if talking about a wart or a cold. My life is a bit more complex now than my pre-diabetic life; Every day I must constantly keep track of my insulin, food, and exercise, and that creates limitations. I have to do a lot of extra thought and planning when going out of the house, doing something different in my regular schedule, etc.

It's easy to forget a small detail and then have a bad blood sugar because of it. I decide to go for a longer walk one day, and in the middle of the night I wake up with cold sweats and pounding heartbeat, drag myself to the kitchen and find out I have a very low sugar. Have to eat in the middle of the night which isn't enjoyable for me, and then brush teeth etc and get back to bed and try falling asleep again.

Or hanging out with friends, and not adhering to a strict schedule, also causes problems and confusion as to diet and insulin planning.

I really hope some cure can be found, because I'm not particularly fond of the idea I may have a shorter lifespan, am a likely candidate for a heart attack when I'm older (3/4 diabetics die of heart attack), might have to get legs amputated, might go blind, etc.

Re:itll be years

[GnuDiff]

Well, I've had Type 1 diabetes since age of 3, that is for 28 years (I am now 31).

Back then it was needles and syringes much bigger and thicker than nowadays, and they had to be boiled before every use. If I needed a blood glucose check, I had to go to the hospital.

It was no picnic of course, and I had to be taken to hospital several times in the first years. Yes, the stress is great, and (especially with kids) I imagine it was a huge strain on my parents - I was too small to notice back then, of course. However, it was manageable then. It is easier now. More is known, better test tools are available, people on the streets sometimes have a an idea of what it is all about, if some problems arise (back then, NOBODY would know what to do on street, if something happened).

Re:itll be years

[Anonymous Coward]

there's a big difference between 'we should be finding one any time' and 'there's a cure thats being tested'

Re:itll be years

[tylernt]

A sugar low means you'll lose thinking ability (you look dumb) and won't realize what you're doing or what's going on.

This leads quickly (just a few minutes sometimes) to passing out (possible convulsions, spasms) and possibly coma/death if no one knows what's happening.

It's worse than that -- a well-intentioned person may actually give you a shot of insulin ("Hm, an unconscious diabetic, diabetics gives themselves shots all the time, I'd better give them a shot!"), which of course makes the problem 10 times worse... if it doesn't kill you.

Re:itll be years

[Anonymous Coward]

As a diabetic for over 26 years, what's waiting a few more?
In the mean time, I control my blood sugar as best as I can... now where's that slice of apple pie?

Re:itll be years

[Lord Apathy]

It will be never. I've been hearing shit like this for years about diabetes. "A cure is right around the corner." "Just a few more years." Same shit over and over.

Point being there is to much money is not curing diabetes than there is curing it. If they just develop a treatment they can keep people hooked on the drugs that keep them alive for a life time. Where if they cure it that is a one time income shot.

One fee for the cure vs a life time of treatment for 40 or 50 years.

Re:itll be years

[ScrewMaster]

Anyone that stupid should be put on an IV insulin drip until they drop into a coma themselves.

Some twenty-odd years ago I was involved in doing the software for a university research lab. They were testing the effects that extremes of blood glucose levels had on mental acuity. The software we came up with would flash LEDs in various patterns (to prevent the subject from predicting them) and measured their response time. As I happened to be on-hand when they were first testing the system I got hooked up to an IV and they ran my blood sugar up and down. The effect of extremely low blood levels on mentation is remarkable. I watched my measured latency (my normal reaction time was well under 200 ms) jump to two or three seconds. Oddly, I didn't really feel much different until it got really low, but there was no question I was impaired.

My father was diagnosed as a Type II diabetic a couple years later. I had a pretty good idea of what he was going through from my experience with that project.

Re:itll be years

[TomGlee]

My oldest son was diagnosed at 14 months in 1977 when there was no fingerstick BG test. We had to wring out the diaper to check his urine spill rate. We tried multiple injections and found it was the only viable solution for a child who could not tell us his BG was low. He is 30 years old now, been on a pump for 2 years and still struggles with his BG control even though the pump has helped tremendously. His eyes needed laser and he is having surgery (4th) in 2 days for detached retina and cataract. It is sad, because it has devastated his life (The diabetes that is) I understand your troubles and hope the best for your girl! Tom Gleeson La Quinta, CA.

Missing something?

[Salvance]

I must be missing something ... if the technique was first described and shown in 2001, then reaffirmed in 2003, why haven't they moved forward with trying to treat humans with severe/end-stage diabetes? In fact, they don't even discuss the possibility, which makes me wonder if there is something else in play (bad side effects for example). This sounds like a MAJOR medical breakthrough, and typically breakthroughs like this are pushed into more expanded trials and even human tests faster than the researchers at MGH are moving forward.

Re:Missing something?

[Adult film producer]

Well, the thing is, one of the side effects of this treatment is cancer of the pancreas. So, there are a few loose ends they've gotta tie-up before going to human guinea pigs.

Re:Missing something?

[Salvance]

Oh, I didn't see that in the article. Are you saying it causes cancer because you have read about this potential diabetes treatment on another site or journal, or just because (in general) stem cells have been shown to become cancerous more readily than researchers had hoped? If the former, I'd love to read the article if you have a link.

Re:Missing something?

[lpret]

I'm diabetic, and while I'm hopeful that someday there will be some great breakthroughs, I'm convinced that Big Pharma won't let it happen. Case in point, my hospital has a fairly large diabetes cure research group. However, in the past three years, every single doctor has gone to work for a pharmaceutical company to develop ways to "help survive cancer." Oh, and they doubled their income in the process. It's a multibillion dollar growing industry filled with hypochondriac baby boomers that could disappear in heartbeat, and Pharma is trying to protect that market.

Re:Missing something?

[Runefox]

It's probably true; Think of how much money they make on cancer treatments and AIDS treatments, and then you'd realize that it's not economical to release a cure, unless that 'cure' needed to be administered on a regular basis. Same with diabetes, MS, and other diseases that are currently incurable-but-slightly-treatable.

My grandfather, who is a type-I diabetic (I'm a type-II myself), staunchly believes that there are cures for AIDS, cancer, diabetes, etc, but the pharmacies are making too much money on the treatments to release them.

Re:Missing something?

[q2k]

Dr. Faustman just got her funding earlier this year to proceed with the BCG Human Clinical Trial. She is being funded by The Iococca Foundation. The Foundation is funding another human trial at UVA. However, it's all in the very early stages. I think actual human trials are at least 3 years away.

It is a promising and comparatively cheap cure if it works the same way in people. There are about 10,000 things that could go wrong between here and there though.

Re:Missing something?

[Rich0]

Uh, could it perhaps just be that the group had a good reputation and the leader got scooped up for a big price, and then quickly afterwards he recruited his former team? And the fact that they're making twice as much isn't that big a deal - everybody knows that you make more in industry than in academia.

What happens whenever a big-shot researcher moves from one university to another...the same thing!

No doubt that Pharma is generally more interested in treatments than cures, but I doubt there in some kind of conspiracy to stifle medical research. And the main reason that they're probably not-so-interested in cures is that it is out of scope - most likely a cure would involve some kind of tissue transplant and not a magic pill that can be mass-produced on a press. Most likely the Toyota Motor Company isn't interested in developing a cure for diabetes either, but I'd hardly call it conspiracy. Pharma does do antibiotic and vaccine R&D, and those would be cures. Of course, they're not very lucrative, so they don't spend much money on it - but can you blame them? If you want R&D performed on non-profitable subjects then call your congressman or an MP and tell them to fund the NIH/whatever. If the NIH is having trouble with their researchers leaving for industry they should pay better...

Re:Missing something?

[Tsu Dho Nimh]

... if the technique was first described and shown in 2001, then reaffirmed in 2003, why haven't they moved forward with trying to treat humans with severe/end-stage diabetes? In fact, they don't even discuss the possibility, which makes me wonder if there is something else in play (bad side effects for example).

Look up "Complete Freund's Adjuvant" ... the stuff induces a massive immune inflammatory response, and is illegal to use in humans. The study has to be replicated, not ONCE, but several times, until they figure out what is really happening. It might be possible to target JUST the immune cells that have "learned" to attack the islet cells, which is far safer than suppressing all of the immune cells.

Re:Missing something?

[Rich0]

Uh, do you know how many people would need to be in on such a conspiracy? The folks who came up with the concept, the folks who developed some molecules that might work, tons of people involved in clinical trials, etc. It would probably be just as easy to fake the Apollo landings.

Now, if you think that cancer has been cured in mice - sure, but that is old news. Cancer has probably been cured in mice a thousand times, but until we can start breeding and treating people like mice it will probably take a little longer to work out a cure in humans... :)

Now, there is no question that the Pharma industry focuses its efforts on profitable diseases, and not as much on ones that do not have a promise of profit. However, a cure for diabetes would make a killing, and until humans are immortal there will always be another disesase to cure. And when you discover a cure for some disease you get to profit from it for 10-15 years! By then most CEOs have retired, so they're not going to care all that much about profits 30 years down the road to care...

Re:Missing something?

[Lunar_Lamp]

The three papers mentioned: 2003 paper (Islet Regeneration During the Reversal of Autoimmune Diabetes in NOD Mice): http://www.sciencemag.org/cgi/content/full/302/564 8/1223?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fu lltext=Faustman&searchid=1&FIRSTINDEX=0&resourcety pe=HWCIT

terst

Re:Missing something?

[Woldry]

... there are cures for AIDS, cancer, diabetes, etc, but the pharmacies are making too much money on the treatments to release them.

AIDS is a viral disease. So are many cancers -- more and more are being identified as such every year. No one has yet figured out a way to cure any viral disease; partly because of the very nature of the beast, it's a nastily difficult problem to solve. Even if the paranoid theory is correct about other diseases, I can't believe that anyone has solved the viral-disease hurdle for a single disease, nor that they will solve it anytime soon.

Re:Missing something?

[Lunar_Lamp]

Sorry, I pressed "submit" rather than "preview". The papers referenced in the article appear to be:

http://www.sciencemag.org/cgi/content/full/314/580 3/1243b?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&f ulltext=Faustman&searchid=1&FIRSTINDEX=0&sortspec= date&resourcetype=HWCIT

http://www.sciencemag.org/cgi/content/full/314/580 3/1243d?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&f ulltext=Faustman&searchid=1&FIRSTINDEX=0&sortspec= date&resourcetype=HWCIT

http://www.sciencemag.org/cgi/content/full/314/580 3/1243a

However, many appear present here http://www.sciencemag.org/cgi/search?&search_submi t.y=0&search_submit=go&search_submit.x=0&site_area =sci&fulltext=Faustman&src=hw&sortspecbrief=date&s ortspec=date

Re:Missing something?

[iawia]

Actually, the research mentioned in the article is not introducing any stem cells, so if that's the source, it doesn't apply to this research. The idea here is that the spleen actually contains 'adult stemcells' that can differentiate into insulin producing cells.

The research in question is done by Faustman financed (at least partly) by the Iococca Foundation. ( http://www.iacoccafoundation.org/grants_diabetes_r esearch.html )
They're preparing for human trials of at least part of this protocol, but it seems that Dr. Faustman's work differs too much from the general direction of diabetes research, and it is not receiving any government funding. I wonder if the NIH mention in this article means that this is going to change.

From the research I've heard about (I have an understandable interest, as a type 1 diabetic), this research seems the 'neatest' solution: fix the immune system so it doesn't attack insulin producing cells anymore, then stimulate an apparently existing system in the human body to start creating new cells. There's still a lot of work to do before we know that this will work in humans, though...

Re:Missing something?

[Andy Dodd]

"I must be missing something ... if the technique was first described and shown in 2001, then reaffirmed in 2003, why haven't they moved forward with trying to treat humans with severe/end-stage diabetes? In fact, they don't even discuss the possibility, which makes me wonder if there is something else in play (bad side effects for example). This sounds like a MAJOR medical breakthrough, and typically breakthroughs like this are pushed into more expanded trials and even human tests faster than the researchers at MGH are moving forward."

There is no such thing as severe/end-stage type I diabetes. Usually by the time you are diagnosed, you are at the "severe/end stage" - Your pancreatic beta cells are gone or nearly so. Insulin can prolong your life for decades, and if your bloodsugars are carefully controlled (via aggressive and careful diet, insulin dosing, and glucose monitoring), you will live just as long a life as a normal person.

If you're talking about severe diabetes complications (Kidney damage, retina damage, etc.)- By the time those present themselves, the cumulative damage of years of abnormal bloodsugars is done and curing the underlying diabetes isn't going to help.

Last but not least, you clearly missed the "In the 2001 and 2003 studies, Faustman and colleagues treated end-stage nonobese diabetic (NOD) mice with Freund's complete adjuvant, a substance that suppresses the activity of the immune cells that destroy islets in type 1 diabetes." line. Immunosuppressants are scary shit, and usually considered an absolute last-resort treatment when the other choice is death. Admittedly, it sounds like this MIGHT be a rather targeted immunosuppressant with fewer side effects than most, but still, it's an immunosuppressant.

I've been a type I diabetic for over a decade and have been looking forward to a cure for years. While this article gave me a lot of hope, the mention of immunosuppressants took a lot of it away. There are already quite a few treatments for Type I diabetes that are proven to work, but generally are only given to those who are already on immunosuppressants for another reason. (For example, pancreas or pancreatic beta cell transplants are only given to patients already receiving another transplant who will be on antirejection drugs and immunosuppressants anyway.)

That said, it sounds like there are fewer side effects than other immunosuppressants, as I have heard that there are plans for human trials starting in 2007 or 2008. Six years from the first results in mice to the first human trials is actually quite quick. There are plenty of examples of cases where botched human trials nearly killed the test cases. (Remember that incident a year or two in London where 6-8 test patients basically swelled up like balloons and found that six months later most of them had trashed immune systems and the beginnings of cancer?) People are REALLY, REALLY careful with human trials.

It sounds like they are conducting one more large-scale study in mice before beginning human trials. They didn't have money for it before, but they received a large amount from one of Lee Iacocca's charities to fund further studies.

Given the involvement of immunosuppressants, I hope they are extra careful with human trials. I can wait another decade if it means I won't be developing cancer or a few years after treatment.

Re:Missing something?

[jesup]

Read the Nov 12th Scientific American article on this release (http://sciam.com/print_version.cfm?articleID=CE7B B73A-E7F2-99DF-3069CE90D77629FB). According to Wikipedia, Freund's adjuvant is highly toxic (http://en.wikipedia.org/wiki/Freund's_adjuvant).

Also, some very early experiments in humans have been done in Israel, using a less-toxic immune-suppressive (which doesn't suppress as much). No success, but there may be some data from it that it was heading in the right direction (see SciAm article).

This would be great if it works; my father is a 72-year-old juvenile diabetic (since age 9 - WAY outliving the probabilities), and my cousin once-removed on my father's side is also a juvenile diabetic (age ~23, diabetic since ~19 or 20). Many type-1 diabetics die before they're 40, often with severe complications.

Re:Missing something?

[Andy Dodd]

Stem cells or no stem cells, cancer is a known side effect of nearly any immunosuppressant, which happens to be a fundamental part of this protocol.

Re:Missing something?

[Andy Dodd]

Interestingly enough, the drug mentioned is usually used as an immune booster, although its tendency to suppress autoresponsive T-cells is an unusual side effect.

http://en.wikipedia.org/wiki/Freund's_adjuvant - One of the core aspects of this treatment. Note that it appears to be a REALLY nasty drug with a lot of side effects, and is in fact currently forbidden for use in humans. (So I have no clue how they are using it in a human trial...)

http://en.wikipedia.org/wiki/Denise_Faustman - There's a lot of controversy surrounding this treatment.

Re:Missing something?

[Anonymous Coward]

...but didn't you know!? The Pharma CEO's are also keeping a lid on the drugs to prolong their lives for hundreds of years.

Re:Missing something?

[Dunbal]

if the technique was first described and shown in 2001, then reaffirmed in 2003, why haven't they moved forward with trying to treat humans with severe/end-stage diabetes?

      First you test it in vitro, in a test tube.
      Then you test it in animals, starting with mice, and eventually working your way up to dogs, pigs, monkeys, etc.
      Then you test it in a few HEALTHY human volunteers, looking for possible side effects.
      Then you test it in sick people, to see if it actually works on humans. You start with small quantities of people, usually the terminally ill, and work your way gradually to include larger populations in randomized, double-blind controlled trials. You also pick up a lot of information on side-effects at this stage.
      Then and only then, can you say you have a "product", technique, or whatever.

      Yes this takes years and years (which is why drug companies complain about patents expiring too quickly). But the Hippocratic oath says primum non nocere (first - do no harm), and we're bound by it.

Re:Missing something?

[mcrbids]

Uh, do you know how many people would need to be in on such a conspiracy? The folks who came up with the concept, the folks who developed some molecules that might work, tons of people involved in clinical trials, etc. It would probably be just as easy to fake the Apollo landings.

Uhm... hello????

Everybody knows that the Apollo missions were faked!

Re:Missing something?

[bsane]

Then you test it in a few HEALTHY human volunteers, looking for possible side effects.
Then you test it in sick people, to see if it actually works on humans.

In some cases healthy people may not be tested first- they may try especially risky procedures only on people who very likely to die if left untreated.

Re:Missing something?

[jesup]

There is no such thing as severe/end-stage type I diabetes. Usually by the time you are diagnosed, you are at the "severe/end stage" - Your pancreatic beta cells are gone or nearly so. Insulin can prolong your life for decades, and if your bloodsugars are carefully controlled (via aggressive and careful diet, insulin dosing, and glucose monitoring), you will live just as long a life as a normal person.

If you're talking about severe diabetes complications (Kidney damage, retina damage, etc.)- By the time those present themselves, the cumulative damage of years of abnormal bloodsugars is done and curing the underlying diabetes isn't going to help.

As the son of a type-1 diabetic, I have to disagree in part. My father is 72 and has had type 1 since he was 9 - way beyond expected survival for a diabetic. He has lived around as long as a normal person, with a tightly-controlled diet, weight, exercise, etc. Due to a kidney tumor, he has one kidney, and diabetes had reduced them to 40%; post-removal the remaining one has stabilized at 30%, which makes for a tricky diet, but doesn't require dialysis. Minor retinal damage until last winter, though still not too bad.

However, an effective cure would help him a lot, even at this late date. It becomes increasingly hard to control blood sugar levels, and he doesn't notice when levels wander into dangerous levels anymore. While it wouldn't reverse the damage to the kidneys, vision, etc, it would remove a major cause of further damage and life-threatening blood sugar swings. Even a partial reversal would help a lot.

Re:Missing something?

[Anonymous Coward]

lol

Re:Missing something?

[Andy Dodd]

"However, an effective cure would help him a lot, even at this late date. It becomes increasingly hard to control blood sugar levels, and he doesn't notice when levels wander into dangerous levels anymore. While it wouldn't reverse the damage to the kidneys, vision, etc, it would remove a major cause of further damage and life-threatening blood sugar swings. Even a partial reversal would help a lot."

The issue is whether the risks of the treatment outweigh the benefits of partial/complete reversal.

My opinion is that diabetes is controllable enough that there is no aspect of type I diabetes that is "late stage" enough to warrant rushing into human testing with immunosuppressants. Yes, it could turn out that the immunosuppressants are targeted enough to have minimal side effects, but in this case, the risks of rushing to human trials without taking appropriate care are far greater than staying with the current "status quo", which I admit has its problems, but the potential side effects of any immunosuppressant-based therapy warrant extreme caution.

In this particular case, it seems that the drug in question suppresses some immune responses, but provokes others, which is a potential recipe for disaster, as the botched drug trial of a particular drug earlier this year shows. I forget the name (It was covered on Slashdot...), but it was a drug which was designed to alter the immune system's response. It proved perfectly safe in monkeys (closer relatives to humans than mice) but had horrendous immediate side effects in human trials. The Wikipedia article for the particular substance mentioned in the article (see a response to my own post for the link) indicates that this particular substance is currently not allowed for human use due to its toxicity, so in some ways I'm wondering how in hell they got it to human trials for 2007/2008ish given that it already has a proven record of toxicity issues.

Re:Missing something?

[jrp2]

What surprises me is the lack of active participation by the insurance industry in the search for a cure for Diabetes. These are the commercial entities most likely to benefit financially by a "cure".

As several have pointed out, the commercial entities most likely to benefit from from treating, rather than curing, are the pharmaceutical and, to a lesser degree, the food industries (diet foods). It is no surprise they are not interested in a cure, but the health insurance industry would benefit directly in lower costs and the life insurance industry in getting more payments before they have to pay out.

The only argument I have heard as to why not is that diabetes (type 2 in particular) is so slow coming on that their patients will move on to other employer's health plans and/or simply become uninsurable.

Re:Missing something?

[RobertLTux]

But the Hippocratic oath says primum non nocere (first - do no harm), and we're bound by it.
tunc of semen vires educo ----what our legal counsel reminds us of (machine translated please correct if you are a native Latin speaker)

Re:Missing something?

[The Step Child]

Immunosuppressants are scary shit, and usually considered an absolute last-resort treatment when the other choice is death. Admittedly, it sounds like this MIGHT be a rather targeted immunosuppressant with fewer side effects than most, but still, it's an immunosuppressant.

Because of the nature of type I diabetes, the only way to cure it is *some* form of immunosuppression. The ideal solution would be to specifically suppress the T cells which are responsible for destroying islet cells. This in itself is technically immunosuppression, and it's also the goal of Faustman's research. We're not talking about "system-wide" immunosuppression, we're talking about killing off the specific T cell population responsible for the autoimmunity. That said, I have two concerns in mind:
 
1) They have to tread carefully in human trials - even more carefully than what is done with normal pharmaceutical trials. If they screw up the amount of TNF-a produced, there's potential for some major havoc to be inflicted (I'm thinking septic shock). All it takes is one screw up - then the entire project is finished.
 
2) I'm not really clear on why autoreactive T cells are preferentially targeted. The study is here, but I haven't access :)

Re:Missing something?

[Slippy.]

The abstract mentions retraining the immune system:

"They also introduced donor spleen cells to retrain the immune system not to attack islets and found that the protocol not only halted the immune destruction caused by diabetes but also allowed the insulin-producing pancreatic islet cells to regenerate."

I would take this as a suggestion that the immune system suppression is temporary, or maybe reduced later. If the immune system can be retrained, why keep taking the drugs, yes?

Re:Missing something?

[CowardWithAName]

if the technique was first described and shown in 2001, then reaffirmed in 2003, why haven't they moved forward with trying to treat humans with severe/end-stage diabetes?

This is only a small nit-pick, but the initial human testing is much more likely to be done on the "good" Type 1 diabetics than on the severe/end-stage groups. Their reaction to the treatment will be clearer and the treatment can be evaluated within tamer limits.

For example, if you were inventing a parachute, you wouldn't do the first test on a fat greasy guy with no legs, even if the whole point of the parachute was to save fat greasy paraplegics.

I've had Type 1 since I was eleven and my endocrinologist says that the level of control I've developed and maintained makes me an excellent candidate for these experimental treatments once they are approved.

- Jon

Re:Missing something?

[jesup]

My comment was in regards partly to your implication that there's no such thing as "late/end-stage diabetes". My father is very lucky and very unusual - but even he is walking an ever-narrower tightrope. Most people, even those who do a good job controlling blood sugar, don't get anywhere hear his age (or relatively low amount of side-effects). And he's had several close calls, especially over the last 10 years.

As for the possible treatment: I'm not advocating "rushing" into human trials (though early trials with related suppressives have begun). The Wikipedia page on the suppressive mentions that it's banned in human use due to toxic side-effects. The trial in Israel (see the SciAm article) uses a known-safe-in-humans suppressant that doesn't suppress as much (but also didn't seem to work well enough; I think the SciAm article said they were going to try higher doses). Also note that the suppressive only suppresses part of the immune system; my understanding is that it's less than what is used in transplants, which are the other main hope for Type 1 diabetics, and as pointed out by someone else, the protocol doesn't involve permanent suppression like a transplant - it's temporary while the immune system is "retrained" not to attack them.

The interesting thing about the new study is that it verifies that the new islets come from spleen cells.

For "brittle"/end-stage diabetics, the loss of the ability to recognize blood-sugar changes and the fact that it starts swinging without warning leads to increasing severe side-effects and often death. Those are some of the patients who've taken part in transplant trials in Canada over the last few years, which have seemed to work, but with some problems with slow rejection/die-off of the transplanted islets. They were chosen because for them, the risks of lifetime use of immuno-suppressives is lower than the risk of not doing something. The same reasoning may end up applying here, but with hopefully lower risks (partial suppression, temporary not lifetime, lower chance of rejection/re-attack of islets).

Re:Missing something?

[Antique Geekmeister]

The lab animals do not have human diabetes: they have a chemically induced form of Type 1 diabetes. And five years is hardly enough to test the safety of a treatment that is turning on, and off, significant chunks of your immune system. Also, good animal studies cost serious money to do: good human studies cost even more. Even though Type 1 diabetes has serious health risks, expect some caution with this treatment.

If you're paranoid and nasty, you might also look at the influence of companies like Eli Lilly on NIH of medical research: the market for insulin is very profitable, and a very stable market. They'll encourage further study and testing while preparing to see the market shrink by a huge amount.

Re:Missing something?

[Antique Geekmeister]

These are adult stem cells in the body of the diabetic: there is no implantation of new stem cells, so I would think that the cancer risk is not increased by the stem cells. Rather, tweaking the autoimmune system is asking for trouble: it's complex, it's not well understood, and changing one feature often changes others. So an increase in cancer risk is a very real one, one that researchers like Dr. Faustman with her background in auto-immune research directly involving cancer will take very seriously.

Re:Missing something?

[jesup]

They aren't using this drug in a trial; see the Scientific American article I linked to in another comment.

Re:Missing something?

[Anonymous Coward]

One other reason that its taken so long to confirm this work is that initially most researchers in the field regarded it as not merely unproven but deeply flawed: the concept behind it requires rewriting large chunks of the "rule book". Faustman took a lot of crap for publishing, and funding was very hard to come by for years. In fact, the most current confirmation of the results was supposed to be a once-and-for-all debunking of the idea. Google "faustman" and "diabetes" for more background.

I know that with 20/20 hindsight people will be lining up to criticize the naysayers and conspiracy theories about politics and vested interests are already circulating, but the simple fact is that's the way science works: extraordinary claims, and especailly ones that overturn the existing canon, are generally treated with skepticism until (a) they are independently confirmed and (b) somebody can explain how the breakthrough can still be consistent with existing experimental results. While occassionally that holds up a valid discovery, it also protects science against flocking to every exciting but under-tested soi-disant breakthrough, like cold fusion.

Oblig /.

[Anonymous Coward]

Who cares about NIH - does Netcraft confirm it?

Re:When will it get converted to real therapy?

[Gription]

Uh, gee, could we make sure we have it right first? This isn't a light switch that they are flipping here. We are trudging about in areas that we don't understand yet. They are still making guesses about the mechanism by which it works!

In 2001 one researcher managed to come up with a repair in mice and published. Then other scientists couldn't repeat the findings. Now a few years later we have scientists who can repeat the findings. Sounds like it is progressing very well and at a pace that you would expect it to progress at.


Master - Grasshopper, you must learn patience...
student - Yeah,yeah,yeah... How long does that take?

Re:When will it get converted to real therapy?

[Anonymous Coward]

It's all that damn FDA's fault. We should just abolish it, then the drug companies can make the big bucks selling experimental treatments to try on your two month old daughter. After all, why should the drug companies have to pay for research or prove that it works, when all they have to do is tell people that their new treatment will cure them and they'll line up for the privilege of being a guinea pig.

Of course, for a Type I diabetes thing, they'd be a little bit more careful, after all, if you go around killing children the parents might get a little upset. They'll have to be sure to set up a proper shell company that can be sued out of existence without losing too much money.

You know...

[PreacherTom]

It gets me sometimes when comments I see in medical threads are just plain ignorant. Yes, this is only in stage 1 trials. Still, promising results *are* the therapies of the future, and they are relevant and interesting. They are especially relevant when speaking of treating something so widespread and degenerative as diabetes. This already has been an age of miracles, folks. Enjoy what the next 10 years will bring.

Re:You know...

[Dunbal]

They are especially relevant when speaking of treating something so widespread and degenerative as diabetes.

      Although type II diabetes is by far more prevalent than type I. Still an effective cure would be a major breakthrough for these people.

may nytimes article on this

[theskeptic]

An article about this was published in may in the nytimes

However...

[WK1]

However, the TCO is cheaper if you just go to the pet store and buy another mouse.

Re:However...

[Dunbal]

the TCO is cheaper if you just go to the pet store and buy another mouse.

      I did that. For some reason these damned mice just won't sit still when I plug them into the USB slots. I have to use duct tape to hold their tails in place. And I have been bitten about 30 times. I think I'll give up and go back to my trackball, they're just not worth the effort.

Re:However...

[Antique Geekmeister]

You're using the wrong lab animal:

          http://www.i-duck.co.uk/

Re:When will it get converted to real therapy?

[Alky_A]

God I wish I was a mouse... they know how to treat everything for them. Wait... what are you doing? What's in that needle??? NOOOOOOOOOOOOOOOOoooooooooooooooo!!!!!!!

Type I, not Type II

[necro81]

It is very important to note that this is a treatment for reversing Type I diabetes, not Type II.

Type I diabetes comes from an autoimmune reaction against the insulin-producing cells. It is more common in children, and accounts for about 10% of all insulin cases.

Type II diabetes tends to be caused by an insulin insensitivity - the insulin receptor in cells looses its effectiveness. The complications from Type II diabetes tend to be worse, and none of them are pleasant. There are many risk factors for Type II diabetes, some of which a person can't do anything about (i.e., genetic predisposition), but the primary risk factor is obesity and inactivity. So, for the foreseeable future, doctors will no doubt continue to caution people to be vigilant about their weight and, for those under treatment for diabetes, to still be especially vigilant about monitoring their blood sugar levels.

Re:Type I, not Type II

[hadhad69]

Type I is generally worse than Type II and this treatment is to actually replace the insulin secreting cells within the pancreas.
from your link

'Type 2 diabetes may go unnoticed for years in a patient before diagnosis, since the symptoms are typically milder (e.g. lack of ketoacidotic episodes) and can be sporadic. However, severe complications can result from unnoticed type 2 diabetes, including renal failure, vascular disease (including coronary artery disease), vision damage, etc.'

Currently, type 1 diabetes can be treated only with insulin, with careful monitoring of blood glucose levels using blood testing monitors.

Type 2 diabetes is usually first treated by changes in physical activity (usually increase), diet (generally decrease carbohydrate intake, especially glucose generating carbohydrates), and through weight loss.

Re:Type I, not Type II

[Anonymous Coward]

It is more common in children

It is more commonly diagnosed in children, but they have it for life and can cause a number of other medical problems.

Re:Type I, not Type II

[retrosteve]

Ah, but there's another consideration --

Type 2 diabetes deteriorates if not kept well-controlled. In advanced stages, the hyperglycemia oxidizes proteins and kills off pancreatic islets, until the pancreas is unable to produce insulin, just as in Type 1.

So if an advanced type-2 diabetic fixed up their insulin resistance, they might still be unable to produce insulin. And the therapy in the article might then be helpful to them too!

Re:Type I, not Type II

[sessamoid]

From a societal standpoint, Type I DM is much worse than Type II simply from the fact that Type I kills children and young adults in the prime of life. Type II is largely a disease of the middle-aged and elderly who have far fewer working years ahead of them.

Re:Type I, not Type II

[Boghog]

the hyperglycemia oxidizes proteins and kills off pancreatic islets, until the pancreas is unable to produce insulin, just as in Type 1.

You are right on the result (pancreas no longer able to produce insulin), but your mechanism (oxidative stress) is at best only part of the picture. If oxidized proteins induced by hyperglycemia were cytotoxic, a lot more cell types in addition to pancreatic islets would be killed off.

The exact mechanism of beta cell burn out in advanced type II diabetes is unclear
http://diabetes.diabetesjournals.org/cgi/content/f ull/54/suppl_2/S108/
however it certainly related to a prolonged an inappropriately high production of insulin (hyperinsulinemia) in response to high levels blood glucose.

Re:Type I, not Type II

[retrosteve]

Point taken. I was, as you note, simplifying the mechanism. There are several others, including amyloidosis brought on by oxidation of amylin normally found in the islets.

Point is still that the pancreas needs new islets, which this therapy may be able to provide. Meaning that advanced type-2's might find this therapy useful just as type-1's do.

it took me some time

[nih]

but i think we can all agree, it was worth the wait

Similair to the Edmonton protocol

[Anonymous Coward]

http://en.wikipedia.org/wiki/Edmonton_protocol

Although the Edmonton protocol was concerned with transplanting pancreatic islets. I wonder if these two procedures could be combined to give a permanent solution to Diabetes.

Re:When will it get converted to real therapy?

[fyngyrz]

Did you ever consider that there are cases with some disease processes where people might be very pleased to consider becoming a "guinea pig"?

Not everyone thinks the government should be their mommy. If you need a mommy, then by all means, have some old lady adopt you. For those adults capable of making informed decisions for themselves, why not stay the heck out of their lives? I know, it is just such a radical idea, but even so... adults, making decisions about their own bodies, for themselves... it almost sounds like... liberty.

But we can't have that. That would be... un-American.

I just wanted to thank science for this feat

[DragonTHC]

Thank you science for making it possible to reverse diabetes type 1.

thank you god for giving us diabetes.

You f ailed to point out the most important thing

[Anonymous Coward]

True that Type II is probably what most adults have to fear getting.

However, Type I is MUCH WORSE .. because with it, you require multiple daily injections. The treatment for Type II is usually only pills or inhaled insulin.

http://en.wikipedia.org/wiki/Diabetes

Re:When will it get converted to real therapy?

[MECC]

Then other scientists couldn't repeat the findings.

Which other scientists (just curious)? What's suspicious about all this is that JRDF, which will throw money at everything from new implantable device research to stem cell research won't fund research into Denise Faustman's legitimate breakthrough discovery. Could it be because her discovery involve a cheap drug whose patent has expired?

More Elegant Approach

[SoyChemist]

The method reported in Islet Recovery and Reversal of Murine Type 1 Diabetes in the Absence of Any Infused Spleen Cell Contribution may work but at what cost. It requires immune system suppressing drugs and cells from a foreign donor. I suspect that immunoconjugates that prevent the attack of islet cells will be used in conjunction with adult stem cells from the diabetic individual that have been differentiated into the appropriate replacement tissue.

Re:When will it get converted to real therapy?

[Anonymous Coward]

making informed decisions

Informed? Ha!

Take Vioxx. Certain employees of Merck decided that they could simply hide the fact that taking Vioxx was linked with a higher incidence of cardiovascular events. Sure, they could have added that to the documentation on the drug, but then they'd have lost millions of dollars from doctors adjusting doses and moving at-risk patients away from it. They wouldn't have even had to stop selling it, there are plenty of drugs more dangerous than that on the market now.

Tell you what, I'll agree that the FDA can go, when we start charging the employees of drug companies with crimes for their parts in their misinformation campaigns. Manslaughter has a nice ring to it, but it implies "accidental". The execs knew about the risk in the 90's, I believe in most jurisdictions, premeditation is usually grounds for first degree murder.

Re:When will it get converted to real therapy?

[fyngyrz]

The fact that there are risks and unknowns do not in any way reduce your ability to make an informed choice. An intelligent adult understands that there are risks and unknowns. You can't be protected from everything, including people who might not care about your particular situation or outcome.

None of that serves as "good reason" to take the right to choose from adults.

As for your outlook on drug companies, fine, whatever. You're entitled to your outlook. That still doesn't give you the right to tell me what to do with my own body.

Not as simple

[DebateG]

Calm down people. They haven't cured diabetes; in fact, this cure for diabetes (in mice) isn't new at all. This isn't a phase I clinical trial. They haven't tried it on people, and I really doubt the FDA will approve any such trials in the next few years.

The controversy is over the role of stem cells. No one disputes that adding Freund's adjuvant to the NOD mice can cure their diabetes, and it seems to work through a hazily-understood modulation of the immune system. That has been established for 15 years. The question is whether adding spleen stem cells to the adjuvant facilitates the process.

When Faustman first published the paper stating the spleen cells were crucial, the NIH quietly contracted three independent labs to confirm the result. No one could could show that the transplanted spleen cells were actually doing anything. Now, it seems that Faustman's group has responded to some of the criticisms, repeated the experiments, and can reproduce their own data. But as long as another lab cannot reproduce it, the role of stem cells will remain very controversial.

Why hasn't there been more of a push to use this in people? The problem in people is that you have to inject the adjuvant fairly early in the disease, and most people with type I diabetes are diagnosed pretty late when most of their beta cells have died. Additionally, no one really knows how exactly the adjuvant works (it's just a bunch of dead bacteria) and whether it will elicit nasty reactions in people that are worse than diabetes itself.

For those technical, you can read the actual papers for free online.

I call bull

[Anonymous Coward]

I am posting this anonymously because Denise Faustman has been known to try and sue individuals who speak against her work. In short, I have read the technical comment and the portion that 'reproduces' the earlier work is clearly attributed to Kodama AND NOT NIH researchers. Now why is this important? Kodama is the same person who did the original experiments (in 2001 and 2003) that nobody has been able to reproduce (there have been multiple attempts published, not one has been able to coax MHC mismatched spleen cells as being accepted let alone transdiferentiation into insulin producing cells). So, if this has been around for 5 years now and only one guy in the world is able to do it, something just doesn't sound right to me.

Re:When will it get converted to real therapy?

[Anonymous Coward]

The JDRF is run by parents of children with diabetes, not the pharmaceutical industry. What is more suspicious is that the scientist who supposedly reproduced this work, Kodama, happens to be the same one who did the original work. He has just changed labs. Maybe this is why the JDRF is not funding this work. It has yet to be shown to work by anyone other than the original authors.

Re:When will it get converted to real therapy?

[Anonymous Coward]

Actually, this has yet to be reproduced by another researcher. Kodama did the original experiments and the current ones as well. I would love to see another group be able to reproduce this work but despite the press release to the contrary, it is yet to happen.

Re:When will it get converted to real therapy?

[WilliamSChips]

We're talking about advertizers here, making provably false claims. Yes, I want the government to prevent companies with good advertizing from killing people.

Re:When will it get converted to real therapy?

[Anonymous Coward]

The fact that there are risks and unknowns do not in any way reduce your ability to make an informed choice.

That statement is ridiculous on the face of it. How many unknowns must there be before "informed choice" simply becomes "choice"? By your standards, taking a random person and asking him to choose the number you are thinking of would be asking for an informed choice, after all, you told him it's a number and you're allegedly thinking of it. Would a response to the demand of "Answer?" to a person be "informed", since you let the participant know you were expecting one?

In this case, it was a known risk that was known to one participant and not the other. You're welcome to believe that this is "ok", but please find some other name for your abomination of an economic theory, since Capitalism is already taken and in most of its forms requires perfect knowledge sharing as well as rational participants who are not trying to kill each other.

Still, it's a start...

[Svartalf]

1) Type I Diabetes patients have equally nasty problems (I know of at least two Type I patients...)- some of which are the same
as the Type II patients.

2) Fixing this one would be amazing- it was thought that generally Type I was treatable only with Insulin injections. To be "cured" would be amazing for them.

3) Some of the meds for Type II Diabetes can QUICKLY and VIOLENTLY turn you into a Type I Diabetic if you get exposed to certain other substances. The Avandia type meds and Glyburide type meds that affect utilization and production of Insulin can torch off what's left of the Islet cells in the Pancreas with exposure to things like...oh...alcohol...contrast dyes...handful of other things... When I was taking Avandia and when I was still taking Glyburide I had a list of things that were JUST NOT A VERY GOOD IDEA FOR ME TO TAKE/DO .

4) They have a metabolic switch that they've discovered that turns OFF Type II Diabetes like a light-switch; but you have to take the med for the rest of your life and they're being VERY cautious moving forward with it because it's a genetic based therapy like the Immune System Booster that they screwed up the lives of those poor bastards in the UK earlier this year.

If you've not figured it out by now, I'm a Type II Diabetic. So what if it doesn't help me? It's a fix for the other people out there that don't have the same set of problems I do, but still have serious issues with Sugar- this could free them from every bit of the issues with Insulin shots and needing to manage or avoid sugars. Not everything sugar free is good for you or a diabetic, contrary to the popular belief otherwise- and not everything uses Splenda (nor is it a certainty that it's any better than Nutrasweet, safety-wise...). To not have to worry much ever again... Wow...

Re:Still, it's a start...

[Danga]

Not everything sugar free is good for you or a diabetic, contrary to the popular belief otherwise- and not everything uses Splenda (nor is it a certainty that it's any better than Nutrasweet, safety-wise...).

Please stay away from Splenda which is basically just chlorinated sugar (I don't want to let any more chlorine into my body if possible) as well as all of the other artificial sweeteners like Nutrasweet, etc. They are NOT natural substances and instead are just man made chemicals, can be dangerous, and there are natural alternatives that are proven to be safe.

Two alternatives that I know of are xylitol and stevia and they actually have some health benefits which I find great.

Xylitol is a naturally occurring wood sugar and is pretty much just as potent as table sugar so it makes a great substitute. One of the best things about xylitol is it is actually tooth friendly and some studies have shown that it can help reduce plaque as well as help repair minor cavities. Xylitol also is absorbed slower than table sugar which is great since it does not cause high blood sugar levels or hyperglycemia. I will mention that xylitol should not be used in baking recipes because it does interfere with the yeast in some way so stevia is a better replacement for baking.

Stevia is also made from a naturally occurring plant. I really like it but it is around 300 times sweeter than table sugar so it took me a while to get used to know how much to use. It also does not alter blood sugar levels like sucrose which makes it great for diabetes and those suffering from hypoclycemia. Japan did extensive research of stevia and has been using it for over 30 years without any causes for concern that I have heard about. The World Health Organization also studied it and found no ill effects. Stevia can be used in baking recipes and does not have the problems that xylitol does.

All I can say is I hope people look to some of the naturally occurring sugar replacements first before putting a man made chemical sugar replacement into their system. I recently found out I had severe hypoglycemia and am pre-diabetic which is why I went looking for some alternatives to sucrose and everyone I talked to and all the information I could obtain pointed towards stevia and xylitol as the best alternatives. After trying both of them out I will say that I don't miss sucrose at all and I wish I had been informed about the alternatives sooner, they are great tasting and SO much better for your body.

Re:Still, it's a start...

[jonabbey]

Please stay away from Splenda which is basically just chlorinated sugar (I don't want to let any more chlorine into my body if possible) as well as all of the other artificial sweeteners like Nutrasweet, etc. They are NOT natural substances and instead are just man made chemicals, can be dangerous, and there are natural alternatives that are proven to be safe.

Watch out, a lot of products feature chlorinated sodium, as well.

Re:Still, it's a start...

[Danga]

That is true but at least sodium chloride is a naturally occurring substance that humans have consumed for thousands of years which is a pretty good long term study to look back on.

Chlorinated sugar on the other hand is only about 30 years old and NO long term studies have been done (and in total only THIRTY SIX humans were ever tested and the longest study was FOUR DAYS) while many of the studies that have been done show that pretty bad things can happen such as: "Sucralose (Splenda) may result shrunken thymus glands, impaired immune system and enlargement of liver and kidneys" (New Scientist, Nov 23, 1991). Take a look at the following article about the dangers of splenda for some more info:
http://www.mercola.com/2000/dec/3/sucralose_danger s.htm

We don't know what long term problems could arise out of humans using sucralose and that is pretty scary and is the reason I won't use myself as one of the test subjects. If you want to assume that using man made chlorinated sugar is fine since using naturally occurring chlorinated salt is fine then go for it. I would prefer to see more long term testing done that shows more favorable results than all of the tests I have taken a look at so far.

I also don't understand why anyone would want to use a man made chemical when many natural sugar replacements are available. The reason the masses don't know about the safe, natural alternatives is because there is not nearly as much money in it as there is if a company comes up with their own man made alternative that they can patent. Did you know that stevia cannot legally call itself a sweetener here in the US because the artificial sweetener companies put pressure on the FDA to not allow it? Even though Japan has extensively studied the herb and proven it is a safe sugar alternative it cannot be called such because of that would threaten the profits that could be made using the man made sweeteners. The FDA would prefer to ban stevia if they could, read more about how stevia has been attacked here:
http://www.rense.com/general37/stev.htm

Diabetes

[stitchesXXIII]

As the parent of a child with Type 1 diabetes...It is "NOT easy to manage by any means". The technology has made it better but thats where it ends. Try to go to bed wondering if you child is going to be OK in the morning or wonder how his blood glocose is affecting him daily no matter how well you think its being "managed". Your an uneducated idiot...Try to tell your kid that he cannot have a simple glass of orange juice in the morning or anytime of day for that matter, or have to stop him in the middle of playing some activity to check his glucose levels, as they are shaking/trembing telling you he feels fine when its apparent that he is not. My wife and I have not had a solid nights sleep since he was diagnosed at just before his second bithday (nice gift) he is now five. I could go on and on (seizures, coma, shock) "NOT SO EASY TO MANAGE"...Sports teams are managed not diseases.....and most importantly .... Hate to say this but there is no money in finding a cure...there will never be any cure so long as there is money to be made. The pharmaceutical companies in the US are too powerful. Take a moment and think about this it if you are educated enough you will know this to be true. Think about the all the monies raised over the years for any given disease (billions per year do some research but I warn you it gets ugly seeing how much money is raised with very little or no improvements whatsoever)...have they found one cure for anything? the answer is NO...the only chance anyone has in finding a cure lies with stem cells and we all know where thats going...nowhere fast...unless you live in Europe leaps and bounds being made in the are of stem cell research (and please don't post a reply telling me to move that would be stupid and show your lack of any education).

No, type 1 and type 2.

[yet another coward]

The current nomenclature is type 1 and type 2. Roman numerals are out of favor to describe the kinds of diabetes. The recommendation from the American Diabetes Association came out in 1997. See here.

Argh!

[jproffer]

Great. I knew I shouldn't have had my spleen removed!

A Type 1 Diabetic's Perspective

[Anonymous Coward]

I'm 19 years old and have had Type I Diabetes since I was 6.

I don't know what's hurt me more over the years... the pain of growing up diabetic or the pain of watching my parents watch me grow up diabetic. They pushed me very hard to keep myself as healthy as possible. I've always been on a strict diet, tested my blood sugar four times a day, taken four or five shots a day, and have managed to keep my A1C below 7.0 (except for once after I moved away from home when it jumped to 7.2). Despite my years of hard work, I've recently started developing peripheral neuropathy in my left foot. My doctor says it's probably because I'm so tall (6'5") that the nerves going from my brain to my feet are so long that it made them very prone to developing the condition.

Sometimes my foot almost feels normal. Sometimes it just tingles a little. And other times it hurts so much that I can't fall asleep at night. But neuropathy rarely stops at a foot. I may develop cardiovascular, gastrointestinal, or ocular neuropathy some time in the near future. Then it will shift from being yet another burden, to being life threatening.

Fortunately (or perhaps unfortunately), I probably won't have to go through the horrible experience of advanced neuropathy or blindness since I have other medical problems that will probably kill me before I get to any of that or before anyone develops a cure for diabetes that works on humans. I just felt like sharing a small portion of my personal experience. Hopefully this will change the perspective for a few ignorant people out there who think managing diabetes is as easy as popping a few pills that fix everything. Diabetes is a losing battle. Some people fight hard and live long lives. Some don't fight at all and get their limbs hacked off. And some fight and lose anyways.

For the sake of all the other diabetics out there, I hope they really do find a cure soon.

Re:When will it get converted to real therapy?

[fyngyrz]

That statement is ridiculous on the face of it.

No. It isn't. Risks and unknowns become a problem only when you are thinking they don't exist. If you can see enough of a problem to evaluate it in your own life, then you should be free to do so. Problems and solutions are not evaluated on unknowns, they are evaluated on knowns. For instance, when you take an aspirin, there is an unknown chance that you will exhibit a side effect. You assume it is small (because the odds are small) but that may not be the case for you.

You are who the founding fathers feared; that person who presumes he can dictate actions to others based upon what he thinks is benevolence, when it is really dictatorial evil.

But not to worry. You're in control. Goodnight, mommy.

Being a Type 1 Diabetic, all I can say is...

[DietPepsiAddict]

Thank You.
I couldn't have said it better myself, and I *AM* a Type 1.
Spent the first 25 years of my life cycling daily, running, hiking, eating healthy foods & generally being as "healthy" as I knew how.
Suddenly I start to get sick, and the next thing I know, I've got "Adult Onset" (26yo) "Juvenile Diabetes" (insulin dependancy) which was found out after I woke up from a week long DKA coma.
With my BSL's in the 800+ range & pH at 6.72, another five minutes in traffic getting me to the hospital and they wouldn't have bothered trying to revive my corspe.
Anyone who tries to tell me that Diabetes is "my fault", risks getting a 50cc insulin injection to the face.
Ok, not really, but it REALLY pisses me off to have someone tell me that my CURRENT weight problem is the CAUSE of my being Diabetic, when it's the complete OTHER way 'round. Then when they try to tell me to "just deal with it", it pisses me off to the point of wanting to SHOW them EXACTLY what it feels like to go through a hypoglycemic reaction despite doing everything possible to keep it at bay.
Diabetes sucks.
My Uncle died of it after losing his legs, an arm, and his vision.
I am NOT looking forward to "old age", which at this point, means hitting 40.
=(

Is this the EDMONTON (Canada) PROTOCOL?

[ivi]

CBC's "Quirks & Quarks" Science program announced the Subject protocol long ago,
and there have been human trials in subsequent years, in Canada, USA & Sweden,
among other places on the planet.

One problems was that folks who'd undergone the procedure had to take drug to
inhibit their immune systems, ie, to reduce the risk of rejection of the islets.

Nevertheless, some found that acceptable (presumably such drugs could be taken
orally, rather than intravenously).

Any, if I've got the name of the protocol right, up there in the Subject, then
WHY didn't it appear in the post's title?

Giving credit to those who've done the original work is to be expected, even if
that work was done outside the USA.

Still, delays in getting this work translated into procedures available for the
folks who have Type 1 diabetes might well be explained as much in the profitability
of older techniques, both to makes of pumps & doctors.

I'm reminded of the awful metal braces that were -once- applied to the legs of very young
sufferers of polio, ie, in -recent- "dark ages" of the treatment of that disease,
while far less intrusive treatments enabled victims to walk on their own were both
known and practiced by innovative doctors - who had been ignored or insulted, ie,
until their methods were - at last - embraced by the medical community.

"Give me Evidence-Based medicine... or NUTHIN'" ;-)

Re:Is this the EDMONTON (Canada) PROTOCOL?

[iawia]

No.

Re:When will it get converted to real therapy?

[MECC]

What is more suspicious is that the scientist who supposedly reproduced this work, Kodama, happens to be the same one who did the original work. He has just changed labs. Maybe this is why the JDRF is not funding this work. It has yet to be shown to work by anyone other than the original authors.

Didn't Faustman do the work in this and the original studies? It seem odd that nobody else has tried to reproduce such promising research.

The knights who say NIH?

[nihkee]

Coincidence?

Heh... Don't get me started...

[Svartalf]

Either it's Splenda, Saccharin, or not at all...things like Xylitol, Malitol, etc., while they're naturally
occurring sugar alcohols and sweeten nicely, they have a nasty side effect of causing laxative effects past a
certain level of consumption. So, they don't use it as a sweetener at restaurants, in sodas, etc. The only
places I've seen these useful sweeteners is in gums and candies- and not all that often (Seems Aspartame's
VERY popular compared to the alternatives, even though it doesn't taste as good because it's cheap compared
to the allowed alternatives and keeps forever as long as you keep it cool before using it.).

You can't patent a plant, so the FDA won't do what needs to be done for Stevia, which as far as I can tell works
just fine and is as sweet as Splenda happens to be- but as you put it, the big pharma companies (who gave us
saccharin (which was just fine...the studies were so screwed up that it was hillarious...), Aspartame, Acesulfame,
and now Sucralose...) don't want it because they can't gouge for the Patent royalties for the stuff. Sounds
paranoid, I know- but go reading between the lines and it isn't so paranoid.

What they don't tell you about Sucralose is that it's chemical formula means that it's not really derived from
sucrose completely like they tell you it is- not to mention truly chlorinated sugar is more a pesticide and is
rather toxic to humans. It MIGHT be safer than Aspartame, it might not be- but for me, I'm stuck between a rock
and a hard place because of all the stupidity.

Re:When will it get converted to real therapy?

[Anonymous Coward]

If you can see enough of a problem to evaluate it in your own life, then you should be free to do so.

What percentage of the population do you think can actually think for themselves? Granted that letting everyone make decisions like this would thin out the gene pool but do you really think that people even read the information sheets that are included with prescriptions? Can we even think that the doctors or the pharmacist would read or care to share the information with the patient if they weren't required by law.

For instance, when you take an aspirin, there is an unknown chance that you will exhibit a side effect.

The usage of aspirin has had a lot of research on it and most people probably know the side effects already. If they don't, they are listed on the box & bottle as required by law. The FDA considers the side effects to be minimal enough that aspirin is available OTC.

Society has developed to the levels we have today by allowing people to specialize. If you require every person in the world to have the ability to understand the complexity of medicines, the world wouldn't have time for everything else.

Jim

Re:When will it get converted to real therapy?

[fyngyrz]

What percentage of the population do you think can actually think for themselves?

[stares hard at Jim, begins to count... 0... moves to next citizen... 1...]

Law for the least common denominator is not a solution. It is a problem.