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

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

[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.

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?

[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: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!!!

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.

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

[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: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

[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

[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.