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T1 CURE...????? really

Discussion in 'Type 1 Diabetes' started by Paul J, Feb 19, 2015.

  1. azure

    azure Type 1 · Expert

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    I'm still optimistic. I don't see Type 1 as like missing an organ or a limb. It's only a small part of the pancreas that's not working. As I said, animal studies have shown that other cells in the pancreas can produce insulin too in the right conditions.

    As for the immune attack, then modification of that, and activation of the other cells that can produce insulin would result in a cure. Both those things are being worked on, so it's not a pie in the sky idea. Yes, it might take some years, but it will happen, I believe.

    Maybe some people deal with diabetes by resigning themselves to it being a lifelong condition, but others like myself like to think of it as lifelong at the moment but with the hope of a cure on the horizon. That isn't wishful thinking. It's based on evidence.

    I see what the OP is saying about big pharma, but the same could be said of a cure for cancer. Huge numbers of people get cancer and large amounts of money are made in treating it.

    In addition, advances in curing one disease often carry across to other conditions.

    Fortunately, my children have avoided diabetes (so far - fingers crossed) but if they did get it, I'd be reassuring them there is hope for a cure and showing them how much work is being done on it and how many advances have been made. Our understanding grows and grows each year, and I think that and the various investigations into a cure will bear fruit in the not too distant future.
     
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  2. Charles Robin

    Charles Robin Type 1 · Well-Known Member

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    My personal view on a cure: IT'S POSSIBLE. Think about the doctors doing research. If you found a cure for diabetes, it would cement your place in history. At that point, your main problem would be finding someone to build you a big enough mantle piece. Because my goodness you would need the space for the cascade of awards you would receive. Drugs companies are big and faceless. However, they are made up of a huge, huge number of individuals.

    Personally, I have never looked forward to a cure. If it happens, I will happily get in line. In the meantime, the best thing to do is manage blood sugars as best as we possibly can. Many conditions don't have that luxury. Allowing a few extra minutes to test, to log and to learn from the data is all it takes, really. There are huge, huge numbers of ways to treat diabetes. Finding your tablets aren't woking? Try something else. If you're a type 1 like me, or type 2 on insulin, there are insulin advances all the time. Having too many hypos? Adjust your dose, or try a different insulin. If that doesn't work, look at your diet/exercise regime. If you feel like you are pestering your health team, you are probably spending the correct amount of time on your diabetes.

    Diabetes management will never be simple. But I get far more stressed over doing my taxes. Fingers crossed a cure comes round, but until that day, let's all be organised and integrate control into our routine :).
     
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  3. Spencer67

    Spencer67 Type 1 · Well-Known Member

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    I'd like to be an optimistic but its unlikely there will be a cure, i need to be the realist and know the facts but if 'smart insulin' progresses like it seems to be then my money would be on that to be the closest thing to a cure.

    I hope the big pharmos aren't so immoral that they would withhold life saving treatment and research for the ailing populations and prefer to lead them through suffering just because of money but even recent human history has taught us it is certainly possible. It's healthy to be cynical it raises the right questions and we should question everything.
     
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  4. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    lol I would rather be hopeful in a possible 'fix for diabetes' rather than cynical :wideyed: but ....................I can be cynical in other walks of life :watching: The human race will always captivate me, astound me and alarm me too :wideyed:
     
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  5. moz1

    moz1 · Well-Known Member

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    I am sure I read about an American trial of a closed loop system with a CGM and pump with both insulin and glucagon which gave good results. I will try and find link
     
  6. tim2000s

    tim2000s Type 1 · Expert
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    Hi @moz1, it is an MIT study using the T-Slim pump. I just think there are algos out there that already do something similar!
     
  7. BigRedSwitch

    BigRedSwitch Type 1 · Well-Known Member

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    A few things - just to clear them up:

    1) type 1 isn't a disease - it's a condition. A disease involves a foreign body.

    2) type 1 isn't 'part of the pancreas not working' - it's part of the pancreas *missing* (which is why I said you might as well be looking for a cure to a missing limb).

    3) for those of you who think I'm mean because I say there's no hope for a cure and people just need to get on with it - I was diagnosed at 3 years and 3 months with 'close to death DKA'. When I started I was on beef insulin which also nearly killed me, and my parents used to have to use glass syringes that they had to sterilise after use. My mother admitted to being 'scared' of me. None of the young ones now have to deal with that kind of stuff, and I'm afraid they just have to stop wallowing in negativity. It's like being upset that your eyes are brown instead of blue - you are what you are, and you just have to deal with it.

    My son was diagnosed at 20 months old. For years (when I was younger) we were told that it isn't hereditary, but it sure as hell is. My parents, between them, have 13 siblings. Each of them has between 2 and 4 children, and I have 2 siblings myself. I'm the ONLY diabetic OF ANY KIND in that bloodline, apart from my son.

    It's hereditary.

    Genuinely the darkest day of my life when I diagnosed my baby boy. He'd only been walking about 6 months. My genetics were to blame for something which I know will be with him all his life.

    All his life.

    There will never be a cure.

    The only thing that I genuinely think would be worse than being to blame for a condition that your son had to deal with all his life would have been if he'd died. I've never known sorrow like that before.

    But I didn't let it drag me down with feeling sorry for myself. I cried - once. Then I decided that, the massive strong bloke that I see in the mirror every day had come through much worse times than he would ever have to face, and that I would look after him so he'd never really be bothered by it.

    I got him on an insulin pump immediately, taught my wife how to count carbohydrates, and we got on with it. The biggest issue for me is how health and safety laws now require him to be classified as 'special needs' - there's nothing special needs about either of us.

    On the very rare occasion he's ever complained about being diabetic (usually during set changes, which sting a bit), I tell him that Iron Man needs the arc reactor (the light on his chest) to keep the shrapnel in his chest from killing him. We need the insulin pump to keep us alive. We're superheroes like iron man.

    And we are.

    Feeling miserable about it and wish there was a cure? Get over it - you're wasting your brain power and your life. Use what certainly hasn't killed you yet to make you stronger, and don't focus on media hype about cures. Until a fabled cure is available as a pill at your local chemist, there's nothing to get psyched about.

    4) DO hope for better treatments. I can't wait for artificial pancreases (next gen pumps) and smart insulin sounds great (although a bit 'blue sky' as far as I'm concerned). Over the last 38 years of being type 1, I've seen a huge change in treatment, and I feel 'less diabetic' now than I ever did, thanks to my pump. Big issue for me is the background side effects that seem to get you as diabetic even if you have good control. My hba1c's have never been above 7.2, but I notice my right hand heals slower than the rest of my body, for example. I hope that new treatments like the AP and smart insulin will have such tight control over blood sugars that these complications will go away too, but until we have them - and they work correctly - we won't know.

    I'd previously left the above out of this thread, as it's about a cure, not treatments. I'm not devoid of hope, but given medical progress and the condition itself, my hope is pointed in the right direction. ;)
     
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  8. Mike D

    Mike D Type 2 · Expert

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    Whilst I can witness (and appreciate) many of your comments, others may not, at least to the degree you think. The advances in medicine for any number of afflictions have been extraordinary. Many need that glimmer of hope. I wouldn't extinguish that flame if it works for their mental approach ... when it's all said and done, you don't know there's no possible cure anymore than I do who will continue to believe it's possible.

    My 2 cents

    Mike :)
     
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  9. BigRedSwitch

    BigRedSwitch Type 1 · Well-Known Member

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    Good on you Mike - really. :)

    But medicines treat illnesses, and we don't have an illness. We have a condition. Whilst it sounds pedantic, it's incredibly important to know the difference.

    They will eventually cure every disease. Because that involves treating something that *shouldn't be on your body*, and hence can be 'taken away'. They'll eventually cure cancer - as its a malfunction of cells (latest research, ironically, is based on essentially what they consider to be the root cause of diabetes - autoimmune response - which will be 'reprogrammed' to attack cancer cells). But diabetes is *something missing*. The only cells (on a cellular level) which are programmed to regrow are liver cells. But you have to have some of them to begin with! We don't have any islets, and they don't regrow. The only way to get them back is to reintroduce them - transplant them - so until they can grow islets which don't get killed by your immune system as a foreign body ('rejection'), the only option is to grow them for individuals, which is a MASSIVE and prohibitively expensive undertaking. In fact - I'm pretty sure they could do it already, if it was cost effective. In other words it ain't happening.

    That makes me sad, but the medical facts speak for themselves. I just choose to be a realist, I guess. :)
     
  10. Mike D

    Mike D Type 2 · Expert

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    I hear you BRS :) Nonetheless, what we "know" today may not match the reality of tomorrow. People need that hope and who are we to deny them that wish?

    I HATE the fact your son is diabetic and loudly applaud you for you for the manner in which you're dealing with it. Reckon it's fantastic.

    That said, many don't have that inner strength and will reach for anything (realistic I'd hope) that give them something to cling on to.

    Mike :)

    .
     
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  11. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    Good morning Mike:), Same here Mike, A 'fix' may not be here in my lifetime, but I hope to god there will be 'cure' in whatever shape or form it may come in. Totally agree with the type 1 children, as many will know what happened with my little granddaughter and how critical she was and for her and the 1,000's of other youngsters out there, it's for them, our future and I will still hang in to that glimmer of hope. I know of a friend who has 4 children, and in October of last year a third child was diagnosed with type 1, thats one girl and two boys now, life sure does suck. Whether I had type 1 or not, whether my granddaughter had it or not, I would want it for them.
    I often think the word 'cure' is used because of it being a hopeful, scientific, eureka moment, as it's a powerful short and understandable word, rather than a sentence of words.
    STILL HOPEFUL :D

    RRB
     
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  12. tim2000s

    tim2000s Type 1 · Expert
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    You are taking a very pessimistic view of the world @BigRedSwitch . You are also missing a big chunk of what is within the art of the possible with gene therapy and genetic manipulation. It is possible to flick a genetic switch to cause a set of cells to do something different. The trick is to know what to flick, and that's something we just don't know now. It does not require an external donor source, and you won't need to regrow anything. This approach is being looked at for a number of chronic conditions.

    If you look into it, you'll find that a couple of inherited disorders, Beta Thalassemia and Choroideremia have successfully undergone gene therapy trials to treat them. Choroideremia is the most applicable to Diabetes as it is a condition where the degeneration of several layers of cells that are essential to sight occurs, causing blindness. The gene therapy treatment caused improvements to sight.

    This stuff isn't science fiction. It is deeply researched and although at an early stage, there is no reason why a gene therapy treatment for Diabetes, allowing cells to produce insulin once more within the body, isn't possible.

    I don't pretend that I will see this happening in my lifetime. I think the vaccine for prevention might get here in that time, but I think the gene therapy will take longer. But as I said earlier, a cure is very much within the realms of biotechnology and has no dependency on transplants or external growth of our own cells and replantation. As someone else said, we will be remembered as those who suffered a condition that was wiped out.
     
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  13. Mike D

    Mike D Type 2 · Expert

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    Like that @tim2000s ... not to decry the message from BRS at all ..... but love the optimism.

    Mike
     
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  14. BigRedSwitch

    BigRedSwitch Type 1 · Well-Known Member

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    I quite literally read everything I can about diabetes. Not for hope, but for education, as that's what I believe in. I have a strong understanding of biology and a 'background' (as such) in medicine, so I understand what I read too.

    You're absolutely right about gene therapies. The problem is, in both the conditions you mention, there are still cells that remain. That's not the case in type 1 diabetes. In order to cure that with gene therapy, you'd also need to find a cell which was 'similar' to an islet, which could be modified in it's action. The risk then is that gene therapies are 'binary' - if you convert a set of cells from one form to another, they ALL turn.

    As I said in the post you replied to, I'm practically certain diabetes could be cured NOW if it was cost effective. Stem cells are still the big hope - they are 'cell blueprints' that can be programmed to become any cell. But therein lies the problem - you either need the stem cells from your own placenta, or you need them from your bone marrow.

    My abdominoplasty cost me £6000, and that was essentially removal of skin and scar tissue. I don't know, but I'd imagine that removal of bone marrow (which is a lot more involved) would cost > double that amount. Then the stem cells need to be removed, and modified to become islets. They then need to be transplanted into the patient, in a location which would allow them to work properly, which is another operation. I'd estimate that if the process was in place, it'd cost circa £100,000 to cure someone of type 1 diabetes. Maybe more. It'd also take weeks of work and an army of medical staff. It's cheaper (and MUCH easier) to just treat them with insulin - if nothing else for cash-flow reasons.

    I guess we'll have to agree to disagree. As I stated earlier, I'm not pessimistic - I don't really care about being diabetic, to be honest with you - has very little bearing on my life other than the sorrow attached to the fact my son has it (which is very much an 'internal blame' thing). I'm actually a realist, plain and simple.

    Put it this way - if they do ever create a simple solution to cure type 1 diabetes (and I mean cure, not treat) in our lifetime, get in touch, and every beer you ever drink for the rest of your life will be on me. :)

    I'd say I'd join you, but I don't drink. Although I'll have a diet coke. :)
     
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  15. tim2000s

    tim2000s Type 1 · Expert
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    I think we need to agree to disagree. There has been a reasonably large amount of research into Gene Therapy for diabetes. Both diabetic mice and rats have seen temporary "cures" via this method and a company called Insulete was seeking permission for human trials of this technique 2 years ago. It appears that the need is for the "Vaccine" to stop the insulin producing cells from being attached once this therapy has been applied.

    This is the high level press release from the University of Wisconsin-Madison School of Medicine and Public Health in 2013. The company is still around and still seems to be working on the same thing, although it is hard to find useful info on it.
     
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  16. BigRedSwitch

    BigRedSwitch Type 1 · Well-Known Member

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    Done! :)
     
  17. Spencer67

    Spencer67 Type 1 · Well-Known Member

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    Screen Shot 2015-02-25 at 09.35.35.png
     
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  18. phoenix

    phoenix Type 1 · Expert

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    You may be be wrong about having no working insulin producing cells. Beta cells are not all destroyed at the time of diagnosis. Some people have residual production when they have had T1 for over 50 years. This isn't the case for all after 40+ years. It does though seem that at diagnosis people still have some functional insulin production and that the loss of this residual function is far slower than was thought in the past.
    It is also suggests that some new cells are created but unfortunately die because of the autoimmune process during this period .

    Note that as well as finding c pep in the majority of living T1s in this study they also found histological evidence of at least a few insulin positive cells in nine pancreases examined post mortem. (some had very few but a couple far more so it does seem to be variable)
    Residual Insulin Production and Pancreatic-CellTurnover After 50 Years of Diabetes: Joslin Medalist Study http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963543/#!po=34.2105
    Dr Faustman has also shown evidence of the persitence of dectable c peptide production.
    http://www.healthline.com/diabetesm...-function-persists-in-long-time-type-1-pwds#1
    The paper mentioned is here http://care.diabetesjournals.org/content/35/3/465.full

    As for stem cells, The cells used in this promising research are blastocysts 'left over' from in vitro fertilisation.
    http://medwatch.dk/Top_picks_in_english/article4344670.ece
     
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  19. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    Good :)
     
  20. BigRedSwitch

    BigRedSwitch Type 1 · Well-Known Member

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    Opinions should never be muted, though - even if you don't agree with them. :)
     
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