That is the goal of Imcyse, a French company running a clinical trial with an immunotherapy designed to stop type 1 diabetes. Patients that have been diagnosed within the last 6 months, who still retain some insulin-producing cells, are given a treatment designed to make the immune system destroy the specific immune cells that are attacking insulin-producing cells. Results are expected later this year and will reveal whether the treatment has the potential to become a cure.
Diabetes doesn’t cause nearly as much of a stir in the media compared to HIV or cancer, but a few well-known names are associated with the disease – Halle Berry, Tom Hanks, and Paula Deen. And who doesn’t love that Food Network maven and American celebrity chef? Scandals aside, diabetes comes in two versions – Type I or Type II. In Type I, the pancreas decides to drop out of the physiological rat race and go on to discover its own metabolic purpose in life. As a result, the body generates little or no insulin, a hormone important in sugar metabolism. In Type II, unfortunate dietary choices, such as eating tons of sugar and carbohydrates, jam up the sugar absorption process, causing the body to become resistant to the insulin hormone. Type 2 makes up 90 percent of all cases of diabetes, which is going to be our focus here as we talk about when there will be a cure for diabetes. (Spoiler alert: Probably only after we ban the Big Gulp and the Big Mac.)
Hypoglycemia means abnormally low blood sugar (glucose). In patients with diabetes, the most common cause of low blood sugar is excessive use of insulin or other glucose-lowering medications, to lower the blood sugar level in diabetic patients in the presence of a delayed or absent meal. When low blood sugar levels occur because of too much insulin, it is called an insulin reaction. Sometimes, low blood sugar can be the result of an insufficient caloric intake or sudden excessive physical exertion.
There is no cure for diabetes. It’s a chronic condition that must be managed for life. This seems odd, given all the modern medical technology we have at our disposal. We can insert heart pacemakers, perform liver transplants, even adapt to bionic limbs, but coming up with a replacement for the islets that produce insulin in the pancreas appears to be out of reach for now. There is something about the pancreas that makes it difficult to fix, which is part of the reason pancreatic cancer remains so deadly.
When the glucose concentration in the blood remains high over time, the kidneys will reach a threshold of reabsorption, and glucose will be excreted in the urine (glycosuria). This increases the osmotic pressure of the urine and inhibits reabsorption of water by the kidney, resulting in increased urine production (polyuria) and increased fluid loss. Lost blood volume will be replaced osmotically from water held in body cells and other body compartments, causing dehydration and increased thirst (polydipsia).
Rarely, people with diabetes erupt in blisters. Diabetic blisters can occur on the backs of fingers, hands, toes, feet and sometimes on legs or forearms. These sores look like burn blisters and often occur in people who have diabetic neuropathy. They are sometimes large, but they are painless and have no redness around them. They heal by themselves, usually without scars, in about three weeks. The only treatment is to bring blood sugar levels under control.
Gestational diabetes mellitus (GDM) resembles type 2 DM in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2–10% of all pregnancies and may improve or disappear after delivery. However, after pregnancy approximately 5–10% of women with GDM are found to have DM, most commonly type 2. GDM is fully treatable, but requires careful medical supervision throughout the pregnancy. Management may include dietary changes, blood glucose monitoring, and in some cases, insulin may be required.
Instead of referring patients to outside specialists, internists and general practitioners can continue to helm their patients’ diabetic care through Diabetes Relief with referrals to a nearby center. The patient’s doctor and the team at Diabetes Relief work together to get the patient on the road to recovery—not just to a plateau of keeping symptoms in check. Or, doctors can expand their scope of practice and own an in-house, turnkey Diabetes Healthcare Center. This helps their patients avoid the suffering and expense of dialysis or amputations through the proven therapies of Diabetes Relief.
A computer-controlled algorithm connects the CGM and insulin pump so they communicate. As the CGM detects high blood sugar, the pump knows to provide a specific amount of insulin. The goal is to provide the patient with more normalized and ideal blood sugar management without the constant hassle of decisions by the patient who is presumably allowed to live a more normal life.
Darkes said several medical professionals worked with him when he was in St. Louis, but he could name only his senior consultant, Dr. Michael Berk. Berk is an endocrinologist who runs his own practice in St. Louis and is also a clinical associate at Washington University. Because Darkes declined a request to submit a medical release form to Berk's office, Live Science could not confirm key elements of his story, or whether or not he was even a patient of Dr. Berk.
James Collip refined Banting and Best’s insulin extraction and purification method. The new substance was tested in the first human in 1922. 14-year old Leonard Thompson was in a critical condition. He was given an insulin injection in his buttocks. This had a negative affect on him and he grew sicker. Collip worked to improve the insulin’s quality and Thompson received another injection soon after. This time, it lowered his blood sugar and saved his life.
Diabetes can occur temporarily during pregnancy, and reports suggest that it occurs in 2% to 10% of all pregnancies. Significant hormonal changes during pregnancy can lead to blood sugar elevation in genetically predisposed individuals. Blood sugar elevation during pregnancy is called gestational diabetes. Gestational diabetes usually resolves once the baby is born. However, 35% to 60% of women with gestational diabetes will eventually develop type 2 diabetes over the next 10 to 20 years, especially in those who require insulin during pregnancy and those who remain overweight after their delivery. Women with gestational diabetes are usually asked to undergo an oral glucose tolerance test about six weeks after giving birth to determine if their diabetes has persisted beyond the pregnancy, or if any evidence (such as impaired glucose tolerance) is present that may be a clue to a risk for developing diabetes.
These surgeries, even today, come with significant side effects. People have to be vigilant about getting their needed nutrients, since many aren’t as easily absorbed through food anymore. Other substances are too easily absorbed by the body, particularly drugs like alcohol. This vulnerability can then lead to alcohol abuse and may even help explain the slightly higher rates of suicide and self-harm seen in patients soon after surgery. Also distressing is that an estimated one of every 10 patients will fail to lose weight or regain the weight back in the long term, while others will require additional operations to fix complications like stomach leakages.
Surveys of people with diabetes report rates of chronic pain anywhere from 20% to over 60% — much higher than rates in the general population. The types of pain most often reported by people with diabetes include back pain and neuropathy pain in the feet or hands. (Peripheral neuropathy, or nerve damage in the feet and hands, is a common complication of diabetes.) Headaches and other pain sites are also frequently reported. Many people with diabetes also have arthritis, fibromyalgia (an arthritis-related illness that causes widespread muscle and joint pain and fatigue), or other painful conditions.
Certain drugs may also help to control pain. These include anti-inflammatory medicines such as ibuprofen, aspirin, naproxen, indomethacin, and many others. While some of these are sold over the counter, they can have side effects, most notably gastrointestinal bleeding. A newer anti-inflammatory, celecoxib (Celebrex), may have fewer gastrointestinal side effects.
“Diabetes type 1 is very different from your standard disease. Insulin requirements vary greatly from one day to another and there is no way patients can know what they need,” Roman Hovorka, Professor at the University of Cambridge, explained to me during an interview. His research group is working on the development of an algorithm that can accurately predict insulin requirements for a specific patient at any moment.
At present, the American Diabetes Association does not recommend general screening of the population for type 1 diabetes, though screening of high risk individuals, such as those with a first degree relative (sibling or parent) with type 1 diabetes should be encouraged. Type 1 diabetes tends to occur in young, lean individuals, usually before 30 years of age; however, older patients do present with this form of diabetes on occasion. This subgroup is referred to as latent autoimmune diabetes in adults (LADA). LADA is a slow, progressive form of type 1 diabetes. Of all the people with diabetes, only approximately 10% have type 1 diabetes and the remaining 90% have type 2 diabetes.
In autoimmune diseases, such as type 1 diabetes, the immune system mistakenly manufactures antibodies and inflammatory cells that are directed against and cause damage to patients' own body tissues. In persons with type 1 diabetes, the beta cells of the pancreas, which are responsible for insulin production, are attacked by the misdirected immune system. It is believed that the tendency to develop abnormal antibodies in type 1 diabetes is, in part, genetically inherited, though the details are not fully understood.
^ Santaguida PL, Balion C, Hunt D, Morrison K, Gerstein H, Raina P, Booker L, Yazdi H. "Diagnosis, Prognosis, and Treatment of Impaired Glucose Tolerance and Impaired Fasting Glucose". Summary of Evidence Report/Technology Assessment, No. 128. Agency for Healthcare Research and Quality. Archived from the original on 16 September 2008. Retrieved 20 July 2008.
This deluge of products alternately offered to fill attendees with energy or to calm us down, but almost never to keep us as we were. The implicit allure of such products was that we were not okay, or at least could be better. Given all the ways in which most people believe we could be improved, “wellness” has become an all-encompassing concept and industry that not only eats into the territory of mainstream medicine, but that has subsumed what used to be called “alternative medicine”—that which alludes to scientific claims when convenient and also defines itself in opposition to the scientific establishment.
Although the promises are big, these technologies are still far from the market. First, clinical trials will have to show they do work. Then, the price could be steep, as cell therapy precedents for other applications, such as oncology, come with price tags that reach the six figures and are finding difficulties to get reimbursed. Considering that compared to cancer, diabetes is not an immediately life-threatening disease, health insurers in some countries might be reluctant to cover the treatment.
^ Pignone M, Alberts MJ, Colwell JA, Cushman M, Inzucchi SE, Mukherjee D, Rosenson RS, Williams CD, Wilson PW, Kirkman MS (June 2010). "Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation". Diabetes Care. 33 (6): 1395–402. doi:10.2337/dc10-0555. PMC 2875463. PMID 20508233.