NIH Confirms Protocol To Reverse Type 1 Diabetes 116
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."
Re:itll be years (Score:5, Informative)
Re:Missing something? (Score:3, Informative)
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.
Type I, not Type II (Score:5, Informative)
Type I diabetes [wikipedia.org] 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 [wikipedia.org] 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:Missing something? (Score:3, Informative)
The research in question is done by Faustman financed (at least partly) by the Iococca Foundation. ( http://www.iacoccafoundation.org/grants_diabetes_
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? (Score:4, Informative)
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? (Score:3, Informative)
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? (Score:3, Informative)
http://en.wikipedia.org/wiki/Freund's_adjuvant [wikipedia.org] - 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 [wikipedia.org] - There's a lot of controversy surrounding this treatment.
Re:itll be years (Score:3, Informative)
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.
Not as simple (Score:2, Informative)
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 [sciencemag.org] for free online.
Re:itll be years (Score:3, Informative)
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.