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Medicine Biotech

Can Two Injections of Tuberculosis Vaccine Cure Diabetes? (fortune.com) 124

An anonymous reader quotes Fortune: The causes of Type 1 diabetes can be significantly reversed over several years with just two injections of a common tuberculosis vaccine injected a few weeks apart, researchers at Massachusetts General Hospital announced Thursday in a paper published in the journal Nature. Researchers found a substantial reduction in the blood-sugar marker HbA1c that is used to diagnose diabetes.

All subjects with diabetes who received the vaccine had a 10% reduction after three years and 18% after four years, bringing them below the cutoff point for a clinical diagnosis. Those subjects followed for a full eight years retained most of the reduction. Participants who received a placebo or were in a reference group that followed normal diabetic management saw their blood sugar measurement rise by a few percentage points during the same periods followed... A 10% reduction in Hb1Ac reduces the risk of death as a result of diabetes by 21%, and drops by 37% other complications, like blindness and loss of feeling in hands and feet, according to a 2000 study.

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Can Two Injections of Tuberculosis Vaccine Cure Diabetes?

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  • by emaname ( 1014225 ) on Saturday June 23, 2018 @06:58PM (#56835590)

    It strikes me as though there is a large number of oral medications and injectables all geared toward "managing" diabetes. That's a lot of revenue for somebody. Now to have something that (if it's true) can reduce the need for diabetic medications seems like it would make those drug manufacturers very unhappy.

    • It strikes me as though there is a large number of oral medications and injectables all geared toward "managing" diabetes. That's a lot of revenue for somebody. Now to have something that (if it's true) can reduce the need for diabetic medications seems like it would make those drug manufacturers very unhappy.

      Therein lies the quandary for the development of humanity-saving drugs... life-long prescriptions produce far more revenue than the next generation of super-antibiotics.

      I suspect this might be a flaw in the free market solves all ills school of thought... unless a future that includes a reduction in the human population of the planet is viewed as a net positive.

      • Gilead just had a huge lesson in the area. Their blockbuster drug cured so much Hep-C that its sales have already plummeted. Cures are short hits. The boom-bust cycle can be more destructive to a company than just never having the boom.
        • Rats. Our only chANCE is that pharmaceutical companies evolve to develop life-changing cures that have to be taken, er, for the rest of our lives.
      • by Baloroth ( 2370816 ) on Saturday June 23, 2018 @08:42PM (#56835898)

        I suspect this might be a flaw in the free market solves all ills school of thought

        But this is also a problem that can be solved by the free market. See, a pharma maker with a drug that manages a disease (rather than curing it) may not be inclined to produce a drug that could cure said disease, but another company, one that does not make such a drug (especially a company that is a competitor to the first) does have a strong incentive to produce a cure, as not only would it make them a large amount of money (even if for a short period of time), it would undermine the revenue stream of the competing company, a win for them. Note that this requires the market to actually be free. Collusion between companies can prevent it from happening, because then it ceases to be a free market (note that this does mean a free market requires some government intervention at times).

        This is why all the conspiracy theories about researches not actually wanting to find a cure for cancer make no sense. Aside from the fact that researchers themselves have ethical incentives to find a cure (not to mention reputational: there is, after all, a Nobel prize in medicine, and a cure for cancer would be a guaranteed shoe-in), and of course the fact that cures for plenty of other diseases have been (and continue to be) developed (which shows that pharma companies really do still put out cures), the company that discovers a cure for cancer would make all the money in cancer treatment, not just some of it, and for quite a long time, and would completely decimate their competitors. Plus ongoing money, since cancer would still occur and need curing (in fact, they could probably end up making even more money in the long run, since people surving cancer means they're more likely to develop another cancer in the future)

        • Yeah, maybe... if it achieves [nih.gov] Lipitor-like success, [investopedia.com] which would require life-long medication.

          Assuming constant incidence, survival, and cost, we projected 13.8 and 18.1 million cancer survivors in 2010 and 2020, respectively, with associated costs of cancer care of 124.57 and 157.77 billion 2010 US dollars. This 27% increase in medical costs reflects US population changes only. The largest increases were in the continuing phase of care for prostate cancer (42%) and female breast cancer (32%). Projections of current trends in incidence (declining) and survival (increasing) had small effects on 2020 estimates. However, if costs of care increase annually by 2% in the initial and last year of life phases of care, the total cost in 2020 is projected to be $173 billion, which represents a 39% increase from 2010.

        • by religionofpeas ( 4511805 ) on Sunday June 24, 2018 @01:18AM (#56836656)

          but another company, one that does not make such a drug (especially a company that is a competitor to the first) does have a strong incentive to produce a cure,

          This company would make even more money if they just produced a competing drug to manage the disease rather than curing it.

          Here are some examples of the best selling diabetes drugs, from different pharma companies. None of them would benefit from a cure.

          https://www.pharmaceutical-tec... [pharmaceut...nology.com]

        • Researchers would love to cure all kinds of things. Big pharma, on the other hand, doesn't care even slightly about curing anything. It just wants to see a profit. These goals are sometimes compatible, and sometimes not, but the real danger in this system is consolidation. Capitalism only works in the presence of competition. Consolidation leads to greater barriers to entry into the market, because larger corporations have more money to spend buying legislation.

      • by ShanghaiBill ( 739463 ) on Saturday June 23, 2018 @08:44PM (#56835910)

        I suspect this might be a flaw in the free market solves all ills school of thought...

        You might want to pay more attention to that school of thought. A "free market" is a market with full transparency of information, and no barriers to entry for either sellers or buyers.

        Medicine has huge barriers to competition, and buyers have almost no information, since doctors don't post prices and often don't even reveal them at the time of delivery. Buyers also have little ability to compare providers for quality. Even review sites like Yelp tell you far more about the rude receptionist than the outcome of the treatments. Furthermore, the "buyer" is insulated from the price, and usually only pays indirectly through their insurance company.

        Healthcare in America is about as far as you can get from a free market. Perhaps this is an area where socialism actually makes sense, but we could do it with no net increase in government by de-socializing tasks the free market can do just fine, like package delivery.

        • So none of the millions of researchers in China and India can find these cures? Wouldn't countries that now have socialized healthcare benefit from cures? Why is it only the US that can do these things? The same goes for stem cell research, nothing can be developed because of America's abortion laws. For some reason aborted Russian, Japanese, and Chinese babies can't be used.
      • by Agripa ( 139780 )

        I suspect this might be a flaw in the free market solves all ills school of thought... unless a future that includes a reduction in the human population of the planet is viewed as a net positive.

        Or regulatory capture of the FDA is being used to prevent development of less economical treatments. Pick your poison.

        There is no free market in medicine.

    • like the US does, so a lot of good basic research is getting done over there. Eventually it makes it's way over the pond.
      • Europe does't put up with their crap, like the US does, so a lot of good basic research is getting done over there.

        Which is why this study was done at the "Massachusetts General Hospital"?

    • by gweihir ( 88907 )

      That is probably the reason this study is so small. But according to Wikipedia, Type 1 is only 5-10% of all cases, so Big Pharma may just not care, not enough money in it.

      • Isn't Type 1 what most kids who are diabetic have?

        Won't someone think of the children?!?

        seems quite appropriate here.

    • They are already complaining about the Hep C cure and how they want to focus more on managing instead of curing.

  • by puck01 ( 207782 ) on Saturday June 23, 2018 @07:04PM (#56835614)

    To be clear, the intervention is not a cure for type I diabetes mellitus. The authors go out of there way to prove and explain this:

    "In this study we observe the long term and stable lowering of blood sugars in humans after BCG vaccinations. In the human, this stable blood sugar control was not driven primarily in these human subjects by pancreas recovery or regeneration. The human pancreas after BCG even at four years after repeat vaccinations did not secrete significant insulin as clinically measured by C-peptide. The mechanism for lowered HbA1c values was not equivalent to the NOD diabetic mouse pancreas regeneration after BCG treatment, despite equally restored and long term improved blood sugar control. The BCG-treated type 1 diabetic subjects at year 4 after glucagon challenge had a negligible to no return of clinically significant C-peptide. The C-peptide values after glucagon were in the range of 2–3 pmol/L of C-peptide (Fig. 1c), but with no known clinical significance. Therefore we concluded that BCG vaccinations did not induce a clinically meaningful return of C-peptide levels in the pancreas by regeneration, as observed in the NOD mouse model of diabetes17,18 Thus pancreas rescue or regeneration could not fully account for the persistent and long term HbA1c lowering in humans receiving BCG."

    The study didn't include type 2 so we really can't say how this intervention will work on that group; however, I don't see a reason to think it wouldn't be effective in this group.

    This is a really interesting study. I've been heavily involved in the past with diabetes mellitus management. This is a novel approach as far as I know. This may revolutionize the approach to treatment for many with diabetes mellitus.

    • I'm somewhat sleep deprived, am I correct in reading that this implies it would lower almost anyone's blood sugar levels slightly for the long term? My understanding is that lowering average blood sugar levels slightly is significantly beneficial to overall health.

      • by puck01 ( 207782 )

        The study is consistent with the possibility that it could improve glycemic control for patients with other types of hyperglycemic disorders (ie. type 2 diabetes mellitus or pre-diabetes) but it certainly hasn't proven this.

      • by arth1 ( 260657 )

        My understanding is that lowering average blood sugar levels slightly is significantly beneficial to overall health.

        No, that's not a given. You don't want to push people with an already low blood glucose level down to hypoglycemia levels.

        Low blood sugar can be a problem not only for diabetics who take too much medicine, but also people with Addison's disease, non-diabetic alcoholics, and people who do endurance sports or very high levels of exercise.

        • My understanding is that lowering average blood sugar levels slightly is significantly beneficial to overall health.

          No, that's not a given. You don't want to push people with an already low blood glucose level down to hypoglycemia levels.

          Low blood sugar can be a problem not only for diabetics who take too much medicine, but also people with Addison's disease, non-diabetic alcoholics, and people who do endurance sports or very high levels of exercise.

          If you read the study, they did address this.

          Semi-annual surveys confirmed that during year 03 to year 08 after BCG vaccinations there were no reports of severe hypoglycemia by any patient, even with lowered HbA1Cs near the normal range, and no change in their care as it related to new insulin pumps or continuous glucose monitoring devices. The placebo group of subjects continued to show hypoglycemia events during the same time periods of monitoring.

          • by arth1 ( 260657 )

            If you read the study, they did address this.

            No, they didn't. The study and control group were all diabetes patients, where the risk of hypoglycemia is from medication. That's a very different situation than someone who has low blood sugar values for other reasons and where lowering it would bring them below a threshold and cause problems.

            My response was to point out that lowering the blood sugar is not always beneficial overall. And indeed, they don't propose that either.

  • The article refers to type one diabetes, not the far more common (and epidemic) type two.

    Nice, but not as useful

    • by phantomfive ( 622387 ) on Saturday June 23, 2018 @07:51PM (#56835744) Journal
      There's recent research showing a cure for type 2 diabetes, as well [thelancet.com]. The conclusion:

      "Our findings show that, at 12 months, almost half of participants achieved remission to a non-diabetic state and off antidiabetic drugs. Remission of type 2 diabetes is a practical target for primary care."

      • Let us hope. I've know too many with all of the serious complications.

        I'm always leary of "it's a target"

        It reminds of the old Microsoft joke... "it's gonna be great"

      • There's recent research showing a cure for type 2 diabetes, as well [thelancet.com]. The conclusion:

        "Our findings show that, at 12 months, almost half of participants achieved remission to a non-diabetic state and off antidiabetic drugs. Remission of type 2 diabetes is a practical target for primary care."

        Since I have type II diabetes, I clicked that with interest to read what miracle might be there. To sum it up...intensive weight loss via exercise.

        Well no shit.

        • by eskayp ( 597995 )

          "To sum it up...intensive weight loss via exercise.
          Well no shit."

          Are you sure you didn't mean
          "...minimal weight loss via intensive exercise.
          Oh well, no shit time left in the day."

    • Most cases of type 2 can be prevented and treated with a better (no sugar/no grains) diet.

      • Yeah, let me know how successful you are with that. It's not JUST sugar/grains... Expand it to the more general and appropriate "carbohydrates" and then tell me what has carbs and how to scrupulously avoid them.

        I the cheese you eat isn't extremely sharp, the residual lactose is a carbohydrate. Legumes, some "good" carbs (not digestable) still some "bad" ones too.

        Did you know protein can metabolize into glucose? Carbs.

        I live this.

        It's not fun but worth the effort.

        • Let's keep a sense of perspective. You want to keep your blood sugars to a "healthy" level. As I understand it, that's between 70 and 100mg/dL fasting and generally below 140 all the time (yeah you spike after eating).
          If you're not dead, you have a blood sugar level of some sort.
          My point is, you should NOT be trying to eliminate sugars or things that will turn into sugars from your diet. You need them. Just figure out what you can eat such that your blood sugar stays at a level your nerves aren't dying of
  • Since getting those injections does no harm why not test responses tor type 2 diabetes?
  • by niittyniemi ( 740307 ) on Sunday June 24, 2018 @04:16AM (#56836980) Homepage

    I'll try and identify a few of them.

    First up: define what a Type 1 diabetic is.

    We had this come up some weeks back, when some Scandinavian doctors came up with the conclusion that the several thousand diabetics they studied did not fall neatly into 2 groups ie. Type 1 & 2. Instead they identified some half a dozen groups.

    I angrily posted about this at the time because this was known over 20 years ago. What was worse is that I (a diabetic who needs insulin) wasn't covered in their groupings and neither was somebody with gestational diabetes or ....etc.

    There's also the problem of what an American doctor diagnoses as a "Type 1" might be somewhat different to what a British or Japanese or Ugandan doctor does. It may even subtly vary among the doctors in just one hospital.

    Treatment regimens will vary also: human or analog insulin? Which analog? Short acting, long acting, mix? Pump, pen, syringe? Which pump running what software?

    The authors of this paper obviously start with the assumption that all the "Type 1 diabetics" they studied were as a result of this mysterious auto-immune disease, a disease whose pathology or very existence is entirely unclear.

    They say in the paper that their cohort had all been diagnosed as "Type 1" as if it's a choice between black or white. It's not, because that term is undefined and in clinical practice covers a significant spectrum of people.

    • It does, apparently, seem to be, as you describe it. It's unclear to me why the Type 1/2 diagnosis isn't based on blood insulin levels. Little or no insulin = Type 1. Lots of insulin but elevated blood glucose (A1C) = type 2.

      But it's not. And if it were, diagnosis would still be difficult once supplemental insulin was used.

      • Unfortunately, the whole business of diabetes, it's diagnosis and it's management is a complete shambles. That wouldn't be so bad if it was an uncommon disease.

        In the old days, type 1 & 2 were essentially known as 'juvenile onset' and 'age onset' respectively and you were chucked in to one or the other category.

        The great & the good decided that those 2 categories didn't quite correlate with the true picture and in their wisdom they decided "Type 1 & 2" was so much better. Of course, it wasn

        • "Unfortunately, the whole business of diabetes, it's diagnosis and it's management is a complete shambles. That wouldn't be so bad if it was an uncommon disease."

          Diagnosis? I'll give them a B+. A1C seems useful and is repeatable if you don't demand more than +- 0.5% accuracy. I'm less wild about blood glucose measurement. The measurement seems repeatable. But my experience is that different meters give results that are more different than they reasonably ought to be. And even with just one meter, my r

  • Does Bayes play here? https://www.google.com/search?... [google.com] I don't have access to PubMed but others here might. Would those May 2017 research articles suggest the area of research around treatment that is now publishing?
  • according to a 2000 study.

    Does this mean this study was done in 2000?
    Or, is the data from this study compared to a different study in 2000?

  • Natural herbs have cured so many illness that drugs and injection cant cure. I've seen the great importance of natural herbs and the wonderful work they have done in people's lives. i read people's testimonies online on how they were cured of herpes, hiv, diabetes etc by Dr. Ogba Kosu herbS, i contacted the doctor because i know nature has the power to heal anything. I was diagnosed with hiv for the past 7 years but Dr. Ogba Kuso cured me with his herbs and i referred my aunt and her husand to him immediate

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