The Future of The Cure

Last night, I attended a wonderful lecture by Thomas Brobson from JDRF on research being done to find a cure for Type 1 Diabetes. It was so encouraging! He believes there will be a cure for diabetes, but that it probably won't be one silver bullet. It will probably be a combination of protocols, and he shared some wonderful things happening in diabetes research.

Huge advancements in research are being made in how to stop the assault of the immune system on the beta cells. The anti-CD3 drug shows great promise in stopping the progression of the disease. The data from that trial will be unlocked within the year. Another approach to slowing the immune attack is to induce tolerance with a series of shots using a piece of the protein on a beta cell. This is similar to taking allergy shots & may have little to no side effects.

There has been lots of research in curing diabetes in mice, but not so much in people. In 2005, there were only 5 clinical trials involving humans and no industry partnerships. In 2010, there are 47+ clinical trials and 28 industry partnerships! That means that enough progress has been made that companies believe there is something worth investing in!

One drug is helping to increase the number of beta cells a person has. The study is being targeted at type 2's , but the benefit would clearly carry over to type 1's. If one drug could halt the assault on beta cells and another drug could help create new ones, an effective cure could result! Researchers have also discovered that even women who have had T1 for a long time with little insulin production suddenly grow new beta cells when they are pregnant. The beta cells help cover the increased insulin needs throughout the pregnancy and then are reabsorbed into the body after delivery. Understanding this process may also help in finding a cure.

Mr. Brobson is type 1 himself and has actually worn the artificial pancreas! It is so much better than I thought! It integrates the pump & a continuous glucose monitor. It uses data over the last few minutes to predict where your BG is going & increases or decreases basal rates based on that. Mr. Brobson is a tightly controlled diabetic with an A1c of I think 5.4! He stayed in the hospital for 2 days. The first day he managed his diabetes himself, and the second day the computer program managed his diabetes. The computer did better than he did!!! I saw all the graphs of what happened each day. He had fewer highs & lows, but most touching was how he said he FELT. It was his first stress-free day since diagnosis. For the first time, he could take a break from his diabetes. He didn't poke his finger, count his carbs, or anything. He was stuck in a hospital room all day, but to him it still felt like a cure.

The components of the system - pump sites & CGM sites are getting smaller. Right now, Andrew doesn't want to wear the CGM. The iPro that he wore was a CGM & he doesn't want to wear that much hardwear all the time (see the bionic boy post in October 2009 for pictures!). Mr. Brobson said they are developing a transmitter the size of a button! Andrew might wear that if it meant no more safety checks at school, baseball, etc. If he wore a CGM, I could take the receiver behind the dugout & get a reading without bothering him at all!

The last research front that he mentioned was in insulin delivery. We are still injecting insulin into fatty tissue & waiting for it to be absorbed. Food hits the bloodstream faster than insulin & causes a spike. A healthy pancreas releases insulin straight into the bloodstream. There is a layer of blood flow just beneath the skin. They are trying to develop a patch with no needle that would infuse insulin into the blood just below the skin. It would be great to be free from needles & also to not have the inevitable spike that comes with eating!

Many of these trials will take years to complete & then get FDA approval. I still expect Andrew to grow up with diabetes. I also expect that Andrew will tell his grandchildren, "When I was a child, I HAD this disease called diabetes..."