Giant leap against Diabetes
news.harvard.edu
news.harvard.edu
(I'd actually recommend giving the paper a skim even if you're not trained in biology. The Introduction and Discussion should still be very comprehensible, and while the Results do suffer from the alphabet soup problem (as do most biological papers), the overall structure of the evidence should be clear - pay particularly close attention to Figure 5A and Figure 6A-C).
Commentary from a very well regarded stem cell scientist (and prolific blogger, Paul Knoepfler) here: http://www.ipscell.com/2014/10/top-10-takeaways-from-harvard...
The key next challenge appears to be the creation and testing of appropriate delivery device that can enable persistent survival of the differentiated cells while still enabling them to sense blood glucose levels.
The calcium ion flux response to glucose challenge was neat. Demonstrates the signaling mechanics being as expected.
This does reinforce my idea that medical technology and research is advancing at an exponential pace, faster than the evolution of diseases can keep up. A treatment for type I diabetes seemed to be impossible. A diabetic's pancreas betrays them and begins killing the cells that produce insulin. There's no pill or surgery that can stop that, nothing short of reprogramming pancreatic cells. And yet, here is a promising sign of a cure! It's really amazing, and the future probably holds even more legitimate medical wonders. We might be the one of first generations to live to 100+ on average.
Type I diabetes is expensive, ~$5,000/yr without insurance. Anyone with this diabetes would probably be willing to pay any amount less than that every year for the rest of their lives in exchange for this treatment. Talk about customer lock-in! Most of the controversy over stem cells has been centered around federal funding, but treatments for chronic and costly diseases will pay for themselves several times over. For now I can only hope that this research advances fast enough to help everyone who is currently dependent on insulin.
Edit: I also know a diabetic that went blind, it's a serious disease and I am all for staying on top of it. I am simply curious in this case.
You know if you are getting into extreme territory (up to a point... eventually the confusion that comes from hypo/hyperglycemia means you won't be aware of it).
The danger of diabetes is that you can end up perpetually a little high, which is what causes all the nasty osmotic side effects (blindness, slow healing (leading to infection and amputation), etc...). You won't be able to know that without testing.
For many diabetics, the amount of insulin they inject depends on their blood sugar. There's no way you could 'sense' it to the level necessary to control dosing.
EDIT: s/deal/interact/
You generally always have a running estimate in your head, "I ate two tacos, took three units of Humolog, needed to correct down an extra 50 points with the extra unit (because I undershot last meal), etc."
But there are factors that you have a more difficult time predicting your levels with, like exercise, illness, the type of carb your eating (some carbs take longer than others to hit your system, but if you treat all the same, you insulin will hit you faster than your carbs and you're now hypoglycemic).
Truly staying on top of your numbers and this disease means constantly checking. You can always make a guess, but when the risk of serious short-term and long-term complications hang in the balance, you tend to want to know for sure.
I think personal meters are only expected to be accurate +/- 20% anyway.
Edit: I'm Type 2, I have it easy.
Seems like they certainly accept donations. Perhaps you can support the JDRF or Helmsley Trust. If not why not contact them directly to ask whether they accept donations directly?
There are many causes worth donating to. I'd recommend taking a sober look at charitable options and give to one that's relatively underfunded.
The mice they have been testing have maintained their glucose at human levels for months (they generally run 60-80 points higher than humans). They've binged and fasted them, made them sick and everything and their levels have maintained.
This is definitely promising, don't be such a wet blanket before researching a little bit!
This is a very incredible result though. Even if immunosuppressants are required, think of all the non-patient outcomes: easily sourced human SC-beta cells for research and high throughput study. This stuff can be grown at volume, and the techniques will only improve. The results will also inform research into other cell lines. Bottom line, this is yet another step forward for stem cell tech.
1. Will the transplanted cells produce insulin in a human host? 2. Will the transplanted cells be targeted by the host's immune system and be destroyed just like the original beta cells? 3. Will the beta cells produce insulin in response to the same regulatory pathways as original system? One major problem with self-injected insulin administration is overdose.
Those are the questions I'd look to answer in the future.
1. Yes 2. No. "Melton said that the device Anderson and his colleagues at Massachusetts Institute of Technology are testing has thus far protected beta cells implanted in mice from immune attack for many months. “They are still producing insulin,” Melton said."
There are two breakthroughs. The mass production AND the ability of the device to protect the cells from destruction.
3. Yes. It reacts ideally in pretty much all scenarios. When you eat, it produces insulin. When you fast, it doesn't lower you into hypoglycemia. When you're sick (like a cold) it regulates insulin as it should, as your body needs more or less as your insulin sensitivity is off.
This is definitely HUGE!
The discussion section referred to the existing technique of islet transplantation [2]. This is sourced from cadaver tissue, and as such requires immunosuppressants. Obviously needed to counteract host v. graft, but I wouldn't be surprised if it masked the autoimmune recognition.
The discussion section alludes to several future hurdles: gene expression differences from primary cell sources, transduction response, local tissue effects (need for tissue engineering), need to produce alpha, gamma, delta, and epsilon cells (alpha and gamma may be important to precise beta function), questions regarding long-term maintenance of phenotype, ...
Nevertheless, this is very exciting! Stem cell researchers are truly hackers in every sense. The results here aren't only applicable to diabetes research, either. Patients aren't the only ones that need these cells.
[1] http://en.wikipedia.org/wiki/Severe_combined_immunodeficienc...
Not only are islet cells able to be mass produced (one transplant means 150 million cells need to be created), but the challenge of the body not simply killing off these cells too through the device created at MIT really seals the deal.
Without the implatable device, this would not be as big of a breakthrough, but having both the challenge of mass producing these cells and ensuring they are able to survive after transplant without use of immunosuppressive drugs (read hardcore side effects) effectively solved makes this a real, viable solution to this problem.
(Some type 2 diabetics might also benefit, the 10% that need insulin injections?)
For once, the focus is on T1 and not T1 lumped into the discussion as it usually is. Hey, I'm all for reporters putting out accurate facts(ie: knowing the differences between T1 & T2), but it's silly to act like this isn't "relevant".
T1 Diabetes is STILL extremely expensive to treat. Just because it's "only" ~10% of the total Diabetic population, doesn't equate to only ~10% of the costs incurred. T1 Diabetics account for FAR more costs(per person compared to T2) via: daily treatment, reoccurring, and emergency. Not to mention that for "most" T2 Diabetics, the disease can be easily managed via proper diet and exercise, something which CANNOT be done with T1 Diabetics.
source: someone who walks around daily with ~$8,000 worth of electronics strapped to their body everyday for the past 15 years.
Startups are too small for shouldering the financial load of developing/testing/insurance/lab facilities/high end staff. Plus, Big Pharma has established distribution channels that would get a Type 1 like me my cure faster, which one may consider ethical territory.