Saturday, September 28, 2013

Until the Cure

Diabetes is Goliath, and researchers often feel like David. How are we ever going to take down such a huge opponent? Where is the cure?

I want those researchers to focus on the cure. But I also support work that looks into how we can live well alongside the beast that is diabetes.

But I have been seeing a lot of angry comments swirling around the internet regarding support of non-cure based research, especially pertaining to the artificial pancreas.
"We don't want another fancy pump! We want a cure!"
"The artificial pancreas is just another money-making device for big pharma! We want a cure!"

I understand. I have had diabetes for 20 years and would give anything to not have it. I would be delighted to be "out of a job" in caring for kids with Type I. There are few other wishes I use on birthday candles and fallen eyelashes.

But I still have a hard time fully sympathizing with those sentiments.

I gave a lecture this past week to first year medical students. They wanted to learn about the dual-hormone artificial pancreas, but starting there would be like picking up a book and reading the second to last chapter first. I had to start from the beginning to help them really appreciate how significant the artificial pancreas will be.

We went over how doctors did not even know that a lack of insulin was what caused diabetes for the 3,500 years it was recognized as an illness. How people died within a year of diagnosis from starvation until Drs. Banting and Best discovered how to effectively use insulin. How the insulin had to be drawn into glass syringes that had to be sterilized with heat and how the very long, very thick needles had to be hand-sharpened each day. And about how the insulin came from animals, which created a series of side-effects in many patients until human insulin was able to be synthesized. And once we had human insulin, things improved again with fast-acting Humalog/Novolog and long-acting Lantus. Insulin pumps were invented and refined year after year.
We also discussed how the measure of insulin's effectiveness could only be examined through urine, then through cumbersome blood tests, and ultimately with the advent of continuous glucose monitoring.

We have made such amazing strides in the last 90 years, but mostly rapidly within the last 30 years. Lantus came out when I was in high school and completely changed my quality of life -- no more rigid time schedules, no more inflexible meal plans. I felt like my day wasn't dictated by diabetes in nearly the same way it had been for so many years. And when pump technology improved, it changed my life for the better tenfold. And my CGM is the only reason I have been able to maintain the tight control that I'm in now.

It is hard to appreciate how far we've come when all you have known is pumps and CGGs. All of these advancements were only possible through research - in petri dishes, in animals, in humans. Research gave us these gifts.

The development of refined insulin saved millions of lives. But what if we had stopped there and only focused on the cure? We wouldn't have any of the amazing products that help us live well with diabetes today.

The artificial pancreas is going to be the next big life-changer. The preliminary data is astounding, with Dr. Damiano's study giving trial patients projected A1Cs of 6.3% with less work than they put into their diabetes now. Why would we not support this? Researchers are devoting their lives to this work and many have children and other family members with Type 1 Diabetes. They hunger for the cure, too. But they hope to make life with diabetes better in the meantime.

People often mistakenly believe that supporting non-cure based research detracts from finding the cure. There are armies of researchers trying to realize hundreds of different possibilities. Projects are taking place simultaneously all over the world to treat, prevent, AND cure diabetes.

Shouldn't we continue to tackle this beast from all angles? My answer to that question will always be yes.

And in this way, we'll eventually take it down.

9 comments:

  1. I for one am so thankful that they never stopped improving care while searching for a cure. We love our pump, CGM and rapid-acting insulin and everything these tools allow us to do. Even though Elise was only dx'd a few years ago, we used NPH because it was the only "long-ish acting" insulin you could dilute (her initial dose was .5 of a unit of U20, once a day). I can't imagine living life that way anymore now that we're pumping.

    I agree 100%!

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  2. Personally, I am all for the coming dual hormone artificial pancreases, and possible future systems that might include symlin, c-peptides, and other hormones.
    I would rather see a cure, and that is what I have always hoped the JDRF was working for.
    The difference between all of the ongoing treatments, like the artificial pancreas, and a cure, is that there is enough financial incentive for medical device companies to work on these things. There is obviously a lot of profit to be made there, year after year.
    A cure would destroy the diabetes management industry, and that's why the work for a cure has to exist outside of that industry.
    Like most people with diabetes, I am in favor of both the cure and the treatment. I want to see continuing work on both. It is not an either/or situation.
    What some of us vigorously oppose is the idea that the next generation of diabetes management technology is a "cure."
    Insulin is not a cure. The artificial pancreas is not a cure.

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  3. I'm in both camps simultaneously: I love the artificial pancreas project because it is so promising. At the same time, there are so many people in the world who can't afford to use insulin pumps or CGMs that I get almost enraged because they are so expensive for something so beneficial. I'm scared of how expensive it will be. I know that when a cure comes out, it will be expensive. It will take years and years to roll out enough of whatever the cure is, and even then there will still be people who have to purchase Novolin N and R at Walmart just to stay alive.

    I fully believe there will be plenty of money to be made when the cure comes out. I'm sure there will be many, many follow up appointments and treatments. We will probably still need to monitor ourselves to make sure things are working.

    I feel like there is a lot of money from the non-profits (like JDRF) going into the artificial pancreas. On the other hand, it probably just looks that way because the artificial pancreas is a very tangible step forward. All the cure researchers can say is "maybe in 50-10 years," but we've heard that so much it's a joke now.

    All in all, this post is a cogent reminder that it's easy to get frustrated when it looks like nobody is trying to cure us. Thank you for that.

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  4. A little part of me wants to believe in the cure. I really do.

    The much larger realistic part of me doesn't believe it is going to happen for a long time, if at all. I am not holding my breath - that much is certain.

    I am, however, very grateful for the amount of research that is being put into improving how we treat and manage diabetes. Those things have a direct impact on our quality of life and on our health right now. Onward with the artificial pancreas I say! Onward with improved glucose monitoring, better insulins, better pumps!

    And if there is a cure at the end of the rainbow - all the better.

    It is the improved treatments and technologies that are going to keep me healthy long enough to perhaps, one day, see the cure.

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  5. well said. even in my 6 years with diabetes I have seen giant improvements, going from R and N to analogs and incorporating a cgm. I'm even excited to try out pumping to see how I like it. I think all well-designed research projects deserve finding. IMO "cure-focused" research with respect to T1D is still in its infancy because we don't fully understand all the mechanistic details of T1D onset and progression. At the same time our ability to quickly screen factors that are involved in this disease has been improving exponentially (i.e. biochemical assays that would take days per sample 10 years ago can now be done for thousands of samples on a single microchip). These kinds of advancements make a lot more possible more quickly in all kinds of research including cancer and diabetes... I think the next 20 years will be revolutionary in both improvements to diabetes care as well as understanding more and more of the molecular links that may allow for preventative solutions, as well as, eventually (undoubtedly) a "cure"..

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  6. This is a great post. Honestly, in the past I've been upset that at times it seems like the focus has been on the artificial pancreas and not the cure but your post definitely put it into perspective for me.

    Thanks!

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  7. BASTARD DREADFUL CRIMINAL DANIEL HEGGLIN EX MORGAN STANLEY SHOULD NOT TERRORIZE GOOGLE AS DEPRAVED SEX MANIAC MAX MOSLEY WANTS TO DO TOO! HE'S REALLY A PAEDERAST, A NAZIMAFIOSO TERRORIST, A PRINCIPAL OF MURDERS, A BRIBED WORM, A STINKY MARKET ABUSER!
    1
    I READ THIS TEXT TELLING ABSOLUTE TRUTHS!!!
    HI, I'M MICHELE CALZOLARI FROM CREDIT SUISSE AND ASSOSIM MILAN. I KNOW EVERYTHING BOUT ... "THE EXTREMELY DIRTY PART OF THE WORLD OF FINANCE AND BANKING".. SO... I NOW FEEL A DEEP DEEP, DEEP PASSION TO LET THE WHOLE WORLD KNOW BOUT ALL THIS!
    BASTARD DREADFUL CRIMINAL DANIEL HEGGLIN EX MORGAN STANLEY SHOULD NOT TERRORIZE GOOGLE AS DEPRAVED SEX MANIAC MAX MOSLEY WANTS TO DO TOO! HE'S REALLY A PAEDERAST, A NAZIMAFIOSO TERRORIST, A PRINCIPAL OF MURDERS, A BRIBED WORM, A STINKY MARKET ABUSER!
    THIS TEXT THAT HERE WILL FOLLOWS IS FANTASTIC AND TELLS US "UNTOUCHABLES" TRUTHFULNESSES ( "UNTOUCHABLES" FOR NAZIMAFIOSI PIG AND PIIG LIKE DANIEL HEGGLIN EX MORGAN STANLEY, NOT FOR TRULY DEMOCRATIC AND HONEST VALUES, SINCE ALWAYS, MINE))!!! SO I'LL PASS THE MEDIATIC LINE ( AND NOT COCAINE LINE, THAT BASTARD BRUTAL CRIMINAL DANIEL HEGGLIN EX MORGAN STANLEY KNOWS REAL WELL), NOW, TO MASSIMO, WHO IN THIS SCRIPT COMING, IS REALLY THE MAXIMUM OF HONESTY AND SUPER EXTRA DUE!!!

    Hello. I'm an ex colleague of the extremely stinky criminal Daniel "Danny" Hegglin ex Morgan Stanley and today i really would like "to empty the bag". My name is Massimo, i'm not english native, so, i'm not mother language as you will well see. But i'll write in my best possible english ( in more or less just an hour i have at disposal, to do it). I worked for many years in London, with the killing Hooligans of worldwide stock exchanges: Morgan Stanley (http://www.goodreads.com/book/show/122335.Fiasco). Elbow to elbow with this absolute Jack the Ripper of international finance who is this really stinky shameless criminal bastard Daniel "Danny" Hegglin, now working by an immense Mafia Money Launderer Box called 4th dimension in Hong Kong http://hk.linkedin.com/pub/danny-hegglin/61/277/93 ( this very lousy crook of Daniel "Danny" Hegglin changes his name on the net from Dan to Danny to Daniel, continuously: typical of those who have lot of stinky things to hide, typical move of delinquent, typical move of "dark gray"collars, i wd say, more than white ones)! I saw with my eyes, i repeat, i saw with my eyes, this bastard mega corrupted, better to say, corru-p-ig and also corru-piig, Daniel Hegglin ex Morgan Stanley, getting 100.000, 200.000, 300.000 pounds, cash, put in handbgas. Inside various pubs close to his ex offices in Canary Wharf.
    " Nazifascist and pro Mafia Morgan Stanley & Co 25 Cabot Square, Canary Wharf London"
    Cause of immense insider dealings and sometimes even insider tradings he passed to colossal Cosa Nostra's money launderers like Ennio Doris and Massimo Doris from Banca 'Mafiolanum, Camorranum, Ndrangolanum, Nazistanum, Mediolanum' ( not for nothing, bank, "in fact", totally owned by disgusting pedophile and nazimalavitoso dictator Silvio Berlusconi.. and so... bank controlled by Cosa Nostra; choleraic rats Silvio Berlusconi, Marina Berlusconi, Ennio Doris, Massimo Doris and Mafia are same assassin shit since the 60's; since much more than half century; since verminous criminal Berlusconi's father, Luigi Berlusconi, used to wash oceans of killing Cosa Nostra's money in Banca Rasini; 'coincidentally' closed down by American Dea, cause was the bank of the most murderous gangs of half world, and not just sicilian world http://it.wikipedia.org/wiki/Banca_Rasini).

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  8. 2
    Same cash and for same reasons, he used to get from another bastard super delinquent, close to lot of Mafia and NaziRacist international organizations: Paolo Barrai. Having an extremely fascist, mafia money laundering ( via Finter Bank Lugano, via Panama, via Dubai, via Marbella, via bitcoins) and inciting murdering violence blog called Mercato 'Merdato' Libero (bastard criminal excrement Paolo Barrai having already been condemned to big fines or jail, many times; by Consob; by Court in Milan; it looks like, also by Court in Biella; and incredibly by Court in Porto Seguro, Brazil; where they want him now for many years in prison.. for this reason, Hitlerian "jailbird" Paolo Barrai sometimes write of Brazil.. but never put a feet in Brazil anymore).

    Again and again and again: Same cash and for same reasons, he used to get from another well known corruptor, stinking Al Capone of Italian Bourse: Attilio Ventura, not for nothing, now in 'Mafiaset Hitlerset Mediaset' board http://www.mediaset.it/investor/governance/organi/scheda_9_it.shtml. And used to get other very criminal money from corruptor Francesco Perilli now heading Equita Sim Milan. And from 100s and 100s of other brokers all over Europe. Basically, if "Mussolinian Hooligans" from Morgan Stanley (like another bastard criminal: Michael Chinnick, now laundering lot of mafia assassin cash by Mandarin Capital Hong Kong: https://www.mdncapital.com/about-us) had to buy, for example, lot of Fiat, in Milan, "Jack the Ripper", loathsome worm Daniel Hegglin ex Morgan Stanley used to call "with his private mobile phone another private mobile phone" ( to circumvent the recording of calls, obviously). Belonging to one of noisome maggots above mentioned. And used to say

    'Ehy you my big Mafia Banker Ennio Doris.... you know, when you come next week to London.. can you take me that Armani's tie i love so much with code n3124'?
    Obviously, the translation of this sort of "full of swastika" secret language given in the pub was 'n' = buy, '3124' = Fiat ( "Jack the ripper', extremely rotten felon Daniel Hegglin 4th Dimension Hong Kong used to give to all his corrupting larvas s a list with all the european stocks, with close to any of them, a number: 3124, obviously was for Fiat). Cholaeric escrement Ennio Doris used to answer on the phone "yes Danny, certainly, thank you, actually, thank you". Then started to buy 1.000.000 Fiat for himself ( from his swiss bank account, in very criminal Arner Bank Lugano: pls google "vado riciclo e torno" that means "i go, i wash lot of killing mafia cash and i'll be back", bout mega mafia money launderings done by Ennio Doris and Massimo Doris from Banca Mediolanum http://espresso.repubblica.it/palazzo/2008/05/15/news/vado-riciclo-e-torno-1.8408). Then, "Hooligan"of Finance ( http://en.wikipedia.org/wiki/Frank_Partnoy) Morgan Stanley, used to arrive via "Jack the Ripper" bastard criminal Daniel Hegglin to buy 15.000.000s of Fiat in just one day. And immense gains to be shared 50 50 were made! Is also a bastard racist, part of many worldwide Ku Kluk Klan, repellent nazist Daniel Hegglin. Is also an extremely pervert paederast. He said many times, to me and many people "there is nothing wrong on fucking a boy or a girl who is 12 years old, i do it, i do it, i do it and even often... on the other hand... in the second or third world it happens every day... young female children.. there .. get pregnant at 12.. so i fuck lot of boys and girls, while they are 12... here in London.. or in my native Switzerland.. i pay and i do it".

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  9. 3

    As mentioned, is also a repulsive nazifascist ( he organized the Edward Snowden's hideout in Hong Kong, where he now launders immensely killing Triade Cash out of a very delinquent Box called "4th dimension" http://hk.linkedin.com/pub/danny-hegglin/61/277/931; and used to organize lot and lot of international murders made via various extreme right worldwide public and private intelligence agencies.. google 'daniel hegglin wikileaks' bout it, pls: http://search.wikileaks.org/gifiles/?viewemailid=3541810). In his houses there were ( and still are, cowardly hided, but still are) hundreds of gadgets, books, videos full of love for Adolf Hitler, Benito Mussolini, Augusto Pinochet, Francisco Franco, Alfredo Stroessner. But also very full of passion and love toward many nazifascist mega killing terrorists like The Skinhead International, Afrikaner Weerstandsbeweging, Alan Berg, Combat 18, Nuclei Armati Rivoluzionari, Order of Flemish Militants, Ordine Nuovo, White Order of Thule. This is the bastard extreme criminal Daniel "Danny Hegglin", not for nothing, fired by Morgan Stanley, fired by TT International, fired by Puricore and many other working places. And if Google will put the head down to him, will be the end of internet, will begin an era of bastard killing nazism all over the world, "ops, what a coincidence", what very fascist Vladimir Putin, Morgan Stanley, Jp Morgan ( who used to finance who killed 6 millions people: Adolf Hitler and Benito Mussolini... never forget, please), as well as Afrikaner Weerstandsbeweging, Alan Berg, Combat 18, Nuclei Armati Rivoluzionari, Order of Flemish Militants, Ordine Nuovo, White Order of Thule exactly want! Massimo. For many years Morgan Stanley London. What i wrote is what i saw and with my own eyes. For many many many years! ModerNazifascist part of Cia, on order of ModerNazifascist and Pro Mafia: James Gorman and Eric Grossman from Morgan Stanley New York, will kill me now??? Better to die as a martyr, meant as a real man ( not certainly meant as other terrorists, like the islamic ones, mean). Who call things with the exact their name! So that the good may have more chances to win the evil. Better to die as a martyr, meant as a real man, than being falsely alive as a passive, amorphous, scared man made diarrea. Massimo a death man walking, now, BUT A REAL (death) MAN (walking).

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