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This is fascinating! I wonder if something like this could get the pancreas to begin producing insulin. Type I Diabetes is no joke. It could save tens or hundre

This is fascinating! I wonder if something like this could get the pancreas to begin producing insulin. Type I Diabetes is no joke. It could save tens or hundreds of millions per year, not to mention multiple injections per person per day.

wbl 9y ago
The issue in Type 1 Diabetes is autoimmune destruction of the islets of Langerhans, so the therapy would need to target the immune system.
aaavl2821 9y ago
There are lots of people working on regenerative medicine and gene therapy for autoimmune diseases (ive worked with several researchers focused on type 1), but unfortunately the field isnt there yet. hemophilia a is a disease caused largely by deficiencies in one specific protein. massive technological breakthroughs in recent years have enabled scientists to deliver genes to human cells to consistently, accurately and sustainably produce specific proteins. so treating diseases like hemophilia a has become tractable however, autoimmune diseases are much more complex and there is no single protein or molecule that causes the diseases. in type 1, people have been trying to discover 1) the "triggering" event and 2) the autoantigens that cause the disease for years, and it looks like there is no "silver bullet". current drug technology can target only one, or sometimes two, disease-causing molecules, so for a disease where many molecules each play a small part, we dont have the answer yet there are a few promising type 1 companies (semma, viacyte, others) trying to turn stem cells into insulin producing cells, but those cells are often rejected by the bodys immune system. some other companies are increasing the number of "regulatory T cells", basically T cells that inhibit autoimmunity (caladrius, celgene / delinia, parvus, lilly / nektar); these have shown promise but it isnt likely theyd be curative, as they just stop the autoimmune attack but cant regenerate beta cells that are already lost if youre interested in type 1 research, diatribe is a great website that aggregates the latest science and presents it in a way that is easy for non-scientists, specifically patients and their families, to understand https://diatribe.org/ https://diatribe.org/
- baldfat 9y ago
  Thankfully artificial pancreas are looking like a good option until we can get to curing type 1. Not only does it save the number of shots like pumps we have today, but it can measure the sugar level and keep the swings down to a minimum. http://www.jdrf.org/research/artificial-pancreas/ http://www.jdrf.org/research/artificial-pancreas/
  - aaavl2821 9y ago
    yeah artificial pancreas seems to be the most promising near-term development. the field has suffered from a lack of funding for translational research as VCs have been focused on other diseases, but hopefully that changes. semma (a startup turning stem cells into beta cells) raised $114M last week
    - thingification 9y ago
      Why are they focused on other diseases? Diabetes is hardly a rare disease, nor one with a low impact on its sufferers. So if what you say is true, what is it that's broken about the market for diabetes treatment? I often hear it said that problems such as this are caused by cures being less profitable compared to drugs, because drugs are purchased repeatedly, cures only once. But competition is supposed to solve that problem. Is inappropriate regulation the real problem?
  - test6554 9y ago
    They seem good as long as the patient's skin is not allergic to the adhesive used to attach it to the body. I know someone who had an insulin pump that worked perfectly except after a day or two, they would get a rash on the skin and the area would swell up blocking the delivery of insulin. Nothing like all this great technology that could save your life that is foiled simply by the type of glue used by the manufacturer.
    - baldfat 9y ago
      They go under the skin (Most of the plans I have read)
jcims 9y ago
My kiddo has been dealing with Type 1 for two years now and I'm endlessly encouraged by developments in this area. She's just switched to a closed loop pump (Medtronic 670), which helps automate her insulin delivery through automated microdoses (think pump on a PID), but it's still a ridiculous pain in the ass. For example, she didn't notice her reservoir was low this morning before she left for school, now she's got an extra stressor in her life that wouldn't be there otherwise. And despite all of the amazing technological and medical advances over the past 10-20 years, the best insulin therapy in the world is still comically shitty when compared to a healthy pancreas. Anyway, it could be way worse and I'm grateful for what is available to us today. Still hope for better days ahead.
olegkikin 9y ago
Looks like it's happening: "Modified blood stem cells reverse type 1 diabetes in mice" https://www.diabetes.co.uk/news/2017/nov/modified-blood-stem-cells-reverse-type-1-diabetes-in-mice-96647921.html https://www.diabetes.co.uk/news/2017/nov/modified-blood-stem... And type 2 got cured by an extreme diet in 86% of patients: https://sciencealert.com/extreme-diet-reverse-type-2-diabetes-up-to-86-patients-remission-weight https://sciencealert.com/extreme-diet-reverse-type-2-diabete...
- aaavl2821 9y ago
  hate to be the bearer of bad news, but there are something like 400+ drugs that have prevented type 1 in mice and another hundred or so that have reversed it. none have worked in people the most common animal model for type 1, the NOD mouse model, is notoriously bad. studies have shown that loud music cures diabetes in these mice. mice raised in one lab get diabetes differently than mice raised in another. the immune systems of these animals are very fickle and almost any environmental perturberance can change an immune response
  - test6554 9y ago
    Lab mice are truly living in a golden age of medicine!
    - sorokod 9y ago
      The humans in the 15th century lived in the golden age of the plague.
  - ImSkeptical 9y ago
    It's some kind of philosophical ethics problem that we can't experiment on humans even though there would be a net benefit. I feel like there are morally unintuitive solutions that may help - perhaps criminals of certain kinds, who have damaged society, could repay their debt, in part, by volunteering for trials we can be sure they understand. We might also leverage The suicidal by offering, after therapy, a way for them to live in comfort while contributing to humanity as experimental subjects. I realize the mind recoils instinctively at these ideas, but it seems so frustrating and horrific that we have to delay life saving medical advanced due to insufficient experimental subjects.

wbl 9y ago

The issue in Type 1 Diabetes is autoimmune destruction of the islets of Langerhans, so the therapy would need to target the immune system.

aaavl2821 9y ago

There are lots of people working on regenerative medicine and gene therapy for autoimmune diseases (ive worked with several researchers focused on type 1), but unfortunately the field isnt there yet. hemophilia a is a disease caused largely by deficiencies in one specific protein. massive technological breakthroughs in recent years have enabled scientists to deliver genes to human cells to consistently, accurately and sustainably produce specific proteins. so treating diseases like hemophilia a has become tractable however, autoimmune diseases are much more complex and there is no single protein or molecule that causes the diseases. in type 1, people have been trying to discover 1) the "triggering" event and 2) the autoantigens that cause the disease for years, and it looks like there is no "silver bullet". current drug technology can target only one, or sometimes two, disease-causing molecules, so for a disease where many molecules each play a small part, we dont have the answer yet there are a few promising type 1 companies (semma, viacyte, others) trying to turn stem cells into insulin producing cells, but those cells are often rejected by the bodys immune system. some other companies are increasing the number of "regulatory T cells", basically T cells that inhibit autoimmunity (caladrius, celgene / delinia, parvus, lilly / nektar); these have shown promise but it isnt likely theyd be curative, as they just stop the autoimmune attack but cant regenerate beta cells that are already lost if youre interested in type 1 research, diatribe is a great website that aggregates the latest science and presents it in a way that is easy for non-scientists, specifically patients and their families, to understand https://diatribe.org/ https://diatribe.org/

baldfat 9y ago
Thankfully artificial pancreas are looking like a good option until we can get to curing type 1. Not only does it save the number of shots like pumps we have today, but it can measure the sugar level and keep the swings down to a minimum. http://www.jdrf.org/research/artificial-pancreas/ http://www.jdrf.org/research/artificial-pancreas/
- aaavl2821 9y ago
  yeah artificial pancreas seems to be the most promising near-term development. the field has suffered from a lack of funding for translational research as VCs have been focused on other diseases, but hopefully that changes. semma (a startup turning stem cells into beta cells) raised $114M last week
  - thingification 9y ago
    Why are they focused on other diseases? Diabetes is hardly a rare disease, nor one with a low impact on its sufferers. So if what you say is true, what is it that's broken about the market for diabetes treatment? I often hear it said that problems such as this are caused by cures being less profitable compared to drugs, because drugs are purchased repeatedly, cures only once. But competition is supposed to solve that problem. Is inappropriate regulation the real problem?
- test6554 9y ago
  They seem good as long as the patient's skin is not allergic to the adhesive used to attach it to the body. I know someone who had an insulin pump that worked perfectly except after a day or two, they would get a rash on the skin and the area would swell up blocking the delivery of insulin. Nothing like all this great technology that could save your life that is foiled simply by the type of glue used by the manufacturer.
  - baldfat 9y ago
    They go under the skin (Most of the plans I have read)

jcims 9y ago

My kiddo has been dealing with Type 1 for two years now and I'm endlessly encouraged by developments in this area. She's just switched to a closed loop pump (Medtronic 670), which helps automate her insulin delivery through automated microdoses (think pump on a PID), but it's still a ridiculous pain in the ass. For example, she didn't notice her reservoir was low this morning before she left for school, now she's got an extra stressor in her life that wouldn't be there otherwise. And despite all of the amazing technological and medical advances over the past 10-20 years, the best insulin therapy in the world is still comically shitty when compared to a healthy pancreas. Anyway, it could be way worse and I'm grateful for what is available to us today. Still hope for better days ahead.

olegkikin 9y ago

Looks like it's happening: "Modified blood stem cells reverse type 1 diabetes in mice" https://www.diabetes.co.uk/news/2017/nov/modified-blood-stem-cells-reverse-type-1-diabetes-in-mice-96647921.html https://www.diabetes.co.uk/news/2017/nov/modified-blood-stem... And type 2 got cured by an extreme diet in 86% of patients: https://sciencealert.com/extreme-diet-reverse-type-2-diabetes-up-to-86-patients-remission-weight https://sciencealert.com/extreme-diet-reverse-type-2-diabete...

aaavl2821 9y ago
hate to be the bearer of bad news, but there are something like 400+ drugs that have prevented type 1 in mice and another hundred or so that have reversed it. none have worked in people the most common animal model for type 1, the NOD mouse model, is notoriously bad. studies have shown that loud music cures diabetes in these mice. mice raised in one lab get diabetes differently than mice raised in another. the immune systems of these animals are very fickle and almost any environmental perturberance can change an immune response
- test6554 9y ago
  Lab mice are truly living in a golden age of medicine!
  - sorokod 9y ago
    The humans in the 15th century lived in the golden age of the plague.
- ImSkeptical 9y ago
  It's some kind of philosophical ethics problem that we can't experiment on humans even though there would be a net benefit. I feel like there are morally unintuitive solutions that may help - perhaps criminals of certain kinds, who have damaged society, could repay their debt, in part, by volunteering for trials we can be sure they understand. We might also leverage The suicidal by offering, after therapy, a way for them to live in comfort while contributing to humanity as experimental subjects. I realize the mind recoils instinctively at these ideas, but it seems so frustrating and horrific that we have to delay life saving medical advanced due to insufficient experimental subjects.