3 ms·

This is cool and all, but it looks like pure PR. I cannot find anything that actually links to "Here is our instruction set for how to make insulin yourself!" o

This is cool and all, but it looks like pure PR. I cannot find anything that actually links to "Here is our instruction set for how to make insulin yourself!" or something. Also, for some people with diabetes or at risk of developing it, diet and lifestyle can make a difference.

elnatro 5y ago
Type 1 diabetes is not related with obesity.
- deleted 5y ago
  [deleted]
- kennywinker 5y ago
  It really is a shame that there isn’t better names for type 1 and type 2 diabetes. They have such different stories, and yet get lumped together constantly.
  - DoreenMichele 5y ago
    There are other forms of diabetes. I know of CFRD and have heard it is neither type 1 nor type 2 and I think there is at least one other form beyond that, but can't recall anything about it. Edit: Diabetes is actually five separate diseases, research suggests https://news.ycombinator.com/item?id=16499376 https://news.ycombinator.com/item?id=16499376 You can add a sixth class. I have been told that Cystic Fibrosis Related Diabetes (CFRD) is neither Type 1 nor Type 2. https://news.ycombinator.com/item?id=16499548 https://news.ycombinator.com/item?id=16499548
    - mnw21cam 5y ago
      Disclosure: I work in diabetes research. That "five types" article is very poor. They simply applied k-means clustering to a large set of people with diabetes. The problem with k-means clustering is that it can generally find anything you want it to. For instance, you tell k-means clustering how many clusters you want it to find, not the other way around. In this example, there is significant overlap/fuzziness between the classes. It's better to say that there is a wide spectrum of the progression of diabetes. It is well-known that type 1 diabetes that arises late in life tends to progress very much more slowly than type 1 diabetes that arises in teenagerhood. A teenager with type 1 diabetes can have a very rapid progression, and have very severe symptoms. A person who develops type 1 in their seventies can have such a slow onset that the treating doctor can get very confused about what is going, and assume that it is type 2 instead, until the patient finally cannot live without insulin. K-means clustering has separated these two situations, but they are a spectrum from aggressive to gentle. But the distinction between type 1 and type 2 is still very relevant. With type 1, the problem is too little insulin (progressing to zero insulin produced because the immune system destroys the insulin-producing pancreatic beta cells), and the treatment is insulin. There is no other treatment. With type 2, the fundamental problem is too much insulin, which the body naturally produces to correct other fundamental problems, namely high blood sugar levels, which has a tight interaction with diet and obesity. The insulin encourages fat/muscle cells to suck sugar out of the blood to reduce it, but this causes other problems. A high level of insulin is then needed to keep the energy stored in the fat cells and stop it coming back into the blood as sugar, and the insulin-producing cells can eventually burn out from over-use. The treatment is to deal with the high blood sugar levels and obesity - the insulin problem is a second-order effect. Injecting more insulin into a patient with type 2 diabetes can make the problem worse - it might sort out the high blood sugar level, but it does that by cramming all that sugar into fat cells, so insulin injections are generally only used when the insulin-producing cells start failing. Diet, exercise, and blood sugar lowering drugs are better treatments. Different people respond differently to this disease, with some people storing fat around their legs (which is a more healthy option) and others storing it around their internal organs (which is really bad). K-means clustering will have separated this continuous spectrum of people into separate clusters too. There are multiple other rarer types of diabetes that tend to be overlooked, and probably don't have much participation in the k-means clustering because of their rarity. These include the CFRD you mention, but also gestational diabetes, diabetes associated with various other more syndromic conditions (like Down syndrome), and monogenic diabetes (a single-gene defect causes an inability to correctly produce insulin - we know of double-figures types of this, some of which can be very easily and cheaply treated, and others need to be treated like type 1). There's also diabetes that is caused by surgery, if a patient has their pancreas removed.
      - DoreenMichele 5y ago
        Thank you, thank you, thank you. Gestational diabetes is probably the other one I was trying to remember.
  - watwut 5y ago
    You can be thin and have diabetes 2 too. There is strong correlation (as in weight is massive risk factor), but in fact thin people can get it too.
    - mnw21cam 5y ago
      As with everything, different people are different. Thin people can get type 2 diabetes, but this is often due to inappropriate fat deposits around internal organs. In a proportion of these "skinny-fat" people, a bit more exercise and a better diet may have prevented the type 2 diabetes. A lot of it is genetic, and each different person will have a different adiposity above which they will start to develop type 2 characteristics. People with an Indian heritage need to be extra-careful on this one.
MattGaiser 5y ago
> "Here is our instruction set for how to make insulin yourself!" or something. I don't think they are there. It is just a project to get there.
- pas 5y ago
  If I understand correctly the problem is that if you go to one of their labs they'll cook you a batch in no time (we know the genes, you can order a plasmid that has all the bells and whistles needed to get it made in yeast), but it'd be illegal for many reasons. (They can't sell it without FDA approval for one, they'd need an approved factory for that, and they are infringing on patents.) They obviously can't advertise this, but in videos they almost literally spell this out. So they do this strange outreach instead, with no clear steps in sight. Plus as others mentioned it's easy to buy insulin. ($25 at Walmart.) About how easy it is to make recombinant insulin I recommend this channel: https://www.youtube.com/watch?v=J3FcbFqSoQY https://www.youtube.com/watch?v=J3FcbFqSoQY
grp000 5y ago
I scanned through the site and their first post was in 2015 and has news articles posted about the company with titles like: "The Community Labs Built on Silicon Valley’s Junk: Trash from biotech startups are citizen scientists’ treasure" and "The Rogue Experimenters". Also, lots of posts about wanting interns. This doesn't give me a good feeling.
- DoreenMichele 5y ago
  It's also apparently kind of a dupe* and the top comment in the previous discussion indicates they looked and there's seemingly nothing "open" about this initiative. I mentioned diet and lifestyle because that's how I manage my otherwise insanely expensive and debilitating condition and did so that way even while homeless. If you are genuinely concerned about the health and finances of poor people, finding a way to educate people about diet and lifestyle strikes me as at least part and parcel if what you ought to be doing and as a generally superior approach. One reason medicine is highly regulated is because screwing it up with unsanitary practices can maim or kill people. * https://news.ycombinator.com/item?id=27854041 https://news.ycombinator.com/item?id=27854041
moron4hire 5y ago
Maybe, instead of constantly drumming on about "diet and lifestyle", we should be studying why the "diet and lifestyle" message has completely failed to move the needle on the obesity crisis. Cuz I'm pretty sure nobody with diabetes has not heard about "diet and lifestyle". So comments like that are not adding anything to the conversation.
- lovemenot 5y ago
  Not specifically about diabetes: to some extent, obesity is a social disease https://www.nih.gov/news-events/nih-research-matters/friends-family-may-play-role-obesity https://www.nih.gov/news-events/nih-research-matters/friends...
  - DoreenMichele 5y ago
    There is also research that connects living in a cluttered/disorganized/messy home to being more at risk of being obese. https://www.prevention.com/weight-loss/a20513150/how-to-get-organized-lose-weight-faster/ https://www.prevention.com/weight-loss/a20513150/how-to-get-...
- Dove 5y ago
  It's the wrong "diet and lifestyle" recommendation - the standard suggestions of eating less and exercising more don't work. What does work specifically is a low carb diet and intermittent fasting lifestyle, together with close medical supervision. https://www.virtahealth.com/ https://www.virtahealth.com/ has had great success with the approach.
  - DoreenMichele 5y ago
    There is also a lot of research indicating that inflammation is an underlying cause of most forms of diabetes. Controlling inflammation, in part by changing my diet, is likely a significant factor in getting my blood sugar issues under control as a side effect of more general efforts to remedy my health problems.

elnatro 5y ago

Type 1 diabetes is not related with obesity.

deleted 5y ago
[deleted]
kennywinker 5y ago
It really is a shame that there isn’t better names for type 1 and type 2 diabetes. They have such different stories, and yet get lumped together constantly.
- DoreenMichele 5y ago
  There are other forms of diabetes. I know of CFRD and have heard it is neither type 1 nor type 2 and I think there is at least one other form beyond that, but can't recall anything about it. Edit: Diabetes is actually five separate diseases, research suggests https://news.ycombinator.com/item?id=16499376 https://news.ycombinator.com/item?id=16499376 You can add a sixth class. I have been told that Cystic Fibrosis Related Diabetes (CFRD) is neither Type 1 nor Type 2. https://news.ycombinator.com/item?id=16499548 https://news.ycombinator.com/item?id=16499548
  - mnw21cam 5y ago
    Disclosure: I work in diabetes research. That "five types" article is very poor. They simply applied k-means clustering to a large set of people with diabetes. The problem with k-means clustering is that it can generally find anything you want it to. For instance, you tell k-means clustering how many clusters you want it to find, not the other way around. In this example, there is significant overlap/fuzziness between the classes. It's better to say that there is a wide spectrum of the progression of diabetes. It is well-known that type 1 diabetes that arises late in life tends to progress very much more slowly than type 1 diabetes that arises in teenagerhood. A teenager with type 1 diabetes can have a very rapid progression, and have very severe symptoms. A person who develops type 1 in their seventies can have such a slow onset that the treating doctor can get very confused about what is going, and assume that it is type 2 instead, until the patient finally cannot live without insulin. K-means clustering has separated these two situations, but they are a spectrum from aggressive to gentle. But the distinction between type 1 and type 2 is still very relevant. With type 1, the problem is too little insulin (progressing to zero insulin produced because the immune system destroys the insulin-producing pancreatic beta cells), and the treatment is insulin. There is no other treatment. With type 2, the fundamental problem is too much insulin, which the body naturally produces to correct other fundamental problems, namely high blood sugar levels, which has a tight interaction with diet and obesity. The insulin encourages fat/muscle cells to suck sugar out of the blood to reduce it, but this causes other problems. A high level of insulin is then needed to keep the energy stored in the fat cells and stop it coming back into the blood as sugar, and the insulin-producing cells can eventually burn out from over-use. The treatment is to deal with the high blood sugar levels and obesity - the insulin problem is a second-order effect. Injecting more insulin into a patient with type 2 diabetes can make the problem worse - it might sort out the high blood sugar level, but it does that by cramming all that sugar into fat cells, so insulin injections are generally only used when the insulin-producing cells start failing. Diet, exercise, and blood sugar lowering drugs are better treatments. Different people respond differently to this disease, with some people storing fat around their legs (which is a more healthy option) and others storing it around their internal organs (which is really bad). K-means clustering will have separated this continuous spectrum of people into separate clusters too. There are multiple other rarer types of diabetes that tend to be overlooked, and probably don't have much participation in the k-means clustering because of their rarity. These include the CFRD you mention, but also gestational diabetes, diabetes associated with various other more syndromic conditions (like Down syndrome), and monogenic diabetes (a single-gene defect causes an inability to correctly produce insulin - we know of double-figures types of this, some of which can be very easily and cheaply treated, and others need to be treated like type 1). There's also diabetes that is caused by surgery, if a patient has their pancreas removed.
    - DoreenMichele 5y ago
      Thank you, thank you, thank you. Gestational diabetes is probably the other one I was trying to remember.
- watwut 5y ago
  You can be thin and have diabetes 2 too. There is strong correlation (as in weight is massive risk factor), but in fact thin people can get it too.
  - mnw21cam 5y ago
    As with everything, different people are different. Thin people can get type 2 diabetes, but this is often due to inappropriate fat deposits around internal organs. In a proportion of these "skinny-fat" people, a bit more exercise and a better diet may have prevented the type 2 diabetes. A lot of it is genetic, and each different person will have a different adiposity above which they will start to develop type 2 characteristics. People with an Indian heritage need to be extra-careful on this one.

MattGaiser 5y ago

> "Here is our instruction set for how to make insulin yourself!" or something. I don't think they are there. It is just a project to get there.

pas 5y ago
If I understand correctly the problem is that if you go to one of their labs they'll cook you a batch in no time (we know the genes, you can order a plasmid that has all the bells and whistles needed to get it made in yeast), but it'd be illegal for many reasons. (They can't sell it without FDA approval for one, they'd need an approved factory for that, and they are infringing on patents.) They obviously can't advertise this, but in videos they almost literally spell this out. So they do this strange outreach instead, with no clear steps in sight. Plus as others mentioned it's easy to buy insulin. ($25 at Walmart.) About how easy it is to make recombinant insulin I recommend this channel: https://www.youtube.com/watch?v=J3FcbFqSoQY https://www.youtube.com/watch?v=J3FcbFqSoQY

grp000 5y ago

I scanned through the site and their first post was in 2015 and has news articles posted about the company with titles like: "The Community Labs Built on Silicon Valley’s Junk: Trash from biotech startups are citizen scientists’ treasure" and "The Rogue Experimenters". Also, lots of posts about wanting interns. This doesn't give me a good feeling.

DoreenMichele 5y ago
It's also apparently kind of a dupe* and the top comment in the previous discussion indicates they looked and there's seemingly nothing "open" about this initiative. I mentioned diet and lifestyle because that's how I manage my otherwise insanely expensive and debilitating condition and did so that way even while homeless. If you are genuinely concerned about the health and finances of poor people, finding a way to educate people about diet and lifestyle strikes me as at least part and parcel if what you ought to be doing and as a generally superior approach. One reason medicine is highly regulated is because screwing it up with unsanitary practices can maim or kill people. * https://news.ycombinator.com/item?id=27854041 https://news.ycombinator.com/item?id=27854041

moron4hire 5y ago

Maybe, instead of constantly drumming on about "diet and lifestyle", we should be studying why the "diet and lifestyle" message has completely failed to move the needle on the obesity crisis. Cuz I'm pretty sure nobody with diabetes has not heard about "diet and lifestyle". So comments like that are not adding anything to the conversation.

lovemenot 5y ago
Not specifically about diabetes: to some extent, obesity is a social disease https://www.nih.gov/news-events/nih-research-matters/friends-family-may-play-role-obesity https://www.nih.gov/news-events/nih-research-matters/friends...
- DoreenMichele 5y ago
  There is also research that connects living in a cluttered/disorganized/messy home to being more at risk of being obese. https://www.prevention.com/weight-loss/a20513150/how-to-get-organized-lose-weight-faster/ https://www.prevention.com/weight-loss/a20513150/how-to-get-...
Dove 5y ago
It's the wrong "diet and lifestyle" recommendation - the standard suggestions of eating less and exercising more don't work. What does work specifically is a low carb diet and intermittent fasting lifestyle, together with close medical supervision. https://www.virtahealth.com/ https://www.virtahealth.com/ has had great success with the approach.
- DoreenMichele 5y ago
  There is also a lot of research indicating that inflammation is an underlying cause of most forms of diabetes. Controlling inflammation, in part by changing my diet, is likely a significant factor in getting my blood sugar issues under control as a side effect of more general efforts to remedy my health problems.