Science Ain't So Bad

SOMETHING FOR TYPE 1?

Sometimes my job sucks.

Occasionally, I hear from readers who say they’re sick.  “Science,” they say, “pah! Who CARES about ‘fascinating’ papers by science geeks ? I need a cure. Not a rat model.”

And- you know what? –  MISTER ScienceAintSoBad gets it.  He does. He knows “interesting” has to take a back seat to “it’s killin’ me.” How often do I find you a nice little pill to cure cancer? I don’t even have anything much for diarrhea.  I read through all kinds of crap about “breakthroughs”. Hah! Some breakthroughs! The mice feel better.  For humans? We’ll get back to you on that.

What a job!

Could be things are getting better. My last article, Alzheimer’s, Things Are Starting To Look Good, had little glitter balls of hope stuck all over it. And now  something about type 1 diabetes that could please you and add to my own optimism about less sick people to drag down Obamacare.  Seriously! It could happen faster than anyone thinks.

The Type 1 vs Type 2 thing

The thing about type 1 is that you can’t make insulin. The cells in the pancreas that  do this job get destroyed by the immune system  Without insulin your blood sugar climbs. If you don’t get yourself stabilized with supplementary insulin,  you won’t last. Even if you are a very good patient, you may have to work very hard at keeping your sugar level in a good range. If you are  lucky you may avoid some of the crappy complications but it won’t be easy. Type 2 usually comes on later in life and is because your body loses its ability to efficiently use the insulin that it produces. It’s not a lack of insulin; just can’t seem to use the stuff right. You wind up needing extra. You don’t want either type of diabetes but individuals with  type 1  often have a tougher challenge.  

What I saw was published in the journal Diabetes. (Dr. Jeffrey Bluestone, PhD and Dr. A.W. and Mary Clausen).  It’s about a drug called teplizumab which, in a very sophisticated way, keeps T-cells (the business end of the immune system) from going after the insulin producing cells on the pancreas. The strength of the results even surprised the scientists conducting the study; they were  “very excited by the efficacy”.

THE CATCH?

Well, here’s the thing. This IS exciting. (That’s what they said in the press release, right?) Great news. BUT these are only phase II trials on 52 kids under 15 years old. Half the kids did great. That’s why so much excitement. But what about the other kids? They didn’t do as well. The study says this might be because it works best where the insulin producing cells are still in fairly good shape. In other words,  where the disease hasn’t been active that long. But, come ON! These were teenagers with newly diagnosed disease. Obviously this part needs to be cleared up. Still. Such great results do justify moving right along to phase III. Great potential here.

By the way, this isn’t the only hope. There’s other research attacking the disease from other directions. That’s good. We don’t want to kick people under the bus just because they’ve been sick for a long time.

Vanquished!

Diabetes: cure.

INSULIN PRODUCING BETA CELLS PROTECTED IN FOUR YEAR STUDY

Let’s see what’s new.

Ah.  Here’s a study from the Juvenile Diabetes Research Foundation about a cure for diabetes.

Now I KNOW I’m dreaming!

A new drug, otelixizumab, is in phase III trials. (Phase III trials are the randomized, controlled, multicenter trials where you figure out if the drug really works).

Forty eight  months into the study, the insulin making cells of the eighty “type 1” patients in the study are still OK.

How’re you doin’? Hair standing up on the back of yer neck? Hands shakin’? If not you don’t get it. This is an atomic bomb! This is a breakthrough of a breakthrough! This is.. well… ScienceAintSoBadRating = 10.

MISTERScienceAintSoBad SHOULD know better than to give away 10’s like this. Something this important’s gotta be tested on more than 80 patients. Maybe the head’ll fall off of the 81st one (considered a setback). But DAMN this is neat!

Maybe there IS something to all this science stuff!

THAT'S one. (A pancreas.)

image from Creative Commons

Medicine: Type 1 Diabetes.

An artificial pancreas really is just over SOME horizon now. An announcement from Cambridge (article in the Lancet) describes the fine work of Dr Roman Hovorka at the University of Cambridge, working with a group of seventeen diabetic kids.

A cure for diabetes would be nice, of course. And there are some intriguing hints but, for now, an artificial pancreas would be stunning enough.

If it works out (and if it is widely accepted), this development has the potential to greatly reduce the complications of the disease, ease peoples’ lives, and reduce health care costs significantly (Wouldn’t THAT be nice?).

Back to which horizon this is over.

It’s hard for MISTER ScienceAintSoBad to say this but, once again, this is only a tantalizing possibility of something that is badly needed. We ARE a lot closer, thanks to the great work being done. Maybe as little are three, four or five years.

Karen Addington (Juvenile Diabetes Research Foundation) says this is a “proof of principle” and that we “need to redouble our efforts.”

I’m not sure that’s what we want to hear. But reality IS so darn real, isn’t it?

ScienceAintSoBadRating = 9

– – – – – – – – – Postscript – – – – – – – – –

Karen Addington was nice enough (and ubiquitous enough) to leave a comment which I am duplicating below since it addresses the question of when this device might really hit the road. Notice that her motivation is personal.

Her comment:

Thanks for picking up on this new research.

We know that developments like the artificial pancrease can’t come quickly enough for people living with type 1 diabetes, and their families. That’s why we’re working really hard to make sure that the artificial pancreas becomes a reality as soon as possible. In January my colleagues at JDRF International (based in the USA) announced a partnership with Animas (a Johnson & Johnson company that manufactures pumps) to develop a first generation artificial pancreas.

The goal is to develop a system that can prevent the extremes of both hypoglycaemia and hyperglycaemia automatically – but will still need some input from the wearer, such as informing the system of meal times and periods of exercise.

This partnership is planned for four years and by the end we hope to reach the point where it will ready to go forward for approval by regulatory bodies like the US Food and Drug Administration (FDA) and the European Medicines Agency (EMEA), and from there to people with type 1.

I have had type 1 diabetes for 30 years, and I’m really excited about what this research could soon mean for me, and everyone else with type 1.

EVIL

Cardiology: Seasoning.

Well.

Here’s the thing. About 25% of you are “salt sensitive”. Which means, if you eat too much salt, you could be at risk for high blood pressure (like you always heard), as well as heart failure, kidney disease, diabetes, cataracts, strokes.. on and on.

As if you didn’t have enough to worry about.

How can you tell if you’re salt sensitive?

Not that easy. A clue: low birth weight kids are prone to it.

If you’re in that group (salt sensitive, that is), you really SHOULD steer clear. Keep it off the table and out of reach. Learn other ways to enjoy food.

Or try exercise.

I’m sure you remember from your running days that you can get sick if you don’t have ENOUGH salt. Good hard exercise (done often enough) chews up the salt and may very well ALLOW you to indulge a bit.

Not such a terrible compromise, is it?

SALT AND HIGH BLOOD PRESSURE

I knew you would ask.

See, keeping extra salt out of your diet is such a standard part of government guidelines, that it is now the orthodoxy. EVERYBODY knows it’s true.

“But,” you may ask, “if one in four of us is salt sensitive, don’t we bias the results of the studies that all this stuff is based on?”

You would think.

What about those of us who aren’t sensitive – the majority?

Dr. Richard Fogoros, from the University of Pittsburgh, talks about the “Salt Wars” and concludes, conservatively, that you should “sell your salt shaker”.

Just in case.

MISTER ScienceAintSoBad, doesn’t want to lead you astray, but, given that most of us AREN’T salt sensitive, maybe a little common sense, based on your own medical history, your known inherited risk factors, and the advice of your Doc might give you license to “shake it”.

Just a little.

Anyway, all this stuff is a reminder that science is great ‘n all. But it doesn’t always lead us to clear answers.

The salt and pepper shaker image is from:

Easier?

Medicine: Color changing lenses for diabetes.

Back to diabetes.

The primary way that diabetics check their blood sugar level (other than passing out, of course) is by analyzing a little blood. They say you get good at it.

So this new thingee from Jin Zhang at the University of Ontario should be very welcome, right? Contact lenses that change color, depending on your sugar level.

Elegant, easy, and convenient.

Have you ever TRIED to poke a lens into your eye? It isn’t the most natural thing in the world. My optometrist claims it’s cause I’m the wrong sex. Women, supposedly, have a contact lens gene. Or, anyway, are more used to screwing around with their eyes.

But for those who find lenses convenient or who already DO wear them, this may be a very appealing idea.

It’s not like I’m running out of 10’s or anything.

ScienceAintsoBadRating = 10