Re: INGAP bounced from failure to failure for 27 years
[ Follow-Ups ]
[ Post Followup ]
[ The Islet Foundation Public Message Forum ]
Posted by Josh on 19:41:11 2010/01/21
In Reply to:
Re: INGAP bounced from failure to failure for 27 years posted by elliott
Well, I'll start by saying that any improvements are gladly welcome. To me, they fall into two buckets:
1) Improvements in quality of life, no matter how small. I personally got excited when I bought a new glucose meter with a built-in USB port. Having diabetes for 15 years, but I've seen a number of evolutionary diabetes care advances such as insulin pens and pumps. Obviously none of these come close to a cure, but they have given me a lot more freedom and arguably better glucose control.
2) Reduction in complications. So far I'm complication-free, but knowing there was a 'cure' for diabetic retinopathy would be huge in my book, even if my blood sugars were out of whack.
I would argue that a semi-successful islet transplant (that smoothed the curve without bringing about complete euglycemia) would be a major improvement in both categories, and I would be the first in line. If, on the other hand, my day-to-day quality of life remained the same (concerns of lows, careful dosing, etc) but my chances of complications went down, I'd be a little more wary about having a recurring operation.
[SIDE QUESTION: Is the "semi-successful islet transplant" a real possibility if the procedure went mainstream? I always assumed that the islet count could be ramped up (assuming the supply problem was no longer an issue). ]
There are a few other pseudo-cures that would get me excited:
- Temporary euglycemia via islet replacement (either encapsulated islets or islet regeneration) where the cells eventually die and require "fill-ups", maybe once a year. Also, I don't care if the cells are from pigs, fish or cell lines.
- Smart insulin, where I would take a daily shot, but not care about dosage. As long as I take my shot in the morning, my glucose levels will be stable. This sounds like an awesome stopgap solution.
- Artificial Pancreas- way lower on my list. In fact, I'd likely not do it. My concerns: mechanical failure, invasive procedure (scarring?), still need to refill it and replace battery
However, I'd still have two major concerns with any of the above solutions (including the semi-successful islet transplant):
1) Public perception as a full on cure. Research money could go down if people feel that any of the above solutions are good enough.
2) The solution biologically gets in the way of a true cure. For example, I'd be worried if encapsulated islets couldn't be recovered from the body and prevented the administration of a more ideal solution. This fear may be unfounded, but I thought I'd bring it up.
Also (a little off topic), I personally think that the above solutions are more likely in the medium-term than an all-encompassing cure because they require replenishment and therefore offer big business a greater incentive to develop them. A depressing thought (and conspiracy theory-esque), but at least an entire industry wouldn't die overnight.
Naturally, the dream situation would be a cure that would fix the underlying problem so I'd be completely normal. For example, smart insulin (or an artificial pancreas) would be great, but my body would likely only get insulin. What about all of the other hormones that are produced, like amylin? They presumably play some role in my body. Also (maybe another unfounded concern), I wonder if a "leaky bucket" solution could take a toll on the body (constantly fighting 'foreign' cells).
-Josh
Follow Ups:
Post a Followup
[ Follow Ups ]
[ Post Followup ]
[ The Islet Foundation Public Message Forum ]