10/13/2013

As diabetics we all imagine a day in the future when a cure for diabetes becomes a reality.



What you may find surprising is that day is not a pipe dream and it is possibly much closer than you may think. The unknown element is what form that "cure" may take.



There is research going on all over the world into dozens of different possibilities, many of which are looking at using the latest technology to effectively cure the condition.



Lets take a look at the ones which are closest to succeeding and the ones which, whilst much further away, hold the most promise:



Closing the Loop



This is a method being developed by most medical device companies that seeks to combine the use of an insulin pump and a continuous glucose monitor (CGM). The CGM reads your blood-glucose levels by various methods (based on the type used) and then communicates wirelessly with the pump to dose according to what your body needs to maintain stable control. This is not a "cure" per say but is the next evolutionary step towards a "closed-loop" artificial pancreas that will operate automatically and mean that the patient is effectively relieved of the responsibility of testing and dosing. It's a curious and appealing idea and is certainly the one that you are most likely to avail of in the near future. Once the issues of battery life, cost and reliability of the CGM are resolved you'll hopefully find that this system becomes commonplace. Eventually it will be coupled with an implantable insulin pump that will complete the closed loop and make your diabetes basically invisible.



Glucose Responsive Insulin



This one is frankly fascinating and is a complete departure from the usual approach to diabetic "cures". A glucose responsive insulin, an idea that is being extensively researched by the JDRF, means an insulin that only acts when it is needed. So for example, you would take a single injection each day which would lay dormant in your body until you ate/exercised etc. It would then sense the presence of rising/falling glucose in the bloodstream and activate or deactivate to maintain normal blood glucose levels. It aims to deliver precise doses of insulin when and where it's needed, device -free and with minimal finger stick testing. It would provide a treatment for type 1 diabetes and type 2 diabetes where patients are using insulin.



Sounds amazing right? Well of course but there's a number of hurdles to clear first. For a start, a treatment like this has never been created for diabetes or any other condition and is completely uncharted territory for both science and regulation. There is a long way to go in terms of development and even when that yields results, there will need to be a lot of time spent gaining approval from many regulatory authorities. But the overall idea is incredibly bold and exciting. It's certainly one to watch!



Take a look at http://countdown.jdrf.org/Features.aspx?id=8589934727 to learn more



Stem cells



Otherwise known as "the holy grail"! If you haven't heard of stem cell therapy then I bid you a warm welcome to the planet earth as you have obviously been living under a rock, on Mars, with your fingers in your ears.



Stem cells are considered to be biological "master" cells that can be coaxed into becoming any tissue that is required. So in theory they can be turned into replacement organs, skin, bone or in case of diabetes- insulin producing islet cells.



The treatment would be administered to effectively replace the damage part of a diabetic pancreas and the patient would simply start to naturally regulate their own blood sugar as though they had never had diabetes. A truly "perfect" cure.



There is huge money and effort being poured into stem cell therapy in the hope that it will yield such a result. However it will take a lot of time and there is no guarantee of success a well as the fact that currently the creation of stem cells requires the destruction of human embryos which causes many ethical issues. However, if these problems can be overcome, stem cells represent the hope of many for a true cure for diabetes. But just like glucose responsive insulins, patience will be a virtue.



The very idea of a "diabetes cure" conjures up many emotions in me. The thought of someone simply giving me an injection and saying "that's it, no more diabetes" seems almost too good to be true. After all this time living with it, diabetes has become a way of life for me. Having spent the majority of my adult life testing 5-6 times a day, counting carbohydrates and adjusting multiple injections accordingly, it would feel very alien and possibly a little unsettling to leave that behind. But I certainly wouldn't say no if and when that "cure" does happen!



In the meantime I would encourage you to keep an eye on tomorrow but don't forget about today. Ignoring the day to day management of diabetes because you think a cure is just around the corner is a hell of a gamble. Make the most of today's treatments and help to make sure that you live healthily and long enough to get your hand on that holy grail!
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