
British man with type 1 diabetes to receive tests after coming off insulin - alexee
http://www.diabetes.co.uk/news/2017/mar/british-man-with-type-1-diabetes-to-receive-tests-after-coming-off-insulin-95040046.html
======
karmel
Here is the story from the Northampton Chronicle that is referenced but not
linked to: [http://www.northamptonchron.co.uk/news/doctors-now-80-per-
ce...](http://www.northamptonchron.co.uk/news/doctors-now-80-per-cent-certain-
daventry-man-is-the-first-person-ever-to-cure-himself-of-
type-1-diabetes-1-7865892)

Note that it is similarly without any substantive details. Not to be a
naysayer, buuuutttt... knowing a fair amount about type 1 diabetes, I can
suggest any number of possible explanations that are far short of "miracle."
The most obvious one is that he had over-treated type 2 diabetes and increased
physical activity is leading to an increase in insulin sensitivity that looks
like a miraculous cure. Alternatively, especially given the late age of
diagnosis, he might have Latent Autoimmune Diabetes of Adults (LADA), which is
kind of like really slowly developing type 1 diabetes. The body naturally goes
through ebbs and flows in relative efficiency and autoimmunity, so if he still
had some functioning beta cells, a temporary period of reduced autoimmunity
could allow those cells to resurge and produce enough insulin to support his
body without the addition of exogenous insulin. However, that's unlikely to
last if that's the case.

Again, not to pooh-pooh all theoretically good news, but... I see lots of
miracle cures for diabetes in headlines, and none on the pharmacy shelves.

~~~
delhanty
Thanks for this - think I should get tested for LADA when I get back home
(Japan) in a month or so ...

But I'm in the U.S. right now: does anyone have any recommendations for a
basic CGM setup that I could get off Amazon?

~~~
robobro
nope, they're pretty spendy.. If you want to see whether or not you're
diabetic, get a cheap glucometer. You ought to be able to get one with 10 or
15 demo strips for under $20. check your blood sugar first thing in the
morning after you wake up, and if it's over 100, you are pre-diabetic
(congratulations!)

~~~
delhanty
Thank you - I will get the strips at least.

Do you have a $ figure for "pretty spendy"? I _really_ want to sort out the
bouts of fatigue though, so in that sense I'm not that price sensitive.

~~~
alexee
You can order Free Style Libre (online), starter package for $200 or so (check
their website). They probably don't ship to the US, as they're not approved
there, so you'd have to use some mail forwarder.

~~~
delhanty
Thank you! That might work for me - I could get it shipped to Japan or the UK.

~~~
terminalcommand
Speaking as a T1D for nearly 10 years, instead of getting a glucometer, go to
a lab and check your Hba1c levels.

The test is really cheap and is an indication of your glucose levels in the
last 3 months. If that is over 7 mg/dl you're diabetic.

I sincerely hope you don't have T1D. Good luck.

~~~
delhanty
Thank you for the recommendation about Hba1c and also the "Good luck".

This blog post on Hyperlipid

[https://high-fat-
nutrition.blogspot.com/2007/10/physiologica...](https://high-fat-
nutrition.blogspot.com/2007/10/physiological-insulin-resistance.html)

kind of relates to what you write: Hab1c is a more accurate indicator of
diabetes than fasting glucose for someone on any form of carbohydrate
restriction, which is me.

edit: s/that/than

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pimeys
I'm a programmer and I've had a type 1 diabetes for the last 21 years. It is
one of the most complex things in my life to take care of when all of the
insulin therapies don't really work that well and I don't wake up to the
nightly hypos. Luckily I'm in the German insurance system and getting an
insulin pump first and later a CGM. Already I'm using an NFC chip in my arm
giving results to my phone and from there to InfluxDB and Grafana. Later with
a proper CGM I also get automatic alarms which wake me and my partner if the
sugar gets to low.

There are great open source systems for us technical people, but the tech is
very expensive without an insurance and requires you to solder an extra device
to get the values to your phone. At least with an NFC device you can wrap a
smartwatch over it to get the readings automatically to your phone, rooted of
course.

~~~
taternuts
> Already I'm using an NFC chip in my arm giving results to my phone and from
> there to InfluxDB and Grafana. Later with a proper CGM I also get automatic
> alarms which wake me and my partner if the sugar gets to low.

Very cool! I've recently become friends with a type 1 diabetic and have been
learning a lot about it myself. It really is an incredibly intrusive thing
that involves constant supervision even with automatic pumps, constantly
switching spots to place the needle that much stay in him constantly. He's
actually getting a service dog in a month that's trained to wake/warn him if
his blood sugar levels get too low. Have you open sourced your solution?

~~~
pimeys
[https://github.com/jamorham/xDrip-plus](https://github.com/jamorham/xDrip-
plus)

This is the fork I'm using and I made the support for InfluxDB. If you want
the cheapest CGM solution, it might be the FreeStyle Libre with a rooted
android watch wrapped next to it. By paying more there are better solutions
but you still need to solder an extra device to carry if you want the readings
with Bluetooth, at least in Europe.

Nightscout is an open source hacker community in Europe providing support and
tools if interested.

[http://www.nightscout.info/](http://www.nightscout.info/)

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bluemax
4 years ago I got diagnosed with type 1 diabetes in my early forties. The
hospital staff showed me how to manage my glucose with long acting and fast
acting insuline.

As a programmer I'm good with numbers so everything was pretty much under
control but I started noticing that I needed less and less insuline up to the
point that I needed no insuline at all. This was about a year ago. At that
same time I had some new physical health problems and it turned out I had
celiac disease as well. Bummer :(

One side-effect of 'untreated' celiac is that carbohydrates are less well
converted to glucose and so my glucose levels stayed normal without using
insuline. Unfortunately it meant I was not cured from type 1 diabetes.

Now that I am on a gluten free diet my insuline usage is back to normal and I
stopped farting as a bonus :)

~~~
UnoriginalGuy
You sure it was Type 1?

Generally people are diagnosed with Type 1 at a very young age, since it is
caused by your own immune system destroying beta cells in the pancreas, which
if untreated results in eventual death.

Type 2 is more often associated with age and diet. It is the most common type
in particular at later ages, but some people get it younger due to genetic
predisposition.

~~~
epmaybe
Type 1.5 is adult onset autoimmune diabetes

~~~
zaroth
That's a bit of an oversimplification. T1 is auto-immune -- the body loses the
ability to produce insulin, and you can detect autoantibodies in the blood. T2
is insulin resistance, and generally has no autoimmune component and no
autoantibodies present.

Typically T1D comes on all at once; the autoantibodies destroy the insulin
producing beta cells and the patient needs exogenous insulin starting
immediately. A subset of adult onset T1D displays a much slower progression of
the destruction of beta cells. This is called LADA (latent autoimmune diabetes
of adults”) or slow-progressing T1D and more recently T1.5D.

Similarly, some T2D patients also show evidence of autoantibodies however
their beta cells are still largely functioning.

So now we further split into groups; Type 1–LADA, Type 1.5 or “double”
diabetes, and Type 2 diabetes with autoantibodies.

This is a good overview: [https://www.diabetesselfmanagement.com/diabetes-
resources/de...](https://www.diabetesselfmanagement.com/diabetes-
resources/definitions/type-1-5-diabetes/)

~~~
epmaybe
Thanks! I'm a little rough on my diabetes pathology/immunology, this was a
good review :)

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lutusp
Quote: "Mr Darkes says that doctors are now 80 per cent convinced he is cured
of the condition, which has never before been reversed."

I suspect (and it can't be more than a suspicion) that many of those with
diabetes diagnoses never take the risk of reevaluating their physical
condition, but passively continue their medication -- and that seems wise and
prudent.

Maybe a carefully designed study, an animal study at first, could reveal that
what happened to this individual is on the roster of possibilities, that some
people have the ability to reactivate their pancreases in the right
circumstances.

It's already well-established that physically active people have a lower risk
for diabetes, but once the condition is diagnosed, most people start an
insulin regimen that never ends. This case suggests that a person's pancreas
can be reactivated -- but for how many? And is the change permanent? These are
unanswered questions.

~~~
SwellJoe
Given the ongoing cost and incredible amount of hassle involved in managing
insulin for diabetics, I would think many would jump at the opportunity to
discontinue medicating multiple times a day, and would go to pretty great
lengths to do so.

But, the risk of "testing" insulin response yourself would be pretty high,
too, so I would hope folks would do so under doctor supervision. Hopefully,
this will make that kind of experimentation become more common. If there's
something to it, a whole lot of people could see a tremendous improvement in
their quality of life.

------
alexee
Sadly this article doesn't say if he can eat cakes or cookies without
dangerously high blood sugars. This test could say quite definitively if he is
cured or not.

Usually term "reversed" is used in context of Type 2 diabetes, meaning that
patient can have normal range blood sugar without any medications, but
patients still cannot eat cookies/cakes without blood sugar spiking to
dangerous levels.

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dude01
tldr: Unsatisfyingly short article about someone no longer having type 1
diabetes -- without any even possible explanation as to why. They only mention
long-distance running as a remote possibility.

~~~
brudgers
The most likely explanation is a misdiagnosis. The inevitability of
statistical ocurrance does not make for an interesting story however.

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bleair
The article is a bit short on medical details. It sounds like he was diagnosed
Type 1 diabetes and then after time they think his pancreas regrew the beta
cells needed in a functioning pancreas

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rjmalagon
Surprise me. I think that both diabetes types are very complex illness.

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known
How do you measure the amount of insulin pancreas is secreting?

~~~
zaroth
Probably indirectly, by consuming a measure of sugar and watching for a rise
(or not) in blood glucose levels.

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stupidcar
This seems... unlikely? Is it possible he had some other, rarer autoimmune
condition that presented diabetes-like symptoms, and that resulted in a false
diagnosis?

