
Diabetes in mice cured rapidly using human stem cell strategy - known
https://medicine.wustl.edu/news/human-stem-cell-strategy-rapidly-cures-diabetes-in-mice/
======
Kwastie
Am I assuming correctly that this only applies for type 1 diabetes?

With type 2 diabetes the body is in general less sensitive to insulin, more
insulin producing cells won't fix the underlying insensitivity issue, right?

~~~
lolc
There is already a therapy that transfers beta cells from healthy people to T1
patients. The trouble is that the patients have to take immunosuppressants
ever after to prevent the immune system from killing the cells off again. And
I don't think that cells grown from stem cells would fare better, because it
was the patients immune system that killed the beta cells in the first place.

Your typical T1 will prefer insulin therapy over immunosuppressants.

~~~
rland
It takes time (several months) for islet cells to get destroyed by the body.
That's the origin of the "Honeymoon phase" experienced by some t1ds after
diagnosis. So successful islet cell transplants last for a few months; at the
beginning, the patient is nearly cured, and then their islet cells are slowly
destroyed by the body. So the appeal of stem cell treatment is that you get a
single booster of islet cells every couple months. No nasty immunosuppressants
required, because the body doesn't reject stem cells crafted from its own
cloth.

~~~
lolc
Ah if it lasts longer I can see how it would become an option. In my case the
"honeymoon" took the better part of a year and if that phase could be repeated
it would definitely improve my therapy.

------
DataDrivenMD
This reminds me of the time I spent at the NIH conducting research on cancer
vaccines. After lots of trial and error, I had finally found something that
seemed to prevent lung cancer in mice. I rushed to show my PI the results. He
listened intently and asked thoughtful questions. Once I finished, I asked if
the findings would be worthy of submitting to Nature.

He looked me straight in the eye and said, “I wouldn’t publish this anywhere,
we still have work to do.”

“What do you mean?” I asked.

“If Nature published every article that purported to cure a human disease
based on a mouse model, then I would be next in line for the Nobel Prize,” he
replied.

Harsh but true. The challenge of curing human disease cannot be replicated in
animal models. At least not yet.

~~~
Amygaz
I stopped counting how many times we cured any forms of diabetes in various
mouse models.

Then there is this thing that bugs me: amount of money spent on finding a
treatment vs. preventing type 2 diabetes in the first place. Because 95% of
type 2 cases are caused by life style decisions. And as climate change,
healthcare costs, covid-19, and other self-inflicted societal crises we prefer
to wait until it chronically costs a massive amount of money (add chronic
deficit to the list).

~~~
laanako08
It's worth noting that "lifestyle" decisions, are mostly not decisions.
They're based on the systemic implications of a person's class, wealth, and
status. If a person has more time, and money, and is of a high-enough class,
they will be better educated on self-care and health, will have the time to
devote to continually ensuring good health, and will have the money to afford
high-quality food and activities. Diabetes is a disease of poverty, not of
character failure.

~~~
jfritsch1984
Healthy food is typically less expensive than junk food. The problem is
education and motivation. I think diabetes is more a disease of affluence.
When you can buy twinkies and pork chops you're not actually poor. When you
are really poor you eat rice and beans and some vegetables you grow for
yourself. And then you don't have diabetes typically.

Disclaimer: Not every T2D is purely from a bad diet. But many are.

~~~
flexblue
> Healthy food is typically less expensive than junk food.

This isn't true, at least in the US. Or maybe we have a very different idea
about what "healthy" food is.

Rice, beans and starchy vegetables are problematic for various (different)
reasons and non-starchy vegetables generally aren't very nutritious from a
macro perspective, which makes them relatively expensive.

~~~
pengaru
It is true, the produce department has some of the cheapest food in the store.
How much is a bundle of bananas? That's a week's breakfast.

Unless you only buy organic, then you might go broke while hungry.

~~~
flexblue
Bananas by themselves are not healthy food, they're very high in sugar and
have little else to offer.

Produce may look cheap, but if you add up the macros (and also some of the
micros), it doesn't look cheap at all.

~~~
pengaru
> Bananas by themselves are not healthy food, they're very high in sugar and
> have little else to offer.

That depends on ripeness [0], I eat a mostly green banana every morning and it
doesn't have much sugar at all while keeping my bowels very regular.

It's been my breakfast for decades, I'm quite healthy, and eat a diet almost
entirely composed of raw produce. The rest is nuts/seeds/legumes and canned
fish. I rarely ever cook, and if I didn't go for organic produce this would be
a very cheap diet except for the nuts.

[0]
[https://en.wikipedia.org/wiki/Resistant_starch#Nutritional_i...](https://en.wikipedia.org/wiki/Resistant_starch#Nutritional_information)

~~~
flexblue
> It's been my breakfast for decades, I'm quite healthy, and eat a diet almost
> entirely composed of raw produce. The rest is nuts/seeds/legumes and canned
> fish.

You get virtually all of your macronutrients from the nuts, seeds, legumes and
the fish - not the produce.

> I rarely ever cook, and if I didn't go for organic produce this would be a
> very cheap diet except for the nuts.

So it would be cheap if it was something else, but it's not.

In any event, I consider any diet high in grains/legumes a science experient
which may or may not work out. I don't consider it a healthy diet.

~~~
jfritsch1984
People eat beans for decades. Why should this be an experiment? Because people
like Dr. Gundry want to sell books? He‘s even admitted on TV that cooking
mitigates the whole problem. And who eats raw beans? I think it‘s pure
hysteria. In observational studies „anti-nutrients“ are mostly associated with
better health outcomes.

~~~
flexblue
> People eat beans for decades. Why should this be an experiment?

People also eat donuts for decades, that means nothing.

People _didn 't_ eat beans for hundreds of thousands of years. They're not a
"natural" part of the diet. They contain poorly researched plant toxins and
anti-nutrients, which can are known to cause issues in sensitive people.

Can you "mitigate" the problem with proper preparation? Apparently, but that
doesn't mean we know they are actually _healthy_ as opposed to "sustainable".
Populations across the world which have _no choice_ but to rely on grains and
legumes as a staple _do_ suffer from malnutrition.

> In observational studies „anti-nutrients“ are mostly associated with better
> health outcomes.

Observational studies are mostly useless, because anybody who buys into
"legumes are healthy" will focus on living a healthy life in other aspects as
well. As I said, swapping in legumes in place of donuts is going to be a
benefit. That doesn't mean it's optimal.

~~~
jfritsch1984
You say that beans are problematic but you don‘t back it up. I only have to
show you that beans are just as much part of human diets as are other foods.
What is the actual science that anybody on earth suffers from the consumption
of beans? For donuts we see a direct correlation between sugary processed
foods and obesity, T2D and other diseases. For beans you can not show this.
The only thing you can show is some mechanistic data, where we can speculate.
In my personal opinion you are the victim of an industry that wants to sell
stuff like Gundrys supplements like „Lectin buster“ and the like.

~~~
flexblue
> What is the actual science that anybody on earth suffers from the
> consumption of beans?

"More than half of the world populations are affected by micronutrient
malnutrition and one third of world’s population suffers from anemia and zinc
deficiency, particularly in developing countries."

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325021/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325021/)

> I only have to show you that beans are just as much part of human diets as
> are other foods.

Again, that literally means nothing. Humans can _survive_ on very poor diets.

> For donuts we see a direct correlation between sugary processed foods and
> obesity, T2D and other diseases. For beans you can not show this.

Of course, I never said beans cause T2 diabetes or any other "disease of
civilization". They cause nutrient deficiences in populations that are
underdeveloped. As for what it does with those few people in developed nations
who choose to adopt a plant-based diet, there's just no good data, yet. That's
a recent phenomenon.

> The only thing you can show is some mechanistic data, where we can
> speculate.

Of course we have to speculate, because _we don 't know_. You can always ask
for more evidence that this-and-that is or isn't harmful in some dose.
Somehow, people are very wary about synthetic toxins or pesticides, but when
it comes to _natural_ toxins that plants produce to defend themselves, we
don't really pay the same kind of attention.

What's the evidence that heavy metals, or dioxin, or any of the other
pollutants are harmful in the doses that we allow them in? There isn't any,
that's why we _allow them_. Does that mean harmful effects don't exist? No. It
means we don't know any better.

Legumes just happen to be the biggest offenders of natural toxins in our diet.
They all have a rich history of requiring preparation to become digestible at
all. We're not evolutionarily prepared to handle them, we haven't eaten them
as a staple for more than a few thousand years. That's a red flag.

> In my personal opinion you are the victim of an industry that wants to sell
> stuff like Gundrys supplements like „Lectin buster“ and the like.

I don't care about Gundry opinions or his supplements, he's no better than
your nutritionfacts guy. Also, it's not like there isn't a whole industry
behind selling the plant-based diet. A much bigger industry in fact, also
fueled by ideology, ethics and virtue signaling. Red flags.

~~~
jfritsch1984
May I ask what your diet is?

------
lolc
> A common problem when you’re trying to transform a human stem cell into an
> insulin-producing beta cell — or a neuron or a heart cell —is that you also
> produce other cells that you don’t want

In my world this is called cancer. So yeah interesting how they're actually
able to tell cells how to grow. But you don't want liver cells mixed into your
pancreas, do you?

> But if a quarter of the cells you make are actually liver cells or other
> pancreas cells, instead of needing a billion cells, you’ll need 1.25 billion
> cells. It makes curing the disease 25% more difficult.

I'd assume the reason they try to get clean cultures is that otherwise they'd
be implanting tumors. Optimizing by 25% sounds like something they'd do after
having proven it on the human model.

~~~
SubiculumCode
I'm not sure that having a liver cell living in the pancreas equals cancer,
unless it starts replicating uncontrollably into more liver cells, and ignores
normular cellular signaling.

~~~
vikramkr
If it's a liver cell in the pancreas, it's already ignoring normal cellular
signalling. And in terms of replicating, these are derived from stem cells.
Cancer is partly defined by cells becoming more stem-cell like and being able
to replciate, so by definition they've already been turned into a state where
they're predisposed to be cancerous (or basically are cancers by definition),
and the coaxed to become a pancreatic cell, but unsuccessfully, so it's not a
good place for it to go wrong.

It's a known problem though and not an insurmountable one. There's been a lot
of work with encapsulation of these cells in a barrier that will prevent the
barely controlled tumor that is an artificial pancreas from breaking out and
wrecking havoc. And methods that are getting better at controlling these cells
like the one in this thread are promising ways of mitigating this risk moving
forward as well.

~~~
jf-
> And in terms of replicating, these are derived from stem cells.

All of everyone’s cells are derived from stem cells. The issue is still how
prone to uncontrolled proliferation they are, not so much having a population
of a particular cell type in the wrong place.

~~~
vikramkr
I was being less technical with my terminology for a layperson audience - but
to clarify - these are derived from induced stem cells, which are cells
engineered to go back into a stem type state, which means they're basically
induced to be cancers. These are not zygotes from germline fells formed in the
niche where they are supported to differentiate correctly etc. IPSCs are not
embryonic stem cells, and even ESC derived stem cell lines have been growing
so long in culture that they do not behave like germline cells. And even then,
the method of differentiation and control is not what happens in normal
development, we're sending them different pathways. Turning somatic cells into
stem cells is fundamentally giving them the ability to proliferate, and their
failure to differentiate into the cells we want shows a failure to control
them. Like I said, this is a known problem and one with significant investment
behind it as people are finding better and better ways to isolate artificial
pancreases to prevent the (currently) inevitable carcinogenesis of these ipsc
derived cells

------
geden
Closed loop insulin delivery systems functionally “cure” t1 diabetics and are
here today. Have implemented for a t1 friend. Has transformed his long term
outlook.

[https://loopkit.github.io/loopdocs/](https://loopkit.github.io/loopdocs/)

Relies on currently quite expensive hardware (continuous glucose monitors /
insulin pump / iPhone / Bluetooth to radio device) but that could all be
combined into 2 cheap devices easily. Regulation and inertia just seems to be
making that process very slow.

~~~
grep_name
> Closed loop insulin delivery systems functionally “cure” t1 diabetics and
> are here today.

You should be careful using that word around type 1 diabetics. Incidentally I
was on medtronic's loop system for about a year and a half, but you couldn't
pay me enough to go back to it. Not saying it doesn't work for some people
(often people with very stable hormonal systems who don't have large
variations in their physical activity levels), but even in the best case
calling it a cure is rough claim to hear being familiar with the reality of
dealing with these things. I'm glad that it was a success for your friend
though.

