
Giant leap against Diabetes - uptown
http://news.harvard.edu/gazette/story/2014/10/giant-leap-against-diabetes/
======
siyer
The authors have uploaded a copy of the paper which can be accessed here:
[http://hsci.harvard.edu/files/hsci/files/pagliuca_et_al_cell...](http://hsci.harvard.edu/files/hsci/files/pagliuca_et_al_cell_2014.pdf)

(I'd actually recommend giving the paper a skim even if you're not trained in
biology. The Introduction and Discussion should still be very comprehensible,
and while the Results do suffer from the alphabet soup problem (as do most
biological papers), the overall structure of the evidence should be clear -
pay particularly close attention to Figure 5A and Figure 6A-C).

Commentary from a very well regarded stem cell scientist (and prolific
blogger, Paul Knoepfler) here:
[http://www.ipscell.com/2014/10/top-10-takeaways-from-
harvard...](http://www.ipscell.com/2014/10/top-10-takeaways-from-harvard-stem-
cell-diabetes-paper/)

The key next challenge appears to be the creation and testing of appropriate
delivery device that can enable persistent survival of the differentiated
cells while still enabling them to sense blood glucose levels.

~~~
possibilistic
The paper was fantastic! The discussion section is a must-read for seeing
where this is going.

The calcium ion flux response to glucose challenge was neat. Demonstrates the
signaling mechanics being as expected.

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hooande
Sure wish there was some way that I could help fund this research. I don't
know if kickstarter campaigns are cool at Harvard, but they would have no
shortage of backers.

This does reinforce my idea that medical technology and research is advancing
at an exponential pace, faster than the evolution of diseases can keep up. A
treatment for type I diabetes seemed to be impossible. A diabetic's pancreas
betrays them and begins killing the cells that produce insulin. There's no
pill or surgery that can stop that, nothing short of reprogramming pancreatic
cells. And yet, here is a promising sign of a cure! It's really amazing, and
the future probably holds even more legitimate medical wonders. We might be
the one of first generations to live to 100+ on average.

Type I diabetes is expensive, ~$5,000/yr without insurance. Anyone with this
diabetes would probably be willing to pay any amount less than that every year
for the rest of their lives in exchange for this treatment. Talk about
customer lock-in! Most of the controversy over stem cells has been centered
around federal funding, but treatments for chronic and costly diseases will
pay for themselves several times over. For now I can only hope that this
research advances fast enough to help everyone who is currently dependent on
insulin.

~~~
BlakePetersen
Without insurance, blood glucose test strips cost $40 for 25. I test myself 8
times a day. That's nearly $5k/yr right there. It is really expensive... Thank
God for health insurance

~~~
Retric
If before using a strip you make a prediction how accurate is it? I only ask
because I know diabetics who say my blood sugar is low/high but I am guessing
that's not enough information in your case?

Edit: I also know a diabetic that went blind, it's a serious disease and I am
all for staying on top of it. I am simply curious in this case.

~~~
JshWright
Not a diabetic, but I interact with folks who are on a regular basis.

You know if you are getting into extreme territory (up to a point...
eventually the confusion that comes from hypo/hyperglycemia means you won't be
aware of it).

The danger of diabetes is that you can end up perpetually a little high, which
is what causes all the nasty osmotic side effects (blindness, slow healing
(leading to infection and amputation), etc...). You won't be able to know that
without testing.

For many diabetics, the amount of insulin they inject depends on their blood
sugar. There's no way you could 'sense' it to the level necessary to control
dosing.

EDIT: s/deal/interact/

~~~
BlakePetersen
This is pretty spot on.

You generally always have a running estimate in your head, "I ate two tacos,
took three units of Humolog, needed to correct down an extra 50 points with
the extra unit (because I undershot last meal), etc."

But there are factors that you have a more difficult time predicting your
levels with, like exercise, illness, the type of carb your eating (some carbs
take longer than others to hit your system, but if you treat all the same, you
insulin will hit you faster than your carbs and you're now hypoglycemic).

Truly staying on top of your numbers and this disease means constantly
checking. You can always make a guess, but when the risk of serious short-term
and long-term complications hang in the balance, you tend to want to know for
sure.

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skbohra123
Can anyone with knowledge about the topic shed some light on it and tell if
it's really a big breakthrough or just like another PR post by labs to attract
and justify more funding?

~~~
fulafel
It's a big breakthrough but not relevant for most diabetics. This is mostly
for type 1 diabetics, 90% of diabetes patients are type 2.

(Some type 2 diabetics might also benefit, the 10% that need insulin
injections?)

~~~
csommers
Not to be a dick, but don't steal the limelight please.

For once, the focus is on T1 and not T1 lumped into the discussion as it
usually is. Hey, I'm all for reporters putting out accurate facts(ie: knowing
the differences between T1 & T2), but it's silly to act like this isn't
"relevant".

T1 Diabetes is STILL extremely expensive to treat. Just because it's "only"
~10% of the total Diabetic population, doesn't equate to only ~10% of the
costs incurred. T1 Diabetics account for FAR more costs(per person compared to
T2) via: daily treatment, reoccurring, and emergency. Not to mention that for
"most" T2 Diabetics, the disease can be easily managed via proper diet and
exercise, something which CANNOT be done with T1 Diabetics.

source: someone who walks around daily with ~$8,000 worth of electronics
strapped to their body everyday for the past 15 years.

------
w1ntermute
Does anyone know what's happening to the IP behind this breakthrough? Are they
forming a startup?

~~~
BlakePetersen
I'd imagine the patents are owned by the institutions the research is being
conducted at and a Big Pharma will company will buy or license those patents
after trials.

Startups are too small for shouldering the financial load of
developing/testing/insurance/lab facilities/high end staff. Plus, Big Pharma
has established distribution channels that would get a Type 1 like me my cure
faster, which one may consider ethical territory.

