In Which "Big Pharma" Is Not Keeping a Cure Under Wraps So They Can Make the Big Bucks

Until Sir Frederick Banting and his colleagues Charles Best and Dr. J.J.R. Macloed refined insulin from the pancreases of dogs and injected it into the first human patient in 1922, type 1 diabetes was universally fatal. This was less than 100 years ago. The first recorded incidence of diabetes occurred in Ancient Egypt in 2550, more than 3000 years ago.  Presumably it was present in the human population even earlier. I like to keep these things in perspective when people in the diabetes community lament the lack of a cure "after so much time."

To be fair, no one told us when Kittygirl was diagnosed that we were lucky because a cure was just 5-10 years away. Apparently many newly diagnosed diabetics have been hearing this since at least the 1970's. In fact, when Kittygirl was diagnosed I didn't even know there was promising cure research happening.

My hypothesis is that, with the technology we have available now and the research happening around the world, there will very likely be a cure and/or a revolutionary treatment that ends insulin dependence for type 1 diabetics within Kittygirl's lifetime. However, scientific research is slow and ponderous with a lot of stops and starts. I imagine it will be at least 10 years before anything resembling a cure is on the scene, possibly closer to 20 years or even longer.

In the meantime, I eagerly follow the advances in diabetes technology that are relatively quickly moving toward a true closed loop system with an insulin pump and a CGM. Such a system would not be a cure, but having normalized blood sugars with a small amount of work would be the next best thing as far as I'm concerned.

Just within the United States I know of several scientific teams that are experimenting with different types of pancreatic beta cell implantation. This has actually led to some human subjects achieving remission of their type 1 diabetes and becoming insulin independent. However, it comes at the cost of a lifetime of anti-rejection meds, which have their own potentially dire side effects. Partly for this reason, there are currently no pediatric trials of this procedure as far as I know.

There's a team of scientists at City of Hope in California who are looking for an immunological cure. According to an interview I heard with the director, their hypothesis is that the cure might look slightly different for everyone. They did achieve insulin independence for one subject. It only lasted a few years, but even a few years free of the burden of diabetes sounds pretty amazing.

At Faustman Lab in Massachusetts, Dr. Denise Faustman is pursuing a unique line of research, using a cheap and widely available tuberculosis vaccine in an attempt to rewire the immune system. So far, her research has resulted in her subjects being able to achieve a lower A1C with less work but it has not yet resulted in insulin independence. However, it is only in phase 2 of testing. If this research pans out, the treatment might be effective for many or even all autoimmune diseases, which would be a medical research coup to top all coups. No autoimmune disease has ever been cured.

About a year ago I read an article about a team of researchers in Indianapolis who were injecting beta cells under the skin of dogs with naturally occurring diabetes (this is noteworthy because in most animal research the animals are made diabetic) which has resulted in three months of insulin independence. I haven't seen any follow ups on this research so I don't know if it's gotten any further.

This is just research in the United States. I don't know much about it, but I know that there is cure research going on around the world. Sometimes people in the diabetes community look at all the research and ask themselves and others why none of it has yet resulted in a cure. They hypothesize that "big pharma" will never allow a cure to come to market because they're making too much money keeping people insulin dependent for life.

I think this attitude is flawed for several reasons. First of all, the fact is that the majority of industrialized nations around the world have government funded universal healthcare. It would be significantly cheaper in these countries for those who have diabetes now and those diagnosed in the future to be cured right away than to be treated for the rest of their lives. Even if a cure were discovered in the U.S. and there was pressure not to make it available here, I have faith that the scientists would get it on the market elsewhere and word would spread. In such a scenario I believe there would be such an outcry that it would eventually have to become available in the U.S. as well.

Secondly, this attitude ignores the fact that scientific research almost never moves in a straight line. Scientists had begun to understand that diabetes was a disorder of the pancreas in the mid 1800's. The islets of Langerhans, the part of the pancreas that produces insulin, were named for the scientist who discovered them in 1869. A variety of scientists had tried to isolate the pancreatic secretion that controlled blood sugar (with limited success) as early as the 1880's.

Dr. Banting, who was surprisingly ignorant given what a huge impact his work had on medical history, did not know about these previous studies when he proposed his own. It's a good thing he didn't, because he said later that, if he had, he would probably not have begun his ultimately successful work.

In the 21st century, it's nearly impossible for one scientist to be unaware of the work of another scientist in their field. It's quite possible that a cure will eventually come from a diverse interdisciplinary team of scientists working separately but in tandem around the world. It's possible that one of the projects currently underway will succeed and provide a cure for all or most diabetics.
It's also possible that all the current research will eventually fail, but will serve as inspiration for an up and coming gen Z scientist who discovers a cure in 20 years.

Even if it takes another 50 or even 500 years for a cure to be discovered, the span of time between the discovery of a lifesaving treatment for diabetes and a cure for diabetes will have been relatively short when looked at within the whole span of human history.

I hope and pray for a cure within Kittygirl's lifetime. I would love for her to be relieved of the burden of taking care of her diabetes for her entire adulthood. However, even if that doesn't happen, I'll remain grateful for the research toward that goal and for the technology that can hold us over until it is reached.