Treatment options vastly improved for Type 1 patients | The Columbus Dispatch

There are 16 comments on the Apr 24, 2011, Columbus Dispatch story titled Treatment options vastly improved for Type 1 patients | The Columbus Dispatch. In it, Columbus Dispatch reports that:

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“Zuzu's Petals”

Since: Sep 10

Bedford Falls

#1 Apr 24, 2011
Hopefully, there will soon be a cure!

Since: Jun 10

Canal Winchester, OH

#2 Apr 24, 2011
Tight control is paramount in keeping the damaging side effects of diabetes in check.
Cost is probably the main obstruction to maintaining proper treatment and control.
When the medication and medical vistis become affordable, there will be a much lower cost of treatment and maintenance.
Fortunately, some medical providers will work with patients in making payments - but others won't. The long list of necessary medications are very pricey and usually in a high cost tier. As expensive as insulin is, it isn't the only medication that has to be purchased to appear healthy. That expense will always hang over the patient like the scythe of the grim reaper.
Jack

New Albany, OH

#3 Apr 24, 2011
Wow, this article makes Type 1 sound like its a walk in the park. I mean, with all this new amazing technology, we should probably not spend any more research dollars trying to cure it. Actually, it seems like pumps and glucose meters ~are~ the cure, huh?

I barely think about my diabetes at all when I take my daily battery of 8-10 injections a day. Feels like a cure to me...

...and by the way, there is NO study that says that tight control (if you can achieve it) still won't results in your death by the disease someday. If you cite the DCCT, I will say that proper interpretation of the results show that there is a decrease in complications, but nowhere does it say you still won't die from diabetes someday (because control is not equal to cure).
An EMT

United States

#4 Apr 24, 2011
At least some people with Type II, develop Type I.
When the ER ask if my patient is type I or II, they really mean, are the Dependant on Insulan Injections.

It appears people with Type II either use diet, excerise, and life still changes to become Pre-diabetic or they progress to being Type I. Sometimes the best efforts result in then becoming Type I.

Too much is not known. Too much is assume and not known.

“Zuzu's Petals”

Since: Sep 10

Bedford Falls

#5 Apr 24, 2011
Jack wrote:
Wow, this article makes Type 1 sound like its a walk in the park. I mean, with all this new amazing technology, we should probably not spend any more research dollars trying to cure it. Actually, it seems like pumps and glucose meters ~are~ the cure, huh?
I barely think about my diabetes at all when I take my daily battery of 8-10 injections a day. Feels like a cure to me...
...and by the way, there is NO study that says that tight control (if you can achieve it) still won't results in your death by the disease someday. If you cite the DCCT, I will say that proper interpretation of the results show that there is a decrease in complications, but nowhere does it say you still won't die from diabetes someday (because control is not equal to cure).
I don't think it is a walk in the park. My 7 year old grand-daughter has JVD aka Type I and it is very difficult for children to undergo multiple finger sticks daily, 8-12 times a day and add insulin injections as well as carb counting. In addition, hospital stays and visits to their pediatrician, endocrinologist, ophthalmologist and podiatrist interrupt their lives. These children are very ill. The hope is with the beta cell research. I hope and pray there will soon be a cure for these patients.

“Zuzu's Petals”

Since: Sep 10

Bedford Falls

#6 Apr 24, 2011
Diabetesnet.com

Beta cell destruction in Type 1 diabetes and insulin resistance in Type 2 lead to metabolic disturbances, and potentially to disabilities or death. To stay healthy with diabetes requires paying attention to the day to day details that others with intact beta cells and responsive fat, liver, and muscle cells can simply ignore.


Real relief may be in sight for those overworked beta cells and souls with diabetes. Researchers are closing in a better solution to diabetes through direct: replacement of damaged beta cells.

Several problems have plagued the replacement of beta cells. Beta cells are very hard to remove from the pancreas without injuring or destroying them. Even if the removal is successful, finding the appropriate material to surround the intact beta cells or islets to keep the immune system from destroying these cells as soon as they are introduced into the body is difficult. A third problem is that stem cells are gradually lost and need to be replaced.Keeping the encapsulated cells alive as long as possible reduces the frequency of sugical replacement.

The normal pancreas has about one million islets, and although a person can lose over 80% of these before diabetes develops, transplanting far more than 20% of the total seems to be necessary before blood sugars can be corrected. Labs such as Islet Sheet Medical in San Francisco estimate 700,000 islets are needed for total reversal of diabetes.
T1 in Canada

Surrey, Canada

#7 Apr 25, 2011
Zoe Regen wrote:
<quoted text>
I don't think it is a walk in the park. My 7 year old grand-daughter has JVD aka Type I and it is very difficult for children to undergo multiple finger sticks daily, 8-12 times a day and add insulin injections as well as carb counting. In addition, hospital stays and visits to their pediatrician, endocrinologist, ophthalmologist and podiatrist interrupt their lives. These children are very ill. The hope is with the beta cell research. I hope and pray there will soon be a cure for these patients.
I think the original post was meant to be ironic.
T1 in Canada

Surrey, Canada

#8 Apr 25, 2011
An EMT wrote:
At least some people with Type II, develop Type I.
When the ER ask if my patient is type I or II, they really mean, are the Dependant on Insulan Injections.
It appears people with Type II either use diet, excerise, and life still changes to become Pre-diabetic or they progress to being Type I. Sometimes the best efforts result in then becoming Type I.
Too much is not known. Too much is assume and not known.
Type 2s can be insulin-dependent. The difference is whether or not there has been an autoimmune attack on the beta cells of the pancreas (the case in Type 1, or autoimmune, diabetes). When Type 2s start using insulin, it doesn't mean they have become Type 1s.

“Zuzu's Petals”

Since: Sep 10

Bedford Falls

#9 Apr 25, 2011
T1 in Canada wrote:
<quoted text>
I think the original post was meant to be ironic.
Could be but this is a very serious disease and I don't appreciate it!
Jack

Columbus, OH

#10 Apr 26, 2011
Yup, ironic (if not sarcastic).

And I know how serious it is: I have it and so does my little one. That is why articles like this one make me very angry. There is a perception in the press (and much of peoples minds) that 1) people are diabetic because they made themselves that way and 2) insulin replacement therapy is a cure. It isn't and it isn't even close.

To reiterative my point above: people who use insulin will still die from diabetes related complications even if they do have tight control. Not because they abuse themselves and their disease, but because diabetes kills people and we don't have a cure yet.

Let's draw an analogy: we have drugs that treat AIDS now, right? And these drugs in many cases are able to extend patients lives considerably. However, no one suggests that these drugs "cure" AIDS or that we should fund AIDS research less. In fact, its usually quite the opposite. However, studies show that the per-patient research dollar investment for AIDS patients is 60x what it is for diabetes patients. If anybody isn't taking this seriously, its everybody else.
Sarah

Swift Current, Canada

#11 Apr 27, 2011
An EMT wrote:
At least some people with Type II, develop Type I.
When the ER ask if my patient is type I or II, they really mean, are the Dependant on Insulan Injections.
It appears people with Type II either use diet, excerise, and life still changes to become Pre-diabetic or they progress to being Type I. Sometimes the best efforts result in then becoming Type I.
Too much is not known. Too much is assume and not known.
WRONG. They want to know the DISEASE, not the treatment. 2 different diseases.

Type 1 diabtes: An AUTOIMMUNE disease that typically appears in childhood, but can occur at any age. Insulin injections are the ONLY way to sustain life in an established Type 1 diabetic. Risk factors for Type 1 diabetes include certain genetics (I.e. HLA DQ8), Northern European ancestory, having Type 1 diabetes OR other autoimmune diseases in the family, such as Celiac Disease or Rheumatoid Arthritis. Or having another autoimmune disease yourself. Type 1 diabetics will die shortly without insulin, and are prone to seizures and coma, as well as extremem variation in BG levels. People with Type 1 diabetes are more prone to severe lows, changes in insulin needs, and to developing other autoimmune diseases that can cause severe problems with diabetes control, such as Addison's disease or autoimmune thryoid disease (which healthcare providers must be able to recognize!). Most Type 1 diabetics are thin and if "well controlled", have normal cholesterol, triglycerides, etc. They don't need copious amounts of the toxic epensive drugs pushed on Type 2 diabetics.

Type 2 diabetes: A metabolic disease resulting in insulin resistance at a cellular level. Risk factors include a diet high in trans fats, simple glucose, high fructuse corn syrup, etc.(poor diet in general), obesity, lack of exercise, aging, and family history of Type 2 diabetes, and certain genes linked to Type 2 diabetes. Usually treated with oral meds, diet and exercise. May or may not need insulin to control the disease, rarely is a Type 2 diabetic truly insulin dependent, prone to low blood sugar seizures, comas, large swings in BG levels, etc. Type 2 diabetics are not at an increased greater risk for autoimmune diseases than the general public. Type 2 diabetics ARE at a much higher risk for heart disease, high cholesterol, high blood pressure, and high triglyercides and are usually on meds for such.

Insulin is simply a shared treatment between the 2 forms of the disease, but that does not make the diseases interchangable. One cannot "become" the other, as they have different genetics and different causes.

For example, a child with cystic fibrosis may use the same albuterol (Ventolin) inhaler as an asthmatic to help open the airways for a treatment, but that doesn't mean they have asthma! Just knowing if the patient uses insulin or not actually tells very little about the patient. This is the problem with nursing education and paramedic education linits. Know WHAT disease they have so you know how to best treat them. Mindsets like this treaten the care of Type 1 diabetics.
Sarah

Swift Current, Canada

#12 Apr 27, 2011
Jack wrote:
Yup, ironic (if not sarcastic).
And I know how serious it is: I have it and so does my little one. That is why articles like this one make me very angry. There is a perception in the press (and much of peoples minds) that 1) people are diabetic because they made themselves that way and 2) insulin replacement therapy is a cure. It isn't and it isn't even close.
To reiterative my point above: people who use insulin will still die from diabetes related complications even if they do have tight control. Not because they abuse themselves and their disease, but because diabetes kills people and we don't have a cure yet.
Let's draw an analogy: we have drugs that treat AIDS now, right? And these drugs in many cases are able to extend patients lives considerably. However, no one suggests that these drugs "cure" AIDS or that we should fund AIDS research less. In fact, its usually quite the opposite. However, studies show that the per-patient research dollar investment for AIDS patients is 60x what it is for diabetes patients. If anybody isn't taking this seriously, its everybody else.
Genius. Totally agree and couldn't have said it better myself. Most of us long timers (even if we aren't that old!) could not agree more. When I was 8 years old and had already lived with T1 diabetes for almost all of that time, I thought diabetes was a cake walk. I'd tell people it's just "something I take care of" with an innocent smile. Sure I had seizures. Sure I had bruises from injections. Sure I was in a DKA coma once or twice because of a bug I picked up at school (I am what is known as a "brittle" diabetic). Sure I was picked on, blah, blah, blah. But none of it mattered...because I was still a kid. T1 diabetes is not so pretty 27+ years in as an adult in the real world. But sadly, nothing has changed. If anythng, the support for Type 1 diabetes has diminished, seemingly due to the increase in Type 2 diabetes cases. The bottom line is, take good care of yourself as best you can, because no one cares. The cure has been "around the corner" and "so close" for the past 60 years.

Figure out what works best for you, and stick with it. I truly believe that a cure is going to be found by accident, in the least expected of places (think chronic low grade infection inducing continous autoimmunity, constant molecular mimicry from food allergen proteins, etc.). It's not going to be a $40,000 a year to run "artificial pancreas" (who wants that kind of potentially dangerous headache strapped to them), or $250,000 every 2 years for encapsulated porcine islets. The cure for T1 is not where we have been looking, so it's time to think outside the box. 50 years and billions in "research" only to have a dismal inefficient external insulin pump at best is mad.
Bernard Farrell

Acton, MA

#13 Apr 27, 2011
You didn't mention two major advances in diabetes treatment, continuous glucose monitors that let us see our blood sugars on a continuous basis. My Dexcom gives me an updated blood sugar reading every five minutes.

The other is a new category of drugs that change how our bodies respond to food. Symlin for people with type 1 diabetes, Byetta and Victoza for people with type 2. This one is the only dramatic change since insulin was first isolated in the 1920s.
Jack

New Albany, OH

#14 Apr 27, 2011
@Bernard Farrell

Point well taken. I've very much enjoyed Symlin, but as revolutionary as it is, its still a "replacement" therapy. Also, the extra injections will eventually take their toll on our bodies.

I haven't used a continuous monitoring system. Maybe someday.
Sarah

Swift Current, Canada

#15 Apr 29, 2011
Bernard Farrell wrote:
You didn't mention two major advances in diabetes treatment, continuous glucose monitors that let us see our blood sugars on a continuous basis. My Dexcom gives me an updated blood sugar reading every five minutes.
The other is a new category of drugs that change how our bodies respond to food. Symlin for people with type 1 diabetes, Byetta and Victoza for people with type 2. This one is the only dramatic change since insulin was first isolated in the 1920s.
I haven't tried Dexcom, but the Medtronic system is dismal. Inaccurate (grossly), painful (leading to bruising, infection, and more scar tissue than my pump sites), and costly ($50 every 3 days for the sensor alone). IMHO, these "advances" are not really adding up to much in the long run. My Alc showed no improvement wearing the system 24/7, and it missed quite a few severe highs and lows. Consumables or new injectable replacement hormones/peptides, etc. are not really much of an improvement IMHO. Then again, I am a very "brittle" T1 who has severe swings in my insulin needs/BG completely independent of food intake/activity. What we really need is a cure, we should not settle for anything less. Big Pharma wants us to all believe this is a manageable disease. However, insulin is simply life support, and even if we take it daily to live, one day most of us will still suffer and die from this disease. And probably at a fairly young age. Saying our disease has better treatments seems to minimalize its effects, only a cure matters at the end of the day. Few would say Cystic Fibrosis is any less serious because new inhaled antibiotics and digestive enzyme therapy improve lifespan. Yet diabetics are constantly told it is a conpletely manageable disease, and they believe it. I fully understand the need for new "diabetes technology", but these types of mini advances have been focused on since the 1970s (the goal for synthetic insulin, pumps, etc.). Now I feel we are wasting money barking up the wrong tree. Just my 2 cents...
An EMT

Blacklick, OH

#16 Apr 29, 2011
Apparently my wife is a type II (adult onset) DM.
Reportly not related to her HC problem.
However, after about seven years, she developed wild swings in her BS which is now controlled by a Pump. Meanwhile, her HC was suppose to be under control (for almost 25 years) and reduced to four "bleedings" per year.
Now after 33 years of "bleeding", it has been kicked back-up to "bleeding" every other week.

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