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December 16, 2006 8:35 PM   Subscribe

Possible cure for diabetes. Researchers at Toronto's Hospital for Sick Kids have made an extraordinary breakthrough in diabetes treatment - one which may save hundreds of thousands of lives every year and save thousands more diabetes sufferers from cardiovascular disease, blindness, kidney failure, and nerve damage.
posted by Dipsomaniac (65 comments total) 10 users marked this as a favorite

 
It may look like a double of this, but it's not.
posted by Dipsomaniac at 8:35 PM on December 16, 2006


Americans saying how bad the Canadian system is, in 3...2...1...
posted by Kickstart70 at 8:50 PM on December 16, 2006 [1 favorite]


If this turns out to be the cure for diabetes, I'll take back every bad thing I ever said about canada (I don't think I've ever said anything bad about canada, but you get the idea).
posted by IronLizard at 8:57 PM on December 16, 2006


I thought one of the most interesting outcomes was the discovery of the neurological connection, and the possible relevance of that connection to other diseases. If it's real, then it's a Nobel candidate for sure.
posted by Dipsomaniac at 8:58 PM on December 16, 2006


Wow. If this pans out it will be impressive indeed. Kudos all around! It will be an interesting turn of events considering Banting and Best's discovery of insulin... a proud day for Canadians, the U of T and Sick Kids indeed.

Disclosure: I've benefited from the work of doctors at Sick Kids and am a little biased about the place. It's just nice to hear about a great breakthrough.
posted by rmm at 9:05 PM on December 16, 2006


Somehow, it'll be unaffordable in the U.S.
posted by paulinsanjuan at 9:14 PM on December 16, 2006


Note that this is for Type 1 diabetes, which is the worst kind. The body doesn't produce enough insulin, sometimes none at all. Early onset, really, really nasty symptoms. A horrible disease, and this is an enormous breakthrough.

But it probably won't relate at all to Type 2 diabetes, in which the body still produces enough insulin, but the cells stop paying attention to it. (aka "insulin resistance".) This is the more common kind. Fortunately, it's also a lot easier to control for most people.
posted by Malor at 9:21 PM on December 16, 2006


Malor, on the 2nd page of the first link you'll see that the treatment also curbed insulin resistance in type 2 diabetes, and that the researchers found that resistance was a major factor in type 1.
posted by Dipsomaniac at 9:23 PM on December 16, 2006


This is exciting stuff.
posted by pointilist at 9:24 PM on December 16, 2006


Americans saying how bad the Canadian system is, in 3...2...1...

Canadians start making snarky comments about Americans in 3...oh, wait, it already happened.
posted by oaf at 9:25 PM on December 16, 2006


Really, though, this is a very good thing. I'm hoping this can start working for people very soon (faster than the glacial pace at which these things usually move).
posted by oaf at 9:27 PM on December 16, 2006


I guess I'll just leave it at "if this remotely pans out, I'll remember hearing about it here first forever."

And that it's totally rad the treatment involves hot pepper oil.

And that a cure has been just-a-few-years-away since I started really paying attention, so color me tentatively excited.
posted by freebird at 9:32 PM on December 16, 2006




I really hope this works out. You never know when they go from mouse to human, but here's hoping.

First the HPV vaccine and now this. It's been a hell of a year for medical research.
posted by dw at 9:35 PM on December 16, 2006


Diabetic mice became healthy virtually overnight after researchers injected a substance to counteract the effect of malfunctioning pain neurons in the pancreas.

"I couldn't believe it," said Dr. Michael Salter, a pain expert at the Hospital for Sick Children and one of the scientists. "Mice with diabetes suddenly didn't have diabetes any more."


Holy shit.

This ad made me tear up the first time I saw it. It worked on me again tonight.
posted by maudlin at 9:37 PM on December 16, 2006


And that a cure has been just-a-few-years-away since I started really paying attention, so color me tentatively excited.

Yeah, me too, and I've been paying attention for the past twenty years. I've heard of probably six different any-day-now cures for diabetes in that time. I'll get excited when I see some former type 1 diabetics. Until then, it's all just marketing for additional research funding.
posted by scottreynen at 9:41 PM on December 16, 2006


Absolutely astounding, if the research transfers from the mouse model to humans. So astounding to think I might live in a time when such a disease can be effectively cured, not just managed!

And so personally sad, if this can come to commercial delivery in the next couple of years, that my mother, who fought Type 2 valiantly for 18 years, and died last year of its eventual complications, would not have lived to see such a treatment, which she hoped to see for so long. For those who have watched loved ones stick themselves numerous times a day for years, and measure every mouthful of food against future difficulties, such a potential treatment as is suggested by these reports is so near miraculous as to be almost too hard to believe.

Like Scott, I remain skeptical for now, partially out of rememberance of previous research findings, which have not panned out.

But how lovely it would be to hope, and have hope fulfilled.
posted by paulsc at 9:46 PM on December 16, 2006


*runs to get twinkies*
posted by wumpus at 10:22 PM on December 16, 2006 [1 favorite]


Wow, this is an exciting breakthrough.
Interesting connection between neuropeptides and diabetes. Males me think of the research done by Candace Pert on neuropeptides and the immune system.

Apparently cinnamon is very effective in lowering blood sugar levels.
posted by nickyskye at 10:22 PM on December 16, 2006 [2 favorites]


This pisses me off so much; i just spent the last semester studying the details of GLUT and SGLT transport proteins in their relation to diabetes, and they're saying that within a year diabetes won't be a concern? wtf was the point? lame ass.
posted by wumpus at 10:26 PM on December 16, 2006


You think you're pissed, wumpus? Imagine how the companies that make insulin and other diabetes drugs must feel. This could turn into major economic bad news. Seriously. (smirk)
posted by wendell at 11:00 PM on December 16, 2006


I hope for my best friend's sake that this actually works out.
posted by Civil_Disobedient at 11:02 PM on December 16, 2006


Here is the free full text of the article in cell. It will be interesting to see if the NOD mice have the same pathogenesis as humans.
posted by scodger at 11:04 PM on December 16, 2006


Holy cow. I'll keep my fingers crossed and hope that this does indeed pan out.
posted by kosher_jenny at 11:34 PM on December 16, 2006


This is amazing.
posted by Titania at 11:52 PM on December 16, 2006


You think you're pissed, wumpus? Imagine how the companies that make insulin and other diabetes drugs must feel. This could turn into major economic bad news. Seriously. (smirk)

Which is why the FDA would never let it through here.
posted by IronLizard at 12:06 AM on December 17, 2006 [1 favorite]


Wow, did you guys see how many other syndromes may operate on the same or similar mechanisms? This may be a larger breakthrough than it sounds (and it sounds huge.)
posted by Mitrovarr at 12:07 AM on December 17, 2006


Every time I hear about one of these great breakthroughs, I get a nice warm fuzzy feeling. This warm fuzzy feeling slowly decays into bitter cynicism over the years as nothing comes of them or they're too expensive for anyone but the filthy rich.
posted by IronLizard at 12:21 AM on December 17, 2006


wow. cold fusion and now this!!

(ok. i'm just being a smart ass. i really do hope this pans out.)
posted by altman at 12:24 AM on December 17, 2006


So, I'm not totally clear, and maybe someone with more of a clue can help me out-- is the post-natal treatment Capsaicin, or is it some other thing (the P-whatsit,) and the Capsaicin was only to kill the cells pre-natally?
posted by blenderfish at 2:09 AM on December 17, 2006


Capsaicin kills off the neurons that are not releasing enough of neuropeptide-P, then injecting neuropeptide-P itself restores function to the islets that weren't producing sufficient insulin, both post-natally. From what I read the capsaicin injection may not be necessary, but it did lead to the discovery that the disfunction of the islets has a neurological trigger.
posted by Dipsomaniac at 2:15 AM on December 17, 2006


Ahh. Thanks, Dipsomaniac.
I'll take another whack at reading the paper tomorrow, but it's a pretty uphill read for a Computer Science guy.
posted by blenderfish at 2:44 AM on December 17, 2006


I found the suggestion of a link between diabetes and MS rather interesting. I'm a recently-diagnosed, underweight, type II diabetic with no history of diabetes in my family, but my sister was diagnosed with MS two years ago. And my father has some sort of chronic nerve/pain issue. Could be an interesting few years for the Pooflinger family if this pans out. I'm not going to hold my breath till I'm Metafilter blue, but then again they said the guy with the take-a-pill-for-instant "ulcer cure" was crazy...for awhile.
posted by Sir BoBoMonkey Pooflinger Esquire III at 2:53 AM on December 17, 2006


The way the article read to me: The pepper extract was used at first to kill the neurons and this produced the effect of curing diabetes. They then investigated further and discovered which peptide was causing the problem and instead of killing the neurons, injected it directly to produce a shorter lived effect while preserving the nerves. IANR (I am no researcher).

Ref:
Suspecting a link between the nerves and diabetes, he and Dr. Salter used an old experimental trick -- injecting capsaicin, the active ingredient in hot chili peppers, to kill the pancreatic sensory nerves in mice that had an equivalent of Type 1 diabetes.

It turns out the nerves secrete neuropeptides that are instrumental in the proper functioning of the islets. Further study by the team, which also involved the University of Calgary and the Jackson Laboratory in Maine, found that the nerves in diabetic mice were releasing too little of the neuropeptides, resulting in a "vicious cycle" of stress on the islets.

So next they injected the neuropeptide "substance P" in the pancreases of diabetic mice, a demanding task given the tiny size of the rodent organs. The results were dramatic.

The islet inflammation cleared up and the diabetes was gone. Some have remained in that state for as long as four months, with just one injection.

posted by IronLizard at 3:18 AM on December 17, 2006


When I first read about this "substance P," it was in connection to fibromyalgia, the victims of which often have hypoglycemia.
posted by Clay201 at 4:07 AM on December 17, 2006


Very exciting. Great post.
posted by LoriFLA at 6:21 AM on December 17, 2006


Type II diabetic here.

The opening paragraph says this: "opening the door to a potential near-cure of the disease"

There's lots of qualifiers there. I refuse to believe this is possible, sounds too easy.

But the implications, if it does work out, are mindblowing for treating disease and understanding how the body works.
posted by Brandon Blatcher at 6:35 AM on December 17, 2006


IronLizard: Which is why the FDA would never let it through here.

New Canuck growth industry: diabetes-cure tourism!
posted by hangashore at 7:21 AM on December 17, 2006


Very exciting news, though I seem to remember a Post headline a few years ago heralding a cure for cancer.

The pressure on journalists to make their stories justify their existence is truly obnoxious. Let's hope this one wasn't too much of an exaggeration.
posted by bicyclefish at 7:26 AM on December 17, 2006


'm not going to hold my breath till I'm Metafilter blue, but then again they said the guy with the take-a-pill-for-instant "ulcer cure" was crazy...for awhile.

Which prompted me this tought : if Elicobacter Pilori is the cause of ulcer with greatest frequency (mode), why wasn't it detect before examining stomach cells and/or secretions , considering post mortem autopsy or gastroscopy in live patients ?

I wonder how much isn't being discovered because we are just NOT looking , not even to the wrong places ?
posted by elpapacito at 7:41 AM on December 17, 2006


*Makes me think

Interesting reading about Substance P and the relationship between pain, illness and depression.
posted by nickyskye at 9:02 AM on December 17, 2006


This is exciting stuff. Type II here, and hoping something like this pans out in the next few years. Even if that means I won't need one of those cool OLED real-time blood sugar display tattoos that the future is supposed to bring :)
posted by Foosnark at 9:39 AM on December 17, 2006


Capsaiciin, you say?

*Goes to Taco Bell, eats Fourthmeal*
posted by dhartung at 9:46 AM on December 17, 2006


I pray to the God of Science that this pans out. Please, O' God of the Test Tube and Microscope, your suffers need you. (Also, try to make it affordable, O' God of Big Business.)
posted by luckypozzo at 10:36 AM on December 17, 2006


Folks, you gotta realize that only a minuscule fraction of treatments that seem successful in mice wind up being effective and safe in humans. Why this stuff make news escapes me.
posted by neuron at 11:17 AM on December 17, 2006


Well neuron, the big news here (to me) is not so much the treatment as it is that there is a neurological component to diabetes that was not only unknown before but would have been dismissed without these test results.

If that same component is found in humans then that offers entirely new routes to research and treatment. It's like being given a map to your town that shows you a highway that you didn't even know existed.
posted by Dipsomaniac at 11:39 AM on December 17, 2006


One thought I'm having though is, why is there an exponential rise in diabetes in so much of the world if there is a correlation between neurotransmitters and diabetes? Our diets, on whole, have taken a slide, but what has changed with how our way of life has affected our neurotransmitters?
Tin-foil answer number one:
electric power lines!
2.) sitting in chairs in front of computers!
or,
3.) the decline in sales of head cheese!
posted by Sir BoBoMonkey Pooflinger Esquire III at 11:51 AM on December 17, 2006


nickyskye, thanks so much for posting that link. I'm definitely checking out that article.

Dipsomaniac, that's a great analogy regarding the highway. It's amazing to think that there's a neurlogical component to this. It's nice to have good news like this every once in a while (about medical discoveries, not that ther'es a neurological component...nevermind, it sounded better in my head).
posted by rmm at 11:56 AM on December 17, 2006


Actually, to continue the analogy - maybe the highway doesn't go where the diabetes researchers want to be, but it's definitely worth seeing where it ends up.
posted by Dipsomaniac at 12:20 PM on December 17, 2006


I remember seeing those little nerves in med school and wondering what the heck they were for. Langerhans was a med student when he discovered the islets, so med students were encouraged to look at them. I was told the nerves were sensory and their function was unknown.

I wonder if they really are involved in the regulatory functions of the islets? That would be very exciting.
posted by ikkyu2 at 1:04 PM on December 17, 2006


I also remember reading somewhere about a possible link between the ph value of a person's blood and and the function of the pancreas, suggesting that the high ph value associated with the "American Diet" causes the islet cells to perform poorly...or something like that. Perhaps Substance P performs better without a high ph? But, alas, I'm no scientist, and I'm holding to my firm belief that the cure is found in mass quantities of head cheese!
posted by Sir BoBoMonkey Pooflinger Esquire III at 1:22 PM on December 17, 2006


Type 1 diabetic here. This is the first "cure around the corner" news that's really caught my attention. I'm not a doctor, but the scenario described has not set my bullshit detector off; it seems very plausible. Fingers crossed.
posted by Benny Andajetz at 1:23 PM on December 17, 2006


I'd like to reiterate that this is really about Type 1. However, while this is about curing type 1, it could still be useful for treating type 2. There is a fairly important relationship between substance P and type II; for example, substance P is decreased substantially in the nerves of diabetic animals, regardless of type-- and insulin reverses this deficit. The idea that increased fructose (e.g. high fructose corn syrup) upregulates GLUT5 (fructose) transporters in the intestine, and thus promotes further absorption of fructose (and thus weight gain, blood sugar, etc) and even makes you hungry (through ghrelin, along with other factors) may mean that no matter how you got diabetes, working through substance P may at least reverse the effects of diabetes, even if it does not cure the cause.
posted by TheLastPsychiatrist at 2:11 PM on December 17, 2006


Where do they find mice with diabetes?
posted by delmoi at 2:33 PM on December 17, 2006


Which is why the FDA would never let it through here.

The chemicals used in the experiment are not regulated by the FDA. (One of them was capcasin, the chemical that makes peppers hot, the other was substance P, which your body uses to signal pain, it exists in your body all the time) The problem is that you have to inject them into a tiny part of the pancreas, but as far as I know medical procedures don't need FDA approval.
posted by delmoi at 2:37 PM on December 17, 2006


Which prompted me this tought : if Elicobacter Pilori is the cause of ulcer with greatest frequency (mode), why wasn't it detect before examining stomach cells and/or secretions , considering post mortem autopsy or gastroscopy in live patients ?

It was known, it's just that people thought they were 'opportunistic infections', that is, the bacteria just enjoyed living in ulcers, not that they caused ulcers.
posted by delmoi at 2:41 PM on December 17, 2006


I also remember reading somewhere about a possible link between the ph value of a person's blood and and the function of the pancreas, suggesting that the high ph value associated with the "American Diet" causes the islet cells to perform poorly

That's just some commonly peddled bullshit.
posted by delmoi at 2:42 PM on December 17, 2006


More on E.Pylori

Some authors suggest that an H. pylori infection may be protective against certain diseases of the esophagus and cardia.

Interesting , it would probably be wise to also try to understand why the nerve endings in pancreas are or become abnormal
posted by elpapacito at 3:13 PM on December 17, 2006


Where do they find mice with diabetes?

At the donut shop.
posted by Brandon Blatcher at 3:30 PM on December 17, 2006


This does look like a breakthrough, but I have a suspicion that what these researchers have discovered is a defense mechanism of the islet cells, and that as they ascend this slope they will see at least one more peak to climb ahead of them before they can plant their flag and claim a cure, even for NOD mice.

It seems reasonable to think islet cells have sensory (pain, here) nerves around them to tell when something is going wrong there, and that when those nerves detect that there is, they set in motion a train of events which serves, or is purposed to serve to protect the islets from harm.

In this case for these mice, these nerve cells are telling the islet cells to turn themselves off and go dormant, which is a good strategy for threats like excitotoxicity and exposure to poisons. The classic mouse model for the study of diabetes starts with injecting the mice with a poison which selectively destroys the islet cells, and that poison is one found in nature and which mice might encounter in the course of their lives, which I think could justify imputing a defensive function to the observed action of the nerve cells.

But in these mice, the immune system is attacking the islets, which parallels human type I diabetes. In humans, the auto-immune attack is thought to be triggered by a viral infection.

If something like what is happening in these mice is happening in humans, and turning the islet cells off has preserved them from destruction by infection directly or the immune system, turning them back on with the virus present and infective might serve merely to expose them to the destruction they have so far avoided.

We may already have before us a model in which something like this has happened. As Oliver Sacks has so memorably described in Awakenings, he was able to 'reanimate' some institutionalized sufferers of Encephalitis Lethargica by injecting them with L-dopa, but the extremely dramatic success of the treatments did not last: the revenants all went back to sleep, and no further injection, nor any other treatment has proved to be able to revive them again.

The cause of EL is not conclusively known, but the Wikipedia article I linked above tenatively attributes it to "an infection by the streptococcus-like bacterium, diplococcus." I would guess that L-dopa caused the surviving cells in the damaged areas of the brain to turn back on, they lost their invisibility and were destroyed by a long-delayed continuation of the disease process-- probably an auto-immune attack in the case of EL.

In the Cell article, causing the islets to turn back on with capsaicin or substance P was not followed, at least immediately, by a renewal of diabetes. On the other hand, nothing was said that I saw which implied the auto-immune attack in these mice could be attributed to an infection.
posted by jamjam at 3:37 PM on December 17, 2006 [1 favorite]


Where do they find mice with diabetes?
MiceWithDiabetes.com, where did you think?

(Ok, they don't have that specific domain registered... but that's one place you can get them)
posted by illovich at 3:46 PM on December 17, 2006


Another Type 1 diabetic here.

I've only been diabetic for about 16 years, but I've been hearing about cures and new treatments the entire time. There has really only been one or two significant advancements in treatment during that time (the insulin pump). The pump has helped significantly improve my life, but honestly its not that complex or amazing. The new ones with integrated blood monitoring are much more interesting, but are not covered by insurance. I have met folks who have had diabetes for 40+ years and they say the same thing. Much promised, but much more has been promised in the media or by doctors than has actually materialized. So, with that in mind, I'm a little skeptical when I read reports like this.

I'd certainly lay down my life savings to be rid of this disease. We may have to - the companies that make blood testing strips would lose Billions, which night not exactly speed up things like FDA approval. Skepticism aside, if something eventually comes of this research it would literally change the world for a few million people.
posted by pkingdesign at 6:24 PM on December 17, 2006


Jamjam, I think you are reading a different article than I am. What I read in the summary is that the islet cells are experienceing "T cell-mediated death". When the TRPV1+ neurons are eliminated diabetes is prevented.
posted by pointilist at 10:13 PM on December 17, 2006


hmm... there are a whole bunch of chronic inflammation diseases that no one really understands the cause of (Crohn's disease, Reiter's syndrome, irritable bowel syndrome, ankylosing spondilytis, etc.) The article mentions that this might have application for Crohn's and asthma, but I hope somebody somewhere will be looking into trying this for all of them! If the action of these nerve cells helps to explain these diseases, it would be a huge breakthrough in medical science.
posted by vorfeed at 10:22 PM on December 17, 2006


Another Type II diabetic here. I'm skeptical but my fingers are crossed.
posted by deborah at 1:14 PM on December 18, 2006


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