What is a cure?

Today marks Sir Frederick Banting’s birthday, the man who discovered insulin was born 124 years ago today and this date, November 14th is officially recognised by the United Nations as World Diabetes Day. World Diabetes Day promotes awareness and gives people the opportunity to campaign and raise money for charitable causes. Last week’s blog looked at the excellent work of Sir Frederick Banting, who was knighted in 1934 for his discovery of insulin. This week, to mark World Diabetes Day, we will look towards the future of diabetes technology, look at the modern pioneers of diabetes research and how far they are going to find a cure for diabetes.
Sir Frederick Banting’s discovery of insulin has undoubtedly saved the lives of millions of people around the world, insulin allows people to live healthy, happy and fulfilling lives. Insulin allows people with type 1 diabetes to not only survive, but thrive. Insulin however, is no cure for type 1 diabetes, which requires around the clock monitoring, is time consuming and anxiety producing. However well type 1 symptoms are managed, the serious consequences of low and high blood sugars are always there, both immediate and long term threats to health. Type 1 diabetes never takes a rest, even whilst the person is sleeping blood sugars can swing to dangerous levels, hence the requirement for constant monitoring. To mark Banting’s 100th birthday, a beacon was lit in London, Ontario, to provide hope for people living with diabetes across the world. The beacon will keep on burning and will only be extinguished once a cure is found. Until then, we can only live in hope.

Flame of hope
Flame of hope

JDRF are well known within the diabetes community as the global charity who fund scientific research into a cure. JDRF have existed for around 40 years, initially set up by a group of parents in New York, but has now expanded into a global charity with a branch, or “chapter” in many countries. Money is pooled together and scientists or doctors with an idea for a cure can then apply to JDRF for funding. We will now look at some of the pioneering ideas that are in the pipeline.
As advocates for type 1 diabetes, we know that the condition occurs when the immune system wrongly attacks the pancreas, killing off the insulin producing cells. Insulin is essential for life, so diabetics currently need to inject insulin, or infuse it via a pump. A Continuous Glucose Monitor (CGM) can also be used to constantly monitor the person’s blood sugar, which can alarm when it gets to dangerous levels. The idea of a “fake pancreas” is basically an extension of this idea, with the two devices communicating with each other. The fake pancreas is now in human trial and it will make management easier because it will take the need to carb count away and will ease anxieties as both low and high blood sugars can be automatically managed from the device. However, this is seen as a technological cure, because the person is still heavily reliant on technology in order to stay alive, we all know technology can go wrong and the device will also need filling and refilling with insulin.
Another development is “smart insulin”, this would mean insulin is injected once a day, or could maybe be developed as a patch, but it is only activated when the person eats carbs or would have high blood sugars for another reason. Smart insulin would also take out the need to carb count and constantly monitor blood sugars and would could be heralded as a cure by many. Smart insulin trials in mice have found that blood sugars can be controlled over a period of several hours, but the idea needs to be human trialled and the long term effects must be determined.
The best cure for type 1 diabetes would be to reverse the damage done to the pancreas, to somehow reactivate the islet cells and make them produce insulin again. Current JDRF funded research is looking into giving a person new insulin producing cells, but this would involve transplantation, which comes with many risks, which currently means the risks outweigh the benefits. Another idea is called “encapsulation” which would look at developing beta cells that are protected from rejection and immune system attack by providing them with a protective coating. A third way of getting the body to produce its own cells is by using stem cells to restart the process of insulin production, this way, the body can use its own supplies. These ideas are still a long way off from becoming available, there is still a lot to learn.
Chris Normington from JDRF North said “JDRF have gotten closer to finding a cure in the last 5 years than the previous 35 of their existence combined, this is because of the development of technology. I am confident that at some point in the future, type 1 diabetes will be curable, then we can concentrate on preventing the illness in the first place. ”
Finding a safe way for the human body to make its own cells for producing insulin would be a true “cure” and would in my opinion, grant permission for the beacon in Ontario to be extinguished. I look forward to that day, but until then, it is important to remember that for many people living with diabetes across the world, what we have already is like a cure to them; that is the ongoing and affordable supply of insulin. Maybe this is a cure to poverty and not diabetes, but we must remember to celebrate what we already have and campaign on behalf of those who do not have this.
To make a donation to The Pendsey trust this World Diabetes Day, click here and for further information on JDRF click here.

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