Will diabetes be cured in the 21st century?

Excellent post!  

2 weeks ago I sat in a room with 30 parents and so many of them said they were told there would be a cure within 10 years!  I was livid to hear that!

Second, Dr.OZ was seen on Oprah pro porting that Parkinson's, MS and Diabetes was 5 years away from a cure.   grrrrrr! 

I am a huge fan of Dr. Melton's work on IPS stem cell research and research like SmartInsulin, because they offer us their genius and the feeling of hope! One in the near future and the other a glimpse of a cure! Ahhh progress, it is as important as the end result!

And I was told in 1974 a cure was ten years away. It is now 2009, thirty five years later, and still no "cure".

I wouldn't get excited about any saying there "will be a cure" in five, ten or more years. Not in the USA at least, I don't even see many in the USA capable of getting a Noble Peace Prize even, very minimal to say the least in that regard now days! But who knows, some one might get lucky and accidentally find a cure in some way they over look things.

About the best description from a doc about reality in my opinion so far, good job I think describing the outlook, especially for type one which I've got, and I'm not fat at all. Skinny to say the least! LOL!

Thanks Doc for posting that, I appreciate that a lot!

DJ

You wrote, "Type 2 diabetes, once established, will be able to go into remission by weight loss -- nothing new!"

The problem is twofold: first, weight loss doesn't work for everyone. I know a type 2 who lost 125 pounds and currently has normal BMI, and her BGs didn't change.

Second, the larger problem is figuring out how people with a lifelong weight problem can lose weight. Most of them have been trying to lose weight all their adult lives, with little success. That is, they lose the weight, but then the urge to eat becomes overwhelming and they regain all the weight, often even more than they lost. Some people think that insulin resistance causes weight gain, rather than the other way around.

There's no question that if you lock people in a ward and give then 500 to 800 calories a day, they'll lose weight. But unless you keep them there, they'll regain all the weight they lose when they go out into the world. It's unrealistic to expect people to maintain such low calorie intakes when surrounded by food. Look at the tiny number of children with leptin deficiency. They can't even eat normal amounts of food; their constant ravenous hunger makes them gorge themselves all day. Give them leptin, and they quickly eat normal amounts of food and reach normal weights.

Showing people food when they're starving is a form of torture. And after weight loss, many people have hunger levels close to those of starvation.

A few people are able to lose weight and keep it off. But they seem to be the exceptions. We really need research into this aspect of weight gain rather than just telling overweight people to try to lose weight.

As one woman said, "Trying to lose weight is easy. I've been doing it all my life. It's succeeding that is hard."

I liked Dr. Bill's breakdown of the categories into "cure", "remission", and "prevention", these seem to sum up the options well.

The main problem in expecting a "remission" at this point in time is that each individual varies greatly in the amount of insulin their own body is producing (if Type 2s),or none at all. People also vary greatly in the amount of beta cell burn-out they have, no two people are exactly alike.   Some folks with type-2 can normalize their blood sugars just through a drastic reduction in carbs, especially starches. Some are obviously past this point of recovery by diet, but may be able to maintain normal levels through both diet and vigorous exericse (check out some promising results of sprint/interval training, 3 x/s a week, to see what I'm talking about).  Some may need drugs on top of diet and  exercise.  Some struggle even doing all this. 

I see three points to be made here:

(1) each individual comes with a unique physiogy and hence it is impossible to label people into anything more than a generalized group- i.e., saying somebody is "type 2" doesn't really tell us much about that person's ability to respond to various strategies, their insulin-producing ability (or lack of), their liver or pancreas condition, etc.  "Type1" is also not a death-sentence, as has been demonstrated many times by folks willing to make the changes necessary to maintain normal glucose levels.

(2) it should be obvious here we are not talking about an easy road to "remission"- at the very least, folks need to be drastically cutting their starches and exercising on a daily basis. There's much too much dependence on one's physician and relying on a drug program, which is a common mentality, and meanwhile eating badly and watching 6 hours of TV a night. If people don't want to take a completely proactive role in their own treatment (i.e., it depends on me, not my drugs), they can expect it to nose-dive year-after-year. This is expecially true for Type 2s, which is primarily a lifestyle condition.  It will take lifestyle changes to start reversing it.  Cleaning up what got one into this mess will also help one get control over it.  Being passive is worthless.

(3) if the above has any validity, moaning about no "cure" isn't the attitude folks should  be taking. The goal (until research can truly find a cure) is simply to maintain good blood sugar levels.  Regardless of other issues, abnormal blood glucose is where all the damage starts, so goal #1 is simply getting this under control..  If one needs everything under the sun (anti-inflammation diet, exercise and drugs, and maybe some divine intervention :-) !), so be it; whatever it takes. Even many Type1s have been able to maintain normalized blood glucose levels over many years, they've experimented till they find what works. The beauty of having a single over-arching strategy like this is that things are kept simple. You'[re not worrying about 20 different health concerns, you're after the root problem.  If maintaining normalized blood glucose isn't a "cure", per se, it at least one thing everyone should be shooting for. Worry about semantics later.  I don't care what people call it :-).  

i think in 50 years there will be an island where all the rich people have clones- then the ones that have DM can harvest a new pancreas- the only problem is if one of the clones finds out the truth...

At this point, I don't ever see a cure. There is way too much money spent on diabetic medicines, supplies, devices and foods. The economy will not allow a cure.

High blood glucose numbers are a sign of the disease, not the disease itself. Nothing has shown that just lowering the numbers produces a meaningful outcome in terms of forestalling major catastrophic events such as heart attack, kidney disease, etc. Exercise is possibly the only real, meaningful treatment for type 2 diabetes, but attacking high blood sugar through weight loss or especially by using drugs, has not been proven to do anything but lower the numbers. It is like curing a person of his cough when he has pneumonia. You don't see the symptoms any more, but the underlying disease is still there.

The medical profession and the pharmacutical companies do not want anything cured - all they want is to give out prescriptions so they can keep the money coming in.  Cures will not happen until you take out licensing, patients, and prohibit companies from putting an high dollar on all  new drugs - it is sad that the only thing they want is money not cures - The medical field is out of control  and needs to be more highly regulated and the money for research should be controled by an outside company making sure that there is a one to one return for invertment and that the patents is still available are one to two years only - allowing generics on the market very quickly so people can have access to the new medicines - it is sad that greed is more important than saving lifes but that is where our medical profession has gotten to.  Why do we have to go to 10 doctors for different issues and only get to see one for 5 minutes on a visit and cannot discuss multiple issues - that is stupid - multitasking is something that most professionals do well - md's seem to have an issue with addressing anything difficult and only want to treat colds and simple diseases - lazy is what I think has happen - get lots of money for little work - GREED  has caused our system to break down and people die each day because  of the GREED and stupidity of the medical professional that claim to want to help - all I see is drug companies working with doctors to peddle new drugs at super high cost making it impossible for normal people to get to better treatement and very few CURES ever get to market as the drug companies keep them out of the market so they can sell drugs - CURES will never occurs as long as the GREED stays in the system - and the drug companies run without control - patients should be done away with - they are a scam to make more money than it costs to create the drug and make massive profits - has nothing to do with actual  costs of making the drug - only more profits for the few at the top - CURE is not a work in the drug or medical business - only peddle more expensive drugs and keep everyone partially sick so they can make massive amounts of money - broken is the word