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January 26, 2003

Research: Cure

Question from Sao Jose dos Campos, San Paulo, Brazil:

Our five year old daughter was diagnosed with type 1 diabetes last week, and she is already under medical treatment, taking insulin and in the process of defining the right types and doses. In these last days we have been briefed by her doctors on the basics of the required care, nutrition aspects, etc. We have also been briefed and read some articles about the basics of autoimmune diseases, especially type 1 diabetes. If our understanding is correct, at this initial stage it might be that not all of her insulin-producing cells are destroyed. Assuming that this might be correct and taking into account the recent advances in diabetes research and bioengineering, my wife and I were wondering if there is something that could be done now which could help in the future (things such as: collecting cells still "healthy" and storing them for future laboratory reproduction and implantation, "stopping" or limiting somehow the effect of the antibodies, etc, etc) In brief, our concern is that there is something that could be done only at this initial stage and to not knowing that, we might "lose" this opportunity.

Answer:

There is a long history of trying to answer this very question. Some ten years ago it seemed that an immunosuppressive drug called Cyclosporin might be the answer; but in time this was shown to cause kidney damage so it had to be discontinued. A number of other attempts to preserve islet cells function such as using BCG were also unsuccessful. Later the emphasis moved to trying to avert insulin dependence in children who already had positive antibodies. Two very large trials one of small doses of subcutaneous insulin in the U.S. (DPT-1) and of Nicotinamide (Icarus) in Europe were only just recently been shown to have no effect. There are still other trials at this stage of inhaled insulin, of modest increases in Vitamin D intake, of omega3 fatty acids (from fish oils) and of various antioxidants; but nothing has reached stage that would reliably help your daughter.

DOB