Musing on the search for a cure, and what we have in the meantime

The cure for type 1 diabetes has been a long, agonizing search. So much invested, so little in return. The cure is all the more problematic because we can’t even agree on what it is. As Kerri Sparling explains in this issue, a “cure” means something different to every person with diabetes – and she eloquently shares what it means for her. Gary Scheiner has his own ideas: he believes a cure means replacing multiple pancreatic hormones besides insulin, a topic that he tackles in his own column. Having recently gone on GLP-1 off-label, I have to say I agree it’s about more than just replacing insulin. What about vaccines? Beta cell regeneration? The artificial pancreas? We give updates on them all in a comprehensive Learning Curve, itself a preview of a 155-page report called Targeting a Cure. We’re publishing it free as a PDF to go along with this issue for those with big-time curiosity.

Until there is a cure...there will be the ADA Annual Meeting, and the 71st such meeting was recently completed in San Diego. With a presentation by Dr. Edward Damiano (who has a son with type 1 diabetes) on his upcoming planned bihormonal study and a presentation by Dr. Jennifer Sherr on a closed-loop system that brought patients into target (80-140 mg/dl) an impressive 91% of time on sedentary days and 79% of time in target on days with exercise, this year’s meeting left us eager in anticipation for the introduction of closed-loop systems. Prospects for drug therapy in type 1 diabetes remain cloudy; a session on type 1 cure-based therapies included several interesting subgroup analyses and theories about why recent late-stage trials (Tolerx, Macrogenics, Diamyd) have been disappointing relative to earlier studies. In addition to the ADA Meeting, it’s been a busy several weeks, with the approval of Amylin/Eli Lilly/Alkermes’ Bydureon in Europe, and Insulet’s acquisition of the diabetes medical equipment distributor Neighborhood Diabetes. All this, plus our special edition Learning Curve about curing type 1 diabetes.

Which leads to another answer for what to do until a cure arrives: help bring it here faster. In the full version of our Targeting a Cure report, we highlight dozens of doctors and researchers devoted to the cause. We wish these brilliant, hardworking scientists every success, and we encourage today’s students to follow their footsteps. But we also want to pay tribute to so many others who are contributing toward a cure however they can: volunteering for studies, donating to foundations, raising awareness, and keeping up hope for the long journey ahead.

Stay strong, and appreciation abounds ~