Tuesday, 4 August 2009

Snake Oil

A bit of a rant today! As with many chronic conditions there are some astounding claims made for ‘cures’ for diabetes. There is no cure for diabetes. It may be possible to gain better control of blood sugar levels by following certain strict diets or by taking certain supplements, but this does not constitute a cure, yet you will see adverts for cures all over the internet (you may even see some on this page, as part of the ‘targeted’ adverts from Google). As I am an insulin-dependent diabetic there is no substitute for insulin – I must therefore inject it to live. Insulin can’t be taken in pill form as the digestive juices in the stomach will destroy it before it can be passed into the bloodstream. Scientists are trying to find a way around this by coating pills in a special protective film so that it can pass into the small intestine unmolested, but this is still some way from being a reality. It is also possible to inhale insulin from a special device, but this method is expensive, difficult to guage dosages, and with unknown potential side effects on the lungs.

One promising area of research is stem cell research, where stem cells transplanted into the pancreas can be transformed into insulin producing beta cells. So far, this has met with some limited success, particularly in newly-diagnosed subjects who may still have some ‘native’ insulin production. There have also been pancreas transplants but this is not a common operation. Because the pancreas is also responsible for producing powerful digestive enzymes, the surgeons have a particularly delicate task trying to ensure that none of these powerful acids leak and damage other organs. Also, with transplants, the subject would then be on a plethora of anti-rejection drugs for life.

Another promising area is in ‘closed-loop’ systems that work like an artificial pancreas. These comprise a continuous blood glucose monitoring system (CGMS) and an insulin delivery device (a pump). The idea is that the CGMS takes frequent readings of blood sugar levels and commands the pump to deliver tiny amounts of insulin to ‘correct’ any high values – thus mimicking the way a real pancreas works. These devices are very close to being a reality. Things have certainly come a long way over the past 100 years, but have some way to go yet before we can all be ‘cured’!

‘Buy our pills!’ I hear you say,
‘Make diabetes go away!
Just take these three times a day,
Believe us – it’s the only way!’

Oh my dear, my goodness gracious!
What you claim is quite audacious!
The cure you offer is fallacious,
And your words are all mendacious!

Making money from the sick
Is such a nasty, evil trick,
So take your pills, one at a time,
And shove them where the Sun don’t shine!

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