I have my Dexcom on the top of my upper thigh (one of the spots that isn’t too torn up yet (*)
(*) The curse of insulin pumps and cgm - you exchange fingertips that are torn up with skin in about 15 or 16 places that is. If someone could make a slow-release growth factor they could coat the sensors with to aid healing - they’d make a mint.
Except they wouldn’t - it would take at least 5 years to get through trials - probably 10 because cancer might be a big risk. By then I’d hope they could make islets in transgenic pigs, and could encapsulate them well enough to last 6 or 7 years - you get the procedure repeated with a new poor pig ; (*)
I suppose if they could do living donor islet transplant with the pig then it could still live a long happy life
(*) Because it’s “not quite” a lifelong cure, the drug company should be happy because they get to recoup the expense (and make a “reasonable” profit that lasts until… well until they figure out how to tell the body to regenerate them and regenerate appropriate regulatory cells.
Insurance companies should also “see the light” and be happy about only paying $20-80K for the procedure every seven years, versus $950/month (2 insulins)127 = $80K. Not counting complications.
(*) If they also figure out how to avoid local non-benign fibrosis where they put the islets each time due to the slow autoimmune reaction that slowly got through the encapsulation.
You are correct that completing a study with a non-covalently attached coating would take a good number of years. I also wonder how much this is an issue in all Type 1’s, i.e. my son is still a teenager and seems to heal from everything really fast. I assume as he ages, this will get worse. But anyway I digress. The next 10 years should be interesting with the latest crop of medical advances.
The best chance of a functioning cure as I can recognize with my limited scientific background is Semma
They claim to be able to grow a virtually unlimited supply of islet cells. Unfortunately they grow all the cells of the pancreas when forming these islet cells. Latest claim they can guarantee that islets will make up 80% of the population of cells with a new separation technique. They are still unable to protect them from immune attack. Still Vertex has bought them for almost 1 billion dollars.
The most promising research seems to be encapsulating the islets in alginate. No box no sheet nothing that will antagonize the immune system. Still this still doesn’t provide much protection from the immune system but does offer the cells more oxygen and nutrients.
The last piece of the puzzle is crystallizing immune rejection drugs and embedding them into the alginate that surrounds the islet. Instead of taking a anti rejection medicine and suppressing your entire immune system embed them in the cell you are trying to protect. Latest research points to fibrosis free in rodents for 1.5 years and primates 6months.
The only other exciting news is how much money is being thrown at this
Eli Lilly’s has pledge about 500 million toward bringing a treatment to market by funding Sigilon a company that encapsulates islet cells.
Just exciting to see money spent on this by the pharmaceutical
