San Francisco
First, the bad news:
Diabetes is America’s No. 7 cause of death, killing 71,000 annually, the Centers for Disease Control and Prevention report. This disorder endangers nearly 26 million Americans and adds 1.9 million new patients annually, or 5,205 daily. If these trends are left unchecked, one third of American adults will be diabetic by 2050. U.S. diabetic care consumes some $245 billion annually and devours 20 percent of Medicare’s budget.
And now the good news:
Scientists, philanthropists, and entrepreneurs are working hard to manage, treat, and ultimately defeat this disease. They are making progress, which should encourage diabetics and those who love them.
• Through the huge windows in her stunning home in the Los Altos Hills above Silicon Valley, American Diabetes Association chair Dr. Karen Talmadge has a perfect view of a deep-space antenna on the Stanford University campus. While her academic neighbors seek intelligent life beyond the solar system, Talmadge peers into inner space. She hopes that cellular-level breakthroughs could make diabetes more manageable or render it merely an interesting memory.
“Diabetes takes a staggering toll, personally, socially, and economically,” Talmadge says. And yet, she adds, “Researchers are not choosing diabetes as their area of study. One reason is the level of funding.”
Talmadge notes that the National Institutes of Health devotes $5.5 billion to researching cancer, a disease that affects 12.5 million Americans. “Many diagnoses that used to be fatal now have become a chronic disease for people. Patients take appropriate medications and live with it.” NIH disburses about $3 billion to fight HIV/AIDS. It afflicts about 1.2 million Americans. Meanwhile, NIH dedicates about $1 billion to diabetes, which ails 25.8 million Americans.
Research dollars “are very uneven,” Talmadge continues. “I don’t want to take a penny from either of those two diseases, but diabetes research cannot keep up unless the budget grows higher.”
Enter ADA’s new Pathway to Stop Diabetes.
Over the next ten years, Pathway aims to award $160 million to 100 promising young scientists who will invent new treatments and seek possible cures. Researchers will compete for these portable, five-year grants of up to $1,625,000 each. ADA wants to initiate researchers and accelerate the work of those already targeting diabetes. ADA particularly wants to introduce experts from unusual specialties to begin battling diabetes with “new or even radical ideas,” in ADA’s words. This could include using materials engineering to create benign cells and tissues to improve diabetics’ metabolisms.
The first five to seven Pathway awardees will be unveiled in January, with grants totaling between some $8 million and $11 million.
• While Dr. Talmadge’s work largely begins with research labs, Tom Gibson’s support for a cure springs from squash courts. His daughter, Lucy, is a 20-year-old junior at Georgetown University, a member of the Hoyas’ squash team, and a Type 1 diabetic (T1D) since age four. Tom and Lucy founded Squash Diabetes, a grassroots effort to amplify diabetes awareness among squash players and raise money for something truly promising: to cure diabetes via a living-cell bio-artificial pancreas that requires no harmful immunosuppressant drugs. It simply would be implanted beneath the skin.
Squash Diabetes aims to cure T1D (or juvenile diabetes) by guiding the bio-artificial pancreas through human trials and then bringing it to patients worldwide. This autoimmune disorder usually strikes children and young adults by killing the insulin-producing islet cells in their pancreases. The result? A lifetime of painful insulin injections, finger pricks to monitor blood sugar, and strict low-carbohydrate diets.
Type 2 or adult-onset diabetes generally arises later in life. The pancreases of T2Ds usually remain partially functional and respond to pills, diet, and exercise. Still, about half of America’s 30 million T2Ds also inject insulin.
Dr. Taylor Wang, a physicist and former astronaut, invented the bio-artificial pancreas. It emerged from research he conducted in zero gravity aboard the space shuttle Challenger in April 1985. Dr. Wang now leads Encapsulife, a company dedicated to developing and marketing this device.
Dr. Taylor Wang’s bio-artificial pancreas. Photo: Encapsulife.
The bio-artificial pancreas contains tens of thousands of living pancreas islets, which are harvested from pigs or human donors today and will be obtained from adult brown-fat stem cells tomorrow. (Thus, Encapsulife’s islet source leaves embryos alone.) These cells would be encased in a polymer capsule, fashioned into a pancake-like patch the size of a half-dollar coin, and inserted subcutaneously. The U.S. Patent Office has judged this device qualified for protection as a bio-artificial organ. Tom Gibson says this patch protects the islets from a diabetic’s autoimmune system. It welcomes the patient’s digestive glucose. This stimulates the islets to produce insulin and then secretes it automatically into the diabetic’s system — as would a working pancreas.
Dr. Wang successfully reversed diabetes for up to seven months in nine dogs in 2007. More recently, he, Harvard’s Dr. James Markmann, and the living-cell patch counteracted diabetes in small monkeys without using immunosuppressants. This milestone was revealed at a closed-door October 21 research conference in Manhattan attended by scientists from the University of Minnesota, MIT, King’s College London, and other institutions. Dr. Wang would not comment on his findings or his imminent patent. However, Geoffrey Mason, CEO of FastPatentPartner, says, “It is unusual for the Patent and Trademark Office to allow a claim with an efficacy statement such as the one in Wang’s Letter of Acceptance. It shows that the PTO believes this invention will work.”
The Juvenile Diabetes Research Foundation (JDRF) and the Helmsley Charitable Trust help fund Encapsulife’s latest work. Endowed by the late Leona and Harry Helmsley, HCF also supported October’s research conclave and a March meeting at which scientists discussed possibly sharing the intellectual property that might spring from islet-transplantation findings.
To help Researcher B not waste resources running down a blind alley that trapped Researcher A, HCT hopes to get diabetes researchers to talk more among themselves. As HCT explains:
Incredibly intelligent and innovative work is going on, but little of it is coordinated. So we made it part of our mission to chart the entire T1D ecosystem. By doing that, we’ve been able to identify bottlenecks in the research-to-therapy pipeline. Our goal is to see to it that the pipe is open and fully flowing.
While researchers seemed highly protective of the future fruits of their laboratories, those close to March’s gathering say it confirmed the seriousness of a treatment that looked fanciful just a year ago.
“This meeting validated that there is enough success in the field of living cell islet transplants to try to accelerate the technology for curing diabetes,” said one leader in this field. “The fact that HCT is providing serious funding for islet transplant technology is really good news.”
HCT exemplifies how private philanthropy can play a role in fighting chronic diseases like diabetes. It already gives $14 million annually to diabetes care, education, and summer camps where young diabetics learn to cope. Since 2009, HCT has given JDRF more than $15 million to treat and cure T1D.
“In our new Squash Diabetes campaign, ‘Squash’ can be either a noun or a verb,” Tom Gibson says. “I prefer ‘squash’ to be an aggressive verb. People forget that Thomas Edison’s first ‘practical’ light bulb lasted only 12 minutes. Likewise, Dr. Wang’s success with the bio-artificial pancreas is a new beginning that will be polished and improved. So, as Lucy puts it, ‘This isn’t research to find a cure. This is the cure.’ We need to get it through FDA and on to the millions of people who suffer from diabetes.”
• Vmersion Health, a San Francisco–based start-up company, has developed Gluco-Share. It lets diabetics use their smartphones to monitor their self-treatment and rewards those who test their blood glucose, take insulin on schedule, and otherwise vigilantly care for themselves. Diabetics might earn, say, ten points every time they test their sugars. Gluco-Share accumulates these points, which can be redeemed for console games, retail gift certificates, and other premiums.
“Young diabetics often do not understand the dire consequences of going off of their treatment regimens,” says Joe Madden, a 48-year-old as broad-shouldered as the ballplayers his sportscaster father, John Madden, described across hundreds of games in his career. Sipping his coffee at the Cup of Joe Cafe on Sutter Street here, Madden adds, “We believe Gluco-Share is a promising way to give new diabetics incentives to keep doing what their doctors prescribe.”
Madden launched Gluco-Share after his son Sam was diagnosed with diabetes at age five. As most parents of diabetics recognize, material inducements motivate their children to manage their disease more carefully.
As a boy growing up with diabetes, Brett A. Shisler, one of this article’s co-authors, remembers being rewarded for maintaining healthy blood-glucose levels. Recognizing this challenging task, his mother showered him with sports equipment and stylish clothes. As he grew older, a later curfew became his treasured prize for properly handling his diabetes.
Gluco-Share is a modern version of what Shisler recalls from his childhood. The 1990s-style baseball-card reward structure has been updated with 21st-century technology. Diabetics, especially young ones, use their smartphones to record each time they check glucose and administer insulin. Soon, users will be able to track diet and exercise. The points generated from each smartphone entry can be redeemed for video games from Electronic Arts (the makers of Madden NFL), online-game currency, and Lego (and other) toys from King’s Variety Stores.
The parents and doctors of diabetics can use Gluco-Share’s data to evaluate patients, confirm their adherence to treatment plans, and correct them when they stray.
“Meanwhile,” Madden adds, “we are recruiting companies whose products and services will attract older diabetics eager to score discounted or free items when they correctly manage their condition.”
While Gluco-Share will not cure diabetes, it is making it easier and, indeed, more fun for diabetics and their loved ones to endure this ailment.
Many miles, millions of research dollars, and countless hours of laboratory time remain before diabetes follows smallpox into oblivion. But, for now, the momentum is undeniable and positive.
— Deroy Murdock is a Manhattan-based Fox News contributor, a nationally syndicated columnist with the Scripps Howard News Service, and a media fellow with the Hoover Institution on War, Revolution and Peace at Stanford University. Manhattan financier Brett A. Shisler is a Type 1 diabetic and a diabetes-research activist.