Type 1 diabetes has a particularly cruel twist. The mechanics of T1D are that the islet cells, which produce insulin, are destroyed by the body’s autoimmune system, possibly because it mistakes them for a virus. When the newly diagnosed person starts injecting insulin, some of those cells spring back into life.
It’s known as the honeymoon period.
The need for insulin decreases, sometimes for days, sometimes for a couple of years. Since July we’ve cut my son’s insulin by half, then by half again, going from around 40 units, to, at one point, seven. My son describes it with 8 year old boy imagination as “the islet cells see that some of their friends have gone on vacation and they work harder and harder until they realise that the others are never coming back and one by one, they quit too.”
The clinic tell you about this “honeymoon” but as the medication decreases, you can’t squash little, vain, hopeful thoughts.
He seems to be getting better, was the diagnosis wrong,
is he cured?
And these hopes are not totally without foundation. In the States there are some trials underway to preserve insulin production during the honeymoon stage. If my son had been diagnosed in five years’ time it might have been possible to reboot his pancreas and protect it from the attack of his immune system.
But too late for us. I think my son’s honeymoon might be ending. His levels have been creeping higher and we’re using more insulin each day. Those busy, remaining cells are getting tired: looking round to see they are the only ones beavering away, they are leaving their workstations. Soon the lights will be out. Those hopes will die too…
…but new ones will take their place. Techniques are advancing in transplanting of islet cells (from stem cells). The problem in the past has been the need for heavy medication with immune suppressants to avoid the body attacking the new cells. “Encapsulation” essentially wraps up the cells in a protective layer. In the future, the aim will be to avoid the need for anti-rejection therapy.
Technology for treating Type 1 Diabetes gets better everyday. But, as my son says “it’s just more stuff to stick into you.” To me, encapsulation is the nearest thing to a cure on the horizon. And that is a good reason to hope.
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