Last updated on February 7th, 2023 at 01:53 pm
Here is another conspiracy or myth that I need to debunk — some corners of the internet claim that Big Pharma is hiding the cure for type 1 diabetes. Trust me on this, they’re not.
I know it’s hard to believe this considering all the news about the high price of insulin in the USA, but finding a cure for type 1 diabetes is difficult, and it might be impossible. Big Pharma isn’t hiding the cure, it doesn’t have one. No one does, it doesn’t exist.
This article will discuss type 1 diabetes and why it’s so difficult to find this elusive cure. It’s a complex disease, which I bet most don’t quite understand unless they have the disease.
What is type 1 diabetes?
I know that a lot of people don’t quite understand what diabetes is, so I hope that this helps. For those of you who have a lot of knowledge about diabetes (because you or a loved one has it), this explanation might be boring.
Type 1 diabetes is a disease where the body does not produce insulin, a small peptide hormone that signals cells to store glucose when blood sugars increase, usually immediately after eating. Then, in between meals, another hormone, glucagon, tells the cells to slowly release stores of glucose, which is the basic energy source for most cells.
Insulin is produced in the beta cells of the pancreatic islets. The beta cells also produce amylin, which works with insulin to regulate the blood levels of glucose. Amylin is given with insulin to a type 1 diabetic who has an overlying type 2 diabetes, a fairly rare combination.
Without insulin, glucose is not put into storage, instead, it circulates in high concentrations in the bloodstream. High levels of glucose in the blood can lead to long-term damage, such as cardiovascular disease, kidney failure, blindness, and loss of limbs — in fact, without insulin, the diabetic will die within a few weeks or months of the start of the disease.
Diabetes can be deadly if uncontrolled blood sugar leads to a life-threatening condition called diabetic ketoacidosis. Without regular insulin injections, a patient has little chance of living beyond a short period of time, and even then it could be a horrifically painful demise. Before insulin was isolated and given to diabetics, about 100 years ago, people who developed diabetes just died.
What causes type 1 diabetes?
Type 1 diabetes is an autoimmune disease in which autoreactive T lymphocytes (T-cells) destroy pancreatic islet cells, which are critical to glucose metabolism since these cells produce insulin. These lymphocytes mistakenly attack the islet cells as if they were a foreign body, as they do with a viral or bacterial infection.
Regulatory T-cells (which are often called Tregs) are supposed to modulate the immune system and should normally reduce the effect of an autoimmune attack. Tregs act like brakes that normally prevent mistaken attacks by the immune system, such as the autoimmune attack on the pancreatic islet cells, without affecting the whole immune system. For some reason, the Tregs do not recognize the islet cells as “self”, so the T-cells attack them.
A branch of diabetes research has hypothesized that abnormal Tregs could be the key to finding the “elusive” cure for type 1 diabetes, by making the Tregs work correctly.
Once the pancreatic islet cells are damaged, they can no longer produce insulin, thereby impairing control of levels of glucose in the blood.
It is not known what causes this autoimmune disease, although there is strong evidence that genetics is the most important factor. However, other things may be implicated, like vaccine-preventable diseases or some other pathogen that could be important triggers to the autoimmune disease. Enterovirus infections are linked to a 4X increased risk of type 1 diabetes.
Viral infections during pregnancy, like rubella, can lead to a nearly 2X increased risk of diabetes in the child, according to this systematic review.
Just to be clear, vaccines are not linked to type 1 diabetes.
Why can’t we cure type 1 diabetes?
Currently, there is no known cure for type 1 diabetes. The only treatment for the disease is regular injections of human insulin, manufactured from genetically engineered E. coli cultures. In addition, careful diet and lifestyle management help regulate blood glucose levels, although they cannot replace insulin injections.
There are several reasons why we have been unable to cure type 1 diabetes:
- We don’t have a good grasp on what causes it. We do know that it’s got a genetic component plus some trigger, probably viral infections. But we don’t understand why the Tregs quit telling the immune system that the beta cells are one’s own cells.
- If we knew how to upregulate the Tregs to do their job, we might go a long way to a cure. In fact, the BCG vaccine is being studied as a method to kickstart the Tregs into doing their job — yes, a vaccine might cure diabetes (we are a decade away from knowing if this works).
- We don’t know if the beta cells can come back even if we were to fix the autoimmune disease. In other words, we don’t know if the cells are permanently gone.
- It would be better to prevent the disease in the first place, but so many viruses are linked to being a trigger for the autoimmune disease, we’re not sure which one to prevent. There are several enterovirus vaccines that are being studied which can help reduce the risk of type 1 diabetes.
Big Pharma is not hiding the cure for type 1 diabetes
There are two good reasons why this is a silly claim. First, if a cure actually existed, everyone would know about it. Most pharmaceutical research is done in academia, and that data would be published. In fact, a lot of research is published every single day about diabetes, and no one has published a “cure.”
Second, to really know if a miracle drug to cure the disease actually existed, it would need to go through the clinical trial process, meaning a large (thousands of patients), randomized, double-blinded clinical trial. Once that happened, we would all know about it. Anyone involved in the clinical trial would be posting to their Facebook or Instagram accounts photos of them throwing away their insulin pens.
Third, the claim that somehow Big Pharma is hiding the cure for type 1 diabetes because they make more money from selling insulin ignores the basics of finance. A “cure” for diabetes would be one of the biggest blockbusters on the market. The company that owns the drug could set exorbitant prices for it because it would still be cheaper for healthcare financing across the world than a lifetime of insulin injections and the consequences of diabetes itself. The company that markets the cure for type 1 diabetes will be rolling in so much cash, it could be one of the highest-valued companies in the world.
This is one of those weird conspiracies that never made sense to anyone who understands the pharmaceutical industry. Big Pharma is not one single entity — there are over 20,000 pharmaceutical companies across the world, and they don’t care very much about one another. If Johnson and Johnson, which doesn’t make insulin, invented the great diabetes cure, they couldn’t care less that Eli Lily makes and sells insulin. The coldhearted executives at JNJ would not shed a single tear that they were destroying Eli Lily’s insulin business.
As a type 1 diabetic, I wish there were a cure for the disease. My early research career was in diabetes, and I think that we are making great progress in understanding diabetes which will lead to a cure. Will it happen next year? No, but if the BCG vaccine works out, it might be here in a decade, more or less.
One day, some researchers will get an “ah-ha” moment that leads them to figure out how to beat those Tregs into submission to do their job of protecting those insulin-producing beta cells. But right now, there’s no secret cure that is being stored in a secret laboratory under the Antarctic ice. And no, there is no miracle herb or alternative medicine out there that will “cure” type 1 diabetes — again, if it did, then it should have clinical trials supporting the claims, and there always isn’t any.
Stay tuned. I’ll be watching all the science.
Citations
- Allen DW, Kim KW, Rawlinson WD, Craig ME. Maternal virus infections in pregnancy and type 1 diabetes in their offspring: Systematic review and meta-analysis of observational studies. Rev Med Virol. 2018 May;28(3):e1974. doi: 10.1002/rmv.1974. Epub 2018 Mar 22. PMID: 29569297.
- Hirsch IB. Insulin pricing in the USA: the saga continues. Lancet Diabetes Endocrinol. 2022 Oct;10(10):695. doi: 10.1016/S2213-8587(22)00251-0. Epub 2022 Sep 1. PMID: 36058208.
- Yeung WC, Rawlinson WD, Craig ME. Enterovirus infection and type 1 diabetes mellitus: systematic review and meta-analysis of observational molecular studies. BMJ. 2011 Feb 3;342:d35. doi: 10.1136/bmj.d35. PMID: 21292721; PMCID: PMC3033438.
