Word: insulin
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...more acute, Type I diabetics have been particularly motivated to adopt strict treatment regimens. "The long-term complications of this disease scare the hell out of me," declares Ken McDonald, a 45-year-old computer engineer from Wellesley, Mass. Instead of sticking with the traditional treatment of two insulin shots a day, he began what is called "intensive therapy" four years ago. In that approach, he receives insulin more or less continuously, as needed. Around his waist McDonald wears an insulin pump the size of a pager, which infuses the hormone through a slender needle positioned just below his skin...
Even with all these tools, McDonald can only approximate what a nondiabetic pancreas does naturally. A pinkish-yellow organ the size of a banana, the pancreas contains millions of specialized cells that continuously manufacture insulin and package it in microscopic granules. In response to rising blood- glucose levels, these tiny factories release the granules into the bloodstream. As glucose levels fall, the insulin release tapers off, thus preventing blood sugar from plummeting to dangerous levels and starving the brain of fuel -- and consciousness. Fortunately, this life-threatening condition, known as hypoglycemia, can easily be countered by eating or drinking something...
Intensive insulin therapy may prevent or delay complications, but it also sharply increases the likelihood of hypoglycemia. For this reason, in 1982 the National Institutes of Health launched a clinical trial to assess the connection between blood-sugar levels and the development of complications. Half the 1,441 volunteers are following the standard policy of two insulin * shots a day. The rest belong to an intensive-therapy group that tries to keep blood sugar as close to normal as possible. Some participants, like Ken McDonald, are using insulin pumps. Others inject themselves with insulin four times a day. The results...
...years medical researchers have dreamed of not just controlling diabetes but preventing it. For Type I diabetes that goal seems tantalizingly close. Like multiple sclerosis and rheumatoid arthritis, Type I diabetes is known to be an autoimmune disorder. What this means is that the insulin-producing areas of the pancreas are attacked by the very cells charged with protecting the body from viruses and other invaders...
...prevents it from attacking the foreign tissue. Intriguingly, clinical trials in the U.S., Canada and France have shown that cyclosporine, when given to people with Type I diabetes, can turn off the autoimmune attack. Cyclosporine is an extremely toxic drug and, in most cases, a very poor trade for insulin. But the clear demonstration that diabetes can be stopped has stirred excitement in the medical community...