I was at a meeting a few weeks ago when discussion wandered onto the artificial pancreas. How weâ€™re making progress towards it, how itâ€™d be great if they could get it controlling blood sugars automatically overnight, but how more complex manoeuvres like dealing with food and exercise will be more of a challenge. And of course itâ€™ll never be as good as an old fashioned, homegrown, organic pancreas.
Then someone asked a question. Rather than getting distracted by imperfect solutions like the artificial pancreas, shouldnâ€™t we be focusing all of our efforts on a cure. Thatâ€™s surely what we really need and want?
In theory, Iâ€™d agree. If the pancreas pixie came tomorrow and waved her magic wand, Iâ€™d be delighted of course. Or if there was any truth in the emails I receive telling me that a week spent doing yoga in a shed in Spain would cure my diabetes, Iâ€™d give it a go. But brace yourselves readers, itâ€™s time to face reality, I donâ€™t think itâ€™s as simple as that.
I have a problem with the â€śall out for a cureâ€ť approach. Firstly the psychology of it worries me. My pancreas has been faulty for nearly 30 years. What a miserable life that would have been if Iâ€™d spent it praying, hoping, yearning for a cure. Convinced that it was only ever that mythical 10 years away, as it was in 1984 and has been ever since. Instead I tend to see a cure in the same vein as I view a multi-million pound lottery win. Theoretically possible, but not something I factor in when planning my life. That means that financially I look for other ways of making money, and healthwise I accept my pancreas is dodgy and focus my efforts on living really well with diabetes today.
One of the problems with diabetes is that for most people, itâ€™s not bad enough to cure. If I were dying, had been given a year to live, Iâ€™d probably do anything to be cured. Iâ€™d risk life and limb, try anything with the slightest chance of success â€“ what have I got to lose?
But thankfully Iâ€™m not in that position. I have an irritating disease which has the potential to ruin lives, but in most cases, with good care and a following wind can be controlled. That makes me fussy. It makes me look at potential â€ścuresâ€ť like pancreas and islet cell transplants with the accompanying lifetime of immunosuppressant drugs and think for me, right now, theyâ€™re not worth the risk. My life is good, why risk it? Would I feel differently if I had severe complications? Probably.
The dictionary definition of a cure talks about something that will â€śeliminate (a disease or condition) with medical treatmentâ€ť. In very few cases do we actually cure anything. We can beat cancer into remission, but its only in fundraising ads that we talk about it being cured. We can eradicate diseases like polio in entire populations, but weâ€™re not so hot at curing it once youâ€™ve got it.
I donâ€™t mean to depress you. Iâ€™m just trying to look at this practically. So to answer the original question, no, I donâ€™t think we should be putting all our efforts into finding a cure. I believe our primary focus should be on improving the excellent treatments we already have, and more importantly, making sure everyone has access to them. Yes, letâ€™s invest in looking for a cure â€“ you never know whatâ€™s out there, we may discover that amputating my left little toe would jump start my pancreas and life would return to normal. But letâ€™s make that the secondary aim, with the primary one being to enable people to live well with diabetes today. Without that, the last 30 years for me would have been bloody miserable ones. What do you think?