the roadI can never know what to expect as a holiday gift from Patrice Cocco, a scientist, at Perle Bioscience.  Her gifts are unique and inspirational.  For example, I have always known that we are a company literally paving a new road for diabetes, so one year Patrice printed this road for me (right).

This year my gift was beyond belief.  Patrice provided me a most unique and artistic rendition, of the elephant in the parable of the blind men and the elephant. It is one of the stories I often use as an introduction when I speak about diabetes (below).  The story tells about each of the blind men’s perspective when they are all surrounding the same elephant.  The one at the tusk describes the animal like something smooth and hard and sharp.  One of the men holds the trunk and describes the beast as a big long snake, while another describes the leg as a large column, while yet another describes a leg as a tree with smooth bark. One describes the animal like a rope because he is touching the tail, and the last blind man describes the elephant by its flapping ears saying it must be a fan.  Of course, they are all correct.

20160124_155736-1-1-1-1

The parable of the blind men and the elephant speaks to me about how different scientists have viewed and studied diabetes.  All of the different thoughts, hypotheses, perceptions leading to scientific studies and putting together the pieces, ultimately leads to the big picture.  It is essential in scientific research to read all of the studies carefully.  Many times conclusions by the authors are challenged.  It is not unusual for studies which provide groundbreaking new ideas, to have editorials by scientists in the field who review and make comment at the same time the study is published.  It is so important to understand why some studies succeed and some fail, because the conclusions are often based on the parameters set for success.  The conclusions of authors are often definitely challenged, when it could be viewed a success from a different perspective.

For example, I disagreed with the conclusions of the authors of a recent study using a proton pump inhibitor in patients with diabetes.  Proton pump inhibitor medicine is best known for treating acid-reflux, but these types of therapies also increase a hormone which promote new islet formation. In one study patients with type 2 diabetes had a 30% rise in beta cell function.   In another study that was funded by the largest insulin producer and using a different proton pump inhibitor, the authors concluded that proton pump inhibitors did not improve diabetes outcomes.

I had a completely different perspective on the data and a different conclusion than the authors.   The patients in the control group, who did NOT receive the proton pump inhibitor had a significant drop in insulin secretion (p=0.002), while the patients treated with the proton pump inhibitor maintained their insulin levels without a fall throughout the study duration.  Given the natural history of both type 1 and 2 diabetes, maintenance of insulin secretion utilizing the proton pump inhibitor may demonstrate a potential role for this treatment in both type 1 and 2 diabetes to maintain insulin production.

We know type 1 diabetes is a big picture with scientists working on the disease from every angle.  We, at Perle are looking at the type 1 elephant from every angle.  We know how to and that we have to because our lives literally depend on it.

My father got diabetes in his 30s after he was stung by a pack of bees and from that day on, I have wondered about this disease called diabetes.  I have seen the devastation and havoc this disease causes and how remarkable it is that people live with blindness and amputations and go on dialysis three times per week.  Worst of all, they hear doctors and nurses call them, patients with this disease,  “noncompliant.”  The only thing that is noncompliant is the pancreas.

Please watch my brave patients, Kaitlin and Joanne, and Tony, who just got a kidney transplant and Linda, who is now off insulin!  One person doesn’t make a cure.  One person doesn’t even make a study.  One person gives me hope that we are moving in the right direction.

My dad, who lived a wonderful life to the age of 91, could fix almost anything and practically everything, but not diabetes.  He struggled with recurrent lows, even though he tried his best at monitoring his food intake, was a faithful exerciser, and took his medicine.  He could not fix his diabetes.  He left that for me to fix for all of you.