The Frederick Banting Foundation

From MedCityNews:

^[1]Drugs that mimic beneficial bacteria found in the human gut,  implantable and incisionless weight loss devices and stem cells that restore pancreatic function.

If the world is going to make a dent in the diabetes epidemic ^[2], it’ll require innovative approaches like those mentioned above – and more.

Solutions to the “whole body” problem of diabetes are coming from a wide variety of sources: the chairman of Whole Foods, innovative but largely unknown startups, entrenched industry giants and stem cell researchers, for example.

The following innovations in the treatment of diabetes provide some hope of lowering blood sugar levels and the economic toll of this costly and chronic condition.

Gut bacteria: The gut is home to trillions of bacteria, some of which can improve or worsen insulin resistance in mice – and perhaps humans. Plus, certain types of bacteria are more often found in the guts of lean or obese mice. If researchers can figure out which bacterial species in the gut are beneficial and which are pathogenic, they might be able to reduce diabetes or even cure it, Nature reported ^[3]. It may be possible to develop drugs that mimic the chemicals produced by the bacteria found in lean people’s guts, or inhibit molecules that lead to insulin resistance and diabetes.

Nu Me Health ^[4], co-founded by the chairman of Whole Foods Market, is developing a proprietary blend of prebiotics and other natural, plant-derived ingredients that are designed to alter the composition of the bacteria living in the gastrointestinal tract in order to help people with prediabetes maintain healthy blood glucose levels and body weight.

Incisionless, implantable devices: Medical device startup EndoSphere ^[5] has developed an incisionless, anti-obesity device that could be used to treat diabetics. The device recently received theCE mark ^[5], and works by slowing the passage of food ^[6] through the duodenum ^[7], the upper part of the smaller intestine that breaks down food. Because food is in contact with the duodenum for a longer time, the device essentially fools the body into thinking that it’s consumed more food than it actually has. It’s implanted with an endoscope in a quick procedure and can be removed just as easily. MetaModix ^[8] also appears to be developing a device based on a similar approach.

Stem cells: Research ^[9] published earlier this year in the journal BMC Medicine details a treatment that uses stem cells from cord blood to re-educate a diabetic’s own immune system cells and restore pancreatic function, allowing the pancreas to start producing insulin and reducing the need for the drug. “The concept is very intriguing, and the treatment seems to be so simple and so safe,” a University of Miami diabetes researcher told USA Today ^[10]. The study was led by a University of Illinois at Chicago professor, who cautioned that it involved only 15 Chinese people and future studies would need to involve a much wider, more diverse patient population.

Smart blood glucose meter: There are plenty of glucose meters in development that wirelessly transmit blood glucose data to health providers, but a company called Hygieia ^[11] is going a step further. The company is developing a device that uses proprietary software to generate recommendations on how diabetes patients should adjust their insulin dosages ^[12]. A physician sets up the device and then patients take it home, and use it to measure their blood glucose levels. The software in the device analyzes patterns in those measurements and generates insulin dosage recommendations. The device would represent a cheaper alternative to diabetics than in-office tests and physician visits. It’s scheduled to be rolled out in the United Kingdom later this year.

Artificial pancreas: The artificial pancreas is often regarded as the Holy Grail ^[13] of diabetes treatment. Ideally, the artificial pancreas would be a small, portable closed-loop system comprising a continuous glucose monitor, an insulin pump capable of delivering precise amounts of insulin and a computer algorithm to tell that pump just how much insulin to deliver based on blood sugar levels. The closest thing we have now to the artificial pancreas is Medtronic’s MiniMed Paradigm Veo ^[14], which is available in Europe but not the U.S.

That device comes with an insulin pump, a built-in continuous glucose monitor and personal therapy management software. A key feature is its Low Glucose Suspend ^[15] (LGS) automation, whichstops the pump from delivering insulin ^[16] for two hours when a patient’s blood sugar level gets too low. The next key step in the quest for the artificial pancreas involves integrating an insulin-delivery algorithm and associated automation with the rest of the technology.

Article printed from MedCity News: http://medcitynews.com

URL to article: http://medcitynews.com/2012/05/5-innovative-new-approaches-to-treating-diabetes/

URLs in this post:

[1] Image: http://medcitynews.com/2012/05/5-innovative-new-approaches-to-treating-diabetes/syringe-2-2/

[2] diabetes epidemic: http://www.who.int/mediacentre/factsheets/fs312/en/index.html

[3] Nature reported: http://www.nature.com/nature/journal/v485/n7398_supp/full/485S12a.html

[4] Nu Me Health: http://medcitynews.com/2012/05/nume-health-focuses-on-good-gut-bacteria-to-help-prevent-type-2-diabetes/

[5] EndoSphere: http://medcitynews.com/2012/04/incisionless-anti-obesity-device-gets-ce-mark/

[6] works by slowing the passage of food: http://www.medcitynews.com/2010/10/california-device-firm-endosphere-heading-to-ohio/

[7] duodenum: http://www.nlm.nih.gov/medlineplus/ency/article/002347.htm

[8] MetaModix: http://medcitynews.com/2012/02/medical-device-firm-using-new-approach-to-treat-type-ii-diabetes-seeking-1-9-million/

[9] Research: http://www.sciencedaily.com/releases/2012/01/120109211827.htm

[10] told USA Today: http://www.usatoday.com/news/health/story/health/story/2012-01-14/Novel-stem-cell-treatment-may-hold-promise-for-type-1-diabetes/52536006/1

[11] Hygieia: http://hygieiainc.com/index.html

[12] adjust their insulin dosages: http://medcitynews.com/2012/05/smart-glucose-meter-recommends-how-diabetics-should-adjust-insulin-dosing/

[13] Holy Grail: http://medcitynews.com/2011/11/diabetes-artificial-pancreas-still-faces-a-long-bumpy-road/

[14] MiniMed Paradigm Veo: http://medcitynews.com/2011/2009/09/medtronic-begins-international-sales-semi-closed-loop-paradigm-veo-diabetes-device/

[15] Low Glucose Suspend: http://www.medtronic-diabetes.co.uk/product-information/paradigm-veo/low-glucose-suspend.html

[16] stops the pump from delivering insulin: http://medcitynews.com/2012/03/artificial-pancreas-medtronic-inching-closer-to-diabetes-holy-grail/

[17] Jill A. Brown: http://www.flickr.com/photos/jill_a_brown/

[18] Image: http://converge-event.medcitynews.com/?utm_source=Post&utm_medium=MCNcom&utm_campaign=Converge

We’re in London and I came across the following quote from Winston Churchill which seems perfectly fitting for our group:

“We make a living by what we get, but we make a life by why we give”

This past Friday marked the 90th anniversary of Frederick Banting’s discovery of insulin.  This remarkable achievement has saved millions of lives.  Banting’s discover made it possible for those with T1D to pursue virtually all day-to-day activities that their siblings would.

Frederick Grant Banting was born in 1891 about 60 km north of Toronto.  He was the youngest of five children  in a  middle-class farm family.  As a young boy he watched a good friend, then only 14, wither away and die from diabetes. This shook him terribly and stayed with him serving as a motivator later in life.  Young Banting was apparently a mediocre student.  He struggled to finish high school and later failed first year Arts at the University of Toronto. But he dreamed of becoming a doctor and so he persevered until he was admitted to the University of Toronto’s Faculty of Medicine in 1912.  In 1916 he graduated and joined the Canadian Army Medical Corps, and served, during the First World War, in France as a medic.  He won the Military Cross for continuing to seek out wounded soldiers and administer care under fire, even after he had been shot in the arm.  In 1934, he was part of the last group of Canadians to be knighted by King George V.  When the Second World War broke out, he served with the medical services and was killed in an air crash in Newfoundland in February 1941. He was 49 years old.  He was survived by a son.

In an informal series of meetings with scientific researchers from all over the country, I determined that the average head of a research group spends at least half of her time raising money — research grant applications seem to be the most time consuming because they are paper intensive and offer a relatively low probability exercise.  These same researchers work for academic institutions with nine or ten figure endowments.   What an interesting situation.  A phenomenally wealthy employer of the world’s brightest research scientist won’t use the institution’s own wealth to keep its researchers focused on research.  This reminds me of the description many apply to venture capitalists (who fund relatively few new investments each year): deep pockets but short arms.  Imagine the impact on the volume of new biotechnology patents at pharma companies if their scientists had to spend half their time raising money.

In fact the research funding situation is even worse.  Most institutions take half of any outside funds generated by their researchers.  Let’s say a scientist working on a novel cure for diabetes raises $10 million of funding for his ongoing research.  The academic institution where the researcher works takes half of th new funds.  In this example our scientist would receive only $5 million for his research, even though he raised $10 million.  The other half “goes to the house”.  This “split” is the accepted standard in investment banking and law firms, but, as these firms grow a successful partner incurs more overhead associated with his activity….more bills, more support staff, more storage.  In fundamental research, at some point, there is nominal incremental overhead.

So, what’s going on here.  Are the academic research institutions supplementing their development staff with their smartest researchers?  It certainly appears so.  We wonder if the research productivity would increase if the academic mother ship would stop taking half of the budget?  It would almost have to because a research scientist would need to spend half as much time raising money and more time on his favorite research project (or working on new research ideas).  Let’s get our smartest diabetes researchers out of the fund raising business.

The bottom line is that the academic “house” is taking half of the research budget after the researcher spends half his time raising the money.  If we changed the current conventional wisdom, the productivity of our smartest researchers would double and the cash required to conduct his favorite research would be cut it half.    Double productivity and cut costs in half! This would be adopted almost immediately in the private sector.

Imagine if a small group changed the fund raising world.  One or more leading academic institution could use their endowment as a “weapon of mass differentiation”.   A portion of these funds could be used to fund basic research, getting the scientist out of the development business.  With the extra time he could teach, publish or research — all of which adds to the cumulative IP of the school.  Plus researchers and their younger colleagues would prefer to work for these institutions.  So the differentiating institution would benefit from a virtuous cycle:  easier recruiting of the best and brightest, more productivity from their researchers and more IP created by their researchers.

We suspect another problem with the current fund raising model is that it discourages truly innovative thinking.  Imagine the typical funding sources for basic research.  NIH, a federal government agency, and large private foundations with their large bureaucratic staff are the leading source of cash for large research projects.  Because  both NIH and large private foundations accept research initiatives based upon committee consensus — this committee decision making leads to acceptance of mainstream, incrementalist projects and a suppression of unique (and likely controversial) ideas and, in all instances, the near certain death of any project that doesn’t generate research papers.

The Frederick Banting Foundation supports research for a cure for  Juvenile Diabetes, sometimes called Type 1 Diabetes (or T1D).   The Banting Foundation supports a variety of scientific and medical research for new technologies, devices or drugs which may improve the lives of those suffering with T1D or result in a cure.

The Foundation is named for Canadian researcher Sir Frederick G. Banting, winner of the 1923 Nobel prize for the discovery of insulin. Prior to 1920, diabetes was a dreaded disease with near-certain death in weeks or months following the diagnosis.

Diabetes had long been recognized but little understood before Sir Frederick Banting’s work (in fact the ancient Greeks even recognized the disease). Early researchers suspected that a defect in the pancreas triggered diabetes. By the early 1900′s researchers confirmed that something in the pancreas triggered diabetes.  Researchers surgically removed the pancreas from animals and the result was the immediate onset of diabetes. Sir Frederick Banting believed that a healthy pancreas produced an anti-diabetic substance that prevented diabetes in healthy patients. By surgically ligating the ducts leading from the pancreas Banting theorized that: (1) the anti-diabetic substance would build up in the otherwise healthy pancreas, (2) he could extract the anti-diabetic secretion and (3) the extraction could be refined as a treatment for diabetes.

In 1921, the University of Toronto provided Dr. Banting with a small lab with outdated equipment, one medical assistant named Charles Best and ten dogs to test his theory. There were no grants to support research in the 1920′s, so Sir Frederick Banting sold his car to provide the seed capital for operating expenses.  The experiments began during the summer of 1921 and by that fall  Sir Frederick Banting and Charles Best had indeed isolated the anti-diabetic substance (he called the extract “isletin”, now called insulin). When Banting and Best injected insletin into a diabetic dog, the dog’s blood glucose level to dropped and the animal seemed healthier and stronger. By giving diabetic dogs a few injections a day, Banting could keep the animals healthy. By the winter of 1922 the isletin extraction and refinement process improved considerably and Banting treated the first human patient; saving a young boy’s life.

Banting gifted his insulin patents to the University of Toronto which licensed the discovery to Eli Lilly. Lilly perfected large-scale insulin production and by the end of 1923 was producing enough insulin to supply all of North America. That same year Banting was awarded the Nobel Prize in Medicine for his discovery.  At only 32 years old Banting was the youngest ever (and to this day remains the youngest ever) Nobel laureate in the area of  Medicine.

Banting’s name was immortalized  by the creation of the Banting and Best Department of Medical Research at the University of Toronto.

The Frederick Banting Foundation is inspired by Dr. Banting’s vision, persistence and success. We provide research funding to those who share Banting’s vision and tenacity with hopes that they too can change the world for Type 1 Diabetes forever.

An overview of some of the research supported by the Banting Foundation is here.

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Copyright 2011, Frederick Banting Foundation, Inc.