What's Fair...

Sometimes writing a blog can be as educational as reading one. For instance, while doing research for this post, I discovered that the first recorded case of diabetes dates back to 1552 BC! Egyptian physician Hesy-Ra had no idea what was causing his patient's ailment, but was aware enough to note "frequent urination" as one of the illness's symptoms.

Of course, even knowing there was such a disease did little in the way of aiding treatment [the timeline linked to above notes that one 19th Century practitioner recommended a diet laden with sugar as therapeutic, while others suggested oatmeal, milk, rice, and even potato diets as helpful!].

Until the 20th Century, diabetes was rightly looked upon as a death sentence. Indeed, in one of the Sherlock Holmes mystery stories [written by Doctor Arthur Conan Doyle], Holmes chooses not to turn a murderer over to the police because, among other reasons, he was a diabetic, and likely to die soon.

The modern era of diabetes treatment began in 1921, when a team at the University of Toronto, led by Dr. F. G. Banting, first isolated insulin. Around 30 years later, oral medications were added to the arsenal of treatment. Research has continued on new treatments and, although diabetes is still incurable, it can be controlled by a combination of diet, exercise and, as needed, medication.

And yet...

And yet, diabetics can still face bias in their careers and everyday lives. Take Sonia Sotomayor, US President Barack Obama's candidate for the Supreme Court. Among other firsts, Sotamayor would, if confirmed by the Senate, become not only the first person of Hispanic ethnicity to serve on the High Court, but the first diabetic [given the age and health histories of some of the previous Justices, I have my doubts on that last point. But she would definitely be the first openly diabetic member]. While her selection has been welcomed in the diabetic community, some concerns have been raised. The argument says that, while Sotomayor seems to be in good health right now, complications arising from diabetes, as well as the on-going progression of diabetes itself, could leave her unable to serve an extended term on the Court [in the US, Supreme Court justices are appointed for life: in practice, however, the Court's members can and do resign when their health makes it impossible to serve]. Politics, of course, enters into the discussion [when doesn't it?]: Sotomayor is perceived as a moderate-to-liberal-leaning judge, based on her previous rulings, and those who agree with her decisions want to ensure that a Justice with that mindset serves as long as possible. Those who disagree with her previous rulings hope that, if she is turned down for the Court, the next candidate offered may be closer to their beliefs.

I am not an expert in law, or politics, or a lot of other things, for that matter. But I do see what goes on in the world, and I believe I can make observations based on what I've seen. I do not believe that anyone can predict the future. You can report statistics, make "educated guesses", or even just throw an idea out for consideration [the Criswell Predicts method]. Yes, Ms. Sotamayor may live a shorter life than other Hispanic women in similar health, but not diabetic. Then again, it is an unarguable fact, based on statistics, that women live, on average, five years longer than men. If another person became the Court nominee, that person could live a longer life than Sotomayor. Or they could be run over by a bus three months into their term. The point is, no one can predict the future. If opponents of Sotomayor base their arguments on opposition to her previous rulings, I respect their opinions, as I hope they would respect mine. But opposing her because of her state of health, or worse, using a health issue to cover other points of disagreement, is nothing more than a bias-laden ploy that should be naturally abhorrent to any fair-minded person. I hope things don't end up coming down to this.

-Mike Riley

Okay, What ELSE Can It DO?

The inquisitiveness of human nature may be one of our most-useful, as well as most-dangerous, character traits. YOU probably can think of "most-dangerous" examples without much help from me. But, for a moment, let's think about the "most-useful" trait of curiosity. For instance, who was that first brave person to get past the forbidding outer surface and enjoy a pineapple? What could have made him or her realize the sweetness that awaited beneath the skin? Or, picking a real hero, why did someone think that the inside parts of the artichoke plant would be good to eat [then again, as sometimes happens in bars at closing time with shots of hot sauce, could it have been a dare]? It's one of those questions that we'll never get a final answer to, but it does show the versatility we humans bring to the table.

Of course, this adaptability is not limited to our table habits. A tire iron is clearly designed for aiding in the removal or attaching of tires, but, in a pinch, it makes a fine weapon, suited for crashing across a rival figure skater's knee cap. What about the cottage industry that's sprung up around unintended uses for WD-40 [the company's official web site admits to over two thousand, and seems to demur only in cases of alleged medical uses]? Balding persons may recall that minoxidil, better known as Rogaine, was originally a high-blood pressure medication, that just happened to grow hair. Who knew?

This all came to me with word that Xoma Ltd, a medical company best known for its work in anti-inflammatory treatment, will report positive results this weekend for its Xoma 052 medication's Phase II testing on diabetics. Xoma 052, an anti-inflammatory, was reported as showing positive results in a presentation last weekend in Rome. Phase I testing was reported as successful last September, and the next report is expected at the American Diabetes Association 's 69th Scientific Sessions, being held in New Orleans. A couple of questions come out of all this:

-Did anyone realize that diabetes could be related to other illnesses caused by inflammation? Don't feel badly if you didn't; I didn't either, until I read a Xoma release that noted the inflammation angle has been under research for the last decade or so.

Xoma has high hopes for 052, believing it can aid sufferers of everything from rheumatoid arthritis, to heart disease, to, of course, diabetes.

-How effective is 052? I'm not a scientific expert, but some of the testing indicates fewer doses may be required than under current treatments. In fact, some research is indicating that as little as one dosage in 90 days, may cause a significant reduction in A1C levels. Anything that reduces the number of treatments will likely reduce the cost of treatment overall. Anything that can do that can help the millions of diabetics around the world that struggle to pay for treatment.

-Where can I get it? Nowhere yet. It's wrapping up Phase II testing in the US, and is on similar tracks in other countries. If the US FDA works at its usual pace, it'll probably be a year or two before Xoma 052 is generally available. This is not necessarily a bad thing. Considering the disaster that followed, for instance, the release of the diet drug fen-phen, a little caution is probably in order.

Is this a breakthrough? Maybe. Keep an eye out for more details as the research into anti-inflammatory and diabetes continues. This site will try to keep up.

-Mike Riley