[It’s finally here – the diabetes and stem cells primer from Jerry Nora that I promised. 🙂 For those reading my blog for the first time, I decided I ought to explain who Jerry Nora is. Aside from being a good friend, he’s also a MD/PhD student with a knack for bioethics who is and occasional guest poster here. – Funky]

Okay, let’s talk about diabetes mellitus (which are diabetic conditions resulting from glucose concentration dysregulation in the blood) and stem cells.

First, about diabetes mellitus: there are two types. Type I, or insulin-dependent diabetes mellitus, generally occurs early in life and involves an autoimmune destruction of insulin-producing cells in the pancreas. Type II is much more common and tends to occur in adults; this is a more complicated disease in that one still produces insulin, but the body does not respond to insulin as it should. Diet and obesity are big factors in Type II DM; treatment involves weight loss and varying drugs to increase insulin sensitivity and boost insulin production. Cholesterol lowering medication comes in handy as well.

From the above guerilla introduction, one should see that in Type I diabetes, we can use stems cells to replace insulin producing cells in the pancreas; there is no guarantee that the immune system won’t just destroy the cells again, but it can give people a better lease on life for some time. In Type II diabetes, there is no obvious target for stem cell therapy that I know of.

So now let’s look at Type I diabetes. If we are to use stem cells to treat it, we have two choices: embryonic, and adult. For a good summary of how these stem cells compare, check out MedLinePlus, which is an excellent resource on biomedical issues. It isn’t exactly right-wing propaganda, either..

The current state of the art would support adult stem cells, even if one has no particular qualms about breaking down microscopic human organisms for their parts. The embryonic research lobby fights hard by playing on people’s subjective feelings of pity, and our natural (and ordinarily laudable) desire to not obstruct ill people from getting help. Recently a young Type I diabetic named Tessa Wick joined the likes of Christopher Reeve and Michael J. Fox in fighting for embryonic research.

Tessa bet on the wrong horse. You see, even pro-embyronic publications like the Washington Post have woken up to the fact that embryonic research has no immediate promise for diseases like Alzheimer’s. In the meantime, we’re on the cusp of adult stem cells delivering the goods for diabetics like Tessa. Adult stem cells are simpler. Embryonic stem cells are balky to handle, and the fact that they are less differentiated means that they can accidentally become that many more unwanted cell types. Also, we can give Tessa adult stem cells from her own marrow, thus bypassing tissue rejection issues. Oh sure, we could also perhaps create a clone of Tessa from her skin, but think of how many extra steps that would take. My brief training in engineering imparted to me the importance of KISS: Keep It Simple, Stupid!

You’d think from the biotech lobby that in denying embryonic research and cloning we’re doing something akin to yanking a flotation device away from the flailing arms of a drowning man, that we were giving them a death sentence. This emotional manipulation was long recognized by pro-lifers, but that Washington Post article is striking, given the source. Since that article, though, the party line in favor of embryonic research amongst the media continued, perhaps even in nominally unbiased wire services.

I should emphasize that I empathize with Tessa, who has a very scary disease and naturally wants to get well. My argument is with the people who manipulate our feelings and Tessa’s, and who blacken science by distorting its results and turning it towards the degradation of humans. My argument is not with patients like Tessa. I hope that Brother and other celebrities will use their gifts and bully pulpit to promote the branches of research that are much more likely to help Tessa in the near future, that are so much simpler than cloning and embryonic manipulation, and are no more ethically problematic than a blood or bone marrow transplant.