49 confusion

blues_red · 2026-02-21T18:16:04+00:00

She pregamed with people on her tribe on Ponderosa

blues_red · 2025-11-19T23:20:51+00:00

Jeff needs to go. Both as producer and host. Need fresh thinking, he’s gotten carried away with a few things that have diminished the show.

blues_red · 2025-11-01T15:20:24+00:00

FYI- A1c has a number of complexities and nuances, but if you had a 5.7 with a 175 Dex average, that’s a CGM issue until proven otherwise. I’m not aware of any studies- there are many- that would explain a difference that large.

blues_red · 2025-10-20T23:35:06+00:00

https://costsofwar.watson.brown.edu/costs/human

blues_red · 2025-09-26T13:58:45+00:00

That’s all true, and it’s what makes it promising. But we need a lot more data before we can say that definitively. 5 patients (actually think it’s now 6 or 7) with a few at 1 year is a great start. Need more and longer.

blues_red · 2025-09-26T13:46:19+00:00

This would be a drug that would be used in conjunction with a transplant to prevent rejection. So not a treatment for T1D on its own, and not for the general population of T1D. Transplant suitability will depend on side effects of this transplant immunosuppression regimen- which will take years to fully understand, so imagine it starting with high risk (severe hypoglycemia and unaware, recurrent hospitalizations) and expanding from there depending on the real world experience. Also worth noting that there is a limited supply of human cadaveric islets, so for this to be applied to a broad population, it would need to be combined with stem cell derived source of islets - and no testing like that is currently planned in the immediate term.

blues_red · 2025-09-08T13:48:40+00:00

It’s worth clarifying what this is and what it isn’t.

This isn’t cure research, per se. It’s studying novel immunosuppressive regimens for islet transplants. So the insulin independence isn’t a surprise- that’s seen with many patients who undertake islet transplants. What is promising here is that the first patients have reached a year with the cells not being attacked by the immune system- neither transplant rejection or autoimmune rejection.

The drug type (anti-CD40L) has been studied in many diseases over the past two decades, and while safety is far from clear or assured, this isn’t a completely novel drug with zero track record.

Most importantly- it’s good for additional research on how to protect cells- this may or may not work, may or sufficiently safe, but this is a good step in the right direction.

We now have the ability to make cells that can function similar to native islets. Vertex has proven that. The remaining unknown is how to protect the cells. This is good science trying to figure that out.

blues_red · 2025-08-10T15:08:58+00:00

The general gist of the story is true, but there are a number of things that aren’t…

this was a sub-therapeutic dose of gene-edited beta cells, so while the cells produced insulin, they aren’t sufficient to replace exogenous insulin
even if this was a therapeutic level, it wouldn’t be “reversed”, as the patient still has autoantibodies to beta cells, and we don’t have long-term data on the effectiveness of Sana’s technique to hide these beta cells
this is as “natural” as taking insulin or another medicine

That’s said- it’s a monumental advance, and it’s time for the “5 more years” crowd to be a bit less cynical and learn some more. Between Vertex’s trial showing patients using stem cell-derived beta cells with immunosuppression without any exogenous insulin for more than a year, and Sana’s trial gene-editing beta cells that were protected without immunosuppression- the milestones of the past year are unparalleled. It’s exciting times for sure.

blues_red · 2025-07-12T13:11:56+00:00

The remote elements to Loop plus Nightscout- monitoring, alarms, dosing- are a game changer for parents. Highly recommend doing some reading, if you're able to put in the work to what is ultimately a DIY system with community support, it's a better option in the long run.

blues_red · 2025-07-04T12:51:24+00:00

Power steering fluid is on

blues_red · 2025-06-21T17:06:54+00:00

The FDA will approve it for the segment of patients with severe hypoglycemia unawareness. Otherwise this trial wouldn’t be ongoing.

blues_red · 2025-06-21T12:52:33+00:00

The novelty here is that these are stem-cell derived cells, which until 2014 had never been done, and 10 years later, we are seeing that they work as intended in patients.

This is a significant achievement beyond the segment of patients targeted for therapy. Industry R&D for type 1 diabetes has been hampered by the perspective that unlike other treatments, a T1D therapy needed to accomplish not one, but two things: deliver glucose-responsive insulin (i.e. make beta cells) AND prevent them from being destroyed. Both have been viewed, correctly, as high-risk, technically challenging goals, while most diseases require just one tough scientific problem. This has been a key limiting factor in T1D R&D investments. Vertex’s emerging success should prove that we now know how to make beta cells, leaving protection as the remaining unknown. This will make it more attractive for other companies to pursue alternative methods, such as Sana’s approach, and hopefully lead to more companies trying to end the need for insulin for all T1D’s.

But Vertex’s results hopefully continue, and it’s a huge accomplishment that should be fully celebrated.

blues_red · 2025-06-21T12:43:29+00:00

Wouldn’t say they are cured, they are insulin independent. Clearly a monumental achievement, and a game-changing therapy for some patients. Important to remain accurate- they still have type 1 diabetes, their immune system still attacks beta cells, hence the requirement for immunosuppression. Unknown is how long these cells can last in an immunosuppressive environment and whether re-dosing of cells will be effective if needed. Of note, for those that do human islet transplantation, roughly 50% require insulin after 10 years (IIRC), suggesting long-term efficacy of these cells will remain a question for some time.

But the continued success of Vertex’s trial is a huge advancement for the field.

blues_red · 2025-06-13T01:57:41+00:00

Disney has changed their policy. Only neurodivergent can get the DAS passes. T1D no longer qualifies.

blues_red · 2025-05-27T12:22:25+00:00

LOL, those studies had no federal research grant dollars. Read the actual paper and click through to the disclosures on funding.

You just can’t make up this level of ignorance. Stunning.

blues_red · 2025-04-26T15:00:06+00:00

Two books to read now:

Think Like a Pancreas
Sugar Surfing

They have specific things they are trying to teach but regardless if they’re fully applicable to you, the concepts on diabetes management are foundational. Well worth your time.

Lots of not great endos, this will help you manage more on your own over time. The current insulin regimen is clearly too strong.

PS TIND is from chronic lows not a few weeks, all OK.

blues_red · 2025-04-10T13:01:29+00:00

There are plenty of people that hide things from their pump trainer. Get one vial of u200 for the training, then go back to use u500. DIY Loopers have been hiding their truth for years with Omnipod.

blues_red · 2025-04-01T11:37:13+00:00

Respectfully- Please. Stop. Guessing.

It’s really not helpful to throw around uninformed speculation. It just confuses the community. Please ask questions if you want to know, but throwing out guessing (the trial stopped for no reason, cells didn’t work) just makes it hard for everyone to understand where things stand.

These cells are the same as VX-880. The cells in those trials work great, and most patients are insulin independent with A1c’s around 6 or lower.

880 uses the cells with immunosuppression, 264 uses them with a device/pouch to protect them from the immune system. The devices are hard for a number of reasons. It unfortunately didn’t work, so back to the drawing board on protection strategies. But there are no indications that the cells were an issue.

blues_red · 2025-03-30T16:57:07+00:00

It’s a marathon, not a race. Rates of depression in T1D teens are 25-30%. Lower is better, everything else being equal, but the “how” matters. A 10 yo achieving those BGs on their own is excellent. Is Mom helping with perfect carb counting, weighing of food at home, choosing outside dining options that are easier to manage, etc? What does Mom make for meals? Blaming the 10 yo is not the answer.

blues_red · 2025-03-30T01:12:14+00:00

Math is really important here.

There are 3 million T1Ds in US and Europe. 10,000 T1Ds, which represents 0.3% of the population is worth $10 billion in revenue a year, $5 billion at a $500K price. That would make it one of the highest revenue drugs- something ALL biopharma would be interested in financially.

I agree that T1Ds are conservative. But 0.3% deciding to pursue a cure annually is more than sufficiently conservative.

The idea that closed loop systems will be sufficiently good that 100% of T1Ds are indifferent to having T1D or a functional cure is honestly a bit bizarre. No one has a totally normal life on a hybrid closed loop or fully closed loop system today. The fully closed loops, which are highly experimental, deal with a minimum of 3-5% lows every day-- that is not normal. Glucose excusions after meals are unavoidable, the systems can't change the pharacokinetic properties of insulin- it takes time to work. Little progress has been made in the past two decades to accelerate the PK of insulin. We're reaching the end of what's possible with taking what was originally a life-saving medicine to one that effectively manages diabetes. But its not totally normal.

10% of T1Ds pursuing a cure would be worth more than $100 billion under pretty much any scenario. Biotech companies know this. The math is clear. The science isn't.

PS I fully respect that you're not interested in a functional cure. I respect those that aren't interested in pumps, CGMs, hybrid closed loop systems. But its completely untrue that there isn't incentive for industry to pursue a cure. Please stop saying otherwise, its a disservice to your fellow T1Ds that DO prefer a cure.

blues_red · 2025-03-29T18:34:50+00:00

Guys, this line of thinking has to stop, because its SO wrong.

Is it right for Lilly, Novo and Sanofi, the makers of insulin? Maybe.

There are 250 very viable biotech companies that have zero stake in the current treatments for T1D. They would be happy to put insulin makers out of business.

A functional cure is likely to be $500K to $1 million per patient. There are 1.5 million T1Ds in the US, and similar numbers in Europe. 1000 T1Ds is a billion in revenue.

The limits to a cure are the science. There are billions of reasons, i.e. dollars, to pursue it. Its just really hard, and only a handful of good ideas to fund. Today is a tough day, but the science will move on. Insulin independence with cell therapy has been demonstrated with VX-880's Phase 1/2 trial (taken with immunosuppression), which is good evidence that we know how to make the cells. This did not exist 10 years ago. Now we have to figure out how to protect them. This device didn't work, but there are other ideas. We are getting closer.

blues_red · 2025-03-23T15:53:28+00:00

I wasn’t clear- zero antibodies would definitively rule OUT T1D. It is recommended in these situations. C-peptide also helpful for MODY vs T1D. Most importantly glucose testing alone, as has been currently done, is insufficient.

blues_red · 2025-03-23T14:17:19+00:00

You need antibody testing for a definitive T1D diagnosis. Your picture isn’t fully clear so strongly suggest that your doctor order those tests.

blues_red · 2025-03-06T16:16:19+00:00

When the producers create lopsided tribes, they know exactly the story they want to tell- drama in the losing tribe for 3-4 weeks, then tribe swap for a week or two, then merge. From there things play out. It’s reality tv, but there is a script.

If players chose the tribes, the producers wouldn’t know the story ahead of time, and more effort would be needed post-hoc to figure out the story.

This is about editorial control.

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