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I know the joke, and I am not joking.

Once a treatment reaches stage 3 trials, it often becomes generally available within 2 years.

Stage 3 is expensive for regular drugs but for treatments like these, the cost of one trial may exceed $100M. The fact it’s happening in several places around the world means there is very high confidence that the treatment is working and the race to market has started.

Most of the times, when people are saying the treatment is 10 years away, they are being very optimistic. Usually it’s after some research shows a new pathway to treatment, usually in mice or other mammals. This is far before human trials and even when human trials start, there is only about 2-7% probability of the treatment making to market. So some mammal responding to treatment in a lab means the chance this treatment will make it through trials for humans is probably in the range of 1%. Saying with certainty it will come in 10 years is a joke.

But contrast this with a treatment in stage 3 clinical trials, where for diabetes treatments specifically, the success rate is between 65% and 70%. And some real snake oil has gotten to stage 3, which this is not. I think it’s quite likely we will see a treatment soon. 10 years is a pessimistic estimate for this.

Stage 3 diabetes treatments are so easy to test, too. If they lower HbA1c, then they work. If they are safe enough that for at least one population of diabetes patients they will significantly extend their life, then the treatment is safe enough. And stem cell implants have the hallmarks of all this.

It’s important to look at the evidence and not be cynical. The treatment can fail onstage 3, but at the current time, it is far more likely to make it to market.




> Stage 3 diabetes treatments are so easy to test, too.

I agree with this.

As for the rest, I appreciate your optimism but I think this recent discussion [1] captures how dire the situation remains for t1d. For example, GLP-1 drugs are not approved for treatment for t1d despite overwhelming evidence that they are useful. Or “We’re really just starting to figure out how to safely and effectively manage weight with lifestyle changes for Type 1 diabetics.” Stem cell miracles have been promising for years [2] and I don’t agree that the situation today is meaningfully different. The recent success with implanted cells is hopeful but the patient was already on immunosuppressants, so the result doesn’t generalize. Despite the overwhelming amount of money thrown at this, a cure is always just around the corner.

[1] https://publichealth.jhu.edu/2024/type-1-diabetes-research

[2] https://pubmed.ncbi.nlm.nih.gov/16278164/


I will hopefully reduce your pessimism on one account: just because drugs are not available generally doesn’t mean they aren’t available off-label. Sometimes you need to get a few prescriptions going abroad before you can convince your doctors to keep prescribing them. That is possible now, I am a t1d on a GLP-1 antagonist now.

Cell transplant once every 5 years can be done globally, right? We can do it in China if the laws are better there.

With the trials, I’m also not so pessimistic. This is much larger scale and its stage 3 — not one offs in a lab.

Open your mind to the possibility that maybe things are a bit more optimistic than you believe. I remember when closed loop pumps were about 5 years away for decades ;)




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