“Our Task”
The world is facing a widespread pandemy of diabetes. We aim to stop and reverse this trend by transforming the clinical protocols that are used to treat the disease.
“The Challenge”
XX century scientific models of diabetes care were based on several assumptions that are no longer valid -ie. the fate of beta-cells, the feasibility of recovering first phase insulin secretion-. We aim to catalyze and promote the transformation of medical models so we can develop safer, more efficient and cost-effective treatments for prevention and reversion of diabetes.
“Our Answer”
The IDDR is being developed to identify the factors, levels and interactions that increase the probability of remission in a person with diabetes. The goal is to enable the deployment of novel solutions as fast as possible.
Our first paper is being prepared, here is the abstract:
Background
The Diabetes Remission Project (DRP) aims to develop a protocol for remission of diabetes. Remission status is operationally defined as being able to sustain regular blood glucose levels (HbA1c < 6.5%, fasting serum glucose < 125 mg/dL) without requiring ongoing pharmacological or surgical treatment. The project has an observational, an analytical and an experimental component. This paper describes the initial findings from the observational component. Results from the analytical component -using statistical learning and large databases- will be available shortly after abstract submission, in May 2018.
Aims
To identify the factors that maximize the probability of sustaining remission of diabetes, with special emphasis on non-surgical and non-pharmacological strategies.
Methods
Cases of remission are identified worldwide, using clinical referrals, online forums and social networks. Participant’s non-pharmacological strategies are explored with three different approaches. Close-ended surveys are used to obtain sociodemographic data, proof of physiological condition and a brief description of non-pharmacological strategies. In-depth interviews are used to deepen on understanding the dietary, physical activity and psychological strategies utilized to sustain remission. Ecological momentary assessment and smartphone data donation is used to collect quantitative data on diet, physical activity and to collect pictures of participant’s food, and physical environment. A mixed-methods assessment is then utilized for cross-reference and quantitative assessment. Special emphasis is given to find a novel or recent physiological hypothesis on how to sustain remission.
Smartphone data donation. To perform this activity, we use of a platform that guarantees data donation in anonymity. In addition, donors can keep record of their donations using a blockchain-based registry. This system was built by Bitmark, Inc.
“Definition of Diabetes Remission”
Following international standards [1,2] a person goes into diabetes remission when the following conditions are fulfilled:
- Had a diagnosis of diabetes
- Fasting Serum Glucose (FSG) is less than 100 mg/ml (5.6mmol/l)
- HbA1c is less than 6.0% (42mmol/dL)
- There is no active hypoglycemic therapy (either pharmacological or surgical)
We define three levels of remission:
- Initial. When the conditions are fulfilled for three months
- Complete. When the conditions are fulfilled for one year
- Operational cure. When the conditions are fulfilled for five years or mor
References:
1. Buse JB, Caprio S, Cefalu WT, Ceriello A, Del Prato S, Inzucchi SE, et al. How do we define cure of diabetes? Diabetes Care. 2009 Nov;32(11):2133–5.
2. World Health Organization (WHO). Global Report on Diabetes 2016 [Internet]. Geneva: World Health Organization; 2016. Available from: http://www.who.int/diabetes/global-report/en/