In part 9, the conclusion of this Exclusive Interview, Dr. Carla Greenbaum talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about the realities of where diabetes research can be in the next five or more years, in relation to a cure as well as other types of treatments.
Carla Greenbaum, MD is Director of the Diabetes Research Program at Benaroya Research Institute at Virginia Mason in Seattle, WA.
Transcript of this video segment:
Steve Freed: You know, so getting back to my original question, a possible cure or what you’re talking about, preventing, you’re involved with that on a day-to-day basis.
Carla Greenbaum: Absolutely.
Steve Freed: So, how comfortable do you feel in saying that we most likely, not that we will, but most likely, could have a possible treatment or cure, what you’re doing for type 1 diabetes. I always thought that diabetes type 1, the knowledge that we’ve gained over just the last 5 years, is probably equivalent to what we’ve learned over the last 50 years. So if you extrapolate that to the next 5 years, okay, it’s unimaginable what we’re going to learn with all the studies that are going on. So, how much more comfortable do you feel saying that we should have it within 5 to 10 years?
Carla Greenbaum: You’re never going to catch me on tape saying it’s going to be 5 years. But I will say this. You know I’m not certain we’ll have a cure in 5 years, but I’m confident that we will be able to start using other types of therapies, which will change the course of disease. It may not make it go completely away. People with arthritis and multiple sclerosis etc. do much better on these kinds of therapies, but it hasn’t cured that disease either. And we need to say stepwise progression means something. You know you still score runs if you’re hitting singles all the time, right? And so I think we just need to sort of look at this as we are now in the stage of applying this tremendous amount of knowledge we’ve gained over the last few years. Applying it means doing trials. And many trials will be negative and we have to say, okay let’s do another trial. How do we make cures and advances in cancer? How do we do it in any other disease? Hundreds and hundreds of different things were tested. I’m not saying we need to do that many, but we do need to do more trials and I’m confident if we take that approach, we will certainly have new therapies for people with type 1 diabetes.
Steve Freed: Not if the government takes away 50% of the money going to research. That’s going to make it tougher.
Carla Greenbaum: Yeah, I guess I’m not one of these people where the sky is falling. As you know there’s strong bipartisan support for medical research in Congress and it’s really Congress that determines the dollars.
Steve Freed: and I always thought that type 1 diabetes should be a lot easier than looking at type 2 because with type 1 you know exactly what you have to do. Somehow you have to prevent the destruction of the beta cells if you really want to find a cure. There’s no other way to get around it unless you replace those beta cells. With type 2, you know, I always tell people, nobody likes me to say it, we already have a cure for type 2. It’s called duct tape. People get mad when I say that because it’s not always the patient’s fault.
Carla Greenbaum: I think the way I would consider it and I’m confident this will happen in 5 years, both diseases start with a lesion of this problem with the beta cell. If [you have] the lesion in the beta cells when you’re young and you have the right or the wrong immune genes, you will get a manifestation of the immune system accelerating that destruction. But people with type 2 diabetes have a beta cell lesion. Just because you’re overweight or sedentary does not give you type 2 diabetes. It may unmask something earlier than the other would and we know for sure you can do treatment with aggressive exercise and therapy. At least for a while, but that fails. It doesn’t fail because the person failed. Their pancreas isn’t working and I think it’s very important to remind people. We have this image out there you know that somehow type 2 diabetes is somebody’s fault. It’s just not, right? They have a disease. A disease of the beta cells.
Steve Freed: And how did you generate this interest in getting involved in what you do because I find that most people that have diabetes have it in their family. We’re somehow motivated to find a way to treat it in some way that would better the lives of people with diabetes. Do you have any diabetes in your family?
Carla Greenbaum: I did not have diabetes in my family, although my training was actually as a family physician and I worked for a number of years in the Indian health service. I saw a lot of people with diabetes in that sense and recognized I wanted to learn and understand more, and that’s when I went back in for more training. But like you said, almost all of my staff, not all of my staff, most of my staff either personally or had a family member who was affected with type 1 diabetes. And these are all very talented people that can make a lot more money doing other things, but they bring incredible passion to work every single day and it makes a big difference.
Steve Freed: I want to thank you for your time.
Carla Greenbaum: Yeah, this was fun. Thank you so much for inviting me.