Male1: If a diabetic keeps his hemoglobin A1c at this low 6 range, exercises, eats correctly, sees an endocrinologist and an ophthalmologist, keeps his control—his life expecting complications would be kept minimal.
Male2: That is correct.
Male1: Will he live close to a normal life?
Male2: Yes, well, I would say so. I am willing to say yes, you have to keep in mind that all of the complications we are now talking about that goes back. We did not have that good control, so then we have people whose complications—they would say have after 20 or 30 years, it probably did not get that controlled, also, we did not have that blood sugar monitoring with good insulin, a pump. It is only in the last 20 or 25 years. So I would not say that guarantees no complications that we have mentioned, but I would say that the chance of these complications are very likely ameliorated and postponed and so that is certainly the way to treat it.
Male1: In the future, down the road, are there anything coming that we could actually make insulin--
Male2: Yes, there are a lot of things—one which is now, not done routinely, but it is in tandem with the transplant. If somebody has diabetes, and also needs kidney transplant or heart transplant, all of these people get transplanted also with a new pancreas. So transplant is one way. One of the draw back and this could be very effective. One of the drawback of transplant is that you have to take immunosuppressive treatment which could be sometimes quite complicated and there are a lot of side effects, another is the artificial pancreas—a lot of companies which are making insulin pump now are working on a glucose sensor and trying to put it together to close the loops or the pump will decide how much insulin to resolve, even checking the blood glucose and intense form of genetic engineering and growing hemo cells—that is also, I do not know if it is on the horizon, but certainly that is the way to go and that would be the final treatment. So I would tell our patients that we do not have anything except for giving insulin, whether by injection or by inhalation and checking blood sugar and life has to be regimented, but I think the future is bright.
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