Caveats appeared up high in the story. Potential harms adequately explained.
But the story may have overstated the benefits of nonmyeloablative stem cell therapy for Type 1 diabetes, because this procedure has only been effective when tried in the first few months after diagnosis.
We wish some estimate had been given of cost. It can’t be inexpensive to use the autologous stem cell transplant method used in the study. But the results – from this tiny study – are interesting, as they reproduce other results from different patient populations.
No estimate was given of the cost of this “cocktail treatment.”
The story states that “Eight teens who took part in the study have remained insulin-free for two years, on average. One patient has gone without insulin injections for 3.5 years.”
A significant limitation of this report is that it fails to note that this procedure (at least in the previous literature) is only effective immediately after the diagnosis of Type 1 diabetes, generally in the first six weeks or so. The procedure works by dampening the immune response that is destroying pancreatic insulin-producing cells, and after about six weeks the great majority of these cells are already destroyed, so treating the immune system will have little effect. Were the patients in the current study identified very early after diagnosis, as has been described in the previous literature (e.g., Couri et al. JAMA 2009)?
The problem is that the article implies that this approach could potentially be beneficial for the millions of existing patients with Type 1 diabetes, rather than merely future patients identified very early after disease onset.
The story reported:
As a result of the immune-system suppressing drugs, most of the patients in Gu’s study experienced side effects including low white blood cell counts, fever, nausea, vomiting, hair loss, and suppression of bone marrow.
Most of those side effects disappeared within two to four weeks, and unlike in previous studies of the experimental therapy, none of the patients developed infections, pneumonia, low sperm counts, or organ damage.
Still, patients have to be followed for years to ensure they do not develop known long-term complications of immune-suppressing drugs, including tumors and infertility, Gu says.
the story appropriate put up high – in the second sentence: “The study was very small, and the procedure is not ready for widespread use.” Indeed. Just 15 teens in the study.
The chief scientific and medical officer of the American Diabetes Association was quoted with independent perspective.
The story did state that “This is the latest of several stem cell studies to show promising results for the treatment of type 1 diabetes,” but it did not give any comparison with any of those other approaches. It did not compare the duration of the insulin-free period, or as noted above the time since Type 1 diabetes diagnosis, with the other studies.
The story stated that the procedure was not ready for widespread use.
The story acknowledged that other stem cell studies showed promising results for Type 1 diabetes.
It does not appear that the story relied solely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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