Diabetes Diary

A Diary of a Patient with Diabetes,

5000 A.D

by Dr AG Unnikrishnan

Introduction

How would diabetes be managed, more than 3000 years from now? I decided to let my imagination soar while writing this article. For one, painful blood glucose testing would be out, and painless glucose testing would become the norm. Secondly, clear cut scientific patterns would help doctors predict, not just diabetes, but also its complications and possible responses to medications. 'Perfect Glucose Control' would become a reality, but in ways which we might never be able to imagine. And of course, doctors would soon be near that golden grail of science, i.e. the promise of immortality and a cure to ageing. But would mankind be happier? Can such immortality in the world bring lasting happiness? What might happen? Read on to know my views.

The Fantastic Glucose Sensor

The roar of the vehicle was unbearable. A shrill note blasted his eardrums. A sudden dip in the glucose level had triggered the alarm. It was time to stop for a ‘drink’; otherwise the blood sugar would fall to dangerous levels by noon. Mr. Zung turned the ring around his left index finger, and the uni-man jet slowed down to 2kmph in 3 seconds, and veered towards a kiosk window.

A glass of milk for me and a chip for my jet, he said. As a high velocity milk stream splashed into his mouth he felt the familiar surge of the glucose levels surging back tonormal. The blood sugar values on his goggles were also improving rapidly...33mg/dl…then 45 mg/dl …then 55 mg/dl…and then, a healthy 88 mg/dl. Actually it was not the goggles at all. The little chip implanted behind his ear lobes would assess glucose levels in the blood and transmit it electromagnetically to an area in the brain called the occipital cortex. The occipital cortex is the area where visual information is stored. This area would precisely calculate the electromagnetic signal, convert it into a glucose number, and project the information to his mind. And what he was seeing on the goggles was not the blood sugar signal, but his mind’s projection of the signal. Oh! So what! Such outdated technology compared to what his jet was using. Anyway the blood sugar had returned to normal. He felt fine and it was time to visit the fetal medicine specialist with his wife.

Predicting from the fetal life itself

“Do you really want the baby? Our profiling of the baby’s genetic pattern shows that at the age of 34 years, she will develop type 2 diabetes. By 40 years she will develop hypertension, and even with good medical treatment, the risk of heart disease is so high that by the age of 55 years, heart disease will develop”, said Dr Wu, the fetal medicine prediction specialist.

Zung looked at his wife, who suddenly looked very forlorn and lonely. There was a difference of opinion between the husband and wife on this. Zung believed in fetal prediction while his wife did not believe in such testing. However it was a Government rule and it could not be disobeyed. Rita Zung had terminated 2 pregnancies- the first because of the risk of cancer, the second because of the risk of cirrhosis and now diabetes! Fetal prediction involved a set of complicated data mining, where previous information that compared genetic profiles with the occurrence of various diseases was used to predict the various diseases the baby might develop. Predictably sick babies were inevitably discarded by a medical abortion.

Dr Wu did not stop. There was a controversy on the management of such cases, she said. For cancer and cirrhosis the guidelines were clear cut. For diabetes, there was no clear recommendation to abort the fetus, she said.

So be it, thought Zung, let there be no recommendation from me as well. Rita looked at her husband, and suddenly smiled when she saw Zung nod his consent for the pregnancy. We are going to have the baby after all, she thought. So what if the child gets diabetes. Can’t it be managed? She transmitted these thoughts wirelessly into her husband’s mind using the mindphone they had just bought. Her husband’s reply came immediately. He felt that diabetes was easily managed by the pancreatic server that had recently appeared on the horizon- a true artificial pancreas. Besides, now there was that new preventive treatment – a pill which could be swallowed one a year. The pill would make the insulin-producing beta cells work better and prevent diabetes in those with high risk of developing it.

The Artificial Pancreas

Several hundred years ago, there was this artificial thing called the internet, Zung thought. The World Wide Web was a much better name. Why, even today, this was called the Mind Web. The Mind Web was a sea of information floating around the world in an energy form. By just thinking about the web and switching on a small pea-sized computer chip on their rings, people’s minds could log on and download information directly into their minds! Some of this information would sneak into the body’s genes and program it differently forever. For instance, today Zung was supposed to perform his monthly diabetic log-in.

Zung sat in his parked jet and used his mind to log on to the web. He could feel the information entering his brain. Soon, that information would be used by the brain to generate little chemicals that would convert the cells of the pancreas into fantastic insulin-producing cells. The small chinks that had occurred in the process (causing him to get hypoglycemia and consequently stop for the milk intake) earlier would be smoothened out by a web update.

Forecasting Diabetic Complications

Zung suddenly received a new message in his mind:

“YOU WILL GET DIABETIC EYE DISEASE IN 14.5 YEARS

YOU WILL GET KIDNEY DISEASE IN 15 YEARS

YOU MAY GET A HEART ATTACK IN 21.1 YEARS

IF YOU CONTROL SUGARS WITH OUR NEW MEDICINE

YOU CAN PREVENT THESE FOREVER- CONTACT DIABETOMINABLES INC. ”

Zung laughed. These advertisements, called mindvertisements, popped up every minute. His doctor had told him to avoid taking them seriously. They represented a computer virus that had infected the web and was sending false information.

Zung knew that with current diabetes management, nobody developed complications of the eye, kidney, heart, nerves and feet. In fact, the electronic newspapers said that the last case of amputation had been performed 600 years ago, i.e. well before he had been born!

And what did Zung have to worry? He was already 512 years old. Another 300 years more, at the most. And he was going to become a father. Diabetes in his children? Pooh! It was not a disease to worry about. He had read in the ancient computer scrolls that about a thousand years ago, people had been injecting insulin into their bodies to treat diabetes. Unimaginable!

Immortality!

It was not diabetes that worried Zung. Far from it. Diabetes was one more step that mankind had crossed. Diabetes was now cured in the wink of an eye, a tweak of the mind. In the past people had died of tuberculosis. Humanity had found a way around it. Heart disease and diabetes appeared next. People had tried pills, injections and even surgery and transplantations for diabetes. Why, even cells of the fetus, called stem cells were used and technology created to develop them into insulin-producing pancreatic beta cells and cure diabetes. And now, with a simple logging on of the mind into the internet-or Web as they called it now, diabetes was gone. What had Zungs’ doctor prescribed to cure diabetes? Just a monthly logging on of the mind to the internet for a brain tuning that could treat diabetes.

No. Diabetes had never worried Zung. On the contrary, what worried Zung was the fear of immortality. There had been more and more news coming in about in the past decade about how humanity was now solving the final disease, i.e. age. Ageing was being rapidly stopped by the combination of biology and technology. And it was posing new problems for humanity. In the last 3 years, 6 people had crossed the government-specified age-limit of 1200 years. And all three had applied to the Government for mercy killing. The reason? Immortality is boring, they said! What is there in life to see for a thousand years! Wasn’t it better to pass through death and (possibly) afterlife, where heaven beckoned them? There had been talk of panels being set up to deal with the problem of immortality. A prominent sociologist had even commented that specialized hospitals be set up to deal with the problems of patients suffering from immortality. In contrast, diabetes offered a safe route. A route to bypass the never ending boredom of a 1000-year old (and still going strong) life!!

Full Circle

The alarm rang in the left temporal lobe of the brain of both Zung and Rita. The temporal lobe, the center for hearing was connected by a chip to their minds. They only had to think of the time, and the alarm was set. Both Rita and Zung “switched on” their minds and turned on the retinal screen embedded in their eyes (in the olden days, this was called TV). The time was 7.00 am, the time for the morning news. Their eyes widened as the heard the news reader say “…the Government empowered panel has now set up Immortality-Tackling Centers to cope with the problems of over-living. Those suffering mentally would be offered psychological counseling. If the counsel feels that this psychological therapy is ineffective, they would be offered a chance to end their lives gradually. They would be given Xsteroid tablets. Xsteroid is a variant of what humanity used to call cortisol or cortisol about thousand years ago. This drug, Xsteroid, would cause ageing without directly increasing any suffering or causing side effects. Xsteroid would cause an acceleration of the ageing process, by inducing old age of cells, causing the blood pressures to rise a little, and also resulting in a slight weight gain and a very mild form of diabetes…”

Conclusion

This article raises several controversies. However, let me first make one important disclaimer. This article is science fiction i.e. 1% science and 99% fiction!! However, this article presents an interesting study in the science of medicine. The normal process of human life is to wither away, and medicines do their best to block this natural process and prolong life. Modern medicines have improved the quality and quantity of life, bringing relief to the pain and sufferings of many. But if scientists aggressively pursued this search for a cure for ageing, what would happen? If we were immortal in the materiel world (as opposed to the so-called occurrences like “afterlife” or “rebirth” ), would it solve all our problems? Or would it generate new problems too? Definitely, this issue is worth a re-think!