Something a bit immersion breaking in all of the books are the references to people having diabetes.
Given the tech level, it would be cured so many times over it isn't even funny!

Just off the top of my head, a couple of cures.


Type 1:
1. Immuno-suppressants (With all the bioware, they can and do have good ones), grow clonal beta cells, insert into pancreas. Cured.
2. Auto-injector linked to biomonitor; cured.
3. Kill bone marrow, pancreas. Grow new ones. Cured.
4. Bio-gland producing insulin-like chemical linked to mol/ml of glucose. Cured.
5. Nano-biomonitor and nano-cancerands full of insulin. Cured.

Type 2 is harder, but still simple.

Type 2:
1. Digestive alteration/expansion: eventual reduction in insulin resistance; cured.
2. Changes in diet. Cured.
3. If it gets particularly severe, some of the type 1 cures.


As a Type 1 diabetic with an interest in medicine, this stuff just bugs me.

((Complete BS Alert))

Actually in 2023 Sweedish doctor Olaf Gunderson made a discovery that diabetes was actually an awakened disease, and that the true cause of the disease was unknown before the awakened occured. It is notable because it is one of the few instances of magic continuing unimpeded through the fifth world into the sixths, and some believe that diabetic mages are better able to control mana in mana voids because of it.

((/Complete BS Alert))

Now anyways, I'm sure there is a cure for diabetes in the sixths world, but I promise you, the lower classes can't afford it. If it improves the quality of life for the lower classes, it doesn't belong in a cyberpunk dystopia.

Your problem is that you assume that everyone can get these things. You may not have noticed, but this is a dystopian setting, not a 'feel good and give everyone the cure for world hunger' setting.

No one is going to give people with diabetes those cures out of the goodness of their hearts, and those cures are going to be more expensive than the regular cheap treatment that is around today (Cheap comparatively, and certainly cheaper by 2070).

So yeah, there -are- cures, just like there -are- cures for blindness (cybereyes) allergies (gene treatment) and just about everything else out there, but that doesn't mean everyone can afford the cure. So yeah, even though there is the tech to cure most anything, people will still have stuff because they can't afford it or don't have the right means to access it.

My cousin uses a device much like this. I think she said it costs about hundred dollars for the auto-injector that was taped to her side. So, yes, I also find it incredulous that the sixth world would have any problems with diabetes, even if they were poor as dirt - if the slums/barrens can get other items that fall off the truck, even a few of these wouldn't be too hard to come by from a street doc, eh? Hell, auto injectors might be even standard in a med kit of sufficient rating. While perhaps insulin is inexpensive, maybe the dystopian setting makes its distribution a challenge for the poor majority but then again, street doc maybe? And they seem to manage to distribute the rest of the junk the corps sell, so... *shrug*

Or more likely it is a great reason to stay loyal to your corp. OK top levels of society will have a cure, no if's and's or but's. The poor/SINless are pretty much doomed. Afterall it's probable that even modern treatments might fade away.

Mid level? well that's a great insentive. "What a shame Mr. Green your son has that illness. Isn't it fortuneate that our corporate health plan covers the needed tyreatment."

IMHO most peoples go for the simpler, less expensive options similar to what we have today, but probably a bit improved (stuff like "smart patches" monitoring sugar level and delivering insulin transdermaly). Like the auto-injector those don't CURE the condition. They alleviate the symptoms and the user able to function normally, but the condition is still here and if for whatever reason he miss hisrefill (that he need to buy regularly) he can expect troubles.

The definitive, genetic or biotech solutions certainly exists, but are expensive and somewhat risky. For exemple your method 3, killing bone marrow and pancreas to replace them with wat-grow replacement is not what I would call a minor procedure, and many peoples will understandably be wary of it if they have an alternative allowing them to function normally or near-normally.

Do we even mention diabetes in SR? 'cause I'm blanking.

I honestly have no idea, and i've been re-reading a lot of source material to prep for my upcoming SR4 campaign. I got nothing.

The majority of these are not CURES... they are treatment plans to alleviate the symptoms of said disease...
Type 1 (2,4, and 5, Treatments, not Cures...... 1 and 3 may or may not actually work for the vast majority, as Diabetes of this type is generally hereditary and genetic, newly grown clonal bodies would probably tend to exibit the disease as well)

Type 2 (All are Treeatments, they never reduce the disease, they may inhibit it or remove symptoms, but you must always use these options, lest the symptoms return)

Gene-Tweaking MIGHT work... assuming you could afford such treatment...

Keep the Faith

What on Earth brought this on? Was diabetes mentioned in some recent sourcebook or something, enough that someone just felt an urge to make an account at 3:30 in the morning and make their first post ever on Dumpshock a rant about it?

I guess so?

I was kinda curious what the OP meant about all the books having reference to diabetes. I don't remember a single reference to it from any of the books that I've read, but it seems OP saw it so much that it completely made SR seem unbelievable to him. :shrug:

I would think that if you had the money, you'd be able to use gene tweaking to cure pretty much anything.

with the exception being magically awakened diseases of course.

• Insulin shots for diabetics mentioned as a use for auto-injectors; Augmentation p. 39
• Mentioned as a side-effect of certain gene treatments that had been rushed to market without proper testing; Augmentation p. 74
• Mentioned as one of the conditions which the ACPS might read from someone's ID, Ghost Cartels p. 140

Also searched: Core (4e and 4a), Runner's Companion, Arsenal, Street Magic (and Digital Grimoire), Unwired, Corporate Enclaves, Feral Cities, Runner's Havens, Emergence, On the Run, Loose Alliances, Contacts and Adventures.

So, a few passing references to it, but nothing big that I can find.

Well, given that the first reference from Augmentation is one of the 'cures' that the OP suggested, it seems silly that would be something he is mad over. And the second reference is giving it to someone, after which they could use one of the 'cures' that were mentioned, so that once again seems very silly.

And as already stated by TJ, most of the 'cures' the OP mentioned don't actually cure it, they just alleviate the symptoms, so I could totally understand diabetes still showing up on someone's ID.

Hmm...I wonder if you could go around giving people diabeties on purpose? Then you could develop a cure to your own disease, sell it to city public health department and make a bundle!

um...sorry. planning my SR4 campaign and i'm trying to think like an evil, amoral corporation.

I don't think diabetes is that easily transferred. I'm fairly sure it is genetic, so you have to be born with it or get a crummy geneware. And if everyone who uses Evilcorp brand geneware gets diabetes and they just happen to sell a fancy diabetes cure, it won't take long for people to figure things out.

I'm sure there are plenty of -other- diseases that could be done for much more discreetly though.

actually, it wouldn't be TOO hard to disguise type II diabetes, esp if you tied the triggering agent to body weight. so you could go around making people fat and diabetic, then offer them diet plans and a cheap genemod cure for Type II diabetes. you'd make money on the junk food/infecting agent sale AND clean up on providing the cure. Hell, even in the real world we've got a problem with type II diabetics in the less affulent areas of the city.

How about Evo has a small subsidiary named Liberty Medical.... spokesperson is a dwarf that looks a lot like Wilford Brimley.

ok, that's funny.

However - I do tend to steal ideas for shadowrun story arcs out of the headlines. just watching the finanical news these days gives me plenty of story seeds for corporate greed, corruption and general purpose skullduggery.

..Considering how insulin is created, I imagine it would be a lot more expensive in the sixth world, for starters. ..I'm hypoglycemic (genetically inclined, fathers type one diabetic) and I never saw anything in the way its treated in SR to even give me pause. Like the others have said.. the things listed there -treat- it, they aren't cures.

Strange random rant is strange.

More expensive? I'm not sure to what method you are referring, but its currently made with recombinant bacteria and (relatively speaking) its dirt cheep. Of course you also have long acting preparations, which are just slightly more involved, but in general this type of thing is going to be damn near ancient tech by 2070.

As to the OP, well he's right for the most part (barring the semantic argument of "treatment" vs "cure"). Any of those options would be highly effectively in managing DM. But I think you have to keep in mind that the books are written for a modern audience (i.e.- us) and the easiest way to convey the implications of this futuristic tech is to relate it to a disease we understand.

I guess the new Diabetes Grenades really set him off.

Ah yes, apologies, was slightly brain wuggy when I wrote that, and was actually thinking about bovine insulin rather than the vat produced stuff, despite the fact that its been in use for ..well longer than I've been alive. Sometimes my brain doesn't provide the correct relevant facts when prodded

And, of course, there is the fact that some people cannot use the bacterially produced "Humulin." My aunt is
allergic to the stuff, having to use initially the Bovine Insulin, and, most recently, Glucotrol(which caused a
whole other series of effects, and so she is back on the Bovine Insulin).

That must be ridiculously irritating.

Yeah, forgot about the dystopian nature of everything.

Also, type 1 has a couple of vectors, so far as I recall.

The current theory is that a virus with a protein shell resembling insulin infects the body, and then the immune system starts killing off beta cells. This would also explain the "honeymoon" period.

The treatment/cure thing is reminiscent of the cyber/bio argument. Sure, if you get a new gland, you aren't actually repairing the damage, but you could say the same thing about cybereyes.

As for type 2, check out some of the newer research.

I would like to note as I have seen a reference or two to it in this thread that diabetes Type 2 is not just a "fat" person disease, nor that eating a sugary/carbohydrate rich diet is going to create the disease in a person. Typically a person is born with a genetic predisposition to it. It also can be brought on due to a lot of trauma to the body (ie., major accident, invasive surgery.) It really irks me that recently, with all the focus on healthcare reform in the real world, people keep repeating "Oh, we could wipe out diabetes if we jsut all ate healthy like we were supposed to" and pretend that it's an avoidable condition. Yes, a balanced diet, proper body weight and exercise all help to moderate the severity and progression of the disease but 90+ % of hte people that have it are still going to be on meds to treat it eventually and the disease will keep getting progressively worse as you age no matter what you do. Currently, diabetes will be your death unless somethign else gets you first.

Sorry, but that all had to be said. As far as the original poster goes, however, I can't figure out what the "rant" is about. Diabetes is barely mentioned within the game and anyone that understands the disease in the least will look at all the other things that can be done medically in 2070 and simply go "It's cured." or "It's completely treatable at a very minimal cost." I would go as far to say that anyone with a moderate lifestyle shouldn't have to worry about it ever and charge a guy that is low or street maybe 50-100 bucks a month for his medical supplies. Really, the OP is being very, very nit-picky here.

Vlad

The same can be said of breathing.

The current terminology for DM in fat people is called "metabolic syndrome" which includes type II DM, but is a distinct clinical entity.

This is kind of a "chicken vs egg" thing. DM causes athlerosclerosis, coronary artery disease, peripheral neuropathy, renal failure, etc, etc. So its not whether something else will kill you, its which something else the DM will cause.

And with that, I'll say that this is far and away the least SR-related discussion I've seen on these boards for awhile (since we pretty much expended any game-related capital this thread had a page and half ago). It kinda makes me sad because I've been hankerin for a good, crunchy SR discussion for awhile and there's not much to go around. Bleh...

Sorry for my even-more-unrelated rant.

I disagree. For one thing, the economy as written doesn't make any sense if this is the rule. Megacorps don't get to continue being megacorps by selling nothing but high end: The fatcats are all way too lean. To stay on top in their cutthroat world of 20 second buyouts and what-not all of the megacorps have to figure out ways to sell stuff to the lower classes. Because if any of them don't, the others will devour them.

Furthermore, there are massive populations of SINless living within blocks of upstanding corporate citizens. Most of these people are only SINless because they got the shitty end of the history stick a generation ago or (with the number of disasters and the amount of "voting off the island" in Shadowrun) even more recently. They certainly aren't all gangers, extremist policlub members, rugged individualists or shadowrunners -- most of them would probably like nothing better than to get back into the corporate rat race. What business couldn't sell things to people like this? Considering the vast numbers of SINless, what business wouldn't?

So there you have it: The two parts you need for an economy that improves (for various definitions of the word) the lives of the lower classes. Not radically or quickly (and with every disaster you can bet there's a marked decline) but it definitely exists and IMO is a core component of a cyberpunk dystopia.


This is what I came here for. Nice to see I'm not the only one on DSF who's played Barkley.

As a diabetic and one who's had to deal with the whole economic side of the disease let me further stipulate. Diabetes is the largest cash cow for the medical supply community. There have been about three real possibilities for a "cure" that were in the woodwork for a while in the pass decade.

First was the concept of injecting cells that would produce insulin in the human body. Further injections would be necessary, but only over about 5 year periods. This was tested on Chimpanzees in Canada on most showed signs of begin cured of diabetes.

Second was a change to the insulin itself. A chemical is filtered out during the insulin production process. This was originally done since it was unknown what it did. Nearly six decades later it was discovered that this chemical is what cause the human body not to be damaged from high blood-sugar spikes (for you non-diabetic types your blood sugar might spike over 400 after a meal but you don't suffer the side effects--normal is around 100 just for a reference). You wouldn't be cured, but there'd be no direct side effects.

Lastly is the potential of stem cells. This has a lot of ethical debate over it and I won't go into it so as not to harm anyone's personal beliefs.

But just so you know, I have to pay $202 dollars US to just pay for my insulin each month. Another $21 for my testing strips and $12 for the special needle tips that go on the special insulin pens.

What really makes me mad is that this is about twice what my old insulin cost me and it doesn't work as well. No company makes a generic of it and I can't find it elsewhere. I'm looking into getting it from Canada as a company cannot pass the cost to research a product onto the customer.

Oh, you know those first two potential cures? They were bought out by the medical companies (not all together, each was bought by someone else) and shut down almost immediately.

That's just the facts that I know of for sure, so if medical-corps today aren't that ethical today, I doubt they'd improve over time.

Sign--

A very bummed Wacky

As much as I would love to walk away from this thread, I feel the need to clarify a few things...

I don't doubt that studies like these have been conducted, but I am highly skeptical that ground breaking treatments were squashed by biotech companies, just to keep milking a cash cow. For one, the owners of any company that found a cost-effective, reliable cure for diabetes would be bazillionares virtually overnight. I don't think any individual would pass that up just to preserve a potential source of revenue for the rest of the "big bad evil biomedical industry". There are perfectly plausible medical reasons why these treatments wouldn't work.

For example, treatments 1 and 3 are essentially the same, unless you are referring to pancreatic transplant. The problem with any of these approaches is that it doesn't work in type 2 DM (because type 2 is mediated by insulin resistance, not a lack of insulin production) and has variable success in type 1 DM (due to the potential for ongoing autoimmnue destruction of the grafted tissue).

As far as, treatment 2 is concerned- I'm not sure what you're referring to. Do you know what the chemical is called? You might be thinking of C Peptide, which is actually being developed in Europe for diabetes management. If you're curious why we don't have it in the US, well the answer has more to do with the FDA (i.e.- government regulation) than free-market greed.

And as an aside- there is growing evidence that bariatric surgery like Lap-Banding may be highly effective at "curing" type 2 DM in people with metabolic syndrome. I can assure you that whoever developed that nifty little procedure is making a considerable amount of money.

I don't know, if you were in charge of a company and had the chance to cure people of diabetes with a $2,000 or keep letting them pay $200 a month, would you really be all that excited about a cure? Sure, you make more money for a bit, but after a year or so, your profits will completely dry up because everyone is cured. Now, I'm not saying if companies here and now would do that or not, but I certainly imagine the megacorps of 2070 repressing any sort of 'cure' so that they can keep selling insulin.

It is like if some company made a car that -never- broke down, never needed repairs, and would basically run forever (So long as you put gas and oil into it). Sure, it would be a big hit, and -tons- of people would buy it, and for a year or so they'd be rolling in the dough. But then people would never need to replace the vehicle, so car sales would go away. No one would need to repair their vehicle, so garages would all go out of business.

In other words, a perfect car would quickly destroy car companies and their supporters. A cure for diabetes would quickly destroy insulin companies and their supporters.

My point is that insulin companies won't be the ones that find the cure, and the ones that find the cure won't give a shit about the insulin companies.

Or to put it in the context of your example: How much sleep did Henry Ford loose about putting the horse drawn buggy companies out of business?

I'm sure he lost a ton

Your right, it won't be the insulin companies, but the insulin companies would want it stopped, and would be willing to put quite alot of resources into doing so (Especially in the SR universe)

As for the horse drawn buggies, that's true, but the product was replaced with something that was essentially the same, if you had a cure for diabetes, or a car that lasted forever, there would be no product replacing it in the long run.

For example, the American government has thrown trillions(I think like 13 trillion, right?) of dollars at auto manufacturers to keep them afloat because they employ so many people. If a product came out that would make auto manufactures all go out of business without providing something new for them to make (Like personal airplanes or something) I'd imagine the government itself would throw a ton of resources at keeping it off the market so that the auto companies can stay around and keep employing the population.

On the other hand, how many Runners were around for the horse drawn buggy companies to hire?

Admittedly, I'm a type 1 so I don't follow type 2 news that closely. I am familiar with how they differ but no, it is not a transplant in the normal sense but an injection of cells (I think the same as those which are called "Island of" something (Forgive me, being dyslexic in an intellect debate never bodes well) which are housed in a plastic that dissolves over time in the person's body. As the plastic leaves the cells are freed and start producing the natural insulin until the host body rides them. As this happens more cells (with different thickness of aforementioned material to trigger at different times) are released to continue the cycle. This can be delayed for quite some time but after 5 years all the cells are gone and more must be placed in the host.



I can't remember what it was exactly (this was starting up about three years ago). Though I'm pretty sure it began with a "deetra-" sound to it (again sorry for the lack of a refrence).



Considering both of the before mentioned possible cures were being researched in Canada (home country of the development of insulin--thank you neighbors to the north!) I'm pretty sure I can safely say that an American agency didn't affect their tests or developments (though an American company could still buy them out).

Any way, I won't start flaming you if you can agree to disagree...you're C-Peptide does actually give me a little hope to all this, which is something I haven't had in a long, long time...

Sign--

Wacky

I think you misunderstand my point. The reason these treatments are being developed outside the US is because none of these companies want to deal with the ridiculously over-regulated FDA approval process. It is not uncommon for life-saving drugs to be available in Europe and Canada years before they are available in the US. Nevermind what's coming out of China (buyer beware).

I will admit that I am not aware of the specific treatment you are referring to (Islets of Langerhans by the way, and the molecular "capsules" are called carcerands). But the problems remain. Type 1 DM is speculated to be an autoimmune disease that destroys beta islet cells. Adding new beta cells isn't a sustainable solution because your immune system just attacks the new cells (sooner or later).

And its not really an "agree to disagree" thing. Nor am I flaming you- its not personal at all. Its science. Simple statements of fact.

I should also point out that I am talking about degrees of success here. Very few medical treatments are all-or-nothing "cures". Some work, sometimes and some work less over time and some work in some people and not in others. The bottom line is any study can show marginal benefit from an experimental treatment, but thats a far cry from developing a cost-effective reliable and safe treatment for the masses.

If that's what you were going for than yes, but there are actually companies that exist completely independent from US ownership (at least to begin with ) which is what I was referring to.



Speculated is the appropriate term. While I'm a prime candidate for support for that theory, the only other diabetic in my elementary school with diabetes type 1 didn't have any major viral triggers. Smaller ones, such as a simple everyday cold, aren't radially thought to trigger it. Not to mention the fact that every human being on the planet carries the begin version of the herpes virus in them--the on that can cause cold sores.

And for not being aware of the treatment, I'm no better without offering a name for it.



Dude, you gotta learn to be more flexible.

But yes, so do I for statements of fact. I've been researching a barrage of possible treatments for dealing with the symptoms not to mention those with the possibility of ridding a subject of the disease. This has expanded to the ownership of companies whom gain the patents to said treatments. I've been doing this on again off again since I was 15; I've recently turned 30 now.

There is a huge slant against diabetics receiving affordable medical supplies and medications by the industry as a whole since the mid 1980's; this isn't paranoid speculation--this is a fact. There use to be actual price competition amongst the companies. When I was four, my parents went into a K-Mart and were told that they could buy any three vials of any type of insulin for $20, didn't matter which type.

Now I can't even get any single vial for less than $67. Plus there are no generics for any insulin made to day (at least not of last year when I last check) in the US. I'm starting to look more and more to Canada for medical supplies.



Granted. But to reiterate my own point, the medication that worked best to control not only my own diabetes, but other diabetics as well, was taken off the market to be replaced by something less effective that costs more. This isn't just my opinion, but that of other diabetics that I work with (I work at an evil retail chain, with over 350 employees, so there are about 5 diabetics in the store).

If said medical corps were that interested in my welfare, why would they give me a new crappy treatment and take the old effective one away?

Sign--

Wacky

Hmmm. Well, good luck in your research, my friend. I hope you find something that works for you.

Thanks, maybe that C-peptide will work out I'll keep an eye out for it from now on.

Sign--

Wacky

There would be a cure just because the complications from Diabetes are so expensive and the disease is so common.

The older you get the more likely you are to get it.

Insurance companies are willing to pay for lapband surgery to cure diabetes because it is cost effective.

And they are so close.

Sure, in a world where basic human decently hasn't been tossed out like the baby in the bathwater, but in the decayed society of a cyberpunk world the corps figure that they can make more money off of treatment than the cure.

And remember "health insurance" is even more of a scam than it is in real life, hell, I wouldn't be suprised if the insurance corps didn't find a way to make money the sicker you were...