This month I thought I might share with you some interesting research that is presently underway that will allow individuals with type 1 diabetes to stop taking insulin or at least drastically reduce the amount of insulin they take daily. Islet cell transplantation is a procedure that is presently recognized as experimental but has demonstrated to be as effective as a pancreas transplant. Many of you may know that the Diabetes Research and Wellness Foundation has been a supporter of this treatment for many years and has funded research done by Dr. Bernard Hering at the University of Minnesota. DRWF is working closely with the Spring Point Project a non-profit that is funding research to improve islet cell transplantation.
Presently the procedure involves extracting islets from a cadaver pancreas and infusing them via a catheter into the portal vein and depositing them near the liver. In recent years the efforts of multiple researchers and the joint efforts of the islet cell transplant consortium have devised a immunosuppressant cocktail that has limited side effects and soon the transplanted islets begin to produce insulin. Depending on the number of available islets a patient may require a second transplantation procedure. I have spoken to many of the recipients and this procedure is life-changing. These individuals now produce their own insulin and no longer require insulin injections. However, over time they may be given low dose of Lantus to preserve their islet cells because as you know the antibodies still exist in an individual with type 1 diabetes and will continue to attack the islet cells.
This year new technology is being evaluated to determine if islet cells can be implanted into a pouch or sac thus protecting the islet cells from being destroyed and allowing immunosuppressant’s to be instilled in the pouch instead of given systemically. Clinical trials are presently underway in Edmonton to evaluate this new device.
At the same time the University of Minnesota and Spring Point Project have built a sterile facility to raise pigs. These pigs will be used to provide an unlimited supply of islet cells that may be implanted into these devices therefore producing an unlimited supply of islet cells. So xenotransplant studies are also being evaluated and are on the horizon.
If you have patients that are suffering from hypoglycemia unawareness, are having a kidney transplant or have had a kidney transplant, or have “brittle diabetes”; this procedure may be something they want to consider. There are centers across the country with information readily available about the number of transplants they have done and their success rate. I have provided a link to an educational brochure and video that you may find helpful to discuss this topic with your patients and share the information with others: http://diabeteswellness.net/Research/IsletCellTransplants.aspx
You also may be interested in reading some information about Islet Sciences and the research that they are engaged in to make this treatment available. http://www.isletsciences.com