The research that has recently been published shows that islet transplantation in patients with type 1 diabetes may prevent sugar drops that are dangerous to health. The results of the work of the scientists are considered a breakthrough in the fight against this chronic disease.
One of the authors of the study, Doctor Xunrong Luo from the University of Chicago argues, that the pancreatic islet cells transplantation is becoming more and more real for the patients with type 1 diabetes. What is more, the results lead to believe that people with the pancreatic islet cells transplantation will not need to use insulin for the rest of their lives.
Type 1 diabetes accounts for 5% of all diabetes cases in Poland. It is usually diagnosed in children and young adults. It is a disease associated with the development of the autoimmune process leading to the destruction of islets of Langerhans, which are responsible for insulin production. Insulin production is necessary to transport glucose from the blood into the cells of the body. In order to regulate blood sugar levels, patients have to deliver insulin from the outside using special pens and insulin pumps.
Early symptoms of hypoglycemia include fatigue, sweating, blurred vision and trembling. In some people, however, the aforementioned warning symptoms do not occur. This may lead to serious complications, such as coma and death.
Despite the best care, up to 30% of patients with type 1 diabetes are not aware of the danger of hypoglycemia. In case of these problems people should seek new methods to prevent such situations. One of such methods might be islet cell transplant proposed by Doctor Luo from Chicago.
The study included 48 patients with type 1 diabetes who, despite professional care from the diabetes specialist and endocrinologist, still had uncontrollable bouts of hypoglycemia. All islet cells that were transplanted came from a deceased donor. It was a very minimally invasive procedure. It was based on distributing purified cells through a catheter placed in the abdominal cavity. They went through the portal vein to the liver. After the completion, the beta cells of the pancreatic islets started to produce insulin. After the transplant patients still required supplementation of insulin, as new islet cells need time to become fully functional.
There were 25 patients who needed insulin even after 75 days after the transplant. In such cases the procedure was repeated. One patient needed 3 doses.
People who participated in the survey were tested for sugar levels and hypoglycemia awareness 1 and 2 years after the transplantation. Year later, in 88% of the participants the glucose levels were almost normal, and the awareness of hypoglycemia was restored. The same was observed in 71% of the participants after 2 years. After a year 52% of patients, did not need insulin therapy anymore.
Dr. Luo stated that the pancreatic islands transplant is a breakthrough and a great hope for patients suffering from irregular type 1 diabetes, and the research should be extended to a wider group of patients.
Written by : Katarzyna Gałaszkiewicz, Klaudia Zyzak, Agata Zwierz
Sources:
1. Phase 3 trial of transplantation of human islets in type 1 diabetes complicated by severe hypoglycemia, Xunrong Luo et al., Diabetes Care, doi: 10.2337/dc15-1988, published online 18 April 2016
2. Decision time for pancreatic islet-cell transplantation Piero Ruggenenti, Andrea Remuzzi, Giuseppe Remuzzi, The Lancet Volume 371, No. 9616, p-883-884, 15 March 2008
3. β-cell transplantation for diabetes therapy, Camillo Ricordi, Berhard J Hering, AM James Shapiro for the Clinical Islet Transplantation Consortium Volume 372, No. 9632, p27-28, 5 July 2008
4. Epidemiology of severe hypoglycemia in the diabetes control and complications trial The DCCT Research Group, The American Journal of Medicine, Volume 90, Issue 4, April 1991, Pages 450-459
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