Cure for Diabetes - Islet Cell Transplants

Type 1 diabetics have some relatively good reason for hope in the past 5 years. Technologies have advanced to the point that islet cell transplants - the cells that produce insulin - can be made to a diabetic patient's pancreas. Specifically, the cells are called the Islets of Langerhans. Of these, beta cells produce the hormone insulin, which is the key that unlocks cells to allow energy from glucose in to power the human body. Without insulin, sugar builds up in the blood to dangerous levels, leading to hyperglycemia and potentially deadly ketoacidoisis.

Unlike regular organ transplants, an islet cell transplant operation only requires transplants of cells (see the diagram below). While that may sound less invasive, in fact, in order to get the number of cells needed, two or more pancreases may be required from deceased donors. And, importantly, it is still considered experimental in the United States. However, islet cell transplants have had some early notable success. Once transplanted, the new islet cells generally begin to make and release insulin, such that the patient technically is no longer considered to be diabetic. Of course, blood sugar tests are conducted on a less frequent basis to ensure the functioning of the new cells.

As with any type of transplant surgery, the patient will have to stay in the hospital for several days post-operative, and must continue to take anti-rejection medication indefinitely. Unfortunately, there can be nasty side-effects of the medicine, including nausea, vomiting, fatigue, acne, diarrhea and some that are more serious, like forms of cancer.

Patients' bodies do not always accept the new cells. At times, the healthy cells, do not become operative in the diabetic's pancreas, and the operation is not a success. This is a risk, of course, of any transplant surgery.

The success rate is good for islet cell transplant surgeries, but could be better. Within a year of transplant, approximately 40 percent of patients are still insulin free. That means the transplanted cells are doing their job and the patient does not need to resort to taking shots to counteract high blood sugar levels. Three years after the surgery, only about 17 percent of the patients are still symptom-free. And, by 5 years, the number drops to 10 percent. Even among the patients that had to use insulin again, however, their overall blood sugar control was much improved than before the operation.

Should we give up? Is this not worth the advances? Absolutely not! Anything that can result in a diabetic not having to count carbohydrates and take shots is an advancement in my book. You have probably just bought that person an additional 10-15 years of life. The bonus as far as quality of life, in addition to longevity, cannot even be quantified.

What about Stem Cell Research?

For the past several years, scientists have had methods to turn embryonic stem cells into islet cells, which would greatly increase the number of cells available for transplant into diabetic patients. Because federal funding has been cut off for stem cell research, the future now rests in the hands of individual states. The American Diabetes Association is a huge advocate of this research and is actively involved in efforts to continue the important scientific advancements that may result from stem cell research, not only for diabetics, but also Multiple Sclerosis, Parkinson's Disease, and a host of other ailments.

The research is controversial, due to the beliefs of right to life groups who have concerns about the use of human life to advance medical technology. Others, however, argue that many frozen embryos would otherwise be destroyed by their parents when they are not used for reproduction (many more embryos are created for infertile couples than are needed).

Fortunately, this debate may not have to reach a zenith. Stem cell research is progressing to the point where scientists can take certain living cells from humans and convert them to other types of cells. Stem cells themselves are undifferentiated "generic" cells that eventually are directed to become specific, specialized cells that serve a purpose in a mature being (i.e., blood cells, bone cells, skin cells, etc.). Until recently, the mature cells could not be "reprogrammed" to become cells other than what they already were.

With each passing year, medical advancements in the field of diabetes continue the march toward a cure for diabetes. I am hopeful we will reach that point in my lifetime! It is exciting to see how far the technologies have come just in the past 5 years. Imagine 10 years from now....