Study offers diabetes hope

A new study offers hope to type-1 diabetes sufferers that a more effective treatment for the disease may be just around the corner.

Researchers from 11 medical centres in the United States, Canada, Sweden, and Norway have begun testing new approaches to transplanting clusters of insulin-producing islets in adults with difficult-to-control type-1 diabetes.

The National Institutes of Health study will determine whether changes to current methods of islet transplantation lead to improved, long-lasting control of blood glucose with fewer side effects.

Islet transplantation is a procedure whereby clusters of islets are taken from a donor pancreas and are infused into the recipient’s liver. When it works, the islets embed in the liver and begin producing insulin.

‘A major goal of the NIH research program in type-1 diabetes is to develop therapies that replace the insulin-producing cells destroyed by the autoimmune process,’ said NIH Director Dr. Elias A. Zerhouni in a press release. ‘These studies, which build on advances in immunology and transplantation research, may open the door to more widespread use of islet transplantation for patients with severe type-1 diabetes.’

Between five and 10 per cent of diabetes sufferers have type-1 diabetes. The disease causes the person’s own immune cells to attack and destroy pancreatic beta-cells, which produce the insulin that people need to survive.

Type-1 diabetes sufferers commonly require three or more insulin injections a day or treatment with an insulin pump to maintain blood-glucose control. But most type-1 diabetes sufferers still face complications including damage to the heart and blood vessels, eyes, nerves and kidneys.

‘Despite steady improvements in managing the disease, type-1 diabetes cuts lives short by about 15 years, with early deaths due mainly to heart attacks and strokes,’ the release stated.

This latest round of testing comes after a University of Alberta, Edmonton research team in 2000 reported sustained insulin independence in seven patients that received islets from two to four donor pancreases and who were treated with an immunorepressive regimen that omitted glucocorticoids, a naturally produced steroid hormone that was thought to be toxic to islets. Other researchers built on the research in the years that followed, but the islets have tended to lose their insulin producing abilities over time.

Researchers have tried to lengthen the survival of donor islets and reduce the side effects – such as anemia, nerve and kidney damage, and vulnerability to infection – of drugs that prevent the body’s destruction of donor islets.

In the new studies, the researchers will culture islets before transplantation to enhance their viability. They will also compare specific anti-rejection drugs for the ability to maximise islet survival while reducing toxicity. As the procedure becomes safer and new sources of beta cells become available, more people are likely to benefit, the release stated.

If the research is ultimately successful, the investigators may ask the US Food and Drug Administration to approve the procedure for people with poorly controlled type-1 diabetes.

‘If these approaches are successful in prolonging islet function with less drug toxicity, type-1 diabetes patients with severe problems controlling their blood glucose may have another treatment option for controlling their diabetes,’ said study chair Dr. Camillo Ricordi of the University of Miami.

For more information on diabetes and treatment, contact the Cayman Islands Diabetes Support Group on 926-1053 or email [email protected].