Transplants of insulin-producing pancreas cells are a source of hope for diabetics. Now, they demonstrate potential to prevent severe and possible fatal blood sugar drops among type 1 diabetes patients.
Researchers showed that transplanting pancreatic islets – clusters containing insulin-making cells – was effective for patients undergoing episodes of severe hypoglycemia, or low blood sugar levels potentially leading to seizures and even death.
As these transplants are currently available in some countries but done in the U.S. only through research, the results sparked possibilities of finally obtaining regulatory approval.
“Our research found that transplanted islet cells provided glycemic control, restored hypoglycemia awareness and protection from severe hypoglycemic events,” reports study author Dr. Xunrong Luo of Northwestern Memorial Hospital, adding that this transplantation ushers in type 1 diabetes therapies not controlled by conventional treatment.
In this procedure, islets from a donor pancreas are transferred into the patient. Using minimally invasive radiology-based method, it infuses working cells that can regulate blood glucose and likely remove the need for insulin therapy.
In type 1 diabetes, the immune system destroys the pancreas cells responsible for producing insulin, a hormone critical to converting blood sugar into energy. About 1 million in the U.S. have the condition and rely on lifetime insulin therapy for survival, yet still undergo complications from blood sugar swings.
The researchers analyzed 48 type 1 diabetes patients from eight medical centers who were given islet cell transplant. At year one, almost 88 percent of these patients experienced no severe hypoglycemia, restored their awareness of blood sugar dips, and even had excellent glycemic control. At year two, 71 percent still fared well.
While the study did not exactly venture to free patients of insulin dependence, 52 percent of the participants no longer required insulin shots after one year, with some using lower doses.
“Cell-based diabetes therapy is real and works and offers tremendous potential for the right patient,” asserts lead author Dr. Bernhard Hering of the University of Minnesota. His team is planning to request FDA approval for the therapy.
Of the different experimental transplants in different hospitals, it had not been clear which of the various methods for culling islet cells worked, according to Dr. Nancy Bridges, transplant chief at the National Institute for Allergy and Infectious Diseases. The FDA rules that a standard procedure for these transplants should be established if ever they will be approved, a necessary feature of insurance coverage.
Donated pancreas cells are often in limited supply, while a lifetime intake of immunosuppressive drugs are necessary for recipients to avoid new cell rejection.
But this new study fills some of the gaps in the procedure, says Bridges.
The findings were discussed April 18 in the journal Diabetes Care.
Photo: Tessa Watson | Flickr