Pancreatic islet cell transplantation provides new hope for people who struggle to control their type 1 diabetes. From the National Institute of Allergy and Infectious Diseases (NIAID), a branch of the NIH, researchers show how transplantation patients benefit from this treatment.
Type 1 diabetes is characterized by an autoimmune response against pancreatic islet cells, which include the beta cells that produce insulin. Those affected must take insulin injections to make up for lost beta cells, and even the most responsible type 1 diabetes patient can lose control of their blood glucose levels.
Hypoglycemia describes a blood glucose level that is dangerously low, often accompanied by tremors, sweating, nausea, and heart palpitations. If someone doesn’t experience these warning signs and is unaware of their hypoglycemic status, there is an increased risk of potentially-life threatening severe hypoglycemic events, including accidents, injuries, coma, and death.
In a new phase 3 clinical trial, researchers recruited 48 participants, all with type 1 diabetes and issues with hypoglycemia unawareness. Each participant received at least one transplantation with pancreatic islet cells, and 88 percent were then free of severe hypoglycemic events after one year. Half of the transplant recipients still required insulin injections to regulate their blood glucose levels, but many reached near-normal blood glucose control as well as began to be aware of their hypoglycemia.
"Islet transplant recipients not only reported a decrease in concerns and fears related to their diabetes, but also felt better overall, despite the need to take daily immunosuppressive drugs to prevent transplant rejection,” explained co-author Nancy D. Bridges, MD.
Among the patients in the study, researchers found that the improvement after the transplantation resulted in a better quality of life and overall health status, even for those patients who still needed insulin injections to manage their diabetes.
"People with type 1 diabetes who are at high risk for hypoglycemic events have to practice caution every moment, even while sleeping. It is an exhausting endeavor that - like the events themselves - can keep them from living full lives," explained National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Director Griffin P. Rodgers, MD. "Although islet transplantation remains experimental, we are very encouraged by these findings, as we are by the rapid improvements in other treatments to help people with type 1 diabetes monitor and manage their blood glucose, including artificial pancreas technology."
"Although insulin therapy is life-saving, type 1 diabetes remains an extremely challenging condition to manage," explained NIAID Director Anthony S. Fauci, MD. "For people unable to safely control type 1 diabetes despite optimal medical management, islet transplantation offers hope for improving not only physical health but also overall quality of life."
The present study was published in the journal Diabetes Care.