Mixed Results in Islet Transplantation Study

For years, the transplantation of insulin-producing pancreatic islet cells has held promise as a potential cure for Type 1 diabetes. Now, a new study has shown that while transplantation can help recipients improve their blood glucose control, the transplanted cells tend to lose function progressively, requiring most recipients to resume insulin injections within two years.

The study, which was published in the September 28 issue of The New England Journal of Medicine, enrolled 36 adults with Type 1 diabetes and hypoglycemia unawareness (a condition in which a person no longer experiences warning signs of low blood glucose levels). At nine transplant centers throughout North American and Europe, participants in the study received up to three infusions of donated islet cells. The centers used a standardized transplantation technique called the Edmonton protocol, which was developed at the University of Alberta, Edmonton, in Canada and showed promise in a smaller study published in 2000.

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All participants had to go on a regimen of immunosuppressive drugs to keep their bodies from rejecting the transplanted cells.

One year after the final infusion, 44% of the study participants did not need insulin injections, and another 28% had partial islet cell function and needed less insulin than they had before their transplants. The transplants failed in the final 28%.

After two years, however, only 14% of participants did not need insulin injections, and by the third year only one participant out of the original 36 was still injection-free. In addition, side effects from the immunosuppressive drugs led 25% of subjects to change their therapy or withdraw from the study.

The study’s outcome was disappointing in that the transplants did not succeed in providing people with Type 1 diabetes with long-term freedom from insulin injections. However, the islet cell transplants did provide protection from severe hypoglycemia and improved HbA1c levels (a measure of blood glucose control over the long term) in participants who achieved even just partial islet cell function.

With further innovations in transplantation techniques and the development of new immunosuppressive drugs, researchers hope to see improved islet cell transplantation outcomes in the near future. What’s more, some small studies have recently shown that the injectable Type 2 diabetes drug exenatide (brand name Byetta) may actually help improve cell survival after islet cell transplantation in people with Type 1 diabetes.

  • dbuitt

    This is real hopefull and can help to slow down the progress of the disease. It is not a cure but could lead to some new discoveries over time.

  • mark322

    I’m diabetic and I don’t beleive there will ever be a cure ( let out to the public anyhow. ) The insurance co. and drug co. would never let that happen, they would go broke if they did. Not only this but cancer and so on. They are only interested in making new meds. to keep up alive longer. the longer we’re around the more money they put in their pockets.

  • kaycee

    I have been a Type I diabetic since 1961. I am really lucky. Moderate damage to eyes, no laser surgery yet =:) No kidney or nerve damage. I have been on an islet cell transplant research program for 4 years. No transplant yet. I have been dreaming of a cure my whole life, but that may not be the case. What I am praying for is stem cell transplants so that patients do not have to take anti-rejection drugs. This research is good – for every success researchers learn more ways to handle this condition! Diabetes is not a disease in my eyes, it is a condition which we must live with to the best of our ability, and be thankful that there are medical advances in which to stay alive!