For a few decades something called islet transplantation has been one of the most promising therapies for type 1 diabetes. Now, a paper delivered at the most recent meeting of the American Diabetes Association indicates that it works.
Islets are groups of cells in the pancreas that make insulin. In people with type 1 diabetes, these cells are destroyed, making it necessary for patients to inject insulin. But if healthy islet cells could be transplanted from a donor, the reasoning has been, the recipient might become insulin independent. Although the idea goes back to the 1970s, it’s only recently, because of advances in transplant technology, that islet transplantation has been tried.
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The research team, which was from the Diabetes Research Institute at the University of Miami Miller School of Medicine, evaluated five adult patients who had received islet transplants between 2002 and 2010. Since then they have remained insulin independent. To better assess their progress, the patients, at their most recent follow-up visits, were given continuous glucose monitoring (CGM) for a week. The resulting information enabled the researchers to find that the subjects showed “near-normal glycemic profiles.” According to David Baidal, MD, one of the lead investigators, “Using continuous glucose monitoring, we now have the ability to accurately evaluate patients’ glucose profiles and their variability. The CGM data we have obtained… clearly demonstrates that islet transplantation can result in glucose levels that are close to those in people who do not have type 1 diabetes, even 10 years or more after undergoing the cell-replacement procedure.” Camillo Ricordi, MD, director of the Diabetes Research Institute, added that the report “confirms the superiority of transplantation of insulin-producing cells compared to insulin therapy.”
Despite the exciting news, the U.S. Food and Drug Administration (FDA) has not yet sanctioned islet transplantation and it can be performed only as part of a preapproved clinical trial. However, according to Dr. Ricordi, “Hopefully, this will be of assistance in bringing islet transplantation closer to FDA approval, allowing the treatment to be made available to U.S. patients, as has already been the case in several other countries for many years.”
Want to read about additional type 1 diabetes news from the 2019 ADA meeting? Read “Immunotherapy Delays Type 1 Diabetes Diagnosis: ADA 2019” and “Gluten-Free Diet Linked to Lower A1C in Type 1 Diabetes.”