Insulin producing cell transplants considered for type 1 diabetics with severe hypos

by Barbara Hewitt on June 26, 2013

Insulin producing cell transplants considered for type 1 diabetics with severe hypos

Insulin producing cell transplants considered for type 1 diabetics with severe hypos

Scientists in the UK are looking at the prospects of islet cell transplants as a treatment for people with type 1 diabetes who suffer severe hypoglycaemic episodes. The Diabetes Research and Wellness Foundation Human Islet Isolation facility at Churchill Hospital in Oxford harvests islets for research and transplant and supplies six other centres across the UK.

People with type 1 diabetes are unable to produce the hormone insulin. Typically, insulin is made by specialised cells found in clusters called the Islets of Langerhans, or simply ‘islets’. Islet cells produce insulin when blood glucose levels in the body are high, bringing them down again, and stop producing insulin when blood glucose levels are low.

Islet cell transplantation involves extracting islet cells from the pancreas of a deceased donor and implanting them in the liver of someone with type 1 diabetes. First islets are extracted from the pancreas of someone who has died and given consent for their organs to be used for transplantation. If this process produces a suitable number of good quality islets, they can be offered to someone in need of a transplant.

Donor islets are injected into a vein within the liver and after a period of around two to six weeks, they start to produce insulin. ‘At this time, the transplant patient will become aware that their blood glucose is easier to manage. Most people require two transplants to get the maximum benefit from the procedure,’ said a DRWF spokesman. ‘At the time of the transplant, the patient must take anti rejection drugs to make sure that their immune system does not reject the newly transplanted islet cells. These drugs must be taken as long as the transplant is working and have known side effects,’ the spokesman added.

Quote from : “Researchers Demonstrate Use of Stem Cells to Analyze Causes, Treatment of Diabetes.”

People with type 1 diabetes who have experienced two or more severe hypos within the last two years, and have impaired awareness of hypoglycaemia and people with type 1 diabetes and a functioning kidney transplant who experience severe hypos and impaired hypoglycaemia awareness or poor blood glucose control are regarded as the best candidates for this kind of treatment. According to Martin Rutter, senior lecturer in cardiometabolic medicine at the University of Manchester most people with type 1 diabetes find that they can manage their sugar levels without experiencing frequent episodes of severe hypoglycaemia.

‘Most people know when their blood sugar is low and this provides a strong signal to eat and thereby prevent glucose levels falling further with potentially serious consequences. Sadly, a minority of people with type 1 diabetes have debilitating problems with severe hypoglycaemia even though they have a healthy diet and work hard to manage their diabetes,’ he said.

‘When a hypoglycaemic episode is so bad that it requires someone else to help, it is called a severe hypo, and as most people with diabetes will know, these episodes can be very dangerous. One in three people with type 1 diabetes will experience at least one episode of severe hypoglycaemia each year,’ he explained. ‘Severe hypoglycaemic episodes can occur in anyone taking insulin, but they have a tendency to occur in older people with longer duration diabetes particularly when they can’t recognise when their blood glucose is low,’ he added.

He pointed out that there are several approaches that can reduce the risk of severe hypoglycaemia, including using multiple injections of modern insulin and by varying the insulin dose according to blood glucose results, food intake and activity level.

Insulin pump therapy, sometimes combined with continuous glucose monitoring, can also be tremendously helpful for many patients. Islet cell transplantation and whole organ pancreas transplantation are available for when these more straightforward measures have failed or are unsuitable.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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