Cure for type I diabetes

[Capsid]

It may be too early in clinical development but hopefully we can add this to the list of cures provided by modern medicine.

A 61-year-old man has become the first person in the UK to be cured of type 1 diabetes thanks to a groundbreaking cell transplant technique.

Source. The technique involves transplanting islet cells into the liver of the recipient.

 

[Ashles]

Darn, I was just about to post this.

It's an impressive breakthrough.

 

[anor277]

This is indeed an impressive breakthrough – mind you I would like to hear of what became of the Canadian patients who had been treated earlier. The fact that islet cells may perhaps be derived from a live donor is also very encouraging.

While this does seem to be a cure for the type 1 condition, as an aside the current treatment of type 1 diabetes is now very advanced to say the least. I have had type 1 for over 20 years and the improvements in treatment over that time have been stunning. Even with 4 injections per day, the thinness (sp.?) and convenience of modern insulin needles and pens contrasts with the glass syringes and thicker needles that I remember in my youth – these did hurt a lot. The injections of today are quite painless; the modern insulins now prescribed are almost as good as a functioning pancreas.

 

[Phaycops]

This is indeed an impressive breakthrough – mind you I would like to hear of what became of the Canadian patients who had been treated earlier. The fact that islet cells may perhaps be derived from a live donor is also very encouraging.

While this does seem to be a cure for the type 1 condition, as an aside the current treatment of type 1 diabetes is now very advanced to say the least. I have had type 1 for over 20 years and the improvements in treatment over that time have been stunning. Even with 4 injections per day, the thinness (sp.?) and convenience of modern insulin needles and pens contrasts with the glass syringes and thicker needles that I remember in my youth – these did hurt a lot. The injections of today are quite painless; the modern insulins now prescribed are almost as good as a functioning pancreas.

Hooray. This is exactly what I came (back) here to find out about!(aside: I agree about the advances, by the way -- I have a good friend on the insulin pump and it has changed his whole outlook on his condition.)

Anyway, I was hoping someone could explain a little more how this works. Obviously, the news accounts are garbage for scientific content, and I'm no doctor, so how, exactly, can pancreas cells transplanted into a liver work properly? I must admit, it seems strange to me. Thanks!

 

[Capsid]

Anyway, I was hoping someone could explain a little more how this works. Obviously, the news accounts are garbage for scientific content, and I'm no doctor, so how, exactly, can pancreas cells transplanted into a liver work properly? I must admit, it seems strange to me. Thanks!

Have a look at this link

The islet cells are injected into the portal vein of the liver under local anaesthetic.

Once into the liver the islet cells develop a blood supply and begin producing insulin.

The liver is able to regenerate itself when damaged, building new blood vessels and supporting tissue. Therefore, when islets cells are transplanted into the liver, new blood vessels form around them so that the insulin they produce can easily get into the blood stream and be carried around the body helping to control blood glucose levels.

The work was pioneered in Canada in 1999.

Since the Edmonton transplantation research trial began, 48 patients have undergone 92 islet infusions in Canada. The most recent statistics from Edmonton (January 2003) state that one year after transplantation 84 per cent of patients remain insulin free and that after three years, 89 per cent of patients are still producing insulin. Previous islet cell transplants have only succeeded in around eight per cent of cases.

The downside is that the patients will have to take drugs for the rest of their lives to prevent rejection of the transplant.

 

[Phaycops]

The downside is that the patients will have to take drugs for the rest of their lives to prevent rejection of the transplant. [/B]

OTOH, from reading some of the information at the Diabetes UK site, it seems that the side effects of the anti-rejection drugs are a lot more bearable than living with uncontrollable blood sugar. And people can get used to pretty much anything. It's always suprised me how doctors and other people say "you'll have to stay on drugs for the rest of your life!" like it's some kind of death sentence. It never struck me as being that freaking difficult, you know? Anyway, my two cents. Thanks a lot for the link, Capsid. Now I won't sound like a dope when I call up my diabetic friend

 

[Rolfe]

I understand that there simply aren't enough donors to handle the enormous numbers of patients who might benefit from this treatment. I expect they'll make it available for particularly life-threatening situations though. The news was that they were trying to make artificial islet cells, but they didn't say how. Sounds like a much bigger undertaking.

Oh, just a quick derail because Barb and her pathetic homoeopathic whining is annoying me. Isn't it awful the way Big Pharma is fighting to suppress this great advance, because its profits depend on keeping all the poor people they've got addicted to insulin - not.

Rolfe.

 

[Phaycops]

I understand that there simply aren't enough donors to handle the enormous numbers of patients who might benefit from this treatment. I expect they'll make it available for particularly life-threatening situations though. The news was that they were trying to make artificial islet cells, but they didn't say how. Sounds like a much bigger undertaking.

Rolfe, I know that originally sheep insulin was used to treat diabetics, before synthetic insulin was available. Do you guys know if animal islet cells would be able to be transplanted into humans?

Seems like a good time to put in a plug -- please make sure you are an organ and tissue donor, and tell your family!

 

[Doghouse Reilly]

I don't know.....are these the same drugs that organ transplant patients have to take?
My uncle had a lung transplant and apparently the drugs suck big time!!
He's bloated and overweight now and it seems to always be a balance between knocking out his immune system so it doesn't reject the lungs and then trying to fight whatever infections he gets because his immune system is knocked out.
I agree that in some cases "staying on drugs for the rest of your life" may not be that big of a deal, but for organ transplant patients it's more like "you will have no immune system for the rest of your life."
That's pretty serious and effects the quality of life in very substantial ways.
Does anyone know if this new diabetes transplant technique would require a much lesser degree of anti-rejection treatment than a full organ transplant?
I hope so, because it sounds promising.

 

[Phaycops]

I don't know.....are these the same drugs that organ transplant patients have to take?
My uncle had a lung transplant and apparently the drugs suck big time!!
He's bloated and overweight now and it seems to always be a balance between knocking out his immune system so it doesn't reject the lungs and then trying to fight whatever infections he gets because his immune system is knocked out.
I agree that in some cases "staying on drugs for the rest of your life" may not be that big of a deal, but for organ transplant patients it's more like "you will have no immune system for the rest of your life."
That's pretty serious and effects the quality of life in very substantial ways.
Does anyone know if this new diabetes transplant technique would require a much lesser degree of anti-rejection treatment than a full organ transplant?
I hope so, because it sounds promising.

I don't know if your uncle was on the very same drugs, but this Q&A seems to indicate that the people in the study experienced very mild side effects. Perhaps your uncle had a rarer, more serious reaction to the drugs? Or perhaps these folks need a lesser dose than someone who has had a lung transplant or heart transplant or similar?

 

[Dilb]

Rolfe, I know that originally sheep insulin was used to treat diabetics, before synthetic insulin was available. Do you guys know if animal islet cells would be able to be transplanted into humans?

Seems like a good time to put in a plug -- please make sure you are an organ and tissue donor, and tell your family!

The problem with any transplant is that the body's immune system starts fighting it, since it's a foreign cell. Humans can't even tolerate other humans cells unless they are on immunosuppresive drugs (identicle twins/family members might be able to avoid this, I'm not sure).

Animal insulin works because it's just one(?) molecule, there shouldn't be any difference between the stuff in dogs/sheep/humans, at least as far as high school biology has informed me. I'd guess there are impurities, differnces in preparations and all sorts of things to annoy someone analyzing it chemically.

Saying that, there has been research into creating animals with human organs for transplant, xenotransplanting. Mostly it involves using pigs, which are amazingly similar to humans anatomically, or at least the right size and much cheaper than apes.

What I can say with certainty is that I'm an organ donor and my family knows, as my brother signed as the witness on it.

 

[Capsid]

Saying that, there has been research into creating animals with human organs for transplant, xenotransplanting. Mostly it involves using pigs, which are amazingly similar to humans anatomically, or at least the right size and much cheaper than apes.

Unfortunately, this approach has been called into question because pigs carry endogenous retroviruses which may give rise to a zoonotic infections.

See this article.