Alternative To Transplant: New Islet Therapy For Diabetes

For those with type-1 diabetes, taking multiple injections of insulin every day or wearing a pump, are simply a part of life.

Their varying levels of insulin can create dangerous life threatening situations.

For some, the only alternative is a pancreas transplant, until now.

A new technique is giving these patients their lives back.

Working out has always been a part of life for Rick Cataldi.

When he was diagnosed with type-1 diabetes 15 years ago, wild blood sugar swings threatened to take his life. Diabetes led to a massive heart attack and another scare later with his wife-to-be.

"She came over to the house and I was sitting there conscious, like comatose, opened eyes with foam coming out of my mouth,” says Rick Cataldi.

Then, Rick found out about a new therapy involving insulin producing cells known as islets.

"The red one is insulin, and these are very, very healthy islets," explains Dr. Ali Naji, MD, PhD, a Kidney and Pancreas Transplant Specialist at Penn Medicine.

Lead investigator Doctor Ali Naji says the purified islets are injected into the patient's liver where they settle and produce insulin.

"Then, they start to sense, what's the blood glucose level of the recipient and they just precisely, and produce the right amount of insulin needed," says Dr. Naji.

“I'm 100 percent off of insulin and I have perfect blood sugars, which is insane," says Rick after two years of therapy.

And he is now riding high on life.

"I can do basically anything better,” says Rick. “It's like I was a young man again."

To optimize their function and the chances for a successful transplant, the donor islet cells are rested for three days prior to transplant.

All patients in the study suffered with severe hypoglycemia unawareness, meaning they had no warning signs of low blood sugar.

After their islet transplant, all patients were able to stop daily insulin injections, and have remained so for at least a year.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC: Alternative To Transplant: New Islet Therapy For Diabetes
REPORT: MB #3707
BACKGROUND: Type 1 diabetes is most commonly found in children and occurs when the body does not produce enough insulin. Insulin is defined as a hormone that moved glucose into the cells to give them energy. If the body is not producing enough insulin, then injections are required to nourish the body. Type 2 diabetes is a more common type of diabetes, which happens when the body does not use insulin properly. If enough insulin doesn't get made, the glucose can stay in blood causing serious issues within the kidneys, nerves, and eyes. (Source: http://www.nlm.nih.gov/medlineplus/diabetes.html)
PREVENTION: To better protect yourself from developing type 2 diabetes, a healthy diet must be implemented. A diabetes diet, or medical nutrition therapy (MNT), is a diet that is rich in nutrients and low in calories and fat. This diet consists primarily of fruits, vegetables, and whole grains. Not only is this a recommended diet for diabetic patients, but it is beneficial for everyone. Those who suffer from type 2 diabetes will also benefit from weight loss and from exercising. This will make it easier on patients to control blood glucose, and will provide other health benefits. (Source: http://www.mayoclinic.com/health/diabetes-diet/DA00027)
NEW TREATMENT: The latest approach to islet transplantation, in which clusters of insulin-producing cells known as islets are transplanted from a donor pancreas into another person's liver, has produced substantially improved results for patients with type 1 diabetes, and may offer a more durable alternative to a whole pancreas transplant. A study at Perelman School of Medicine, University of Pennsylvania, included 12 adult patients with severe hypoglycemia unawareness, a dangerous condition in which there are no warning signs of low blood sugar. Participants in the study got islet cells isolated from the pancreas of organ donors to help their bodies produce insulin. The new approach, which allowed the harvested cells a short period of rest prior to transplant, resulted in increased levels of insulin production to the degree that patients were able to discontinue daily insulin injections. For the study, researchers used an advanced technique to isolate and harvest islet cells from donor pancreases. Unlike prior methods in which isolated islet cells were immediately transferred to the recipient, the new technique allowed the extracted cells to rest in a controlled environment for three days prior to transplant. Inflammation that occurs when the cells are harvested can often predispose the recipient to rejection after transplantation. However, by allowing the cells to rest, the inflammation is reduced. Also, the resting period also resulted in a more efficient process by allowing investigators to use fewer islet cells than previous methods, which required cells from two or more donor pancreases achieve similar results. (Source: http://www.uphs.upenn.edu/news/News_Releases/2013/09/islet/)
FOR MORE INFORMATION, PLEASE CONTACT:
Eileen Markmann, BSN, RN
Islet Cell Transplant Coordinator
Penn Transplant Center
(215) 662-4449

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com.


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