Hope for People with Type 1 Diabetes

By Bernhard J. Hering, M.D.
(Sept. 5, 2005)

The estimated 1 million Americans living with type 1 diabetes may have new hope because of recent advances in clinical studies of islet transplants at the University of Minnesota. Islets are clusters of cells that produce insulin and regulate blood-glucose levels. People with type 1 diabetes have islets, but certain, important cells in the islets (beta cells) either have been destroyed or do not function properly, resulting in elevated blood-glucose levels.

Some of the complications that can arise from type 1 diabetes are heart disease, blindness, nerve damage, and kidney damage. A patient’s risk of experiencing these complications increases as his or her total lifetime exposure to these elevated levels of blood glucose increases. As a result, people either need to take insulin shots, use an insulin pump, or replace their islets to help regulate their blood-glucose levels.

Through clinical research involving islet transplants at the University of Minnesota’s Diabetes Institute for Immunology and Transplantation (DIIT), we are developing more effective treatments for people with type 1 diabetes. Currently, the only way to restore normal blood-glucose levels is to replace the patient’s islets, either by transplantation of a whole pancreas or by infusion of isolated pancreatic islets.

Until last year, islets from more than one donor pancreas were needed to achieve insulin independence in an islet transplant patient. More recently, through our studies, we have been able to restore insulin independence in islet transplant recipients with just one infusion of islets from one donor pancreas. A major advantage of islet transplantation is that it is far less invasive than a pancreas transplant, requiring only a local anesthetic and about 60 minutes. The process is performed by isolating islet cells from a donor pancreas and transplanting them into the portal vein of the liver in adults with type 1 diabetes.

Currently, islet transplants are performed only as part of a clinical trial, an investigational study that establishes that islet transplants are safe and effective for the treatment of type 1 diabetes. Through our studies, we continue to improve many aspects of islet transplantation and we’re optimistic that our research will translate into improved  care for people with diabetes. Our goal is to make islet transplantation a routine treatment option for people with type 1 diabetes to help them achieve insulin independence and minimize long-term complications.

As an alternative to an islet transplant, people with diabetes may may want to consider a pancreas transplant, which is already available as a standard treatment option. To learn more about pancreas transplants, contact the Transplant Center at University of Minnesota Medical Center, Fairview (612-625-5115, 800-328-5465, http://www.fairviewtransplant.org).

Dr. Bernhard Hering is associate professor of surgery and holder of the Eunice L. Dwan Diabetes Research Chair at the University of Minnesota.. If you have diabetes and want more information about participating in an islet transplant clinical trial, visit http://www.diabetesinstitute.org or call 612-626-3016. This column is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalk.umn.edu.