A Diabetes Cure?
Posted April 1, 1998
It is estimated that nearly 15.7 million people in the U.S. have some form of diabetes. For 75 years, insulin-dependent diabetes mellitus (IDDM) has been treated
with daily injections of insulin. This metabolic disorder is found in people whose pancreas produces little or no insulin. Without the proper amounts of insulin, glucose cannot get into
body cells to fuel cellular reactions. Glucose levels in those with IDDM rise in the blood and glucose overflows into the urine. High levels of glucose in the blood can induce a coma.
On the other hand, an injection of too much insulin can lead to shakiness, confusion, and blackouts.
There are two possible alternative treatments to daily insulin shots for IDDM sufferers. The most successful alternative treatment is the transplantation of a whole
pancreas. Pancreas transplants have been performed successfully since 1966. Between October 1987 and May 1995, the one-year survival rate of patients receiving a pancreas transplant
was 91 percent. This transplant operation, though, is not recommended for all IDDM patients. The immune system of the IDDM patient recognizes the transplanted pancreas as foreign material,
thus the immune system attacks it. In order to stop this attack, the patient must take large doses of expensive immune suppressing drugs the rest of his or her life. These immunosuppressive
drugs also have serious potential side effects. Doctors recommend transplants for only two groups of IDDM patients: 1) IDDM patients who are undergoing another type of transplant that
will require that they take immunosuppressive drugs, and 2) IDDM patients whose diabetic problems are determined to be more serious than the side effects of the immunosuppressive drugs.
During the last 20 years, an experimental pancreatic cell transplantation technique has been studied. This technique involves isolating the insulin-producing beta
cells (islet cells) from donated organs and injecting them into the body. So far, during the period of 1990-1994, 48 percent (86 of 180) of the patients given this type of transplant
have achieved insulin independence. As this technique improves, a major problem must be overcome. It takes an average of 3.4 donor pancreas organs to treat one 70 kg diabetic patient.
Possible solutions being studied are culturing beta cells in the lab or the use of pig pancreatic islet cells.
References
Sutherland, David E. R., Paul F. Gores, Bernard J. Hering, David Wahoff, Debra A. McKeehen, and Rainer W. G. Gruessner. "Islet Transplantation: A Safer Cure in
the Making," Diabetes/Metabolism Reviews, Vol. 12, No. 2, 1996, pp. 137-150.
Lacy, Paul E. "Treating Diabetes with Transplanted Cells," Scientific American, July 1995, pp.50-58.
Sutherland, David E. R., Rainer W. G. Gruessner, Paul F. Gores, Kenneth Brayman, David Wahoff, and Angelika Gruessner. "Pancreas Transplantation: An Update," Insulin-Free
World Foundation, http://www.insulin-free.org/pupdate.htm
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