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Feature

Promise for type-1 diabetes treatment

From eNews, March 10, 2005

About 18.2 million people in the United States have diabetes, according to the American Diabetes Association. And while most of them are diagnosed with type-2 diabetes, an estimated 5-10 percent are diagnosed with type-1 diabetes--previously known as juvenile diabetes because it's usually diagnosed in children and young adults. Type-1 diabetes increases one's risk for heart disease, blindness, and kidney damage.

Recently, researchers at the University of Minnesota's Diabetes Institute for Immunology and Transplantation published a study in which they were able to restore insulin independence in type-1 diabetics who had undergone an islet cells transplant from a single-donor pancreas. In the past, this type of transplantation required the researchers to harvest the insulin-producing islet cells from more than one donor pancreas.

Islet transplantation is a far less invasive procedure than a pancreas transplant because it requires only a local anesthetic and takes about 60 minutes. The islets are injected into the liver where they secrete insulin directly into the circulatory system to control blood sugars. In type-1 diabetes, the body does not produce insulin, which it needs to use sugar. (Sugar is the basic fuel for our cells, and insulin takes sugar from the blood and puts it into our cells.) Hyperglycemia and hypoglycemia--too much or too little sugar in the blood--are common conditions associated with type-1 diabetes.

Advanced treatments for diabetes

The University of Minnesota pioneered both pancreas and islet cell transplantation. Its Diabetes Institute for Immunology and Transplantation, formed in 1994, is one of six leading centers in the world perfecting the use of donated pancreatic islet cells for transplantation as a treatment and potential cure for diabetes. The U's pancreas transplant program is the oldest and largest in the world, with U surgeons performing the world's first transplant and more than 1,600 since 1966.

To learn more about diabetes research at the U, see www.diabetesinstitute.org.

"For islet transplants to become a viable treatment option for those living with type-1 diabetes, we must find a way to make the process more efficient and cost-effective," says Bernhard Hering, associate professor of surgery and the L. Dwan Diabetes Research Chair at the U. "Our findings may have implications for the ongoing transition of islet transplants from clinical investigation to routine clinical care."

Hering and his team were able to reverse type-1 diabetes in eight clinical trial participants. Five of the eight participants remained insulin independent for more than one year. The transplanted islet cells could not keep producing enough insulin for the other three participants; they had to rely once again on insulin injections.

While the reported findings may suggest a distinct advance in islet transplantation, Hering says further study in a larger population with a longer follow-up period will be critical in assessing the risk-benefit ratio of this emerging therapeutic option. The procedure is still investigational and only available to those participating in clinical trials.

The study was published in the February 16 issue of the Journal of the American Medical Association.

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