New diabetes research

[dreya]

In another post Dr Sharky mentioned a new clinical trial for a possible new treatment (or even a cure) for diabetes. Dr Sharky (or anyone else) I would really like to hear more about this! I heard part of a story on NPR about it, and it sounds very exciting and promising. Is this the study where new cells are placed into the pancreas to stimulate normal insulin production? Or are there a couple possible new break-throughs? Tell me/us more, anyone who knows!!
- Curious Dreya :pinkfishy

[drsharky]

Hi Dreya--
The research that is being called "new" has actually been going on since the mid to late nineteen eighties I think. Now, recognize I'm not a doctor but I'll try to explain as best as I understand it. Recognize I might get some details wrong. A great place to learn more is at the Diabetes Research Institute Web site or if you just type in the words "islet transplant" to any search engine you can come up with hundreds of sites.
The stuff I made the inclusion criteria for (and might get cut from later, for any number of reasons) is called islet cell transplantation. You're right. They take islet cells (they are the ones that make insulin; only some cells in the pancreas make insulin and those islets have to be separated from the rest of the pancreas). Once they harvest the cells, they transplant those into a big vein in a person's liver. Apparently you can't do it in the pancreas because some people actually don't have one and I think I remember that the rejection rates were really high when pancreatic tissue was involved.
From that point on there are two key approaches:
****) The "Edmonton protocol" puts a person on anti-rejection drugs for the rest of their life. They likely would receive other transplants of cells after the first transplant "takes." This was the study that I applied for but which doctors said I should lose some weight to participate (because a lower BMI improves the ability of candidates to become fully insulin independent after just two cell transplants).
****) A newer procedure gives the recipient cells only from one donor, but along with that they also give them bone marrow from the same donor (and NO radiation). These people stay on anti-rejection drugs for about **** months to one year, and then are weaned off. They hope this will result in CHIMERISM, a process where the recipient's body would be "tricked" into thinking the transplant cells actually belong to them (because when you get marrow you reproduce those cells). I met a man who lives in my community who had the very first one of these in the whole world. His transplant failed eventually, but he experienced significant health improvements in other areas (like being able to sense low blood sugar better than before, and a body fat percentage that put him in a much healthier range). Another disadvantage to this study is that since you only get cells from one donor, it is likely that the recipient would not be fully insulin independent (they might still have to take injections). But the man I met said he went down to just twenty per cent of his initial requirement, and that is a HUGE improvement.
I think that's it. There is a separate debate over the use of stem cells which I won't get into here, but I'm still gathering information and hoping to talk to folks at the Diabetes Research Institute (the ones who are running "my" study) some more.
Email me if you have any more questions!
s

[dreya]

Wow, that is so interesting! Thanks, Dr Sharky.
How do they get the donor cells? Can anyone (like me!) sign up to donate marrow and cells or do they come from cadavers?
When will you be getting your treatment?
I hope the treatment is successful! Like you said, even if it only meant you could cut back on your insulin, that would be great.
love, dreya :pinkfishy

[drsharky]

Thanks, Dreya--
Donation has to be cadaveric-- live people need all of their islet cells. But (related to another post), this is one reason why I wish more people would go through the trouble of signing donor cards.
s