Diabetes could be cured in the United States

It's Trahnel Mays' job to make sure everything is set and ready to go for surgery.

She's a transplant tech -- and ironically -- she is one of the first people in the United States to receive an islet cell transplant to cure her type-one diabetes.

The 43-year-old has been dealing with diabetes since she was 13.

Before her insulin pump, Trahnel was giving herself five shots a day. 

Ohio State University transplant surgeon Amer Rajab sees the sickest of the sick.  Their only option: a pancreas transplant.

Trahnel is part of new research that is transplanting only the insulin-making islet cells.  During a nine-hour process, surgeons dissect a donor pancreas, separate, purify and test the islet cells.

Then, through an IV, not an operation, the cells are transplanted.

The patient still needs to take anti-rejection medicine.  Success is measured if the patients can stop taking insulin altogether.  So far, the success rate is 65-percent compared to 80-percent for a full pancreas transplant.

Eight weeks after Trahnel's transplant, she's down from 70 units of insulin a day to 20 and she is set to go in for a second islet cell transplant.

A cure for her could be a cure for millions.

More information on next page

BACKGROUND: Type 1 diabetes is an autoimmune disease in which the body's immune system attacks and destroys insulin-producing cells. Patients with type 1 diabetes must take insulin daily to live. However, there is a new treatment option for patients with type 1 diabetes called islet transplantation.

THE TREATMENT: Islet cells make up one to two percent of the pancreas and are responsible for insulin production. In islet transplantation, islet cells are taken from a deceased donor's pancreas and injected into the patient's liver via a catheter. The patient usually receives 10,000 islet equivalents per kilogram of body weight, an amount, which usually requires two donors. After the transplant, the patient must take immunosuppressive drugs, or anti-rejection drugs. These drugs prevent the patient's immune system from recognizing the new islet cells as foreign (SOURCE: diabetes.niddk.nih.gov).

Ideally, after islet transplantation, the patient will be able to control blood glucose levels without regular injections of insulin; effectively, they will be cured of type 1 diabetes. In the University of Alberta's 2005 follow up study of patients who had undergone islet transplantation in 2000, ten percent of the 65 patients remained "insulin independent" five years after the transplant. Though most of the patients did return to insulin injections, researchers found that many of them were able to decrease the amount of insulin they needed (SOURCE: diabetes.niddk.nih.gov).

DRAWBACKS: Islet transplantation still has a number of obstacles to overcome before it becomes widespread. One of the major problems with islet transplantation is a lack of islets. Even though about 7,000 people donate their organs every year in the U.S., fewer than half of the donated pancreases are suitable for the harvesting of islets. With most islet transplants requiring islets from two different donors, this makes islet transplants available for a very small fraction of the people with type 1 diabetes. However, researchers are working on ways to circumvent the problem by transplanting islet cells from living donors, animals such as pigs or monkeys, or creating islet cells out of stem cells (SOURCE: diabetes.niddk.nih.gov).

Amer Rajab, M.D., Ph.D.
The Ohio State University
Columbus, OH

Information: Ivanhoe

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