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My first TEST ping...
Posted on 09/27/2006 6:06:01 PM PDT by neverdem
WEDNESDAY, Sept. 27 (HealthDay News) -- The latest study on islet cell transplantation has both good and bad news for people with type 1 diabetes.
The good news is that nearly half of those who receive an islet cell transplant are insulin-free at one year after transplant; the bad news is that by the end of the second year that number drops to about one in seven.
Still, researchers expect that with improvements in the technical aspects of the procedure, and better anti-rejection drugs, those numbers will improve.
"A phenomenal amount of glycemic control can be provided with islet transplantation," said study author Dr. A.M. James Shapiro, director of the clinical islet transplant program at the University of Alberta in Edmonton, Canada.
For people with diabetes, he said, "There's excitement and definite hope on the horizon. There's a robust treatment happening today in humans, not just in mice or rats."
Results of the study were expected to be published in the Sept. 28 issue of the New England Journal of Medicine.
"You can look at this as the glass being half full or half empty," said Dr. Jonathan Bromberg, who directs the transplant institute at Mt. Sinai School of Medicine in New York City.
For people with type 1 diabetes, Bromberg said, the glass is definitely half full as work on islet transplantation is moving forward and they're having some success. But, he said, for policymakers and health-care administrators, the glass is half empty because while there's been modest success for islet transplants, "They have to try to figure out if this is the best way to spend limited health-care dollars vs. doing screening and more intensive diabetes care to a large number of patients."
The field of islet transplantation is relatively young, with the first real success coming just six years ago from Shapiro's group in Edmonton.
"Up until the first Edmonton study came out, islet transplantation had been in the doldrums for a decade and a half," said Bromberg.
The procedure used by the Canadian researchers for that study was so successful that it's been dubbed the Edmonton protocol. The procedure involves collecting about 1 million islet cells from a donor pancreas, purifying the cells and then injecting them into the liver of someone with type 1 diabetes.
Thirty-six patients were involved in the current study, and to be included, they needed to have tried and failed standard diabetes treatments and had to have severe, recurrent episodes of low blood sugar (hypoglycemia).
The volunteers underwent islet transplantation at one of nine international centers. The islets came from deceased donors, and all were transplanted within two hours of being harvested.
As with other transplants, patients have to take immune-suppressing medications so their bodies don't reject the foreign cells.
After one year, 16 people (44 percent) were insulin-free. Another 28 percent had partial glycemic control from the functioning islets, while the remaining 28 percent had what's known as complete graft loss after a year. That means the transplanted cells were no longer functioning.
Of the 16 who were able to get off insulin for a year, five were still insulin-free at the end of two years.
"Overall, the results are impressive," said Shapiro. "The most important thing is to recognize that this is the first ever multinational trial to be done on islet transplantation. Some sites had never done this before."
"This field can be improved. With tweaks in protocol and changes in the anti-rejection drugs," Shapiro added, the success rate should go even higher. He noted his group is currently testing new anti-rejection drugs, something that's desperately needed because the current crop of immunosuppressants can be toxic to islet cells.
Shapiro said the issue of supply is going to be another problem that will have to be addressed as the technique improves and more people are transplanted.
"There's a lot of hope that islet transplantation may change the lives of people with diabetes, but a bigger picture view is that there are a lot of modalities available for treating diabetes today -- insulin pumps, semi-synthetic insulins and more -- all of which are improving the lives of diabetics," Bromberg said.
To learn more about islet cell transplantation, visit the National Institute of Diabetes and Digestive and Kidney Diseases.
International Trial of the Edmonton Protocol for Islet Transplantation
I personally believe the answer will be found at the DNA level, Where Islet Cells could be made to resist any Auto Immune attack from the host body. There are at least Seven other studies going on as well.
This has turned into a God awful Disease to have to live with. It has already caused her Diabetic Cataracts and robbed her sight, both eyes have had to have Lens implants to restore some sight, THEN there's the Neuropathy Pain to deal with, (feet, legs, stomach...). THIS kind of pain has to be dealt with at the Neurological level, etc, etc...
...and she just turned 20 yrs. old this year.
Our Faith in God is strong, It has to be.
*If you can this year, PLEASE donate to JDRF ( Juvenile Diabetes Research Foundation ) -WE Thank You.
Shortage Of Family Doctors Predicted
FReepmail me if you want on or off my health and science ping list.
Thanks for the thread. Is there a Diabetes ping list?
Type I since 1994.
Since only about 10% of diabetics are Type I, most of the research funding, understandably, goes into Type II (adult-onset), which is almost controllable (if not preventable), so stories like these really reach out and grab the Injector's Attention.
Islet Cell transplants, in theory, are supposed to work sort of like an "oil change" in a car. Though, frankly, I don't want to go under general anesthesia every five years.
Carry on! If it works, may God go with them! I'd gladly be a research subject.
[If there are any other Type I's reading this who have heard the nationwide radio ads running for the big Inhaled Insulin trial, look into it. I did, and decided against it because I didn't want to have to drive twenty miles twice a week and I have mine reasonably under control (7.9 A1C). Still, YMMV, and the study is huge.]
UPDATED list of FReeper PING LISTS... Vol. IV - April Edition: NEW & IMPROVED!
You'll have to check.
Thanks. Maybe I'll start one.
Islandjeff,
Go ahead, start the "Type 1 Ping list" & add me to it. I would do a lousy job at it as I am only on the Computer every other day.
P.S. Like I tell my daughter; I Know it's hard. Hang in there, the Cure is coming!
So many people are pushing so many good ideas that *one* of them has to take root soon!
Mom of 15 yo son, currently doing his Eagle project, dxed at age 3.
Put me on the Type I ping list.
Please include me on the ping list.
I have a serious question for you. How do you sleep? I stay up until 1-3AM every night to make sure he's OK. I'd say once a month I catch a low this way. I get chills thinking about what would've happened if I hadn't tested him. I wonder frequently what he's going to do when he's on his own. I come across articles every few months about some college freshman going to sleep and never waking up and that terrifies me.
I want a CGM, but only one has been approved for children (and the insurance will pay for) and that's the Glucowatch. From what I've heard, it's unreliable.
How in the hell am I supposed to handle the night?? Do all mothers of diabetics do what I do? Stand vigil every night for years?
This is the worst part of this whole disease. He has to let his guard down for 1/3rd of his life. Even without complications, how does *any* diabetic survive to 50?
(Sorry for the rant. My daughter just had serious foot surgery yesterday and I'm exhausted!)
MarMema,
Congrats for your son, I hope his project goes well. We have Eagle Scouts in our family too. ( I have No doubt he will make Eagle! )
I know the Emotional part is tougher than the Physical part, Hang in there & keep in mind, with him Making Eagle, we all Know that takes commitment & discipline! That will help him as he gets out on his own to stay focused & on track, -to stay healthy!
Sounds Like YOU have done a excellent job Helping and Teaching him, ALL of this will help as he gets older and Taking care of Himself, (Re: his Diabetes!)
Well Done Mom.
Marie,
I too am NOT looking forward to any transplants for my daughter, like you said, just trading one problem for another...
Yes the night's can be Hell sometimes. Is a Pump an option for you? It was only slightly better in our case for Night Low's, but hey, take the victories when you can get them....
But I do think we are not far away from some major breakthroughs, but more funding would help!
But we are largely dealing with an Ignorant Public, Who seems to know someone as a Type 2, but a Type 1 ??? ( isn't it the same? can't they just take pills for that??? Insulin Pump? what's that? etc,etc... it just wears me out!)
And I mean no disrespect here, but until the vast majority of the public understands that Many of our Kid's are not in Wheelchairs or on Crutches, BUT still have a Disease that NEEDS a cure, ....... the pecking order for Fed. Funding will always be # 5, 6, or 7 on the list, unfortunately.
It worked. Thanks.
What is your son's regimen?
Ping list found me.
Islandjeff, Way To Go! Thanks for getting it up & going!
I don't care what anyone says, replacing a pancreas perfectly with what we have available is impossible. There are *so* many things that affect blood sugar that it's incredible. Illness, hormones, emotions, activity, excitement, temperature, etc. And that's if the set doesn't go bad, the insulin doesn't get warm and go bad, the line doesn't get pulled and him not realize it, etc. (We've had three bad sets in a row this week and I'm starting to get irritated. That almost never happens.)
I'm sorry that you're going through this as well, but it is a small comfort to know that I'm not the only mom doing the night thing.
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