Islet Cell Transplants and T1D – What’s around the Corner

I attended a type 1 diabetes event last week. The event was put on by Diabetes Canada and the keynote speaker was a researcher from Vancouver, BC. She discussed what is happening around the world in regards to islet cell transplants. I found her talk extremely interesting, so I decided to share a summary of the evening with you.

Disclaimer: I am not a doctor or researcher. This information is being reiterated from the event I attended and is not to be taken as medical advice. There will be links to different research facilities where applicable. You can further look into current studies through those links. There are also affiliate links in this post.

What is type 1 diabetes?

Before I jump into research and medical terminology, I want to make sure we’re on the same page.

The cause of T1D is not completely understood. No one knows what causes the disease. What we do know is that it’s an autoimmune disease. The immune systems T-cells mistakenly attack insulin-producing beta cells and kill them off.

This attack makes the person’s pancreas unable to produce insulin, which is required to survive.

Treatment of type 1 diabetes

Before 1922, the treatment of T1D was starvation. There was a 0% survival rate. The starvation method simply allowed people to live a bit longer. But there was no quality of life. These people were unable to do anything, they would eventually end up in a coma caused by DKA, which would then take their life.

Then insulin was discovered. To this day, insulin treatment is the only way for people with type 1 diabetes to survive.

We have gone from glass syringes that need to be boiled, sharpened, and reused, to insulin pens, insulin pumps, and closed-loop insulin delivery systems.

We have gone from crude animal insulin to long-acting and rapid-acting insulins.

As a side note, I find the differences in diabetes care fascinating. If you’d like to learn more about advancements in diabetes treatment over the past several decades, check out Richard Vaughn’s book, “Beating the Odds: 64 Years of Diabetes Health”  (Get it in Canada here)

But with all the advancements in technology and science, it still boils down to one thing: people with type 1 diabetes need insulin.

Islet Cell Transplants

This is where islet cell transplants come in.

Islet cell transplants are not new. Doctors have been performing this surgery for almost 2 decades now. Over 1500 islet cell transplants have been done worldwide. Almost a third of them in Edmonton, Alberta.

Basically, the patient gets islet cells from a donor pancreas transplanted into their liver. These cells start producing insulin, which greatly reduces or eliminates the need for injected insulin.

So… why aren’t islet cell transplants used more often??

Islet cell transplants are not a cure for type 1 diabetes. There are two major problems with the current method:

1. Each islet cell transplant needs two donor pancreata. (Yes – “pancreata” is the plural of pancreas). The problem here is, of course, that there are simply not enough islet cells to transplant into all of the T1D patients.
2. An islet cell transplant is still a transplant. As with any transplant, the patient has to take anti-rejection medications for the rest of their life. These drugs have serious side-effects and are generally considered to be more dangerous than living with T1D.

Because of these problems, only people who have severe hypoglycemic episodes and/ or other organ failure are eligible for islet cell transplants.

But scientists are working on both problems

The issue of having enough islet cells to transplant is being attacked by many angles:

• Researchers have discovered that alpha cells can turn into beta cells.
• Beta cells are being created from human embryonic stem cells, grown to maturity, and then transplanted into patients.
• Labs are finding better ways to isolate islet cells in donor pancreata, resulting in more potential procedures.

Several scientists and researchers from around the globe have solved this problem in a few different ways. But the problem remains…

Type 1 diabetes is an autoimmune disease. Putting new beta cells in the body doesn’t do much good if your immune system just kills them off.

Avoiding the autoimmune attack

One thing researchers are working on is a physical barrier that will keep the T-cells from getting to the beta cells at all. It was described as being like a teabag.

The new beta cells are placed in the teabag, and the teabag is implanted under the skin. Glucose in the blood can come in, insulin can go out, but other cells (like the destructive T-cells) are too big to get through.

Human trials are happening right now in Alberta. Vancouver is looking into following suit. An implant about the size of a penny goes just under your skin. The results so far have been promising. It’s exciting news!

But is it a cure?

During the presentation, someone asked, “How long will this ‘teabag’ last? Is it life-long? A year? How long will this actually work?”

The researcher responded that they are aiming for it to last “at least a year, maybe two.” I could almost feel the room deflate. That wasn’t the answer people were hoping for.

I myself felt a bit disappointed at the response. Until I started thinking about it.

Really think about it…

A very small, minimally invasive procedure once a year and you’re free.

Free from pokes. Free from guessing. Free from calculations, over-planning, and over-packing. No worrying about going low during the night. No pump failures or bad insulin.

Your body would be producing its own insulin again. This wouldn’t be a cure, but wouldn’t that be amazing??

What do you think? If this procedure becomes available, would you do it? Let me know why or why not in the comments!

Happy Carb Counting!

~ Leah

Human trials are currently underway at the University of Alberta. If you’re interested in following these trials or to volunteer to be part of a research study check out the website at http://www.islet.ca/.