King's breakthrough ISLET transplantation to help diabetes sufferers

Althought this is sound a good new to those diabetic patient's

Howevr, my advise is the Golden Mantra "Prevention Is Better Than Cure"

Less Sugar in your drinks.


King's breakthrough ISLET transplantation to help diabetes sufferers

09 March 2005

New breakthrough means insulin dependence could be a thing of the past for diabetes sufferers

A multidisciplinary team at King’s College Hospital has successfully achieved islet cell¹ transplantation in a Type 1² diabetes patient. This breakthrough has major implications for diabetes sufferers and has never before been achieved in the United Kingdom. The patient, a 61 year old man, now no longer needs insulin injections, following three transplants of islet cells isolated from cadaveric donor pancreases.

Historically, islet transplants have only been partially successful, in that they have reduced the amount of insulin required, but the need for regular injections still remained. The first reports of insulin independence came recently from a programme in Canada. The King’s programme is the first to report a comparable result for the UK. This patient has proved that it is possible for islet transplants to lead to freedom from administered insulin and diabetes treatment associated problems.

The patient suffered from Type 1 diabetes for over 30 years, experiencing increasing problems with his diabetes therapy. Prior to the islet transplant he endured severe, potentially life threatening hypoglycaemic³ attacks, which profoundly affected his quality of life. Following the islet transplant he is now producing his own insulin and is completely free from hypoglycaemia.

The King’s team, a collaboration between the Department of Diabetes and the Liver Unit’s transplantation team, has to date transplanted three Type 1 diabetes patients with pancreatic islet cells. The first two patients achieved partial success, achieving relief of hypoglycaemia problems, but still requiring small doses of insulin.

Islet cells are obtained from donor pancreases and are transplanted by injection, into the liver of the recipient. Once in the liver, the cells develop their own blood supply and begin producing insulin. This procedure is minimally invasive and only takes around 45 minutes to complete.

There are around 250,000 people in the UK currently suffering from Type 1 diabetes. The patients live with the constant need to be aware of their blood glucose levels and the threat of long term complications such as blindness, renal failure, amputation and cardiovascular disease. Hypoglycaemia is also an ever-present threat. Hypoglycaemia can vary from being mildly uncomfortable to life threatening. People with Type 1 diabetes often live extremely regimented lives, requiring self blood testing four times or more times per day, injecting insulin five times per day and constantly being aware of the food they eat, level of exercise and levels of alcohol consumption.

Professor Stephanie Amiel, Consultant in Diabetes commented: “This breakthough is hugely exciting. The implications for the future are enormous. Eventually, this could mean the end of insulin dependence for all Type 1 diabetes sufferers. In its current state of technology though, islet transplantation is not perfect. We do not have enough organ donors, therefore we cannot extract enough islets to help all Type 1 patients. More research needs to be done to perfect the islet isolation procedures and the drugs we use to prevent rejection of the islets and recurrence of the diabetes. At present we can therefore only offer this treatment to patients, in whom conventional treatments are failing in a major way. However, it is our aim that ultimately all people with Type 1 diabetes would become eligible for islet transplantation and free from insulin dependence.”

Mr Nigel Heaton, Consultant Liver Surgeon, commented: “This breakthrough in islet transplantation is remarkable. King’s is the first centre in the UK to achieve insulin independence in Type 1 patients. The research approach at King’s is totally multidisciplinary, with experts across specialities in diabetes, liver transplantation, cell isolation and radiology all working together.

“The result of this work will have far reaching implications, not only for Type 1 diabetes patients, but also in the wider area of cell research. We have shown that cell transplantation, with both pancreatic islet cells and previously with hepatocyte cells, can offer patients a valuable alternative to conventional treatments.”

The islet cell research has been funded by King’s College Hospital Charitable Trust and Dixons Charitable Foundation. The clinical costs are supported by Diabetes UK.

Information for patients

The islet transplantation team at King’s College Hospital has an active islet transplantation programme

This is still an experimental procedure for people with Type 1 diabetes in which pancreatic islets from human donor organs are infused into the body to try and replace some of the islet function which the patient has lost. In order to prevent rejection of the islet graft and recurrence of the diabetes, the recipient is committed to taking drugs that suppress the body’s immune system.

Islet transplantation is not yet a perfect procedure and cannot guarentee insulin independence. It can however stop recurrent severe hypoglycaemia (low blood sugar) in insulin treated patients, reduce their insulin requirements and give much better glucose control, as long as the islets survive.

You may be suitable for islet transplantation IF:

* You have Type 1 (juvenile onset, insulin dependent) diabetes and
* You are aged between 18 and 65 and
* You are using multiple daily insulin injection therapy (> 3 injections per day) and
* You are experiencing problems with SEVERE HYPOGLYCAEMIA - episodes of low blood glucose you cannot treat yourself and
* You are requiring no more than 0.7 units of insulin per kg body weight to maintain a reasonably good average blood glucose and
* You have good kidney function

If you think you may be eligible, you should discuss your interest with your usual diabetes consultant. We are happy to accept referrals. A questionnaire will be sent to you and your diabetes consultant to complete, to make sure you have no contraindications and, if appropriate, we will then offer you an appointment.

Referrals can be made in writing to:

Professor Stephanie A Amiel
Diabetes Department
King’s College Hospital,
Denmark Hill,
London SE5 9RS

And the questionnaires can be posted to you on receipt of your name, date of birth, date of diagnosis and current insulin regimen to: Sophia.Coker@kcl.ac.uk

King's College Hospital NHS Trust: King's breakthrough ISLET transplantation to help diabetes sufferers

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