Islet Cell Transplantation For Diabetes: What Are The Benefits And Risks?

Type 1 diabetes develops when the immune system destroys the islet cells located in the pancreas. Islet cells are responsible for producing the hormone insulin, which regulates glucose metabolism (breakdown). Most patients with type 1 diabetes are treated using insulin. However, a small proportion of patients can be treated using islet cell transplantation.

What is islet cell transplantation?

Who qualifies for islet cell transplantation?

Most people with type 1 diabetes won’t need or qualify for an islet transplantation. This procedure is recommended for patients who consistently experience severe hypoglycemia (low blood sugar levels), which constitutes about a third of all patients with type 1 diabetes. Hypoglycemia can be quite severe and in rare cases, result in seizures, coma and death. Some patients may also experience a dangerous condition known as hypoglycemia unawareness, in which they can’t recognize that their blood sugar levels are low. For this small number of patients, an islet cell transplantation can be life-changing and potentially life-saving.

Patients who may qualify for islet cell transplantation include those who have experienced either two or more incidences of severe hypoglycemia in the last two years and have hypoglycemia unawareness. Additionally, patients who have had a kidney transplant, experience severe hypoglycemia, have hypoglycemia unawareness, and can’t control their blood sugar levels despite therapy are also eligible for islet cell transplantation.

Who does not qualify for an islet cell transplantation?

Certain people don’t qualify for an islet cell transplantation. This include people who need a lot of insulin, those who weigh more than 85 kg, and those with poor kidney function. Additionally, patients who are desperate to stop insulin injections should not undergo islet cell transplantation as you will still need to continue to take insulin injections. Even if you are free of insulin injections for a short period of time, people will generally have to go back at some point and start insulin injections again.

What are the benefits of islet cell transplantation?

The benefits associated with islet cell transplantation include:

• Islet cell transplantations reduce the risk of severe hypoglycemia. In fact, once study showed that the frequency of hypoglycemic episodes was reduced from 23 episodes per patient per year to less than one hypoglycemic episode per patient per year.
• Islet cell transplantations improve awareness of hypoglycemia, so patients can recognize symptoms and act on them. Islet cell transplantation also reduces the patient’s fear of hypoglycemia.
• Patients experience less variability in blood glucose levels.
• There is reduced need to constantly check your blood glucose levels and administering daily insulin injections. A small number of people stop needing insulin injections three years after transplantation. However, this may only last a few months to a year.
• There is a reduced risk of long-term complications associated with diabetes such as heart disease, stroke, eye complications and kidney disease.
• Patients experience improved quality of life.

What are the risks of islet cell transplantation?

Unfortunately, islet cell transplantation comes with some risks as well.

As with all other types of transplants, there is a risk that the patient’s body will reject the islet cell transplant. Patients have to take medications that suppress the immune system and prevent the body from rejecting the transplant. Patients may experience severe side effects associated with these anti-rejection medications as they are similar to the medication given to patients who undergo other types of transplantation.

Patients also have higher risk of developing specific types of cancer and severe infections. However, this risk is very small.

The future of islet cell transplantation

Two main areas of research into islet transplantation are currently ongoing. Firstly, researchers are focused on being able to collect enough islet cells to perform a transplant, as islet cells from one donor are usually not enough and often, several donors are needed for one person. Therefore, researchers are trying to grow islet cells using laboratory techniques. Secondly, there is still a significant issue of tissue rejection, so many researchers are focused on developing better anti-rejection drugs with less harmful side effects.

Conclusion

Islet cell transplantation is not a cure for diabetes, but instead a way to control severe symptoms. Talk to your doctor to see if you would be eligible for an islet cell transplant.