New technique may help type 1 diabetics get off insulin

• Technique called "islet transportation" -- introducing cells that produce insulin to control blood sugar levels -- allowed patients with type 1 diabetes who received cells from a single donor pancreas to achieve insulin independence one year later, according to a study in the February 16 issue of JAMA, a theme issue on medical applications of biotechnology.
• Type 1 diabetes remains a therapeutic challenge, according to background information in the article.
• The success rate of islet (cells that produce insulin to control blood sugar levels) transplants has recently been increased markedly by transplanting a higher number of islets prepared from 2 to 4 donor pancreases.
• However, for islet transplants to become a widespread clinical reality, additional advances are still needed.
• In particular, restoration of insulin independence must be achieved with a single donor, as is also the case with pancreas transplants, to reduce the risks and costs and increase the availability of islet transplantation.
• All eight recipients achieved insulin independence and freedom from hypoglycemia.
• Five remained insulin-independent for longer than 1 year.
• "Our results mark a distinct advance in islet transplant efficacy.
• We not only achieved insulin independence using islets from only 1 donor pancreas [as compared with 2 to 4 in another trial], we also achieved superior glycemic control (as evidenced by normal results of oral glucose tolerance testing in 4 of 5 recipients with sustained insulin independence) using significantly fewer islets," the authors write.
• "These findings may have implications for the ongoing transition of islet transplantation from clinical investigation to routine clinical care," say the researchers.
• "While these findings may suggest a distinct advance in islet transplantation, further study in a larger population with longer follow-up will be critical to assess the risk-benefit ratio of this emerging therapeutic option," the researchers conclude.