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Doctors Combine Cell Biology, Endocrinology to Eliminate Insulin Implants

October 1, 2005

Some diabetes patients who cannot live without insulin injections now have a new option: a transplant of islet cells, which produce insulin in the body. Drawing upon advances in cell biology and endocrinology, surgeons go through a 14-hour process to isolate and purify the islet cells from a donated pancreas. While there's no guarantee the success will last, it may prevent some life-threatening situations.

CHARLOTTE, N.C.--Diabetic patients who couldn't live without insulin injections are now enjoying insulin independence thanks to a new type of transplant.

Annie Anderson has a refreshing outlook on life, but that wasn't the case a few months ago. Anderson, an islet cell transplant patient says, "Totally unaware of where I was ... didn't know what had happened ... very confused -- I couldn't speak. My mind was working, but I couldn't get words out." Anderson is describing the scene that unfolded when her diabetes caused her to slip into unconsciousness. Episodes like that are no longer a threat for her. Becasue her type 1 diabetes was corrected through an experimental cell transplant.

Dr. Paul Gores, director of pancreas and islet transplantation at Carolinas Medical Center in Charlotte, N.C., says, "An islet cell transplant is a means of reversing diabetes in a patient who has lost their beta cells, which are the important cells within the little clusters of cells we call islets, which reside inside the pancreas, which produce insulin."

Transplant surgeons go through a painstaking 14-hour process to isolate and purify the islet cells from a donated pancreas. Those cells will produce insulin. Patients who go through the procedure must take immune-suppressing drugs for life with no guarantee the success will last. Dr. Gores says, "Of course, we don't know that at six, seven, eight, nine years maybe the insulin production they have right now might just totally go away and they might get totally back to square one."

For Anderson, there is no question the transplant was the right choice. She says, "It's totally changed my life, and I am so fortunate and grateful."

The longest study shows about 80 percent of patients still produce some insulin five years after their islet cell transplant, but not enough to continue to go without insulin injections. Only about 2 percent of type 1 diabetics are considered candidates for islet cell transplantation at this point, but doctors hope that number will increase.

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