Diabetes "cured" by transplant

Mar 9 2005

61-year-old businessman and community activist, Richard Lane, has become Britain's first fully successful islet cell transplant recipient.

Richard who has been insulin dependent since 1976 when he was diagnosed with type 1 diabetes, has been having to inject himself four times a day. He says he is euphoric and has not felt better in 30 years. In an attempt to control the "hypos" (hypoglycaemic (low blood sugar) attacks), which he was getting four to six times a week four years ago, he began using an insulin pump instead, with the fast-acting version of the insulin hormone being infused from a reservoir attached to his body. The pump did stem the hypos for a while but they returned and complications with his eyes meant he needed laser treatment.

The attacks, a result of his low blood sugar levels, sometimes led to unconsciousness. In 1997 he had a serious car accident after suffering a blackout when his blood sugar fell too low and he required major surgery on his spine.

Richard, from Bromley in Kent, had to retire from his job as a partner in an accountancy firm and give up some of his charitable work because of ill health.

When offered the chance of being an islets guinea pig some years ago, he turned down the offer. He later changed his mind and had his first islet cells transplanted at the end of September last year. He was home after four days in hospital. Within days, he had a second and finally on January 26, he had his third transplant.

The transplant, done under local anaesthetic, involved infusing islet cells extracted from cadavers through a cannula into the portal vein that supplies the liver. The cells become lodged in the liver where they function to produce insulin similar to a normal pancreas. Richard still has to take a small amount of insulin at night - three units compared to 80 previously - to protect the islet cells.

Between the last two visits his insulin requirements fell by half. In a few days, he will be off insulin, if not for good, hopefully for a long time.

Since the first transplant, he has not had one "hypo". He will have to take anti-rejection drugs for the rest of his life, the number of tablets runs well into double figures each day, Richard says the benefits are so enormous, it's worth it.

He is now able to walk briskly for 30 minutes each day and has lost quite a lot of weight. Following his accident he was doing six blood tests a day. This now down to two and his blood sugar levels have steadied to acceptable levels. He feels a totally different person.

Doctors at King's College Hospital in London, who performed the transplant, said they had transplanted three diabetes patients with islet cells but only Richard had achieved complete success. They said it heralded a new era for the 250,000 patients with type 1 diabetes like Richard, who are dependent on daily insulin injections.

Professor Stephanie Amiel, consultant in diabetes who led the team, said "this breakthrough 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."

A Canadian team was the first to achieve complete insulin independence following a transplant.

Islet cell transplants were pioneered by a British surgeon, James Shapiro, at the University of Alberta. In 2000, he reported that seven patients had been insulin independent for 11 months. The King's College team has been working to refine the technique for growing, harvesting and transplanting the cells and is the only centre in the UK offering it as a treatment.

The treatment is currently being offered only to those who have major problems with conventional insulin therapy or who are suffering dangerous "hypos".