Type 1 diabetes controlled by stem cell transplants therapy

Apr 15 2009

Scientists in the United States have found that stem cell transplants enabled people with type 1 diabetes to manage for as long as four years without needing insulin injections and to maintain good glycemic control - such patients typically need daily insulin therapy to control their diabetes.

The researchers believe the process, which involves injecting people with stem cells made from their bone marrow cells, has a lasting effect.

The study involved patients with type 1 diabetes, formerly called juvenile diabetes, which occurs when the immune system goes haywire and starts attacking itself, destroying insulin-producing cells in the pancreas needed to control blood sugar.

The procedure - autologous non-myeloablative hematopoietic stem-cell transplantation (HSCT) - first came to notice in 2007 when a team at Northwestern University's Feinberg School of Medicine in Chicago and colleagues first reported short-term success of the method - HSCT, which uses a patient's own blood stem cells, involves the removal and treatment of the stem cells, and their return to the patient by intravenous injection.

Dr. Richard Burt and his colleagues have since looked at how long it persisted and they say 20 of 23 patients, age from 13 to 31, became insulin free - twelve continuously and eight transiently, for periods as long as four years - the transient group of eight had to restart insulin at reduced levels.

In order to find out if the change was lasting the research team said they measured levels of C-peptides, which show how well the body is producing insulin and found those levels increased for up to 24 months after transplantation and were maintained until at least 36 months and even in the group which had to start again, there was still a significant increase in C-peptide levels that lasted at least two years.

The researchers say the procedure was able to induce "prolonged and significant increases of C-peptide levels" in the small group of patients who were taking little or no insulin and say HSCT is the only treatment capable of reversing type 1 diabetes mellitus in humans, but more research is needed to confirm the role of this treatment in changing the natural history of type 1 diabetes.

The research is published in the Journal of the American Medical Association.