Cures on the Horizon
As exciting as the notion of an artificial pancreas is, parents and caregivers are not giving up on a true biological cure for diabetes, either through islet cell replacement or regeneration. Work continues to progress, and hope is there as well.
Islet Cell Replacement
The buzz was huge in 2000 when the Edmonton Protocol was announced. Cadaver islet cells were used to replace the destroyed cells in a group of patients with Type 1 diabetes. With the help of some strong immunosuppressant drugs, the patients were able to remain insulin-free, some for more than five years. At the time, it was hailed as a near cure, a possible end to the question of how diabetes would be cured.
But some concerns lingered. The drugs given to keep the autoimmunity from attacking the new working islets were harsh; children could never go on them. Only patients in dire straits were considered. Most of the patients were eventually (within two to five years) back on insulin. In time, the scientific community realized that this procedure was not the “cure,” but it was a breakthrough.
Although most patients eventually ended up back on insulin, they also regained their ability to feel lows coming on; most of them had lost this ability, which had led to difficulty living their normal lives. Also, the procedure showed that islets can be easily “transplanted” into the body with just a day-patient treatment. All this data will help scientists move forward in search of a true cure.
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Regeneration of Islets
Scientists have also discovered something intriguing: Even in patients who have had diabetes for more than two decades, a tiny bit of islet cell activity remains. That finding brought forth the concept of islet cell regeneration. If researchers could coax the body's remaining cells into creating new cells, the body could replace its dying cells on its own, eliminating the need for any kind of transplant. In other words, the patient would no longer need any kind of immunosuppressant drugs, since the replacement cells would come from their own body. Researchers around the world are working on this concept daily. Regeneration could also eliminate the need for a large amount of islet cells from cadavers or another source, something that scientists are struggling with now as well.
If scientists can find a way to get a human body to constantly reproduce islet cells, they could find a way for the body to fight off autoimmune diabetes for good.
Regeneration is still being studied in animal models, but groups like the Diabetes Research Institute and the Juvenile Diabetes Research Foundation are dedicating millions of dollars to push the science forward.
Drugs, such as AntiCD-3 , are in human clinical trial right now to reverse autoimmunity in people with diabetes, as well as with other autoimmune diseases such as celiac disease and psoriasis. If these drugs work well in humans, they could, when combined with regeneration or islet cell replacement, bring researchers closer to the entire puzzle of a cure for diabetes. They could also be used to stop the progression of diabetes when detected early, protecting the remaining functioning islet cells before too many are killed off and, thus, stopping the onset of Type 1 before a child is fully diagnosed.