Islet Cell Transplantation: Breakthroughs in Treatment for Patients with Type 1 Diabetes

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It is shocking when you think about the 21 million people in the United States who have diabetes and have anticipated a cure for so long that has yet to come. Research breakthroughs in diabetes show that a procedure called the islet cell transplantation could give diabetics hope. Those suffering with type 1diabetes do not produce any insulin, which causes extremely high or low blood sugar levels.

The Islet transplantation depends on the removal of insulin-secreting islet cells from a deceased donor's pancreas then injecting the cells into the liver of a patient with type 1 diabetes. Islet cell transplants are not a cure for type 1 diabetes but have shown significant potential to control the disease.

In this inspiring Patient Power program, Host Andrew Schorr and Dr. Fouad Kandeel, director of the Department of Diabetes, Endocrinology and Metabolism at City of Hope National Medical Center, speak directly to patients with diabetes and offer inspiring words of hope that a cure is not far off in the future.

Dr. Kandeel says “I believe that there is significant progress being made almost every week in the field of diabetes research both for type 1 diabetes and type 2. Certainly in the case of trying to generate the islets and trying to improve the efficiency of islet transplantation, and expand the islets within the body of the individual who receives them after you give them a single islet transplant, are all very promising approaches.”

Dr. Kandeel explains how exciting the progress in islet transplantation research is in helping to control the complications of this diabetes. He goes on to explain what stem cell transplantation is doing for patients with type 2 diabetes, and how insulin pumps and the artificial pancreas are changing conventional thinking in the world of diabetes.

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Transcript

Andrew Schorr:

Hello and thank you for joining us once again. I'm Andrew Schorr broadcasting live from Seattle. I'm delighted you can be with us. Each day we talk about another significant health issue. One of the biggest in America today is diabetes. We've talked about heart disease, and we've talked about weight. We've talked about all these things, but certainly when you think about the holidays now and people worried about overeating or maybe we don't worry about overeating, what are the consequences as America gains weight? Well that can often be adult onset diabetes and millions of people are affected by that. That's type 2 diabetes. There is also another type of diabetes. It doesn't affect as many people, but it certainly affects many people for sure and often sometimes more than one person in the family. That's type 1 diabetes.

Fortunately in both areas there is a lot of research going on. One of our leading research centers in the country is the City of Hope National Medical Center in Duarte, California that is just east of Pasadena, east of Los Angeles. It's really in Los Angeles the way things are today. The leader of the research effort there, the Director of the Department of Diabetes Endocrinology and Metabolism is Dr. Fouad Kandeel. He joins us today for a whole hour on Patient Power. This is our first program with City of Hope, so we are delighted to have that leading medical center connected with us.

Dr. Kandeel let's set the stage first. As I say diabetes is a terrible problem in the world, and particularly in the United States we have an epidemic of it. Then we have this subset of people where they are diagnosed with type 1, and their pancreas is failing. Help us understand what diabetes is first of all and then help us understand how type 1 and type 2 are different.

Dr. Kandeel:

Diabetes is a metabolic disease in which either the insulin-producing-cells in the pancreas fail to produce insulin, or the insulin that is produced from the beta cell of the pancreas, the insulin producing cell of the pancreas, fail to work at the target organ, which are the various tissues in the body. So as you indicated quite rightly type 2 diabetes, which is called adult onset diabetes in which the pancreas is capable of producing insulin, but that insulin fails to act on the target tissues, the liver, the muscles, the fat and other tissues in the body, whereas in type 1 there is a deficiency in the insulin production from the pancreas. That really results from the immune system activation. One's own immune system becomes activated and attacks the insulin producing cell in the pancreas. Once that disease has developed, the pancreas is not capable of producing insulin to help the metabolism of the body and as a result that group of people can suffer from significant metabolic consequences including coma and even death.

Type 2 diabetes has a strong relationship to weight and to genes, you know genetic predisposition and susceptibility that is inherited within the family. So commonly a patient with type 2 diabetes has multiple other members in their family with type 2 diabetes. Commonly patients with type 2 diabetes are overweight, and in fact the overweight is a significant predisposing factor to the manifestation of that type 2 diabetes. Weight loss and exercise has been recognized as a very important aspect of managing type 2 diabetes. Whereas type 1 diabetic individuals are commonly not overweight, commonly suffer from the disease before the age of 30, and as I indicated earlier there is a destruction of the insulin producing cell in the pancreas, so there is very limited or no insulin production at all. Those individuals do require replacement of insulin through injection of insulin whether by multiple injections a day or wearing an insulin infusion pump that gives insulin continuously across the 24 hours of the day in order for them to remain metabolically sound and not going into metabolic decompensation and coma and potentially death.

The two aspects or two types of diabetes are quite separate from one another for the most part and require different treatment strategies for each one of those types of diabetes.

Andrew Schorr:

So we call it all diabetes, but they are very different. I want to help people understand. First of all we are visiting with a leading expert and that's Dr. Fouad Kandeel from the City of Hope National Medical Center just outside of Los Angeles, and we welcome your calls about diabetes. We are going to focus particularly on some new research strategies for type 1 diabetes, but we will welcome all calls and emails. Also we have done many other programs on diabetes but not the focus that we are going to have today on the latest research. If you want more background, you can always just look up diabetes on www.PatientPower.info.

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