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[IPp] U of M reports advance in diabetes treatment

U of M reports advance in diabetes treatment
by Tom Scheck, Minnesota Public Radio
February 15, 2005 

 Drs. David Sutherland, left, and Bernhard Hering, right, run the Diabetes
Institute for Immunology and Transplantation. They've released new research
which shows a promising advance in treatment of Type 1 diabetes. (Photo courtesy
of Children with Diabetes Foundation)
 Researchers at the University of Minnesota have moved one step closer to giving
people with Type 1 diabetes an insulin-free life. The researchers at the U of
M's Diabetes Institute for Immunology and Transplantation reversed Type 1
diabetes in several patients by transplanting insulin-producing cells from a
donor pancreas. The procedure has been done in the past. But until now it's
taken more than one pancreas. This time surgeons were successful with a single

 St. Paul, Minn.  It's been two and a half years since surgeons at the U of M
inserted a tiny cluster of islet cells into Lynn Hopperstad's liver. Islet cells
come from the portion of the pancreas that produces insulin. Once surgeons
transplanted those cells into Hopperstad, her body immediately started producing

 The process is remarkable, considering people with Type 1 diabetes, like
Hopperstad, produce little or no insulin at all.

 "I am no longer considered diabetic, and the change in my life has been huge,"
says Hopperstad.

 Hopperstad was one of eight patients who enrolled in a University of Minnesota
study to see if an islet transplant from a single pancreas would work.
 Islet transplant

 At first, all eight were able to stop using insulin. Two years later, Five of
the eight are still insulin-independent. The findings were reported in the
latest edition of the Journal of American Medical Association.

 Hopperstad says she was the perfect candidate for the experimental procedure,
because her body couldn't tell her when her blood sugar was low.

 Diabetics like Hopperstad must take insulin shots and monitor their blood sugar
to prevent swings in blood sugar levels. If they don't regulate their blood
sugar, diabetics increase their chances for kidney failure, stroke and heart

 In some cases, patients can't effectively regulate their blood sugar even with
insulin. Without warning, those people could go into a coma or die. Hopperstad
says she had to test her blood sugar at least seven times a day.

 "Every time I got in the car I tested my blood sugar. I had to test my blood
sugar if I was doing yard work. If I was doing any strenuous activity I would
have to stop after an hour, just to make sure my blood sugar was doing OK," says

I am no longer considered diabetic, and the change in my life has been huge.
- Lynn Hopperstad, transplant recipient

 Islet transplants have been performed successfully since 2000. The procedure is
safer and easier than transplanting an entire pancreas, which is not as common a

 In order for an islet transplant to be successful, surgeons needed to take
islet cells from several donated pancreases. By better matching the cells from
donated organs with patients, and improving technology, the U of M's Bernhard
Hering says his team can now do the procedure with one pancreas.

 "What this study shows is not a cure of diabetes. But it shows very clearly
that with higher efficiency -- comparable to the efficiency of a pancreas
transplant at least in a select group of recipients -- we can achieve very
favorable outcomes," says Hering.

 Hering says the findings are important because there aren't enough organs for
people who need them. He says showing that the procedure can be successful with
one pancreas increases the likelihood that it will be done more often.

 The Mayo Clinic's Robert Rizza, president-elect of the American Diabetes
Association, says the research is promising. But Izza still worries there won't
be enough donated organs to do a high number of transplants. Izza also says
researchers need to learn how long the transplanted cells will be effective.

 "The concern is having enough organs. And the second concern is being sure that
once the islets or organs are transplanted, that they function over the long
term," says Rizza.

 Other researchers say about half of the patients who received islet transplants
are still insulin-dependent, which raises questions about whether the procedure
should be done at all.

 That's because patients who receive a transplant still won't lead perfectly
healthy lives. They'll have to take anti-rejection medicine for the rest of
their lives. They're also more likely to get sick, since they'll have a weaker
immune system.

 About one million people in the United States have Type 1 diabetes, which
usually is diagnosed at an early age. The procedure is not considered effective
for treatment of Type 2 diabetes, which affects 16 million people in the U.S,
since people with Type 2 diabetes produce some insulin.

 Nevertheless, Richard Bergenstal with the International Diabetes Center at Park
Nicollet Hospitals says the procedure should give hope to people with Type 1

 "This is going to be a limited process initially, but at least it's hopeful
that it can succeed," says Bergenstal. "We need to overcome a few more hurdles
on the immune-suppressing medications you take, and the need for more islet
cells. But at least it gives people hope that it is possible."

 The U of M's Hering says he hopes to do another clinical trial with a larger
number of patients.

Rachel - email @ redacted/jracheln

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