New Diabetes Treatment Has Limited Benefits
Infusions of cells that produce insulin initially reversed severe type 1 diabetes in some patients but later failed in most cases, according to a study published on Thursday in the New England Journal of Medicine, the New York Times reports.
For the study, A.M. James Shapiro and colleagues at the University of Alberta infused islet cells from the pancreas of a deceased organ donor into 36 type 1 diabetes patients at nine medical centers in the U.S., Canada and Europe. Researchers infused the cells through a tube inserted in the abdomen to allow them to reach the liver, where they inhabit small blood vessels.
After one year, the infusions failed completely in 10 of the 36 participants, eliminated the need for insulin injections in 16 participants and reduced the need for insulin injections in 10 participants, the study finds. However, 86% of participants required insulin injections after two years, according to the study.
Severe side effects caused by the infusions also prompted 25% of participants to switch immunosuppressants, the study finds. The study does not recommend the infusions as a treatment for Type 1 diabetes patients.
Jonathan Bromberg, director of transplantation at Mount Sinai Hospital, said, "I don't think this is ready for prime time" (Grady, New York Times, 9/28).
Shapiro said, "We've only got a small number of cells that end up engrafting, and they're all having to work at maximum capacity," adding, "When an engine runs at 3,000 revs every minute of the day and doesn't get a break, eventually some of them start to burn out" (Reuters/Arizona Daily Star, 9/28). In addition, he said, "I would be first to admit that it has a long way to go before it matches whole pancreas transplantation," he added (New York Times, 9/28).
Robert Goldstein, chief scientific officer for the Juvenile Diabetes Research Foundation International, said that, "for a select few, this represents a major alternative in their quality of life" (Chang, AP/Albany Times Union, 9/27).