The international team of investigators report that the Edmonton Protocol (a method of implantation of pancreatic islets for the treatment of diabetes) can safely and successfully promote long-term stabilization of blood sugar levels in "brittle" diabetes patients and in some cases, relieve them of the need for insulin injections altogether for at least two years.
The multicentre study, begun in 2001, studied 36 volunteers diagnosed with brittle type 1 diabetes: patients who, despite their best efforts, had wide, unpredictable fluctuations in their blood sugar levels. Using the Edmonton Protocol for type 1 diabetes, each participant received up to three infusions of donated insulin-producing islet cells at one of nine participating clinical centres in the US, Canada and Europe.
Investigators found that one year after receiving the final transplant, 72% (26/36) of patients had benefited from the technique, with 16 patients achieving freedom from insulin injections and ten requiring insulin, but maintaining improved control of blood glucose levels. After two years, five of these 26 patients remained insulin independent, while the remainder continued to require less insulin by injection and showed improved measures of blood glucose control and reversal of hypoglycemic unawareness - a condition in which people with type 1 diabetes can no longer recognize the early symptoms of low blood sugar, thus making them vulnerable to sudden and severe confusion, loss of consciousness and seizures.
"Not only does this show that islet transplantation can offer enormous benefits for brittle type 1 diabetes patients, but we now know that a single, standardized technique can be successfully applied at facilities around the world," Dr. Robert Goldstein, Chief Scientific Officer of the Juvenile Diabetes Research Foundation that helped fund the study.
"Tolerance therapies" to prevent rejection are now the primary focus of continuing research.
MEDICA.de; Source: Immune Tolerance Network