Commonly diagnosed in children and young adults, Type 1 diabetes is a lifelong disease that causes the body to stop producing insulin. But now scientists have taken a bold step toward reversing its progression, which theoretically could lead to the end of insulin treatments…down the road.
Researchers at the University of Sao Paulo in Brazil and Northwestern University in Chicago discovered that a patient's own stem cells can be put to work to restart insulin production in those with Type 1 diabetes. In their initial study in 2007, the researchers had success with 15 patients treated with their own stem cells who then no longer required insulin to control their diabetes. This second study followed that up with the same protocols and added eight more patients who likewise achieved freedom from insulin therapy.
The beta cells of the pancreas are responsible for producing the body's supply of insulin, a hormone that converts dietary sugar into energy that powers cells in your body. People with Type 1 diabetes have a malfunction in the immune system that causes it to attack these beta cells and destroy them. As more and more of the body's beta cells are wiped out, blood glucose levels begin to rise and the symptoms of diabetes -- such as frequent urination, extreme thirst, and unexplained weight loss -- start to appear.
Between five and ten percent of the people diagnosed with diabetes have Type 1, which was formerly called juvenile diabetes. On the whole, diabetes affects approximately 23.6 million people in the United States alone and its incidence is rising worldwide, with a huge jump expected in just the next ten years.
The scientists involved in this research theorized that replacing part of the immune system would stop it from attacking beta cells in the pancreas, thus stopping the disease, which would allow new beta cells to safely grow. Each subject in the study had to undergo a rigorous treatment regimen that started with the extraction of immune stem cells from their bone marrow. They next had to endure radiation therapy, the same type of treatment given to cancer patients. The radiation effectively eliminated the existing immune system so it could no longer attack beta cells.
The stem cells were then injected back into the patients so they could begin growing as beta cells in the pancreas and start producing insulin. Blood tests proved the success of these methods in 20 out of the 23 participants. Twelve of them needed no insulin treatments for three years and another eight only had to use insulin occasionally over the course of five years after the procedure.
As much as this is a huge scientific leap, however, the subjects all eventually did end up requiring daily dosing of insulin at some point. As each of the patient's immune systems regained their functions, they began once again destroying the newly formed beta cells, not to mention the fact that the patients had to endure the effects of severely compromised immune systems until they rebuilt. That said, this type of treatment may show the most promise with those in whom Type 1 diabetes was newly diagnosed, since they should have the most remaining beta cells to work with.
Insulin therapy is obviously somewhat unpleasant, as it typically entails two to three shots per day during the early stages of the disease, then usually increases to three to four times each day. The only other option for most patients is to use a pump that regularly delivers insulin directly into the body through a catheter. It is essential to maintain control over blood glucose levels and monitor them regularly because if left unchecked they can wreak havoc throughout the body, doing particular damage to the eyes, kidneys, and nerves.
At this point in time, a three-year hiatus from insulin treatment is probably not worth the potential for serious side effects brought about by the use of radiation. There are numerous problems it can cause, including severe nausea, intense fatigue, and the increased risk of developing cancer.
It is hoped, however, that this research can eventually be expanded upon and the scientific community can make the results last longer and longer. Already much progress has been made in this area since previous studies only managed to keep patients off of insulin for six months. One day, though, doctors may actually find a way to work "with" the immune system and reprogram it so that it no longer attacks beta cells, rather than simply destroying it. Now that truly would be a cure!