Multiple Americans have been cured of their diabetes after a groundbreaking trial has let them put down their insulin for good, researchers have announced.
A team at the University of Chicago Medicine Transplant Institute has updated the results of the ongoing clinical trial of patients with type 1 diabetes.
Unlike type 2 diabetes, which typically comes on later in life and is caused by lifestyle factors such as obesity, type 1 diabetes, which affects as many as 4 million Americans, is an unpreventable autoimmune disorder in which the immune system destroys insulin-producing cells in the pancreas.
Without insulin, type 1 diabetics’ bodies have no way to regulate blood sugar, which can build up in the bloodstream and skyrocket. Instead, their bodies break down fat for fuel, creating acidic byproducts called ketones and eventually cause diabetic ketoacidosis (DKA), leading to brain swelling, kidney failure, cardiac arrest and potential death.
In the trial, 10 type 1 diabetics underwent transplantation of islet cells, tiny clusters of specialized cells scattered throughout the pancreas that produce hormones to regulate blood sugar.
After just four weeks, all 10 achieved insulin independence, meaning their bodies were able to produce insulin on their own without costly supplemental injections.
Their A1C, which measures the amount of glucose in the blood, also fell from eight percent on average, which indicates diabetes, to 5.3 percent, which is considered non-diabetic.
The new results, unveiled earlier this month, are updated from initial findings published last year, which showed an initial favorable response and gradually decreasing A1C levels.
In a new trial, 10 patients have effectively been cured of their type 1 diabetes after having islet cell transplants (stock image)
Following the transplant, patients also took a monoclonal antibody drug called tegoprubart, which is meant to keep their bodies from rejecting the new cells.
Tegoprubart was well-tolerated and none of the patients suffered cell rejection.
‘It is exciting to see islet transplant recipients in this trial who no longer need to administer insulin and who are experiencing fewer side effects than with traditional immunosuppressive regimens,’ Dr Aaron Kowalski, CEO of Breakthrough T1D, which helped fund the research, said.
The CDC estimates 90 to 95 percent of the 40 million diabetes cases in the US are type 2, making type 1 far less common. However, that still leaves 2 to 4 million Americans with type 1 diabetes.
Islet cell transplantation involves taking islet cells, which live in the pancreas and produce insulin, from a healthy or deceased donor and injecting them into a person with type 1 diabetes.
In the UChicago trial, cells came from deceased donors.
The cells are infused via a catheter into the portal vein in the liver, in a minimally invasive procedure.
In many cases, patients need two to three infusions for full success, though it is possible to achieve success with just one.
Patients usually have to be hospitalized for one to four days after the procedure and need to limit their daily activities for six to eight weeks.
Currently, islet cell transplants are estimated to cost around $100,000 since they are not yet FDA approved. Further studies are needed in larger groups to eventually get approval.
After receiving any kind of transplant, patients normally have to take immunosuppressant drugs for weeks or months because the body thinks transplanted cells or organs are foreign and dangerous and will mount an immune system response to kill them.
The drugs help stop that response and prevent the immune system from attacking the new cells.
Marlaina Goedel (pictured here) was just five years old when she was diagnosed with type 1 diabetes, causing her to constantly worry if she would wake up the next day. She has now been cured with an islet cell transplant
Goedel is now looking forward to making up for lost time, going back to school and riding her horse without worrying about a blood sugar crash
While necessary for transplant success, typical immunosuppressant drugs come with major side effects such as weight gain, increased risk of infection, nausea and vomiting.
However, tegoprubart did not. Trial patients taking the medication after islet transplantation suffered only minor side effects such as fatigue, headache, muscle spasms, sleepiness and cold-like illness.
In many cases, immunosuppressants are needed for life after a transplant, but it’s unclear if that is the case for tegoprubart.
One of the trial participants cured of diabetes was Marlaina Goedel, an Illinois mother-of-one who was diagnosed with type 1 diabetes at just five years old. Within four weeks of the procedure, she no longer had to take insulin.
She said her condition was so extreme that she felt robbed of a normal childhood and was in and out of hospitals with DKA. As an adult, Goedel once crashed her car into a brick building during a diabetic attack. The condition also robbed her of her chance to have more children, as the blood sugar fluctuations made her prone to miscarriages.
But her ‘tipping point’ was when her daughter found her passed out on the kitchen floor in the middle of the night after suffering an attack. ‘Something needed to change,’ she previously told the Daily Mail.
Since her transplant, she said that for the first time in her life, she can ride her horse and spend time with her daughter without worrying about a blood sugar crash.
‘The cure is out there,’ she said.
