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How Islet Transplants Are Transforming Diabetic Treatment

Photo: Courtesy of Diabetes Research Institute, University of Miami

For some diabetes patients, islet transplants make insulin injections a thing of the past.

For people with type 1 diabetes (T1D), even one day without finger pricks, carb counting, insulin injections, and worry would be a welcome break from the disease. Thanks to a procedure called islet transplantation, certain patients with T1D get to live this reality.

Diabetes Research Institute (DRI) scientists have shown that people with T1D can be freed from insulin injections after having an islet transplant because they can again produce their own insulin to control blood sugar levels.

Near-normal blood sugar levels

But just how good is that blood sugar control? To answer that question, DRI scientists studied a small group of islet transplant patients who were still insulin-independent an average of 10 years later. Using a continuous glucose monitor (CGM), which takes blood sugar readings every five minutes, the researchers collected each patient’s sugar levels for an entire week. They observed that all of the patients’ levels were near normal more than 96 percent of the time, on average. They also had fewer blood sugar swings and reduced risk of hypoglycemia (dangerously low blood sugar levels).  

“The CGM data we have obtained from our islet transplant patients clearly demonstrates that islet transplantation can result in glucose levels that are close to those in people who do not have type 1 diabetes, even 10 years or more after undergoing the cell-replacement procedure,” said David Baidal, M.D., of the Diabetes Research Institute at the University of Miami.

Quality of life

Randi Fibus-Caster, 62, knows firsthand how life-changing islet transplantation can be. Diagnosed with T1D at age 5, she dealt with out-of-control blood sugar levels for decades. Over time, those sugar swings affected her eyesight, she lost concentration easily, and emergency calls became routine.

Then, Fibus-Caster learned she was a candidate for the islet transplant procedure. After receiving two islet transplants, she has not needed any insulin injections for nine years and takes minimal anti-rejection drugs to prevent her body from rejecting the donor cells.

“My quality of life is so perfect. I’m like a new person,” she said. “I have no side effects, I don’t have insulin reactions, and I don’t have everybody looking over my shoulder to make sure I’m okay. I’m perfectly normal.”

Making this life-saving therapy available to more people with T1D is a critical next step. Currently, islet transplantation remains an experimental procedure for the most severe T1D patients.  

“This report confirms the superiority of transplantation of insulin-producing cells compared to insulin therapy. Hopefully, this will help bring islet transplantation closer to FDA approval, allowing the treatment to be made available to U.S. patients, as has already been the case in several other countries, for many years,” said Camillo Ricordi, M.D., director of the DRI.

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