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January 26, 2004

Research: Cure

Question from Rome, Georgia, USA:

At age 40, my brother was diagnosed with type 1 diabetes. His pancreas produces no insulin. Can several family members go together and donate islet cells for him? John has always been very athletic and healthy and we as a family would do what ever it took to keep him that way. Is there any real hope for him?

Answer:

There have been important advances in the technique of islet cell transplantation in the last few years; but it still requires two or more cadaveric pancreas’ for a successful outcome in autoimmune diabetes so that the equivalent number of partial panceatectomies in family volunteers is not really practical. Great efforts are being made to circumvent these problems as well as the need for lifetime immunosuppression. Before these come to be available clinically though, it is likely that one of the new blood glucose sensors will prove reliable and safe enough to control a pump and thus act as an external equivalent islet insulin. In the meantime someone with LADA (Late Autoimmune Diabetes in Adults) can achieve good blood glucose control using either a pump or the new insulin combination of bedtime Glargine (Lantus) with meal time Humalog or NovoLog where the dose is adjusted for ‘carbs’ consumed and the premeal blood sugar level and with this level of control can come an essentially normal life expectancy.

DOB