My 9 year old daughter, diagnosed two years ago, read in the newspaper of the successful islet cell transplant surgery performed at the University of Alberta in Canada. She would like to know, realistically, how long before this treatment (or cure, as she likes to call it) will be available to children in the United States.

The studies in Alberta will need to be repeated in other centers before they come to be generally accepted and even if they are, there is likely to be a problem with sufficient donors as it now takes two donor pancreases to provide enough islets for one islet transplant. In any case there will be a reluctance to commit children to an indefinite period of so far little used immunomodulatory drugs. There are other hopeful signs of progress however. One of the pump companies also has a subcutaneous glucose sensor and they have plans to start trials soon of an instrument that combines these two and if successful it will be essentially an artificial pancreas as far as insulin is concerned. There is a group in New Zealand that are trying to get permission to use a technique that uses porcine islets that have been protected against destruction by the host’s immune system. These can be injected intraperitoneally in just a few minutes so as to make it an outpatient procedure. Finally it seems possible that ‘stem’ cells can be persuaded to grow into insulin producing cells that are not rejected by the host.

In short, for the next five years I think there will be a lot of progress in caring for diabetics; but I think it will be at least another five years probably longer before islet cell transplants will be widely available to children.

DOB
Additional comments from Jeff Hitchcock, The Editor:

See also:

Alberta Foundation Reports on Successful Islet Transplants
Report on the Alberta Foundation’s Successful Islet Transplants
Islet Transplantation in Seven Patients with Type 1 Diabetes Mellitus Using a Glucocorticoid-free Immunosuppressive Regimen

JSH