My daughter was diagnosed with diabetes type 1 a week ago. The doctor mentioned that at this stage her immune system had destroyed about 80% of her pancreas. Is there anything that can be done to maintain the other 20%? How close are we to finding a cure with stem cell research?

Attempts to conserve residual islet cell function at the onset of clinical diabetes have been both extensive and disappointing. Two major trials, one in the U.S.of small doses of insulin (DPT-1) and another of nicotinamide in Europe and Canada have recently failed to show any advantage. There are still a number of other trials going on including one of MMF, a transplant immunosuppressive, and another of anti CD-3 another way of interrupting the autoimmune process. Yet other trials are exploring the hugely complex problem of islet cell regeneration in the face of continuing autoimmunity.

My personal feeling is that the nearest we shall get to a cure in the next few years will be when pump manufacturers are able to devise a reasonably durable glucose sensor and to use it to safely and reliably control a pump. Good progress is being made.

Stem cell transplantation, as an alternative to islet cell transplantation which works; but is is handicapped by the lack of donors and the present need for lifetime immunisation, is under vigorous scrutiny; but still many years away from human trials. Political issues did indeed hamper stem cell research for a number of years until it was realised that stem cells from bone marrow and other tissues could be diverted to insulin production and transplantation facilitated by the immunomodulatory agent anti-CD154.

DOB