November 2, 2003
Question from Lake Elsinore, California, USA:
My daughter was diagnosed with type 1 diabetes a week ago, and 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%?
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.
Additional comments from Dr. Andrea Scaramuzza:
Today, the only thing that works to maintain residual beta cell function is immunotherapy, but in my experience, this therapy is not well tolerated, and today this therapeutical option is not pursued by many diabetes centers around the world. Surely, the stem cell option is more interesting for the future of our children, but I think that it will be working in some years (and truly I don’t know to quantify them for sure, but if you think well insulin itself was found only 80 years ago, so you have to be optimistic for your daughter).
Additional comments from Dr. Larry Deeb:
There is literature that control helps preserve pancreas function so that is what I recommend and try to do.