Cell Transplant For Those with Hypoglycemic Unawareness
A recent study suggests islet cell transplant may be worthwhile for those who can no longer detect lows.
Hypoglycemia unawareness is a terrifying reality for many individuals living with Type 1 diabetes. This occurs when individuals can no longer sense the symptoms of low blood sugar, which can lead to seizures, coma, and even death. Affected individuals may be benefit from islet cell transplant, according to new research.
Dr. Nancy Bridges, chief of transplantation at the U.S. National Institute of Allergy and Infectious Diseases, co-authored a study on the benefits of cell transplant for people who can no longer detect lows. “This is people who may have to give up driving. People who might not be able to take care of their own children. People who may lose their jobs or who can’t do their jobs. People who have to live with the notion that every decision you make might lead to an uncontrollable hypoglycemic event. Am I going to be able to walk the dog? Or, will I wake up two blocks away with the EMTs standing over me? The impact on their lives is enormous.”
These individuals are prime candidates for islet cell transplant, which restores function to insulin-producing islet cells in the pancreas, because they are severely restricted in terms of work and daily activities.
Unfortunately, the invasive procedure carries its own risks. The primary risk relates to the immunosuppressant drugs that individuals are required to take following a transplant of foreign materials into the body. These drugs are widely known to increase risk of developing infections and cancer. Individuals with Type 1 diabetes may also be at higher risk for developing complications in the kidneys. Because of these risks, the procedure is only considered for individuals for whom traditional insulin therapy is not enough, such as those with hypoglycemia unawareness. “Given what we know about the physical and emotional burden of hypoglycemia unawareness, we thought patients would feel it was a good trade-off,” Bridges explains.
The phase 3 clinical trial involved 48 people with T1D and hypoglycemia unawareness who were between 26 and 65 years old. On average, participants had lived with T1D for 28 years. All received islet cell transplants, completing quality-of-life surveys before and after the procedure.
Nearly 90 percent of study participants claimed not to have any severe low blood sugar episodes for at least one year. These individuals also reported that they were able to achieve normal blood sugar levels. Some, but not all, could do so without any insulin therapy. All reported improvements in quality of life.
Researchers acknowledged the need for further analysis, including studies of the effects of immune-suppressing drugs on individuals with Type 1 diabetes.
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